Résumé
Objective To investigate the effect of hydrogen-rich saline postconditioning on the expression of vascular endothelial growth factor receptor-1 (VEGFR1) during myocardial ischemiareperfusion (I/R) injury in rats.Methods Thirty-six adult male Sprague-Dawley rats,weighing 250-280 g,were randomly divided into 3 groups (n=12 each) using a random number table:sham operation group (group S),group I/R and hydrogen-rich saline group (group H2).Myocardial I/R was induced by 30 min ligation of anterior descending branch of the left coronary artery followed by 2 h reperfusion.In group H2,hydrogen-rich saline 5 ml/kg was injected intravenously at 5 min before reperfusion,while the equal volume of normal saline was given in group I/R.Left ventricular systolic pressure (LVSP),left ventricular enddiastolic pressure (LVEDP) and ± dp/dtmax were measured and recorded during reperfusion and at 120 min of reperfusion.The rats were sacrificed at 120 min of reperfusion,and myocardial specimens were obtained for determination of myocardial infarct size,contents of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) (using ELISA),and expression of VEGFR1 (by Western blot).At 120 min of reperfusion,blood samples were collected from the common carotid artery to measure cardiac troponin I (cTnI) concentrations in serum.Results Compared with group S,LVSP and ± dp/dtmax were significantly decreased,LVEDP was increased,the myocardial infarct size was enlarged,cTnI concentrations in serum and contents of IL-6 and TNF-α were increased,and the expression of VEGFR1 was down-regulated at 120 min of reperfusion in H2 and I/R groups.Compared with group I/R,LVSP and ± dp/dtmax were significantly increased,LVEDP and myocardial infarct size were decreased,cTnI concentrations in serum and contents of IL-6 and TNF-α were decreased,and the expression of VEGFR1 was up-regulated at 120 min of reperfusion in group H2.Conclusion Hydrogen-rich saline postconditioning can reduce myocardial I/R injury possibly by upregulating myocardial VEGFR1 expression and inhibiting inflammatory responses in the myocardium of rats.
Résumé
Objective To observe the impacts of lumbar plexus block combined with sciatic nerve block on postoperative cognitive function and plasma S100βlevel in eldly patients undergoing hip surgeries.Methods Sixty patients of ASA Ⅱ or Ⅲ aged 65-85 years,undergoing selective hip sur-geries,were randomly divided into 2 groups (n=30 each).Group G received general anesthesia with tracheal intubation,while group L received ultrasound-guided lumbar plexus block and parasacral sci-atic nerve block combined with general anesthesia.The mini-mental state examination (MMSE)score was recorded before anesthesia,1 d,3 d and 7 d after operation.The plasma S100βlevel was detected before anesthesia,1 h and 7 d after operation.Results The MMSE scores declined on 1 d after oper-ation in both groups(P <0.05),and the value was lower in group G(P <0.05).There were 18 (56.7%)patients diagnosed with POCD in group G at the first day postoperatively,while it was 10 (33.3%)in group L,and the difference was significant(P<0.05).The MMSE scores were still low-er at 3 d after operation (P<0.05).The concentrations of plasma S100βincreased in both groups at 1 h after operation,and it was more obviously in group G (P <0.05).Conclusion Lumbar plexus block combined with parasacral sciatic nerve block might reduce the stress reaction and dosages of general anesthetics in eldly patients undergoing hip surgeries,minimize the damages of central nervous system,protect the cognitive function and reduce the incidence of POCD.