ABSTRACT
Objective To explore the effect of ulinastatin treatment on postoperative delirium (POD) in elderly patients receiving hip fracture surgery.Methods Ninety-six elderly patients (38 males,58 females,aged 70-93 years,ASA grade Ⅱ or Ⅲ) undergoing elective hip fracture surgery were randomly divided into two groups using a random number table: ulinastatin group (group U) and control group (group C),48 cases in each group.After spinal anesthesia and fascia iliaca compartment block,ulinastatin 5 000 U/kg diluted with normal saline to a volume of 50 ml (group U) was administered intravenously over 10 min before surgical incision and the equal doses on post-operative days 1,2.The equal volume of normal saline was administered intravenously in group C at the same time.POD was assessed by using the Confusion Assessment Method (CAM) on post-operative days 1-3.Serum samples were collected to measure the levels of IL-6,IL-10 and S100β before the anesthesia (T0),at the end of surgery (T1) and three days after surgery (T2) by ELISA.Results The incidence of POD in group U was significantly lower than that in group C (4.3% vs.28.2%) (P<0.05).Compared with T0,the levels of serum IL-6 and IL-10 in group C at both T1 and T2 significantly increased (P<0.05).Compared with group C,serum IL-6 levels in group U decreased at both T1 and T2 (P<0.05).Compared with T0,the levels of serum S100β in group C at T1 significantly increased (P<0.05).Compared with group C,ulinastatin significantly inhibited the release of serum S100β at T1 (P<0.05).Conclusion Ulinastatin can significantly reduce the incidence of POD in elderly patients undergoing hip fracture surgery.The mechanism may involve inhibition of IL-6 and S100β in serum.
ABSTRACT
Objective To evaluate the effect of umbilical cord mesenchymal stem cell (UC-MSC) transplantation on cognitive function in endotoxemic rats.Methods Seventy-two pathogen-free male Wistar rats,aged 180-250 g,were randomly divided into 4 groups (n=18 each) using a random number table:control group (group C),endotoxemia group (group E),UC-MSC group (group M),and endotoxemia+ MSC group (group PM).Cognitive function was assessed using Morris water maze test.At 4 h before training on 2nd day of place navigation test,lipopolysaccharide 100 μg/kg was injected intraperitoneally in group E,the equal volume of normal saline was given in group C,UC-MSC suspension 300 μl (5× 105cells,the fluid was normal saline) was injected via the tail vein immediately after intraperitoneal lipopolysaccharide in group PM,and UC-MSCs were injected via the tail vein in group M.At 4 h after injection,Morris water maze test was continued.At 4,24 h and 5 days after intraperitoneal injection or injection via the tail vein (T1-3),6 rats were selected,and blood samples were collected from hearts.The rats were then sacrificed,and the hippocampus was removed.The levels of interleukin-lbeta (IL-1β),IL-6 and tumor necrosis factor-alpha (TNF-α) in serum and hippocampus were determined.Results Compared with group C,the escape latency was significantly prolonged on 2nd and 3rd days of Morris water maze test,the number of crossing the platform was significantly decreased,the percentage of swimming distance in 1 st quadrant in the total swimming distance was significantly decreased,and the levels of IL-1 β,IL-6 and TNF-α in serum and hippocampus were significantly increased at T1,2 in group E (P＜0.05).Compared with group E,the escape latency was significantly shortened on 2nd and 3rd days of Morris water maze test,the number of crossing the platform was significantly increased,the percentage of swimming distance in 1st quadrant in the total swimming distance was significantly increased,and the levels of IL-1β,IL-6 and TNF-α in serum and hippocampus were significantly decreased at T1,2 in group PM (P＜0.05).Conclusion UC-MSC transplantation can improve the cognitive decline in endotoxemic rats.