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@#Abstract: Integrated stress response is an adaptive response produced by eukaryotic cells after intracellular and extracellular stimulation. The activation of integrated stress response inhibits the translation of most proteins, yet it can promote the translation of certain proteins to cope with complex cellular microenvironment changes. A large number of studies have found that in a variety of nervous system diseases, the integrated stress response can be activated by stress signals of disease-related cells and participates in the occurrence and progression of diseases through processes such as learning and memory consolidation, myelin regeneration and synaptic plasticity. This article summarizes the role, mechanism and possible drug targets of integrated stress response in central nervous system diseases and discusses the potential of pharmacological methods to regulate integrated stress response in the treatment of central nervous system diseases, in order to provide reference for pathological research on and drug development for central nervous system diseases.
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Metal elements are the most common and widely distributed chemical elements in nature,which are closely related to human health,and their excess or lack will have a profound impact on the physio-logical and pathological processes of the body.This paper defines the concept of"metal element stress re-sponse",that is,the stress response that can occur in various cells,tissues and organs throughout the body when the content of metal elements in the body exceeds or falls below a certain level.According to the degree of stress,it can be divided into four dimensions:physiological stress,burden stress,pathological stress and disease stress.This paper comprehensively describes the degree,mode and biological effect of the interaction between metal elements and organism,and"four-dimensional theory"of metal element stress response is pro-posed,aiming to provide new ideas and new methods for seeking the potential intervention strategies of metal element stress response in the future
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Objective To evaluate the effects of transcutaneous electrical acupoint stimulation(TEAS)combined with Chinese medicine emotional intervention on immune function and psychological stress in patients undergoing laparoscopic radical rectal cancer surgery.Methods A total of 100 patients hospitalized for laparoscopic radical surgery for rectal cancer were randomly divided into 4 groups of Group A,B,C,and D,25 patients in each group.Group A was given TEAS for 30 minutes before anesthesia,Group B was given TEAS continuously until the end of the surgery,Group C was given TEAS for 30 minutes and Chinese medicine emotional intervention before anesthesia,Group D was given TEAS continuously until the end of the surgery together with Chinese medicine emotional intervention.TEAS was performed at bilateral Zusanli(ST36)points,bilateral Sanyinjiao(SP6)points,Baihui(GV20)points,bilateral Neiguan(PC6)points.The changes of perioperative outcomes and the changes of parameters associated with the immune function,molecular mechanism of Th1/Th2 cells,and psychological stress response before the surgery and 3 days after the surgery in each group were observed.Moreover,the occurrence of adverse reactions in each group was compared.Results(1)The differences of perioperative outcomes operation time,bleeding volume and infusion amount were not statistically significant among the 4 groups(P＞0.05).The Sufentanil dosage,Remifentanil dosage,postoperative awakening time,and 24-hour postoperative pain Visual Analogue Scale(VAS)scores of group D were lower than those of Groups A,B,and C(P＜0.05),and the above indexes of group B and group C were all lower than those of Group A(P＜0.05).(2)Three days after the surgery,the levels of immune function indicators of T lymphocyte subsets CD3+,CD4+ and natural killer(NK)cells in Group D were higher than those in Groups A,B,and C(P＜0.05),while the above indexes in Groups B and C were higher than those in Group A(P＜0.05).(3)Three days after the surgery,the levels of parameters associated with the molecular mechanism of Th1/Th2 cells such as interleukin 2(IL-2)and interferon gamma(IFN-γ)in Group D were higher(P＜0.05),and the serum interleukin 10(IL-10)level was lower than those in Groups A,B,and C(P＜0.05);the serum IL-2 and IFN-γ levels in Group B and C were higher(P＜0.05)and serum IL-10 level was lower than those in Group A(P＜0.05).(4)Three days after the surgery,the scores of the psychological stress response indicators of self-rating anxiety scale(SAS)and self-rating depression scale(SDS)in Group D were lower than those in Groups A,B,and C(P＜0.05),while the above scores in Groups B and C were lower than those in Group A(P＜0.05).(5)In Group A,there was one case of nausea and vomiting;in Group B,there were two cases of nausea and vomiting and one case of dizziness;no adverse reaction occurred in Group C,and there was one case of nausea and vomiting in Group D.The incidences of adverse reactions in Groups A,B,C and D were 4.0%(1/25),12.0%(3/25),0.0%(0/25),and 4.0%(1/25),respectively.The intergroup comparison showed no statistically significant difference among the 4 groups(χ2 = 0.400,P = 0.527).Conclusion In treating patients undergoing laparoscopic radical surgery for rectal cancer,TEAS combined with Chinese medicine emotional intervention can effectively regulate the perioperative immune function,reduce the stress response,and alleviate the anxiety of the patients.Moreover,the therapy exerts certain analgesic effect,which leads to the reduction of the dosage of opioids and the increase of perioperative comfort and surgical tolerance of the patients.
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Objective To investigate the effect of ultrasound guided block of pericapsular nerve(PENG)combined with lateral femoral cutaneous nerve(LFCN)on analgesia,stress response and postoperative cognitive function in patients undergoing hip replacement.Methods 102 patients who underwent hip Joint replacement in our hospital from September 2020 to September 2022 were selected and randomly divided into control group(51 cases)and study group(51 cases).The control group was given ultrasound guided iliac fascia space block(FICB),and the study group was given ultrasound guided PENG combined with LFCN block.The perioperative related indicators,postoperative analgesia effect,stress response indicators and postoperative cognitive function of the two groups were compared.Results There was no statistically significant difference in the comparison of surgical time between the two groups(P＞0.05).The amount of sufentanil used and the number of analgesic pump used within 48 hours after surgery in the study group were significantly lower than those in the control group(P＜0.05).The first postoperative time of getting out of bed and hospitalization in the study group were significantly shorter than those in the control group(P＜0.05).There was no statistically significant difference in VAS scores between the two groups at 6 h,12 h,24 h,and 48 h after surgery(P＞0.05).The VAS scores of the study group were significantly lower than those of the control group at 6 h,12 h,and 24 h after surgery(P＜0.05).The heart rate(HR)and Mean arterial pressure(MAP)of the control group were higher at the time of block(T1),30 min of block(T1)(T2),and the end of block(T3)than at the time of entry(T0)(P＜0.05).HR and MAP of the study group were significantly lower than those of the control group(P＜0.05).The MMSE scores of the two groups at 6 h,12 h,24 h,and 48 h after surgery were lower than those before surgery(P＜0.05),but the MMSE scores of the study group were significantly higher than those of the control group(P＜0.05).Conclusion Using ultrasound guided PENG combined with LFCN block for patients undergoing hip Joint replacement can more effectively reduce the amount of opioids and the number of use of analgesia pump,reduce postoperative pain in the exercise state,reduce stress reaction,and have less impact on cognitive function,so as to promote faster recovery of patients.
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Objective To explore the effect of laparoscopic salpingectomy on ovarian reserve function and serum neuropeptide Y(NPY)and cortisol(Cor)in patients with ectopic pregnancy.Methods 82 patients with ectopic pregnancy who had visited Chaohu Hospital Affiliated to Anhui Medical University from June 2018 to June 2021 were randomly divided into two groups,with 41 in each group.The control group underwent laparoscopic salpingostomy and suturing for embryo retrieval,while the study group underwent laparoscopic salpingectomy.Surgical duration,intraoperative blood loss,time to postsurgical mobilization,length of hospital stay,serum NPY and Cor levels,antral follicle count(AFC),indexes for peak flow velocity and resistance of ovarian artery were compared between the two groups.Follow-up was conducted for two years after surgery,and the success rate of pregnancy and the ectopic pregnancy rate were recorded.Results The surgical duration in the study group was shorter than that in the control group(P<0.05).The differences in serum NPY and Cor values between the two groups immediately after surgery and at postoperative week one were not statistically significant(P>0.05).At postoperative months1 and 6,the peak flow velocity of the affected ovary was lower in the study group than in the control group,whereas the resistance index was higher(P<0.05).At postoperative month 6,both groups showed an increase in peak flow velocity and a decrease in resistance index(P<0.05).There were no statistically signifi-cant differences in AFC and the success rate of pregnancy between the two groups postoperatively(P>0.05).The ectopic pregnancy rate in the study group was lower than that in the control group(P<0.05).Conclusion As compared with laparoscopic salpingostomy,laparoscopic salpingectomy for ectopic pregnancy can also preserve postoperative ovarian antral follicle count(AFC),and it has greater advantage in reducing the risk of recurrent ectopic pregnancy after surgery.
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Objective To investigate the impacts of Nalbuphine combined with Sufentanil on postoperative analgesia and stress response in patients undergoing laparoscopic colorectal cancer surgery.Methods 86 patients who underwent laparoscopic colorectal cancer surgery from August 2020 to April 2022 were collected and grouped into an experimental group and a control group according to the analgesic plan,with 43 patients in each group.The control group was given Sufentanil after surgery,and the experimental group was given Nalbuphine + Sufentanil.The analgesic and sedative effects at different time points after surgery(1,6,12,24 and 48 h),and the changes in serum pain mediator and stress response indicators were observed and compared.The time of getting out of bed after surgery,the number of patient-controlled analgesia,the number of cases of remedial analgesia,the recovery of gastrointestinal function,and the occurrence of adverse reactions within 48 hours after surgery were recorded in both groups.Results Compared with the control group,the experimental group had a shorter time to get out of bed for the first time after surgery(t = 3.29,P = 0.001),and had fewer instances of patient-controlled analgesia(Z = 4.53,P = 0.000)and cases of remedial analgesia(χ2 = 4.48,P = 0.034);Postoperative 12,24 and 48 h after surgery,the visual analogue scale(VAS)in the experimental group was obviously lower than that in the control group(t = 2.86,t = 2.55,t = 0.10,P<0.05);Postoperative 1 and 6 h,the Ramsay sedation score in the experimental group patients was lower than that in the control group(t = 2.10,t = 2.07,P<0.05);Postoperative 6,12 and 24 h,the serum substance P(SP)(t = 3.63,t = 5.51,t = 3.46,P<0.05)and prostaglandin E2(PGE2)(t = 2.34,t = 3.56,t = 0.33,P<0.05)levels in the experimental group were obviously lower than those in the control group;Postoperative 6,12 and 24 h,the serum cortisol(Cor)level in the experimental group was obviously lower than that in the control group(t = 4.65,t = 6.50,t = 6.52,P<0.05);Postoperative 6,12,24 and 48 h,the serum norepinephrine(NE)(t = 5.49,t = 7.85,t = 7.70,t = 2.18,P<0.05),tumor necrosis factor-α(TNF-α)(t = 5.43,t = 7.83,t = 5.27,t = 2.32,P<0.05),and hypersensitivity C-reactive protein(hs-CRP)(t = 3.39,t = 9.241,t = 4.87,t = 2.37,P<0.05)levels in the experimental group were obviously lower than those in the control group.There was no statistically obvious difference between the two groups in terms of postoperative exhaust time,defecation time,bowel sounds occurrence time,and incidence of adverse reactions(P>0.05).Conclusion Nalbuphine combined with Sufentanil is effective in postoperative analgesia of laparoscopic colorectal cancer patients,and can effectively regulate the post-traumatic stress response of the body after surgery.
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Objective:To investigate the post-traumatic stress response in women with unintended pregnancy termination and analyze its related factors.Methods:Totally 388 women with unintended pregnancy termination from two public hospitals in Fujian were selected as the research subjects.They were assessed with the Impact of E-vent Scale-Revised(IES-R),Hospital Anxiety and Depression Scale(HADS),Connor-Davidson Resilience Scale(CD-RISC)and Perinatal Grief Scale(PGS).The total score of IES-R ≥35 was positive for post-traumatic stress disorder screening.Results:The total score of IES-R was(20.6±12.4),and the positive rate of post-traumatic stress disorder screening was 16.5％.Multiple linear regression analysis showed that the IES-R total scores were higher in those who thought pregnancy timing was appropriate than those who thought pregnancy timing was wrong(β=0.13),and lower in women with moderate pain during termination than in those with severe pain(β=-0.09).The IES-R total scores were positively correlated with gestational weeks,depression scores of the HADS and grief scores of the PGS(β=0.18,0.27,0.16),and negatively correlated with optimism scores of the CD-RISC(β=-0.12).Conclusion:The post-traumatic stress response of unintended termination of pregnancy is at a moder-ate level.Post-traumatic stress symptoms are more likely to occur in women who thought pregnancy timing is ap-propriate,and those with severe pain during pregnancy termination,large gestational weeks,high level of depression during pregnancy,and high level of grief after pregnancy termination.
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Background: Intense sympathetic activity is linked to laryngoscopy and endotracheal intubation, which could lead to intraoperative problems. We undertook this study to compare the effects of preoperative nebulized Fentanyl and Dexmedetomidine on hemodynamic response to laryngoscopy and endotracheal intubation, taking advantage of their high bioavailability and better absorption through nasal mucosa. Aim and Objectives: The objectives of the study were (i) to compare the effect of preoperative nebulization on the hemodynamic response to laryngoscopy and intubation; and (ii) to assess intraoperative requirement of anesthetic agents. Materials and Methods: This prospective, randomized, and comparative study was conducted among 100 American Society of Anesthesiologists (ASA) I, II patients (of either gender) undergoing elective surgeries and requiring tracheal intubation, were randomized in two groups. Group A was given Fentanyl Nebulization (2 ?g/kg in 4 ml of 0.9% saline) and Group B was given Dexmedetomidine nebulization (1 ?g/kg in 4 ml of 0.9% saline) 10 min before anesthesia induction. Hemodynamic parameters were noted before and immediately after induction, 1 min, 5 min and 10 min after intubation. The main goal was to assess how Fentanyl and dexmedetomidine nebulization affect the laryngoscopy and intubation-induced stress response. The secondary outcome was to assess the intraoperative requirement of anesthetic agents, observe adverse effects of study drug and sedation score. Results: Dexmedetomidine nebulization was found to be more effective in blunting rise in heart rate post laryngoscopy compared to Fentanyl Nebulization (P < 0.0001) as well as in MAP after 10 min of intubation (P < 0.0001). Requirement of propofol was seen to be significantly reduced in Group B compared to Group A (P < 0.05). Sedation scores were significantly higher in Group B (P < 0.05). No evidence of side effects was observed in any group. Conclusion: Nebulisation of dexmedetomidine was found to be more effective in attenuation of stress response of laryngoscopy and intubation compared to nebulisation of fentanyl, with stable intraoperative hemodynamic and no significant side effects.
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Abstract We aimed to evaluate the effects of somatostatin combined with early hemoperfusion on inflammatory and stress responses during acute pancreatitis (AP) treatment. A total of 159 AP patients treated from September 2016 to January 2020 were randomly divided into three groups A-C (n=53). In addition to routine treatment, groups A-C were additionally given somatostatin, early hemoperfusion, and somatostatin combined with early hemoperfusion, respectively. Their inflammatory factors, stress response, intestinal mucosal barrier, hemorheological indices, recovery time, length of stay, clinical efficacy, and adverse reactions were compared. The levels of serum interleukin-10 (IL - 10), catalase and glutathione peroxidase rose in the three groups after ten days of treatment, compared with values before treatment, being the highest rise in group C. The levels of IL -18, tumor necrosis factor-α, soluble intercellular adhesion molecule-1, procalcitonin, high mobility group protein B1, lipid hydrogen peroxide, advanced oxidation protein products, epinephrine, cortisol, D-lactic acid, diamine oxidase, and endotoxin decreased after ten days of treatment compared with those before treatment, which were lowest in group C (P<0.05). After ten days of treatment, the levels of hemorheological indices were significantly lower than those before treatment (P<0.05). Compared with groups A and B, group C had a shorter recovery time of urine amylase, bowel sound and passing gas, remission time of abdominal pain, length of stay, and a higher total response rate (P<0.05). During AP treatment, somatostatin combined with early hemoperfusion effectively relieved inflammatory and stress responses, protected the intestinal mucosal barrier function and improved the hemorheology, thereby promoting the recovery and benefiting the prognosis of patients.
Resumen Nuestro objetivo fue evaluar los efectos de la somatostatina combinada con hemoperfusión temprana sobre las respuestas inflamatorias y de estrés durante el tratamiento de la pancreatitis aguda (PA). Un total de 159 pacientes con PA tratados entre septiembre de 2016 y enero de 2020 se dividieron aleatoriamente en tres grupos A-C (n=53). Con base en el tratamiento de rutina, los grupos A-C recibieron además somatostatina, hemoperfusión temprana y somatostatina combinada con hemoperfusión temprana, respectivamente. Se compararon sus factores inflamatorios, respuesta al estrés, barrera de la mucosa intestinal, índices hemorreológicos, tiempo de recuperación, tiempo de estancia, eficacia clínica y reacciones adversas. Los niveles séricos de interleucina-10 (IL -10), catalasa y glutatión peroxidasa aumentaron en los tres grupos después de 10 días de tratamiento, comparados con los valores antes del tratamiento, siendo más elevados en el grupo C. Los niveles de IL - 18, factor de necrosis tumoral α, molécula de adhesión intercelular 1 soluble, procalcitonina, proteína B1 del grupo de alta movilidad, peróxido de hidrógeno lipídico, los productos proteicos de oxidación avanzada, epinefrina, cortisol, ácido D-láctico, diaminooxidasa y endotoxina disminuyeron después de 10 días de tratamiento en comparación con los previos al tratamiento, que fueron más bajos en el grupo C (P<0,05). Después de 10 días de tratamiento, los índices hemorreológicos fueron significativamente menores que los previos al tratamiento (P<0,05). En comparación con los grupos A y B, el grupo C tuvo un tiempo de recuperación más corto de amilasa en orina, sonido y escape intestinal, tiempo de remisión del dolor abdominal y tiempo de estancia, y una tasa de respuesta total más alta (P<0,05). Durante el tratamiento de la AP, la somatostatina combinada con hemoperfusión precoz alivia eficazmente las respuestas inflamatorias y de estrés, protege la función de la barrera de la mucosa intestinal y mejora la hemorología, favoreciendo la recuperación y beneficiando el pronóstico de los pacientes.
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SUN gene is a group of key genes regulating plant growth and development. Here, SUN gene families of strawberry were identified from the genome of the diploid Fragaria vesca, and their physicochemical properties, genes structure, evolution and genes expression were also analyzed. Our results showed that there were thirty-one FvSUN genes in F. vesca and the FvSUNs encoded proteins were classified into seven groups, and the members in the same group showed high similarity in gene structures and conservative motifs. The electronic subcellular localization of FvSUNs was mainly in the nucleus. Collinearity analysis showed that the members of FvSUN gene family were mainly expanded by segmental duplication in F. vesca, and Arabidopsis and F. vesca shared twenty-three pairs of orthologous SUN genes. According to the expression pattern in different tissues shown by the transcriptome data of F. vesca, the FvSUNs gene can be divided into three types: (1) expressed in nearly all tissues, (2) hardly expressed in any tissues, and (3) expressed in special tissues. The gene expression pattern of FvSUNs was further verified by quantitative real-time polymerase chain reaction (qRT-PCR). Additionally, the seedlings of F. vesca were treated by different abiotic stresses, and the expression level of 31 FvSUNs genes were assayed by qRT-PCR. The expression of most of the tested genes was induced by cold, high salt or drought stress. Our studies may facilitate revealing the biological function and molecular mechanism of SUN genes in strawberry.
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Fragaria/metabolismo , Genes de Plantas , Estresse Fisiológico/genética , Arabidopsis/genética , Desenvolvimento Vegetal , Regulação da Expressão Gênica de Plantas , Proteínas de Plantas/metabolismoRESUMO
Extubation during the recovery period of general anesthesia patients often causes hemodynamic fluctuations and increases myocardial oxygen consumption, which is easy to cause myocardial hypoxia, ischemia and cardiovascular complications. Especially for patients with hypertension, hemodynamic fluctuation is more obvious, and the risk of anesthesia is greater. The timing of tracheal catheter extubation is one of the key factors affecting cardiovascular reactions and related complications. This paper reported the data of 35 patients with hypertension who underwent general anesthesia from May. 2020 to Jun. 2021 in Wuhu Hospital of Traditional Chinese Medicine, and analyzed the technical advantages of tracheal catheter removal before consciousness recovery under general anesthesia.
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Objective:To investigate the influences of Dixon anus preserving surgery on the curative effect, anorectal function and stress response of patients with low rectal cancer.Methods:A total of 150 patients with low rectal cancer admitted to Zhangjiakou Fifth Hospital from May 2016 to March 2019 were retrospective analysis as the study subjects. According to the different surgical methods, the patients were divided into the study group (75 cases) and the control group (75 cases). The patients in the study group received Dixon operation, and the patients in the control group received Miles operation. The general condition of operation, postoperative urination function, stress response [C reactive protein (CRP), interleukin-6 (IL-6), cortisol (Cor) and adrenocorticotropic hormone (ACTH)], anorectal function [anal resting pressure (ARP), maximal squeeze pressure (MSP), anal longest contraction time (ALCT)], quality of life (PAC-QOL score), postoperative complications, local recurrence rate, distant metastasis rate, 3-year tumor free survival rate and 3-year overall survival rate were compared between the two groups.Results:The operation time, intraoperative blood loss and postoperative drainage volume in the study group were lower than those in the control group: (172.28 ± 23.45) min vs. (189.57 ± 23.68) min, (177.39 ± 21.23) ml vs. (191.35 ± 22.67) ml, (342.36 ± 52.89) ml vs. (489.42 ± 63.33) ml, there were statistical differences ( P<0.05). The levels of CRP, IL-6, Cor and ACTH in the study group were lower than those in the control group: (22.35 ± 4.75) mg/L vs. (35.65 ± 5.28) mg/L, (58.74 ± 15.11) μg/L vs. (79.63 ± 20.23) μg/L, (145.36 ± 27.48) ng/L vs. (156.48 ± 32.55) ng/L, (44.58 ± 5.27) ng/L vs. (49.62 ± 5.68) ng/L, there were statistical differences ( P<0.05). The urination function and anorectal function of the patients in the study group were obviously better than those in the control group 6 months after operation, and the PAC-QOL score was obviously lower than that in the control group: (22.53 ± 2.86) scores vs. (27.54 ± 3.21) scores ( P<0.05); there was no obvious difference between the study group and the control group in the incidence of postoperative complications, local recurrence rate, distant metastasis rate, 3-year tumor free survival rate and 3-year total survival rate ( P>0.05). Conclusions:Dixon operation is effective in the treatment of low rectal cancer. It can preserve the anorectal function of patients to the greatest extent, protect urination function, reduce stress reaction of patients, and it is more conducive to rapid rehabilitation of patients.
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Objective:To explore the effects of dexmedetomidine (DEX) on intestinal stress response and cellular immune function in patients with gynecologic malignancies undergoing laparoscopic surgery.Methods:A total of 60 patients with gynecologic malignancies who scheduled to undergo laparoscopic surgery under general anesthesia in the Second Hospital of Shanxi Medical University from March 2021 to March 2022 were selected. All patients were divided into the DEX group and the control group according to the random number table method, with 30 cases in each group. The DEX group included 12 cases of cervical cancer, 10 cases of endometrial cancer and 8 cases of ovarian cancer; the control group included 14 cases of cervical cancer, 9 cases of endometrial cancer and 7 cases of ovarian cancer. The DEX group: intravenous anesthesia was induced with a dose of DEX 0.5 μg/kg (infusion was completed within 10 min), general anesthesia was maintained with DEX 0.2 μg·kg -1·h -1 pumped intravenously, and the drug was stopped 30 min before surgery. The control group: equal amount of 0.9% sodium chloride solution was pumped intravenously. The venous blood was drawn at the time points of 10 min before general anesthesia (T 0), at the end of operation (T 1) and 1 d after the operation (T 2) to detect the stress response indicators such as cortisol (COR), epinephrine (E), norepinephrine (NE) levels, and immune indicators such as CD4 +, CD8 + proportions and CD4 +/CD8 + at T 0, T 1,and T 2. In addition, the pneumoperitoneum time, general anesthesia time, operation time and intestinal function recovery time were recorded. Results:At T 0, there were no statistically significant differences in the levels of COR, E and NE between the DEX group and the control group (all P > 0.05). At T 1, the levels of COR, E and NE were (146±12) μg/L, (158±14) ng/L, (265±12) ng/L, respectively in the control group, and (136±18) μg/L, (149±15) ng/L, (158±12) ng/L, respectively in the DEX group; the levels of COR, E and NE in the DEX group were lower than those in the control group ( t values were -2.51, -2.37, -2.08, all P < 0.05). At T 2, the levels of COR, E and NE were (124±12) μg/L, (131±16) ng/L, (234±8) ng/L, respectively in the control group, and (116±15) μg/L, (123±12) ng/L, (228±10) ng/L, respectively in the DEX group; the levels of COR, E and NE in the DEX group were also lower than those in the control group ( t values were -2.35, -2.23, -2.17, all P < 0.05). At T 0, there were no statistically significant differences in the proportions of CD4 +, CD8 + and CD4 +/CD8 + between the DEX group and the control group (all P > 0.05). At T 1, the proportions of CD4 +, CD8 + and CD4 +/CD8 + were (23±3)%, (20±3)%, 1.12±0.16, respectively in the control group, and (27±4)%, (23±4)%,1.22±0.19, respectively in the DEX group; the proportions of CD4 +, CD8 + and CD4 +/CD8 + in the DEX group were higher than those in the control group ( t values were -3.43, -2.29, 2.13, all P < 0.05). At T 2, the proportions of CD4 +, CD8 + and CD4 +/CD8 + were (26±3)%, (23±4)%, 1.17±0.16, respectively in the control group, and (31±5)%, (25±4)%, 1.26±0.19, respectively in the DEX group; the proportions of CD4 +, CD8 + and CD4 +/CD8 + in the DEX group were higher than those in the control group ( t values were -4.32, -2.02, 2.02, all P < 0.05). In addition, the time of first exhaust in the DEX group was shorter than that in the control group ( P<0.05). Conclusions:DEX can reduce the intestinal stress response of gynecologic malignancies patients undergoing laparoscopic surgery, thereby improving the immunosuppression of patients. It is also of great significance to protect intestinal mucosal barrier and recover the intestinal function, and DEX has a high safety.
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Objective To explore the effect midazolam combination with propofol on postoperative recovery in patients undergoing laparoscopic cholecystectomy. Methods A total of 162 patients who were admitted to the hospital for laparoscopic cholecystectomy from April 2019 to January 2021 were selected. According to different anesthesia methods, they were divided into control group (midazolam anesthesia) and observation group (midazolam combined with propofol anesthesia), with 81 cases in each group. The stress index levels before and after operation, MoCA scores before operation (T0), 24 h after operation (T1) and 48 h after operation (T2), sleep quality at T0, the first day after operation (T3) and the second day after operation (T4), the perioperative recovery were compared between the two groups. Results The levels of Cor and NE, the recovery time of eyes opening, extubation, orientation, and the incidence of adverse reactions in the observation group were lower than those in the control group (P<0.05). Observation group MMSE score when T1, T2, T3, T4 sleep quality score were higher than control group (P<0.05). Conclusion Midazolam combined with propofol was safe and had good postoperative recovery in patients undergoing laparoscopic cholecystectomy.
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Objective To investigate the effect of ultrasound-guided transverse abdominal plane block(TAPB)on pain inhibition and stress response in patients undergoing laparoscopic sleeve gastrectomy(LSG).Methods 98 cases of laparoscopic sleeve Gastrectomy patients admitted from March 2021 to October 2022 were selected as the research object,and they were randomly divided into control group(49 cases)and observation group(49 cases)by double blind method.The control group received general anesthesia,and the observation group received TAPB+general anesthesia.The postoperative pain,analgesic dosage,stress level,hemodynamics and adverse reactions of the two groups were compared.Results The dosage of sufentanil and propofol in the observation group,as well as the effective press frequency of the intravenous analgesia pump 48 hours after surgery[(232.38±29.62)μg,(328.40± 40.68)mg and(5.60±1.25)],were lower than those in the control group[(294.07±35.88)μg,(402.25±46.74)mg and(9.75±2.40)](P＜0.05).The visual analogue scale(VAS)scores for each time period of the observation group were(2.43±0.49),(2.29±0.46),(2.85±0.49),(2.41± 0.39),(2.12±0.41)and(1.82±0.32),respectivly.While,the control group were(2.95±0.46),(3.22±0.51),(3.92±0.47),(3.13±0.65),(2.83±0.57)and(2.05±0.53),respectivly.The difference between the two groups was statistically significant(P＜0.05).At the time of tracheal intubation(T2),at the end of operation(T3),and at the time of leaving the anesthesia recovery room(T4),the fluctuation range of mean arterial pressure[86.00(79.00,94.00)mmHg,87.00(80.00,90.00)mmHg and 89.00(84.00,95.00)mmHg vs 82.00(75.00,90.00)mmHg,85.00(77.00,93.00)mmHg and 87.00(80.00,97.00)mmHg],heart rate[78.00(67.00,83.00)times/min,80.00(74.00,86.00)times/min and 81.00(76.00,90.00)times/min vs 78.00(67.00,83.00)times/min,80.00(74.00,86.00)times/min and 81.00(76.00,90.00)times/min]and blood oxygen saturation[97.38(97.00,97.75)％,98.69(98.30,99.05)％and 99.16(98.80,99.35)％vs 96.54(96.15,96.80)％,98.02(97.65,98.45)％and 98.73(98.43,99.15)％]in the observation group was significantly smaller than that of the control group(P＜0.05).In the observation group,cortisol levels were(192.47 ±40.25)ng/ml,(151.34±39.62)ng/ml and(118.69±30.57)ng/ml at 6 hours,24 hours and 48 hours,respectively,while in the control group were(206.24±45.34)ng/ml,(178.24±37.58)ng/ml and(143.63±32.34)ng/ml,respectively;C-reactive protein(CRP)in the observation group were(25.24±6.29)mg/L,(20.93±5.83)mg/L and(13.61±4.29)mg/L,respectively,while in the control group were(28.13±6.92)mg/L,(23.25±5.21)mg/L and(16.38±4.35)mg/L,respectively;interleukin-6(IL-6)in the observation group were(44.87±7.95)pg/L,(38.34±6.13)pg/L and(34.27±5.32)pg/L,respectively,while in the control group were(56.43±7.23)pg/L、(42.24±6.58)pg/L、(37.66±6.03)pg/L,respectively.The difference between the two groups was statistically significant(P＜0.05).The total incidence of adverse reactions of the observation group(4.08％)was lower in than that of the control group(20.41％)(P＜0.05).Conclusion Ultrasound-guided TAPB for LSG patients has a good effect on postoperative pain suppression,can reduce the stress response of the body after surgery,and is safe.
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Argon is the most abundant inert gas in the atmosphere. For the past few years, the biological functions of argon have been discovered and gradually recognized by scientists. Argon, as a gaseous molecule with cytoprotective functions, could positively affect the physiological and pathological processes to varying degrees. Compared with the classic gasotransmitters, argon is non-toxic, harmless, and abundant, attracting extensive attention in all professions. This review outlined the biological effects and the potential molecular mechanisms of argon, and summarized the supply methods and the positive roles of argon in neuroprotection, cardiovascular disease, inflammatory disease, organ transplantation, and other animal clinical models, and also overviewed the research progress in post-harvest preservation of agricultural products and plant tolerance to abiotic stress. The mechanisms in the above studies about the biological effects of argon were closely related to argon control of receptors, ion channel proteins, reprogramming gene expression, and re-establishment of redox and ion homeostasis. Meanwhile, argon-regulated phosphorylation and dephosphorylation modification in enzyme proteins might be crucial in argon biology. The potential applications of argon have excellent prospects in medicine and agriculture with security and cost advantages.
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Objective To investigate the effect of appropriate dosage of remimazolam in combination with remifentanil on stress response and cognitive function in elderly patients gastrointestinal endoscopy.Methods Elderly patients undergoing gastrointestinal endoscopy in the Department of Anesthesiology and Pain of the First People's Hospital of Yongkang from June 2021 to June 2023 were selected as the study subjects and were divided into group A(0.15 mg·kg-1),group B(0.20 mg·kg-1)and group C(0.25 mg·kg-1)according to the different doses of remimazolam.Modified alertness/sedation(MOAA/S)scores,anesthesia-related indexes(first sedation success,gastrointestinal endoscopy time awakening time,and discharge time),stress-related indexes[cortisol(COR),epinephrine(ADR)and adrenocorticotropic hormone(ACTH)],mini-mental status examination(MMSE)scores and anesthesia-related adverse reactions were compared among the three groups.Results A total of 186 patients were included in the study,with 62 patients in each group.The MOAA/S scores of groups B and C were significantly lower than those in group A(P<0.05)immediately after gastrointestinal endoscopy,3 min and 6 min for gastroenteroscopy.The success rate of first sedation in groups B and C was significantly higher than that in group A,while the time of gastrointestinal endoscopy was significantly lower than that in group A,and the time of awakening and leaving the room were significantly longer than those in group A(P<0.05).The levels of COR,ADR and ACTH immediately after gastrointestinal endoscopy in groups B and C were significantly lower than those in group A(P<0.05).The MMSE scores of groups B and C at 10 min and 30 min after wake were significantly higher than those in group A(P<0.05).The total incidence of adverse reactions in group B was significantly lower than that in groups A and C(P<0.05).Conclusion 0.20 mg·kg-1 and 0.25 mg·kg-1 remimazolam for geriatric gastrointestinal endoscopy have better sedative effect,can reduce the degree of stress response,and have less impact on cognitive function,but the dose of 0.25 mg·kg-1 can lead to an increase in the incidence of hypotension and hypoxemia,and the recommended dose of remimazolam in geriatric gastrointestinal endoscopy is 0.20 mg·kg-1.
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Objective:To investigate the application value of intravenous anesthesia combined with ultrasound-guided nerve block in patients with intestinal cancer.Methods:A total of 200 patients who prepared to undergo laparoscopic radical resection of intestinal cancer under general anesthesia in Beijing Yanhua Hospital between January 2017 and January 2022 were selected as the study subjects.They were divide into study group and control group according to inter-group matching principle,with 100 cases in each group.Control group adopted single intravenous anesthesia,and study group adopted intravenous anesthesia combined with ultrasound-guided nerve block.The heart rate(HR),mean arterial pressure(MAP),blood oxygen saturation(SpO2)before anesthesia(T0),after anesthesia(T1),when skin incision(T2)and when completed surgery(T3),and the visual analogue scale(VAS)values,the time of the first exhausting,the time of postoperative hospital stay,the occurrence of adverse reaction at the 6th h(T4)and 12th h(T5)after surgery between two groups were compared.The drive pressure(DP)values at five time points included 5min(t1)after endotracheal intubation,5min(t2)after establishing pneumoperitoneum,5min(t3)and 60min(t4)after implementing the position with lower head and higher foot,and 5min(t5)after restoring horizontal position of pneumoperitoneum exhaust were recorded.And then,the concentrations of serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),angiotensin(AngⅡ)and cortisol(Cor)before and 24h after surgery were respectively measured.Results:The results of one-way ANOVA indicated that there were no statistically significant differences in HR,MAP and SpO2 between the two groups at T0,T1,T2 and T3(P>0.05),respectively.The dosage of Propofol within unit time of study group was significantly lower than that of control group(t=8.305,P<0.05),and the time of the first exhausting and the time of hospital stay of study group were significantly shorter than those of control group(t=7.978,t=9.141,P<0.05),respectively.The VAS scores of study group were significantly lower than that of control group at T4 and T5(t=10.033,t=9.071,P<0.05),and the incidence of adverse reaction of study group was significantly lower than that of control group(x2=13.78,P<0.05),respectively.The results of one-way ANOVA showed that there were statistically significant differences in DP values between the two groups at different times(F=595.765,F=448.108,P<0.05),and the DP values of two groups at t2,t3,t4 and t5 were significantly higher than that at t1(10.59±1.52)(F=595.765,P<0.05).The DP values at t2,t3 and t4 of study group were significantly higher than those of control group(t2=17.69±2.12,t3=20.16±2.06,t4=20.06±2.0)(t=9.650,t=14.339,t=0.738,P<0.05),respectively.The differences of the serum AngⅡ,Cor,TNF-α and IL-6 levels between two groups were not statistically significant before surgery(P>0.05).The serum AngⅡ,Cor,TNF-α and IL-6 levels of the two groups of patients after surgery were significantly higher than them before surgery.At 24 hours after surgery,the serum AngⅡ,Cor and TNF-α and IL-6 levels of study group of patients were significantly lower than them of control group(t=2.601,t=3.790,t=5.779,t=6.154,P<0.05),respectively.Conclusion:The application of intravenous anesthesia combined with ultrasound-guided nerve block in patients who undergo laparoscopic radical resection of intestinal cancer can effectively maintain intraoperative hemodynamic stability,and reduce the amount of anesthetic,and shorten the times of the first exhausting and hospital stay,and reduce postoperative pain,stress and inflammation reaction,and improve respiratory function.
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Objective To evaluate the effect of an empathy intervention program based on 5-step empathetic model(5-SEM)on stress response,anxiety and depression,and sleep quality among patients with acute cerebral infarction.Methods The 100 participants were admitted to the Second Affiliated Hospital of Wenzhou Medical University from November 2022 to April 2023.According to the admission time,they were divided into two groups,with 50 cases in each group.The patients in the control group received normal care,while those in the observation group underwent an empathy intervention program based on 5-SEM.This program includes the establishment of an empathetic intervention team,comprised of physicians,psychologists,head nurses,and nurses with more than 5 years of work experience and a bachelor's degree or higher.The intervention team,based on searches and collation of relevant literature from databases such as CNKI,Wanfang Data,the National Library of Medicine's PubMed database,and the Dutch medical abstracts EMBase database,is responsible for assessing patient conditions.A final draft of the empathetic intervention plan based on the 5-SEM is then formed by the supervising nurse.nurses in the empathetic intervention team was responsible for implementing the 5-SEM intervention plan.The outcomes were evaluated by Athens insomnia scale(AIS),hospital anxiety and depression scale(HADS),and stress response questionnaire(SRQ).Results After intervention,the scores for sleep quality,anxiety and depression,and stress response in both groups showed a significant decrease compared to pre-intervention[sleep quality scores:control group was 6.74±1.77 vs.12.08±2.94,observation group was 4.84±2.04 vs.11.90±2.80;anxiety scores:control group was 7.14±2.20 vs.8.58±2.38,observation group was 6.06±2.47 vs.8.34±2.03;depression scores:control group was 7.28±2.12 vs.8.72±2.34,observation group was 6.26±2.03 vs.8.82±2.80;physical reaction scores:control group was 17.72±4.29 vs.22.94±3.73,observation group was 16.10±3.19 vs.22.62±3.25;emotional reaction scores:control group was 21.82±2.98 vs.26.80±3.21,observation group was 20.60±2.45 vs.26.32±4.32;behavioral reaction scores:control group was 12.68±1.75 vs.15.46±3.18,observation group was 11.16±1.98 vs.14.90±2.24;stress response scores:control group was 55.40±4.89 vs.69.46±6.28,observation group was 50.98±4.68 vs.68.08±6.18,all P<0.05],post-intervention,the scores in the observation group were significantly lower than those in the control group(all P<0.05).Conclusion The empathy intervention program based on the 5-SEM could alleviate anxiety,depression,and stress responses among patients with acute cerebral infarction,while also improving sleep quality.
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Objective @# To explore the role of Argonaute ( Ago) gene and RNA⁃Dependent RNA Polymerase (RDRP) gene of Aspergillus flavus in the growth and development about the RNAi mechanism . @*Methods @# A. flavus Ago1 , Ago2 , RDRP1 , RDRP3 gene mutant strains were constructed by homologous recombination . The growth and development of the mutant strains were observed on potato dextrose agar(PDA) + uracil uridine (UU) medium inoculated with 3 μl 106 CFU/mL spores . 200 , 400 μg cell wall pressure agent conidored ( CR) , 0. 8 mol/L , 1 . 6 mol/L osmotic pressure agent NaCl , 2 mmol/L , 4 mmol/L oxidative pressure agent hydrogen peroxide (H2 O2 ) and 0. 01% , 0. 02% genomic damage agent methyl mesylate (MMS) were added to the Yeast extract Glucose Minimum (YGM) + UU medium to analyze the stress response of the mutant strains . @*Results @#A. flavus mutant strains about ΔAgo1 , ΔAgo2 , ΔRDRP1 , ΔRDRP3 were successfully constructed and its growth and development were normal . The ΔAgo1 and ΔAgo2 strains reduced the stress effects on cell wall and osmotic pressure compared to the control . Ago1 gene deletion reduced the effect of H2 O2 , and conversely RDRP3 gene deletion increased the inhibition of H2 O2 . The Ago2 and RDRP1 strains reduced the effect on genetic damage agent . In addition , ΔRDRP1 increased the effect of osmotic stress . @*Conclusion @# The Ago1 , Ago2 , RDRP1 and RDRP3 genes of A. flavus are not in⁃ volved in the regulation of growth rate and asexual reproduction and can participate in the regulating of the host stress response to the environment .