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Objective@#To evaluate the role of necroptosis in hyperoxia-induced acute lung injury (ALI) in preadolescent rats.@*Methods@#A total of 72 clean-grade healthy male Sprague-Dawley rats, aged 14 days, weighing 40-50 g, were divided into 3 groups (n=24 each) by using a random number table method: control group (group C), hyperoxia-induced ALI group (group ALI) and hyperoxia-induced ALI and necrostatin-1 group (group ALI+ N). The rats of group ALI+ N was intraperitoneally injected with necrostatin-1 1.0 mg/kg once a day for 3 consecutive days.The rats were intraperitoneally injected with dimethyl sulfoxide 0.2 ml/kg once a day for 3 consecutive days in C and ALI groups.The animals were sacrificed at 72 h after inhaling oxygen, and bronchoalveolar lavage fluid (BALF) was collected for determination of interleukin-6 (IL-6) and IL-8 concentrations (by enzyme-linked immunosorbent assay), superoxide dismutase (SOD) activity (by xanthine oxidase method), and malondialdehyde (MDA) concentration (by thiobarbituric acid method). Lung tissues were taken for measurement of wet/dry weight ratio (W/D ratio) and for examination of the pathological changes (with a light microscope) and ultrastructure of lung tissues (with an electron microscope). The injured alveolus rate (IAR) was calculated.The expression of receptor-interacting protein kinase 1 (RIPK1), RIPK3 and mixed-lineage kinase domain-like protein (MLKL) in lung tissues was detected by Western blot.@*Results@#Compared with group C, the concentrations of IL-6, IL-8 and MDA in BALF were significantly increased, the activity of SOD in BALF was decreased, the W/D ratio and IAR of lung tissues were increased, the expression of RIPK1, RIPK3 and MLKL in lung tissues was up-regulated (P<0.05), and the pathological damage was accentuated in group ALI.Compared with group ALI, the concentrations of IL-6, IL-8 and MDA in BALF were significantly deceased, the activity of SOD in BALF was increased, the W/D ratio and IAR of lung tissues were decreased, the expression of RIPK1, RIPK3 and MLKL in lung tissues was down-regulated (P<0.05), and the pathological damage was significantly attenuated in group ALI+ N.@*Conclusion@#Necroptosis is involved in the pathophysiological process of hyperoxia-induced ALI in preadolescent rats.
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Objective To evaluate the role of necroptosis in hyperoxia-induced acute lung injury(ALI)in preadolescent rats.Methods A total of 72 clean-grade healthy male Sprague-Dawley rats,aged 14 days,weighing 40-50 g,were divided into 3 groups(n＝24 each)by using a random number table method: control group(group C),hyperoxia-induced ALI group(group ALI)and hyperoxia-induced ALI and necrostatin-1 group(group ALI+N).The rats of group ALI+N was intraperitoneally injected with ne-crostatin-1 1.0 mg/kg once a day for 3 consecutive days.The rats were intraperitoneally injected with dime-thyl sulfoxide 0.2 ml/kg once a day for 3 consecutive days in C and ALI groups.The animals were sacrificed at 72 h after inhaling oxygen,and bronchoalveolar lavage fluid(BALF)was collected for determination of interleukin-6(IL-6)and IL-8 concentrations(by enzyme-linked immunosorbent assay),superoxide dis-mutase(SOD)activity(by xanthine oxidase method),and malondialdehyde(MDA)concentration(by thiobarbituric acid method).Lung tissues were taken for measurement of wet/dry weight ratio(W/D ratio)and for examination of the pathological changes(with a light microscope)and ultrastructure of lung tissues(with an electron microscope).The injured alveolus rate(IAR)was calculated.The expression of recep-tor-interacting protein kinase 1(RIPK1),RIPK3 and mixed-lineage kinase domain-like protein(MLKL)in lung tissues was detected by Western blot.Results Compared with group C,the concentrations of IL-6,IL-8 and MDA in BALF were significantly increased,the activity of SOD in BALF was decreased,the W/D ratio and IAR of lung tissues were increased,the expression of RIPK1,RIPK3 and MLKL in lung tis-sues was up-regulated(P＜0.05),and the pathological damage was accentuated in group ALI.Compared with group ALI,the concentrations of IL-6,IL-8 and MDA in BALF were significantly deceased,the ac-tivity of SOD in BALF was increased,the W/D ratio and IAR of lung tissues were decreased,the expres-sion of RIPK1,RIPK3 and MLKL in lung tissues was down-regulated(P＜0.05),and the pathological damage was significantly attenuated in group ALI+N.Conclusion Necroptosis is involved in the patho-physiological process of hyperoxia-induced ALI in preadolescent rats.
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Objective To compare the effect and safety of propofol with intranasal dexmedetomidine in analgesic enteroscopy for children.Methods Ninety children undergoing analgesic enteroscopy were ran-domly assigned to 3 groups.Intranasal dexmedetomidine followed by propofol was administered in the observ-ing group;sufentanil and followed by propofol was intravenously given to the control group A;propofol was given to the control group B.The scale of anesthetic effect,HR,RR,MAP and SpO2 30 min after intranasal administration were monitored.The intranasal sedation satisfaction rate,the dose of propofol,wake-up time, hospitalization,hemodynamics,adverse reaction and complication after anesthesia were recorded.Results Intranasal sedation satisfaction rate of the observing group was 83.3%(25 /30).The anesthetic effect in ob-serving group(excellent/good /bad:24 /6 /0)showed no significant difference from that in the control group A (excellent/good /bad:25 /5 /0),but better than that in the control group B(excellent/good /bad:12 /14 /4) (P <0.05).The amount of propofol in the observing group(96.2 ±5.3)mg showed no significant difference from that of group A(93.7 ±4.6)mg,but less than group B[(121.1 ±4.9)mg,P <0.05].The time of re-covery of infants in the control group A[(14.2 ±5.5)min]and the control group B[(13.7 ±3.9)min] were longer than that in observing group[(7.9 ±4.1)min,P <0.05].The hospitalization time of observing group[(14.3 ±5.4)min]was shorter than those of group A[(27.5 ±3.7)min,P <0.05]and group B [(26.3 ±6.6)min,P <0.05].The incidences of breath suppression,glossoptosis,nausea and dizziness were the lowest in the observing group,compared with the two others (all P <0.05).Conclusion In-tranasal dexmedetomidine combined with propofol,increasing children compliance,decreasing the adverse reaction,is satisfactory and safe for children anesthesia.
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One hundred and fifty ASA Ⅰ-Ⅱ infants scheduled to undergo surgery on unilateral inguinal region,were randomly assigned to 3 groups with 50 in each group.In groups Ⅰ and Ⅱ puncture was performed at traversus abdominis plane under ultrasound-guidance,0.4 or 0.5/kg of 0.25％ ropivacaine was injected respectively.In group Ⅲ the triangle of Petit was positioned through palpating and then 0.5 ml/kg of 0.25％ ropivacaine was injected.HR,RR,SpO2,PETCO2,expired sevoflurane concentration and BIS value at the time of entering the operation room (T1),incision of skin (T2),pulling hernia sac (T3),ending the surgery (T4),waking (T5),the number of pressing the analgesia pump after operation were recorded.The results showed that HR at T2 and T3 of groups Ⅰ and Ⅱ was lower than group Ⅲ (P ＜ 0.05).The were significant differences in case numbers of insufficient intraoperative analgesia among 3 groups(x2 =10.500,P =0.005).The CHEOPS scores and the number of pressing analgesia pump after operation in groups Ⅰ and Ⅱ were lower than those in group Ⅲ (x2 =7.230,P =0.027).Results indicate that ultrasound-guided transversus abdominis plane block is safer and more effective than conventional method for operations of inguinal region in infants; it may reduce dose of local anesthetics and postoperative use of analgesics.
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Objective Intranasal drops of dexmedetomidine can induce conscious sedation in children .This study was to com-pare the sedative effects of different doses of intranasal dexmedetomidine in different age groups of children patients . Methods We e-qually randomized 90 hernia children waiting for elective unilateral inguinal surgery ( ASAⅠ-Ⅱ) to groupsⅠ,ⅡandⅢ.At 35 minutes be-fore surgery, we obtained the heart rate (HR), mean artery pressure (MAP) of all the patients.The children in groupsⅠandⅡreceived nasal instillation of dexmedetomidine at 1 and 2μg/kg respectively, while those in groupⅢ0.4 mL of normal saline, followed by sevoflu-rane induction, intravenous injection of sufentanil (0.2μg/kg), and laryngeal mask airway anesthesia with sevoflurane .We recorded HR, MAP before medication, at 10 min, 20 min and 30 min before mediation, right after surgery, and at the recovery to consciousness . We also recorded the sedation onset time and post-surgery recovery time and assessed sedation satisfaction using the Ramsay score . Results The rates of satisfactory preoperative sedation were 50 and 63% in groupsⅠandⅡ, significantly higher than 10%in groupⅢ(P time and post-surgery recovery time showed no significant differences between groupsⅠandⅡ(P>0.05).In the 5-8-year group, seda-tion satisfaction rate was markedly higher in groupⅡthan in groupsⅢ(77%vs 22%, P<0.05) andⅠ(77%vs 45%) . Conclusion At 1 and 2μg/kg, intranasal drops of dexmedetomidine produces similar rates of satisfactory sedation in children aged 1-4 years, and at 2μg/kg can achieve an even higher rate of satisfactory sedation without adverse hemodynamic effects in those aged 5-8 years.
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Objective To observe the effect of application of dexmedetomidine on cerebral injury in infants after cardiopulmonary bypass.Methods 60 cases of congenital heart disease were divided into 3 groups,each group 20 infants,namely D1,D2 and N group.Group D1 dexmedetomidine 1.0μg/kg,in 0.2μg · kg-1 · h-1 intravenous infusion,until the end of operation; group D2 with dexmedetomidine 0.5 μg/kg,in 0.1 μg · kg-1 · h-1,drug concentration and injection speed was the same as the group D1.Group N intravenous normal saline in the whole operation process,infusion speed was the same as the experimental group,anesthesia and experimental group agreement.Take blood samples sent to laboratory before the operation (T1),at the end of CPB (T2),after CPB 2 h (T3),6 h (T4),24 h (T5) respectively,colleced records of perioperative data.Results There were no significant in 3 groups,for infant's age,weight,operation time,CPB time difference (P ＞0.05).In T1,there was no statistical difference between the 3 groups in S-100β protein and NSE (P ＞ 0.05).In group N,S-100β protein and NSE in T2,T3,T4,T5 were increased significantly than the level in T1 (P ＜ 0.05).In T2,compared with group D2,S-100β and NSE increased significantly in group N and D1 (P ＜ 0.01),and there were more in D2 than D1 group.Differences in heart rate,blood pressure and hemodynamics were observed in infant during perioperative period was not significant (P ＞ 0.05).Conclusion Dexmedetomidine can reduce the ascensional range of S-100β and NSE in infant after cardiopulmonary bypass,and relieve the cerebral injury.