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OBJECTIVE@#To investigate the effect of Akt2 inhibitor on macrophage polarization in the periapical tissue in a rat model of periapical inflammation.@*METHODS@#Rat models of periapical inflammation were established in 28 normal SD rats by opening the pulp cavity of the mandibular first molars, followed by injection of normal saline and Akt2 inhibitor into the left and right medullary cavities, respectively. Four rats without any treatment served as the healthy control group. At 7, 14, 21 and 28 days after modeling, 7 rat models and 1 control rat were randomly selected for observation of inflammatory infiltration in the periapical tissues by X-ray and HE staining. Immunohistochemistry was used to detect the expression and localization of Akt2, macrophages and the inflammatory mediators. RT-PCR was performed to detect the mRNA expressions of Akt2, CD86, CD163, inflammatory mediators, miR-155-5p and C/EBPβ to analyze the changes in macrophage polarization.@*RESULTS@#X-ray and HE staining showed that periapical inflammation was the most obvious at 21 days after modeling in the rats. Immunohistochemistry and RT-PCR showed that compared with those in the control rats, the expressions of Akt2, CD86, CD163, miR-155-5p, C/EBPβ, and IL-10 increased significantly in the rat models at 21 days (P < 0.05). Compared with saline treatment, treatment with the Akt2 inhibitor significantly decreased the expression levels of Akt2, CD86, miR-155-5p and IL-6 and the ratio of CD86+M1/CD163+M2 macrophages (P < 0.05) and increased the expression levels of CD163, C/EBPβ and IL-10 in the rat models (P < 0.05).@*CONCLUSION@#Inhibition of Akt2 can delay the progression of periapical inflammation in rats and promote M2 macrophage polarization in the periapical inflammatory microenvironment possibly by reducing miR-155-5p expression and activating the expression of C/EBPβ in the Akt signaling pathway.
Subject(s)
Rats , Animals , Proto-Oncogene Proteins c-akt/metabolism , MicroRNAs/genetics , Interleukin-10 , Rats, Sprague-Dawley , Macrophages/metabolism , Inflammation/metabolismABSTRACT
Objective:To investigate the effects of early rehabilitation training after total knee arthroplasty surgery by continuous femoral nerve block (CFNB) with or without periarticular local infiltration analgesia (PLIA).Methods:In this randomized,double-blind,controlled study,100 patients undergoing primary unilateral total knee arthroplasty in patients with knee osteoarthritis were enrolled.All the patients received CFNB for postoperative analgesia before combined spinal epidural anesthesia.They were randomly divided into 2 groups (n =50 each):CFNB group,CFNB combined with PLIA group (PLIA group).Group PLIA received periarticular local infiltration analgesia with 20 mL ropivacaine (5 g/L),while the equal volume of normal saline was used instead of ropivacaine in group CFNB.Postoperative pain during rest and passive exercises including front and rear portions of knees,the time of ability to perform an active straight leg raise,the time of ability to reach 90° knee flexion,and preoperative and postoperative hospital for special surgery knee score (HSS) were evaluated.Results:Compared with group CFNB,the visual analogue scores (VAS) of front of knees at rest time in group PLIA had no significant difference (P ＞ 0.05);there were significant differences at 4,8,12,24 h postoperation in portions of knees at rest time (P ＜ 0.05);the VAS had significant differences at 24 h in passive exercises of knees (P ＜ 0.05);the VAS had significant differences at 12,24 h in portions of knees at passive exercises of the knees (P ＜ 0.05);the time of ability to perform an active straight leg raise had significant differences in the two groups (P ＜ 0.05).Conclusion:Compared with CFNB postoperative analgesia alone,CFNB with PLIA could relieve rest pain and pain during passive movement after total knee arthroplasty.CFNB with PLIA could shorten the time to perform an active straight leg raise and the time of ability to reach 90° knee flexion.And so some patients could improve postoperative rehabilitation training.
ABSTRACT
OBJECTIVE@#To observe the effects of different maintain doses of Dexmedetomidine on plasma cortisol and glucose during anesthesia recovery period in patients undergoing uvulopalatopharyngoplasty under sevoflurane inhalation anesthesia.@*METHOD@#In this prospective, randomized, double-blind study, 120 ASA I and II patients undergoing selective uvulopalatopharyngoplasty under general anesthesia were included. The patients were randomly allocated to three groups (n = 40): Dexmedetomidine low maintain dose group (D1), Dexmedetomidine high maintain dose group (group D2) and control group (group C). The Dexmedetomidine groups and control group were given Dexmedetomidine 1 microg/kg and normal saline in 20 ml within 15 min just before induction of anesthesia. Then Dexmedetomidine were maintained at 0.2 microg x kg(-1) x h(-1) and 0.7 microg x kg(-1) x h(-1) in group D1 and group D2 and were withdrawed 5 min before the end of operation, the same maintained speed of normal saline was given in group C. BIS value was maintained at 40-60 by adjusting the inhaled concentration of sevoflurane. Anesthetic was withdrawed 10 min before the end of operation. Thus, plasma cortisol concentration and blood glucose was needed to be detected just before anesthesia (T0), tracheal extubation (T1), 5 min after extubation (T2) and 15 min after extubation (T3). Duration of operation and anesthesia, consumption of sevoflurane, emergence time, extubation time, the occurrence of dysphoria, bucking and hypoxemia (SpO2 0.05).@*CONCLUSION@#In the patients undergoing UPPP under sevoflurane inhalation anesthesia, Dexmedetomidine infused at 0.2 microg x kg(-1) x h(-1) maintains a stable hemodynamics without respiratory depression, alleviates stress response during extubation and reduces both the consumption of sevoflurane and the occurrence of dysphoria without prolonging emergence time and extubation time.