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Objective:To investigate the effect of curcumin on skin wound healing and angiogenesis in rats and its possible mechanism.Methods:Rats with full-thickness dermal defect were prepared and randomly divided into model group, low-dose, medium-dose and high-dose groups of curcumin, with 10 rats in each group. Curcumin was injected intraperitoneally. The low-dose, medium-dose and high-dose groups of curcumin were given 5, 15, 45 mg/(kg·d) curcumin respectively. The rats in the model group were injected intraperitoneally with 0.5% sodium carboxymethyl cellulose for 14 days. The wound healing rate of rats in each group was measured; The wound tissue was stained with haematoxylin and eosin staining, Masson and immunohistochemistry; The levels of angiopoietin-1 (Ang-1) and basic fibroblast growth factor (bFGF) in the wound tissue of rats in each group were detected by enzyme-linked immunosorbent assay (ELISA); The relative expression of vascular endothelial growth factor A (VEGFA) and vascular endothelial growth factor receptor-2 (VEGFR-2) mRNA in wound tissue was detected by real-time quantitative polymerase chain reaction (qRT-PCR); Western blot was used to detect the expression of VEGFA, VEGFR-2, Notch1, Jagged1, Hes1 protein in the wound tissue.Results:The wound healing rate, the vascular density and the level of Ang-1 and bFGF, the mRNA of VEGFA and VEGFR-2, the relative expression of Notch1, Jagged1, Hes1, VEGFA and VEGFR-2 protein in wound tissue of rats in low, medium and high dose groups of curcumin were higher than those in the model group (all P<0.05). Histological staining results showed that the reepithelialization of the wound tissue was not obvious in the model group, with severe infiltration of inflammatory cells and less collagen deposition; the reepithelialization of the wound tissue in the low-dose, medium-dose and high-dose groups of curcumin was gradually obvious, with thickened epidermis, reduced inflammatory cell infiltration and increased collagen deposition. The effect of curcumin on skin wounds in rats was enhanced in a dose-dependent manner (all P<0.05). Conclusions:Curcumin could promote wound healing and angiogenesis in rats, and its mechanism may be related to the activation of Notch signaling pathway.
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Objective:To investigate the effects of ultrasound-guided lumbar erector spinae plane block (L-ESPB) combined with general anesthesia using a laryngeal mask airway on postoperative delirium and early outcome in older adult patients undergoing hip arthroplasty.Methods:Sixty older adult patients who underwent unilateral total hip arthroplasty under general anesthesia using a laryngeal mask airway from August 2020 to May 2021 were included in this study. They were randomly assigned to observation and control groups, with 30 patients in each group. All patients underwent general anesthesia using a laryngeal mask airway. In the observation group, L-ESPB with 30 mL 0.375% ropivacaine was performed before induction of general anesthesia. Patient-controlled intravenous analgesia was performed in all patients after surgery. The Visual Analogue Scale score was > 4 points, and dezocine was intravenously injected for rescue analgesia. The amount of general anesthetics, the rate of use of vasoactive drugs, the time to pull out the laryngeal mask airway, length of stay in postanesthesia care unit, and the incidence of restlessness during the recovery period were recorded. Resting-state VAS score and Bruggrmann comfort scale score at 4, 8, 12, 24 and 48 hours after surgery, effective times of pressing the analgesia pump, the rate of rescue analgesia, the incidence of anesthesia-related adverse reactions at 48 hours after surgery, Pittsburgh Sleep Quality Index (PSQI) score at 1 day before and 1, 3 and 5 days after surgery, the incidence of postoperative delirium within 5 days after surgery, the time to get out of bed the first time, and the incidence of pulmonary infection were recorded.Results:The amount of remifentanil and propofol used during surgery were significantly lower in the observation group than those in the control group ( t = -6.80, -5.23, both P < 0.05). The rate of use of urapidil and esmolol were significantly lower in the observation group than those in the control group ( χ2 = 4.32, 5.46, both P < 0.05). The time to pull out the laryngeal mask airway, length of stay in postanesthesia care unit, and the time to get out of bed the first time in the observation group were (14 ± 2) minutes, (21 ± 2) minutes and (2.4 ± 0.5) days respectively, which were significantly shorter than those in the control group [(18 ± 2) minutes, (26 ± 3) minutes and (2.8 ± 0.7) days, t = -6.64, -7.18, -2.51, all P < 0.05]. The incidence of restlessness during the recovery period, postoperative delirium, and pulmonary infection in the observation group were 0.0%, 3.3% and 0.0% respectively, which were significantly lower than those in the control group [20.0%, 26.7%, 20.0%, all P < 0.05]. Resting-state VAS score at each time point was significantly lower in the observation group than that in the control group ( t = 3.32, 2.97, 4.33, 3.81, 3.10, all P < 0.05). Bruggrmann comfort scale score at each time point was significantly higher in the observation group than that in the control group ( t = 9.20, 8.62, 5.73, 5.72, 6.28, all P < 0.05). The effective times of pressing the analgesia pump, the rate of rescue analgesia, and the incidence of nausea and vomiting at 48 hours after surgery in the observation group were 0 (0, 0), 10.0% and 6.7% respectively, which were significantly lower than those in the control group [1(0, 2), 33.3% and 30.0%, Z = -3.41, χ2 = 4.81, 5.46, all P < 0.05]. PSQI score measured at 1, 3, and 5 days after surgery were significantly increased compared with those measured 1 day before surgery in each group ( F = 116.80, 325.64, both P < 0.001). PSQI measured at 1, 3 and 5 days after surgery was significantly lower than those in the control group ( t = -7.26, -6.41, -11.17, all P < 0.001). There were no significant differences in the incidence of dizziness, drowsiness, urinary retention and atelectasis between the two groups ( P > 0.05). Conclusion:Ultrasound-guided L-ESPB combined with general anesthesia using a laryngeal mask airway for hip arthroplasty in older adult patients can decrease the incidences of postoperative delirium and complications, which are conducive to early postoperative outcomes.
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Objective: To investigate the feasibility of thoracic paravertebral block [TPVB] for percutaneous nephrolithotomy [PCNL] in comparison with epidural anesthesia [EA] combined with moderate sedation
Subjects and Methods: One hundred American Society of Anesthesiologists [ASA] I-II adult patients scheduled for first-stage unilateral PCNL were randomly assigned to receive either TPVB or EA. All patients were given standard sedation and analgesia with propofol and sufentanil. Patient characteristics, surgical outcomes, anesthetic outcomes, and time to first use of a patient-controlled intravenous analgesic [PCIA] device and postoperative consumption of sufentanil in the first 24 h were recorded. Intergroup differences of the parameters were analyzed using an independent t test, Mann-Whitney test, and X2 test as appropriate
Results: Patients who received TPVB consumed more propofol during ureteroscopy [56.2 +/- 28.4 vs. 42.9 +/- 27.5 mg, p < 0.05] and more sufentanil during ureteroscopy [9.7 +/- 4.8 vs. 3.9 +/- 2.7 microg, p < 0.05] and during PCNL [7.0 +/- 4.3 vs. 1.9 +/- 1.8 microg, p < 0.05] than those who received EA. The volume fluids infused in patients who received TPVB was less than in those who received EA [854 +/- 362 vs. 1,320 +/- 468 ml, p < 0.05]. Time to first PCIA use, postoperative 24-hour consumption of sufentanil, and other parameters were comparable between groups
Conclusions: In this study, TPVB was as effective and safe as EA in providing intraoperative anesthesia and postoperative analgesia for PCNL, although more sedatives and analgesics were used during PCNL in patients who received TPVB
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Objective To investigate the effects of sericin pretreatment on the expression of extracellular matrix(ECM) associated protein in diabetic nephropathy(DN) rats' kidney.Methods Sixty six male SD rats were randomly divided into 3 groups(n=12):normal control group,DN model group and sericine pretreatment group.DN rats model in model group and sericine pretreatment group were established by intraperitoneally injection of streptozotocin(STZ).Blood glucose≥16.7 mmol/L was taken as the standard of successful modelization.The rats in sericine pretreatment group were lavaged with sericine(2.4 g·kg~(-1)·d~(-1)) for 35 days before injecting STZ.The enzymic method was used to measure the blood glucose.Type Ⅳ collagen(cⅣ)and laminin(LN)content in the serum were detected by ELBA.The expression of transforming growth factor-β_1,(TGF-β_1)and tissue inhibitors of maprix metalloproteinase-1(TMP-1) protein in the kidney was observed by immunohistochemical staining.The expression of Smad 3 protein in the kidney was detected by Western blot.Results Compared with normal control rats,the blood glucose,cⅣ and LN content in the serum,TGF-β_1,TIMP-1 and Smad 3 expression in the kidney of the model group rats increased obviously(P<0.01).The blood glucose,cⅣ and LN content in the serum,TGF-β_1,TMP-1 and Smad3 expression in the kidney of rats in sericine pretreatment group were significantly lower than those of the rats in model group(P<0.01).Conclusion Sericin pretreatment can inhibit the activation of TGF-β/Smad 3 signal pathway in the kidney of DN rats,and prevent the decrease of MMPs activity induced by up-regulation of TIMP-1.So sericin can prevent accumulation of ECM and glomerulosclerosis during DN,and has satisfactory apotropaic effects on the development of DN.
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Objective To compare the efficacy of the laryngeal mask airway Classic (CLMA), Streamlined Liner of Pharyngeal Airway (SLIPA) and laryngeal mask airway ProSeal (PLMA) in patients undergoing laparoscopic surgery. Methods One hundred and twenty-three ASA Ⅰ or Ⅱ patients aged 20-64 yr undergoing elective laparoscopic surgery were randomly divided into 3 groups: CLMA group (group C, n =41 ), SLIPA group (group S, n =42) and PLMA group (group P, n =40). Laryngeal mask was inserted after induction of anesthesia with sufentanil 0.3 μg/kg, atracurium 0.5 mg/kg and propofol 2 mg/kg. Mll the patients were ventilated with intermittent positive-pressure ventilation. Anesthesia was maintained with contiunous infusion of propofol 6-8 mg· kg-1· h-1 and with supplementary administration of sufentsnil 0.1-0.2 μg/kg and atracurium 0.2 mg/kg as required. The degree of difficulty in inserting the laryngeal mask was evaluated. The rate of successful placement at first attempt, device placement time, recovery time and complications were recorded . Peak inspiratory pressure (PIP) and the number of patients with an airway sealing pressure less than PIP were recorded before pneumoperitoneum and when intra-abdominal pressure achieved 12 mm Hg. Results The placement was easier and the placement time and recovery time were significantly shorter in group S, and the placement time was significantly longer,the airway sealing pressure was significantly higher and the number of patients with an airway sealing pressure less than PIP was lower in group P than in group C ( P ＜ 0.05). The placement time and recovery time were significantly longer, the placement was harder, the airway sealing pressure was significantly higher, and the number of patients with an airway sealing pressure less than PIP was lower in group P than in group S ( P ＜ 0.05). PIP was significantiy higher when intra-abdominal pressure achieved 12 mm Hg than that before pneumoperitoneum in all the three groups ( P ＜ 0.05). There was no significant difference in the incidence of complications and rate of successful placement at first attempt among the three groups ( P ＞ 0.05). Conclusion All the three airway devices can provide adequate ventilation during operation, with fewer complications. SLIPA placement is easiest. PLMA can assure good airway sealing and is most suitable for patients undergoing laparoscopic surgery.
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Objective To study the relationship between analgesic effect of total alkaloids in Papaver nudicaule(TAPN) and prostaglandins(PGs) with opium receptors.Methods The analgesic effect of TAPN was studied by hot-plate, writhing,electric-evoked methods of mice.The analgesic mechanisms of TAPN and PGs with opium receptors were studied by the writhing numbers induced by different substances(Ach,AA,MgSO_4),the PGE_2 level in celiac fluid in mice after treated by AA writhing test and the antagonistic experiment of Naloxone.Results The inhibitory effect of TAPN on the writhing induced by Ach and AA in mice was stronger than that induced by MgSO_4.TAPN could also lower the PGE_2 level in celiac fluid.In the antagonistic experiment of Naloxone,no antagonism to the analgesic effect of TAPN had been found by ip or icv Naloxone.Conclusion It may be the mainly peripheral analgesic mechanism that TAPN could lower the PGE_2 level in celiac fluid.Its central analgesic mechanisms are not related to opium receptors.