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Objective@#To evaluate the role of microRNA-125b (miR-125b) on ventilator-induced lung injury (VILI) in mice.@*Methods@#Forty healthy male C57BL/6 male mice, weighing 25-30 g, aged 2-3 months, were divided into 4 groups (n=10 each) using a random number table method: sham operation group (group Sham), group VILI, VILI plus miR-125b negative control group (group VILI+ NC), and VILI plus miR-125b overexpression group (group VILI+ miR-125b agomir). In VILI+ NC and VILI+ miR-125b agomir groups, miR-125b negative control and miR-125b agomir transfection complex 50 μl were intratracheally instilled, respectively, and 48 h later VILI model was established.The animals were mechanically ventilated for 4 h with high tidal volume (40 ml/kg) to induce VILI.Blood samples were obtained from the femoral artery at 4 h of mechanical ventilation for detection of PaO2, then animals were sacrificed, lungs were removed for determination of wet to dry weight ratio (W/D ratio) and for examination of pathological changes (with a light microscope), and lung injury was scored.In VILI+ NC and VILI+ miR-125b agomir groups, bronchoalveolar lavage fluid (BALF) was collected to measure the concentrations of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) by enzyme-linked immunosorbent assay.The cell apoptosis of lung tissues was measured using TUNEL, apoptosis index was calculated, the caspase-3 expression was detected by Western blot, and the miR-125b expression was detected by real-time polymerase chain reaction.@*Results@#Compared with Sham group, PaO2 was significantly decreased, and W/D ratio and lung injury score were increased in VILI, VILI+ NC and VILI+ miR-125b agomir groups, and the expression of miR-125b was down-regulated in VILI and VILI+ NC groups (P<0.05). Compared with VILI group, PaO2 was significantly increased, W/D ratio and lung injury score were decreased, the expression of miR-125b was up-regulated (P<0.05), the pathological changes of lung tissues were significantly attenuated in group VILI+ miR-125b agomir, and no significant change was found in the parameters mentioned above in group VILI+ NC (P<0.05). Compared with group VILI+ NC, the concentrations of TNF-α and IL-6 in BALF and apoptotic index were significantly decreased, and the expression of caspase-3 was down regulated in group VILI+ miR-125b agomir (P<0.05).@*Conclusion@#MiR-125b is involved in the endogenous protective mechanism of VILI in mice.
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Objective@#To identify the risk factors for postoperative fatigue syndrome (POFS) in outpatients with painless gastroscopy.@*Methods@#The outpatients received painless gastroscopy from October 2016 to February 2017 in our hospital were included in this study.The possible factors related to POFS were summarized by reviewing the relevant literature.The questionnaires were completed by the methods such as preoperative interview, intraoperative recording, and telephone follow-up.POFS occurrence, score and outcomes were evaluated.The patients were divided into POFS group (groupⅠ) and non-POFS group (groupⅡ) according to whether POFS occurred.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify the risk factors.@*Results@#Two hundred and forty-six patients completed this study.Sixty-nine cases developed POFS, and the incidence was 28.0%, the initial fatigue score was (5.2±2.4), and the duration of POFS was 3(9) h. The mean consumption of propofol (according to anesthesia time, mg/min) was an independent risk factor for POFS.@*Conclusion@#The mean consumption of propofol is an independent risk factor for POFS in outpatients with painless gastroscopy.
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Objective To identify the risk factors for postoperative fatigue syndrome(POFS)in outpatients with painless gastroscopy.Methods The outpatients received painless gastroscopy from October 2016 to February 2017 in our hospital were included in this study.The possible factors related to POFS were summarized by reviewing the relevant literature.The questionnaires were completed by the methods such as preoperative interview,intraoperative recording,and telephone follow-up.POFS occurrence,score and outcomes were evaluated.The patients were divided into POFS group(groupⅠ)and non-POFS group(groupⅡ)according to whether POFS occurred.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify the risk factors.Results Two hundred and forty-six patients completed this study.Sixty-nine cases developed POFS,and the incidence was 28.0％,the initial fatigue score was(5.2±2.4),and the duration of POFS was 3(9)h.The mean con-sumption of propofol(according to anesthesia time,mg/min)was an independent risk factor for POFS.Conclusion The mean consumption of propofol is an independent risk factor for POFS in outpatients with painless gastroscopy.
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Objective To evaluate the role of microRNA-125b (miR-125b) on ventilator-induced lung injury (VILI) in mice.Methods Forty healthy male C57BL/6 male mice,weighing 25-30 g,aged 2-3 months,were divided into 4 groups (n=10 each) using a random number table method:sham operation group (group Sham),group VILI,VILI plus miR-125b negative control group (group VILI+NC),and VILI plus miR-125b overexpression group (group VILI+miR-125b agomir).In VILI+NC and VILI+miR-125b agomir groups,miR-125b negative control and miR-125b agomir transfection complex 50 μl were intratracheally instilled,respectively,and 48 h later VILI model was established.The animals were mechanically ventilated for 4 h with high tidal volume (40 ml/kg) to induce VILI.Blood samples were obtained from the femoral artery at 4 h of mechanical ventilation for detection of PaO2,then animals were sacrificed,lungs were removed for determination of wet to dry weight ratio (W/D ratio) and for examination of pathological changes (with a light microscope),and lung injury was scored.In VILI+NC and VILI+miR-125b agomir groups,bronchoalveolar lavage fluid (BALF) was collected to measure the concentrations of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) by enzyme-linked immunosorbent assay.The cell apoptosis of lung tissues was measured using TUNEL,apoptosis index was calculated,the caspase-3expression was detected by Western blot,and the miR-125b expression was detected by real-time polymerase chain reaction.Results Compared with Sham group,PaO2 was significantly decreased,and W/D ratio and lung injury score were increased in VILI,VILI+NC and VILI+miR-125b agomir groups,and the expression of miR-125b was down-regulated in VILI and VILI+NC groups (P＜0.05).Compared with VILI group,PaO2 was significantly increased,W/D ratio and lung injury score were decreased,the expression of miR-125b was up-regulated (P＜0.05),the pathological changes of lung tissues were significantly attenuated in group VILI+miR-125b agomir,and no significant change was found in the parameters mentioned above in group VILI+NC (P＜0.05).Compared with group VILI+NC,the concentrations of TNF-α and IL-6 in BALF and apoptotic index were significantly decreased,and the expression of caspase-3 was down regulated in group VILI+miR-125b agomir (P＜0.05).Conclusion MiR-125b is involved in the endogenous protective mechanism of VILI in mice.
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Objective To evaluate the accuracy of respiratory variations of internal jugular vein (IJV) in monitoring fluid responsiveness in patients undergoing radical gastrectomy for gastric cancer.Methods Fifty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 40-64 yr,scheduled for elective radical gastrectomy for gastric cancer,were enrolled in this study.Before induction of anesthesia,the hemodynamic parameters such as heart rate,central venous pressure,cardiac index,stroke volume index (SVI),stroke volume variation and respiratory variation of IJV were recorded after haemodynamics was stable and were recorded again at 10 min after endotracheal intubation,and a loading dose of 6％ 130/0.4 hydroxyethyl starch 7 ml/kg was infused over 15 min.The parameters mentioned above were recorded within 5 min after loading dose.Patients were divided into 2 groups according to the percentage of increase in SVI (△SVI) after volume expansion:△SVI≥ 15％ was considered to be a positive response (responder group) and △SVI＜15％ was considered to be a negative response after volume expansion (non-responder group).Results The area under the receiver operating characteristic curve of respiratory variations of IJV in monitoring fluid responsiveness and 95％ confidence interval were 0.852 (0.744-0.961).Respiratory variation of IJV 24.6％ was considered as the cut-off value and used to monitor fluid responsiveness,and the sensitivity and specificity were 67.6％ and 92.3％,respectively.Conclusion Respiratory variation of IJV can be considered as an effective index in monitoring fluid responsiveness in the patients undergoing radical gastrectomy for gastric cancer.
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Objective To assess the accuracy and feasibility of respirophasic variation in carotid artery blood flow peak velocity (△Vpeak-CA) as predictors of fluid responsiveness in laparoscopic surgery.Methods Fifty-five patients undergoing laparoscopic surgeries,29 males and 26 females,aged 45-75 years,ASA physical status Ⅰ-Ⅲ,with body mass index 20-24 kg/m2,were enrolled.When intra-abdominal pressure was steady at the level of 13-15 mm Hg,6％ hydroxyethylstarch (HES 130/0.4) 500 ml was infused at the speed of 7 ml/kg within 20 minutes.After volume expansion,subjects were classified as responders (group R,n =32) if cardiac index increased (△CI) was≥ 15％ and no responders (group NR,n =23) as △CI＜15％.The receiver operating characteristic curve (ROC) curve for △Vpeak-CA in determining the volume expansion responsiveness was plotted,and the diagnostic threshold was determined.The area under curve (AUC) and 95 ％ confidence interval (CI) was calculated.Cardiac index (CI),△Vpeak-CA and stroke volume variation (SW) were independently recorded at 5 minutes after induction (T1),5 minutes after intra-abdominal pressure were stable at the level of 13-15 mm Hg (T2) and 5 minutes after volume expansion (T3).Results △Vpeak-CA is highly negatively correlated with CI (r=-0.843,P＜0.001).The results of ROC curve analysis showed,△Vpeak-CA threshold discriminated between responders and non-responders with a sensitivity of 81.3％ and a specificity of 91.3％,and the AUC was 0.884 (95％ CI 0.793-0.975).Conclusion △Vpeak-CA seems to be a highly feasible and reliable predictor for fluid responsiveness in laparoscopic surgery patients.
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Objective To evaluate the role of syndecan-4 (SDC-4) in inflammatory responses of rats with ventilator-induced lung injury (VILI).Methods Twenty-four healthy male wild type Sprague-Dawley rats and 24 male SDC-4 gene knockout Sprague-Dawley rats,aged 2-3 months,weighing 200-220 g,were assigned into 2 groups (n =12 each) using a random number table:control group (group C)and VILI group.The animals were anesthetized with pentobarbital sodium and tracheostomized.The rats kept spontaneous breathing in group C.The rats were mechanically ventilated for 4 h in group VILI.Blood samples were taken from the femoral artery at the end of mechanical ventilation for detection of arterial oxygen partial pressure (PaO2).The animals were sacrificed after blood sampling.The left lung was lavaged,and the broncho-alveolar lavage fluid (BALF) was collected for determination of the tumor necrosis factor-α (TNF-α),interleukin-1beta (IL-1β) and IL-18 concentrations (by enzyme-linked immunosorbent assay) and total protein concentrations (by BCA assay).The right lungs were removed for determination of the wet to dry weight ratio (W/D ratio) and expression of TNF-α,IL-1β and IL-18 mRNA in lung tissues (by real-time polymerase chain reaction) and for examination of the pathological changes (with a light microscope).The lung injury scores were recorded.Results Compared with group C of wild type rats,PaO2 was significantly decreased,W/D ratio and lung injury scores were increased,the concentrations of total protein,TNF-α,IL-1β and IL-18 in BALF were increased,and the expression of TNF-α,IL-1β and IL-18 mRNA in lung tissues was up-regulated in group VILI of wild type rats (P＜0.05),and no significant change was found in the variables mentioned above in group C of gene knockout rats (P＞0.05).Compared with group C of gene knockout rats,PaO2 was significantly decreased,W/D ratio and lung injury scores were increased,the concentrations of total protein,TNF-α,IL-1β and IL-18 in BALF were increased,and the expression of TNF-α,IL-1β and IL-18 mRNA in lung tissues was up-regulated in group VILI of gene knockout rats (P＜0.05).Compared with group VILI of wild type rats,PaO2 was significantly decreased,W/D ratio and lung injury scores were increased,the concentrations of total protein,TNF-α,IL-1β and IL-18 in BALF were increased,and the expression of TNF-α,IL-1β and IL-18 mRNA in lung tissues was up-regulated in group VILI of gene knockout rats (P＜0.05).Conclusion SDC-4 can inhibit inflammatory responses of rats with VILI and is involved in the endogenous protective mechanism.
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Objective To evaluate the efficacy of dexmedetomidine mixed with ropivacaine for thoracic paravertebral nerve blocks by multiple injections for preemptive analgesia on postoperative analgesia of patients undergoing thoracotomy. Methods Ninety patients, all genders, ASA Ⅰ or Ⅱ, aged 35-64, BMI 18-24 kg/m2, undergoing radical operation for esophageal carcinoma were randomly divided into three groups (each group 30 patients): group C received general anesthesia, group R received ropivacaine for thoracic paravertebral nerve block and group RD received dexmedetomidine mixed with ropivacaine for thoracic paravertebral nerve block.Three groups all used intravenous infusion of propofol, refentanyl and inhalation sevoflurane for anesthesia maintenance, and PCIA pump started before the end of surgery in 3 groups.Meanwhile, group R and group RD received ultrasound-guided T4-T8thoracic paravertebral nerve blocks by multiple injections on operation side preoperatively.In group R, the mixture of 0.5% ropivacaine 19 ml and 1ml of normal saline was injected, and in group RD, the mixture of dexmedetomidine 1 μg/kg and 19 ml of 0.5% ropivacaine was injected.The analgesia process lasted 48 h after surgery of these 3 groups, and the VAS score was maintained<4 points.When the VAS score was 4 or more points, intravenous injection of morphine 5- 10 mg was delivered. Postoperative PCIA liquid and morphine consumption, somnolence, nausea, vomiting, respiratory depression, itching and urinary retention was recorded. Additionally, the occurrences of adverse events about thoracic paravertebral nerve blocks were recorded.Results The dosages of propofol, refentanyl in group R and group RD were lower than those in group G:(7.2 ± 0.6),(6.1 ± 0.5)mg/(kg·h)vs.(8.1 ± 0.5)mg/(kg·h), and there were significant differences(P<0.05).The dosage of propofol in group RD was lower than that in group R: (6.1 ± 0.5) mg/(kg·h) vs. (7.2 ± 0.6) mg/(kg·h), and there was significant difference (P <0.05). Compared with group G, the consumption of PCIA liqud and the usage rate of morphine was reduced in group R and group RD (P < 0.05); the consumption of PCIA liqud and the usage rate of morphine was lower in group RD than that in group R(P<0.05).The rate of nausea and vomiting and itch in group R and group RD was lower than that in group G,and there were significant differences(P<0.05). No significant difference in somnolence showed between three groups (P > 0.05). Conclusions Ropivacaine combined with dexmedetomidine for target thoracic paravertebral nerve blocks by multiple injections for preemptive analgesia can significantly improve the efficacy of postoperative analgesia after thoracotomy, meanwhile,it can also save the dosage of anesthetic drugs during the operation.
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Objective To evaluate the relationship between the shedding of syndecan-4(SDC-4) in lung tissues and ventilator-induced lung injury in rats. Methods Thirty pathogen-free healthy adult male Wistar rats, weighing 220-250 g, were divided into 3 groups(n=10 each)using a random number table:control group(group C), mechanical ventilation with traditional tidal volume(VT)group(group T-VT) and mechanical ventilation with high VTgroup(group H-VT). The animals were anesthetized with pento-barbital sodium and tracheostomized. The rats kept spontaneous breathing in group C. The rats were me-chanically ventilated for 4 h with the VTset at 6 ml∕kg in group T-VT and with the VTset at 40 ml∕kg in group H-VT. Blood samples were collected immediately after the end of ventilation for measurement of serum SDC-4 concentrations by enzyme-linked immunosorbent assay. The left lung was lavaged, and broncho-alveolar lavage fluid was collected for determination of interleukin-1beta(IL-1β), IL-18, tumor necrosis factor-alpha and SDC-4 concentrations by enzyme-linked immunosorbent assay. The lungs were removed for determination of the wet to dry weight ratio and expression of SDC-4 protein and mRNA in lung tissues(by Western blot and real-time polymerase chain reaction, respectively)and for examination of the pathological changes. The lung injury scores were recorded. Results Compared with group C, the wet to dry weight ratio, lung injury scores, concentrations of IL-1β, IL-18, tumor necrosis factor-alpha and SDC-4 in bron-cho-alveolar lavage fluid and concentrations of SDC-4 in serum were significantly increased, the expression of SDC-4 mRNA was up-regulated, and the expression of SDC-4 was down-regulated in group H-VT(P<005), and no significant change was found in the parameters mentioned above in group T-VT(P>005).Marked pathological changes of lung tissues were found in group H-VT. Conclusion A large shedding of SDC-4 in lung tissues may be involved in the pathophysiological mechanism of ventilatior-induced lung injury in rats.
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Objective To evaluate the accuracy of respirophasic variation in carotid artery blood flow peak velocity(ΔVpeak-CA)in predicting fluid responsiveness in the patients undergoing surgery in the prone position. Methods Forty-three American Society of Anesthesiologists physical status Ⅰ-Ⅲ pa-tients of both sexes, aged 45-75 yr, with body mass index of 20-25 kg∕m2, scheduled for elective posteri-or approach lumbar surgery, were enrolled in the study.After induction of anesthesia, hydroxyethyl starch 130∕0.4 sodium chloride injection 7 ml∕kg was intravenously infused over 20 min when the patients were in the prone position.Subjects were classified as responders if stroke volume index increased≥15% after vol-ume expansion.The receiver operating characteristic curve for ΔVpeak-CA in determining positive fluid re-sponsiveness was drawn. Results The results of receiver operating characteristic curve analysis showed that: the cut-off value of ΔVpeak-CA in predicting positive fluid responsiveness was 7.94%, sensitivity 81.8%, specificity 70.0%, and the area under the curve(95% confidence interval)was 0.818 (0.378-0.757). Conclusion Respirophasic ΔVpeak-CA can accurately predict fluid responsiveness in the patients undergoing surgery in the prone position.
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Objective To evaluate the relationship between hippocampal monocyte chemotactic protein-1 (MCP-1) and its receptor C-C chemokine receptor 2 (CCR2) and postoperative cognitive dysfunction (POCD) in aged rats.Methods Forty-eight male Sprague-Dawley rats,aged 20-22 months,weighing 480-550 g,were randomly divided into 2 groups (n =24 each) using a random number table:control group (group C) and POCD group.POCD group inhaled 2.0％ isoflurane and underwent splenectomy.Before surgery and at 1,3 and 7 days after surgery,Morris water maze test was performed to evaluate the spatial learning and memory ability.The escape latency and swimming distance were recorded.Eight rats were sacrificed after the end of Morris water maze test performed at 1,3 and 7 days after surgery.Then the brains were removed,and the hippocampi were isolated for detection of the expression of MCP-1 and CCR2 by Western blot.Results Compared with group C,the escape latency and swimming distance were significantly prolonged,and the expression of MCP-1 and CCR2 in hippocampi was up-regulated at 1,3 and 7 days after surgery in POCD group.Conclusion Up-regulation of hippocampal MCP-1 and CCR2 expression may be involved in the mechanism of POCD in aged rats.
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Objective To evaluate the role of spinal RhoA/ROCK signaling pathway in the development of lipopolysaccharide (IP)-induced inflammatory pain(IP) in rats.Methods Fifty-two male Sprague-Dawley rats, weighing 180-220 g, were equally randomized into 4 groups using a random number table: normal saline group (group NS) , LPS group, RhoA inhibitor C3 exoenzyme group (group LC) , and ROCK inhibitor Y27632 group (group LY).Inflammatory pain was induced by injecting LPS 25 μl (300 ng) into the plantar surface of hindpaws in IP, LC and LY groups, while the equal volume of normal saline was injected instead in NS group.C3 exoenzyme 10 pg and Y27632 10 nmol were injected intrathecally at 30 min prior to LPS administration in LC and LY groups, respectively.Before LPS injection (T0) , and at 1, 3, 5, 12 and 24 h after LPS injection (T1-5) , the mechanical and thermal pain thresholds were measured.Five rats in each group were sacrificed after pain thresholds were measured at T3, and L4.5 segments of the spinal cord were removed for determination of tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β) mRNA expression in spinal dorsal horns by real-time reverse transcriptase-polymerase chain reaction.Results Compared with group NS, the mechanical and thermal pain thresholds were significantly decreased at T2-5in IP, LC and LY groups, and TNF-α and IL-1β mRNA expression was up-regulated at T3 in IP group.Compared with group IP, the mechanical and thermal pain thresholds were significantly increased at T2-5, and TNF-α and IL-1β mRNA expression was down-regulated at T3 in LC and LY groups.Conclusion Spinal RhoA/ROCK signaling pathway is involved in the development of LPS-induced IP in rats.
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Objective To evaluate the effects of mechanical stretch preconditioning on pathological stretch-induced activation of nuclear factor kappa B (NF-κB) and signal transducer and activator of transcription 3 (STAT3) signaling pathways in human type Ⅱ alveolar epithelial cells.Methods Human type Ⅱ alveolar epithelial cell line A549 cells cultured in vitro were randomly divided into 3 groups (n =24 each) using a random number table: control group (group Ⅰ), pathological stretch group (group Ⅱ), and mechanical stretch preconditioning group (group Ⅲ).In group Ⅰ , A549 cells were cultured routinely without receiving pathological stretch.In group Ⅱ , A549 cells were exposed to 20％ cyclic stretch at 0.3 Hz for 6 h.In group Ⅲ , A549 cells were exposed to 5％ cyclic stretch at 0.3 Hz for 60 min, and then exposed to 20％ cyclic stretch at 0.3 Hz for 6 h.After the end of the treatment, the cells were collected for determination of the cell viability (by methyl thiazolyl tetrazolium assay) and lactate dehydrogeuase (LDH)release (by colorimetric method).The concentrations of tumor necrosis factor-alpha (TNF-α),interleukin-8 (IL-8) and high mobility group box 1 (HMGB1) in the culture medium were detected using enzyme linked immunosorbent assay.The expression of total NF-κB, phosphorylated NF-κB, total STAT3 and phosphorylated STAT3 was detected using Western blot.The ratios of phosphorylated NF-κB to total NF-κB and phosphorylated STAT3 to total STAT3 were calculated to reflect the activation.Results Compared with group Ⅰ , the cell viability was significantly decreased, the amount of LDH released was increased, and the concentrations of TNF-α, IL-8 and HMGB1, and activation of NF-κB and STAT3 were increased in Ⅱ and Ⅲ groups.Compared with group Ⅱ , the cell viability was significantly increased, the amount of LDH released was decreased, and the concentrations of TNF-α, IL-8 and HMGB1, and activation of NF-κB and STAT3 were decreased in group Ⅲ.Conclusion The mechanism by which mechanical stretch preconditioning attenuates pathological stretch-induced damage to human type Ⅱ alveolar epithelial cells is related to inhibited activation of NF-κB and STAT3 signaling pathways.
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Objective To evaluate the effects of intrathecal 2-PMPA on chronic inflammatory pain in rats . Methods Twenty four male Sprague-Dawley rats ,aged 4-6 months ,weighing 200-250 g ,were randomly divided into 3 groups (n=8 each) using a random number table :normal saline (NS) group ,complete Freund′s adjuvant (CFA ) group and N-acetylaspartylglutamate peptidase inhibitor 2-PMPA group (group 2-PMPA ) . Chronic inflammatory pain was induced by injecting 100μl of CFA into the plantar surface of the left hindpaw .Immediately after injection of CFA ,2-PMPA 100 μg was injected intrathecally once a day for 3 consecutive days in group 2-PMPA ,while the equal volume of NS was given instead of 2-PMPA in NS and CFA groups .The paw withdrawal latency to thermal nociceptive stimulus (TWL ) and paw withdrawal threshold (PWT ) to von Frey filament stimulation were measured before injection of CFA (baseline ,T1 ) and after the last injection of CFA (T2 ) .Then the rats were sacrificed and the L4 ,5 segments of the spinal cord were removed for determination of NR2B expression by Western blot .Results Compared with group NS ,TWL and PWT were significantly decreased at T2 and the expression of NR2B was up-regulated in CFA and 2-PMPA groups ( P<0.05 ) .Compared with group CFA ,TWL and PWT were significantly increased at T2 and the expression of NR2B was down-regulated in group 2-PMPA ( P<0.05) .Conclusion Intrathecal 2-PMPA can alleviate CFA-induced chronic inflammatory pain in rats ,and inhibition of NR2B expression in the spinal cord is involved in the mechanism .