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Objective:To evaluate the efficacy of acupuncture-drug balanced anesthesia in improving the outcomes following radical correction of tetralogy of Fallot (TOF) under cardiopulmonary bypass (CPB) in the pediatric patients.Methods:A total of 100 pediatric patients, aged 3-8 yr, weighing 9-24 kg, with American Society of Anesthesiologists physical status Ⅱ or Ⅲ, scheduled for elective radical correction of TOF with CPB, were divided into 2 groups ( n=50 each) using a random number table method: acupuncture-drug balanced anesthesia group (group ADBA) and conventional anesthesia group (group CA). In group ADBA, transcutaneous acupoint electrical stimulation (disperse-dense wave, frequency 2/100 Hz, current intensity 6 mA, pulse width 0.2-0.6 ms) of Baihui (GV20) and bilateral acupoints of Neiguan (PC6), Hegu (LI4), and Ximen (PC4) acupoints was performed after induction of general anesthesia and maintained until the end of surgery.In group CA, the children received combined intravenous-inhalational anesthesia, and electrodes were only applied on the same acupoints without electrical stimulation.Venous blood samples were collected for blood routine examination and for determination of the concentrations of interleukin-6 (IL-6), IL-8 and tumor necrosis factor-alpha(TNF-α) at 30 min before surgery (T 1), 30 min after the start of surgery (T 2) and 1 h and 1, 2, 3 and 5 days after surgery (T 3-7). The length of hospital stay and development of postoperative major adverse events were recorded. Results:Compared with group CA, the plasma concentrations of IL-6, IL-8 and TNF-α at T 2-7 and white blood cell count, neutrophil count and neutrophil percentage at T 4-7 were significantly decreased, postoperative length of hospital stay was shortened ( P<0.05), and the incidence of acute lung injury was decreased obviously in group ADBA ( P<0.05). Conclusion:Acupuncture-drug balanced anesthesia can improve the outcomes following radical correction of TOF under CPB to a certain extent, and the mechanism is related to inhibiting inflammatory responses in pediatric patients.
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Objective To investigate the role of transient receptor potential melastatin 7 (TR PM7) in the protective role of sevoflurane preconditioning against hippocampal neuron injury caused by oxygen glucose deprivation (OGD).Methods Hippocampal neurons were harvested from postnatal day 1 SD rats,and randomly divided into 5 groups:control group (group C),sevoflurane group (group Sev),oxygen-glucose deprivation group (group OGD),sevoflurane+ OGD group (group SD) and sevoflurane+OGD+bradykinin group (group B).To build up the model of OGD,the neurons were cultured in a deoxygenated glucose-free medium and exposed to 95％ N2 and 5％％ CO2 in an anaerobic chamber equilibrated at 37℃ for 1.5 h,followed by replacement with glucose containing medium and return to a standard incubator for additional 24 h.The neurons in group C received no treatment.Group OGD was preconditioned with 2 ％ sevoflurane for 1 h.The neurons in group OGD were subjected to OGD.Group SD was preconditioned with 2％ sevoflurane for 1 h,followed by OGD at 24 h after the sevoflurane exposure.The neurons in group B was incubated in a medium supplemented with 200 μmol/L bradykinin (the selective agonist of TRPM7),followed sequen tially by the preconditioning of 2％ sevoflurane for 1 h and then OGD challenge.Twenty-four hours after re-oxygenation,The relative neuronal cell viability was determined by MTT assay,the neuronal apoptotic rate was analyzed by TUNEL assay,the protein expression of TRPM7 was detected by Western blot,the mRNA level of TRPM7 was estimated by real-time PCR,the neuronal release of IL-1β and TNF-α in the serum was measured by ELISA.Results Compared with group C,the mR NA and protein levels of TRPM7,the neuronal apoptotic rate,the mRNA and supernatant protein levels of IL-1β and TNFα were significantly up-regulated in group OGD (P＜0.05),whereas the cell viability was decreased (P＜0.05).Compared with group OGD,the mRNA and protein levels of TRPM7,the neuronal apoptotic rate,the mRNA and supernatant protein levels of IL1β and TNF-α were significantly down-regulated in group SD (P＜0.05),whereas the cell viability was increased (P＜0.05).Compared with group SD,the mRNA and protein levels of TRPM7,the neuronal apoptotic rate,the mRNA and supernatant protein levels of IL-1β and TNF-α were significantly up-regula ted in group B (P＜0.05),whereas the cell viability was decreased (P＜0.05).Conclusion Sevoflurane attenuates apoptosis and inflammatory responses induced by OGD via reduction of the overex pression of TRPM7 in the hippocampal neurons.
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Objective To evaluate the effect of cardamonin on acute lung injury induced by hemorrhagic shock and resuscitation (HSR) in rats.Methods Thirty-two male Sprague-Dawley rats,aged 18-24 weeks,weighing 200-250 g,were divided into 4 groups (n =8 each) using a random number table:sham operation group (group Sham);group HSR;cardamonin group (group CA);cardamonin + adenosina A2A receptor antagonist ZM241385 group (group CZM).Bilateral common carotid arteries were only cannulated in group Sham.The left common carotid artery was cannulated for blood-letting until mean arterial pressure was reduced to 35-45 mmHg and maintained at this level for 30 min,and the animals were then resuscitated by infusion of shed blood and normal saline two-fold volume of shed blood to establish HSR model in HSR,CA and CZM groups.ZM241385 5 mg/kg was injected intraperitoneally at 30 min before blood-letting in group CZM,and cardamonin 75 mg/kg was injected intraperitoneally immediately after the beginning of resuscitation in CA and CZM groups.The rats were sacrificed at 2 h after completion of resuscitation,bronchoalveolar lavage fluid (BALF) was collected for determination of neutrophil count,and lungs were removed for microscopic examination of the pathological changes and for determination of wet/dry lung weight ratio (W/D ratio),contents of tumor necrosis factor-alpha (TNF-ct),interleukin-1 (IL-1β) and IL-6 (by enzyme-linked immunosorbent assay) and expression of adenosine A2A receptors in lung tissues (by Western blot).Results Compared with group Sham,the neutrophil count in BALF,W/D ratio and contents of TNF-α,IL-1β and IL-6 were significantly increased,the expression of adenosine A2A receptors was significantly down-regulated in group HSR,and the neutrophil count in BALF and contents of TNF-α and IL-6 were significantly increased (P＜0.05),and no significant changes were found in W/D ratio,content of IL-1β,and expression of adenosine A2A receptors in group CA (P＞0.05).Compared with group HSR,the neutrophil count in BALF,W/D ratio and contents of TNF-α,IL-1β and IL-6 were significantly decreased,the expression of adenosine A2A receptors was significantly up-regulated (P＜0.05),and the pathological changes were significantly attenuated in group CA,and no significant changes were found in the parameters mentioned above in group CZM (P＞0.05).Compared with group CA,the neutrophil count in BALF,W/D ratio and contents of TNF-α,IL-1β and IL-6 were significantly increased,the expression of adenosine A2A receptors was significantly down-regulated (P＜0.05),and the pathological changes were aggravated in group CZM.Conclusion Cardamonin can attenuate acute lung injury induced by HSR in rats,and activated adenosine A2A receptors and inhibited inflammatory responses are involved in the mechanism.
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Objective To investigate the ultrasonic image characteristics of Zenker diverticulum(ZD).Methods The ultrasonographic features were summarized using the analysis confirmed by surgery pathology or X-ray imaging of the ZD in six eases.Results The diverticulum of Zenker located behind the thyroid gland in all the six cases,with five cases to the left and one to the right.The internal hyperechoic foci caused by air was found for all the six cases.The diverticulum wall appeared to be semicircular,narrow-band and acoustic halo low echo with an average thinckness of 0.53 mm.The Doppler sonogram of the six diverticulums showed no vascular signal.Conclusions The ZD had several unique characterisitics for identification by ultrasonic diagnosis,which included hyperechoic foci caused by air,internal changes of echo after drinking water and the special layered structure of the five-layer ZD wall.