Effect of methoxymine on prevention and treatment of myocardial injury and cardiac function in elderly patients with hypotension during intraspinal anesthesia.

OBJECTIVE: We aimed to investigate the effects of methoxamine to prevent hypotension in the elderly with intraspinal anesthesia (IA) on myocardial injury and cardiac function. PATIENTS AND METHODS: A retrospective study was conducted by enrolling sixty elderly patients who underwent femoral head replacement (FHR) under IA in our hospital from August 2019 to August 2020. The patients were divided into two groups according to the random number table method. In the control group (CG) (30 patients), 5 mg of ephedrine was administered sedately when patients developed hypotension (20% below basal blood pressure). In the research group (RG) (30 cases), 2 µg/(kg·h) of methoxamine hydrochloride was given as a constant-rate pump before anesthesia, and 1 mg of methoxamine hydrochloride was administered intraoperatively if hypotension occurred. The hemodynamic [systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR)], myocardial injury indexes [cardiac troponin I (cTnI), creatine kinase isoenzyme MB (CK-MB), fatty acid binding protein (FABP), plasma amino-terminal brain natriuretic peptide precursor (NT-proBNP)], cardiac function indexes [systemic vascular resistance (SVR), stroke volume (SV), net percentage ejection time (ET)] were observed before anesthesia (T1), at the end of surgery (T2), and 6 h after surgery (T3) in both groups. The Bruggemann Comfort Score (BCS) and Visual Analog Scale (VAS) scores at T3, 12 h postoperatively (T4) and 24 h postoperatively (T5) in both groups were observed, and the incidence of adverse reactions to intralesional anesthesia in both groups was counted. RESULTS: SBP, DBP and HR at T2 were lower than those at T1 in both groups, and SBP, DBP and HR at T3 were higher than those at T2, and SBP, DBP and HR at T2 and T3 in the RG were higher than those in the CG (p<0.05). In both groups, cTnⅠ, CK-MB and FABP were higher at T2 and T3 than at T1, higher at T3 than at T2, and NT-proBNP was higher at T2 than at T1 and T3, and lower in the RG than in the CG (p<0.05). In both groups, SVR and SV at time point T2 were lower than at time point T1 and ET was higher than at time point T1, SVR and SV at time point T3 were higher than at time point T2 and ET was lower than at time point T2, SVR and SV in the RG were higher than in the CG and ET was lower than in the CG (p<0.05). VAS scores were higher in both groups at T4 and T5 than at T3, and lower in the RG than in the CG (p<0.05). CONCLUSIONS: Methoxamine can effectively reduce the risk of hypotension in geriatric endotracheal anesthesia, which can reduce myocardial injury and stabilize cardiac function in patients.

Sevoflurane inhibits neuronal apoptosis and expressions of HIF-1 and HSP70 in brain tissues of rats with cerebral ischemia/reperfusion injury.

OBJECTIVE: To observe the influences of sevoflurane on neuronal apoptosis and expressions of hypoxia-inducible factor 1 (HIF-1), and heat-shock protein 70 (HSP70) in brain tissues of rats with cerebral ischemia/reperfusion (I/R) injury. MATERIALS AND METHODS: A total of 60 Sprague-Dawley rats were selected and divided into sham-operation group (Sham group, n=20), cerebral I/R model group (Model group, n=20), and 3% sevoflurane treatment group (Sevoflurane group, n=20). The rats in each group received neurological scoring, and the blood and brain tissues were collected to detect the concentrations of serum K+, Na+ and glucose (Glu). Enzyme-linked immunosorbent assay (ELISA) was adopted to measure the levels of inflammatory factors [tumor necrosis factor-ß (TNF-ß) and interleukin-6 (IL-6)] and oxidative stress [catalase (CAT), malondialdehyde (MDA) and superoxide dismutase (SOD)]. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay was performed to determine the nerve cell apoptosis in the brain tissues. The gene and protein expressions of Caspase-3, HIF-1, and HSP70 in the brain tissues were measured via quantitative Reverse Transcription-Polymerase Chain Reaction (qRT-PCR) and Western blotting. RESULTS: In Sevoflurane group, the content of serum Glu and Na+ was decreased markedly, that of K+ was increased notably, and the levels of TNF-ß, IL-1 and IL-6 were lowered remarkably compared with those in Model group (p<0.05). Moreover, the neurological score was reduced evidently (p<0.05). Model group had significantly strengthened the activity of MDA and CAT and decreased SOD content, while Sevoflurane group exhibited the opposite results. TUNEL staining showed that there were distinctly more apoptotic cells that were dominated by glial cells in Model group and fewer apoptotic cells in Sevoflurane group. It was indicated in gene assay that the messenger ribonucleic acid (mRNA) expression levels of HIF-1, HSP70, and Caspase-3 in Model group were remarkably higher than those in Sham group and Sevoflurane group (p<0.05). According to the results of Western blotting, the protein expressions of HIF-1 and HSP70 in Sevoflurane group were markedly lower than those in Model group. CONCLUSIONS: Sevoflurane can reduce the content of inflammatory factors, inhibit apoptosis, and reduce the expressions of HIF-1 and HSP70 in the case of cerebral I/R injury, thus exerting protective effects on rats with cerebral I/R injury.

[Effects of hypothyroidism on Goalpha gene expression in hippocampus and dentate gyrus during early development of rat brain].

AIM: To study the expression of Goalpha mRNA in hippocampus and dentate gyrus of 7-day rats with hypothyroidism. METHODS: We use wistar rat model of hypothyroidism and non-radioactive in situ hybridization technique to observe the changs of Goalpha mRNA levels in hippocampus and dentate gyrus of 7-day rats with or without hypothyroidism. RESULTS: Perinatal hypothyroidism can increase Goalpha mRNA levels in all areas of hippocampus and dentate gyrus of 7-day rats. CONCLUSION: Thyroid hormone can down-regulate Goalpha gene transcription in hippocampus and dentate gyrus during the early development of rat brain.

Antibodies to trophoblast in normal pregnant and secondary aborting women.

Enzyme-linked immunosorbent assays (ELISA) with the use of chorionic villous plasma membranes prepared from first trimester and term placentae were employed to detect antibodies to trophoblast in normal primigravid women. Normal pregnant women were found to produce IgG antibodies to trophoblast. These antibodies could be eluted from first trimester placentae. This antibody response was observed in the first trimester and gradually decreased as pregnancy progressed. IgM antibody responses were observed only in the third trimester. Antibodies in some primigravid women and secondary recurrent aborters showed allotypic reactivity with individual trophoblast membranes. This finding was confirmed by immunoblotting experiments in which antibodies from some normal pregnant women were shown to recognize the same trophoblast antigens as those recognized by antibodies from secondary recurrent spontaneous aborters.