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Objective To compare the efficacy of femoral triangle versus adductor canal approach to saphenous nerve block for postoperative analgesia in the patients undergoing knee arthroplasty.Methods Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 53-68yr,scheduled for elective total knee arthroplasty under general anesthesia,were assigned into 2 groups (n=30 each) using a random number table method:femoral triangle approach to saphenous nerve block group (group F) and adductor canal approach to saphenous nerve block group (group A).Femoral triangle and adductor canal approach to saphenous nerve block was performed by injecting 0.5% ropivacaine 20 ml in group F and group A,respectively.Patient-controlled saphenous nerve block analgesia was used in two groups,and the analgesic pump solution contained 1% ropivacaine 400 mg diluted to 160 ml in 0.9% sodium chloride injection.The analgesic pump was set up with a 5 ml bolus dose,a 30-main lockout interval and background infusion at a rate of 5 ml/h,and analgesia lasted until 72 h after operation.When visual analog scale score > 4 and pain was not relived after 30-min pressing by patients,pethidine hydrochloride 100 mg was intramuscularly injected as rescue analgesic.The muscle strength of quadriceps femoris was assessed by manual muscle test at 4,8,24,48 and 72 h after operation.The patient's satisfaction score was assessed and recorded at 72 h after operation.Rescue analgesia and development of adverse reactions (local anesthetic intoxication,itching,dizziness,urinary retention,nausea and vomiting) were recorded within 72 h after operation.Results Compared with group F,the muscle strength of quadriceps femoris was significantly increased at 4,8 and 24 h after operation,the rate of postoperative rescue analgesia was decreased (P<0.05),and no significant change was found in patient's satisfaction score or incidence of adverse reactions in group A (P>0.05).Conclusion Adductor canal approach to saphenous nerve block provides better efficacy for postoperative analgesia than femoral triangle approach to saphenous nerve block in the patients undergoing knee arthroplasty.
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Objective To evaluate the effect of bone marrow-derived mesenchymal stem cells (BMSCs) on transforming growth factor-β1 (TGF-β1)/Smad signaling pathway during acute lung injury (ALI) in rats.Methods Healthy clean-grade adult male Sprague-Dawley rats,aged 4-5 weeks,weighing 100-120 g,were selected,and BMSCs were prepared and cultured in vitro.Eighty-four healthy clean-grade adult male Sprague-Dawley rats,aged 4 weeks,weighing 170-190 g,were selected and divided into 4 groups (n=21 each) using a random number table method:control group (group C),group ALI,ALI plus BMSCs group (group ALI + BMSCs),and ALI plus phosphate buffer solution (PBS)group (group ALI+PBS).ALI was induced by intraperitoneally injecting 5 mg/kg lipopolysaccharide 0.5 ml in anesthetized rats.In group ALI+BMSCs,1×104 cells/ml BMSCs 0.5 ml (in PBS) was injected via the tail vein after intraperitoneal injection of lipopolysaccharide.PBS 0.5 ml was injected via the tail vein after intraperitoneal injection of lipopolysaccharide in group ALI+PBS.Arterial blood samples were collected at 6,24 and 48 h after injecting BMSCs for blood gas analysis and for determination of wet to dry weight ratio (W/D ratio),pathological changes (using haematoxylin and eosin staining),and expression of TGF-β1,Smad2 and Smad3 in lung tissues (by Western blot).Results Compared with group C,PaO2 was significantly decreased,PaCO2 and W/D ratio were increased,the expression of TGF-β1,Smad2 and Smad3 in lung tissues was up-regulated (P<0.05),and the pathological changes of lung tissues were accentuated in ALI,ALI+BMSCs and ALI+PBS groups.Compared with group ALI,PaO2 was significantly increased,PaCO2and W/D ratio were decreased,the expression of TGF-β1,Smad2 and Smad3 in lung tissues was down-regulated (P<0.05),and the pathological changes of lung tissues were significantly reduced in group ALI+BMSCs.Conclusion The mechanism by which BMSCs mitigates ALI may be associated with inhibiting TGF-β1/Smad signaling pathway in rats.
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Objective@#To compare the efficacy of femoral triangle versus adductor canal approach to saphenous nerve block for postoperative analgesia in the patients undergoing knee arthroplasty.@*Methods@#Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes, aged 53-68 yr, scheduled for elective total knee arthroplasty under general anesthesia, were assigned into 2 groups (n=30 each) using a random number table method: femoral triangle approach to saphenous nerve block group (group F) and adductor canal approach to saphenous nerve block group (group A). Femoral triangle and adductor canal approach to saphenous nerve block was performed by injecting 0.5% ropivacaine 20 ml in group F and group A, respectively.Patient-controlled saphenous nerve block analgesia was used in two groups, and the analgesic pump solution contained 1% ropivacaine 400 mg diluted to 160 ml in 0.9% sodium chloride injection.The analgesic pump was set up with a 5 ml bolus dose, a 30-min lockout interval and background infusion at a rate of 5 ml/h, and analgesia lasted until 72 h after operation.When visual analog scale score > 4 and pain was not relived after 30-min pressing by patients, pethidine hydrochloride 100 mg was intramuscularly injected as rescue analgesic.The muscle strength of quadriceps femoris was assessed by manual muscle test at 4, 8, 24, 48 and 72 h after operation.The patient′s satisfaction score was assessed and recorded at 72 h after operation.Rescue analgesia and development of adverse reactions (local anesthetic intoxication, itching, dizziness, urinary retention, nausea and vomiting) were recorded within 72 h after operation.@*Results@#Compared with group F, the muscle strength of quadriceps femoris was significantly increased at 4, 8 and 24 h after operation, the rate of postoperative rescue analgesia was decreased (P<0.05), and no significant change was found in patient′s satisfaction score or incidence of adverse reactions in group A (P>0.05).@*Conclusion@#Adductor canal approach to saphenous nerve block provides better efficacy for postoperative analgesia than femoral triangle approach to saphenous nerve block in the patients undergoing knee arthroplasty.
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Objective To evaluate the effect of bone marrow-derived mesenchymal stem cells (BMSCs) on mammalian target of rapamycin (mTOR) signaling pathways in lung tissues of rats with acute lung injury (ALI).Methods Healthy pathogen-free adult male Sprague-Dawley rats were selected,and the BMSCs were obtained and cultured in vitro.One hundred and five healthy clean adult male SpragueDawley rats,weighing 170-190 g,were divided into 5 groups (n=21 each) using a random number table:control group (group C),PBS group,group ALI,ALI plus BMSC group (group ALI+BMSCs),and ALI plus phosphate buffer solution (PBS) group (group ALI+PBS).Group C received no treatment.PBS 0.5 ml was injected via the tail vein in group PBS.Lipopolysaccharide (LPS,0.5 ml) 5 mg/kg was intraperitoneally injected to establish the model of ALI in group ALI.BMSCs (0.5 ml) 1×104 cells/ml were injected via the tail vein after intraperitoneal injection of LPS in group ALI+ BMSCs.PBS 0.5 ml was injected via the tail vein after intraperitoneal injection of LPS in group ALI+PBS.Arterial blood samples were collected for blood gas analysis at 6,24 and 48 h after injection of BMSCs.Lungs were then removed for determination of wet/dry weight ratio (W/D ratio) and expression of mTOR,nuclear factor kappa B (NF-κB) and tumor necrosis factor-alpha (TNF-o) in lung tissues (by Western blot) and for examination of the pathologic changes of lungs tissues (using haematoxylin and eosin staining).Results Compared with group C,pH value and PaO2 were significantly decreased,PaCO2 and W/D ratio were increased,and the expression of mTOR,NF-κB and TNF-α was up-regulated at each time point in ALI,ALI+BMSCs and ALI+PBS groups (P<0.05).Compared with group ALI,pH value and PaO2 were significantly increased,PaCO2 and W/D ratio were decreased,the expression of mTOR,NF-κB and TNF-α was down-regulated at each time point (P<0.05),and the pathologic changes of lungs tissues were significantly attenuated in group ALI+BMSCs.Conclusion The mechanism by which BMSCs reduce ALI may be associated with inhibiting mTOR signaling pathways in lung tissues of rats.
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As a pandemic metabolic disease, obesity has become a worldwide problem, which endangering human health. The change in body weight reflects the energy imbalance. And the homeostasis regulation of the central and peripheral melanocortin system may maintain the energy balance and then affect the body weight. Recent studies have found that melanocortin receptor-4 ( MC4R) plays an important role in energy homeostasis and body weight changes, but its specific mechanism needs further elucidation. In this paper, we reviewed the research progress of MC4R in body weight and energy regulation, so as to provide a theoretical basis for further exploring the potential role of MC4R in improving energy metabolism imbalance and obesity.
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To explore the treatment method and preventive measures on epidemic keratoconjunctivitis. 108 patients with epidemic keratoconjunctivitis who received treatment in our hospital from January, 2015 to September, 2015.were selected. These patients were treated with interferon eye drops, Ganciclovir ophthalmic gel, and alternating eye treatment of tobramycin-dexamethasone eye drops and diclofenac sodium eye drops. Meanwhile, health education was also performed among patients, so as to promote the recovery of the disease as soon as possible and to prevent the spread of the disease Among the 108 patients, there were 101 patients recovered. 7 patients had cornea remained sub epithelial round hoary haze, including 2 patients with evident cornea remained sub epithelial round hoary haze due to the occurrence of glucocorticoid-induced intraocular pressure and the tobramycin and dexamethasone eye drops were suspend. The clinical cure rate was 91.79%. There was no pathophoresis to health patients among the 108 patients. Active treatment of epidemic keratoconjunctivitis, combined with health education and publicity could increase the clinical cure rate and control the transmit of the disease spread
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Objective To evaluate the efficacy of intra-articular dexmedetomidine mixed with ropivacaine for postoperative analgesia after arthroscopic knee surgery.Methods Sixty ASA physical status Ⅰ or Ⅱ patients,aged 20-64 yr,weighing 50-90 kg,with body height 160-180cm,scheduled for elective arthroscopic knee surgery,were randomly assigned into 2 equal groups using a random number table:ropivacaine group (group R) and dexmedetomidine mixed with ropivacaine group (group RD).In group R,the mixture of noraml saline 1 ml and 19 ml of 0.25% ropivacaine was injected intra-articularly at the end of surgery.In group RD,the mixture of dexmedetomidine 1 μg/kg and 19 ml of 0.25% ropivacaine was injected intra-articularly at the end of surgery.VAS scores at rest and during activity were observed and recorded at 1,2,4,8,12,20 and 24 h after surgery.The duration of analgesia after sugery (from the time immediately after intra-articular administration to the time of first administration of fentanyl as an adjunct to analgesia) and consumption of fentanyl at 24 h after surgery were recorded.Results Compared with group R,VAS scores were significantly decreased at 1,2,4 and 8 h after surgery,the duration of analgesia after sugery was prolonged,and the consumption of fentanyl at 24 h after surgery was reduced in group RD (P < 0.05 or 0.01).There was no significant difference in VAS scores at 12-24 h after surgery between the two groups (P > 0.05).Conclusion Intra-articular dexmedetomidine can significantly improve the efficacy of ropivacaine for postoperative analgesia after arthroscopic knee surgery.