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Objective:To evaluate the role of ferroptosis in lung injury in a rat model of autologous orthotopic liver transplantation.Methods:Twenty-four healthy adult SPF-grade male rats, aged 8-10 weeks, weighing 230-270 g, were divided into 3 groups ( n=8 each) using the random number table method: sham operation group (S group), autologous in situ liver transplantation group (LT group) and ferroptosis inhibitor Ferrostain-1 group (LT+ Fer-1 group). In LT group and LT+ Fer-1 group, an autologous in situ liver transplantation model was developed in anesthetized animals, and Ferrostain-1 5 mg/kg was intraperitoneally injected at 30 min before surgery in LT+ Fer-1 group. The inferior vena cava blood samples were obtained at 6 h of reperfusion, then animals were sacrificed, and lung tissues were obtained. The morphology of lung tissues was examined, and the lung injury was scored. The serum malondialdehyde (MDA) concentration and contents of MDA, reduced glutathione (GSH), glutathione peroxidase4 (GPX4), and Fe 2+ in lung tissues were measured by enzyme-linked immunosorbent assay. The expression of ferritin heavy chain 1 (FTH1) and solute carrier family 7 member 11 recombinant protein (SLC7A11) was determined by Western blot. Results:Compared with S group, the lung injury, serum MDA concentration, and contents of MDA and Fe 2+ were significantly increased, the contents of GSH and GPX4 were decreased, and the expression of FTH1 and SLC7A11 was down-regulated in LT group ( P<0.05). Compared with LT group, the lung injury, serum MDA concentration, and contents of MDA and Fe 2+ were significantly decreased, the contents of GSH and GPX4 were increased, and the expression of FTH1 and SLC7A11 was up-regulated in LT+ Fer-1 group ( P< 0.05). Conclusions:Ferroptosis is involved in the pathophysiology of lung injury in a rat model of autologous orthotopic liver transplantation.
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AIM: To investigate the clinical effect of 25G+pars plana vitrectomy(PPV)combined with preoperative intravitreal injection of conbercept in the treatment of patients with proliferative diabetic retinopathy(PDR), and analyze the influence on visual acuity, central foveal thickness(CMT)and serum vascular endothelial growth factor(VEGF)level.METHODS: A retrospective study was conducted from October 2019 to January 2022. A total of 80 patients(87 eyes)with PDR were divided into the two groups according to the treatment method, with 40 patients(45 eyes)treated with 25G+PPV in the control group, and 40 patients(42 eyes)treated with 25G+PPV combined with preoperative intravitreal injection of conbercept in the observation group. The two groups were compared in terms of the best corrected visual acuity(BCVA), intraocular pressure, CMT and serum VEGF level before treatment and at 2wk, 1 and 3mo after treatment. The patients were followed up for 3mo, with postoperative complications and recurrence recorded.RESULTS: The incidence of intraoperative bleeding in the observation group was significantly lower than that in the control group(P&#x003C;0.05). After treatment, the BCVA of the two groups was improved(P&#x003C;0.05), CMT and serum VEGF level were decreased(P&#x003C;0.05), but there was no significant change in intraocular pressure(P&#x003E;0.05). The BCVA and CMT of observation group were lower than those of control group at 1 and 3mo after treatment(P&#x003C;0.05). Serum VEGF level in the observation group was lower than that in the control group at 3mo after treatment(P&#x003C;0.05). The incidence of complications in observation group(5%)within 3mo after treatment was significantly lower than that in control group(18%; P&#x003C;0.05). There was no statistically significant difference in recurrence rate of PDR between the two groups(P&#x003E;0.05).CONCLUSION: With few complications, 25G+PPV combined with preoperative intravitreal injection of conbercept is effective in the treatment of patients with PDR, which can better promote postoperative vision recovery, improve macular edema, and reduce serum VEGF level.
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Objective:To evaluate the optimization efficacy of ropivacaine mixed with nalbuphine for epidural labor analgesia through comparison with ropivacaine mixed with sufentanil in primiparas.Methods:Four hundred and forty primiparas with a singleton fetus in vertex presentation without abnormal fetus, aged 19-36 yr, at 37-42 weeks of gestation, who were suitable and volunteered to receive epidural labor analgesia, were selected and randomly divided into observation group (NR group, n=220) and conventional group (C group, n=220).Epidural labor analgesia solution contained nalbuphine 40 mg and ropivacaine 120 mg in 150 ml of normal saline in group NR.Epidural labor analgesia solution contained sufentanil 50 μg and ropivacaine 120 mg in 150 ml of normal saline in group C. The analgesia pump was set up to deliver a 5 ml bolus dose with a 20-min lockout interval, programmed intermittent bolus 10-15 ml/h and background infusion at 2 ml/h after an initial dose of 15 ml to maintain VAS score <3.The length of labor, adverse reactions during labor analgesia, neonatal Apgar score, parameters of umbilical artery blood gas analysis and neonatal behavioral neurological assessment score were recorded. Results:Compared with group C, the incidence of urinary retention, pruritus, nausea and vomiting and fever at birth was significantly decreased in group NR ( P<0.05).The duration of the first and second stages of labor, neonatal Apgar score, pH value of umbilical artery blood, lactate concentrations, and neonatal behavioral neurological assessment score were within the normal range in both groups, and there was no significant difference between the two groups ( P>0.05). Conclusions:Compared with conventional medication, nalbuphine mixed with ropivacaine has the same efficacy when used for epidural labor analgesia in primiparas, but it has a certain optimization efficacy in terms of safety.
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BACKGROUND: The posterolateral approach is the most commonly used surgical approach for total hip arthroplasty. In recent years, total hip replacement by direct anterior approach has been applied in clinic gradually, and has achieved good treatment outcomes. OBJECTIVE: To compare the clinical efficacy of the direct anterior approach in supine position and the posterolateral approach in supine position for total hip arthroplasty. METHODS: Ninety patients undergoing unilateral primary total hip arthroplasty at Baoding Municipal First Center Hospital from April 2015 to April 2019 were included, including 35 males and 55 females, aged 35-70 years. The patients were divided into direct anterior approach group (n=45) and posterolateral approach group (n=45) by the random number table method. Postoperative follow-up was used to evaluate the Harris hip scores, Visual Analogue Scale scores, initial fixation mass of prosthesis and safe range of the cup. The study was approved by the Ethics Committee of Baoding Municipal First Center Hospital. RESULTS AND CONCLUSION: (1) Ninety patients were followed up for 3-51 months, with an average 14 months. There were 2 cases of intraoperative great trochanteric fracture, 1 case of femoral lateral cutaneous nerve injury, 4 cases of femoral nerve injury, and 20 cases of tensor fascia lata injury. No such complications occurred in the posterolateral approach group. (2) The direct anterior approach group showed significant superior outcomes compared with the posterolateral approach group in the Harris hip scores and Visual Analogue Scale scores at 1 month after surgery (P 0.05). (3) In the direct anterior approach group, the femoral prosthesis of 44 hips was in neutral position, and 1 hip was in varus position. The initial fixation quality of all prosthesis was excellent. In the posterolateral approach group, the femoral prosthesis of 43 hips was in neutral position, 2 hips were in varus position and all prosthesis initial fixation quality was excellent. No significant difference was found between two groups (P > 0.05). (4) The ratio of acetabular cups in the safety range of Lewinnek in the direct anterior approach group was higher than that in the posterolateral approach group (100%, 82%, P < 0.05). (5) These results imply that compared with the posterolateral approach, direct anterior approach in supine position for total hip arthroplasty can significantly reduce postoperative pain, promote postoperative early rapid recovery, obtain more accurate angle of the acetabular prosthesis, and be more conducive to the equalization of both lower limbs. It is a safe and reliable approach. However, direct anterior approach has certain technical difficulty and needs a learning curve. And there are some complications different from other approaches.
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OBJECTIVE@#To summarize the experience of diagnosis and surgical treatment of renal oncocytoma, and to evaluate the surgical results based on follow-up results, in order to find the best strategy.@*METHODS@#In the study, 21 cases with renal oncocytoma from December 2003 to April 2016 in Peking University Third Hospital were retrospectively analyzed, including 4 males, and 17 females, with 10 cases on the right side and 11 cases on the left side. Their age was between 15 to 80 years (average: 58 years). Ultrasound or CT examination after admission was conducted. Ultrasound examination showed solid nodules. CT manifestations were solid masses with enhancement, and the tumor size was between 1.5 cm to 6.5 cm (average: 3.3 cm). Of the 21 cases, 9 were located in the middle of kidney, 7 were located in the upper pole, and 5 were located in the lower pole. After preoperative examination, according to the size and location of the tumor, laparoscopic partial nephrectomy or laparoscopic nephrectomy was performed, respectively.@*RESULTS@#All the operations were successful, in which 17 cases underwent laparoscopic partial nephrectomy (including 3 cases which were converted to open surgery), and 4 cases underwent laparoscopic radical nephrectomy. The operation time ranged from 75 to 274 min (mean: 144 min), and the blood loss ranged from 10 to 1 000 mL (mean: 115 mL). The postoperative hospital stay time ranged from 6 to 13 d (average: 8.2 d). The pathological results were all renal oncocytoma. In the study, 17 cases were followed up while 4 cases were lost to follow-up. The follow-up time ranged from 12 to 175 months (mean: 44 months). One case died in 20 months after operation with unknown reason, and there were no recurrence or metastasis in the other 16 cases.@*CONCLUSION@#Renal oncocytoma is a benign tumor with good prognosis. Enhanced CT is an effective diagnostic method in assistant examination, but it is difficult to differentiate clear cell carcinoma only from the naked eye. It is worthwhile to measure CT value at different stages of the tumor by picture archiving and communication systems (PACS), and to compare with CT value of adjacent kidney tissue may improve the diagnostic efficiency of CT. Laparoscopic surgery is an effective treatment for renal oncocytoma. We recommend laparoscopic partial nephrectomy for the patients with renal oncocytoma as the best choice if conditions permit.
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Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Adenoma, Oxyphilic/therapy , Carcinoma, Renal Cell , Kidney Neoplasms/therapy , Laparoscopy , Nephrectomy , Retrospective StudiesABSTRACT
Objective To discuss the application value of vehicle-pedestrian collision road traffic accidents reconstruction based on PC-Crash software in forensic identification. Methods A case of vehicle-pedestrian collision was chosen based on a tachograph, then PC-Crash software was applied to construct a vehicle-pedestrian collision model, and reconstruct the vehicle-pedestrian collision road traffic accident. Finally, the process of vehicle-pedestrian collision was reproduced. Results In accident reconstruction, when the car speed was lower than 50km/h, the landing point of the pedestrian after collision was in the front of the car. When the car speed was higher than 50 km/h, after collision, the pedestrian flipped towards the car roof and landed behind the car. With the increase of vehicle speed, throwing distance of the pedestrian increased continuously. When the vehicle collision speed reached 60 km/h, the experimental results in this case were basically consistent with the actual situation of the case. Head acceleration of the pedestrian was at the maximum （1 655.70 m/s2） at 0.080 s. Chest acceleration of the pedestrian increased from 597.63 m/s2 to the peak 675.52 m/s2 at 0.055-0.060 s. Tibia acceleration of the pedestrian increased from 759.26 m/s2 to the first peak 1 367.06 m/s2, then reached the maximum speed （1 718.19 m/s2） at 1.225 s. Conclusion The process of vehicle-pedestrian collision road traffic accidents can be reconstructed based on PC-Crash software under a situation of limited conditions, and can further clarify the speed of the vehicle, the location and degree of human body injury as well as the mechanism of damage of the pedestrian in the accident. Therefore, PC-Crash software has a certain practical value in forensic identification of road traffic accidents.
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Humans , Acceleration , Accidents, Traffic , Forensic Sciences , Head , Pedestrians , SoftwareABSTRACT
Objective To evaluate the role of necroptosis in intestinal injury induced by autologous orthotopic liver transplantation ( AOLT) in rats. Methods Twenty-four SPF adult male Sprague-Dawley rats, aged 10-12 weeks, weighing 250-280 g, were divided into 3 groups ( n=8 each) using a random number table method: sham operation group ( group S) , AOLT group ( group T) and necroptosis inhibitor necrostatin-1 group ( group N) . Necrostatin-11. 0 mg∕kg and the equal volume of dimethyl sulfoxide ( DM-SO) were intraperitoneally injected at 30 min before surgery in N and T groups, respectively. Blood samples were collected from the inferior vena cava at 6 h after opening the portal vein ( at 6 h after the end of surgery in group S) for determination of serum diamine oxidase ( DAO) , D-lactic acid ( D-LA) and intestinal fatty acid binding protein ( I-FABP ) concentrations by enzyme-linked immunosorbent assay. Rats were sacrificed after blood sampling, and the intestine was removed for examination of the pathological changes ( with a light microscope ) and for determination of malondialdehyde ( MDA ) contents and superoxide dismutase ( SOD) activities ( using a spectrophotometer) , and the expression of receptor-interacting protein kinase-1 ( RIPK1) , RIPK3 and mixed lineage kinase domain-like protein ( MLKL) in intestinal tissues ( by Western blot) . Intestinal damage was assessed and scored using Chiu' s scoring system. Results Compared with group S, the serum DAO, D-LA and I-FABP concentrations, MDA content and Chiu's score were signifi-cantly increased, SOD activity was decreased, and the expression of RIPK1, RIPK3 and MLKL was up-regulated in group T ( P<0. 05) . Compared with group T, the serum DAO, D-LA and I-FABP concentra-tions, MDA content and Chiu's score were significantly decreased, the SOD activity was increased, and the expression of RIPK1, RIPK3 and MLKL was down-regulated in group N ( P<0. 05) . Conclusion Ne-croptosis is involved in the pathophysiological process of intestinal injury induced by AOLT in rats.
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Objective To evaluate the role of necroptosis in liver injury in rats undergoing autolo-gous orthotopic liver transplantation ( AOLT). Methods Twenty-four SPF adult male Sprague-Dawley rats, weighing 250-280 g, were divided into 3 groups ( n=8 each) using a random number table method:sham operation group ( group S ) , AOLT group ( group T ) and necroptosis inhibitor necrostatin-1 group ( group N) . Rats were anesthetized using intraperitoneal 5％ chloral hydrate 0. 5 ml∕100 g. A standard mod-el of OALT was established as previously described by Yao et al. in T and N groups. Necrostatin-11. 0 mg∕kg and the equal volume of dimethyl sulfoxide were intraperitoneally injected at 30 min before surgery in N and T groups, respectively. Blood samples were collected from the inferior vena cava at 6 h after opening the portal vein ( at 6 h after operation in group S) for determination of serum aspartate amino-transferase(AST) and alanine amino-transferase (ALT) concentrations. The livers were removed for examination of the pathological changes (with a light microscope) and for determination of the malondialdehyde (MDA) contents and superoxide dismutase ( SOD) activity ( using a spectrophotometer) and expression of receptor-interacting protein kinase-1 ( RIPK1) , RIPK3 and mixed lineage kinase domain-like ( MLKL) in liver tis-sues ( by Western blot) . The damage to livers was evaluated using Suzuki′s scoring system. Results Com-pared with group S, the serum AST and ALT concentrations, Suzuki′s score of liver tissues and MDA con-tent were significantly increased, the SOD activity was decreased, and the expression of RIPK1, RIPK3 and MLKL was up-regulated in group T ( P<0. 05) . Compared with group T, the serum AST and ALT con-centrations, Suzuki′s score of liver tissues and MDA content were significantly decreased, the SOD activity was increased, and the expression of RIPK1, RIPK3 and MLKL was down-regulated in group N ( P<0. 05) . Conclusion Necroptosis is involved in liver injury in rats undergoing AOLT.
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With the development of the computer simulation technology and the digital simulation technology, the traditional calculation method has been gradually replaced by the digital method to deal the road traffic accident scene and analyse the process. The PC-Crash software simulation system can reconstruct the traffic accidents within 32 vehicles, and the accuracy of reconstruction has been fully verified, which is widely used by the transport police department and the accreditation agency. In this paper, the research of road traffic accident reconstruction using PC-Crash software is reviewed, and the application of road traffic accident reconstruction technology based on PC-Crash software and some existing problems in forensic practice are discussed, which provides reference for the research and identification of road traffic accident simulation and reconstruction and theoretical basis for accident treatment.
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Humans , Accidents, Traffic , Computer Simulation , Models, Theoretical , Police , SoftwareABSTRACT
Objective To investigate the effects of ulinastatin preconditioning combined with postconditioning on kidney injury of pediatric patients undergoing living donor liver transplantation (LDLT) and the underlying mechanism.Methods Forty pediatric patients with biliary atresia,scheduled for LDLT,were randomly divided into two groups (n =20 each):the ulinastatin group and the control group using a random number table.Ulinastatin (20 000 U/kg) was diluted into 10 000 U/mL with normal saline,and it was then injected intravenously in 2 parts (1/2 was given before skin incision;1/2 at 5 min before portal vein declamping) in the ulinastatin group.In the control group,the equal volume of normal saline was given instead of ulinastatin.Blood samples and urine specimens were taken from the central vein immediately before skin incision (T0,baseline),at 30 min of anhepatic period (T1),at 1 h of neohepatic period (T2),at the end of surgery (T3),and 24 h after surgery (T4) for the determination.The concentrations of serum and urine β2-microglobulin (β2-MG) were measured using an immunonephelometric method.The levels of serum TNF-α,IL-6 and IL-18 were measured using an ELISA method.The serum concentrations of creatinine (Cr) and blood urea nitrogen (BUN) were measured using a colorimetry method.Results The serum Cr,BUN,β2-MG and urine β2-MG concentrations were higher at T2-4 than at T0 in the two groups (P＜0.05 or 0.01).As compared with the control group,the serum Cr,BUN,β2-MG and urine β2-MG concentrations were significantly decreased in the ulinastatin group (P＜0.05 or 0.01).The serum levels of TNF-α,IL-6 and IL-18 were higher at T2 4 than at T0 in the two groups (P＜0.05 or 0.01).As compared with the control group,the serum levels of TNF-α,IL-6,and IL-18 were significantly decreased in the ulinastatin group (P＜0.05 or 0.01).Conclusion Ulinastatin preconditioning combined with postconditioning can alleviate kidney injury in pediatric patients undergoing LDLT to some extent,which may be related to inhibiting the excessive release of inflammatory factors.
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Aim To investigate the effects of gastrodin on SH-SY5Y cell autophagy induced by methamphet-amine (METH) and the underlying mechanisms. Methods SY5Y cells were treated by METH with the concentration of 0.5,1.0,1.5,2.0,2.5,3.0 mmol·L-1for 24 h. The morphological changes were ob-served by microscopy,the expression of LC3-Ⅱ,Bec-lin-1,Akt,p-Akt,mTOR and p-mTOR were detected by Western blot. Gastrodin was added to the medium 1 h before METH treatment. Results The SY 5 Y cells were morphologically featured by shrinkage and den-drite disruption after exposed to METH(0~3 mmol· L-1),and autophagic vacuoles occurred in cytoplasm. The expression of LC3-Ⅱ increased over METH dose. Confocal results showed that LC3-Ⅱsignificantly in-creased in METH group as compared with control, while decreased in METH+ Gastrodin group. The ex-pression levels of LC3-Ⅱand Beclin-1 significantly in-creased (P<0.01) in METH group, p-mTOR and p-Akt decreased, and mTOR and Akt showed no signifi-cant difference as compared with control. However, the gastrodin could decrease the expression of LC3-Ⅱand Beclin-1 and increase the expression of mTOR,p-mTOR,Akt and p-Akt as compared with METH-trea-ted groups. Conclusions METH can induce SY5Y cells autophagy. The protective effect of gastrodin a-gainst METH-induced autophag may be related to gast-rodin regulation mTOR and Akt signaling pathway.
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Objective To evaluate the effect of ulinastatin on acute kidney injury in the pediatric patients undergoing living-donor liver transplantation (LDLT).Methods Forty pediatric patients with congenital biliary atresia,aged 5-14 months,weighing 5.5-10.0 kg,of American Society of Anesthesiologists physical status Ⅲ or Ⅳ,scheduled for elective LDLT,were divided into either control group (group C,n=20) or ulinastatin group (group U,n=20) using a random number table.Ulinastatin 20 000 U/kg was diluted to 10 000 U/ml in normal saline and then intravenously infused in 2 parts (1/2 was given immediately before skin incision;1/2 at 5 min before portal vein declamping) in group U.The equal volume of normal saline was given instead of ulinastatin at the same time points in group C.Immediately before skin incision (To,baseline),at 30 min of anhepatic period (T1),at 1 h of neohepatic period (T2),at the end of surgery (T3) and at 24 h after surgery (T4),blood samples from the central vein and urine specimens were collected for determination of creatinine (Cr) and blood urea nitrogen (BUN) concentrations in serum (by colorimetric assay) and β2-microglobulin (β2-MG) concentrations in serum and urine (using immunoturbidimetric method).The urine volume,requirement for dopamine and diuretics and occurrence of adverse cardiovascular events (hypotension,myocardial ischemia,ventricular premature beat)were recorded during surgery.The changing rates of Cr,BUN and β2-MG concentrations in serum and β2-MG concentrations in urine were calculated at T1-4.Results Compared with group C,the urine volume was significantly increased,Cr and β2-MG concentrations in serum,β2-MG concentrations in urine and the changing rates were decreased at T2-4,serum BUN concentrations and the changing rates were decreased at T3,4 (P＜0.05 or 0.01),and no significant changes were found in the incidence of adverse cardiovascular events or requirement for dopamine and diureitcs in group C (P＞0.05).Conclusion Ulinastatin can attenuate acute kidney injury in the pediatric patients undergoing LDLT.
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Objective To investigate the changes of hemodynamics and cardiac function in pediatric living donor liver transplantation (LDLT).Methods 50 cases of pediatric living donor liver transplantation in our hospital from January 2016 to January 2017 were collected.The hemodynamics was monitored by Mostcare with the radial artery.Acquisition of heart rate (HR),mean arterial pressure (MAP),peripheral vascular resistance index (SVR/SVRI),stroke volume / stroke index (SV/SVI),cardiac output (CO/CI),cardiac index / stroke volume variability (SVV),dp/dtmax (cardiac contractility),cardiac cycle efficiency (CCE) at the moment of the start of operation(T0),before occlusion of the inferior vena cava (T1),immediately after occlusion of the inferior vena cava (T2),anhepatic phase 30 min (T3),immediately after reperfusion(T4),neohepatic phase 5 min (T5),30 min (T6) and 60 min (T7).Results There were no significantly hemodynamic fluctuations before occlusion of the portal vein.At T3,the increased of MAP,CI,SVRI (T3 vs T0,P＜0.05),while CCE decreased significantly (T3 vs T0,P＜0.05);MAP,SVRI,lower HR,CI and dp/dtmax have different degrees of liver T4,but the change was not significant.SVV fluctuated in the anhepatic phase at 11％ ～ 15％,maintained in the new liver stage at 12％ ～ 15％,but fluctuated slightly.Conclusion Mostcare can be used to monitor the hemodynamic and cardiac function changes in pediatric living donor liver transplantation,but the reasons for the change of the monitoring indicators and the significance of guiding the perioperative treatment need to be further studied.
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Objective To investigate the effects of different infusion rates of remifentanil infusion on spontaneous ventilation in children received sevoflurane anesthesia. Methods A total of 120 children underwent strabismus surgery were randomly assigned to four groups: C group (administration of saline), L group (remifentanil 0.03 μg · kg-1 · min-1), M group (remifentanil 0.06μg · kg-1 · min-1) and H group (remifentanil 0.09μg · kg-1 · min-1). The mean blood pressure (MBP), heart rate (HR), respiratory rate (RR), tidal volume (VT), minute ventilation (MV), endtidal CO2 [p(CO2)] and endtidal SEV were recorded after laryngeal mask insertion (T1), an initial bolus dose of remifentanil (T2),10 mins after remifentanil infu-sion (T3),15 mins after remifentanil infusion (T4) and laryngeal mask remove (T5) respectively. The adverse events and time of induction, maintenance and emergence were also recoded. Results There were no significant differences in patient age, body mass index, anesthesia time, operation time, HR and MBP at different time points between four groups. No body movement and hypoxemia were observed. The values of RR and MV at T3, T4 and T5 were significantly lower in H group than those of other three groups (P <0.05). Values of p(CO2)at T3 and T4 were significantly higher in H group than those of other three groups (P<0.05). The values of RR at T3, T4 and T5 were significantly lower in L group and M group than those of C group. The values of MV at T3 and T4 were significantly lower in L group and M group than those of C group. p(CO2)at T4 was significantly higher in L group and M group than that of C group(P<0.05), but no significant difference was found be-tween L group and M group. There was no significant difference in value of VT between four groups. Conclusion Remifent-anil infusion at a rate of 0.03~0.09μg·kg-1·min-1 could depress spontaneous ventilation in children received sevoflurane an-esthesia. The respiratory depression effect is mainly manifested by reduction of RR. It is a good option to choose 0.03~0.06μg · kg-1 · min-1 infusion to keep spontaneous ventilation and avoid severe respiratory depression according to the demand of operations in children.
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Objective To investigate the effect of berberine preconditioning on the intestinal injury caused by liver cold ischemia/reperfusion (I/R) in rats.Methods Twenty-four pathogen-free male Sprague-Dawley rats,weighing 220-250 g,were randomized into 3 groups (n =8 each) using a random number table:sham operation group (S group),I/R group,and berberine preconditioning group (B group).The animals were anesthetized with 5％ chloral hydrate 60 mg/kg.In B group,berberine 200 mg/kg was administered through a gastric tube once a day for 7 consecutive days starting from 7 days before operation.The equal volume of normal saline was given instead of berberine in group Ⅰ/R.At 8 h after operation,the rats were sacrificed and the intestines were harvested for determination of wet/dry lung weight ratio (W/D ratio),levels of malondialdehyde (MDA) and superoxide dismutase (SOD),expression of cytochrome C,Bax and Bcl-2 and apoptotic cell count,and for microscopic examination.Intestinal damage was assessed and scored according to Chiu.Results Compared with group S,Chiu's score,W/D ratio,MDA content and apoptotic cell count were significantly increased,SOD activity was decreased,the expression of cytochrome C and Bax was up-regulated,and the expression of Bcl-2 was downregulated in I/R and B groups.Compared with group I/R,Chiu's score,W/D ratio,MDA content and apoptotic cell count were significantly decreased,SOD activity was increased,the expression of cytochrome C and Bax was down-regulated,and the expression of Bcl-2 was up-regulated in B group.Conclusion Berberine preconditioning can reduce the intestinal injury caused by liver cold I/R in rats,and the mechanism is related to inhibition of lipid peroxidation and cell apoptosis.
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Objective To investigate the effect of sevoflurane postconditioning on oxidative stress responses during focal cerebral ischemia-reperfusion (I/R) in rats.Methods Twenty-four male Wistar rats,weighing 240-280 g,were randomly assigned into 3 groups:sham operation group (group S),focal cerebral I/R group (group I/R) and sevoflurane postconditioning group (group SP).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.Focal cerebral I/R was produced by middle cerebral artery occlusion.In group SP,3.9％ sevoflurane (1.5 MAC) was inhaled starting from 20 min before reperfusion until 10 min after reperfusion.While 100％ O2 and air were given instead of sevoflurane in groups I/R and S,respectively.Six rats chosen from each group at 24 h of reperfusion were sacrificed and brains were removed for determination of malondialdehyde (MDA),glutathione (GSH),superoxide dismutase (SOD),catalase (CAT),glutathione peroxidase (GSH-Px) and glutathione reductase (GR) levels and for microscopic examination.The cerebral infarct size was measured by TTC staining.Results Compared with group S,MDA level and cerebral infarct size were significantly increased in groups I/R and SP,and GSH,SOD,CAT,GSH-Px and GR levels were decreased in group I/R,and GSH-Px level was decreased in group SP (P ＜ 0.05).Compared with group I/R,cerebral infarct size and MDA level were decreased,and GSH,SOD,CAT,GSH-Px and GR levels were decreased in group SP (P ＜ 0.05).The pathological changes were significantly attenuated in group SP compared with group I/R.Conclusion The mechanism by which sevoflurane postconditioning mitigates focal cerebral I/R injury in rats is related to enhanced antioxidase activity and inhibition of oxidative stress responses.
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Objective To investigate the effects of hydrogen-rich HC-A solution,the self-made kidney preservation solution,on renal cold ischemia/reperfusion (I/R) injury in rats.Methods Twenty-four healthy male Wistar rats,aged 8-10 weeks,weighing 200-250 g,were randomly divided into 3 groups (n =8 each):control group (H1 group),common kidney preservation solution group (H2 group) and hydrogen-rich HC-A kidney preservation solution group (H3 group).In H1 group,only the right kidney was removed.In H2 group,the left kidney was perfused with and cold stored in 4 ℃ common HC-A kidney preservation solution.In H3 group,the left kidney was perfused with and cold stored in a container filled with 4 ℃ common HC-A kidney preservation solution.Blood samples were obtained from the inferior vena cava at 24 h of reperfusion to detect the levels of serum blood urea nitrogen (BUN),creatinine (Cr),TNF-α and IL-6.Left kidneys were removed for determination of malondialdehyde (MDA) and 8-hydroxy-2'-deoxyguanosine (8-OHdG) contents and for examination of the pathological changes in renal tissues (by light microscopy).Results The levels of serum BUN,Cr,TNF-α and IL-6 and contents of MDA and 8-OHdG were significantly higher in H2 and H3 groups than in H1 group,and lower in H3 group than in H2 group (P ＜ 0.05).There were no significant pathological changes in renal tissues in H1 group,the damage to renal tubules was obvious in H2 group and the damage to renal tubules was significantly ameliorated in H3 group as compared with H2 group.Conclusion Hydrogen-rich kidney preservation solution can attenuate renal cold I/R injury in rats.
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Objective To investigate the effects of adenosine supplementing cold blood cardioplegia on myocardial injury in patients undergoing milral valve replacement(MVR).Methods Thirty ASA Ⅱ or Ⅲ patients aged 18-64 yr with a BMI of 18-24 kg/m2 undergoing elective MVR were randomly divided into 2 groups(n =15each):control group(C)and adenosine group(A).In group A myocardial arrest was produced by infusing adenosine 6 mg diluted in normal saline 20 ml through aortic root after aorta was cross-clamped followed by cold blood cardiaplegic solution 20 mg/kg.In group C asystole was produced with cold blood cardioplegic solution 20 ml/kg alone every 30 min.Blood samples were taken from central vein at 5 min before(T1)and 4 h after aortic crossclamping(T2)and 24 h after operation(T3)for determination of plasma cardiac troponin Ⅰ(cTnI)concentration and creatine kinase-MB(CK-MB)activity.The amount of cardioplegic solution infused,cardiac arrest induction time(from infusion of adenosine or cardioplegic solution to asystole shown by ECG),restoration of spontaneous heartbeat,the amount of dopamine administered during the 2 h after CPB and aortic cross-clamping time were recorded.Results Supplementation of cold blood cardioplegia with adenosine significantly reduced cardiac arrest induction time,the total amount of dopamine administered during the 2 h after CPB and plasma cTnl concentration and CK-MB activity in group A compared with group C.Conclusion Cold blood cardioplegia supplemented with adenosine can attenuate myocardial injury in patients undergoing MVR.
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Objective To investigate the effects of ulinastatin on the myocardial injury in patients undergoing live donor liver transplantation.Methods Forty patients (AHA classification grade A or B),aged 40-64 yr,with a body mass index of 18-25 kg/m2,scheduled for live donor liver transplantation,were randomly divided into 2 groups ( n =20 each):control group (group C) and ulinastatin group (group U).Anesthesia was induced with midazolam,sufentanil,and cisatracurium besilate.The patients were tracheal intubated and mechanically ventilated.Ulinastatin 300 000 IU in 100 ml of normal saline was infused intravenously over 30 min after anesthesia induction and then the infusion was repeated at 4 h interval until the end of operation in group U,while the equal volume of normal saline was given in group C.Blood samples were taken from the central vein immediately before skin incision (T0,baseline),at 30 min of anhepatic phase (T1),at 30 min of neohepatic phase (T2),and at 0,4 and 24 h after operation (T3-5) for determination of the concentrations of serum cardiac troponin Ⅰ (cTnI),creatine kinase-MB (CK-MB) and N-terminal pro-brain natriuretic peptide (NT-proBNP).The changing rates of cTnI and CK-MB at T1-5 were calculated.The use of cardiovascular drugs and cardiovsscular accidents were recorded during operation.Results The serum cTnI,CK-MB and NT-proBNP concentrations were significantly higher at T2-5 than at T0 in the two groups ( P ＜ 0.05).Compared with group C,the serum cTnI,CK- MB and NT-proBNP concentrations at T2-5 were significantly deceased in group U ( P ＜ 0.05).The maximal changing rates of cTnI,CK-MB and NT-proBNP concentrations were 4.71 ± 1.62,6.85 ± 1.53 and 4.96 ± 1.23 respectively in group C,decreased to 3.26 ± 1.51,4.56 ± 1.62 and 3.67 ± 1.02 respectively in group U.There was no significant difference in the incidence of cardiovascular accidents and the use of dopamine between the two groups.Conclusion Intravenous infusion of ulinastatin can attenuate the myocardial injury to some extent in patients undergoing live donor liver transplantation.
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Objective To investigate the effects of sevoflurane wash-in during cardiopulmonary bypass (CPB) on myocardial injury in patients undergoing coronary artery bypass grafting(CABG).Methods Forty ASA Ⅱ or Ⅲ patients aged 50-64 yr,weighing 53-90 kg undergoing scheduled for CABG under CPB were randomly divided into 2 groups (n =20): control group (group C) and sevoflurane group(group S).Anesthesia was maintained with propofol 3-5 mg·kg-1 ·h-1 and sufentanil 0.5-1.0 μg·kg-1 ·h-1 in both groups.Sevoflurane 1％-2％ was washed into extracorporeal circuit during CPB in group S.Blood samples were taken from central vein after the induction of anesthesia (T0,baseline) and at 6,12 and 24 h (T1-3) after operation for determination of plasma cardiac troponin I(cTnI) concentration and creatine kinase-MB (CK-MB) activity.Myocardial specimens were obtained from right auricle before aortic cross-clamping and at the end of CPB for ultrastructure examination.The severity of mitochondria injury was assessment and scored (0 =normal,4 =impaired inner mitochondrial membrane integrity).Results CPB significantly increased plasma cTnI concentration at T1-3 as compared with the baseline values at T0 before CPB.Plasma cTnI concentration was significantly lower at T2 and T3 in group S than in group C.Mitochondrial injury index was significantly lower at the end of CPB in group S than in group C.There was no significant difference in plasma CK-MB activity between the 2 groups.Conclusion Wash-in of sevoflurane during CPB can attenuate myocardial injury in patients undergoing CABG.