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Objective To observe whether ketamine improves the symptoms of post-traumatic stress disorder (PTSD).Methods Sixty male SD rats were randomized into four groups:groups CN,CK,PN and PK,15 in each.PTSD animal model was established by inescapable foot shock (IFS) procedure.In groups PK and CK,rats were treated with ketamine 2.5 mg/kg by intraperitoneal injection beginning at 30 min after the IFS procedure once a day for 14 days.Twelve rats were used for be havioral tests,and the others were sacrificed to collect hippocampus tissues for Western blot in each group 14 d after IFS procedure,respectively.The expression of neuroligin (NLGN)-1 was detected by Western blot.Results In the fear conditioning test,compared with group CN,the percent age of freezing time in total time in group PN was significantly increased (P＜0.01).Compared with group PN,the percent age of freezing time in PK group was significantly decreased (P＜0.01).In the water maze test,compared with group CN,the escape latency of group PN was significantly increased on day 2,3,4,5 of training period (P＜0.05).Compared with group PN,the escape latency of group PK was significantly decreased on day 2,4,5 of training period (P＜0.05).There was no significant difference in the time spent in the target quadrant.The expression of NLGN-1 in the hippocampus was significantly increased in PN group compared with group CN (P＜0.05);compared with group PN,the expression of NLGN-1 in the hippocampus was significantly decreased in PK group (P＜0.05).Conclusion The study suggest that the fear memory is significantly,increased and the hippo campus-dependent spatial learning capacity is impaired in the PTSD model rats.And the increased ex pression of hippocampal NLGN-1 may be involved in the development of PTSD.Ketamine mediated down regulation of NLGN-1 in the hippocampus might contribute to attenuating the fear memory and improving the hippocampus dependent spatial learning in the PTSD model rats.
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Objective To evaluate the effect of intraoperative application of dexmedetomidine on acute post-traumatic stress disorder (PTSD) in female patients with lower limb fracture.Methods Ninety female patients with lower limb fractures caused by traffic accident,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 20-35 yr,weighing 40-72 kg,scheduled for elective internal fixation,were divided into 3 groups (n =30 each) using a random number table:control group (group C),low-dose dexmedetomidine group (group D1) and high-dose dexmedetomidine group (group D2).Ropivacaine (0.75％) 10-15 ml was injected into the epidural space,and operation was started after pain disappeared at the plane T8-10.Two percent lidocaine 5-10 ml was intermittently injected to maintain the anesthetic plane at T10.After successful epidural anesthesia,dexmedetomidine 0.5 and 1.0 μg/kg were intravenously infused over 30 min in D1 and D2 groups,respectively,while the equal volume of normal saline was given in group C.Patient-controlled epidural analgesia was performed with 0.15％ ropivacaine after operation and lasted until 48 h postoperatively,maintaining visual analogue scale score ≤ 3 (baseline).Morphine 3 mg was intravenously injected for rescue analgesia when visual analogue scale score＞3.The requirement for rescue analgesia within 48 h after operation was recorded.Acute Stress Disorder Scale (ASDS),Self-Rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores were assessed at 1 h before operation and on 1,3 and 7 days after operation.The patients were followed up for 3 months by telephone,and the PTSD Checklist-Civilian Version score was evaluated.The occurrence of acute PTSD (PTSD Checklist-Civilian Version score ＞ 38) was recorded.Results Compared with group C,the ASDS,SAS and SDS scores were significantly decreased on 1,3 and 7 days after operation,and the incidence of acute PTSD was decreased in D1 and D2 groups (P＜0.05).Compared with group D1,the ASDS scores were significantly decreased on 1,3 and 7 days after operation,and the incidence of acute PTSD was decreased (P＜0.05),and no significant change was found in SAS or SDS scores at each time point in group D2 (P＞ 0.05).There was no significant difference in the requirement for rescue analgesia between the three groups (P＞0.05).Conclusion Intraoperative application of dexmedetomidine can reduce the occurrence of acute PTSD and it is dose-related in female patients.
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Objective To investigate the effect of hydrogen-rich saline postconditioning on the expression of vascular endothelial growth factor receptor-1 (VEGFR1) during myocardial ischemiareperfusion (I/R) injury in rats.Methods Thirty-six adult male Sprague-Dawley rats,weighing 250-280 g,were randomly divided into 3 groups (n=12 each) using a random number table:sham operation group (group S),group I/R and hydrogen-rich saline group (group H2).Myocardial I/R was induced by 30 min ligation of anterior descending branch of the left coronary artery followed by 2 h reperfusion.In group H2,hydrogen-rich saline 5 ml/kg was injected intravenously at 5 min before reperfusion,while the equal volume of normal saline was given in group I/R.Left ventricular systolic pressure (LVSP),left ventricular enddiastolic pressure (LVEDP) and ± dp/dtmax were measured and recorded during reperfusion and at 120 min of reperfusion.The rats were sacrificed at 120 min of reperfusion,and myocardial specimens were obtained for determination of myocardial infarct size,contents of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) (using ELISA),and expression of VEGFR1 (by Western blot).At 120 min of reperfusion,blood samples were collected from the common carotid artery to measure cardiac troponin I (cTnI) concentrations in serum.Results Compared with group S,LVSP and ± dp/dtmax were significantly decreased,LVEDP was increased,the myocardial infarct size was enlarged,cTnI concentrations in serum and contents of IL-6 and TNF-α were increased,and the expression of VEGFR1 was down-regulated at 120 min of reperfusion in H2 and I/R groups.Compared with group I/R,LVSP and ± dp/dtmax were significantly increased,LVEDP and myocardial infarct size were decreased,cTnI concentrations in serum and contents of IL-6 and TNF-α were decreased,and the expression of VEGFR1 was up-regulated at 120 min of reperfusion in group H2.Conclusion Hydrogen-rich saline postconditioning can reduce myocardial I/R injury possibly by upregulating myocardial VEGFR1 expression and inhibiting inflammatory responses in the myocardium of rats.
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Objective To compare local infiltration anesthesia with different concentrations of ropivacaine for postoperative analgesia in pediatric patients undergoing tonsillectomy.Methods Sixty ASA physical status Ⅰ patients of both sexes,aged 6-12 yr,weighing 18-41 kg,scheduled for elective tonsillectomy,were randomly divided into 3 groups (n =20 each) using a random number table:control group (group C); 0.2％ ropivacaine group (group R1) ; 0.5 ％ ropivacaine group (group R2).Anesthesia was induced with inhalation of sevoflurane,injection of sufentanil and cisatracurium and maintained with inhalation of sevoflurane and iv infusion of remifentanil.The tonsil was locally infiltrated vith 0.2 ％ and 0.5％ ropivacaine (3-5 ml on each side of the tonsil) before surgery in R1 and R2 groups,respectively.Tonsillectomy was performed under general anesthesia.At 1,3,6,12,and 24 h after surgery,pain was assessed using faces pain scale-revised (FPS-R).Paracetamol 5 mg/kg was used as rescue analgesic when FPS-R scores ≥4.The interval between awake extubation and the first request for analgesic,requirement for postoperative analgesic and development of adverse effects were recorded.Results Compared with group C,the interval between awake extubation and the first request for analgesic was significantly prolonged,and the requirement for postoperative analgesic was decreased in R1 and R2 groups (P ＜ 0.05).Compared with group R1,the interval between awake extubation and the first request for analgesic was significantly prolonged,and the requirement for postoperative analgesic was decreased in R2 group (P ＜ 0.05).There was no significant difference in the incidence of adverse effects between the two groups (P ＞ 0.05).Conclusion The optinum concentration of locally infiltrated ropivacaine is 0.5 ％ for postoperative analgesia in pediatric patients undergoing tonsillectomy.