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Objective @#To explore the effect of esketamine on anxiety-depressive-like behavior in mice and its rela- tionship with inflammation．@*Methods @#SPF grade healthy adult male C57BL/6J mice，weighing 20 －24 g，were used in the exprement．The random number table method was used to divide into 5 groups (n = 8) : control group ( Con group) ，esketamine group (ESK group) ，model group ( LPS group) ，model + esketamine prevention group (LPS + ESK1 group) and model + esketamine treatment group ( LPS + ESK2 group) ．An inflammation-induced anxiety-depression model was prepared by intraperitoneal injection of LPS 0. 83 mg / kg．The ESK group was injec- ted with esketamine 10 mg / kg ; LPS group was injected with LPS 0. 83 mg / kg ; LPS + ESK1 group was injected with LPS 0. 83 mg / kg before 24 hours intraperitoneal injection of esketamine 10 mg / kg ; and the LPS + ESK2 group was injected with LPS 0. 83 mg / kg and 30 minutes later with esketamine 10 mg / kg．24 h after intraperitoneal injec- tion of LPS，the anxiety-depression-like behaviors of mice were measured using behavioral experiments．At the end of behavioral experiments，the spleen was taken immediately ; hippocampal tissues were taken and enzyme-linked immunosorbent assay (ELISA) was used to detect the contents of interleukin-1 β (IL-1 β) ，tumor necrosis factor al- pha (TNF-α) and interleukin 6 (IL-6) and neuronal pathological changes in hippocampal tissues were observed by HE staining. @*Results @#Compared with the Con group，mice in the LPS group showed increased anxiety and depres- sion-like behavior (P＜0. 05) ，increased spleen weight / body weight (P ＜0. 05 ) ，increased hippocampal tissue concentrations of IL-1 β , TNF-α and IL-6 (P＜0. 05) ，and increased neuronal degeneration necrosis，there was no statistically significant difference in these indicators in the ESK group compared with the Con group．Compared with the LPS group，mice in the LPS + ESK1 and LPS + ESK2 groups showed reduced anxiety-depression-like behavior (P＜0. 05) ，decreased splenic weight / body weight (P ＜0. 05) ，hippocampal tissue IL-1 β , TNF-α , IL- 6 con- centrations were reduced (P＜0. 05) ，and neuronal degeneration necrosis was reduced．Compared with the LPS + ESK1 group，the LPS + ESK2 group showed an increase in the distance travelled in the central area of the open field experiment and the distance into the open arm of the elevated cross maze experiment (P＜0. 05) ，a decrease in IL-6 and TNF-α concentrations (P＜0. 05) ，and a reduction in the degree of neuronal damage．@*Conclusion@#Esketamine ameliorates LPS-induced anxiety-depression-like behavior and neuronal damage in mice by a mechanism that may be related to reduced inflammation.
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Objective @#To study the protective effect and mechanism of remimazolam on cognitive function in septic mice．@*Results @#In the LPS group，the number of platform crossing times，the percentage of staying time in the first quadrant，GSH level and SOD activity significantly decreased，and TNF-α, IL-1 β and MDA levels significantly increased．In addition，the arrangement of neurons in CA1 area of hippocampus was disturbed ; cytoplasmic staining was deepened ; and the nucleus was solidly stained．Comparing RM10 ，RM15 and RM20 groups with the LPS group，the number of platform crossing times，the sta- ying time in the first quadrant，GSH level and SOD activity increased，and the levels of TNF-α, IL-1 β and MDA decreased．And the results of hippocampal staining showed a decrease in degenerated neuronal cells．When it came to the comparision in the groups with different doses of remimazolam injection，septic mice in the RM20 group showed less improvement in cognitive dysfunction and inflammatory oxidative stress than the RM10 and RM15 groups．@*Conclusion @# Remimazolam has a protective effect on cognitive dysfunction in septic mice，and its mechanism may be related to its binding of translocator protein ( TSPO) to inhibit macrophage polarization and thus reduce neuroinflammation and oxidative stress damage．It also reflects that dose of 10 mg / kg and 15 mg / kg has more significant protective effect than that of 20 mg / kg.
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Objective:To evaluate the effect of dexmedetomidine on intracranial pressure in pediatric patients undergoing laparoscopic surgery through measurement of optic nerve sheath diameter (ONSD) by ultrasound.Methods:Ninety-three pediatric patients of both sexes, aged 3-12 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, with body mass index of 15.2-18.1 kg/m 2, scheduled for elective laparoscopic appendectomy, were divided into 2 groups using a random number table method: control group (group C, n=45) and dexmedetomidine group (group D, n=48). Dexmedetomidine was infused intravenously in a loading dose of 0.5 μg/kg over 10 min before induction of anesthesia followed by an infusion of 0.5 μg·kg -1·h -1 in group D, while the equal volume of normal saline was given instead in group C. ONSD was measured using ultrasound after entering the operating room (T 0), after tracheal intubation (T 1), at 5 min after pneumoperitoneum (T 2), at 5 min after trendelenburg position (T 3), at the end of anesthesia (T 4) and when orientation recovered (T 5). The development of increased intracranial pressure in pediatric patients was diagnosed according to ONSD.The time for extubation, time for recovery of orientation, the Ramsay score when orientation recovered and postoperative nausea and vomiting were recorded. Results:Compared with group C, ONSD was significantly decreased at T 2, 3, the incidence of increased intracranial pressure was decreased, and the Ramsay score when the patients recovered orientation was increased ( P<0.01), and no significant change was found in the time for extubation, time for recovery of orientation and postoperative nausea and vomiting in group D ( P>0.05). Conclusion:Dexmedetomidine can decrease the development of increased intracranial pressure and produces no effect on the postoperative recovery in pediatric patients undergoing laparoscopic surgery.
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OBJECTIVE：To o bserve the e fficacy and safety of the application of etomidate combined with propofol in diagnosis and treatment of elderly patients with painless tracheoscope. METHODS ：A total of 124 elderly patients with first selective bronchoscopy under general anesthesia were collected from Anhui Chest Hospital during Oct. 2019-May 2020，and then divided into propofol group （group P ），etomidate and propofol group （group EP ）according to random number table ，with 62 cases in each group. At anesthesia induction ，Sufentanil citrate injection 5 µg was slowly injected into both groups. Based on this base，group P was given Propofol injectable emulsion 2 mg/kg intravenously ；after the eyelash reflex disappeared ，group P was given intravenous infusion of Propofol injectable emulsion 4 mg/（kg·h）to maintain sedation and Remifentanil hydrochloride for injection 0.1-0.2 µg/（kg·min）to maintain analgesia. Group EP was given slow intravenous injection of 0.5％ Propofol injectable emulsion 1 mg/kg+0.1％ Etomidate injectable emulsion 0.2 mg/kg；after the eyelash reflex disappeared ，group EP was given intravenous pump of 0.5％ Propofol injectable emulsion+ 0.1％ Etomidate injectable emulision mixture（1 ∶ 1，V/V）20 mL/h to maintain sedation and Remifentanil hydrochloride for injection to maintain analgesia （same usage and dosage as group P ）；at the same time ，2 groups were given intravenous injection of Cisatracurium besilate for injection 0.1 mg/kg，the laryngeal mask was inserted into the anesthesia machine for mechanical ventilation ，and then the laryngeal mask w as placed into the tracheoscope fordiagnosis and treatment. Heart rate （HR） and mean arterial pressure （MAP） were observed in 2 groups at the time of entering the room （T1）， at the time of eyelash reflex disappearing after anesthesia induction （T2），at the beginning of t racheal intubation examination （T3），10 min after the beginning of the exam ination（T4），at the time of anesthesia recovery （T5），and at the time of leaving the room （T6）；operation time，anesthesia recovery time ，the use of vasoactive drugs ，postoperative 4 h cognitive function and adverse reactions were also observed in 2 groups. RESULTS ：Two patients in each group were excluded. At T 1，there was no statistical significance in MAP and HR between 2 groups（P＞0.05）. There was no statistical significance in MAP of group EP among different time points （P＞ 0.05）. MAP and HR of group P at T 2，MAP of group P at T 4，HR of group EP at T 2 were significantly lower than same group at T1，and MAP of group P at T 2 and T 4 were significantly shorter or lower than those of group EP at the same time （P＜0.05）. The anesthesia recovery time ，the incidence of hypotension and the utilization rate of vasoactive drugs in group EP were significantly lower than group P ；memory ability ，calculation ability and orientation force pass rate of group EP were significantly higher than those of group P of 4 h after operation （P＜0.05）. There was no statistical significance in operation time ，the incidence of injection pain，muscle spasm ，nausea and vomiting ，focus ability ，language ability ，structure ability ，reasoning ability pass rate between 2 groups（P＞0.05）. CONCLUSIONS ：Etomidate combined with propofol shows good therapeutic efficacy and safety for elderly patients with painless tracheoscope.
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Objective To investigate the effect of different pressure CO2pneumoperitoneum on postoperative gastroeuteric function in female patients undergoing gynecological laparoscopic surgery. Methods A total of 120 female patients,aged 30-60 years,ASA physical status Ⅰ or Ⅱ,scheduled for elective gynecological laparoscopic surgery were randomly into three groups (n=40 in each).The pressure of CO2pneumoperitoneum were set at 6-8,9-11 and 12-14 mm Hg in group L,group M and group H,respectively.All patients were detected on an empty stomach of serum concentrations of D-lactic acid 6 hours before operation and after opration.In addition,pH,PaCO2and PaO2were recor-ded before anesthesia (T1),before pneumoperitoneum (T2),1 hour after pneumoperitoneum (T3)2 hours after pneumoperitoneum (T4)and 1 hour (T5)after stopping pneumoperitoneum.The time of pneumoperitoneum,the time of first flatus,intake and defecation,length of primary hospital stays after operation were recorded.Results Compared with 6 hours before operation,the serum concen-trations of D-lactic acid were obviously increased at postoperative 6 hours in all groups (P<0.05). Compared with group L,the serum concentrations of D-lactic acid at 6 hours after operation were ob-viously increased in group M and group H (P<0.05).PaO2in three groups was not different at T1-T5.Compared with group L,pH at T3,T4was significantly decreased in group M and group H (P<0.05).Compared with group L,PaCO2was significantly increased at T3-T5in group M and group H (P<0.05 ).Compared with group L,the time of first flatus,intake and defecation,length of primary hospital stays after operation were obviously delayed in group M and group H(P<0.05). Conclusion The low pressure of CO2pneumoperitoneum can reduce the damage of CO2pneumoper-itoneum on postoperative gastroeuteric function and avail the recovery of parents’postoperative gas-troeutericfunction in female patients undergoing gynecological laparoscopic surgery.
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Objective To evaluate the changes in the status of macrophages during the non-ventilated lung injury in the patients undergoing long-time one-lung ventilation (OLV).Methods Thirty patients of both sexes,aged 35-64 yr,weighing 50-80 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective pulmonary lobectomy for lung cancer,were divided into 2 groups (n=15 each) according to the time of OLV:short-time OLV group (＜30 min,group S) and long-time OLV group (＞2 h,group L).Anesthesia was routinely induced and maintained.Normal lung tissues around the cancer tissues from the lobe of the lung excised were obtained for microscopic examination of pathologic changes which were scored.The activated macrophages (CD68 positive),polarized M1 macrophages (CD86 positive) and polarized M2 macrophages (CD206 positive) in lung tissues were detected using immunofluorescence.The ratio of CD86 positive cells to CD206 positive cells was calculated.Results Compared with group S,lung injury scores on the non-ventilated side were significantly increased,the number of CD68,CD86 and CD206 positive cells in lung tissues was increased,and the ratio of CD86 positive cells to CD206 positive cells was increased in group L (P＜0.05).Conclusion Long-time OLV (＞2 h) can result in increased number of activated macrophages,especially the polarized M1 macrophages,which may be one of the mechanisms underlying lung injury on the non-ventilated side.
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Objective To investigate the effect of different pressure CO 2 pneumoperitoneum on early postoperative cognitive function in female patients undergoing gynecological laparoscopic sur-gery.Methods Ninety female patients,aged 40-60 years,ASA physical status Ⅰor Ⅱ,scheduled for elective gynecological laparoscopic surgery,were randomly divided into three groups (n = 30). The pressure of CO 2 pneumoperitoneum were set at 6-8,9-1 1 and 12-14 mm Hg in groups L,M and H,respectively.All of the patients were tested by the neuropsychology and questionnaire review to estimate whether the patient got cognitive decline at 24 h before the operation.The venous blood sam-ples 10 minutes before anesthesia (T1 ),at the end of surgery (T2 ),6 hours after surgery (T3 ),24 hours after surgery (T4 )and 72 hours after surgery (T5 )were collected for determination of serum concentrations of NSE and S100βprotein.The pH,PaCO 2 and PaO 2 were recorded before anesthesia (Ta ),before pneumoperitoneum (Tb ),1 hour after pneumoperitoneum (Tc ),2 hours after pneumo-peritoneum (Td )and 1 hour after stopping pneumoperitoneum (Te ).Results Scores of these tests in three groups were not different and there was no patient with cognitive decline after surgery.Com-pared with group H,the concentration of NSE at T2 and T3 was significantly lower in groups L and M (P <0.05).Compared with group H,the concentration of S100βprotein at T2 was significantly lower in groups L and M (P <0.05).Compared with group L,pH at Tc and Td was significantly decreased in groups M and H (P <0.05).Compared with group L,PaCO 2 was significantly increased at Tc-Te in groups M and H (P <0.05).Conclusion Different pressure of CO 2 pneumoperitoneum has no ob-vious effect on the early cognitive function,but low (6-8 mm Hg)CO 2 pneumoperitoneum can reduce the release of NSE and S100βprotein after operation.
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Objective To evaluate the effect of bispectral index (BIS) and muscle relaxation monitoring on robot-assisted laparoscopic radical prostatectomy in elderly patients.Methods One hundred elderly patients (aged 65-80 years,ASA Ⅰ or Ⅱ) who underwent robot-assisted laparoscopic radical prostatectomy were randomly allocated into BIS and muscle relaxation monitoring group (group AA,n=50) and control group (group AC,n=50).In group AA,propofol was infused to achieve the BIS value of 45-55,and we monitored the muscle relaxation to conduct closed-loop infusion of cisatracurium.In group AC,we regulated the depth of anesthetic with the patients` vital signs according to anesthetists` experience.Mean arterial pressures (MAP),heart rates (HR),airway platform pressure (Pplat),and airway peak pressure (Ppeak) were recorded at following time points: before anesthesia induction (T0),after anesthesia induction (T1),10 min (T2),60 min (T3) after artificial pneumoperitoneum,and the end of operation (T4).We recorded dosage of propofol,cisatracurium,sufentanil,remifentanil,vasoactive agent,extubation time and PACU stay time.Results At T1,T2 and T4,the MAP and HR in group AC were significantly higher than those in group AA (P<0.05);at T3,MAP in group AC were apparently lower than those in group AA (P<0.05).Compared with T0,MAP and HR in group AC were significantly increased at T1,T2 and T4(P<0.05),MAP in group AC were obviously reduced at T3 (P<0.05),MAP and HR in group AC were also fluctuated obviously at different time points.MAP and HR in group AA at each point had no statistically significant difference.Compared with T1,Pplat and Ppeak in the two groups were significantly increased at T2-T4 (P<0.05).Pplat and Ppeak in grpup AC were higher than those in group AA at T2,T3 (P<0.05).Compared with group AC,the dosages of propofol and cisatracurium were less in group AA.The postoperative extubation time and PACU stay time were shorter in group AA.Conclusion BIS and muscle relaxation monitoring in robot-assisted laparoscopic radical prostatectomy can effectively stablize hemodynamics,reduce airway pressure fluctuation and the dosage of anesthetics.It also shortens the extubation time and the PACU stay time and improves the anesthesia recovery quality.
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Objective To explore the level of autophagy induced by oxygen glucose deprivation/reperfusion(OGD/R) injury in L02 cell.Methods L02 cells were cultured to establish the model of OGD/R injury and simulate clinical hepatic ischemia-reperfusion injury.The L02 cells were randomly divided into 5 groups : normal control group, oxygen-glucose deprivation 6 h/reperfusion 1,3,6,12 h group (OGD 6 h/R 1,3,6,12 h).Then observe the form changes of the L02 cells by optical microscope.The appreciation of the company's relative L02 cells was detected by MTT.The expression of autophagy related proteins such as Beclin-1, LC3 and p62 were evaluated by Western blot.Results Compared with the normal control group, the form damaged and the cells proliferation activity of L02 cells in the OGD/R group were gradually increased in a time-dependent manner.Compared with the normal control group, autophagy related proteins LC3 , Beclin-1 were increased at OGD 6 h/R 1 h.The expression of LC3 was gradually increased as the time went on and was increased gradually at OGD 6 h/R 6 h, reached a peak at OGD 6 h/R 12 h(P<0.01).The expression of Beclin-1 was gradually increased as the time went on and was increased gradually at OGD 6 h/R 6 h and OGD 6 h/R 12 h (P<0.01).The expression of p62 had no obvious change at OGD 6 h/R 1 h and OGD 6 h/R 3 h, began to increase sharply at OGD 6 h/R 6 h and reached a peak at OGD 6 h/R 12 h(P<0.01).Conclusion Our data suggests that oxygen-glucose deprivation/reperfusion may increase the level of autophagy and lead to autophagic cell death in L02 cell.
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Objective To evaluate the effects of dexmedetomidine on dreaming during general anesthesia in pediatric patients.Methods A total of 400 pediatric patients of both sexes,aged 5-12 yr,with body mass index of 15.2-18.1 kg/m2,of American Society of Anesthesiologists physical status Ⅰ,undergoing elective orthopedic surgery under general anesthesia,were randomly divided into control group (group C,n=200) and dexmedetomidine group (group D,n =200) according to the computer-generated random numeral order and numeral parity.Dexmedetomidine was infused intravenously in a loading dose of 0.5 μg/kg over 10 min before induction of anesthesia followed by infusion of 0.5 μg · kg-1 · h-1 until 30 min before the end of surgery in group D,while the equal volume of normal saline was given instead of dexmedetomidine in group C.The pediatric patients who regained consciousness and recovered orientation in post-anesthesia care unit were interviewed for dreaming using a modified Brice questionnaire,and the dream (emotion,hearing and behaviours in dreams,memories for dreams) was evaluated using a 5-point Likert scale.Results Compared with group C,the incidence of dreaming was significantly decreased,the memory score was decreased (P＜0.05),and no significant change was found in emotion,hearing and behaviour scores in dreams in group D (P＞0.05).Conclusion Dexmedetomidine can decrease the development of dreaming during general anesthesia and produces no effect on the content of dreams (most are pleasant) in pediatric patients.