ABSTRACT
Objective To explore the effects of different anesthesia methods on cognitive function and serum interleukin-6 ( IL -6), interleukin -8 ( IL -8) levels in elderly patients with lung cancer during perioperative period.Methods From March 2015 to March 2017, ninety elderly patients undergoing radical resection of lung cancer treated in Heji Hospital Affiliated to Changzhi Medical College were selected in the research.According to the different anesthesia methods,they were divided into inhalation anesthesia group( A group),general intravenous anes-thesia group(B group) and epidural block anesthesia group(C group),with 30 cases in each group.The minimum mental state examination(MMSE) scores,cognitive dysfunction rate,serum IL-6 and IL-8 levels of the three groups before operation,one day after operation and three days after operation were compared.Results One day and three days after operation,the MMSE scores of C group were (25.62 ± 2.11) points,(27.12 ± 2.04) points,respectively, which were higher than those of group A[(22.61 ± 2.75) points,(25.78 ± 2.68)points] and B group[(22.34 ± 2.01)points,(25.81 ± 2.42) points],the differences were statistically significant(tA group =4.756,2.179,tB group =6.165,2.267,all P<0.05).One day and three days after operation,the cognitive dysfunction rates of C group were 26.67% (8/30),6.67% (2/30),respectively,which were lower than those of A group[50.00% (15/30),26.67% (8/30)] and B group[66.67% (20/30),30.00% (9/30)],the differences were statistically significant(χ2A group =3.455,4.320,χ2B group =9.643,5.455,all P<0.05).One day and three days after operation,the serum IL-6 and IL-8 levels of C group[IL-6:(99.53 ± 16.82)ng/mL,(83.24 ± 8.34) ng/mL,IL-8:(50.43 ± 7.84)ng/mL, (42.15 ± 5.25)ng/mL] were lower than those of A group[IL-6:(122.43 ± 18.41)ng/mL,(88.51 ± 10.42)ng/mL, IL-8:(64.53 ± 8.94)ng/mL,(55.62 ± 6.78) ng/mL] and B group[IL-6:(124.52 ± 20.10) ng/mL,(87.95 ± 9.34)ng/mL,IL-8:(63.27 ± 9.03)ng/mL,(54.62 ± 6.30) ng/mL],the differences were statistically significant (IL-6:tA group =5.030,2.163,tB group =5.222,2.060,all P<0.05;IL-8:tA group =6.495,8.604,tB group =5.881, 8.329,all P<0.05).Conclusion The influence of epidural block anesthesia on postoperative cognitive dysfunction in elderly patients with radical resection of lung cancer is minimal,which can inhibit the expression of inflammatory factors.It is better than the other two anesthesia methods,and it is worthy of radical operation for elderly patients with lung cancer.
ABSTRACT
BACKGROUND:Stem cells are a kind of cells characterized as species diversity, self-replication and renewal ability, multiple differentiation potential and high proliferation potential. Then, the stem celltreatment for ischemic brain injury would be of great benefit. Stem celltherapy provides a new way for the treatment of ischemic stroke, but the mechanism is stil unclear. OBJECTIVE:To describe the types of stem cells and review the mechanism underlying stem celltreatment for ischemic stroke. METHODS:The first author retrieved PubMed database, Chinese Journal Ful-text Database for articles related to stem cellclassification and effectiveness, safety and mechanism of stem celltherapy for ischemic stroke published from January 1992 to September 2012. The key words were“stem cells, brain ischemic stroke, transplantation, treatment”in English and Chinese, respectively. A total of 168 literatures were retrieved, and 61 articles met the inclusion criteria. RESULTS AND CONCLUSION:Stem celltherapy for ischemic stroke has shown a promising prospect though it is staged in the period of animal models. Stem celltransplantation for promoting functional recovery in the treatment of stroke has been completed in the clinical phase I or phase II trials. Stem celltransplantation for ischemic stroke appears to have no adverse reactions and to promote functional recovery. Main difficulties in stem celltransplantation for treatment of ischemic stroke include sources of stem cells, transplantation approach, stem cellsurvival in the host body, stem cellintegration with the host brain, therapeutic effectiveness and security. Based on the acquired results from the mechanism research and clinical trials, how to safely and quickly apply the stem celltherapy from the experiments to the clinic stil needs to work.