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Objective:To investigate the effects of oxycodone on vascular endothelial injury in patients undergoing laparoscopic surgery under general anesthesia.Methods:Eighty patients who received laparoscopic surgery in Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, China between September 2018 and September 2019 were included in this study. They were randomly assigned to undergo either intravenous administration of 10 mL 0.9% sodium chloride injection (control group, n = 40) or intravenous administration of 10 mg oxycodone hydrochloride before pneumoperitoneum (observation group, n = 40). Serum levels of norepinephrine (NE), epinephrine (E), heparin sulfate (HS), DPT-1 and vascular cell adhesion molecule-1 (VCAM-1) were measured in each group before pneumoperitoneum (baseline, T 0), at 1 hour after pneumoperitoneum (T 1), 2 hours after pneumoperitoneum (T 2), at the end of pneumoperitoneum (T 3) and at 24 hours after surgery (T 4). Operative time, pneumoperitoneum time and blood loss were recorded in both groups. The incidence of complications (arrhythmia, hypertension, irritability, pruritus, postoperative nausea and vomiting) was recorded. Postoperative Visual Analogue Scale score was compared between the observation and control groups. Results:At T 3 and T 4, serum levels of HS, DPT-1 and VCAM-1 in each group were significantly increased compared with T 0 (all P < 0.05). At T 4, serum levels of HS, DPT-1, and VCAM-1 in the observation group were (15.7 ± 4.8) μg/L, (31.5 ± 6.4) μg/L and (609.7 ± 90.4) μg/L, respectively, which were significantly lower than those in the control group [(18.6 ± 5.4) μg/L, (36.9 ± 7.3) μg/L, (653.2 ± 91.8) μg/L, t = 2.539, 3.518, 2.135, all P < 0.05]. At T 2 and T 3, serum levels of NE and E in each group were significantly increased compared with T 0 (all P < 0.05). At T 2, serum levels of NE and E in the observation group were (124.6 ± 14.5) μg/L and (106.4 ± 11.5) μg/L, respectively, which were significantly lower than those in the control group [(132.9 ± 12.4) μg/L, (111.8 ± 10.4) μg/L, t = 2.751, 2.203, both P < 0.05]. The incidence of postoperative irritability and Visual Analogue Scale score in the observation group were significantly lower than those in the control group (both P < 0.05). Conclusion:Intravenous administration of 10 mg oxycodone hydrochloride before pneumoperitoneum in patients subjected to laparoscopic surgery is beneficial to inhibiting inflammatory reaction, reducing the degradation of endothelial glycocalyx caused by pneumoperitoneum in laparoscopic surgery, and reducing vascular endothelial injury. This study is innovative and scientific.
RESUMO
Studies on coat protein I (COPI) have contributed to a basic understanding of how coat proteins generate vesicles to initiate intracellular transport. The core component of the COPI complex is coatomer, which is a multimeric complex that needs to be recruited from the cytosol to membrane in order to function in membrane bending and cargo sorting. Previous structural studies on the clathrin adaptors have found that membrane recruitment induces a large conformational change in promoting their role in cargo sorting. Here, pursuing negative-stain electron microscopy coupled with single-particle analyses, and also performing CXMS (chemical cross-linking coupled with mass spectrometry) for validation, we have reconstructed the structure of coatomer in its soluble form. When compared to the previously elucidated structure of coatomer in its membrane-bound form we do not observe a large conformational change. Thus, the result uncovers a key difference between how COPI versus clathrin coats are regulated by membrane recruitment.