Objective To assess the systematic reviews of magnesium sulfate used to treat severe asthma. Methods An electronic search was performed in The Cochrane Library (Issue 2, 2008), ACP Journal Club (1991 to June 2008), MEDLINE (1990 to June 2008), Chinese Journal Full-text Database (1979 to June 2008), Chinese Scientific and Technological Periodical Databases (VIP) (1980 to June 2008), and Chinese Bio-medicine Database (CBM) (1980 to June 2008) to collect systematic reviews of magnesium sulfate treatment for severe asthma. The retrieved systematic reviews were reassessed, and then we adopted the evidence for clinical practice. Results Nine systematic reviews were included, and all of them included 14.1 ± 2.9 items of QUOROM (the quality of reporting of Meta-analyses) on average. In general, the included systematic reviews had comparatively high quality. Evidence illustrated that intravenous infusion of magnesium sulfate could improve pulmonary function and reduce hospital admission without any serious side effects. However, no evidence could verify that patients with asthma can benefit from aerosolized and oral magnesium sulfate. In a specific case with severe asthma, we used magnesium sulfate via intravenous infusion which helped the control of symptoms with no adverse reactions. Conclusion Magnesium sulfate via intravenous infusion can improve pulmonary function and reduce hospital admission rates. Due to its effectiveness, safety, and low cost, it deserves widespread application in patients with severe asthma.
Objective To research in vitro biocompatibility of silicon containing micro-arc oxidation (MAO) coated magnesium alloy ZK60 with osteoblasts. Methods The surface microstructure of silicon containing MAO coated magnesium alloy ZK60 was observed by a scanning electron microscopy (SEM), and chemical composition of the coating surface was determined by energy dispersive spectrum analysis. The experiments were divided into 4 groups: silicon containing MAO coated magnesium alloy ZK60 group (group A), uncoated magnesium alloy ZK60 group (group B), titanium alloy group (group C), and negative control group (group D). Extracts were prepared respectively with the surface area to extraction medium ratio (1.25 cm2/ mL) according to ISO 10993-12 standard in groups A, B, and C, and were used to culture osteoblasts MC3T3-E1. The α-MEM medium supplemented with 10% fetal bovine serum was used as negative control in group D. The cell morphology was observed by inverted phase contrast microscopy. MTT assay was used to determine the cell viability. The activity of alkaline phosphatase (ALP) was detected. Cell attachment morphology on the surface of different samples was observed by SEM. The capability of protein adsorption of the coating surface was assayed, then DAPI and calcein-AM/ethidium homodimer 1 (calcein-AM/EthD-1) staining were carried out to observe cell adhesion and growth status. Results The surface characterization showed a rough and porous layer with major composition of Mg, O, and Si on the surface of silicon containing MAO coated magnesium alloy ZK60 by SEM. After cultured with the extract, cells grew well and presented good shape in all groups by inverted phase contrast microscopy, group A was even better than the other groups. At 5 days, MTT assay showed that group A presented a higher cell proliferation than the other groups (P lt; 0.05). Osteoblasts in groups A and C presented a better cell extension than group B under SEM, and group A exhibited better cell adhesion and affinity. Protein adsorption in group A [ (152.7 ± 6.3) µg/mL] was significantly higher than that of group B [(96.3 ± 3.9) µg/mL] and group C [ (96.1 ± 8.7) µg/mL] (P lt; 0.05). At each time point, the adherent cells on the sample surface of group A were significantly more than those of groups B and C (P lt; 0.05). The calcein-AM/EthD-1 staining showed that groups A and C presented better cell adhesion and growth status than group B. The ALP activities in groups A and B were 15.55 ± 0.29 and 13.75 ± 0.44 respectively, which were significantly higher than those in group C (10.43 ± 0.79) and group D (10.73 ± 0.47) (P lt; 0.05), and group A was significantly higher than group B (P lt; 0.05). Conclusion The silicon containing MAO coated magnesium alloy ZK60 has obvious promoting effects on the proliferation, adhesion, and differentiation of osteoblasts, showing a good biocompatibility, so it might be an ideal surface modification method on magnesium alloys.
Objective To review the progress of in vivo study on degradable magnesium alloys application as bone-implant materials. Methods Recent literature was extensively reviewed and summarized, concerning the in vivo study on degradable magnesium alloys as orthopaedic implants. Results Magnesium alloys possess a natural ability to degrade via corrosion in vivo, which is promising candidate material for orthopaedic medical device applications. A great progress has been made to improve in vivo performance and integration with bone tissue. However, the degradation mechanism of magnesium-based materials in the physiological environment and long-term effect on body are not available. The modulation of the corrosion rate of magnesium alloys must also be accomplished. Conclusion Magnesium alloys have the potential to serve as degradable implants for orthopaedic applications, but a great deal of further investigation is still necessary.
Objective To investigate the effect of magnesium phosphate cement (MPC) to fix fractures.Methods In vitro: fifty four pairs of fresh pig femoral heads were made 1 cm2 fracture and divided into 6 groups(n=9 pairs ). MPC was used to agglutinate fracture of femoral headsat 100% humidity and at 25℃, 37℃ respectively. At 30 minutes, 2 and 24hours after agglutination, the biomechanical strength was measured. In vivo:the tibia plateau fracture models on both sides of 24 rabbits were made, one side was fixed with “L” shaped plate, and the other side was fixed with MPC. Then the effect of treatment was investigated by macrography, micrography, radiography and the changes of serum electrolyte levels at 3 days, 3，6 and 9 weeks after operation. Results In vitro: the adhesive ability of MPCwas b. At 24 hours after MPC agglutination, the average tensile strength was 117.16±23.29 N/cm2. In vivo:after 6 weeks of fixation, the X-ray results showed that all rabbits’ tibia plateau fractures were healed without displacement, and MPC was absorbed gradually. The changes ofserum electrolyte levels were very minimal. The macrography observation showed that reduction of fracture were good at 3 days after operation, partial MPC remained in fracture end at 3 weeks, fracture line disappeared at 6 weeks and good remodeling was achieved at 9 weeks after operation in the experimental group. Themicrography observation showed that the interface between bone and MPC was distinct at 3 days, MPC was degraded gradually and trabeculae began to grow into MPCat 3 weeks, and almost all MPC was degraded at 6 and 9 weeks of operation. Conclusion MPC is a promising biomaterial, and might potentially be used for fracture treatment.
Eighteen SD rats with streptozotocin-induced diabetes were observed for the influence of magnesium in glycolytic pathway in their retinal tissue.The diabetic rats were divided into 3 groups:6 of them drank 0.5% Mgso4 solution every day,6 received intramuscular Mgso4 (0.05/kg)in half month interval,and the another 6 drank tape water every day.Six normal rats were employed as employed as nondiabetic control.The activity of the three crucial rate-limiting enzymes ralating to glycolytic pathway-hexokinase,phosphofructokinase and pyruvate kinase in retinal tissue of the rats was investigated after a period of 30days.The results revealed that the levels of the enzymes were significantly depressed in diabetic rats not taking magnesium,while the enzyme levels maintained nearly the same in diabetic rats taking magnesium,while the enzyme levels maintained nearly the same in diabetic rats taking magnesium as in the control group.This suggested that the glycolytic pathway in retinal tissue was disturbed in early stage of diabtes,and magnesium might play an important role in maintaining the normal metabolism of glucose. （Chin J Ocul Fundus Dis,1993,9:81-83）
Tweenty-one SD rats with streptozotocin-induced diabetes were investigated for the influence of magnesium in cAMP level in the retina of the diabetic rats. The diabetic rats were divided into 3 groups: group 1, drinking tap hehwater; group 2, drinking 0.5% MgSO4 solution and group 3, receiving intramuscular MgSO4(0.1g/kg) once a month. In addition, group 4, a controlgroup of normal nondiabetic rats fed with tap water. In aperiod of 5 months examination, the growth and health conditions of diabetic rats were found to be nearly normal in group 2, 3 and 4, manifested by gaining weight and soft, smooth hairs on the skin, in contrast with loss in weight, rough hairs and even dying of infection in 2 of the diabetic rats in group 1. furthermore, the level of cAMP content in retina was found significantly higher in the diabetic rats taking Mg++ in spite of the route of administration(group 2, 3), as well as in the control group(group 4) than that of the diabetic rats which were fed with tap water. These results demonstrated that Mg++ might play an important role in improving the metabolism of diabetic rats including the retinal tissue by influencing the level of cAMP content, which is necessary in nuclear acid metabolism, protein synthesis, proliferation and differentiation, and other intracellular metabolic processes. （Chin J Ocul Fundus Dis,1992,8:141-143）
The retina of SD rats was incubated in four types of the Eagle solution respectively. The results showed the cAMP level of retinas was the lowest in the hGnMg(high glucose with normal magnesium) solution but the cAMP level was significantly increased in the hGhMg(high glucose with high magnesium) and higher than that of normal control group. The cAMP level was the highest in the nGhMg(normal glucose with high magnesium). The results suggested that magnesium might play an important role in maintaining the normal metabolism of glucose of the retinal tissue. （Chin J Ocul Fundus Dis,1992,8:138-140）
Objective To systematically evaluate the effects of magnesium sulfate on postoperative pain and complications after general anesthesia. Methods A literature search was conducted in following databases as The Cochrane Library, EMbase, PubMed, EBSCO, Springer, Ovid, CNKI and CBM from the date of establishment to September 2011 to identify randomized controlled trials (RCTs) about intravenous infusion of magnesium sulfate during general anesthesia. All included RCTs were assessed and the data were extracted according to the standard of Cochrane systematic review. The homogenous studies were pooled using RevMan 5.1 software. Results A total of 11 RCTs involving 905 patients were included. The results of meta-analyses showed that compared with the control group, intravenous infusion of magnesium sulfate during general anesthesia significantly reduced the visual analog scale (VAS) scores at the time-points of 2, 4, 6, 8, 16, and 24 hours, respectively, after surgery, the postoperative 24 hours morphine requirements, and the incidents of postoperative nausea and vomiting (RR=0.61, 95%CI 0.40 to 0.91, P=0.02) and chilling (RR=0.29, 95%CI 0.14 to 0.59, P=0.000 7). Although the incidents of bradycardia (RR=1.93, 95%CI 1.05 to 3.53, P=0.03) increased, there were no adverse events or significant differences in the incidents of hypotension and serum concentration changes of magnesium. Conclusion Intravenous infusion of magnesium sulfate during general anesthesia may obviously decrease the pain intensity, and the incidents of nausea and vomiting and chilling after surgery, without increasing cardiovascular adverse events and risk of hypermagnesemia. The results still need to be confirmed by more high-quality and large-sample RCTs.
ObjectiveTo explore the degradation of AZ31 magnesium alloy and poly (lactic-co-glycolic acid) (PLGA) in the femoral condyle, and then evaluate the laws of degradation of AZ31 magnesium alloy by Micro-CT images and data. MethodsForty 3-month-old male New Zealand white rabbits (weighing, 2.5 kg) were randomly divided into 4 groups, 10 rabbits each group. Forty micro-arc-oxidized AZ31 magnesium alloy pins and 40 PLGA pins were implanted into the right and left femoral condyle, respectively. Micro-CT images and data analysis were used to evaluate the degradation at 4, 8, 12, and 16 weeks after operation (n=10). Degradation was evaluated by weight difference between pre-and post-implantation. The inflammatory response was observed around the implants by HE staining. The weight loss of magnesium alloy and Micro-CT results were compared. ResultsThe Micro-CT images showed that PLGA pins had gray low signal, which was similar to the soft tissue around. At 4 weeks after operation, no signs of degradation were observed, and there were little corrosion pitting on the magnesium alloy. At 8 weeks, corrosion pitting gradually expanded, the boundary between the longitudinal axis and the cross section became blurred; at 16 weeks, corrosion pitting became bigger, and the boundary was discontinuous. Micro-CT quantitative analysis showed that the volume fraction of magnesium pins decreased slowly at 4 and 8 weeks; it was significantly lower at 12 and 16 weeks than 4 and 8 weeks (P < 0.05). The magnesium cylinder mineral density continuously decreased during the study period, it had a rapidly speed from 12 to 16 weeks (P < 0.05). However, the magnesium CT image density showed a slight change (P>0.05). The surface-to-volume ratio of the pins constantly increased, and the ratio was significantly larger at 12 and 16 weeks than 4 and 8 weeks, and at 16 weeks than 12 weeks (P < 0.05). There was more and more corrosion pitting on the surface with time, which resulted in a decrease in the radius that mean trabecular thickness gradually decreased, showing significant difference between different time points after 8 weeks (P < 0.05). The weight loss detection showed that the degradation of magnesium pin and PLGA gradually increased with time (P < 0.05), and the degradation rate of magnesium pin was significantly lower than that of PLGA at 8-12 weeks (P < 0.05), but the degradation rate of magnesium pin was higher than that of PLGA at 16 weeks. At each time point, the weight loss of magnesium alloy was similar to that by Micro-CT, but mass fraction was lower than volume fraction and had significant differences at 8, 12, and 16 weeks (P < 0.05). HE staining revealed that slight inflammatory response was observed around the magnesium pins at 4 weeks, and inflammatory reaction gradually reduced with time and disappeared at 16 weeks, but no inflammatory reaction was seen around PLGA. ConclusionMicro-CT has the advantages of non-trauma, in vivo detection, quantitative analysis, and precise data in evaluating the degradation of AZ31 magnesium alloy. Regarding the degradation of the magnesium alloy and PLGA in vivo, the degradation rate is slow in the early stage, and then increases with time. The degradation of PLGA is faster and earlier but it is then overtaken by AZ31 magnesium alloy at 16 weeks. During the degradation, the density of the magnesium has almost no change. The biomaterials can not firmly attach to the surrounding tissues due to inadequate holding forces.
ObjectiveTo explore the effects of postoperative magnesium sulphate on pain relief after open gynecological surgery. MethodsSixty women who were diagnosed as hysteromyoma in Lucheng People' Hospital in Wenzhou city and underwent open hysterectomy from July 2011 to May 2012 were randomly divided into two groups (30 women in each group). Applying epidural administration of magnesium sulfate, the magnesium sulfate group (n=30) was given 500 μg magnesium sulfate and 1 mg morphine, while the control group (n=30) was only given 1 mg morphine. Pain scores (at 2 h, 4 h, 8 h, 16 h and 24 h, respectively) as well as complications were observed. Plasma levels of β-endorphin (β-EP) (in 4 h and 24 h, respectively) and the first time when needs postoperative analgesia were recorded. ResultsCompared with the control group, pain scores during 24 h after operation, levels of β-EP at 4 h and 24 h, and the first time for postoperative analgesia were better improved in the magnesium sulfate group. ConclusionEpidural administration of magnesium sulfate combined with morphine is an effective and safe method to improve the effects of postoperative magnesium sulphate on pain relief after open gynecological surgery.