Diagnostic value of MRI retention enema cannula enhanced scanning in high complex anal fistula / 中国医师进修杂志

Objective:To investigate the clinical diagnostic value of MRI retention enema cannula enhanced scanning in the high complex anal fistula.Methods:The clinical data of 60 anal fistula patients underwent surgery treatment from May 2020 to May 2022 in Affiliated Hospital of Shanxi University of Traditional Chinese Medicine were retrospectively analyzed. All patients underwent MRI plain scanning and enhanced scanning before operation. Compared with the surgical results, the difference between MRI plain scanning and enhanced scanning in the diagnosis of high complex anal fistula was compared.Results:All of the 60 patients successfully completed surgical treatment, and 58 cases internal orifices, 55 cases complex anal fistulas and 53 cases high anal fistulas were found intraoperatively. MRI plain scanning results showed 32 cases internal orifices, 46 cases complex anal fistulas and 42 cases high anal fistulas were found. MRI enhanced scanning results showed 54 cases internal orifices, 53 cases complex anal fistulas and 50 cases high anal fistulas were found. Based on surgical results, the coincidence rates of internal orifice, complex anal fistula and high anal fistula in MRI enhanced scanning were significantly higher than those in MRI plain scanning: 93.10% (54/58) vs. 55.17% (32/58), 96.36% (53/55) vs. 83.64% (46/55) and 94.34% (50/53) vs. 79.25% (42/53), and there were statistical differences ( χ2 = 21.76, 4.95 and 5.27; P<0.01 or <0.05). Conclusions:The MRI retention enema cannula enhanced scanning has obvious advantages in the diagnosis of high complex anal fistula, which provides scientific reference value for the diagnosis and operation of high complex anal fistula in clinic.

Effect of inhibition of IL-6 trans-signaling on sepsis-associated encephalopathy in mice / 中华麻醉学杂志

Objective:To evaluate the effect of inhibition of interleukin-6 (IL-6) trans-signaling on sepsis-associated encephalopathy (SAE) in mice.Methods:Eighty healthy male C57BL/6J mice, aged 8-10 weeks, weighing 22-24 g, were divided into 4 groups using a random number table method: sham operation group (Sham group, n=10), SAE group ( n=35), SAE plus sgp130Fc group ( n=25) and sgp130Fc group ( n=10). Sepsis was induced by cecal ligation and puncture (CLP) in anesthetized animals.Sham and sgp130Fc groups received no CLP.In group sgp130Fc and group SAE+ sgp130Fc, sgp130Fc 0.5 mg/kg was intraperitoneally injected at 1 h after sham operation or CLP.The survival rates, body weight and neurological function scores were recorded within 1-10 days after sham operation or CLP.Four mice in each group were selected at 24 h after sham operation or CLP to detect the expression of occlusin in hippocampus by Western blot.Five mice in each group were selected to measure cognitive function using Morris water maze test at day 4 after sham operation or CLP. Results:Compared with group Sham, the survival mice, body weight and neurological function scores on days 2-10 after CLP were significantly decreased, the expression of occludin was down-regulated, the frequency of crossing the original platform was decreased, and the time spent in target quadrant was shortened in group SAE ( P<0.05), and no significant change was found in the indexes mentioned above in group sgp130Fc ( P>0.05). Compared with group SAE, the survival rate and neurological function scores on days 3-10 after CLP were significantly increased, the expression of occludin was up-regulated, the frequency of crossing the original platform was increased, and the time spent in target quadrant was prolonged ( P<0.05), and no significant change was found in body weight in group SAE+ sgp130Fc ( P>0.05). Conclusions:Inhibition of IL-6 trans-signaling can reduce the damage to the blood brain barrier and SAE in mice.

Changes in expression of hippocampal HSP70 during postoperative cognitive dysfunction in aged rats / 中华麻醉学杂志

Objective:To evaluate the changes in the expression of hippocampal HSP70 during postoperative cognitive dysfunction in aged rats.Methods:Twelve pathogen-free healthy male Sprague-Dawley rats, aged 18 weeks, weighing 500-650 g, were divided into 2 groups ( n=6 each) using a random number table method: old control group (group O) and old surgery group (group OS). Another 12 pathogen-free healthy male Sprague-Dawley rats served as control and divided into 2 groups ( n=6 each) according to a random number table method: adult control group (group A) and adult surgery group (group AS). Exploratory laparotomy was performed in group AS and group OS.Morris water maze test was performed at 3 days after operation, and then the rats were sacrificed, and the hippocampi were removed for determination of the expression of heat shock protein 70 (HSP70) (by Western blot) and contents of interleukin-1beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) (by enzyme-linked immunosorbent assay). Results:Compared with group A, the expression of HSP70 was significantly up-regulated ( P<0.05), and no significant change was found in the other indices in group AS ( P>0.05). Compared with group O, the escape latency was significantly prolonged, the frequency of crossing platform was decreased, the contents of IL-1β and TNF-α were increased, and the expression of HSP70 was up-regulated in group OS ( P<0.05). Compared with group AS, the escape latency was significantly prolonged, the frequency of crossing platform was decreased, the contents of IL-1β and TNF-α were increased ( P<0.05), and no significant change was found in the expression of HSP70 in group OS ( P>0.05). Conclusion:HSP70 expression in hippocampi is up-regulated during postoperative cognitive dysfunction and is helpful in inhibiting the inflammatory response and exerting endogenous neuroprotective effect in aged rats.

Relationship between early postoperative cognitive dysfunction and neuromodulator protein 1β in aged rats / 中华麻醉学杂志

Objective:To evaluate the relationship between early postoperative cognitive dysfunction and neuromodulator protein 1β(NRG1β) in aged rats.Methods:Pathogen-free healthy male Sprague-Dawley rats, aged 18-20 months, weighing 600-700 g, were divided into 3 groups ( n=10 each) using a random number table method: control group (group C), operation group (group O) and NRG1β group (group N). Exploratory laparotomy was performed in group O and group N. NRG1β 0.5 μg/kg was slowly injected into the lateral ventricle on 1 day before surgery in group N, while the equal volume of 0.1 mol/L phosphate buffer solution was given instead in C and O groups.Learning and memory function was assessed using Morris water maze test performed at day 3 after operation.The rats were then sacrificed, and the hippocampi were removed for determination of the expression of nuclear factor kappa B (NF-κB) p65 (by Western blot) and contents of interleukin-1beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) (by enzyme-linked immunosorbent assay). Results:Compared with group C, the postoperative escape latency was significantly prolonged, the expression of NF-κB p65 was up-regulated, and the contents of IL-1β and TNF-α were increased in group O and group N ( P<0.05). Compared with group O, the postoperative escape latency was significantly shortened, the expression of NF-κB p65 was down-regulated, and the contents of IL-1β and TNF-α were decreased in group N ( P<0.05). Conclusion:NRG1β is involved in the endogenous protective mechanism of early postoperative cognitive dysfunction probably by inhibiting the activation of NF-κB pathway and inhibiting inflammatory responses in aged rats.

Role of cPKCγ/GAP-43 signaling pathway in ketamine-induced apoptosis in hippocampal neurons of developing rats:an in vitro experiment / 中华麻醉学杂志

Objective To evaluate the role of conventional protein kinase Cγ (cPKCγ)/growthassociated protein-43 (GAP-43) signaling pathway in ketamine-induced apoptosis in hippocampal neurons of developing rats in an in vitro experiment.Methods Primarily cultured hippocampal neurons were seeded in culture plates at a density of 1×10.6 cells/ml and divided into 2 groups (n=10 each) using a random number table:control group (C group) and ketamine group (K group).Group C received no treatment.Ketamine was added with the final concentration of 300 μmol/L in group K.At 12 h of culture or incubation,the apoptosis in hippocampal neurons was detected by flow cytometry.The apoptotic rate was calculated.The expression of cPKCγ,GAP-43 and phosphorylated GAP-43 in hippocampal neurons was measured by Western blot.Results Compared with group C,the apoptotic rates of hippocampal neurons were significantly increased,and the expression of cPKCγ,GAP-43 and phosphorylated GAP-43 was down-regulated in group K (P<0.01).Conclusion The mechanism by which ketamine induces apoptosis in hippocampal neurons of developing rats may be related to inhibition of cPKCγ/GAP-43 signaling pathway activation in an in vitro experiment.

Mechanism underlying propofol-induced inhibition of migration of human breast cancer cells: the relationship with glycolysis / 中华麻醉学杂志

Objective To evaluate the relationship between the mechanism underlying propofol-induced inhibition of migration of human breast cancer cells and glyc olysis.Methods Human breast cancer cell line MDA-MB-231 cells were inoculated in 12-well culture plates at a density of 3× 105 cells/well.After being cultured for 24 h,the cells were divided into 2 groups (n=12 each) by using a random number table:control group (group C) and propofol group (group P).Propofol at the final concentration of 5 μg/ml was added to the culture medium in group P,and the equal volume of phosphate buffer solution was added to the culture medium in group C.At 6 h of incubation,the culture media were changed to the common culture media containing no drugs,and the cells were then incubated for another 24 h.The culture media were collected for determination of glucose concentrations (by oxidase mnethod) and lactate concentrations (by chemical colorimetry).Glucose consumption and lactate production were calculated according to glucose and lactate concentrations.Cells were collected,the expression of lactate dehydrogenase A was detected by Western blot,and the migration of cells was determined by cell scratch test.Results Compared with group C,the consumption of glucose and production of lactate were significantly decreased,the expression of lactate dehydrogenase A was down-regulated,and the migration rate was decreased in group P (P＜0.05).Conclusion The mechanism by which propofol inhibits migration of human breast cancer cells may be associated with inhibition of glycolysis.

Agreement between regional cerebral oxygen saturation and jugular bulb venous oxygen saturation during one-lung ventilation in elderly patients / 中华麻醉学杂志

Objective To evaluate the agreement between regional cerebral oxygen saturation (rSO2) and jugular bulb venous oxygen saturation (SjvO2) during one-lung ventilation (OLV) in elderly patients.Methods Twenty-two patients of both sexes,aged 65-76 yr,with body mass index of 21-32 kg/m2,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,undergoing open pulmonary lobectomy or radical resection of esophageal cancer with combined intravenous-inhalational anesthesia,were selected.Immediately after beginning of two-lung ventilation (T0),at stable two-lung ventilation in the lateral position (T1),at 5,25 and 45 min of OLV in the lateral position (T2-4) and at the end of OLV in the lateral position (T5),blood samples were collected from the jugular bulb for blood gas analysis,and SjvO2 was recorded,rSO2 was also recorded at the time points mentioned above.Bland-Altman analysis was used to evaluate the agreement.Results SjvO2 was significantly lower at T0-5 than rSO2 (P＜0.05).rSO2 and SjvO2 were gradually decreased at T1-5 (P＜0.05).The results of Bland-Altman analysis showed that the difference between rSO2 more than 95％ and SjvO2 was within the range of 95％ limits of agreement,and the absolute value of the maximum difference was 20.8％.Conclusion There is a good agreement between rSO2 and SjvO2 during OLV in elderly patients,and SjvO2 can be recommended as an alternative to rSO2 clinically.

Preparation and release character of sinomenine hydrochloride multivesicular liposomes / 中草药

Objective To prepare the sinomenine hydrochloride multivesicular liposomes with high entrapment efficiency and sustained release character.Methods Multiple emulsion method was used to prepare the sinomenine hydrochloride multivesicular liposomes.Uniform design was applied to optimize the formulation and pharmaceutical process.The shape,the particle size,and the release charcter of the liposome were evaluated.Results The sinomenine hydrochloride multivesicular liposomes prepared were spherical and the size of majority particles was in the range of 20—30 ?m and well distributed.The encapsulation efficiency was more than 80% and its in-vitro release profile accorded well with the Higuchi model with t1/2 up to 52.7 h.Conclusion The formulation and pharmaceutical process of the sinomenine hydrochloride multivesicular liposomes are stable and feasible with the high encapsulation efficiency and good sustained-release character.

Preparation and quality assessment of sinomenine hydrochloride transfersomes / 中草药

Objective To prepare sinomenine hydrochloride transfersomes and evaluate their qualities. MethodsThree different preparation methods including film dispersion, reverse phase evaporation, and ethanol injection methods were compared according to the encapsulation efficiency of transfersomes. Uniform design was applied to optimize the formulation and pharmaceutical process of reverse phase evaporation. The particle size, the appearance, the Z-potential, and the stability were also evaluated. ResultsThe transfersomes prepared by reverse-phase evaporation method possessed the highest encapsulation efficiency. The ideal combinations of preparation and formulation were: soya lecithin/sodium cholate was 200/30 mg/mg, chloroform/PBS was 5 mL/mL, pH of PBS was 6.5, added sinomenine hydrochloride was 10 mg. The transfersomes obtained were milky white translucent suspension, with a mean encapsulation efficiency of 62.2%. The shape of their particles was spherical or similar to spherical under microscope, which was smooth and disconglutinated with an average diameter of 96.4 nm, and a Z-potential of-35.93 mV. Aggregation or deposition was not observed after exposure under the temperature of 4 ℃ for 30 d. ConclusionThe preparation process of sinomenine hydrochloride transfersomes is feasible, the quality of obtained transfersomes is stable.It is expected to provide a new preparation for clinical use of sinomenine hydrochloride.