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Objective:To explore the early predictive value of umbilical cord blood S100β protein and lactate combined with amplitude integrated electroencephalogram（aEEG）in small for gestational age（SGA）preterm infants with brain injury.Methods:One hundred and six cases of SGA preterm infants were enrolled in this study in Neonatology Department of Inner Mongolia People's Hospital from January 2019 to December 2021. Umbilical cord blood serum S100β protein and lactate at birth of All SGA preterm infants were tested，and aEEG was monitored at 6h and 72 h after birth，corrected gestational age of 32 weeks and 37 weeks. According to the diagnostic criteria of brain injury in preterm infants，SGA preterm infants were divided into brain injury group（45 cases）and non-brain injury group（61 cases），and compared the differences of S100β protein，lactate and the designated time aEEG between the two groups.SGA preterm infants with brain injury were further divided into symmetrical group（28 cases）and non-symmetrical group（15 cases）. The differences of umbilical cord blood S100β protein and lactate level between the two groups were compared，and the diagnostic value in different types of SGA preterm infants with brain injury was also compared.Results:SGA preterm infants in the brain injury group had significantly higher levels of umbilical cord blood S100β protein［（0.826±0.218）μg/L vs（0.397±0.196）μg/L， t=8.316， P<0.05］and lactate［（8.5±1.3）mmol/L vs（3.8±0.9）mmol/L， t=3.281， P<0.05］than those in non-brain injury group.Symmetric SGA group had higher level of S100β protein than the asymmetric SGA group［（0.924±0.205）μg/L vs（0.438±0.196）μg/L， t=5.734， P<0.05］.But there was no statistically significant difference in lactate levels［（5.6±1.4）mmol/L vs（3.9±1.2）mmol/L， t=0.932， P>0.05］between symmetric SGA group and asymmetric SGA group. The abnormal rates of aEEG in brain injury group and non-brain injury group were respectively 100%（45/45）vs 22.95%（14/61）at 6 h after birth，95.56%（43/45）vs 16.39%（10/61）at 72 h after birth，62.22%（28/45）vs 6.56%（4/61）at 32 weeks of corrected gestational age，22.22%（10/45）vs 3.28%（2/61）at 37 weeks of corrected gestational age. The abnormal rate of brain injury group was higher than the non-brain injury group in the same nodal time，and the differences were statistically significant（ χ 2 value respectively 62.292，64.913，38.074，9.257，all P<0.05）. Conclusion:There were significant value in umbilical cord blood S100β protein，lactate level and aEEG monitoring in the early diagnosis in preterm infants SGA with brain injury. The combination of the three might be more helpful for the early diagnosis and timely treatment of brain injury in SGA preterm infants.
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Objective To explore the effects of permissive hypercapnia on postoperative cognitive function in elderly patients with diabetes mellitus.Methods Sixty elderly patients with diabetes mellitus scheduled for laparoscopic upper abdominal surgery under general anesthesia,were randomly divided into two groups:the permissive hypercapnia ventilation diabetes mellitus group(group DH)and the routine ven-tilation diabetes mellitus group(group DR),30 patients in each group.Another sixty elderly patients with non-diabetes mellitus scheduled for laparoscopic upper abdominal surgery under general anesthesia,were randomly divided into two groups:the permissive hypercapnia ventilation non-diabetes mellitus group(group NH)and the routine ventilation group(group NR),30 patients in each group.All patients in four groups were performed with tracheal intubation and mechanical ventilation after anesthesia induction.The respiratory parameters were adjusted to maintain PaCO2 in a range of 45-65 mmHg in groups DH and NH,and PaCO2 in a range of 35-45 mmHg in groups DR and NR.PETCO2 was recorded 5 minutes before pneu-moperitoneum,5,15,and 30 minutes after pneumoperitoneum.Blood samples were taken from the radial artery and jugular bulb for blood gas analysis 5 minutes before pneumoperitoneum,5,15,and 30 minutes after pneumoperitoneum.pH value and PaCO2 were recorded and arterial internal jugular vein bulbar oxygen difference(Da-jvO2)and cerebral oxygen extraction rate(CERO2)were calculated at the same time.The serum S100β protein concentration were detected before anesthesia induction and 3 days after operation.Montreal cognitive assessment(MoCA)scores and occurrence of postoperative cognitive dysfunction were recorded 1 day before operation,and 1 day,3 days and 7 days after operation.Results Compared with the baseline value 5 minutes before pneumoperitoneum,PETCO2 and PaCO2 were significantly increased,pH value,Da-jvO2 and CERO2 were significantly decreased 5,15,and 30 minutes after pneumoperitoneum in the four groups(P＜0.05).Compared with before anesthesia induction,the serum S100β protein concen-tration were significantly increased 3 days after operation in the four groups(P＜0.05).Compared with the last day before operation,MoCA scores were significantly decreased 1 day and 3 days after operation in the four groups(P＜0.05).Compared with group DR,PETCO2 was significantly increased,pH value,Da-jvO2,and CERO2 were significantly decreased 5 minutes before pneumoperitoneum,5,15,and 30 mi-nutes after pneumoperitoneum,the serum S100β protein concentration was significantly decreased 3 days af-ter operation,MoCA scores were significantly increased 1 day and 3 days after operation,the incidence rate of POCD was significantly decreased in group DH(P＜0.05).Compared with group NR,PETCO2 was sig-nificantly increased,pH value,Da-jvO2,and CERO2 were significantly decreased 5 minutes before pneu-moperitoneum,5,15,and 30 minutes after pneumoperitoneum,the serum S100β protein concentration was significantly decreased 3 days after operation,MoCA scores were significantly increased 1 day and 3 days af-ter operation,the incidence rate of POCD was significantly decreased in group NH(P＜0.05).Compared with group NH,Da-jvO2 and CERO2 were significantly increased 5 minutes before pneumoperitoneum,5,15,and 30 minutes after pneumoperitoneum,the serum S100β protein concentration was significantly in-creased 3 days after operation,MoCA scores were significantly decreased 1 day and 3 days after operation in group DH(P＜0.05).Conclusion Permissive hypercapnia can improve the cerebral oxygen metabolism during operation,reduce postoperative serum S100β protein concentration and reduce the incidence rate of POCD in the elderly patients with diabetes mellitus.
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【Objective】 To investigate the predictive value of regional cerebral oxygen saturation (rScO2) monitoring during total aortic arch replacement and stent trunk surgery for perioperative neurocognitive disorders (PND) and changes in plasma S100β protein and neuron-specific enolase (NSE) concentrations and their relationship with PND. 【Methods】 Sixty-five Stanford type A aortic dissection patients who planned to undergo total aortic arch replacement and trunk stenting were selected. Their rScO2 values were monitored throughout the operation and recorded after induction (T1), the beginning of CPB (T2), during deep hypothermic circulatory arrest (T3), rewarming to 36℃(T4), CPB stop for 1 hour (T5), and post-operation (T6). After induction (Ta), rewarming to 36℃ (Tb),1 h (Tc), 6 h (Td) and 24 h (Te) after cessation of cardiopulmonary bypass, central venous blood was collected from patients, and the concentrations of S100β protein and NSE in plasma were detected by ELISA. The patients were divided into PND group and non-PND group by the evaluation of MMSE scale at time of before operation, on the day of extubation, and 7 days after operation. 【Results】 The incidence of PND was 44.6%. The rScO2 value at T2 was significantly lower than that at T1 (P<0.05). The rScO2 value of PND group at T3 and T6 was significantly lower than that at T1 and non-PND group (P<0.05). The mean value of rScO2 and the minimum value of rScO2 in PND group were significantly lower than those in non-PND group, while rScO2 %max in PND group was significantly higher than that in non-PND group (P<0.05). The intraoperative critical value of rScO2 %max was >9.89%, the area under curve (AUC) was 0.658 (95% CI: 0.525-0.791, P<0.05), and sensitivity and specificity were 48.3% and 75.0%, respectively. The concentrations of S100β protein and NSE protein in PND group were significantly higher than those in non-PND group at Tc and Td (P<0.01). Compared with Ta, the concentration of S100β protein in PND group was significantly increased at Tc and Td (P<0.001), and the concentration of NSE protein was significantly increased at Tb-Te (P<0.01). CPB time was an independent risk factor for PND. 【Conclusion】 The occurrence of PND after total arch replacement and stenting may be related to the decrease of rScO2 and the increase of S100β protein and NSE protein. Intraoperative rScO2 %max >9.89% can be a potential predictor of PND.
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Objective To analyze the correlation between serum orexin-A (OXA) and early postoperative cognitive function in elderly patients undergoing lumbar spinal surgery under general anesthesia. Methods A total of 76 elderly patients (age ≥65 years) underwent lumbar spine surgery under general anesthesia from December 2018 to December 2019 in the Affiliated Hospital of Inner Mongolia Medical University were collected. All the enrolled patients were evaluated by the same doctor with the Montreal cognitive assessment scale (MoCA) on one day before the surgery and one to three days after the surgery, and venous blood was extracted from the patient on the operation day and one day after the operation, and the serum levels of OXA and S100β were measured by ELISA. According to the results of cognitive function assessment, the patients were divided into postoperative cognitive dysfunction (POCD) group and non-postoperative cognitive dysfunction (NPOCD) group. The differences in serum OXA and S100β protein levels between the two groups and their correlation with MoCA scores were statistically analyzed. Results There was no statistically significant difference in the MoCA score, serum OXA level, and S100β protein level before surgery, and heart rate (HR), mean artery pressure (MAP), bispectral index (BIS) and pulse oxygen saturation (SpO2) levels before anesthesia induction (T0), at the start of surgery (T1), at 1h after the start of surgery (T2), at the withdrawal time (T3), and at 15 minutes after extubation (T4) between the two groups (P>0.05). At the first, second, and third day after operation, the MoCA scores of the POCD group were lower than those before the operation, and they were both lower than those of the NPOCD group, the difference was statistically significant (P<0.001). There was a statistically significant difference in serum OXA levels between the two groups after the operation (P<0.05). The postoperative S100β protein level was higher than that before the operation in the two groups, and the POCD group increased more significantly, the difference between the two groups after the operation was statistically significant (P<0.05). The postoperative OXA level was positively correlated with the MoCA score (r=0.545, 0.531, 0.779) and negatively correlated with the S100β protein level (r=-0.591, -0.362, -0.743) in the two groups, and the difference was statistically significant (P<0.05). Conclusions The level of serum OXA is positively correlated with early postoperative cognitive function in elderly patients undergoing lumbal spine surgery under general anesthesia, suggesting that OXA may be a potential target for reducing the risk of postoperative cognitive dysfunction in such patients, so as to provide new ideas for preventing and improving the postoperative cognitive dysfunction in elderly patients in the future.
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Objective To investigate the value of S100β protein and electroencephalogram ( EEG) in cerebral function monitoring of critically ill children. Methods Sixty critically ill children admitted in our department from September 2014 to December 2016,were divided into 2 groups according to pediatric critical illness score ( PCIS) ,30 cases in critical group ( PCIS≤80 scores) and 30 cases of non critical group ( PCIS>80 scores) . Serum samples were collected from the 60 cases at 24 h,72 h and 1 week after admission, respectively. The serum S100β protein and EEG were dynamically monitored on 3 time points. ELISA was used to test the content of S100βprotein of collected samples. Results There was no statistically significant difference in gender and age between critical group and non critical group[ male/female:22/8 vs. 21/9;age:(3. 68 ± 1. 37)years vs. (2. 52 ± 0. 86)years,P>0. 05]. The glasgow score of critical group was lower than that of non critical group(8. 67 ± 1. 83 vs. 13. 05 ± 2. 94,P<0. 05). Serum S100βprotein contents of critical group were(112. 55 ± 29. 20)μg/L,(120. 86 ± 17. 10)μg/L,and (279. 82 ± 28. 80)μg/L) at 24 h,72 h and 1 week respectively, which were obviously higher than those of non cricical group [ ( 0. 51 ± 0. 06 )μg/L, (0. 32 ± 0. 03)μg/L,(0. 34 ± 0. 05)μg/L](P<0. 05). Meanwhile,the abnormal rate of EEG monitoring of critical group were 19 cases ( 63. 3％) , 18 cases ( 60. 0％) , 20 cases ( 66. 7％) at 24 hours, 72 hours and 1 week respectively,which were also obviously higher than those of non critical group [ 9 cases ( 30. 0％) , 7 cases(23. 3％),6 cases(20. 0％)](P<0. 05). Conclusion Both serum S100β protein and dynamically EEG monitoring contribute to detect the status of cerebral injury in early stage, with significant value in cerebral function monitoring of critically ill children.
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Objective: To prepare chitosan neurotoxin nanoparticles (CS-NT-NP) and study its effect on the permeability of blood brain barrier and the serum levels of S100β by intranasal administration. Methods: A formamide extraction-ultraviolet spectrophotometry method was employed to determine the concentration of Evans blue (EB) in brain by different routes of administration and preparations. Qualitative analysis of fluorescence intensity and distribution of EB in brain tissue was performed by fluorescence microscopy. The serum S100β protein concentration was determined by ELISA. Results: Compared with the control group and NT group, CS-NT-NP could significantly increase the content of EB in the brain with time-effect relation and reached the peak at 120 min (P < 0.01); Compared with muscle injection and ip injection, intranasal administration could significantly increase the content of EB and reached peak time quickly. The results were consistent with the experimental results of qualitative analysis of fluorescence intensity and distribution of EB in brain tissue by fluorescence microscopy and S100β protein in serum. It was consistent with the experimental results of S100β protein. Conclusion: CS-NT-NP by intranasal administration can significantly increase the permeability of BBB, and further increase the drug concentration in the brain, which is a good carrier of macromolecular drugs into the brain.
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Objective To investigate the prognostic value of serum neutrophil gelatinase associated protein lipocalin (NGAL) and S-100β protein level on postoperative delirium (POD) in patient underwent gynecological laparoscopic tumor resection. Methods 256 patients underwent gynecological laparoscopic tumor resection from March 2015 to June 2016 were enrolled the study and divided into POD group (n = 31) and non-POD group (n = 225). Serum levels of NGAL, S-100β protein, creatinine (Scr) and cystatin C (Cys-c) were compared between the two groups at 5 min before anesthesia induction, immediately after extubation, during their stay in post anesthesia care unit (PACU) and at 24, 48, 72 h after operation. The area under receiver-operating characteristic curve (AUC) was performed to evaluate prognostic value of each index in POD. Results Serum levels of NGAL and S-100βafter anesthesia in the two groups were all significantly higher than those before anesthesia (P < 0.05). Serum levels of NGAL in POD group immediately after extubation, during their stay in PACU and at 24 h after operation were significantly higher than those in non-POD group (P < 0.05). Serum levels of S-100β protein in POD group immediately after extubation, durng their stay in PACU and at 24, 48, 72 h after operation were significantly higherthan those in non-POD group (P < 0.05). There was no acute renal injury in all patients. There were no significant difference in serum levels of Scr and Cys-C between two groups at every time points (P > 0.05). The AUC of serum NGAL and S-100 protein immediately after extubation, durng their stay in PACU and at 24h after operation were 0.75, 0.77, 0.66 and 0.85, 0.83, 0.80 respectively (P < 0.05). Conclusions Serum NGAL and S-100β protein levels could be used as predictors of POD in patients undergoing gynecological laparoscopic tumor resection, and prediction effect of the latter was better, especially immediately after extubation and durng their stay in PACU.
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Objective To investigate the prognostic value of serum neutrophil gelatinase associated protein lipocalin (NGAL) and S-100β protein level on postoperative delirium (POD) in patient underwent gynecological laparoscopic tumor resection. Methods 256 patients underwent gynecological laparoscopic tumor resection from March 2015 to June 2016 were enrolled the study and divided into POD group (n = 31) and non-POD group (n = 225). Serum levels of NGAL, S-100β protein, creatinine (Scr) and cystatin C (Cys-c) were compared between the two groups at 5 min before anesthesia induction, immediately after extubation, during their stay in post anesthesia care unit (PACU) and at 24, 48, 72 h after operation. The area under receiver-operating characteristic curve (AUC) was performed to evaluate prognostic value of each index in POD. Results Serum levels of NGAL and S-100βafter anesthesia in the two groups were all significantly higher than those before anesthesia (P < 0.05). Serum levels of NGAL in POD group immediately after extubation, during their stay in PACU and at 24 h after operation were significantly higher than those in non-POD group (P < 0.05). Serum levels of S-100β protein in POD group immediately after extubation, durng their stay in PACU and at 24, 48, 72 h after operation were significantly higherthan those in non-POD group (P < 0.05). There was no acute renal injury in all patients. There were no significant difference in serum levels of Scr and Cys-C between two groups at every time points (P > 0.05). The AUC of serum NGAL and S-100 protein immediately after extubation, durng their stay in PACU and at 24h after operation were 0.75, 0.77, 0.66 and 0.85, 0.83, 0.80 respectively (P < 0.05). Conclusions Serum NGAL and S-100β protein levels could be used as predictors of POD in patients undergoing gynecological laparoscopic tumor resection, and prediction effect of the latter was better, especially immediately after extubation and durng their stay in PACU.
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Objective To investigate the influence of Trisialoganglioside-GTlb combined with Edaravone Injection on clinical effect and serum related indicators in patients with acute cerebral infarction.Methods A total of 126 cases of patients with acute cerebral infarction in our hospital from October 2010 to May 2016 were selected and divided into observation group and control group,63 cases in each group.Patients in the control group were treated with regular treatment and Edaravone Injection,and patients in the observation group were treated with regular treatment,Edaravone Injection and Trisialoganglioside-GTlb.The clinical effect,NIHSS scores,Barthel index scores,serum level of neuron specific enolase (NSE),S100β protein,superoxyde dismutase (SOD),advanced oxidation protein products (AOPP) and malondiadehyde (MDA) were compared.Results The total effective rate of the observation group (90.48％) was significantly higher than that of the control group (76.19％),the difference between the two groups was statistically significant (P ＜ 0.05).After two weeks of treatment,two groups of NIHSS and Barthel index scores were significantly lower than before treatment,the difference was statistically significant (P ＜ 0.05);and the NIHSS and Barthel index scores of observation group were significantly lower than that of control group,the difference was statistically significant (P ＜ 0.05).NIHSS scores,Barthel index scores of the observation group were significantly better than that of the control group (P ＜ 0.05);The serum level of NSE,S100,AOPP,MDA of two groups after treatment were significantly lower than that before treatment,the difference was statistically significant (P ＜ 0.05);and the above indexes of the observation group was significantly lower than the control group,the difference was statistically significant (P ＜ 0.05);SOD levels of two groups were significantly increased than before treatment,the difference was statistically significant (P ＜ 0.05);and the SOD levels of observation group was significantly higher than that of control group,the difference was statistically significant (P ＜ 0.05).Conclusion Trisialoganglioside-GT1b can synergy improve the clinical effect of Edaravone Injection in patients with acute cerebral infarction,and be good to recovery the neurologic function and ability of daily living,and these may be related to the change of the serum level of NSE,S100β protein,SOD,AOPP and MDA.
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Objective To investigate the effect of dexmedetomidine on the serum concentrations of S-100 β protein and neurone specific enolase (NSE) in elderly patients undergoing surgery.Methods One hundred ASA Ⅱ or Ⅲ patients,aged 65 ～75 yr with a body mass index of ＜25 kg/m2,scheduled for elective hip joint replacement surgery under general anesthesia,were randomly divided into 2 groups (n =50):control group (group C) and dexmedetomidine group (group D).Dexmedetomidine 0.5 μg/kg was infused intravenously over 15 min before anesthesia induction in group D and was maintained 0.4 μg/(kg·h) until 30 min before operation end,while the same volume of normal saline was infused in group C.Anesthesia was induced by iv injection of sufentanil 0.4 μg/kg and propofol 1 ～ 2 mg/kg until loss of consciousness.Tracheal intubation was facilitated with 0.6 mg/kg rocuronium bromide and the patients were mechanically ventilated.Anesthesia was maintained with sevoflurane by target controlled inhalation (TCI) (end-tidal concentration set at 1％～3％) and sufentanil 0.2 μg/(kg·h) in both groups.BIS was maintained at 40～60 during operation.Venous blood samples were obtained for determination of serum concentrations of S-100β protein and NSE before anesthesia (baseline),operation end and at 12h after operation.Patients were sent to Intensive Care Unit when operation end.All the patients were assessed for the development of delirium by experience research staff using Confusion Assessment Method for Intensive Care Unit.The incidence of postoperative delirium within 24h after operation were recorded,and compared between the two groups.Results The serum concentrations of S-100β protein and NSE was significantly increased at T1～2 than at T0 in two groups.The total dose of each anesthetic (propofol,sevoflurane),the serum concentrations of S-1005 protein and NSE,and the incidence of postoperative delirium were significantly lower in group D than in group C (P＜0.05).Conclusions Dexmedetomidine can reduce the serum concentrations of S-100 β protein and NSE,and can also reduce the occurrence of postoperative delirium in elderly patients undergoing hip joint replacement surgery.Dexmedetomidine can provides cerebral protection in elderly patients undergoing surgery.
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OBJECTIVE:To explore the efficacy and safety of probucol combined with butylphthalide in the treatment of pa-tients with acute cerebral infarction. METHODS:172 patients with acute cerebral infarction were randomly divided into observation group and control group,86 cases in each group. All patients received conventional treatment for acute cerebral infarction,includ-ing thrombolysis,anti-platelet aggregation,reducing intracranial pressure,nutritional support,intensive lipid-lowering within onset 4.5 h,timely treatment of the underlying diseases;based on it,control group received Probucol tablet,0.5 g every times,bid. Ob-servation group additionally received Butylphthalide and sodium chloride injection,100 ml every times,bid,in 9:00 and 17:00 ev-ery day,infusion within 50-90 min. Both groups lasted for 2 weeks. Lipid metabolic indexes,the changes of serum S100β,NSE and hs-CRP levels,NIHSS score,clinical efficacy before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:Compared with before treatment,triglyceride(TG),total cholesterol(TC)and low-density lipoprotein cholesterol (LDL-C) levels in 2 groups significantly decreased,high-density lipoprotein cholesterol level significantly increased, and TG,TC and LDL-C levels in observation group decreased more significantly,the differences were statistically significant(P<0.05). Serum S100β,NSE and hs-CRP levels and NIHSS scores in 2 groups significantly decreased,and NSE level NIHSS scores and in observation group decreased more significantly,the differences were statistically significant (P<0.05). The total effective rate in observation group was 89.5%,significantly higher than control group (62.8%),the difference was statistically significant (P<0.05). There were no obvious adverse reactions during treatment,and also no obvious liver and kidney function,blood coagula-tion and ECG changes. CONCLUSIONS:Probucol combined with butylphthalide can effectively improve the lipid metabolism and decrease serum NSE level in the treatment of patients with acute cerebral infarction,and plays positive role in early recovery of neu-rological function.
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Objective To observe the effects of different anesthetic solutions on postoperative cognitive function and serum S100β protein levels.Methods A prospective randomized controlled trial was conducted. Ninety patients necessary to perform off-pump coronary artery bypass grafting (op-CABG) in Tianjin Chest Hospital from November 2013 to July 2014 were enrolled. They were divided into three groups by random number table: P1, P2 and P3 groups, 30 cases in each group. The anesthesia was maintained with propofol by target-controlled infusion (TCI) in all the patients in the three groups, and the respective dosages were 3.0 - 4.0μg/mL. The operation time, anesthesia time, dosages of propofol and the incidence of postoperative cognitive dysfunction (POCD) were compared among the three groups. At the following times: before induction of anesthesia (T0), completion of anesthesia induction (T1), after tracheal intubation (T2), skin incision (T3), 1 hour after operation (T4), 2 hours after operation (T5) and the end of operation (T6), the narcotrend index (NTI) and hemodynamic levels were observed; the serum S100β protein levels were measured at the following times: before induction of anesthesia (Ta), 2 hours after operation (Tb), the end of operation (Tc), postoperative 6 hours (Td) and postoperative 24 hours (Te).Results There were no significant differences in operation times and anesthesia times among three groups (allP > 0.05); dosages of propofol in P2 and P3 groups were obviously higher than those of P1 group (mg: 1 746.3±43.9, 2 332.7±42.8 vs. 968.5±35.6, bothP < 0.05), and the incidences of POCD in P2 and P3 groups were lower than that in P1 group (10.00%, 6.67% vs. 33.33%, bothP < 0.05). With the extension of anesthesia time, the level of NTI was gradually declined in each group, in P3 group, it was occasionally increased at T6, and beginning from time point T1 afterwards, the NTI levels were lower than those of P1 and P2 groups at all the time points (allP < 0.05); the mean arterial pressure (MAP) in the three groups had a tendency of firstly going down and then increasing, and the inflection point being at T2, in P1 group, the elevation of MAP level persisted to T4, and it began to decline at T5, while in P2 and P3 groups, the levels started to decline at T4; the heart rate (HR) in three groups showed a tendency of firstly going up and then declining, and the inflection point being at T3; until T6, in P3 group, MAP and HR were all lower than those of P1 and P2 groups, the differences being statistically significant [MAP (mmHg, 1 mmHg = 0.133 kPa): 74.9±8.3 vs. 85.3±11.2, 84.2±10.1;HR (bpm): 74.1±4.2 vs. 80.9±8.1, 78.7±7.9, allP < 0.05]. The serum S100β protein levels of three groups at Tb began to be obviously higher than those at Ta, and reached the peak points at Tc, then the levels started to decline until Td, and the levels at Te was approximately close to those of Ta, but the serum S100β protein levels in P2 and P3 groups were lower than that in P1 group, the differences being statistically significant (mg/L: 1.05±0.22, 1.04±0.21 vs. 1.33±0.22, bothP < 0.05).Conclusion Application of propofol by TCI 2.0 - 3.0μg/mL for maintenance of anesthesia can achieve the satisfactory depth of anesthesia, and it not only can reduce the effects on hemodynamics, but also can decrease the serum S100β protein level and the incidence of POCD.
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OBJECTIVE:To discuss the effect of etomidate and propofol on early postoperative cognitive dysfunction (POCD)of elderly patients after laparoscopic cholecystectomy(LC)and significance of serum protein S100β to the occurrence of early POCD in total intravenous anesthesia. METHODS:60 patients aged 65 years old above undergoing LC in total LMA intrave-nous anesthesia were selected and randomly divided into etomidate group(group E)and propofol group(group P),with 30 cases in each group. Anesthesia was induced by etomidate 0.3 mg/kg (group E) or propofol 1.5 mg/kg (group P),and additionally in-duced by sufentanil 0.4 μg/kg and vecuronium 0.12 mg/kg. Anesthesia was maintained with intravenous pump of remifentanil 0.15 μg/(kg·min),continuous target controlled infusion of etomidate(target concentration 1.0-1.5 μg/ml)(group E)or propofol(target concentration 3.0-4.0 μg/ml)(group P);the dual brain index(BIS)values were maintained between 40 and 50 throμgh adjusting target concentration of etomidate or propofol. The blood samples were collected 1 h before operation(T0),2 h(T1),24 h(T2), 48 h(T3)after operation,and the content of S100βprotein was detected and mini-mental state examination(MMSE)score were re-corded. Meanwhile,recovery time,laryngeal mask removal time,intraoperative dosage and the occurrence of intraoperative aware-ness were observed and recorded in 2 groups. RESULTS:There was no statistically significant difference in MMSE score between 2 groups at different time points(P>0.05);MMSE score of 2 groups at T1 and T2 was significantly lower than at T0,with statisti-cal significance(P0.05);The contents of S100β protein in 2 groups at T1 and T2 were significantly higher than at T0,with sta-tistical significance(P0.05). The amount of ephedrine in group P was significantly higher than in group E,with statisti-cal significance (P<0.05). No intraoperative awareness oc-curred in 2 groups throμgh postoperative follow-up. CONCLUSIONS:Etomidate and propofol total intravenous anesthesia can be safely used in elderly patients with LC,and they can cause short-term POCD at different degrees. The amount of S100β protein has some relevance with the occurrence of early POCD .
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Objective To investigate the effects of naloxone injected into cisterna magna on S100β protein and neuron-specific enolase (NSE) levels in serum and the histopathology of brain tissue of rats following cardiopulmonary resuscitation(CPR). Methods Thirty adult male SD rats were randomly divided into 3 groups: Sham group, Conventional CPR group (intravenous injection of epinephrine, 0.2 mg/kg) and Naloxone CPR group(cisterna magna injection of naloxone, 2 mg/kg). Asphyxiation was used to set up rat cardiac arrest model, and corresponding drugs were given when the resuscitation was carried out. The blood samples were taken from orbital venous plexus at 0.5 h, 3 h, 6 h and 24 h after restoration of spontaneous circulation (ROSC). Enzyme-linked immunosorbent assay (ELISA) was used to detect serum levels of S100β protein and NSE. Brain tissue was taken after the last blood sampling and the pathology of brain was observed by hematoxylin-eosin (H-E) staining. Results Serum S100β protein levels of the Conventional CPR group and Naloxone CPR group were significantly higher than those of the Sham group at all time points (P <0.01); compared with the Conventional CPR group, S100β protein levels in Naloxone CPR group were significantly decreased at 3 h, 6 h, and 24 h after ROSC (P <0.05 or P <0.01). Serum NSE protein level of the Conventional CPR group at all time points and Naloxone CPR group at 6 h and 24 h after ROSC were significantly higher than those of the Sham group (P <0.05 or P <0.01). Serum NSE protein levels were significantly decreased at 6 h and 24 h after ROSC in Naloxone CPR group compared with the Conventional CPR group (P <0.05 or P <0.01). Moreover, hippocampus glial cells of Conventional CPR group were scattered and decreased, with condensed eosinophilic cytoplasm, narrowed nuclues, unclear nucleolus, and swollen and deformed capillaries. However, most nerve cells of Naloxone CPR group had rich cytoplasm and the nucleolus was clear; only a few nerve cells and capillaries showed edema-like changes of different degrees. Conclusion Naloxone injected into cisterna magna has a prominent protective effect on the brain of rats following cardiopulmonary resuscitation.
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Objective To study the protective effect of erythropoietin (EPO) on brain tissue with cardiac arrest-cardiopulmonary resuscitation (CA-CPR) and its mechanism.Methods 120 male Sprague-Dawley (SD) rats were randomly divided into three groups (each n =40),namely:sham group,routine chest compression group,and conventional chest compression + EPO group (EPO group).The rats in each group were subdivided into CA and 6,12,24,48 hours after restoration of spontaneous circulation (ROSC) five subgroups (each n =8).The model of CA was reproduced according to the Hendrickx classical asphyxia method followed by routine chest compression,and the rats in sham group only underwent anesthesia,tracheostomy intubation and venous-puncture without asphyxia and CPR.The rats in EPO group were given the routine chest compression + EPO 5 kU/kg (2 mL/kg) after CA.Blood sample was collected at different time points of intervention for the determination the content of serum S100 β protein by enzyme linked immunosorbent assay (ELISA).All the rats were sacrificed at the corresponding time points,and the hippocampus was harvested for the calculation of the number of S100 β protein positive cells,and to examine the pathological changes and their scores at 24 hours after ROSC by light microscopy.Results With prolongation of ROSC time,the serum levels of S100 β protein (μg/L) in the routine chose compression group and the EPO group were significantly elevated,peaking at 24 hours (compared with CA:305.7 ± 29.2 vs.44.4 ± 6.2 in routine chest compression group,and 276.7±28.9 vs.44.7±5.6 in the EPO group,both P ＜ 0.05),followed by a fall.The levels of S100β protein at each time point after ROSC in EPO group were significanthy lower than those of the routine chest compression group (83.2 ± 7.5 vs.114.3 ± 15.3 at 6 hours,123.9 ± 20.2 vs.184.9 ± 22.2 at 12 hours,276.7 ± 28.9 vs.305.7 ± 29.2 at 24 hours,256.3 ± 26.6 vs.283.2 ± 23.6 at 48 hours,all P ＜ 0.05).With the prolongation of ROSC time,the S100 β protein positive cell number in brain (cells/HP) in the routine chest compression group and the EPO group was significantly increased,peaking at 24 hours (compared with CA:14.3±2.2 vs.6.7±0.7 in the routine chest compression group,11.3± 1.3 vs.6.8±0.9 in the EPO group,both P ＜ 0.05),then it began to fall.The S100 β protein positive cell number in brain at each time point after ROSC in the EPO group was significantly lower than that of the routine chest compression group (7.0±0.9 vs.7.9± 1.9 at6 hours,8.4± 1.1 vs.10.2±2.2 at 12 hours,11.3± 1.3 vs.14.3±2.2 at24 hours,8.3±0.8 vs.10.8±2.0 at48 hours,all P ＜ 0.05).Under the light microscope,a serious brain cortex injury was found after reproduction of the model,and the degree of injury was reduced after EPO intervention.The pathological score at 24 hours after ROSC in EPO group was lower than that of routine chest compression group (3.83±0.73 vs.4.17±0.75,P ＜ 0.05).Conclusions The S100β protein level in serum and brain tissue was increased early in asphyxia CA-CPR rats.EPO intervention can reduce the expression of S100 protein and reduce the degree of brain injury.
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Objective To investigate the diagnostic value of nuron specific enolase( NSE),S100βprotein,glial fibrillary acidic protein( GFAP)and myelin basic protein( MBP)in patients with early brain contusion and laceration. Methods One hundred and twelve cases with brain contusion and laceration diagnosed by CT or MRI were selected as our subjects who hospitalized Harrison international peace hospital from Apr. 2012 to Jul. 2013. Of them,68 cases with mild head injury were served as mild group and 44 cases of severe traumatic brain injury were served as severe group. And 83 healthy people without lung disease and nervous system diseases were served as control group. Electro chemiluminescence assay and ELISA methods were used to measure the level of NSE,S100β,GFAP,MBP. Results the level of serum NSE,S100β protein,GFAP and MBP in mild group were(18. 14 ± 6. 83),(0. 92 ± 0. 45),(0. 78 ± 0. 37))(4. 37 ± 1. 84)μg/ L,respectively, and(32. 11 ± 12. 48),(1. 58 ± 0. 94),(4. 26 ± 1. 96),(14. 72 ± 6. 77)μg/ L,respectively in severe group, and(8. 94 ± 3. 49),(0. 12 ± 0. 08),(0. 13 ± 0. 09),(1. 98 ± 0. 89)μg/ L,respectively in control group. There were significant differences among three groups( F = 137. 520,120. 083,283. 727,205. 569 respectively;P< 0. 01). All indexes were different between control and mild groups( q = 10. 599,13. 296,5. 881,6. 018;P< 0. 01),as well as between the mild and severe groups(q = 13. 600,9. 249,26. 639,22. 029;P < 0. 01),and between control and severe group(q = 23. 408,21. 258,32. 797,28. 134;P < 0. 01). Conclusion The level of serum NSE,S100β,GFAP,MBP can be used as early indicators of brain injury secondary diagnosis and secondary index for evaluating damage degree.
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Objective To study the applicability of unilateral and bilateral antegrade cerebral perfusion during deep hy-potbermia circulatory arrest (DHCT) surgery and to determine a better method of brain protection. Methods 60 patients un-derwent aortic arch surgery were random divided into either unilateral cerebral perfusion group with a cannula in the innominate artery (n = 30 ) , or bilateral cerebral peffusion gToup with an additional cannula in the left carotid artery ( n = 30 ). S-100β,neuron specific enolase (NSE) were assayed at the following time points: the beginning of cardiopulmonary bypass (T_1), the beginning of circulatory arrcst( T_2 ), antegradc cerebral perfusion (ACP) 25 min( T_3 ), the end of ACP( T_4 ), the end of car-diopulmonary bypass ( T_5 ) , 1h( T_6 ) , 6h ( T_7 ) and 24h( T_8 ) after operation. Neurological deficit incidence and mortality were also obtained. Results There is no statistical significance for S-100β and NSE plasma concentration among time points of T_1、T_2 and T_3. But every time point among T_4、T_5、T_6、T_7 ,Ts do have statistical significances. The incidence of central nervous system dysfunction in group unilateral ACP was higher than that in group bilateral ACP ( 33.33% vs. 10.00%, P = 0.028 ).But there is no significant difference between the two groups in mortality( 3.33% vs. 6.66% ,P = 1. 000 ). Conclusion There is no significant difference between unilateral ACP and bilateral ACP in 25 min during DHCA. But as the DHCA time extends, the effect of bilateral ACP will be better.
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Objective To investigate the serum concentration and expressions of S100β protein in hippocampus CA1 region and the changes of water content in rats with asphyxia following ulinastatin injection after cardiopul-monary resuscitation (CPR). Method One hundred twenty male adult SD rots were randomly divided into 3 groups:sham-operation group, CPR group and ulinastafin group. And each group was further divided into 5 sub-groups (n=8) based on various intervals, 0.5 h,3 h,6 h,12 h and 24 h after tracheotomy in sham-operation group or after ROSC in CPR group and ulinastatin group. Asphyxial cardiac arrest and CPR model of rat was used in CPR group and ulinastatin group in which bolus dose of 100 000 U/kg ulinastatin was injection into arteria carotis. Anaesthesia, tracheotomy and vascular canratlafion without asphyxia and CPR in sham-operation group. Samples from subgroups were taken at different intervals. Brain water content was measured by using wet-dry weight method. Serum S100β protein was measured with enzyme-linked immunosorbent assay ( ELISA). The expres-sion of S100β protein in hippocampus CA1 region was measured by using immunohistochemistry. Data were ana-lyzed by SPSS version 10.0 software. Results Compared with sham-operation group, the brain water content of rats elevated significantly in all CPR subgroups after ROSC (P<0.05 or P<0.01). The brain water content of rats decreased significantly 12 h and 24 h after ROSC in ulinastatin group in comparison with CPR group (P<0.05). The serum S100β protein started to elevated significantly 0.5 h after ROSC in CPR group, and reached the peak 12 h after ROSC (P<0.01).serum S100β decreased 6 h,12 h and 24 h after ROSC in ulinastatin group compared with CPR group (P<0.01).The expression of S100β protein in hippocampus CA1 region remained at a low level in sham-operation group. The expression of S100β protein elevated significantly in all CPR subgroups after ROSC compared with sham-operation group (P<0.05 or P<0.01). Compared with CPR group, the ex-pression of S100β protein decreased after ROSC in ulinastatin group(P<0.05) .However,the expression of S100β protein in hippocampus CA1 region was significantly correlative with brain edema in all subgroups of CPR (r=0.862, P<0.05). Conclusions Ulinastatin can decrease serum S100β protein and the expression of S100β pro-tein in hippocampus CA1 region and lessen the severity of cerebral edema, alleviate the brain isehemic injury in rats after cardiopulmonary resuscitation.
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Objective To observe the expression of S100β protein in the traumatic brain injury and investigate its relation to the severity of the TBI patients.Methods To collect 30 volunteer controls,30 patients with traumatic brain injury and 30 patients with trauma expect traumatic brain injury.according Glasgow Coma Scale(GCS),TBI patients were divided into tow groups,the minor group is GCS≥8,the severegroup is GCS<8.ELISA method was used for observing the expression of S100β protein in serum from the controls and patients.Results Within 6 hours after TBI,the concentration of S100β protein increased higher in patients of TBI than the others(P<0.05).The concentration of S100β protein increased higher in the severe group(GCS<8)than the minor group(P<0.05).The higher level of seium S100β protein,the more severe of TBI patients,the higher level of serum S100β protein.Conclusion The serums S100β protein can be a special index for the early diagnosis of TBI,the higher level of it,The more severe of patients.
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Objective To explore the effects of Tongfu Huayu Daotan Decoction (通化阏导痰汤)on the serum concentration of S-100β protein, neuron-specific enolase(NSE) and Prognosis in patients with severe craniocerebral injury.Methods Sixty patients with severe craniocerebral injury were randomly divided into a a'eatment group and a control group.The treated group was treated with Tongfu Huayu Daotan Decoction plus conventional treatments including dehydration,antibiotics, organ functional support, nerve nutrition, prevention of complication, etc.; the control group was treated with conventional treatments alone. The concentration of serum S-100β protein and neuron-specific enolase(NSE) in plasma at admission and at24, 36, 72huors, and 5, 7 days after treatment were determined respectively; the Glasgow outcome scale (GOS)and neurological deficits scoring at 2weeks and 4weeks after hospitalization were compared to observe the efficacy of the patients. Results The concentration of serum S-100β protein and neuron-specific enolase (NSE) in plasma at previous treatment and at 24, 36 hours after the treatment had no statistical difference in the two groups(P＞0.05 ), The concentration of serum S-100β protein and neuron-specific enolase (NSE) in plasma at 72huors, 5 and 7 days after the treatment in the Tongfu Huayu Daotan Decoction group were lower than those in the control group, the differences being significant (P＜0.01). The Glasgow outcome scale (GOS) and neurological deficits scoring at 2weeks and 4weeks after the treatment in the Tongfu Huayu Daotan Decoction group were significantly nigher than those in the control group, the differences being significant (P＜0.01) .Conclusion Tongfu Huayu Daotan Decoction can alleviate the plasma concentrations of S-100β protein and neuron-specific enolase (NSE) in patients with severe craniocerebral injury and markedly improve the clinical therapeutic effects. Combined Tongfu Huayu Daotan Decoction and western medicine can significantly reduce mortality and improve the Glasgow outcome scale (GOS), neurological deficits scoring and therapeutic effect.