RESUMO
Objective To investigate the effect of ultrasound guided block of pericapsular nerve(PENG)combined with lateral femoral cutaneous nerve(LFCN)on analgesia,stress response and postoperative cognitive function in patients undergoing hip replacement.Methods 102 patients who underwent hip Joint replacement in our hospital from September 2020 to September 2022 were selected and randomly divided into control group(51 cases)and study group(51 cases).The control group was given ultrasound guided iliac fascia space block(FICB),and the study group was given ultrasound guided PENG combined with LFCN block.The perioperative related indicators,postoperative analgesia effect,stress response indicators and postoperative cognitive function of the two groups were compared.Results There was no statistically significant difference in the comparison of surgical time between the two groups(P>0.05).The amount of sufentanil used and the number of analgesic pump used within 48 hours after surgery in the study group were significantly lower than those in the control group(P<0.05).The first postoperative time of getting out of bed and hospitalization in the study group were significantly shorter than those in the control group(P<0.05).There was no statistically significant difference in VAS scores between the two groups at 6 h,12 h,24 h,and 48 h after surgery(P>0.05).The VAS scores of the study group were significantly lower than those of the control group at 6 h,12 h,and 24 h after surgery(P<0.05).The heart rate(HR)and Mean arterial pressure(MAP)of the control group were higher at the time of block(T1),30 min of block(T1)(T2),and the end of block(T3)than at the time of entry(T0)(P<0.05).HR and MAP of the study group were significantly lower than those of the control group(P<0.05).The MMSE scores of the two groups at 6 h,12 h,24 h,and 48 h after surgery were lower than those before surgery(P<0.05),but the MMSE scores of the study group were significantly higher than those of the control group(P<0.05).Conclusion Using ultrasound guided PENG combined with LFCN block for patients undergoing hip Joint replacement can more effectively reduce the amount of opioids and the number of use of analgesia pump,reduce postoperative pain in the exercise state,reduce stress reaction,and have less impact on cognitive function,so as to promote faster recovery of patients.
RESUMO
OBJECTIVE:To investigate protective effects of different doses of atorvastatin pretreatment on non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients underwent percutaneous coronary intervention (PCI). METHODS:A total of 81 NSTE-ACS patients in a hospital during Jan. 2014-Apr. 2016 were divided into high-dose group(40 cases)and low dose group(41 cases)according to random number table. High-dose group was given Atorvastatin calcium tablet 80 mg 12-24 h before PCI,and then 40 mg 2 h before PCI. Low-dose group was given Atorvastatin calcium tablet 10 mg 12-24 h before PCI. Fractional flow reserve(FFR),coronary flow reserve(CFR)and index of microcirculation resistance(IMR)after surgery were all observed in 2 groups. The levels of creatine kinase(CK),creatine kinase myocardial band(CK-MB)and high sensitive C-re-active protein (hs-CRP) were compared between 2 groups before and after surgery. RESULTS:There was no statistical signifi-cance in FFR and CFR after surgery between 2 groups (P>0.05);IMR of high-dose group was significantly lower than low-dose group,with statistical significance(P<0.05). There was no statistical significance in CK,CK-MB or CRP between 2 groups before surgery(P>0.05). After surgery,the levels of CK-MB and CRP in low-dose group were significantly higher than high-dose group,with statistical significance(P<0.05). There was no statistical significance in CK level between 2 groups after surgery (P>0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:During PCI,pre-treatment with high-dose of atorvastatin(80→40 mg)could effectively improve microcirculatory disturbance and inhibit inflammatory reaction of NSTE-ACS patients.
RESUMO
Objective To explore the antidepressant effects of low dose fisetin combined with piperine and its possible mechanism. Methods The tail suspension test and the forced swimming test were used to explore the antidepressant ef-fects of low dose fisetin combined with piperine. In addition, the locomotor activity test was used to exclude the false positive effect in behavioral despair tests. High performance liquid chromatography (HPLC) was used to determine the expression of monoamine. The monoamine oxidase activity in the mouse brain was also determined by fluorospec-trophotometry. Results The results showed that fisetin (1.25 mg/kg, 2.5 mg/kg and 5 mg/kg, ig) combined with piperine (2.5 mg/kg, ip) significantly reduced the duration of immobility in both tail suspension and forced swimming tests. The effective doses did not alter locomotor activity. Moreover, neurochemical assays showed that its produced an increase in monoamine levels in the hippocampus, fronal cortex and amygdala. Monoamine oxidase (MAO) activity in the mouse brain was inhibited while MAO-B activity was not affected. Conclusion These findings suggestde that low dose fisetin combined with piperine exerted antidepressant effect in behavioral despair tests and the underlying mechanism may in-volve the inhibition monoamine oxidase activity in the mouse brain.
RESUMO
This study is to explore the amelioration of piperine on chronic acute combining stress rat with depression-like behavior, visceral sensitivity, and its effect on the expression of serotonin (5-HT) and synaptophysin. Forty two SD rats were divided into seven groups: blank group, model group, piperine (12.5, 25, 50 and 100 mgkg-1, ig) and imipramine (10 mgkg-1, ip) groups. The rat model of irritable bowel syndrome was established by chronic acute combining stress, and then to evaluate depression-like behavior and visceral sensitivity. The expressions of 5-HT and synaptophysin in the hippocampus and colon were determined by high performance liquid chromatography (HPLC) and Western blotting, respectively. The duration of immobility of IBS rat in the forced swimming test had been significantly increased, the sucrose consumption of IBS rat had been reduced and visceral sensitivity was obviously elevated in the IBS model group as compared with those in the normal control group (P<0.05, P<0.01). As compared with those in the normal control group, the expression of 5-HT significantly decreased, 5-HIAA/5-HT ratio significantly increased in the hippocampus of IBS model group (P<0.05), but opposite presentations were noted in the colon (P<0.05). As compared with that in the normal control group, the synaptophysin expression in the hippocampus decreased significantly but obviously increased in the colon (P<0.05). Piperine improved the behavior of IBS rats, and reversed the levels of 5-HT and 5-HIAA, and 5-HIAA/5-HT proportion in the hippocampus and colon (P<0.05); besides, they significantly reverse the synaptophysin level in the hippocampus and colon (P<0.05). The presence of depression and visceral sensitivity had been changed in IBS rats, with abnormal expression of 5-HT and synaptophysin in the brain-gut system. Piperine can ameliorate the changes of the behavior and regulation of serotonin and synaptophysin expression in IBS rat model.