Application of laryngeal mask airway inhalated with desflurane anesthesia in the interventional treatment of in-fant facial superficial mixed hemangioma / 局解手术学杂志

Objective To investigate the application effect of interventional surgery in the treatment of facial superficial mixed hemangi-oma through the laryngeal mask ventilation under desflurane anesthesia. Methods In the period from February 2016 to April 2017 in our hospital 118 cases of facial superficial hemangioma under interventional surgery in infants( aged 3-15 months) were retrospectively analyzed;according to the difference of anesthesia,they were divided into control group (51 cases) and observation group (67 cases);the two groups of children were administered sufentanil anesthesia, in the control group laryngeal mask airway under propofol, the observation group was giv-en under laryngeal mask airway inhalation of desflurane maintenance. Then was compared the difference in anesthesia monitoring indexes of the two groups, such as mean arterial pressure ( MAP) , saturation of pulse oximetry ( SpO2 ) , heart rate ( HR) , end-tidal carbon dioxide ( ETCO2 ) , laryngeal mask removal time, loss of consciousness time, laryngeal mask removal time, consciousness recovery duration, clinical efficacy and intraoperative and postoperative adverse reactions difference. Results For the control group, the laryngeal mask removal time and consciousness recovery time length were significantly longer than those of the observation group and the difference was statistically signifi-cant (P<0. 05);after anesthesia induction, the laryngeal mask insertion time, operation start time and laryngeal mask removal time, MAP and HR of the observation group and the control group were lower than those before anesthesia induction, and MAP and HR of control group were lower than those of the observation group and the deference was statistically significant (P<0. 05). The total efficiency of the observa-tion group (97. 02％) was significantly higher than the control group (88. 24％), the adverse reaction rate (23. 52％) of children in the control group was significantly higher than that (7. 46％) of those in the observation group, and the differences were statistically significant (P<0. 05). Conclusion In the infant facial superficial hemangioma interventional surgery, laryngeal mask airway can be used for anesthe-sia maintenance for desflurane effect and clinical curative effect in the effective protection of anesthesia at the same time, but also can reduce the risk of anesthesia and intraoperative blood pressure fluctuations, especially in the stabilization of hemodynamics of the patients.

Pim-1 Kinase Regulating Dynamics Related Protein 1 Mediates Sevoflurane Postconditioning-induced Cardioprotection / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>It is well documented that sevoflurane postconditioning (SP) has a significant myocardial protection effect. However, the mechanisms underlying SP are still unclear. In the present study, we investigated the hypothesis that the Pim-1 kinase played a key role in SP-induced cardioprotection by regulating dynamics-related protein 1 (Drp1).</p><p><b>METHODS</b>A Langendorff model was used in this study. Seventy-two rats were randomly assigned into six groups as follows: CON group, ischemia reperfusion (I/R) group, SP group , SP+proto-oncogene serine/threonine-protein kinase 1 (Pim-1) inhibitor II group, SP+dimethylsufoxide group, and Pim-1 inhibitor II group (n = 12, each). Hemodynamic parameters and infarct size were measured to reflect the extent of myocardial I/R injury. The expressions of Pim-1, B-cell leukemia/lymphoma 2 (Bcl-2) and cytochrome C (Cyt C) in cytoplasm and mitochondria, the Drp1 in mitochondria, and the total Drp1 and p-Drp1ser637 were measured by Western blotting. In addition, transmission electron microscope was used to observe mitochondrial morphology. The experiment began in October 2014 and continued until July 2016.</p><p><b>RESULTS</b>SP improved myocardial I/R injury-induced hemodynamic parametric changes, cardiac function, and preserved mitochondrial phenotype and decreased myocardial infarct size (24.49 ± 1.72% in Sev group compared with 41.98 ± 4.37% in I/R group; P< 0.05). However, Pim-1 inhibitor II significantly (P < 0.05) abolished the protective effect of SP. Western blotting analysis demonstrated that, compared with I/R group, the expression of Pim-1 and Bcl-2 in cytoplasm and mitochondria as well as the total p-Drp1ser637 in Sev group (P < 0.05) were upregulated. Meanwhile, SP inhibited Drp1 compartmentalization to the mitochondria followed by a reduction in the release of Cyt C. Pretreatment with Pim-1 inhibitor II significantly (P < 0.05) abolished SP-induced Pim-1/p-Drp1ser637 signaling activation.</p><p><b>CONCLUSIONS</b>These findings suggested that SP could attenuate myocardial ischemia-reperfusion injury by increasing the expression of the Pim-1 kinase. Upregulation of Pim-1 might phosphorylate Drp1 and prevent extensive mitochondrial fission through Drp1 cytosolic sequestration.</p>

Wnt/Glycogen Synthase Kinase 3β/β-catenin Signaling Activation Mediated Sevoflurane Preconditioning-induced Cardioprotection / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Sevoflurane preconditioning (SP) has been shown to invoke potent myocardial protection in animal studies and clinical trials. However, the mechanisms underlying SP are complex and not yet well understood. We investigated the hypothesis that the cardioprotection afforded by SP is mediated via the Wnt/glycogen synthase kinase 3β (GSK3β)/β-catenin signaling pathway.</p><p><b>METHODS</b>Two models were established: a Langendorff perfused rat heart model and the H9C2 cell hypoxia/reoxygenation model. Both rats and H9C2 cells were randomly divided into 6 groups as follows: S group, ischemia-reperfusion (I/R) group, DMSO group, IWP group, SP group, and SP + IWP group. Hemodynamic parameters, lactate dehydrogenase (LDH) activity in coronary effluent and cell culture supernatant, and the infarct size were measured to evaluate myocardial ischemia-reperfusion injuries. To determine the activity of Wnt/GSK3β/β-catenin signaling pathway, the expressions of Wnt3a, phospho-GSK3β, and β-catenin were measured by Western blotting.</p><p><b>RESULTS</b>SP improved cardiac function recovery, reduced infarct size (18 ± 2% in the SP group compared with 35 ± 4% in the I/R group; P < 0.05), decreased LDH activity in coronary effluent, and culture supernatant. IWP-2, an inhibitor of Wnt, abolished the cardioprotection by SP. In addition, Western blotting analysis demonstrated that the expressions of Wnt3a, phospho-GSK3β, and β-catenin significantly (P < 0.05) increased in the I/R group, compared with the S group; and compared to I/R group, SP significantly (P < 0.05) increased Wnt3a, phospho-GSK3β, and β-catenin expressions. Pretreatment with IWP-2 significantly (P < 0.05) abolished SP-induced Wnt/GSK3β/β-catenin signaling activation.</p><p><b>CONCLUSIONS</b>The results showed for thefirst time that cardioprotection afforded by SP may be mediated partly via the Wnt/GSK3β/β-catenin signaling pathway.</p>