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Objective To evaluate the role and mechanism of ifenprodil, which is the selective antagonist of N-methyl-D-aspartic acid subtype receptor NR2B, in soflurane-induced cognitive dysfunction in neonatal rats.Methods Twenty-eight 7-day-old Sprague Dawley rats, weighing 15-18 g, were randomly divided into 4 groups (n=7 each): control group (group C), ifenprodil group (group I), sevoflurane group (group S) and ifenprodil+sevoflurane group (group IS).Normal saline 0.2 ml was injected intraperitoneally in group C.Specific NR2B receptor antagonist ifenprodil 5 mg/kg was injected intraperitoneally at the corresponding time points in group I.Normal saline 0.2 ml was injected intraperitoneally and 2.0% sevoflurane was inhaled for 4 h in group S.Ifenprodil 5 mg/kg was injected intraperitoneally 2 h before sevoflurance inhalation, and 2.0% sevoflurance was inhaled for 4 h in group IS.The rats were then sacrificed 3 weeks after administration, their brains were immediately removed and hippocampal slices were prepared for electrophyisological experiments.The value of population spike amplitude (PSA) and long-term potentiation (LTP) were measured every 10 minutes.Induced LTP was recorded.Results Compared with group C, the values of PSA and rates of induced LTP were significantly decreased in group S (P＜0.01).The values of PSA and rates of induced LTP were significantly increased in group IS than those in group S (P＜0.01).Conclusion NR2B receptor is involved in sevoflurance-induced cognitive dysfunction in the neonatal rats.Pretreatment with ifenprodil 5.0 mg/kg can improve the neurotoxicity and protect the brain.
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Objective To investigate the improving effects of Shenshao decoction on myocardial structure and function in diabetic cardiomyopathy,and its effect on expression of TLR4/MyD88-dependent pathway signal in diabetic cardiomyopathy.Methods Diabetes mellitus was induced in 8-week-old male Wistar rats by a single intraperitoneal injection of streptozotocin.The changes of plasma myocardial enzyme (CK, LDH) and high sensitive C reactive protein (hsCRP) were measured.Cardiac function was measured by left ventricular intubation.Hematoxylin and eosin staining and electron microscopy were used to observe the changes of myocardial morphology and ultrastructure in rats.Expression of Toll-like receptor 4(TLR4), myeloid differentiation protein 88(MyD88), and nuclear factor-κB P65(NF-κB P65) were tested by immunohistochemistry.Results After 6 weeks of treatment, the left ventricular diastolic and systolic functions were obviously improved;the degrees of myocardial fibers and mitochondrial damage were obviously relieved;the content of CK, LDH and hsCRP decreased (P 0.05).Conclusions Shenshao decoction can reduce the myocardial injury in diabetic cardiomyopathy and improve cardiac diastolic and systolic functions.The mechanism may be related to attenuated inflammation by TLR4/MyD88 dependent signaling pathway.
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Objective To explore the feasibility of continuous sciatic nerve block via lateral poplit eal approach with single shot femoral nerve block for enhanced recovery after surgery in ankle and foot surgery.Methods Sixty adult patients scheduled for elective ankle and foot surgery were randomly assigned into 2 group (n =30 each):Group A received sciatic nerve block via lateral popliteal approach with a catheter placed and a single shot femoral nerve block under ultrasound guidance followed by patient-controlled postoperative analgesia with 0.2％ ropivacaine through the perineural catheter;Group B received the routine epidural puncture and a catheter placement at L2-3 level followed by postoperative analgesia with 0.2％ ropivacaine through the catheter.Systolic blood pressure (SBP),diastolic blood pressure (DBP) and heart beat (HR) were recorded before and after anesthesia.The block efficacy,the volume of fluid influsion during operation and the usage of ephedrine were recorded.The pain severity at rest and upon movement with a 0-10 numeric rating scale (NRS,0 =no pain and 10 =worst possible pain),the modified Bromage score of the motor block of the affected extremity,the number of effective patient-controlled bolus of ropivacaine and the number of need for opioid rescue within 48 h after surgery were assessed.The first time of leaving bed after operation,the length of hospital stay and the occurring of complication related to puncture and analgelsia were also recorded.Results SBP and DBP at each time point after anesthesia were higher in group A than those in group B (P ＜ 0.05).The volume of fluid infusion during operation and the occurence of ephedrine use were less in group A than those in group B (P ＜0.05).There was no indifference in terms of the NRS scores at rest and upon movement,the number of effective patient-controlled bolus of ropivacaine and the number of need for opioids rescue (P ＞ 0.05),but the complications such as nausea and vomiting,urinary retention occurred more in group B (P ＜0.05).The modified Bromage score of the motor block at each time point within 24 h after surgery was lower in group B than that in group B (P ＜ 0.05).The first time of leaving bed after operation and the length of hospital stay were shorter in group A than those in group B (P ＜ 0.05).Conclusions Ultrasound-guided continuous sciatic nerve block via lateral popliteal approach with single shot femoral nerve block can provide exact anesthetic effect with minimal interference on haemodynamics and excelent postoperative analgesia with less influence on movement.It's helpful in the ankle and foot surgery to improve the recovery after surgery.
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Objective To investigate the efficacy of high frequency jet ventilation via the nasopha?ryngeal catheter in assissting ventilation in patients with obstructive sleep apnea hypopnea syndrome ( OS?AHS) undergoing gastroscopy. Methods Eighty patients with OSAHS of both sexes, aged 40-64 yr, weighing 65-99 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, with an apnea?hy?popnea index 20-40 events∕h, scheduled for elective painless gastroscopy, were divided into control group and test group using a random number table, with 40 patients in each group. In control group, a nasopha?ryngeal catheter 6.0-7.0 mm in internal diameter was inserted, and oxygen was inhaled at 4 L∕min through the catheter. In test group, a nasopharyngeal catheter 4.0 mm in internal diameter was inserted, and a high frequency jet ventilator was connected ( inspiratory∕expiratory ratio 1. 0 ∶ 1. 5, frequency 150 bpm, peak pressure 0.4 kPa, tidal volume 180 ml) . Anesthesia was maintained with propofol in both groups. The oc?currence of hypoxemia during ventilation, and peak value of partial pressure of end?tidal CO2 before induc?tion of anesthesia and during ventilation, and occurrence of chin lift, mask ventilation, and epistaxis after insertion of the catheter during operation were recorded. Results Compared with control group, the inci?dence of hypoxemia, peak value of partial pressure of end?tidal CO2 during ventilation, and incidence of chin lift, mask ventilation and epistaxis during operation were significantly decreased in test group ( P<0.05) . Conclusion High frequency jet ventilation via the nasopharyngeal catheter can be safely and effec?tively used to assisst ventilation in patients with OSAHS undergoing gastroscopy.
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Objective To evaluate the role of gamma-aminobutyric acid A (GABAA) receptor in isoflurane-induced cognitive dysfunction in neonatal rats.Methods Twenty-eight 7-day-old Sprague Dawley rats,weighing 16-18 g,were randomly divided into 4 groups (n =7 each):control group (group Con),securinine group (group See),isoflurane group (group Iso) and securinine + isoflurane group (group Sec + Iso).Normal saline 0.2 ml was injected intraperitoneally in group Con.Specific GABAA receptor antagonist securinine 30 mg/kg was injected intraperitoneally at the corresponding time points in group Sec.Normal saline 0.2 ml was injected intraperitoneally and 1.4％ isoflurane was inhaled for 6 h in group Iso.Securinine 30 mg/kg was injected intraperitoneally at 30 min before isoflurane inhalation and 3 h of inhalation,and 1.4％ isoflurane was inhaled for 6 h in group Sec + Iso.The rats were then sacrificed at 3 weeks after administration,their brains were immediately removed and hippocampal slices were prepared for electrophysiological experiments.The value of population spike amplitude (PSA) and long-term potentiation (LTP) were measured every 5 min.The successful LTP induction was recorded.Results Compared with group Con,the values of PSA and rates of successful LTP induction were significantly decreased in group Iso (P ＜ 0.01),and no significant change was found in the parameters mentioned above in groups Sec and Sec + Iso (P ＞ 0.05).The values of PSA and rates of successful LTP induction were significantly higher in group Sec + Iso than in group Iso (P ＜ 0.01).Conclusion GABAA receptor is involved in isoflurane-induced cognitive dysfunction in the neonatal rats.
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Objective To explore the clinical value of prospective electrocardiography-triggering high-pitch spiral acquisition by dual-source CT (HP mode ) in children with congenital heart diseases (CHD).MethodsThirty-six patients ( mean age:0.67 years,range:1 month to 2 years and 6 months; 25 males;mean weight:7.7 kg)underwent prospective ECG-triggering high-pitch spiral acquisition.The dose length product (DLP) was recorded to calculate effective dose ( ED ).Two experienced radiologists made diagnosis and assessed the overall image quality by a five-point scale independently.The consistency of their judgment was determined by Kappa statistics.Surgeries were performed in 29 patients,and conventional cardiac angiography(CCA) was performed in 7 patients.The accuracy,sensitivity and specificity of HP mode were calculated based on the surgical or CCA findings.ResultsThe DLP was (5.12 ± 1.64) mGy.cm with a range of 2.4 mGy · cm to 9.2 mGy · cm and ED was (0.125 ± 0.027 ) mSv ranging from 0.078 mSv to 0.179 mSv.The average subjective image quality score was 4.2 ± 0.7.All images were diagnosable.Two radiologists made good agreement ( K =0.774,P ＜ 0.05 ).The accuracy,sensitivity and specificity of HP mode were 98.9％,94.2％ and 99.8％,respectively.ConclusionLow radiation dose with the accurate diagnosis of anomalies makes HP mode a new choice for children with CHD.
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Objective To investigate the effects of minute quantity of endogenous endotoxin originating from the lung on ventilator-induced lung injury in rats. Methods Thirty-two pathogen-free male adult SD rats weighing 370-390 g were randomly divided into 4 groups ( n = 8 each): group I spontaneous breathing (group C) ; group Ⅱ spontaneous breathing + IPS (group CL) ; group IE mechanical ventilation (group M) and group IV mechanical ventilation + LPS (group ML). The animals were anesthetized with intraperitoneal 20% urethane 0.8 ml/100 g. Right common carotid artery and left femoral vein were cannulated for BP monitoring and fluid and drug administration. The animals were tracheostomized. In group CL and ML LPS 100μg /kg was instilled into trachea. In group M and ML the animals were mechanically ventilated (V_T 20 ml/kg, PEEP=0, I = E = 1:1). P_(ET) CO_2 was maintained at 35-45 nun Hg by adjusting respiratory rate. The animals were breathing or ventilated with room air,and ECG, BP, HR and P_(ET)CO_2 were continuously monitored. Blood gases were analyzed at the beginning and 1, 2 and 3 h of experiment. The animals were sacrificed at 3 h of experiment. The lungs were removed for microscopic examination. The pathological changes of the lung were scored (0 = normal,3 = severe change) . Wet/dry lung weight ratio was determined. The left lung was lavaged. The broncho-alveolar lavage fluid (BALF) was collected. WBCs in BALF were counted. Pulmonary albumin permeability (PAP) (BALF protein concentration/plasma protein concentration) was determined. Plasma TNF-a and macrophage inflammatory protein 2 (MIP-2) concentrations were detected with ELISA. The endotoxin receptor CD14 mRNA expression in lung tissue was determined by RT-PCR and the macrophage CD14 expression in BALF was determined by immuno histochemistry in group C and M. Results Wet/dry lung weight ratio and PAP were significantly higher in group ML than in group M and C. WBC count in BALF, the pathological score and plasma MIP-2 concentration were significantly higher in group M and ML than in group C and were significantly higher in group ML than in group M. TNF-a concentration was significantly higher in group CL and ML and was not detected in group C and M. CD14mRNA expression in the lung tissue and CD14 expression in BALF macrophage were significantly higher in group M than in group C. Conclusion Minute amount of endogenous endotoxin from the lung can aggravate ventilator-induced lung injury in rats. Mechanical ventilation with large tidal volume sensitizes the lung to LPS stimulation through up-regulation of CD14 exexpression.