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Objective To investigate the effect of brachial plexus block on stress response in patients who underwent shoulder arthroscopic surgery.Methods A total of 150 patients with shoulder arthritis who underwent shoulder arthroscopic surgery in the Shanghai Fifth People's Hospital,Fudan University from December 2021 to December 2022 were selected as the study subjects.All patients were divided into the control group and the observation group by random number table method,with 75 cases in each group.Patients in the control group were given general anesthesia,while patients in the observation group were given brachial plexus block on the basis of the control group.The mean arterial pressure(MAP),heart rate(HR),norepinephrine(NE),cortisol(Cor)before operation(T0),10 minutes after operation(T1),30 minutes after operation(T2),at the end of operation(T3)and 30 minutes after extubation(T4)of the two groups were compared.The transforming growth factor-β1(TGF-β1),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)before and 3 days after operation of the two groups were compared.The visual analogue scale(VAS)scores at postoperative wakefulness and 6,12 and 24 hours after operation of the two groups were compared.Results Compared with T0,the levels of MAP and HR at T1,T2,T3,and T4 in the observation group and the control group were obviously decreased(P<0.01),the levels of NE and Cor were obviously increased(P<0.01),while the levels of MAP,HR,NE,and Cor at T1,T2,T3,and T4 in the observation group were obviously lower than those in the control group(P<0.01).The levels of TGF-β1,TNF-α,and CRP 3 days after operation in the observation group and the control group were obviously increased compared with those before operation (P<0. 01), and the above indicators after operation in the observation group were obviously lower than those in the control group (P<0. 01). The VAS scores at postoperative wakefulness and 6, 12 and 24 hours after operation in the observation group were obviously lower than those in the control group (P<0. 01). Conclusion Ultrasound-guided brachial plexus block by interscalene approach can ensure the stability of the vital signs of patients with shoulder arthritis during shoulder arthroscopic surgery, alleviate pain, reduce stress, and reduce inflammatory response.
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Objective: To explore the protective effect and the preliminary mechanism of Dihuang Yinzi on cerebral ischemia-reperfusion injury in rats. Method: The middle cerebral artery occlusion (MCAO) model was established. Totally 90 SD rats were randomly divided into 6 groups:sham operation group, model group, nimodipine group (0.01 g·kg-1) and high, medium, low-dose Dihuang Yinzi groups (38.80, 19.40, 9.70 g·kg-1), with 20 rats in each group.The modified neurological severity score (mNSS) was assayed at the 7th, 14th, 28th days after operation, and the volume of cerebral infarction, pathological changes of brain tissue, the BrdU positive cells and mRNA levels of Notch1, Jagged1 and Hes1 in subventricular zone(SVZ)were observed respectively by triphenyl tetrazolium chloride(TTC) stain, htorylin eastin(HE) stain, immunofluorescence technique and reverse transcriphase polymerase chain reaction(Real-time PCR) methods at the 28th day after the operation. Result: The mNSS on the 7th, 14th, 28th days of high, medium-dose Dihuang Yinzi groups and nimodipine group were significantly lower than that of model group(PPth day, the percentage of cerebral infarction volume in brain tissue volume of high, medium-dose Dihuang Yinzi groups and nimodipine group were smaller than that of model group(Pth day, the BrdU positive cells in SVZ of the above 3 groups were significantly higher than model group(PPPth day, the mRNA levels of Notch1, Jagged1 and Hes1 of high, medium-dose Dihuang Yinzi groups and nimodipine group were significantly higher than those of model group(PPPPConclusion: Dihuang Yinzi can improve the nerve function defect of MCAO rat model, and reduce the volume of cerebral infarction and the pathological changes of brain tissue, thus playing a protective role in cerebral ischemia-reperfusion injury rats. Its mechanism may be related to the activation of the Notch signaling pathway, and the up-regulation of expressions of Notch1, Jagged1 and Hes1 mRNA, thus promoting the proliferation of NSCs.