Budesonide ameliorates lung injury induced by large volume ventilation.

BACKGROUND: Ventilation-induced lung injury (VILI) is a health problem for patients with acute respiratory dysfunction syndrome. The aim of this study was to investigate the effectiveness of budesonide in treating VILI. METHODS: Twenty-four rats were randomized to three groups: a ventilation group, ventilation/budesonide group, and sham group were ventilated with 30 ml/kg tidal volume or only anesthesia for 4 hor saline or budesonide airway instillation immediately after ventilation. The PaO2/FiO2and wet-to-dry weight ratios, protein concentration, neutrophil count, and neutrophil elastase levels in bronchoalveolar lavage fluid (BALF) and the levels of inflammation-related factors were examined. Histological evaluation of and apoptosis measurement inthe lung were conducted. RESULTS: Compared with that in the ventilation group, the PaO2/FiO2 ratio was significantly increased by treatment with budesonide. The lung wet-to-dry weight ratio, total protein, neutrophil elastase level, and neutrophilcount in BALF were decreased in the budesonide group. The BALF and plasma tumor necrosis factor (TNF)-α, interleukin (IL)-1ß, IL-6, intercellular adhesion molecule (ICAM)-1, and macrophage inflammatory protein (MIP)-2 levels were decreased, whereas the IL-10 level was increased in the budesonide group. The phosphorylated nuclear factor (NF)-kBlevels in lung tissue were inhibited by budesonide. The histological changes in the lung and apoptosis were reduced by budesonide treatment. Bax, caspase-3, and cleaved caspase-3 were down-regulated, and Bcl-2 was up-regulated by budesonide. CONCLUSIONS: Budesonide ameliorated lung injury induced by large volume ventilation, likely by improving epithelial permeability, decreasing edema, inhibiting local and systemic inflammation, and reducing apoptosis in VILI.

EDA2R knockdown alleviates myocardial ischemia/reperfusion injury through inhibiting the activation of the NF-κB signaling pathway.

Ischemia/reperfusion (I/R) is a pathological process that occurs in numerous organs and is often associated with severe cellular damage and death. Ectodysplasin-A2 receptor (EDA2R) is a member of the TNF receptor family that has anti-inflammatory and antioxidant effects. However, to the best of our knowledge, its role in the progression of myocardial I/R injury remains unclear. The present study aimed to investigate the role of EDA2R during myocardial I/R injury and the molecular mechanisms involved. In vitro, dexmedetomidine (DEX) exhibited a protective effect on hypoxia/reoxygenation (H/R)-induced cardiomyocyte injury and downregulated EDA2R expression. Subsequently, EDA2R silencing enhanced cell viability and reduced the apoptosis of cardiomyocytes. Furthermore, knockdown of EDA2R led to an elevated mitochondrial membrane potential (MMP), repressed the release of Cytochrome C and upregulated Bcl-2 expression. EDA2R knockdown also resulted in downregulated expression of Bax, and decreased activity of Caspase-3 and Caspase-9 in cardiomyocytes, reversing the effects of H/R on mitochondria-mediated apoptosis. In addition, knockdown of EDA2R suppressed H/R-induced oxidative stress. Mechanistically, EDA2R knockdown inactivated the NF-κB signaling pathway. Additionally, downregulation of EDA2R weakened myocardial I/R injury in mice, as reflected by improved left ventricular function and reduced infarct size, as well as suppressed apoptosis and oxidative stress. Additionally, EDA2R knockdown repressed the activation of NF-κB signal in vivo. Collectively, knockdown of EDA2R exerted anti-apoptotic and antioxidant effects against I/R injury in vivo and in vitro by suppressing the NF-κB signaling pathway.

Effect of transcutaneous electrical acupoint stimulation on nausea and vomiting induced by patient controlled intravenous analgesia with tramadol.

OBJECTIVE: To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) on nausea and vomiting (N&V) induced by patient controlled intravenous analgesia (PCIA) with Tramadol. METHODS: Sixty patients who were ready to receive scheduled operation for tumor in the head-neck region and post-operation PCIA, aged 39-65 years, with the physique grades I-II of ASA, were randomized into two groups, A and B, 30 in each group. The pre-operation medication, induction of analgesia and continuous anesthesia used in the two groups were the same. TEAS on bilateral Hegu (LI4) and Neiguan (PC6) points was intermittently applied to the patients in group A starting from 30 min before analgesia induction to 24 h after operation, and the incidence and score of nausea and vomiting, antiemetic used, visual analogue scores (VAS), and PCIA pressing times in 4 time segments (0-4, 4-8, 8-12 and 12-24 h after the operation was finished) were determined. The same management was applied to patients in Group B, with sham TEAS for control. RESULTS: The incidence and degree of N&V, as well as the number of patients who needed remedial antiemetic in Group A were less than those in Group B. The VAS score and PCIA pressing time were lower in Group A than those in Group B in the corresponding time segments respectively. CONCLUSION: TEAS could prevent N&V induced by PCIA with Tramadol.

Effect of general anaesthesia with combination of acupuncture and enflurane applied in radical operation of laryngocarcinoma.

OBJECTIVE: To observe the effect of general anaesthesia with combination of acupuncture [conducted with Han's acupoint nerve stimulator (HANS) applied] and enflurane in radical operation of laryngocarcinoma (LC). METHODS: Sixty patients with LC of grade I - II , classified according to the standard of American Society of Anesthesiologists (ASA), were assigned by randomizing number table to the control group and the tested group, 30 patients in each group. The control group received anaesthesia with enflurane alone for inducing and maintaining; the tested group was anaesthetized with enflurane like that given to the control group but also received additionally needling stimulation conducted by HANS. The dosage of enflurane used, the minimum effective concentration of enflurane in alveolar air (MACEnf) and the changes of heart rate (HR) as well as blood pressure (BP) in patients at different time points in the operational process were observed. RESULTS: As compared with those in the control group, in the tested group, both the MACEnf and the dosage of enflurane were reduced, with the difference between the two groups significant (P<0. 01). The changes of HR and BP among different time points in the tested group were slight, and as compared with those in the control group at the corresponding time points, the difference was significant ( P <0. 05 or P<0.01). CONCLUSION: General anaesthesia with combination of enflurane and needling conducted by HANS applied in radical operation of LC has definite effect with less complication. Needling could be cooperated with narcotics, and so it could be taken as an auxiliary measure of anaesthesia for radical operation of LC.

Isoflurane potency in mice from the first and second parity.

As an approach to investigating mechanisms of anesthetic action, studies using selective breeding of animal stocks with different anesthetic sensitivity have increased during recent years. Mice are an ideal model for such studies due to their small size, short reproductive cycle, well-established behavioral endpoints of anesthesia, and well-known genetic background. Because single litters are not large enough for simultaneous selective breeding and conservation of the stock, mice must be used from successive litters. However, the stability of isoflurane anesthetic potency across successive litters has not been reported. In the present study, 24 (12 male and 12 female) outbred ICR mice were mated. Each pair was allowed to produce 2 successive litters. Offspring were separated by sex after weaning at 21 d of age. Reproductive characteristics were documented, including litter size at birth, sex ratio at weaning, and neonatal mortality. At 65 to 75 d of age, the median effective dose (ED(50)) of inhaled isoflurane was measured in mice from the 2 parities by using a bracketing design. Loss of righting reflex was chosen as the criterion for successful anesthesia. The 2 parities did not differ significantly with regard to reproductive parameters and isoflurane ED(50) of offspring. These results indicate that offspring in the second litter from the same parents can be used for stock conservation and anesthesia research.