Propofol ameliorates cognitive deficits following splenectomy in aged rats by inhibiting ferroptosis via the SIRT1/Nrf2/GPX4 pathway.

The aim of this study was to investigate the mechanism by which propofol reduces postoperative cognitive dysfunction after splenectomy in aged rats. The rats in the model group and propofol group were subjected to splenectomy, and anesthetized with isoflurane and propofol, respectively. Utilizing the western blotting to assess the expression of sirtuin-1 (SIRT1) in the hippocampus. Molecular docking technology was used to predict the binding ability of propofol and SIRT1. Behavioral tests were performed using the Morris water maze, and the hippocampus was isolated for mechanistic investigations. Molecular docking showed that propofol and SIRT1 had a strong binding affinity. The expression of SIRT1 and its related proteins Nrf2, HO-1, NQO1, and GPX4 in the model rats was decreased compared with the sham group. Moreover, the model group exhibited cognitive decline, such as extended escape latency and decreased number of platform crossings. Pathological analysis showed that the number of apoptotic neurons, the levels of oxidative stress and neuroinflammation, the iron deposition, and the expressions of ACSL4 and TFR1 were increased, while the expressions of SLC7A11 and FTH1 were decreased in the hippocampal CA1 region within the model group. These pathological changes in the propofol group were, however, less than those in the model group. Nevertheless, the SIRT1 inhibitor increased these pathological changes compared with the propofol group. Compared with isoflurane, propofol inhibits ferroptosis in the hippocampus of splenectomized rats by causing less downregulation of the SIRT1/Nrf2/GPX4 pathway, thereby reducing the negative impact on cognitive function.

Effects of Different Volumes of Ropivacaine for Pericapsular Nerve Group Block on Incidence of Quadriceps Weakness and Analgesic Efficacy Following Hip Arthroplasty: A Randomized Controlled Trial.

INTRODUCTION: The pericapsular nerve group (PENG) block has been shown to be an effective approach to alleviating pain and reducing the need for opioids among older adults following hip surgery, with possible motor-sparing effects. No reports to date, however, have described appropriate ropivacaine volumes for use in the context of PENG block. The present prospective randomized controlled study was thus developed to assess the quadriceps muscle strength and analgesic efficacy associated with PENG block performed using three different volumes of 0.33% ropivacaine following general anesthesia in older adults undergoing hip arthroplasty. METHODS: In this prospective randomized double-blind controlled clinical study, 60 patients were assigned at random to undergo ultrasound-guided PENG block for hip arthroplasty using different volumes of ropivacaine. Specifically, these patients were administered 10 ml (Group A, n = 20), 20 ml (Group B, n = 20), or 30 ml (Group C, n = 20) of 0.33% ropivacaine. Quadriceps muscle strength was evaluated at 6 h post-surgery. Visual analog scale (VAS) scores at rest and with movement were assessed at 4, 6, 12, and 24 h post-surgery. Block duration, adverse event incidence, and patient satisfaction were evaluated at 24 h post-surgery. RESULTS: Quadriceps motor block incidence rates at 6 h post-surgery in the 10 ml, 20 ml, and 30 ml groups were 5%, 20%, and 75%, respectively. Quadriceps muscle weakness at 6 h post-surgery was significantly more common in the 30 ml group relative to the others (p < 0.001). Patients administered 10 ml 0.33% ropivacaine exhibited significantly higher VAS pain scores at rest and with movement relative to those patients in the 20 ml and 30 ml treatment groups at all time points (p < 0.05). No apparent differences in analgesic efficacy were observed when comparing the 20 ml and 30 ml groups at 4, 6, 12, and 24 h post-surgery. No significant differences in block duration, satisfaction, or adverse event incidence were observed among groups. CONCLUSIONS: The preservation of motor function in the 20 ml 0.33% ropivacaine group was superior to that in the 30 ml 0.33% ropivacaine group. Relative to the group that received 10 ml 0.33% ropivacaine during PENG block, those elderly patients administered 20 ml and 30 ml volumes of 0.33% ropivacaine experienced superior postoperative pain relief following hip arthroplasty.

The Efficiency of Ultrasound-Guided Pericapsular Nerve Group Block for Pain Management after Hip Surgery: A Meta-analysis.

INTRODUCTION: Patients with hip surgery often experience moderate to severe postoperative pain, and need large doses of opioids to relieve it, which is not conducive to patient rehabilitation. Pericapsular nerve group (PENG) block is a new regional block technique that is considered to reduce postoperative pain and the use of opioids. The purpose of this study was to evaluate the efficacy and safety of PENG block for postoperative analgesia after hip surgery. METHODS: We searched multiple databases for randomized controlled trials (RCTs) published in English, which compared PENG block with fascia iliaca compartment block (FICB). The primary outcome was 24 h postsurgical opioid consumption (OC). The secondary outcomes were pain scores (PSs) at different timepoints after surgery and the incidence of postoperative nausea and vomiting (PONV). RESULTS: Five RCTs involving 234 patients were selected for our analysis. Our results show that the 24 h OC was drastically lower in PENG block versus FICB patients (SMD -0.60, 95% CI -1.08 to -0.11); P < 0.05, I2 = 69%). At the same time, there were no significant difference in postsurgical PSs between the two cohorts (6 h: MD -0.07, 95% CI -0.67 to 0.53; P = 0.82, I2 = 43%; 12 h: MD -0.60, 95% CI -1.40 to 0.19; P = 0.14, I2 = 31%; 24 h: MD 0.17, 95% CI -0.87 to 1.21; P = 0.75, I2 = 76%; 36 h: MD 0.80, 95% CI -0.92 to 2.51; P = 0.36, I2 = 73%; 48 h: MD -0.06, 95% CI -0.75 to 0.63; P = 0.86, I2 = 0%) and the incidence of PONV (RR 1.00, 95% CI 0.40-2.50, P = 1.00, I2 = 35%). CONCLUSIONS: Our research shows that PENG block can reduce the use of opioids after hip surgery and is effective in postoperative analgesia. Future research should explore the injection method, concentration, and dosage.

[Effect of moxibustion at "acupoint-open on-time" on immune function and nuclear factor-κB signaling pathway in aging rats].

OBJECTIVE: To observe the effect of moxibustion at "acupoint-open on-time" （Linggui Bafa） on immune function and nuclear factor-κB (NF-κB) signaling pathway in aging rats, so as to reveal its underlying mechanism of anti-agingt. METHODS: Forty SD rats were randomly divided into control, model, "Linggui Bafa" and "Shenque (CV8)" groups (n=10 in each group). Aging model was established by intraperitoneal injection of D-galactose (300 mg/kg) for 42 days. Moxibustion was applied at "acupoint-open on-time" or CV8 once daily for 28 days. The serum levels of TNF-α, IgG, IgA and IgM were detected by ELISA. The spleen index of rats was calculated. The expression of NF-κB p65 and NF-κB inhibitor protein (IκB) α mRNA of spleen tissues was detected by real-time PCR. RESULTS: Compared with the control group, the expression level of serum TNF-α, the mRNA expression levels of NF-κB p65 and IκBα in the model group was significantly increased (P<0.01), while the expression levels of serum IgG, IgA and IgM, and the spleen index in the model group were significantly decreased (P<0.01). After the treatment, mode-ling-induced increase of serum TNF-α, NF-κB p65 and IκBα mRNA expression levels and decrease of serum IgG, IgA, IgM levels, the spleen index were all completely reversed in the two treatment groups relevant to the model group (P<0.01, P<0.05). No significant change was found in the above-mentioned indexes between the two treatment groups (P>0.05). CONCLUSION: Moxibustion at both "acupoint-open on-time" and CV8 can enhance the immune function of aging rats, which may be related to its effects in inhibiting NF-κB signaling pathway.

[Effect of moxibustion at "Shenque" (CV8) and "Zusanli" (ST36) on expression of adiponectin and adiponectin receptor in Alzheimer's disease rats].

OBJECTIVE: To observe the effect of moxibustion on serum adiponectin content, and expression of adiponectin and adiponectin receptor in adipose tissue in Alzheimer's disease (AD) rats, so as to explore its mechanism underlying improvement of AD. METHODS: Fifty male SD rats were randomly divided into control, model, Shenque (CV8), Zusanli (ST36) and CV8＋ST36 groups (n＝10 in each group). The AD model was established by intraperitoneal injection of D-galactose (400 mg•kg－1•d－1) for 5 weeks and scopolamine hydrobromide (3 mg •kg－1•d－1) for 2 weeks. Moxibustion was applied to CV8, ST36 and CV8＋ST36 respectively for 3 moxa-cones every time, once daily for 5 weeks. Morris water maze tests were used to assess the rats' learning-memory ability. The contents of serum adiponectin were assayed using ELISA, and the expression of adiponectin and adiponectin receptor in the adipose tissue was detected by quantitative real-time PCR and Western blot, separately. RESULTS: Following modeling, the average escape latency of Morris water maze tests was significantly prolonged (P<0.05), the content of serum adiponectin and the expression level of adiponectin mRNA in adipose tissue were significantly decreased (P<0.01), the expression of adiponectin receptor protein significantly decreased in the model group relevant to the control group (P<0.01). After the intervention, the average escape latency was significantly shortened (P<0.05), the decreased serum adiponectin content and adiponectin mRNA expression, and the decreased adiponectin receptor protein expression in adipose tissue were all reversed in the 3 treatment groups (P<0.01，P<0.05). No significant differences were found among the three moxibustion groups in the above indexes (P>0.05). CONCLUSION: Moxibustion at CV8, ST36 and CV8＋ST36 is effective in up-regulating serum adiponectin content，adiponectin mRNA expression and adiponectin receptor protein expression in adipose tissue, which may provide evidence for clinical election of acupoints.

[Effects of acute hypervolemic hemodilution with hydroxyethyl starch 130/0.4 on the lung in a rabbit model of sepsis].

OBJECTIVE: To investigate the effects of acute hypervolemic hemodilution (AHH) with hydroxyethyl starch (HES) 130/0.4 on the lung in a rabbit model of sepsis and their possible mechanism. METHODS: Thirty healthy New Zealand rabbits were randomly divided into three groups (n=10 each): group sham operation (C), group sepsis model (E) and group AHH. Sepsis model was reproduced with modified colon ascendens stent peritonitis (CASP). In group C laparotomy was done but without puncturing the colon. At 4 hours after CASP, AHH was carried out intravenous infusion of 6% HES 130/0.4 20 ml/kg at 20 ml/min. Lactated Ringer solution was infused at 10 ml kg (-1) h (-1) in all three groups during the experiment. The animals breathed spontaneously during the experiment. A catheter was introduced into the right carotid artery for blood sampling, and it was connected to a pressure transducer for continuous mean arterial pressure (MAP) and heart rate (HR) monitoring. At 4 hours and 8 hours after CASP, a median abdominal incision was made and photographic documentation of abdominal situs was made. At the same time arterial blood samples were drawn at 4 hours and 8 hours after CASP for blood gas analysis and determination of hemoglobin (Hb) and hematocrit (Hct). The plasma component was separated and tumor necrosis factor-alpha (TNF-alpha) was measured. Respiratory rate and urinary output were record. The rabbits were sacrificed at 8 hours after CASP. The right lungs were immediately removed for determination of total protein concentration in broncho-alveolar lavage fluid (BALF). The wet/dry (W/D) lung weight rate were calculated. The sections of lung were stained with hematoxylin and eosin for light microscopic examination and the injury score was recorded. RESULTS: (1)MAP declined gradually and HR tended to accelerate during the course of the experiment in group E, but no significant differences were found in both group C and group AHH. (2)After AHH, the Hb and Hct decreased by 20% in group AHH. In group E, arterial oxygen saturation (SaO(2)), arterial partial pressure of oxygen (PaO(2)), arterial partial pressure of carbon dioxide (PaCO(2)) and pH decreased significantly at 8 hours after CASP compared with group C (all P<0.05). (3)TNF-alpha concentration in plasma was higher in group E and group AHH than in group C at 4 hours after CASP (both P<0.05). At 8 hours TNF-alpha concentration was increased in group E compared with group C (P<0.05), but there was no significant difference between group C and group AHH. (4)In group E, score of morphological changes in lung was significantly increased compared with group AHH (6.9+/-1.4 vs. 11.2+/-1.7, P<0.05). CONCLUSION: AHH with HES 130/0.4 can protect the lungs from sepsis. Inhibition of proinflammatory cytokines may be involved in the mechanism.