Effects of small-dose lidocaine combined with ketamine on early postoperative cognitive function in elderly patients undergoing gastrointestinal tumor surgery / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the effects of anesthetic intervention with small-dose lidocaine and ketamine on early postoperative cognitive function in elderly patients undergoing surgeries for gastrointestinal tumors.</p><p><b>METHODS</b>Sixty patients (ASA I-III, aged 63-82 years) scheduled for surgeries for gastrointestinal tumors were randomized into intervention group (n=30) and control group (n=30). After intravenous induction and tracheal intubation, the patients in the interventional group received intravenous infusion of 0.5 mg/kg lidocaine and 0.5 mg/kg ketamine, followed by continuous infusion of lidocaine at the rate of 0.5 mg·kg(-1)·h(-1) till the end of the operation; the patients in the control group received saline infusion only. The cognitive function of the patients was assessed at 3 day before and 2 day after the operation using comprehensive neuro-psychological tests. Peripheral venous blood was extracted before anesthesia induction (T0), at the end of the surgery (T1), and at 1 day (T2) and 2 days (T3) after the operation for measurement of serum S-100β protein, NSE and IL-6 levels using ELISA.</p><p><b>RESULTS</b>The difference between the test scores before and after the operation (X values) was significantly smaller in the intervention group than in the control group (P<0.05). The intervention group showed a significantly lower incidence rate of postoperative cognitive dysfunction (POCD) than the control group (6.7% vs 33.3%, P<0.05). Compared with the control group, the intervention group exhibited significantly lower serum levels of S-100β protein, NSE and IL-6 at T1 (P<0.05), significantly lower NSE and IL-6 levels at T2 (P<0.05) time point, and significantly lower IL-6 level at T3 (P<0.05).</p><p><b>CONCLUSION</b>Intravenous injection of small-dose lidocaine and ketamine during the operation can reduce the incidence of POCD in elderly patients undergoing surgeries for gastrointestinal tumors possibly in relation to decreased serum S-100β, NSE and IL-6 levels.</p>

Study of geniposide-acid on anti-inflammatory action for adjuvant-induced arthritis rats and mechanism of synoviocyte apoptosis in vitro / 中国中药杂志

<p><b>OBJECTIVE</b>To study the effect of geniposide-acid(GA) on the anti-inflammatory action for adjuvant-induced arthritis (AA) rats and the proliferation of synoviocytes in AA rats and the feasible mechanism of apoptosis in vitro.</p><p><b>METHOD</b>Forty-eight health male Wistar rats were divided randomly into six groups and were administered respectively with 200, 100, 50 mg x kg(-1) GA and 0.75 mg x kg(-1) MTX and normal sodium (normal or model control group) for four weeks when right posterior paw pads of rats excluding normal control group were injected intrademally with complete Freund's adjuvant after 19 days. The left posterior paws swelling degree, swelling inhibition ratio and arthritis index of secondary inflamation were detected. The TNF-alpha and IL-1beta proteins in serum of rats were assayed by enzyme linked immunosorbent assay (ELISA) kits. The synovial fibroblasts of AA rats were exposed to 1-4 micromol x L(-1) GA or 4 micromol x L(-1) MTX. The effect of GA on the proliferation of synoviocytes was detected by MTT assay. The morphologic change of apoptosis cells was observed by Hoechst/PI double stainning and fluorescence microscope. The rate of apoptosis cells was analyzed by flow cytometry. The mRNA expresstion of Bcl-2 and Bax gene was detected by reverse transcription PCR (RT-PCR).</p><p><b>RESULT</b>200 mg kg(-1) or 100 mg kg(-1) GA could decrease significantly the paw swelling degree, arthritis index and the level of TNF-alpha and IL-1beta proteins in serum of AA rats (P < 0.05 or P < 0.01) with 25.4%, 21.37% of the swelling inhibition ratio respectivly, 34.61%, 28% of protein inhibition ratio of TNF-alpha and 29.05%, 21.65% of that of IL-1beta. GA(1-4 micromol x L(-1)) inhibitated significantly the proliferation of synoviocytes culcured for 5 days. Flow cytometry showed that 1, 2, 4 micromol x L(-1) GA increased obviously the rate of apoptosis cells, the apoptosis ratios were 15.8%, 24.3%, 40.7% respectivly (P < 0.01). RT-PCR showed GA could decrease the expression level of Bcl-2 gene but increase that of Bax gene (P < 0.05 or P < 0.01).</p><p><b>CONCLUSION</b>GA could inhibit the secondary inflamation of AA rats and decrease the level of TNF-alpha and IL-1beta protein in the AA rats serum. GA could inhibit the proliferation of AA rat synoviocytes in vitro and induce apoptosis which mechanism was concerned with down-regulating the mRNA expression of Bcl-2 and up-regulating that of Bax.</p>