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AIM: To investigate the effect of remifentanil in the management of sedation and analgesia after severe traumatic brain injury and its influence on the incidence of inflammatory stress. METHODS: From January 2017 to April 2020, 92 patients with severe head trauma surgery in our hospital were selected as the research objects, randomly divided into groups, each with 46 cases. Both groups received postoperative sedation and analgesia management, the control group received dexmedetomidine + 0.9% sodium chloride injection, and the observation group received dexmedetomidine combined with remifentanil. The effects of sedation and analgesia, vital signs, and inflammatory stimuli C reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10)related indicators, serum cortisol, β-endorphin, and the incidence of adverse reactions in the two groups were observed and counted. RESULTS: The scores of sedation and analgesia in the observation group were lower than control group at 2 h, 4 h, and 12 h after administration (P 0.05). CONCLUSION: Remifentanil is used in the management of sedation and analgesia after severe traumatic brain injury, which can effectively improve the effect of sedation and analgesia, reduce inflammatory stimulation, regulate the levels of cortisol, and β-endorphin It is worthy of clinical application.
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Idiosyncratic drug-induced liver injury (IDILI) is an unpredictable serious adverse drug reaction, which only occurs in a minority of special susceptible individuals. Although the mechanism of IDILI has not been fully understood, several hypotheses have been proposed to explain the action mode and specific mechanism of IDILI. Of these hypotheses, inflammatory stress hypothesis is one of the most important theories. Under the condition of inflammatory stress, drugs interact with inflammation and mediate the occurrence of IDILI through a variety of mechanisms, which can induce the production of inflammatory cytokines, activate coagulation system, affect the activity of metabolites, induce cholestasis, affect mitochondrial damage, and others. This review will summarize the main mechanisms and influencing factors of IDILI mediated by inflammatory stress, in order to provide a reference for preclinical drug development and basic research on drug-induced liver injury.
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Objective To investigate the effect of Dahuang Ling Xian Capsules(DLXC) on miRNAs in bile duct cells at inflammatory state. Methods The cultured well-grown bile duct cells at logarithmic phase were chosen for the experiment. Lipopolysaccharide (LPS , 5 μg/mL) was used to induce the model of bile duct cells at inflammatory state, and then DLXC (1 mg/mL) was added. After co-culturing for 72 h, the total RNA of bile duct cells was collected for miRNA chip detection and bioinformatics analysis. Results DLXC showed regulatory effect on the expression of 30 miRNAs in bile duct cells at inflammatory state, through which to affect biological processes involving with bile duct cell signal transduction, organic compound reaction and hypoxia stress, cell components such as cytoplasm , endoplasmic reticulum and membrane rafts , molecular biological functions of signal transduction activity , DNA binding in transcription regulation region and voltage-gated potassium channel activity , and multiple pathways of hypoxia-inducible factor-1(HIF-1) signaling pathway , uanosine 3 ' , 5 '-cyclic monophosphate-protein kinase C (cGMP-PKG) signaling pathway , tumor necrosis factor alpha (TNF-α) signaling pathway, chemokine signaling pathway, apoptosis signaling pathway, phosphatidylinositol-3-kinase (PI3K)-Akt signaling pathway and Toll-like signaling pathway. Conclusion DLXC exert the multidimensional regulation of bile duct cells at inflammatory state with miRNAs as targets.
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Objective:To analyze influence of vaginal hysteroscopy and laparoscopic surgery on tubal pregnancy patients’ surgical outcome and inflammatory stress response.Methods: Chosen 86 cases of tubal pregnancy patients between July 2012 to July 2013 in our hospital undergoing surgery as study object, according to a random number table divided into hysteroscopy group (43 cases) and laparoscopic group (43 cases), compared surgical outcomes, perioperative differences in the level of inflammation and stress level.Results: No significant difference between hysteroscopy group and laparoscopic group on surgical success rate and ipsilateral tubal patency statistically(x2=0.241,x2=0.193;P>0.05), postoperative intrauterine pregnancy rate was higher than laparoscopic group, again ectopic pregnancy rate was less than laparoscopic patients(x2=7.294,x2=8.283;P<0.05); hysteroscopic surgery group E, Cor, IL-2, IL-6, IL-8, CRP levels were lower than laparoscopic group(t=6.842,t=6.283,t=8.536,t=6.106,t=6.283,t=6.376;P<0.05),TSH levels was higher than laparoscopic group(t=6.823,P<0.05).Conclusion:Vaginal hysteroscopy and laparoscopy can be used for the treatment of tubal pregnancy, hysteroscopy has an advantage in improving patient again intrauterine pregnancy, reduce postoperative systemic stress and inflammation levels, and promote the recovery of patients after surgery respect.
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Objective To observe the influence of ulinastatin for the gastrointestinal function and inflammatory stress state of patients with severe acute pancreatitis.Methods 46 patients with severe acute pancreatitis in our hospital from October 2015 to July 2016 were randomly divided into control group and observation group with 23 cases in each group, the control group was treated with routine treatment of severe acute pancreatitis , the observation group was treated with ulinastatin on the basic treatment of control group, then the serum gastrointestinal hormones before and after meal and inflammatory stress indexes of two groups at different time before and after the treatment were compared .Results The serum gastrointestinal hormones before and after meal and inflammatory stress indexes of two groups before the treatment were compared,the differences were not significant,while the serum gastrointestinal hormones and inflammatory stress indexes of observation group after the treatment were all better than those of control group,the differences were all significant(all P<0.05).Conclusion The ulinastatin can significantly improve the gastrointestinal function and inflammatory stress state of patients with severe acute pancreatitis, so the application value in the patients with severe acute pancreatitis is higher.
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Objective To analyze the differences of video laryngoscope, direct laryngoscopy and fibreoptic bron﹣choscope nasal intubation on hemodynamics, inflammatory and stress response. Methods 117 patients underwent surgery from November 2013 to March 2015 were chose as research subjects and randomly divided into video laryn﹣goscope group, direct laryngoscopy group, fiberoptic bronchoscope group based on different cannula enrolled way. Then compared the hemodynamics, inflammation, stress level after intubation among the three groups. Results Com﹣pared with the T0, the three groups patients' systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), C-reactive protein (CRP), interleukin -6 (IL-6), tumor necrosis factor (TNF-α), norepinephrine (NE), plasma cortisol (Cor), angiotensinⅡ(ATⅡ) differences had no significant difference (P>0.05);compared with direct laryn﹣goscopy group, video laryngoscope group, fiberoptic bronchoscope group patients' T1, T2, T3 SBP, DBP, HR, CRP, TNF-α, IL-6, NE, Cor, ATⅡ levels were lower; compared with the video laryngoscope group, optical fiber bron﹣choscopy group patients SBP, DBP, HR, CRP, TNF-α, IL-6, NE, Cor, ATⅡ low levels at T1, T2, T3 were lower (P<0.05). Conclusions Fibreoptic bronchoscope nasal intubation has less influence on patients, will not cause severe stress and inflammatory response, it is one of the ideal instrument anesthesia induction intubation.