Quality of life and influencing factors in lung cancer patients after video-assisted thoracic surgery / 中国胸心血管外科临床杂志

@#Objective    To investigate the short-term quality of life in patients after single-direction video-assisted thoracic surgery (VATS) for lung cancer, and explore the related influencing factors. Methods    Patients who underwent single-direction VATS for lung cancer in the Department of Thoracic Surgery, West China Hospital, Sichuan University from July 2020 to August 2021 were continuously selected. The QLQ-C30 and QLQ-LC13 were used to evaluate the quality of life of the patients after the surgery, and the influencing factors were analyzed. Results    A total of 193 patients were collected. There were 73 males aged 59.44±11.40 years, and 120 females aged 53.73±11.15 years. The QLQ-C30 score of the patients after single-direction VATS for lung cancer was 69.09±20.21 points. Univariate analysis and Pearson correlation analysis showed that age, occupation, anesthesia time, postoperative complications, postoperative antibiotic use time, postoperative hospital stay, insomnia, economic stress, hemoptysis, chest pain, dysphagia, arm or shoulder pain were associated with the quality of life (P≤0.05). The results of multiple regression analysis showed that anesthesia time, economic pressure, insomnia and chest pain had a significant impact on the overall quality of life 30 days after the surgery (P≤0.05). Conclusion    The anesthesia time, economic pressure, insomnia and chest pain are independent influencing factors for the quality of life after the VATS lung cancer surgery.

Analysis and Prediction of False Negative Results for SARS-CoV-2 Detection with Pharyngeal Swab Specimen in COVID-19 Patients: A Retrospective Study

BackgroundFalse negative results of SARS-CoV-2 nucleic acid detection pose threats to COVID-19 patients and medical workers alike. ObjectiveTo develop multivariate models to determine clinical characteristics that contribute to false negative results of SARS-CoV-2 nucleic acid detection, and use them to predict false negative results as well as time windows for testing positive. DesignRetrospective Cohort Study (Ethics number of Tongji Hospital: No. IRBID: TJ-20200320) SettingA database of outpatients in Tongji Hospital (University Hospital) from 15 January 2020 to 19 February 2020. Patients1,324 outpatients with COVID-19 MeasurementsClinical information on CT imaging reports, blood routine tests, and clinic symptoms were collected. A multivariate logistic regression was used to explain and predict false negative testing results of SARS-CoV-2 detection. A multivariate accelerated failure model was used to analyze and predict delayed time windows for testing positive. ResultsOf the 1,324 outpatients who diagnosed of COVID-19, 633 patients tested positive in their first SARS-CoV-2 nucleic acid test (47.8%), with a mean age of 51 years (SD=14.9); the rest, which had a mean age of 47 years (SD=15.4), tested negative in the first test. "Ground glass opacity" in a CT imaging report was associated with a lower chance of false negatives (aOR, 0.56), and reduced the length of time window for testing positive by 26%. "Consolidation" was associated with a higher chance of false negatives (aOR, 1.57), and extended the length of time window for testing positive by 44%. In blood routine tests, basophils (aOR, 1.28) and eosinophils (aOR, 1.29) were associated with a higher chance of false negatives, and were found to extend the time window for testing positive by 23% and 41%, respectively. Age and gender also affected the significantly. LimitationData were generated in a large single-center study. ConclusionTesting outcome and positive window of SARS-CoV-2 detection for COVID-19 patients were associated with CT imaging results, blood routine tests, and clinical symptoms. Taking into account relevant information in CT imaging reports, blood routine tests, and clinical symptoms helped reduce a false negative testing outcome. The predictive AFT model, what we believe to be one of the first statistical models for predicting time window of SARS-CoV-2 detection, could help clinicians improve the accuracy and efficiency of the diagnosis, and hence, optimizes the timing of nucleic acid detection and alleviates the shortage of nucleic acid detection kits around the world. Primary Funding SourceNone.

Anesthesia management for cesarean section during novel coronavirous epidemic / 中华麻醉学杂志

Thirty-six puerperas who underwent emergency cesarean section at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 24, 2020 to February 9, 2020, who all wore medical surgical masks, were retrospectively included in this study. Anesthesia management was performed under tertiary medical protection measures. A dedicated anesthesia equipment was separately sterilized. Narcotic drugs were used for one patient only, and disposable medical supplies were used for anesthetic supplies. Contact transmission should be avoided when a neonate required resuscitation, and early isolation and nucleic acid testing were provided for the neonates. The rate of suspected cases of novel coronavirus (2019-nCoV) was 11% , and the rate of clinically diagnosed cases was 17% before surgery. The rate of clinically diagnosed cases of 2019-nCoV was 22%, the rate of confirmed cases was 8%, and the total positive rate of diagnosis was 31% after surgery. The rate of neuraxial anesthesia was 86%, the rate of general anesthesia was 14%, the time of spinal puncture was (15±7) min, the time of tracheal intubation under general anesthesia was (2.1±1.3) min, the operation time was (95±36) min, and blood loss was (276±166) ml. The Apgar score of newborns was 8.8 ± 0.5. There was 1 neonate whose mother was diagnosed as having 2019 novel coronavirous disease after operation, an oropharyngeal swab specimen was obtained at 36 h of birth, and the swab was tested positive for 2019-nCoV by nucleic acid testing. As of February 10, 2020, an anesthesiologist involved in the operation was diagnosed to have infection by 2019-nCoV. In conclusion, diagnosis of 2019 novel coronavirous disease during pregnancy is more difficult, it is necessary to perform anesthesia management for cesarean section under tertiary medical protection. Although the difficulty in anesthesia operation is increased under tertiary medical protection, anesthesiologists can carry out standardized anesthesia management and guarantee the safety of maternal and infants and anesthesiologists themselves as long as they are rigorously trained and adhere to protective protocols.

Anesthesia management for cesarean section during coronavirus disease 2019 epidemic / 中华麻醉学杂志

Thirty-six puerperas who underwent emergency cesarean section at Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 24, 2020 to February 9, 2020, who all wore medical surgical masks, were retrospectively included in this study.Anesthesia management was performed under tertiary medical protection measures.A dedicated anesthesia equipment was separately sterilized.Narcotic drugs were used for one patient only, and disposable medical supplies were used for anesthetic supplies.Contact transmission should be avoided when a neonate required resuscitation, and early isolation and nucleic acid testing were provided for the neonates.The rate of suspected cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was 11% , and the rate of clinically diagnosed cases was 17% before surgery.The rate of clinically diagnosed cases of SARS-CoV-2 was 22%, the rate of confirmed cases was 8%, and the total positive rate of diagnosis was 31% after surgery.The rate of neuraxial anesthesia was 86%, the rate of general anesthesia was 14%, the time of spinal puncture was (15±7) min, the time of tracheal intubation under general anesthesia was (2.1±1.3) min, the operation time was (95±36) min, and blood loss was (276±166) ml.The Apgar score of newborns was 8.8±0.5.There was 1 neonate whose mother was diagnosed as having coronavirus disease 2019 after operation, an oropharyngeal swab specimen was obtained at 36 h of birth, and the swab was tested positive for SARS-CoV-2 by nucleic acid testing.As of February 10, 2020, an anesthesiologist involved in the operation was diagnosed to have infection by SARS-CoV-2.In conclusion, diagnosis of coronavirus disease 2019 during pregnancy is more difficult, it is necessary to perform anesthesia management for cesarean section under tertiary medical protection.Although the difficulty in anesthesia operation is increased under tertiary medical protection, anesthesiologists can carry out standardized anesthesia management and guarantee the safety of maternal and infants and anesthesiologists themselves as long as they are rigorously trained and adhere to protective protocols.

Recommendations for anesthesia management and infection control in elderly patients with COVID-19 / 中华麻醉学杂志

During the epidemic of coronavirus disease 2019 (COVID-19), the infection of the elderly population will bring great challenges to clinical diagnosis and treatment, outcome and management.Combined with the characteristics of anesthesia and the pathophysiological characteristics of COVID-19 on lung function impairment in elderly patients, Chinese Society of Anesthesiology formulated the " Recommendations for anesthesia management and infection control in elderly patients with COVID-19″. This recommendation expounds preoperative visit and infection control, anesthesia management protocol, anesthesia monitoring, anesthesia induction/endotracheal intubation, anesthesia maintenance and infection control, intraoperative lung protection strategy, anti-stress and anti-inflammatory management, hemodynamic optimization, infection control during emergence from anesthesia, and postoperative analgesia in elderly patients with COVID-19, and provides the reference for the safe and effective implementation of anesthesia management in elderly patients during the prevention and control of COVID-19 epidemic.

Abnormalities in Inflammatory Cytokines Confer Susceptible to Chronic Neuropathic Pain-related Anhedonia in a Rat Model of Spared Nerve Injury

OBJECTIVE: Patients with chronic neuropathic pain (CNP) have a higher incidence to develop depression. However, its pathogenesis has not yet been fully elucidated. Here we aimed to investigate the role of inflammatory cytokines in CNP-related anhedonia, which is a core symptom of depression, and to explore the effects of ketamine and parecoxib on pain and anhedonia. METHODS: A rat model of spared nerve injury (SNI) was constructed to mimic CNP. Hierarchical cluster analysis of sucrose preference test (SPT) was applied to classify the SNI rats into anhedonia susceptible and unsusceptible. Inflammatory cytokines in medial prefrontal cortex (mPFC) of brain, serum and L2–5 spinal cord were measured. Moreover, effects of ketamine or parecoxib on mechanical withdrawal test (MWT) and SPT in anhedonia susceptible rats were detected. RESULTS: Tumor necrosis factor (TNF)-α was increased in mPFC, serum and and spinal cord of anhedonia susceptible rats. Furthermore, anhedonia susceptible and unsusceptible rats both increased the interleukin (IL)-1β level in mPFC, serum and spinal cord. IL-6 was altered in serum and spinal cord, but not in mPFC. IL-10 was significantly altered in mPFC and serum, but not in spinal cord. Additionally, ketamine treatment significantly attenuated the decreased results of MWT and SPT in anhedonia susceptible rats, and that parecoxib significantly improved the MWT score, but failed to alter the result of SPT. CONCLUSION: These findings suggest that abnormalities in inflammatory cytokines confer susceptible to anhedonia in a rat model of SNI. Ketamine, a fast-acting antidepressant, has pharmacological benefits to alleviate pain and anhedonia symptoms.

Anesthesia for cesarean section after failed labor under combined spinal and epidural analgesia: analysis of 58 cases / 中华围产医学杂志

Objective To summarize the experience in anesthesia management for cesarean section(CS) after failed labor in women with combined spinal and epidural analgesia and to provide evidence for more effective and safer clinical practice.Methods We included 58 singleton pregnant women who received spinal and epidural analgesia during labor but converted to CS at Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from October 2017 to October 2018.When CS was indicated,10 ml of 0.125％ ropivacaine was given through the epidural catheter immediately,and 5 ml of 1％ lidocaine was given when arriving at the operating room.Five minutes later,10 ml of 1％ ropivacaine was administered.General anesthesia would be required when epidural anesthesia was considered to be failed 10 min after the usage of ropivacaine.Clinical datas were retrospectively reviewed.The management and effects of anesthesia for CS,maternal and neonatal outcomes were described.Results Of the 58 patients when CS was indicated during labor,5.2％(3/58) received general anesthesia immediately.Among the other 94.8％ (55/58) who received epidural anesthesia,3.6％(2/55) converted to general anesthesia later.Adverse effects of epidural anesthesia included reduced mean artery pressure (8/53,15.1％),nausea and vomiting (3/53,5.7％).For the neonatal Apgar score at 1 min,one out of the 58 babies (1.7％) was between 0 and 3,ten (17.2％) between 4 and 7,and 47 (81.0％) between 8 and 10.The two babies (3.4％) with Apgar score between 4 and 7 at 5 min were both referred to the department of Neonatology,and the rest 56 neonates (96.6％) scored 8-10.Conclusions Spinal and epidural analgesia in labor can be safely and effectively adjusted to anesthesia for CS.

Using quantile regression to re-evaluate the epidural labor analgesia under new partogram: a prospective cohort study / 中华围产医学杂志

Objective To investigate the influence of epidural analgesia on labor duration under the new partogram recommendations using quantile regression.Methods In this study,we recruited 300 nulliparous women at full term who were hospitalized in Department of Obstetrics and Gynecology,Tongji Medical College,Huazhong University of Science and Technology from May to September,2018.The participants who were willing to receive epidural analgesia during labor were assigned to the epidural group (n=150),and those who were not to the control group (n=150).Labor duration and delivery outcomes were analyzed by Student's t test,Mann-Whitney U test,Chi-square test and Fisher's exact test.Quantile regression models were also used to investigate the effect of epidural analgesia on labor duration.Results The median durations of first-and second-stage labor in the epidural group were 600(400-840) and 66(45-98) min,respectively,which were significantly longer than those of the control group [420(320-610) and 52(33-87) min] (Z=-4.273,P＜0.001;Z=-3.210,P=0.001).Quantile regression analysis showed that,for the first stage of labor,epidural analgesia was associated with labor prolongation,and had significant effects on all the percentiles (all P＜0.05).The regression coefficients increased (95.630-285.000) correspondingly as the percentiles of the labor duration (from 10th to 90th percentiles) increased.For the second stage of labor,epidural analgesia showed a significant impact on prolongation only between the 25th and 75th percentiles (coefficients:10.000～18.143;all P＜0.05).Although the epidural group had a significant higher episiotomy rate [46.8％(65/139) vs 33.3％(48/144),x2=5.318,P=0.021],more times of urine catheterization during labor [1(0-1) vs 0(0-1),Z=-0.974,P=0.001]and higher rate of oxytocin administration during labor [48.7％(73/150) vs 30.0％(45/150),x2=10.952,P=0.001],when compared with the control group,there was no significant difference in cesarean section rate,assisted vaginal delivery rate and neonatal outcomes between the two groups (all P＞0.05).Conclusions Epidural analgesia may associated with the prolongation of the first and second stage of labor,especially with the first stage of labor,but has no adverse effects on maternal and neonatal outcomes.

Relationship between SIRT1-ERK1∕2 pathway and chikusetsu saponin IVa-induced reduction of isoflurane-elicited neurotoxicity in fetal rats: an in vitro experiment / 中华麻醉学杂志

Objective To evaluate the relationship between silent information regulator 1 ( SIRT1)-extracellular-regulated kinase1∕2 ( ERK1∕2) pathway and chikusetsu saponin IVa-induced reduc-tion of isoflurane-elicited neurotoxicity in fetal rats in an in vitro experiment. Methods The hippocampal neurons isolated from rats at 16-18 days of gestation were primarily cultured for 7 days and divided into 3 groups ( n = 6 each) using a random number table method: control group ( Con group) , isoflurane group (Iso group) and chikusetsu saponin IVa plus isoflurane group (ChIV+Iso group). Hippocampal neurons were cultured routinely for 6 h in Con group. Hippocampal neurons were exposed to 1. 8％ isoflurane for 6 h in an incubator in Iso group. Chikusetsu saponin IVa 25μg∕ml was added to the culture medium, and hipp-ocampal neurons were incubated for 6 h and then exposed to 1. 8％ isoflurane for 6 h in an incubator in ChIV+Iso group. The supernatant was collected for determination of the amount of lactic dehydrogenase ( LDH) released, neuronal viability ( by CCK-8) and expression of SIRT1, ERK1∕2 and phosphorylated ERK1∕2 ( p-ERK1∕2) ( by Western blot) . Results Compared with Con group, the neuronal viability was significantly decreased, the amount of LDH released was increased, and the expression of SIRT1 and p-ERK1∕2 was down-regulated in Iso group ( P<0. 05) . Compared with Iso group, the neuronal viability was significantly increased, the amount of LDH released was decreased, and the expression of SIRT1 and p-ERK1∕2 was up-regulated in ChIV+Iso group ( P<0. 05) . Conclusion The mechanism by which chikuset-su saponin IVa reduces isoflurane-elicited neurotoxicity is related to activating SIRT1-ERK1∕2 pathway in fe-tal rats in an in vitro experiment.

Related factor analysis on sore throat and pharyngeal xeransis during thyroid surgery / 临床麻醉学杂志

Objective To explore the related factors on sore throat and pharyngeal xeransis during thyroid surgery.Methods Twenty-nine female patients, aged 24-67 years, BMI 18-30 kg/m2, falling into ASA physical status Ⅰ or Ⅱ, were scheduled for thyroid surgery.After anesthesia induction and tracheal intubation, the endotracheal intracuff was inflated to 20 mm Hg.Intracuff pressure was monitored every 5 minutes by a pressure transducer.At the time of 24 hours after tracheal intubation, the patients were asked about their throat complaints such as sore throat and pharyngeal xeransis.Results Endotracheal intracuff pressure during thyroid surgery was in a discrete distribution.Multiple linear regression model analysis found that age, BMI, anesthesia time and intracuff pressure had no obvious effects on sore throat.Decision tree model analysis found that patients undergoing thyroid surgery had higher probability of pharyngeal xeransis grade Ⅳ, when the average intracuff pressure was higher than 29 mm Hg.Conclusion Excessive endotracheal intracuff pressure during thyroid surgery due to operation causes pharyngeal xeransis.

Comparison of the Effects of Subarachnoid Block with Different Temperatures of Bupivacaine for Cesarean Section / 医药导报

Objective To observe the effect of subarachnoid block with 0.5% bupivacaine at different temperatures during cesarean section.Methods 100 cases of elective cesarean section were randomly divided into room temperature group and heating group,50 cases in each group.Room temperature group: bupivacaine hydrochloride injection and glucose injection equilibrated group in a constant temperature thermostatic bath of 24 degrees thermostatic bath heating for above 30 min.Heating group: bupivacaine hydrochloride injection and glucose injection heated in the constant temperature thermostatic bath of 37 degrees thermostatic bath heatingfor above 30 min.Anesthesia was injected into the subarachnoid space at different temperatures to observe the anesthetic effect.Results The anesthesia increased rapidly, and the analgesia and muscle relaxation effects were better in the heating group than room temperature group, but the heating group had hypotension rate was higher than the room temperature group (36.0% vs.16.0%).There was no obvious difference between the incidence of adverse reactions such as nausea and vomiting in both groups.Conclusion Different temperatures of bupivacaine can be used safely for section anesthesia.The anesthesia effect of the heateding bupivacaine is faster, the anesthesia level is higher, the anesthesic and muscle relaxant effect is better.Bupivacaine at room temperature has relatively small effect on hemodynamics.

A risk analysis of acute kidney injury after orthotropic liver transplantation for benign end-stage liver disease in adults / 临床麻醉学杂志

Objective To analyze the risk factors of acute kidney injury after orthotropic liver transplantation for adult benign end-stage liver disease.Methods A retrospective analysis was conducted in 30 recipients (18 males,12 females,aged 23-68 years,ASA grade Ⅲ or Ⅳ) who underwent orthotropic liver transplantation for benign end-stage liver disease at Tongji Hospital from May,2014 to December,2014.Both demographic characteristics and perioperative parameters were collected,including general condition,surgery and anesthesia factors and intraoperative salvage autotransfusion or not.Perioperative laboratory findings related to renal function including urine volume,serum creatinine (Scr) and urea nitrogen (BUN) were collected,too.All variables tested in the univariate analysis with a P<0.10 were included in a multiple logistic regression analysis.Results There were less intraoperative salvage autotransfusion,more platelet transfusion and a higher using rate of vasopressors in the AKI group after surgery than those did not.Patients who received intraoperative salvage autotransfusion had 0.058 time odds (95%CI 0.005-0.649) of AKI than those did not;patients who required platelet transfusion had 10.706 times higher odds (95%CI 1.212-94.963) of AKI than those did not.Conclusion It is likely that intraoperative salvage autotransfusion was able to decrease the morbidity of AKI,while platelet transfusion and vasopressor administration to maintain blood pressure could increase the possibility of AKI.

Effects of general anesthesia combined with thoracic paravertebral block on postoperative recovery after pulmonary lobectomy / 临床外科杂志

Objective To evaluate Effects of general anesthesia combined with thoracic paraver-tebral block(TPVB)on postoperative recovery after thoracoscopic pulmonary lobectomy. Methods Eighty patients were randomized into the general anesthesia group( G group)and general anesthesia combined TPVB group(GT group). Under the guidance of ultrasound,patients in the GT group received 20ml of 0. 5% ropivacaine for TPVB,and sevoflurane and propofol for combined anesthesia. Patients in the G group received sevoflurane,propofol and remifentanil for combined anesthesia. Extubation time,postoperative vis-ual analogue scale(VAS),quality of recovery(QoR)score,and adverse reaction were all recorded. Results Patients in the GT group had less extubation time and earlier ambulation time compared to the G group. Postoperatively,at the 1st,24th and 48th hour,patients in the G group had significantly higher VAS values both at rest and on movement than GT group(P < 0. 05). The opioid consumptions in GT group were lower than the G group(P < 0. 05). The QoR values of GT group at 24th and 48th hour[(152 ± 21)min and (175 ± 17)min]were significantly higher than the G group[(134 ± 25)min and(162 ± 20)min]respec-tively. There were significant differences in hospitalization expenses,the hospitalization stay and the inci-dence of complications between the two groups. Conclusion The ultrasound-guided paravertebral block can improve the quality of recovery in patients undergoing thoracoscopic pulmonary lobectomy.

Randomized controlled trial of palonosetron in preventing postoperative nausea and vomiting in gyneco-logical surgeries / 临床麻醉学杂志

Objective To compare the effects of a single injection of palonosetron and tropise-tron to prevent postoperative nausea and vomiting (PONV ) in gynecological surgeries. Methods Sixty patients undergoing elective major gynecological surgeries with general anesthesia (Apfel score ≥ 3 ) were included and randomized to group P (palonosetron ) and group T (tropisetron),30 patients in each group.All patients received general anesthesia with tracheal intuba-tion,and palonosetron 0.25 mg or tropisetron 5 mg were injected before anesthesia respectively in two groups.Intravenous hydromorphine was delivered for postoperative analgesia in all patients. PONV were evaluated and followed up for 72 hours.The degree of PONV was recorded and the com-plete response rate (CR)and complete control rate (CC)were calculated.Results The degree of PONV in 0-24 h and 24-48 h was milder in group P than in group T (P <0.05),while in 48-72 h the degree of PONV was similar between the two groups.In group P,5 patients had vomiting postopera-tively with the failure period of treatment of (1 9.6±9.4)h,and no patients needed rescue treatments. While in group T,1 9 patients suffered from vomiting with the failure period of treatment of (20.6± 4.5)h,and rescue treatments were delivered 3 times in total.The CR and CC of preventing PONV in 0-24 h,24-48 h and 0-72 h were significantly higher in group P than in group T (P <0.05).The CR and CC of the two groups were comparable in 48-72 h postoperatively.Conclusion A preoperative single dose of palonosetron 0.25 mg is better than tropisetron 5 mg in preventing PONV within 48hours after gynecological surgery.

Effect of ketamine on mitochondrial function of rat neurons subjected to anoxia / 中华麻醉学杂志

Objective To investigate the effect of ketamine on the mitochondrial function of rat neurons subjected to anoxia. Methods Primarily cultured rat hippocampal neurons were seeded in culture dishes (35 mm in diameter) at the density of 5×105-1×106 cells∕ml, and divided into 3 groups (n=11 each) using a random number table: control group, anoxia group and ketamine group. The neurons were exposed to 90% N2 plus 10% CO2 50 ml∕min for 5 min in anoxia group. In ketamine group, ketamine was added to the culture medium with the final concentration of 20 μmol∕L at 1 h before anoxia, and then the neurons were exposed to 90% N2 plus 10% CO2 50 ml∕min for 5 min. After the end of treatment in each group, the dead neurons were detected using trypan blue staining, the ATP content was determined by ATP bioluminescence assay, and mitochondrial membrane potential was measured by rhodamine 123 staining. Results Compared with control group, the mortality rate of hippocampal neurons was significantly in?creased, and the ATP content and mitochondrial membrane potential were significantly decreased in anoxia group and ketamine group ( P<0.05) . Compared with anoxia group, the mortality rate of hippocampal neu?rons was significantly decreased, and the ATP content and mitochondrial membrane potential were signifi?cantly increased in ketamine group (P<0.05). Conclusion The mechanism by which ketamine amelio?rates anoxia?induced damage to rat neurons is related to improved mitochondrial function.

Improvement Effect of Minocycline on Cognitive Dysfunction Induced by Old RBCs Transfusion in Rats / 中国药师

Objective:To observe the effect of old RBCs transfusion on cognitive function in rats and the improvement effect of mi -nocycline.Methods: Male SD rats at the age of 6 months were randomly divided into 4 groups.The RBCs were obtained from male rats by centrifuging the total blood and stored at 4℃.The rats of fresh RBCs group (group F) were transfused with the RBCs stored for 1 day.The rats of old RBCs group (group O) were transfused with the RBCs stored for 7 days.The rats of treatment group (group T) received 40 mg· kg-1 minocycline with intraperitoneal injection before the transfusion .The rats of the control group ( group C) were transfused with the normal saline .The brain levels of IL-1βand IL-6 were determined with Quantikine ELISA kits in 24 hours after the blood transfusion (n=6).The rats were subjected to Barnes maze tests after 1 week of the blood transfusion (n=10).Results:The brain levels of IL-1βand IL-6 in group O were higher than those in group C and F (P<0.05), which were lower in group T than those in group O(P<0.05).The rats of group O spent longer time finding the target box than those of group C and F in the Barnes maze (P<0.05), and the time was shorter in group T than that in group O (P<0.05).Conclusion: Old RBCs transfusion plays a role in neuro-inflammation and induces cognitive dysfunction in rats , which may be improved by minocycline .

Protective Effects of Memantine on Isofluane￣induced Decrease of Proliferation in Neural Stem Cells / 医药导报

Objective To investigate the protective effects of memantine on isofluane￣induced decrease of proliferation in neural stem cells ( NSCs) and the potential mechanisms in vitro. Methods Neural stem cells were isolated from rat hippocampi (postnatal day 1) and grew in culture. Cultured NSCs were randomly divided into the control ( Group Control), Vehicle (Group Vehicle), Isoflurane ( Group Iso), Isoflurane +Memantine ( Group Iso +Mem) and Isoflurane + Memantine +LY294002 groups (Group Iso+Mem+LY).Proliferation was assessed by cell counting and BrdU incorporation.Western blot was conducted to detect protein expression of phospho￣Akt. Results Compared with the control group,BrdU incorporation and phospho￣Akt expressions in neural stem cells significantly declined after 2.4% isoflurane exposure for 6 h (P<0.01).However, isofluane￣induced decrease of BrdU incorporation and phospho￣Akt expressions was attenuated by the treatments of memantine (P<0.01)). It was showed that Akt inhibitors LY294002 reversed the protective effects on neural stem cells proliferation by memantine(P<0.01). Conclusion The results suggest that memantine treatment might attenuate isofluane￣induced decrease of proliferation in neural stem cells via Akt signaling pathway.

The effect of analgesia with dezocine on CD4+ and CD8+ T lymphocytes in patients after pulmonary lobectomy / 中国医师进修杂志

Objective To investigate the effect of analgesia with dezocine on CD4+ and CD8+ T lymphocytes in patients after pulmonary lobectomy.Methods Seveuty patients with early non-small-cell lung cancer were selected,and they were scheduled the pulmonary lobectomy.The patients were divided into control group and dezocine group by random digits table method with 35 cases each.The patients in dezocine group were given 0.5 mg/ml dezocine by patient-controlled analgesia (PCA) pump,and the patients in control group were given 0.9％ sodium chloride by PCA pump.The peripheral blood lymphocytes count and percentages of CD4+ T lymphocytes,CD8+ T lymphocytes,natural killer cell (NK cell) before anesthesia induction and 4,24,48 h after operation were detected.Results In control group,the peripheral blood lymphocytes count and NK cell 24 h after operation were (1.08 ± 0.21) × 109/L and 0.141 4 ± 0.021 8,which before anesthesia induction were (1.71 ± 0.33) × 109/L and 0.190 9 ± 0.022 8,and there were statistical differences (P ＜ 0.05).In dezocine group,the peripheral blood lymphocytes count and NK cell 24 h after operation were (1.14 ±0.28) × 109/L and 0.124 9 ± 0.027 6,which before anesthesia induction were (1.69 ± 0.28) × 109/L and 0.198 6 ± 0.027 5,and there were statistical differences (P ＜ 0.05).The CD4+ T lymphocytes 24 h after operation in dezocine group was significantly higher than that in control group (0.355 6 ±0.031 1 vs.0.273 5 ±0.029 4),and there was statistical difference (P ＜0.05).There was no statistical difference in CD8+ T lymphocytes between the 2 groups (P ＞ 0.05).Conclusion Analgesia with dezocine can notably improve immunosuppression in patients after pulmonary lobectomy.

Effect of lithium chloride pretreatment on isoflurane-induced cognitive dysfunction and inflammatory response in hippocampus in aged rats / 中华麻醉学杂志

Objective To evaluate the effect of lithium chloride (LiCl) pretreatment on isoflurane-induced cognitive dysfunction and inflammatory response in hippocampus in aged rats.Methods Eighty 20-month-old male Sprague-Dawley rats,weighing 350-400 g,were randomly assigned into 4 groups (n =20 each):control group (group C),1.4％ isoflurane group (group I),100 mg/kg LiCI + 1.4％ isoflurane group (group L+ I),and 100 mg/kg LiC1 group (group L).Group I was exposed to 1.4％ isoflurane in 30％ O2-70％ N2 for 6 h,while group C was exposed to 30％ O2-70％ N2 only.LiCl 100 mg/kg was injected intraperitoneally once a day for 3 consecutive days and isoflurane anesthesia was performed on 4th day in group L + I.LiCl 100 mg/kg was injected intraperitoneally once a day for 3 consecutive days and then the rats inhaled 30％ O2-70％ N2 for 6 h on 4th day in group L.Blood samples were taken immediately after the end of anesthesia for blood gas analysis.Hippocampi were isolated 24 h after the end of anesthesia for determination of the expression of glycogen synthase kinase-3β (GSK-3β) and acetyl-NF-κB (Lys310) (by Western blot) and TNF-α,IL-1β and IL-6 mRNA (by RT-PCR).The levels of TNF-α,IL-1β and IL-6 were determined by ELISA and the contents of TNF-α,IL-1β and IL-6 were calculated.The cognitive function was assessed on 2nd day after the end of anesthesia.Results Compared with group C,the expression of GSK-3β and acetyl-NF-κB (Lys310) was significantly up-regulated,the expression of TNF-α,IL-1β and IL-6 mRNA and contents of TNF-α,IL-1β and IL-6 were increased,the escape latency was prolonged,and the time of staying at the original platform quadrant was shortened in group I (P ＜ 0.05).Compared with group I,the expression of GSK-3β and acetyl-NF-κB (Lys310) was significantly down-regulated,the expression of TNF-α,IL-1β and IL-6 mRNA and contents of TNF-α,IL-1β and IL-6 were decreased,the escape latency was shortened,and the time of staying at the original platform quadrant was prolonged in group L + I (P ＜ 0.05).Conclusion LiC1 pretreatment can improve isoflurane-induced cognitive dysfunction and inhibition of inflammatory response in hippocampus is involved in the mechanism in aged rats.

Effects of pentobarbital sodium on compound muscle action potentials in rats / 中华麻醉学杂志

Objective To investigate the effects of pentobarbital sodium on compound muscle action potentials (CMAPs) in rats.Methods Ten adult Sprague-Dawley rats (5 males,5 females),aged 8 weeks,weighing 240-260 g,were anesthetized with intraperitoneal 1％ pentobarbital sodium 40 mg/kg.The sciatic nerve was stimulated (intensity 0.50,0.55 and 0.60 V,wave length 0.05 ms,frequency 10 Hz) starting from 8 min after administration.Each intensity was repeated three times at 1 s interval.The stimulation mentioned above was repeated every 5 min.CMAPs from the gastrocnemius muscle were recorded starting from 8 min after administration (T1) and then were recorded every 5 min for 9 times (T2-10),Results The peak value of CMAP was significantly decreased at T3-5 when the intensity was 0.50,0.55 and 0.60 V,and CMAP latency was significantly prolonged at T3-6 when the intensity was 0.50 V,and at T4,5 when the intensity was 0.55 and 0.60 V as compared with those at T1 ( P ＜ 0.05 or 0.01 ).Conclusion Pentobarbital sodium can inhibit CMAPs in rats.