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Objective:To investigate the effects of different doses of dexmedetomidine combined with tramadol on intravenous analgesia and sleep quality after cesarean section.Methods:One hundred and twenty pregnant women who underwent cesarean section in Zhongshan Boai Hospital from March 2019 to July 2020 were selected. They were randomly divided into four groups, with 30 patients in each group. The patients in group Awere given patient controlled anesthesia with tramadol 800 mg+ tropisetron 5mg after cesarean section, and the patients in group B1, B2 and B3 were given 1.0, 1.5, 2.0 μg/kg dexmedetomidine on the basis of group A. The scores of exercise and rest of visual analogue scale (VAS) at 6, 12, 24 and 48 h after the surgery were observed. The scores of Athens insomnia scale (AIS) before and after surgery were compared. The Ramsay sedation scores and basic vital signs were recorded, compared and analyzed at 6, 12, 24 and 48 h after the surgery. The incidence of adverse reactions within 48 h after the surgery was counted in the four groups.Results:The scores of exercise and rest of VAS at 6, 12, 24 and 48 h after the surgery in four groups had significant differences ( P<0.05). The scores of group A were the highest, and next were the group B1, B2 and B3. The scores of AIS at 1 and 2 d after surgery in four groups had significant differences ( P<0.05).The scores of group A were the highest, and next were the group B1, B2 and B3.The level of oxyhemoglobin saturation (SpO 2) after surgery in four groups had no significant difference ( P>0.05). The levels of systolicblood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) after surgery in four groups had significant differences ( P<0.05). The levels of SBP, DBP, HR in group A were the highest, and next were the group B1, B2 and B3. Thelevels of SBP, DBP, HR in group A, B1 and B2 were in normal range, but the levels of SBP, DBP and HR in group B3 were in lower limits of normal, the level of HR in some patients was below normal. The Ramsay sedation scores at 6, 12, 24 and 48 h after surgery in the four groups had significant differences ( P<0.05). Ramsay sedation scores in group A were the lowest, and next were the group B1, B2 and B3. The total incidence of adverse reactions in group B3 was the highest with 33.33%(10/30), and in group B1 was the lowest with 6.67%(2/30). Conclusions:Medium dose of dexmedetomidine (1.5 μg/kg) combined with tramadol has a good effect on postoperative intravenous sedation and analgesia in patients after cesarean section, which can improve the sleep quality of patients. Besides, the drug safety can be guaranteed.
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Objective To evaluate the effect of dexmedetomidine pretreatment on the expression of mitochondrial transcription factor A ( TFAM) and succinate dehydrogenase ( SDHA) during lung ischemia-reperfusion ( I∕R) in mice. Methods Twenty-four clean-grade healthy male C57BL∕6J mice, aged 8-10 weeks, weighing 18-22 g, were divided into 3 groups ( n=8 each) using a random number table method:sham operation group ( group S ) , lung I∕R group ( group I∕R ) and dexmedetomidine pretreatment group ( group D) . In I∕R and D groups, lung I∕R was induced by clamping the left pulmonary hilum for 60 min followed by 120-min reperfusion in anesthetized mice. The chest was only opened, but the left pulmonary hilum was not occluded in group S. Dexmedetomidine 25μg∕kg was intraperitoneally injected at 30 min be-fore ischemia in group D, while the equal volume of normal saline was given instead of dexmedetomidine in I∕R and S groups. The mice were sacrificed at 120 min of reperfusion, and lungs were removed for determi-nation of wet∕dry weight ratio ( W∕D ratio) , cell apoptosis ( by TUNEL) and expression of TFAM and SDHA mRNA in lung tissues ( by real-time polymerase chain reaction ) and for examination of the pathological changes of lung tissues. The apoptosis index was calculated. Results Compared with group S, the W∕D ratio, apoptosis index and lung injury scores were significantly increased, and the expression of TFAM and SDHA mRNA was down-regulated in I∕R and D groups ( P<0. 05) . Compared with group I∕R, the W∕D ra-tio, apoptosis index and lung injury scores were significantly decreased, and the expression of TFAM and SDHA mRNA was up-regulated in group D ( P<0. 05) . Conclusion The mechanism by which dexmedeto-midine pretreatment attenuates lung I∕R injury is related to up-regulating the expression of TFAM and SDHA in mice.
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Objective To evaluate the role of necroptosis in liver injury induced by intestinal ischemia-reperfusion (I/R) in rats.Methods Thirty-two healthy adult male Sprague-Dawley rats,weighing 250-300 g,were divided into 4 groups (n=8 each) using a random number table:sham operation group (S group),I/R group,specific necroptosis inhibitor necrostatin-1 group (N group) and dimethyl sulfoxide (DMSO) group (D group).Intestinal I/R was produced by occlusion of the superior mesenteric artery for 1.5 h followed by 6 h of reperfusion.The superior mesenteric artery was only isolated but not ligated in group S.At 30 min before ischemia,necrostatin-1 1 mg/kg (diluted to 200 μl in DMSO) was intraperitoneally injected in group N,while the equal volume of DMSO was given instead in group D.The animals were sacrificed at the end of reperfusion,livers were removed for examination of the pathological changes with a light microscope,and the severity of liver injury was evaluated using the Eckhoff's scale score.Blood samples were collected from the cardiac apex for determination of serum alanine transaminase (ALT) concentrations by enzyme-linked immunosorbent assay.The expression of receptor-interacting protein kinase 1 (RIP1),RIP3 and high-mobility group box 1 protein (HMGB1) in cytoplasm of hepatocytes was detected by Western blot.The location of RIP1 and RIP3 in liver tissues was determined by immunohistochemistry,and the translocation of HMGB1 from nucleus to cytoplasm was tested by immunofluorescence.Results Compared with group S,the Eckhoff's scale score of liver tissues and serum ALT concentration were significantly increased,the expression of RIP1,RIP3 and HMGB1 in liver tissues was up-regulated (P＜0.05),and the hepatocytes in which RIP1 and RIP3 were highly expressed in the portal area were increased in group I/R.Compared with group I/R,the Eckhoff's scale score of liver tissues and serum ALT concentration were significantly decreased,the expression of RIP1,RIP3 and HMGB1 in liver tissues was down-regulated (P＜0.05),and the hepatocytes in which RIP1 and RIP3 were highly expressed in the portal area were decreased in group N,and no significant changes were found in the variables mentioned above in group D (P＞0.05).HMGB1 was expressed in the nucleus of hepatocytes in the portal area in group S;a large number of HMGB1 in hepatocytes in the portal area was translocated to cytoplasm in I/R and D groups;a small number of HMGB1 in hepatocytes in the portal area was translocated to cytoplasm in group N.Conclusion Necroptosis is involved in intestinal I/R-induced liver injury in rats.
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[Objective] To explore whether necroptosis is involved in the mechanism of lung injury induced by intestinal ischemia-reperfusion.[Method] Thirty-two healthy male Sprague-Dawley rats were randomly assigned into 4 groups (n--8):sham operation group (sham group),isehemia/ reperfusion group (I/R group),necroptosis inhibitor necrostatin-1 group (Nec-1 group) and solvent dimethyl sulfoxide (DMSO) group (DMSO group).Model of intestinal I/R injury was produced by clamping the superior mesenteric artery for 1.5 h followed by 6 h reperfusion in rats.Necrostatin-1 1.0 mg/kg was administered 30 min before occlusion in Nec1 group,while the equal volume of DMSO was given instead in DMSO group.The rats were sacrificed at 6 h of reperfusion and the lung tissues were removed for measurement of wet-dry ratio and microscopic examination and scored.The expression of receptor-interacting protein 1 (RIP1) and receptor-interacting protein 3 (RIP3) in lung tissues was detected using Western-blot and immunohistochemistry.[Result] Compared with sham group,lung morphology score and wet/dry ratio in I/R,DMSO group raised (P ＜ 0.05).Lung morphology score and wet/dry ratio statistically declined in Nec-1 group compared with I/R and DMSO group (P ＜ 0.05),while there was no statistical difference of wet/dry ratio between sham group and Nec-1 group (P ＞ 0.05).As the result of westernblot and immunohistochemistry showed,the expression of RIP1 and RIP3 was up-regulated in I/R group and DMSO group (P ＜0.05),which was inhibited by Nec-1 in Nec-1 group (P ＜ 0.05).[Conclusion] Necroptosis is involved in the mechanism of lung injury induced by intestinal ischemia-reperfusion,and Nec-1,the special inhibitor of RIP1,can reduce the injury.
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Objective To evaluate the effect of remifentanil preconditioning ( RP ) on intestinal is?chemia?reperfusion ( I∕R) injury in rats and its relationship with opioid receptors. Methods Seventy?two Sprague?Dawley rats, aged 6-7 weeks, weighing 250-280 g, were randomly divided to 9 groups ( n=8 each): sham operation group (S), intestinal I∕R group (group I∕R), RP group, different opioid receptor antagonists groups (N, BNI and CTOP groups), and opioid receptor antagonists + RP groups (N+RP, BNI+RP and CTOP+RP groups) . Intestinal I∕R was produced by clamping the superior mesenteric artery for 1 h followed by 2 h reperfusion in all the groups except group S. RP was induced by 3 cycles of 5 min infusion of remifentanil 0?2 μg·kg-1 ·min -1 followed by 5 min infusion of normal saline before ischemia. Naltrindole (δ?receptor antagonist, 5 mg∕kg) , nor?binaltorphimine (κ?receptor antagonist, 5 mg∕kg) and CTOP (μ?receptor antagonist, 1 mg∕kg) were administered before RP. At 2 h of reperfusion, blood sam?ples were collected from the cardiac apex for determination of serum diamine oxidase ( DAO) activity. Intes? tinal tissues were then removed for microscopic examination. Intestinal damage was assessed and scored ac?cording to Chiu. Apoptosis in intestinal mucosal epithelial cells was detected using TUNEL assay, and ap?optosis index was calculated. The expression of activated caspase?3 in intestinal mucosal epithelial cells was measured by Western blot. Results Compared with group S, the serum DAO activity, Chiu′s score, and apoptosis index were significantly increased, and the expression of activated caspase?3 was up?regulated in I∕R and RP groups ( P0?05). Compared with group RP, the serum DAO activity, Chiu′s score, and apoptosis index were significantly increased, and the expression of activa?ted caspase?3 was up?regulated in N+RP and CTOP+RP groups ( P0?05) . Conclusion RP can mitigate in?testinal I∕R injury in rats, and the mechanism is related to the anti?apoptotic effect mediated by activation ofδ?and μ?opioid receptors, but not κ?opioid receptors.
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Objective To evaluate the role of necroptosis in intestinal ischemia-reperfusion (I/R) injury in rats.Methods Thirty-two healthy male Sprague-Dawley rats,weighing 200-220 g,were randomly assigned into 4 groups (n =.8 each) using a random number table:sham operation group (Sham group),I/R group,necroptosis inhibitor necrostatin-1 group (Nec-1 group) and solvent dimethyl sulfoxide (DMSO) group (group DMSO).Intestinal I/R injury was produced by clamping the superior mesenteric artery for 1 h followed by 24 h reperfusion in rats anesthetized with chloral hydrate.Necrostatin-1 1.0 mg/kg was administered intraperitoneally at 30 min before occlusion in Nec-1 group,while the equal volume of DMSO was given instead in group DMSO.The rats were sacrificed at 24 h of reperfusion and the intestinal tissues were removed for microscopic examination.Intestinal damage was assessed and scored according to Chiu.Blood samples were taken for determination of serum diamine oxidase (DAO) activity.The expression of activitied caspase-3 and receptor-interacting protein 1 (RIP1) in intestinal tissues was detected using Western blot.Results Compared with Sham group,Chiu's score,serum DAO activity,and the expression of activitied caspase-3 and RIP1 was up-regulated in I/R,DMSO and Nec-1 groups.Compared with I/R and DMSO groups,Chiu's score and DAO activity were significantly decreased,the expression of RIP1 was down-regulated,and no significant change was found in the expression of activitied caspase3 in group Nec-1.Conclusion Necroptosis is involved in intestinal I/R injury in rats.
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Aim To investigate the the protective effects of a novel recombinant Trichinella spiralis 38 ku protein ( rTsP38 ) on intestinal I/R injury and the po-tential mechanisms. Methods Male BALB/c mice were randomly divided into sham group ( group S) , in-jury group ( group I) , rTsP38 vaccinated group ( group T) and adjuvants vaccinated group ( group A ) , and received subcutaneously phosphate buffer solution (PBS), PBS, rTsP38, or adjuvants, respectively, at 2-week intervals 6 weeks before the surgical proce-dure. Results Intestinal I/R caused severe intestinal injury evidenced by significant increases in modified Chiu 's score and neutrophils infiltration, accompanied by decreases in daily food intake and body weight. The mRNA level of arginase-1 ( Arg-1 ) was decreased and the mRNA level of inducible nitric oxide synthase 2 ( NOS2) was increased in group I. RTsP38 significant-ly ameliorated intestinal injury and improved intestinal function following intestinal I/R accompanied by de-crease in neutrophils infiltration and increase in cell proliferation in the intestine, compared to mice without rTsP38 pretreatment. Fold changes of Arg-1 mRNA level were significantly increased in group T. Conclu-sions These findings indicate that rTsP38 exerts pro-tection on intestinal I/R injury in mice via promoting M2 macrophages polarization.
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Objective To investigate the optimum dose of dexmedetomidine when combined with propofol for induction of anesthesia.Methods One hundred and twenty ASA physical status Ⅰ or 1Ⅱ patients of beth sexes,aged 18-60 yr,with body mass index of 18.5-30.0 kg/m2,scheduled for elective ophthalmologic operation under general anesthesia,were randomly divided into 6 groups (n =20 each) using a random number table:normal saline group (NS group) and different doses of dexmedetomidine groups (D1-D5 groups).Different loading doses of dexmedetomidine 0.2,0.4,0.6,0.8 and 1.0 μg/kg (in normal saline 50 ml) were infused intravenously in D1-D5 groups,respectively.The equal volume of normal saline was infused over 15 min in group NS.After 10 min observation,target-controlled infusion (TCI) of propofol was started.The initial target plasma concentration was set at 3.2 μg/ml.Loss of consciousness was considered to be positive response.The median effective concentration (EC50) and 95％ confidence interval of propofol TCI required for loss of consciousness were calculated.After administration of dexmedetomidine,the development of adverse effects was recorded before propofol TCI.Results Compared with NS group,the EC50 of propofol TCI required for loss of consciousness was significantly decreased in D2-D5 groups,and no significant change was found in the EC50 of propofol TCI required for loss of consciousness in D1 group.The EC50 of propofol TCI was decreased gradually with the increasing doses of dexmedetomidine between D1 and D2 groups,between D2 and D3 groups,and between D4 and D5 groups,while there was no significant difference in the EC50 of propofol TCI required for loss of consciousness between D3 and D4 groups.The incidence of hypotension was 5％ (D3 group),11％ (D4 group) and 31％ (D5 group),and the incidence of bradycardia was 0 (D3 group),11％ (D4 group),and 19 ％ (D5 group).No hypotension and bradycardia developed in D1 and D2 groups.The incidence of hypotension and bradycardia was significant increased in D4 and D5 groups as compared with NS,D1,D2 and D3 groups.Conclusion The optimum dose of dexmedetomidine is 0.4μg/kg when combined with propofol for induction of anesthesia.
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Objective To investigate the effects of hydrogen inhalation on the brain injury after intestinal ischemia/reperfusion (I/R) in rats.Methods Fifty-four healthy male Sprague-Dawley rats aged 6-8 months,weighing 285-350 g,were randomly allocated to one of 3 groups (n =18 each):sham operation group (group S),intestinal I/R group (group I/R) and hydrogen inhalation group (group H2).Intestinal I/R was produced by occlusion of the superior mesenteric artery for 90 min followed by reperfusion.2％ hydrogen was inhaled for 3 h starting from the end of ischemia.The cognitive function was detected at 1,2 and 5 days of reperfusion using Morris water maze test.The animals were sacrificed after the test and brains were isolated for detection of the cerebral edema and morphology in brain tissues.The cerebral water content ((wet weight-dry weight)/ wet weight × 100％) was measured.The pathological changes in the prefrontal cortex was observed under light microscope.The neuronal apoptosis was detected by TUNEL.Results Compared with the S group,the number of normal neurons in the prefrontal cortex was significantly decreased,the latency and swimming distance were both prolonged,the frequency of crossing the original platform was decreased,and the cerebral water content and the number of apoptotic neurons were increased in groups I/R and H2 (P ＜ 0.05).Compared with I/R group,the number of normal neurons in the prefrontal cortex was significantly increased,the latency and swimming distance were both shortened,the frequency of crossing the original platform was increased,the cerebral water content and the nunber of apoptotic neurons were decreased in group H2 (P ＜ 0.05).The pathological changes were obvious in I/R group,however,they were significantly attenuated in H2 group.Conclusion H2 inhalation can reduce the brain damage and improve the cognitive dysfunction after intestinal I/R in rats.
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Objective To evaluate the efficacy of parecoxib sodium combined with epidural morphine for multi-mode analgesia after gynecologic operation in a randomized,double-blind,placebo-controlled,multicenter,prospective study.Methods Two hundred and forty ASA Ⅰ or Ⅱ female patients,aged 18-64 yr,scheduled for elective gynecologic operation under combined spinal-epidural anesthesia,were randomly divided into 2 groups:control group (group C) and parecoxib sodium group (group P).Normal saline 2 ml or parecoxib sodium 40 mg was injected intravenously 30 min before the start of operation and was injected again 12,24 and 36 h later.Patient-controlled epidural analgesia with morphine was used for postoperative analgesia in both groups.VAS score was maintained ≤ 3 after operation.When VAS score ＞ 4,tramadol was injected as rescue analgesic.The number of attempts,the number of successfully delivered doses,the amount of morphine used,requirement for the rescue analgesic within 48 h after operation and patient' s satisfaction at 48 h after operation were recorded.Blood samples were taken at 48 h after operation for determination of serum creatinine (Cr),blood urea nitrogen (BUN),alanine aminotransferase (ALT),aspartate transaminase (AST),total bilirubin levels and coagulation function.The abnormality in the parameters was recorded.The adverse effects (nausea,vomiting,pruritus) and recovery of gastrointestinal function were recorded within 48 h after operation.Results Of the 225 patients who completed the study,there was 112 cases in group P and 113 cases in group C.Compared with group C,the number of attempts,the number of successfully delivered doses,amount of morphine used and requirement for the rescue analgesic were significantly decreased,the satisfaction score was increased and the incidence of postoperative vomiting was decreased in group P (P ＜ 0.05 or 0.01).There was no significant difference in the incidence of nausea and pruritus,recovery of gastrointestinal function,and abnormality in the parameters of liver and kidney functions and coagulation function between the two groups (P ＞ 0.05).Conclusion Parecoxib sodium combined with epidural morphine can be safely and effectively used for multi-mode analgesia after gynecologic operation and reduce the requirement for morphine and side effects of morphine.
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Objective To investigate the effects of remote limb ischemic preconditioning (RLIP) on the lung injury in patients undergoing abdominal aortic aneurysm repair.Methods Sixty-two ASA Ⅱ or Ⅲ patients of both sexes,aged 54-72 yr,with body mass index 21-36 kg/m2,undergoing elective abdominal aortic aneurysm repair,were randomly divided to 2 groups ( n =31 each):control group (group C) and RLIP group.RLIP consisted of two 5-min cycles of left upper limb ischemia induced by a blood pressure cuff placed on the left upper arm and inflated to 200 mm Hg,with an intervening 5 min of reperfusion,during which time the cuff was deflated.RLIP was performed after anesthesia induction and before the start of surgery.Arterial and venous blood samples were taken at 10 min after intubation (T0),and 30 min and 4,8,12 and 24 h after aortic unclamping (T1-5) for blood gas analysis and determination of the concentrations of serum interleukin (IL)-6,tumor necrosis factor (TNF)-α,and plasma malondialdehyde (MDA) and superoxide dismutase (SOD) activity.The alveolar-arterial oxygen pressure difference (PA-aO2 ) and respiratory index (RI) were calculated.The peak airway pressure (Ppeak),plat airway pressure (Pplat) and positive end expiratory pressure (PEEP) were recorded at the same time points mentioned above to calculate dynamic lung compliance (Cd) and static lung compliance (Cs).The incidence of hypoxemia,extubation time and duration of stay in intensive care unit (IGU) were also recorded.Results Compared with group C,PA-aO2,RI and the concentration of IL-6 were significantly decreased at T3-5,Cs,Cd and SOD activity were significantly increased at T2-5,and the concentrations of TNF-α and MDA were significantly decreased at T2-5 in group RLIP ( P ＜ 0.05).Compared with group C,the incidence of hypoxemia was significantly decreased,and extubation time and duration of stay in ICU were significantly shortened in group RLIP ( P ＜ 0.05).Conclusion RLIP can reduce the lung injury through inhibition of the inflammatory response and lipid peroxidation in patients undergoing abdominal aortic aneurysm repair.
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Objective To investigate the effects of intestinal ischemia-reperfusion (I/R) on the brain in rats. Methods Sixty-four healthy male SD rats weighing 250-300 g were randomly allocated to one of 2 groups (n = 32 each): sham operation group (S) and intestinal I/R group (I/R). Intestinal I/R was produced by occlusion of superior mesenteric artery (SMA) for 90 min followed by reperfusion. Eight animals were sacrificed at each of the following time points: 2, 6, 12 and 24 h of reperfusion (T1-4) in each group. After a median sternotomyblood samples were taken from left ventricle for measurement of plasma TNF-α and IL-6 (by ELISA). Intestine and brain tissue was harvested for microscopic examination and detection of apoptosis ( by TUNEL). The cognitive function was tested using Morris water maze at 24 h. Results No abnormality was found in intestine and brain tissue in group S. Intestinal damage and neurodegeneration were detected in group I/R. Intestinal I/R significantly increased cerebral apoptosis in group I/R compared with group S. Plasma TNF-a and IL-6 concentrations were significantly higher at T1-4 in group I/R than in group S. The escape latency and swimming distance were significantly increased, while the number of crossing the platform was decreased in group I/R compared with group S. There was no significant difference in the swimming speed between the 2 groups. Conclusion Intestinal I/R can induce brain injury and lead to cognitive dysfunction. I/R-induced release of inflammatory mediators and neuronal apoptosis are involved in the underlying mechanism.
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ObjectiveTo evaluate the effects of parecoxib on efficacy of patient-controlled epidural analgesia(PCEA) with different doses of morphine after cesarean section.MethodsThree hundred ASA Ⅰ or Ⅱ parturients at full term aged 20-40 yr weighing 54-89 kg undergoing elective cesarean section were randomly divided into 3 morphine groups-regular,median and small dose (groups Ⅰ,Ⅱ[ and Ⅲ) ( n ＝ 100 each).Each group was further divided into 2 subgroups ( n ＝ 50 each):parecoxib group (groups P1.2.3 ) and control group (groups C1,2.3 ).In groups P1.2.3 psrecoxib 40 mg was administered iv at the end of operation while in groups C1.2.3 normal saline (NS) was administered instead of parecoxib.Groups Ⅰ,Ⅱ and Ⅱ received a loading dose of morphine 2.0/1.5/1.0 mg+ 0.15％ ropivacaine 8 ml respectively.The PCEA solution contained morphine 3.0/2.0/1.5mg+ ropivacaine 150 mg + granisetron 3 mg+ dexamethasone 5 mg in 100 ml of NS in groups Ⅰ,Ⅱ,and Ⅲ respectively.PCEA pump was set up with a background infusion of 2 ml/h,and a bolus dose of 0.5 ml with a lockout-interval of 15 min.VAS was used to assess intensity of pain (0 ＝ no pain,10 ＝ worst pain).VAS score ≤4 was considered as effective analgesia.Adverse effects including nausea and vomiting and pruritus were recorded.ResultsThere was no significant difference in the rate of effective analgesia between groups P1,P2 and C1,C2 The rate of effective analgesia during movement was significant higher in group P3 than in group C3.The incidence of nausea and vomiting and pruritis were significantly lower in group P3 than in groups P1 and P2.Conclusion Parecoxib can enhance the efficacy of PCEA with small dose of morphine.
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ObjectiveTo investigate the role of 15-F2t-isoprostane in intestinal injury induced by intestinal ischemia/reperfusion (I/R) in rats.MethodsThirty-two pathogen free adult male SD rats weighing 230-255 g were randomly divided into 4 groups ( n =8 each):group sham operation (group S) ; group intestinal I/R; group SQ-29548 (TXA2 receptor antagonist) (group SQ) and group DMSO (the solvent).Intestinal I/R was induced by 60 min occlusion of superior mesenteric artery (SMA) followed by 120 main reperfusion in groups I/R,SQ and DMSO SQ-29548 2 μmol/kg and DMSO were injected subcutaneusly at abdominal wall at 30 min before SMS in groups SQ and DMSO respectively.Arterial blood samples were taken at 120 min of reperfusion for determination of serum diamine oxidase (DAO) activity and 15-F2t-isoprostane,endothelin-1 (ET-1) and thromboxane B2 (TXB2) concentrations.Intestinal tissues were removed for microscopic examination and determination of myeloperoxidase (MPO) and SOD activities,MDA and lactate contents.Intestinal damage was assessed and scored according to Chiu (0 =normal,5 =disruption of tunica propria,bleeding and ulceration).ResultsIntestinal I/R significantly increased Chiu's score,MDA and lactate contents and MPO activity and decreased SOD activity in intestine in group I/R as compared with group S.SQ-29548 pretreatment significantly decreased Chiu's score,lactate content and MPO activity in intestine and increased intestinal SOD activity and decreased serum DAO activity and ET-1 concentration in group SQ as compared with group I/R.Conclusion15-F2t-isoprostane is involved in the development of intestinal injury induced by intestinal I/R by activating TXA2 receptor,increasing ET-1 production and promoting neutrophil infiltration.
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Objective To investigate the changes in skin microcirculatory perfusion during induction of general anesthesia and the effects oftwo fluid therapy regimens in patients undergoing abdominal surgery.Methods Thirty-six ASA Ⅰ or Ⅱ patients aged 18-64 yr scheduled for elective major abdominal surgery were randomized to receive either 6% hydroxyetlayl starch(130/0.4)7 ml/kg(HES group,n=18)or lactated Ringer's solution 7 ml/kg(RL group,n=18)for compensatory intravascular volultne expansion(CVE)before tracheal intubation.Meanwhile both groups received continuous intravenous infusion of RL at a of 8 ml·kg~(-1)·h~(-1).Tracheal intubation was performed at 40 min after the onset of infusion.Anesthesia was maintained with with sevoflurane,remifentanil and rocuronium.Operation was started at 20 min after tracheal intubation.The microcirculatory perfusion was measured on forehead skin by using Doppler perfusion imaging system(LDPI)PI)at the onset of fluid infusion(T_0,baseline),the end of endotracheal intubation(T_1)and the onset of skin incision(T_2).Rwsults The MAP,HR,blood gases and body temperature were within the normal during the experiment and there was no significant difference between the 2 groups.The skin microcirculatory perfusion and CVP at T_1 were significantly higher in group HES than in group RL(P<0.05 or 0.01).Compared with the baseline value at T_0,the skin microcirculatory perfusion at T_1 was significantly increased in group HES(P<0.01),but there was no significant change in the skin microcirculatory perfusion at T_1 in group RL(P>0.05),the skin microcirculatory perfusion at T_2 was singificantly decreased in both groups(P<0.01),and CVP and PaO_2/FiO_2 at T_(1.2) were significantly increased,while Hb at T_(1.2) was significantly decreased in both groups(P<0.05).The skin microcirculatory perfusion in both groups was significantly lower at T_2 than at T_1(P<0.01).Conclusion The infusion of 6% HES 130/0.4 can improve the skin microcirculatory perfusion and the effect is better than that of RL during induction of general anesthesia in patients seheduled for abdominal surgery.
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Objective To investigate the changes of proteins expressions in intestinal mucosa of rats after is chemic postconditioning (IPo) against intestinal ischemic/reperfusion (Ⅱ/R) injury of intestine in order to elucidate its potential mechanisms of protective role. Methods Sixteen SD rats were randomly divided into Ⅱ/R group and IPo group ( n = 8). Rats of both groups received an episode of ischemic/reperfusion insult to intstine that was made by occlusion of the superior mesenteric artery (SMA) for 60 minutes. Rats of IPo group underwent three additional episodes of clamping SMA on for 30 seconds and off for 30 seconds successively after prolonged reperfusion/reperfusion of intestine. The intestinal mucosa was taken by scratching immediately after reperfusion in both groups, and total proteins were separated by immobilized pH gradient (IPG) based two-dimensional gel electrophoresis (2-DE). The differentially expressed proteins were analyzed using Image Master 2D Elite 5.0 image analysis software, and the proteins were cut out from the gel and then identified using MALDI-TOF-MS. The biological information of these proteins was looked for in the database of these peptide mass finger-printing (PMF) .Results Ten differentially expressed proteins were found, of which 6 were up-regulated and 4 were down-regulated in IPo group. Nine proteins were identified and characterized by their bioelements including aldose reductase and aldehyde dehydrogenase that were related to anti-oxidative stress and inhibition of cell apoptosis. Conclusions The well-reproducible 2-DE profiles of intestinal mucosa in II/R and IPo groups were established. The potentially protective effects of IPo may be attributed to up-regulating protein expressions of aldose reductase and aldehyde dehydrogenase, and thereby suppressing oxidative stress and cell apoptosis.
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Objective To evaluate the safety and the feasibility of hypophysin injection for hemostasis during laparoscopic stripping of ovarian endometrioma.Methods Retrospective analysis of 86 cases with ovarian endometrionm.Forty-two patients with prophylactic dilute hypophysin injection into cornua uterus and mesosalpinx(study group),and 44 patients without vasopressin(control group).The operative time,intraoperative blood loss,the highest postoperative temperature,postoperative stay and the rate of recurrence were compared.Results The operative time in the study group and the control group were(51.24±22.58)min and(67.02±25.14)min,the intraoperative blood loss were(42.16±26.10)ml and (68.23±28.21)ml,respectively.There was significantly different between two groups(P＜0.01).The rates of recurrence in the study group and the control group were 4.76% and 11.36%,respectively.But it was no significantly different between two groups(P＞0.05).Both the highest postoperative temperature and postoperative stay was no difference between two groups(P＞0.05).Conclusions Hypophysin can reduce the operative time and intraoperative blood loss during laparoscopic stripping of ovarian endometrioma,and it is possible to reduce the rate of recurrence.It is a safe,feasible,cheapand convenient method,and worth using in clinic.
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AIM: To investigate the effects of electrical stimulation of vagus nerve on gut injury following intestinal ischemia-reperfusion in rats. METHODS: 30 adult male Wistar rats subjected to bilateral cervical vagotomy were randomly divided into three groups (n=10 per group): (1) Intestinal ischemia-reperfusion group (group I/R): laparotomy and I/R induced by clamping arteria mesenterica superior for 1 h followed by reperfusion for 2 h. (2) Vagus nerve stimulation group (group VNS): laparotomy, I/R and electric stimulation with pulse train of constant amplitude 5V, pulse width 2 ms and frequency 1 Hz at the left caudal vagus ends for 20 minutes before and after occlusion. (3) Sham control group (group SC): sham operation and sham stimulation. Carotid artery was cannulated for mean arterial pressure (MAP) monitoring. A strip of small intestine was taken from distal end of ileum for light microscopic (LM) and transient electron microscopic (TEM) examination at the time of 2 h after reperfusion. Improved Chiu’s scale was used to quantitatively assay the damage degree. The levels of malondialdehyde (MDA) and TNF-? in plasma were detected. RESULTS: MAP in every group kept steady during ischemia, but decreased gradually with the prolongation in the time of reperfusion. MAP decreased more dramaticly in group I/R than that in group VNS (P
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Objective To investigate the effects of pretreatment with Chinese herbal Sini Decoction ( SND) on the acute lung injury induced by intestinal ischemia / reperfusion (I/R) .Methods Thirty-two healthy SD rats of both sexes weighing 275-300 g were randomly divided into four groups of 8 animals : (Ⅰ) control group in which sham operation was performed, ( Ⅱ) I/R group in which superior mesenteric artery was clamped for 1 h followed by 3 h reperfusion; (Ⅲ) and (Ⅳ) SND group 1 and 2 in which SND 3 g?kg-1 ( Ⅲ) or 6 g?kg-1 (Ⅳ) was given via gastric tube every day for 3 days before I/R. Carotid artery was cannulated for MAP monitoring. The animals were sacrificed by decapitation at the end of 3 h reperfusion. Blood was collected and the lungs were immediately removed for determination of lung water content [ (wet weight - dry weight) / wet weight ?100% ], lung NO, endothelin-1 (ET-1) and MDA contents and SOD activity, lung permeability index (BALF protein concentration/serum protein concentration) and microscopic examination. Results SND pretreatment significantly alleviated the hypotension and morphological changes of the lungs induced by intestinal I/R. Lung water content, lung permeability index and lung MDA and NO contents increased significantly whereas lung SOD activity significantly decreased in I/R group ( group Ⅱ) compared with those in control group ( P
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0.05), but pretreatment with yohimbine 10 ug significantly reduced the antinociceptive effect of tramadol ( 10ug) at 35 min and 40 min and the nociception score increased by 56% and 41 % respectively ( P 0.05). Scatchard analysis of the saturation isotherms showed that H-yohimbine was bound to a single binding site with a Kd value of 1.79 nM. The competition curve of tramadol was sigmoidal with a Ki value of 34.14 uM and an IC50 value of 68.25 uM. Tramadol was 19 000-fold less potent for binding to a2-adrenoceptor of the spinal cord as compared to H-yahimbine. Conclusion Intrathecal tramadol produces time-dependent antinociception. Tramadol has very low affinity with a2-adrenoceptor of the spinal cord. A part of its intrathecal antinociceptive effect was related to indirect a2-adrenoceptor effect of the spinal cord.