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Objective:To systematically compare the analgesic efficacy of pericapsular nerve group (PENG) block and fascia iliaca compartment block (FICB) after hip fracture surgery.Methods:Databases including Pubmed, Embase, Cochrane, CNKI, Wanfang and VIP were searched for randomized controlled trials involving comparison of the analgesic efficacy of PENG block and FICB after hip fracture surgery from inception to August 2022. The primary outcome was the postoperative pain score, and the secondary outcome was the amount of postoperative analgesics and incidence of postoperative adverse reactions. The data were analyzed using Revman 5.4 software.Results:Eight studies were included ( n=374), and the pain score at rest 30 min after block was significantly lower in PENG group than in FICB group ( MD=-0.35, 95% CI -0.60--0.11, I2=14%, P<0.05). There was no statistically significant difference between PENG group and FICB group in pain scores at rest and during activity at 6, 12, 24 and 48 h after operation ( P>0.05). Compared with FICB group, the amount of analgesics used was significantly reduced at 24 and 48 h after operation in PENG group ( MD=-9.10, 95% CI -19.11-0.91, I2=95%, P<0.05). There was no statistically significant difference in the incidence of adverse reactions after operation between the two groups ( P>0.05). Conclusions:PENG block provides better efficacy when used for analgesia following hip fracture than FICB.
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AIM: To investigate the PI3K/AKT/GSK-3β signaling pathway involved in the protective effect and mechanism of propofol on the cerebral ischemia-reperfusion injury in rats. METHODS: There were 72 healthy male SD rats. All rats established a model of focal cerebral ischemia-reperfusion injury according to the Zea Longa method and were randomly divided into six groups (n=12), A-sham operation group, B-model group (MCAO), C-Propofol group, D-Propofol+adenosine A1R antagonist group (DPCPX), E-Propofol group+PI3K specific inhibitor (LY294002), F-Propofol+GSK3β inhibitor group (SB216763). The neurological scores of rats 24 h after operation, LDF monitors changes in cerebral blood flow before and after embolization were observed. The TTC staining method was used to detect the cerebral infarction volume of rats in each group; HE staining method was used to observe the morphological changes of the rat brain tissue; Immunohistochemical method was used to detect Bcl-2 positive cells expression; TUNEL was used to detect cerebral cortex ischemia in each group. The percentage of neuronal apoptotic cells. RESULTS: Compared with group A, the behaviors, cerebral infarction volume, apoptosis rate, and Bcl-2 protein expression of rats in groups B, C, D, E, and F all increased (P<0.05); compared with group C, the behavioral scores, cerebral infarction volume and apoptosis rate of rats in groups B, D and E all increased significantly, and the expression of Bcl-2 protein was decreased significantly (P<0.01), but the expression of Bcl-2 protein in group F was increased, cell apoptosis rate decreased (P<0.05), behavior score and infarcts decreased (P<0.05). CONCLUSION: The neuroprotective effect of propofol mediated by adenosine A1R on ischemia-reperfusion injury in rats may be related to the PI3K/AKT/GSK-3β signal transduction pathway.
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Objective To evaluate the effect of melatonin pretreament on cell apoptosis and autophagy during lung ischemia-reperfusion (I/R) in rats.Methods Thirty-six adult male Sprague-Dawley rats,weighing 230-280 g,were divided into 3 groups (n=12 each) using a random number table method:sham operation group (group Sham),pulmonary I/R group (LIR group) and melatonin pretreatment group (MLT group).Lung I/R injury model was established by clamping the left hilum of lung for 60 min followed by 2 h reperfusion in LIR and MLT groups.Melatonin 1 mg/100 g was intraperitoneally injected at 15 min before clamping the left hilum of lung in group MLT.The rats were sacrificed at the end of reperfusion,the left lung was lavaged and the broncho-alveolar lavage fluid (BALF) was colleted for determination of protein concentrations.Lungs were removed for microscopic examination of the pathological changes (with a light microscope) which were scored and for determination of wet to dry weight ratio (W/D ratio),cell apoptosis (by TUNEL) and expression of Bcl-2,Bax,microtubule-related protein 1 light chain 3B Ⅰ (LC3B Ⅰ),LC3B Ⅱ,Beclin-1 and phosphorylated mammal rapamycin target protein receptor (p-mTOR) (using Western blot).The apoptosis index,Bcl-2/Bax ratio and LC3B Ⅱ/LC3B Ⅰ ratio were calculated.Results Compared with Sham group,the protein concentration in BALF,W/D ratio of lung tissues,apoptosis index,LC3B Ⅱ/LC3B Ⅰ ratio and Beclin-1 expression were significantly increased,and Bcl-2/Bax ratio and p-mTOR expression were decreased in LIR and MLT groups (P＜0.05).Compared with LIR group,the protein concentration in BALF,W/D ratio of lung tissues,apoptosis index,LC3B Ⅱ/LC3B Ⅰ ratio and Beclin-1 expression were significantly decreased,and Bcl-2/Bax ratio and p-mTOR expression were increased in MLT group (P＜0.05).Conclusion The mechanism by which melatonin pretreatment mitigates lung I/R injury may be related to inhibiting cell apoptosis and autophagy in rats.
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ObjectiveTo investigate the effect of isoflurane preconditioning on calcitonin gene-related peptide (CGRP) and NF-kappa B following local cerebral ischemia/reperfusion (I/R) in rabbits.MethodsFiftyfour adult New Zealand white rabbits of both sexes weighing 2.0-2.5 kg were randomly divided into three groups (n ＝ 18 each):sham operation group (group S),group I/R and isoflurane preconditioning group(group I).After anesthesia induction with intramuscular injection of ketamine 70 mg/kg and scopolamine 0.006 mg/kg and maintenance of anesthesia with intravenous injection of midazolam 0.1 mg/kg,fentanyl 0.01 mg/kg and vecuronium 0.1 mg/kg,endotracheal intubation was performed and mechanical ventilation was employed.In groups I/R and S,midazolam at 0.1 mg·kg-1·h-1 was infused through the left ear vein.After the rabbits in group I inhaling 1.4％ isoflurane for 30 minutes,which was then eluted for 10 minutes,local cerebral ischemia was made in groups I/Rand I with thread ligation method and reperfusion was made 2 hours later,simultaneously midasolam at 0.1 mg·kg- 1 · h - 1 was injected.All the rabbits in three groups were infused with fentanyl at 0.05 mg· kg- 1 · h- 1 and vecurenium at 0.10 mg· kg-1 · h-1.After blood samples were collected from the central artery of the ear for determination of plasma CGRP before anesthesia,immediately before reperfusion,and 1,2,3,4,and 5 h of reperfusion,all the animals were sacrificed at the corresponding time points and brain tissues were obtained for determination of NF-κB activity and its expression with Western blotting and immunohistochemistry staining.ResultsThe plasma concentration of CGRP,the activity and expression of NF-κB were higher in group I/R than in group S ( P <0.05).The plasma concentration of CGRP was higher and the activity and expression of NF-κB were lower in group I than in group I/R ( P < 0.05 ).ConclusionIsoflurane preconditioning can reduce local cerebral I/R injury in rabbits through promoting CGRP release and inhibiting NF-κB function.