Pub Date : 2019-10-20DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.10.029
Yanyan Wang, Zhongcong Xie, W. Mi
{"title":"Research progress in relationship between anesthesia and brain function impairment in the elderly and young","authors":"Yanyan Wang, Zhongcong Xie, W. Mi","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.10.029","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.10.029","url":null,"abstract":"","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1263-1266"},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45336120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To evaluate the effect of penehyclidine hydrochloride on the expression of airway mucin 5AC (MUC5AC) during ventilator-induced lung injury (VILI) and the relationship with Toll-like receptor 4/myeloid differentiation factor 88 (TLR4/MyD88) signaling pathway in rats. Methods Thirty-six clean-grade healthy male Sprague-Dawley rats, aged 6-8 weeks, weighing 200-250 g, were divided into 3 groups (n=12 each) using a random number table method: sham operation group (group S), VILI group (group VILI), and penehyclidine hydrochloride group (group P). The rats were tracheotomized in group S. The rats were tracheotomized, connected to a small animal ventilator and mechanically ventilated for 4 h with the tidal volume of 20 ml/kg, respiratory rate 80 breaths/min, inspiratory/expiratory ratio 1∶1, and inspired oxygen fraction ratio 21% in VILI and P groups.At 30 min before mechanical ventilation, penehyclidine hydrochloride 2 mg/kg was injected via the tail vein in group P, and the equal volume of normal saline was given instead in S and VILI groups.At 4 h of mechanical ventilation, the arterial blood samples were taken for measurement of PaO2.The rats were then sacrificed, and broncho-alveolar lavage fluid (BALF) was collected for determination of interleukin-1β (IL-1β), IL-6 and tumor necrosis factor-α (TNF-α) concentrations by enzyme-linked immunosorbent assay.The lung specimens were collected for calculation of the wet/dry weight ratio (W/D ratio), for examination of pathological changes which were scored after haematoxylin and eosin staining (under a light microscope), and for determination of the expression of MUC5AC (by immunohistochemistry), expression of TLR4, MyD88, p38 mitogen-activated protein kinase (p38MAPK) and nuclear factor-kappa B (NF-κB) in lung tissues (by Western blot), and expression of MUC5AC mRNA in lung tissues (by real-time polymerase chain reaction). Results Compared with group S, PaO2 was significantly decreased, the W/D ratio and lung injury score were increased, the expression of MUC5AC protein and mRNA was up-regulated, the concentrations of IL-1β, IL-6 and TNF-α in BALF were increased, and the expression of TLR4, p38MAPK, MyD88 and NF-κB was up-regulated in VILI and P groups (P<0.01). Compared with group VILI, PaO2 was significantly increased, the W/D ratio and lung injury score were decreased, the expression of MUC5AC protein and mRNA was down-regulated, the concentrations of IL-1β, IL-6 and TNF-α in BALF were decreased, and the expression of TLR4, p38MAPK, MyD88 and NF-κB was down-regulated in group P (P<0.05). Conclusion Penehyclidine hydrochloride can decrease the expression of airway MUC5AC during VILI, and the mechanism may be related to inhibiting activation of TLR4/MyD88 signaling pathway in rats. Key words: Cholinergic antagonists; Respiration, artificial; Acute lung injury; Mucin 5AC; Toll-like receptor 4; Myeloid differentiation factor 88
{"title":"Effect of penehyclidine hydrochloride on expression of airway MUC5AC during ventilator-induced lung injury and the relationship with TLR4/MyD88 signaling pathway in rats","authors":"Jun-ling Yan, Chunrui Yu, Lixin Sun, Fu-guo Ma, Fei Shi, Qiu-jie Li, Mingshan Wang","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.10.025","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.10.025","url":null,"abstract":"Objective \u0000To evaluate the effect of penehyclidine hydrochloride on the expression of airway mucin 5AC (MUC5AC) during ventilator-induced lung injury (VILI) and the relationship with Toll-like receptor 4/myeloid differentiation factor 88 (TLR4/MyD88) signaling pathway in rats. \u0000 \u0000 \u0000Methods \u0000Thirty-six clean-grade healthy male Sprague-Dawley rats, aged 6-8 weeks, weighing 200-250 g, were divided into 3 groups (n=12 each) using a random number table method: sham operation group (group S), VILI group (group VILI), and penehyclidine hydrochloride group (group P). The rats were tracheotomized in group S. The rats were tracheotomized, connected to a small animal ventilator and mechanically ventilated for 4 h with the tidal volume of 20 ml/kg, respiratory rate 80 breaths/min, inspiratory/expiratory ratio 1∶1, and inspired oxygen fraction ratio 21% in VILI and P groups.At 30 min before mechanical ventilation, penehyclidine hydrochloride 2 mg/kg was injected via the tail vein in group P, and the equal volume of normal saline was given instead in S and VILI groups.At 4 h of mechanical ventilation, the arterial blood samples were taken for measurement of PaO2.The rats were then sacrificed, and broncho-alveolar lavage fluid (BALF) was collected for determination of interleukin-1β (IL-1β), IL-6 and tumor necrosis factor-α (TNF-α) concentrations by enzyme-linked immunosorbent assay.The lung specimens were collected for calculation of the wet/dry weight ratio (W/D ratio), for examination of pathological changes which were scored after haematoxylin and eosin staining (under a light microscope), and for determination of the expression of MUC5AC (by immunohistochemistry), expression of TLR4, MyD88, p38 mitogen-activated protein kinase (p38MAPK) and nuclear factor-kappa B (NF-κB) in lung tissues (by Western blot), and expression of MUC5AC mRNA in lung tissues (by real-time polymerase chain reaction). \u0000 \u0000 \u0000Results \u0000Compared with group S, PaO2 was significantly decreased, the W/D ratio and lung injury score were increased, the expression of MUC5AC protein and mRNA was up-regulated, the concentrations of IL-1β, IL-6 and TNF-α in BALF were increased, and the expression of TLR4, p38MAPK, MyD88 and NF-κB was up-regulated in VILI and P groups (P<0.01). Compared with group VILI, PaO2 was significantly increased, the W/D ratio and lung injury score were decreased, the expression of MUC5AC protein and mRNA was down-regulated, the concentrations of IL-1β, IL-6 and TNF-α in BALF were decreased, and the expression of TLR4, p38MAPK, MyD88 and NF-κB was down-regulated in group P (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Penehyclidine hydrochloride can decrease the expression of airway MUC5AC during VILI, and the mechanism may be related to inhibiting activation of TLR4/MyD88 signaling pathway in rats. \u0000 \u0000 \u0000Key words: \u0000Cholinergic antagonists; Respiration, artificial; Acute lung injury; Mucin 5AC; Toll-like receptor 4; Myeloid differentiation factor 88","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1248-1252"},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46712206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-20DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.10.026
Haibing Lu, Yingping Jia, W. Yuan, Y. Qiu, R. Zhou
Objective To evaluate the role of necroptosis in hyperoxia-induced acute lung injury (ALI) in preadolescent rats. Methods A total of 72 clean-grade healthy male Sprague-Dawley rats, aged 14 days, weighing 40-50 g, were divided into 3 groups (n=24 each) by using a random number table method: control group (group C), hyperoxia-induced ALI group (group ALI) and hyperoxia-induced ALI and necrostatin-1 group (group ALI+ N). The rats of group ALI+ N was intraperitoneally injected with necrostatin-1 1.0 mg/kg once a day for 3 consecutive days.The rats were intraperitoneally injected with dimethyl sulfoxide 0.2 ml/kg once a day for 3 consecutive days in C and ALI groups.The animals were sacrificed at 72 h after inhaling oxygen, and bronchoalveolar lavage fluid (BALF) was collected for determination of interleukin-6 (IL-6) and IL-8 concentrations (by enzyme-linked immunosorbent assay), superoxide dismutase (SOD) activity (by xanthine oxidase method), and malondialdehyde (MDA) concentration (by thiobarbituric acid method). Lung tissues were taken for measurement of wet/dry weight ratio (W/D ratio) and for examination of the pathological changes (with a light microscope) and ultrastructure of lung tissues (with an electron microscope). The injured alveolus rate (IAR) was calculated.The expression of receptor-interacting protein kinase 1 (RIPK1), RIPK3 and mixed-lineage kinase domain-like protein (MLKL) in lung tissues was detected by Western blot. Results Compared with group C, the concentrations of IL-6, IL-8 and MDA in BALF were significantly increased, the activity of SOD in BALF was decreased, the W/D ratio and IAR of lung tissues were increased, the expression of RIPK1, RIPK3 and MLKL in lung tissues was up-regulated (P<0.05), and the pathological damage was accentuated in group ALI.Compared with group ALI, the concentrations of IL-6, IL-8 and MDA in BALF were significantly deceased, the activity of SOD in BALF was increased, the W/D ratio and IAR of lung tissues were decreased, the expression of RIPK1, RIPK3 and MLKL in lung tissues was down-regulated (P<0.05), and the pathological damage was significantly attenuated in group ALI+ N. Conclusion Necroptosis is involved in the pathophysiological process of hyperoxia-induced ALI in preadolescent rats. Key words: Necrosis; Infant; Hyperoxia; Acute lung injury
{"title":"Role of necroptosis in hyperoxia-induced acute lung injury in preadolescent rats","authors":"Haibing Lu, Yingping Jia, W. Yuan, Y. Qiu, R. Zhou","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.10.026","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.10.026","url":null,"abstract":"Objective \u0000To evaluate the role of necroptosis in hyperoxia-induced acute lung injury (ALI) in preadolescent rats. \u0000 \u0000 \u0000Methods \u0000A total of 72 clean-grade healthy male Sprague-Dawley rats, aged 14 days, weighing 40-50 g, were divided into 3 groups (n=24 each) by using a random number table method: control group (group C), hyperoxia-induced ALI group (group ALI) and hyperoxia-induced ALI and necrostatin-1 group (group ALI+ N). The rats of group ALI+ N was intraperitoneally injected with necrostatin-1 1.0 mg/kg once a day for 3 consecutive days.The rats were intraperitoneally injected with dimethyl sulfoxide 0.2 ml/kg once a day for 3 consecutive days in C and ALI groups.The animals were sacrificed at 72 h after inhaling oxygen, and bronchoalveolar lavage fluid (BALF) was collected for determination of interleukin-6 (IL-6) and IL-8 concentrations (by enzyme-linked immunosorbent assay), superoxide dismutase (SOD) activity (by xanthine oxidase method), and malondialdehyde (MDA) concentration (by thiobarbituric acid method). Lung tissues were taken for measurement of wet/dry weight ratio (W/D ratio) and for examination of the pathological changes (with a light microscope) and ultrastructure of lung tissues (with an electron microscope). The injured alveolus rate (IAR) was calculated.The expression of receptor-interacting protein kinase 1 (RIPK1), RIPK3 and mixed-lineage kinase domain-like protein (MLKL) in lung tissues was detected by Western blot. \u0000 \u0000 \u0000Results \u0000Compared with group C, the concentrations of IL-6, IL-8 and MDA in BALF were significantly increased, the activity of SOD in BALF was decreased, the W/D ratio and IAR of lung tissues were increased, the expression of RIPK1, RIPK3 and MLKL in lung tissues was up-regulated (P<0.05), and the pathological damage was accentuated in group ALI.Compared with group ALI, the concentrations of IL-6, IL-8 and MDA in BALF were significantly deceased, the activity of SOD in BALF was increased, the W/D ratio and IAR of lung tissues were decreased, the expression of RIPK1, RIPK3 and MLKL in lung tissues was down-regulated (P<0.05), and the pathological damage was significantly attenuated in group ALI+ N. \u0000 \u0000 \u0000Conclusion \u0000Necroptosis is involved in the pathophysiological process of hyperoxia-induced ALI in preadolescent rats. \u0000 \u0000 \u0000Key words: \u0000Necrosis; Infant; Hyperoxia; Acute lung injury","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1253-1257"},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41680116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-20DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.10.020
K. Xie, Yaoqi Wang, Yi Jiang, X. Mao, Hongguang Chen, Yang Zhang, Yonghao Yu
Objective To evaluate the effect of hydrogen on the mitochondrial function in brain tissues of mice with sepsis-associated encephalopathy (SAE). Methods Two hundred and sixty-eight healthy male C57 mice, aged 6 weeks, weighing 20-25 g, were divided into 4 groups (n=67 each) using a random number table method: sham operation group (group SH), sham operation plus hydrogen gas group (group SH+ H2), group SAE, and SAE plus hydrogen gas group (group SAE+ H2). Sepsis was produced by cecal ligation and puncture in anesthetized mice.The mice in group SH+ H2 and group SAE+ H2 inhaled 2% hydrogen gas for 1 h starting from 1 and 6 h after operation, respectively.The postoperative 7-day survival rate was recorded.Brain tissues were obtained at 24 h after operation to count the normal neurons in hippocampal CA1 region.At 6, 12 and 24 h after operation, hippocampal mitochondria were isolated for determination of mitochondrial membrane potential (MMP) by fluorescence spectrophotometry and ATP content by a bioluminescence assay.Y-maze (spontaneous alternation) test was performed at days 3, 5 and 7 after operation. Results Compared with group SH, the 7-day survival rate was significantly decreased, the number of normal neurons in hippocampal CA1 region, MMP, mitochondrial ATP content and spontaneous alternation percentage in Y-maze test were significantly decreased in group SAE and group SAE+ H2 (P<0.05). Compared with group SAE, the 7-day survival rate, the number of normal neurons in hippocampal CA1 region, MMP, mitochondrial ATP content and spontaneous alternation percentage in Y-maze test were significantly increased in group SAE+ H2 (P<0.05). Conclusion The mechanism by which hydrogen reduces SAE is probably associated with improving mitochondrial function in brain tissues of mice. Key words: Hydrogen; Sepsis; Brain; Mitochondria
{"title":"Effect of hydrogen on mitochondrial function in brain tissues of mice with sepsis-associated encephalopathy","authors":"K. Xie, Yaoqi Wang, Yi Jiang, X. Mao, Hongguang Chen, Yang Zhang, Yonghao Yu","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.10.020","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.10.020","url":null,"abstract":"Objective \u0000To evaluate the effect of hydrogen on the mitochondrial function in brain tissues of mice with sepsis-associated encephalopathy (SAE). \u0000 \u0000 \u0000Methods \u0000Two hundred and sixty-eight healthy male C57 mice, aged 6 weeks, weighing 20-25 g, were divided into 4 groups (n=67 each) using a random number table method: sham operation group (group SH), sham operation plus hydrogen gas group (group SH+ H2), group SAE, and SAE plus hydrogen gas group (group SAE+ H2). Sepsis was produced by cecal ligation and puncture in anesthetized mice.The mice in group SH+ H2 and group SAE+ H2 inhaled 2% hydrogen gas for 1 h starting from 1 and 6 h after operation, respectively.The postoperative 7-day survival rate was recorded.Brain tissues were obtained at 24 h after operation to count the normal neurons in hippocampal CA1 region.At 6, 12 and 24 h after operation, hippocampal mitochondria were isolated for determination of mitochondrial membrane potential (MMP) by fluorescence spectrophotometry and ATP content by a bioluminescence assay.Y-maze (spontaneous alternation) test was performed at days 3, 5 and 7 after operation. \u0000 \u0000 \u0000Results \u0000Compared with group SH, the 7-day survival rate was significantly decreased, the number of normal neurons in hippocampal CA1 region, MMP, mitochondrial ATP content and spontaneous alternation percentage in Y-maze test were significantly decreased in group SAE and group SAE+ H2 (P<0.05). Compared with group SAE, the 7-day survival rate, the number of normal neurons in hippocampal CA1 region, MMP, mitochondrial ATP content and spontaneous alternation percentage in Y-maze test were significantly increased in group SAE+ H2 (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000The mechanism by which hydrogen reduces SAE is probably associated with improving mitochondrial function in brain tissues of mice. \u0000 \u0000 \u0000Key words: \u0000Hydrogen; Sepsis; Brain; Mitochondria","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1228-1232"},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46651497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-20DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.10.006
Fu-guo Ma, Yanli Liu, Qian Wang, Lixin Sun
Objective To compare the effect of total intravenous anesthesia with propofol and combined intravenous-inhalational anesthesia with sevoflurane on postoperative sleep quality in elderly female patients. Methods One hundred and twenty patients, aged 65-80 yr, with body mass index of 18.5-25.0 kg/m2, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, scheduled for elective gynecological laparoscopic operation, were divided into 2 groups (n=60 each) by a random number table method: total intravenous anesthesia with propofol group (group P) and combined intravenous-inhalational anesthesia with sevoflurane group (group S). Anesthesia was induced with intravenous etomidate 0.2-0.3mg/kg, sufentanil 0.2-0.4 μg/kg and cisatracurium 0.10-0.15 mg/kg.Anesthesia was maintained as follows: propofol was given by target-controlled infusion with the target plasma concentration set at 2-4 μg/ml in group P, 1.2-2.3% sevoflurane was inhaled in group S, and sufentanil 0.2-0.3 μg/kg and cisatracurium 0.04-0.06 mg/kg were intermittently injected in two groups.The patients were followed up at 7-8 a. m.on the day of hospitalization, the day of operation and 1, 3, 7 and 30 days after operation.The Pittsburgh Sleep Quality Index (PSQI) was recorded, PSQI > 7 points was considered as sleep disorders, and the occurrence of sleep disorders was recorded.The morning urine was collected at the time points mentioned above, and the concentrations of melatonin sulfate and free cortisol were determined by enzyme-linked immunosorbent assay. Results Compared with group S, the PSQI was significantly decreased on 3 and 7 days after operation, the incidence of sleep disorder was decreased on 7 days after operation, the concentrations of melatonin sulfate in urine were increased (P 0.05). Conclusion The effect of total intravenous anesthesia with propofol on postoperative sleep quality is less than that of combined intravenous-inhalational anesthesia with sevoflurane in elderly female patients. Key words: Propofol; Anesthetics, inhalation; Anesthesia, general; Aged; Femininity; Sleep quality
{"title":"Comparison of effect of total intravenous anesthesia with propofol and combined intravenous-inhalational anesthesia with sevoflurane on postoperative sleep quality in elderly female patients","authors":"Fu-guo Ma, Yanli Liu, Qian Wang, Lixin Sun","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.10.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.10.006","url":null,"abstract":"Objective \u0000To compare the effect of total intravenous anesthesia with propofol and combined intravenous-inhalational anesthesia with sevoflurane on postoperative sleep quality in elderly female patients. \u0000 \u0000 \u0000Methods \u0000One hundred and twenty patients, aged 65-80 yr, with body mass index of 18.5-25.0 kg/m2, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, scheduled for elective gynecological laparoscopic operation, were divided into 2 groups (n=60 each) by a random number table method: total intravenous anesthesia with propofol group (group P) and combined intravenous-inhalational anesthesia with sevoflurane group (group S). Anesthesia was induced with intravenous etomidate 0.2-0.3mg/kg, sufentanil 0.2-0.4 μg/kg and cisatracurium 0.10-0.15 mg/kg.Anesthesia was maintained as follows: propofol was given by target-controlled infusion with the target plasma concentration set at 2-4 μg/ml in group P, 1.2-2.3% sevoflurane was inhaled in group S, and sufentanil 0.2-0.3 μg/kg and cisatracurium 0.04-0.06 mg/kg were intermittently injected in two groups.The patients were followed up at 7-8 a. m.on the day of hospitalization, the day of operation and 1, 3, 7 and 30 days after operation.The Pittsburgh Sleep Quality Index (PSQI) was recorded, PSQI > 7 points was considered as sleep disorders, and the occurrence of sleep disorders was recorded.The morning urine was collected at the time points mentioned above, and the concentrations of melatonin sulfate and free cortisol were determined by enzyme-linked immunosorbent assay. \u0000 \u0000 \u0000Results \u0000Compared with group S, the PSQI was significantly decreased on 3 and 7 days after operation, the incidence of sleep disorder was decreased on 7 days after operation, the concentrations of melatonin sulfate in urine were increased (P 0.05). \u0000 \u0000 \u0000Conclusion \u0000The effect of total intravenous anesthesia with propofol on postoperative sleep quality is less than that of combined intravenous-inhalational anesthesia with sevoflurane in elderly female patients. \u0000 \u0000 \u0000Key words: \u0000Propofol; Anesthetics, inhalation; Anesthesia, general; Aged; Femininity; Sleep quality","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1168-1171"},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44802742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To evaluate the effect of different hemoglobin (Hb) concentrations on the lung injury in a rabbit model of hemorrhagic shock and resuscitation (HS-R). Methods Fifty healthy male New Zealand rabbits, aged 2 months, weighing 1.9-2.4 kg, were divided into 5 groups (n=10 each) using a random number table method: control group (group C), HS-R group (group H), and three HS-R plus infusion of concentrated red blood cell groups group R1 (60 g/L≤Hb<80 g/L), group R2 (80 g/L≤Hb<100 g/L) and group R3 (100 g/L≤Hb<120 g/L). The animals were sacrificed at 3 h after resuscitation, lung tissues were obtained for examination of the pathological changes with a light microscope, and lung tissues were obtained again for determination of wet to dry weight ratio (W/D ratio), neutrophil myeloperoxidase (MPO), NO level and cell apoptosis (by TUNEL). Results Compared with group C, the levels of MAP and NO, W/D ratio and apoptosis index were significantly increased in the other groups (P 0.05). Conclusion Maintaining Hb 80-100 g/L after HS-R reduces acute lung injury in rabbits. Key words: Shock, hemorrhagic; Cardiopulmonary resuscitation; Hemoglobins; Acute lung injury
{"title":"Effects of different hemoglobin concentrations on lung injury in a rabbit model of hemorrhagic shock and resuscitation","authors":"Xiao-Qian Liu, Li Liu, Xun Zhou, Na-Na Zhu, Yong-Quan Chen, Xiao-ju Jin, Jianrong Guo","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.10.021","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.10.021","url":null,"abstract":"Objective \u0000To evaluate the effect of different hemoglobin (Hb) concentrations on the lung injury in a rabbit model of hemorrhagic shock and resuscitation (HS-R). \u0000 \u0000 \u0000Methods \u0000Fifty healthy male New Zealand rabbits, aged 2 months, weighing 1.9-2.4 kg, were divided into 5 groups (n=10 each) using a random number table method: control group (group C), HS-R group (group H), and three HS-R plus infusion of concentrated red blood cell groups group R1 (60 g/L≤Hb<80 g/L), group R2 (80 g/L≤Hb<100 g/L) and group R3 (100 g/L≤Hb<120 g/L). The animals were sacrificed at 3 h after resuscitation, lung tissues were obtained for examination of the pathological changes with a light microscope, and lung tissues were obtained again for determination of wet to dry weight ratio (W/D ratio), neutrophil myeloperoxidase (MPO), NO level and cell apoptosis (by TUNEL). \u0000 \u0000 \u0000Results \u0000Compared with group C, the levels of MAP and NO, W/D ratio and apoptosis index were significantly increased in the other groups (P 0.05). \u0000 \u0000 \u0000Conclusion \u0000Maintaining Hb 80-100 g/L after HS-R reduces acute lung injury in rabbits. \u0000 \u0000 \u0000Key words: \u0000Shock, hemorrhagic; Cardiopulmonary resuscitation; Hemoglobins; Acute lung injury","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1233-1236"},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46480270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-20DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.10.015
Pingping Jiang, Yanxia Guo, Yang Xiaolin, Hongyu Liao, Xiaomei Chen
Objective To evaluate the effect of remifentanil on the minimum alveolar concentration of sevoflurane required to blunt the adrenergic response (MACBAR) in the patients with hepatic dysfunction undergoing laparoscopic surgery. Methods The patients, aged 18-64 yr, with body mass index < 30 kg/m2, undergoing elective laparoscopic hepatobiliary surgery, were selected.Patients with normal liver function were selected as control group (C group), and patients with liver dysfunction (Child-Pugh grade B) were selected as test group and divided into 3 subgroups by a random number table method: no remifentanil group (R0 group) and different target plasma concentrations of remifentanil groups (R1 group and R2 group). Anesthesia was induced by intravenously injecting propofol 2-3 mg/kg, remifentanil 2 μg/kg and cisatracurium 0.15 mg/kg.After endotracheal intubation, mechanical ventilation was performed.The end-tidal sevoflurane concentration was adjusted to the preset concentration in each group and maintained at the level for 20 min before the pneumoperitoneum was established.Anesthesia was maintained as follows: remifentanil was not used in C group and R0 group, and the target plasma concentration of remifentanil was 1 and 2 ng/ml in group R1 and group R2, respectively, and sevoflurane was inhaled.The MACBAR of sevoflurane was determined using the sequential method.The initial end-tidal sevoflurane concentrations were 5.0%, 4.6%, 2.6% and 2.4% in group C, group R0, group R1 and group R2, respectively.MAP and HR were recorded and blood samples were collected before and after pneumoperitoneum, and the plasma epinephrine and norepinephrine concentrations were measured by enzyme-linked immunosorbent assay, and the difference in MAP and HR before and after pneumoperitoneum was calculated. Results A total of 14 cases in group C, 19 cases in group R0, 19 cases in group R1 and 15 cases in group R2 completed the study.Compared with group C, the MACBAR of sevoflurane and plasma adrenergic concentration before and after pneumoperitoneum were significantly decreased (P 0.05). Compared with group R0, the MACBAR of sevoflurane was significantly decreased in group R1 and group R2, and HR before and after pneumoperitoneum and the difference were significantly decreased in group R2(P<0.05). The MACBAR of sevoflurane was significantly lower in group R2 than in group R1 (P<0.05). Conclusion Remifentanil can decrease the MACBAR of sevoflurane and enhance the efficacy in inhibiting the stress responses in the patients with hepatic dysfunction undergoing laparoscopic surgery. Key words: Anesthetics, inhalation; Piperidines; Hepatic insufficiency; Dose-response relationship, drug
{"title":"Effect of remifentanil on MACBAR of sevoflurane in patients with hepatic dysfunction undergoing laparoscopic surgery","authors":"Pingping Jiang, Yanxia Guo, Yang Xiaolin, Hongyu Liao, Xiaomei Chen","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.10.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.10.015","url":null,"abstract":"Objective \u0000To evaluate the effect of remifentanil on the minimum alveolar concentration of sevoflurane required to blunt the adrenergic response (MACBAR) in the patients with hepatic dysfunction undergoing laparoscopic surgery. \u0000 \u0000 \u0000Methods \u0000The patients, aged 18-64 yr, with body mass index < 30 kg/m2, undergoing elective laparoscopic hepatobiliary surgery, were selected.Patients with normal liver function were selected as control group (C group), and patients with liver dysfunction (Child-Pugh grade B) were selected as test group and divided into 3 subgroups by a random number table method: no remifentanil group (R0 group) and different target plasma concentrations of remifentanil groups (R1 group and R2 group). Anesthesia was induced by intravenously injecting propofol 2-3 mg/kg, remifentanil 2 μg/kg and cisatracurium 0.15 mg/kg.After endotracheal intubation, mechanical ventilation was performed.The end-tidal sevoflurane concentration was adjusted to the preset concentration in each group and maintained at the level for 20 min before the pneumoperitoneum was established.Anesthesia was maintained as follows: remifentanil was not used in C group and R0 group, and the target plasma concentration of remifentanil was 1 and 2 ng/ml in group R1 and group R2, respectively, and sevoflurane was inhaled.The MACBAR of sevoflurane was determined using the sequential method.The initial end-tidal sevoflurane concentrations were 5.0%, 4.6%, 2.6% and 2.4% in group C, group R0, group R1 and group R2, respectively.MAP and HR were recorded and blood samples were collected before and after pneumoperitoneum, and the plasma epinephrine and norepinephrine concentrations were measured by enzyme-linked immunosorbent assay, and the difference in MAP and HR before and after pneumoperitoneum was calculated. \u0000 \u0000 \u0000Results \u0000A total of 14 cases in group C, 19 cases in group R0, 19 cases in group R1 and 15 cases in group R2 completed the study.Compared with group C, the MACBAR of sevoflurane and plasma adrenergic concentration before and after pneumoperitoneum were significantly decreased (P 0.05). Compared with group R0, the MACBAR of sevoflurane was significantly decreased in group R1 and group R2, and HR before and after pneumoperitoneum and the difference were significantly decreased in group R2(P<0.05). The MACBAR of sevoflurane was significantly lower in group R2 than in group R1 (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Remifentanil can decrease the MACBAR of sevoflurane and enhance the efficacy in inhibiting the stress responses in the patients with hepatic dysfunction undergoing laparoscopic surgery. \u0000 \u0000 \u0000Key words: \u0000Anesthetics, inhalation; Piperidines; Hepatic insufficiency; Dose-response relationship, drug","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1207-1211"},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46550581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-20DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.09.009
Limei Zhang, Lili Jia, Wenli Yu
Objective To evaluate the role of pyroptosis in brain injury in a rat model of hepatic ischemia-reperfusion (I/R). Methods Thirty clean-grade healthy male Sprague-Dawley rats of both sexes, aged 6-8 weeks, weighing 180-200 g, were divided into 3 groups (n=10 each) using a random number table method: sham operation group (group S, n=10), hepatic I/R plus dimethyl sulfoxide (DMSO) group (group I/R+ DMSO, n=10), and hepatic I/R plus caspase-1 inhibitor Ac-YVAD-cmk group (group I/R+ YVAD, n=10). Hepatic I/R was produced by occluding the left hepatic artery and portal vein for 90 min followed by 6-h reperfusion in anesthetized rats.At 2 h before reperfusion, Ac-YVAD-cmk 5 mg/kg was intraperitoneally injected in group I/R+ YVAD, and the equal volume of DMSO was given instead in group I/R+ DMSO.Hippocampal and cortical samples were obtained at the end of reperfusion for determination of reactive oxygen species (ROS) content (using DCFH-DA fluorescence probe), malondialdehyde (MDA) content (using thiobarbituric acid method), superoxide dismutase (SOD) activity (by xanthine oxidase method), expression of NLRP3, cleaved-caspase-1 and apoptosis-associated speck-like protein containing a CAR (ASC) (by Western blot), nucleotide-binding domain, leucine rich family (NLR) pyrin domain containing 3 (NLRP3) expression (by immunohistochemical staining), and concentrations of IL-1β, IL-18, S100-β protein and neuron-specific enolase (NSE) in serum (by enzyme-linked immunosorbent assay). Results Compared with group S, the contents of ROS and MDA in hippocampus and cortex were significantly increased, the activity of SOD in hippocampus and cortex was decreased, the expression of NLRP3, cleaved-caspase-1 and ASC was up-regulated, and the concentrations of IL-1β, IL-18, S-100β protein and NSE in serum were increased in group I/R+ DMSO (P<0.05). Compared with group I/R+ DMSO, the contents of ROS and MDA in hippocampus and cortex were significantly decreased, the activity of SOD in hippocampus and cortex was increased, the expression of NLRP3, cleaved-caspase-1 and ASC was down-regulated, and the concentrations of IL-1β, IL-18, S-100β protein and NSE in serum were decreased in group I/R+ YVAD (P<0.05). Conclusion Pyroptosis is involved in the pathophysiological mechanism of brain injury induced by hepatic I/R injury in rats. Key words: Pyroptosis; Reperfusion injury; Liver; Brain injuries
{"title":"Role of pyroptosis in brain injury in a rat model of hepatic ischemia-reperfusion","authors":"Limei Zhang, Lili Jia, Wenli Yu","doi":"10.3760/CMA.J.ISSN.0254-1416.2019.09.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1416.2019.09.009","url":null,"abstract":"Objective \u0000To evaluate the role of pyroptosis in brain injury in a rat model of hepatic ischemia-reperfusion (I/R). \u0000 \u0000 \u0000Methods \u0000Thirty clean-grade healthy male Sprague-Dawley rats of both sexes, aged 6-8 weeks, weighing 180-200 g, were divided into 3 groups (n=10 each) using a random number table method: sham operation group (group S, n=10), hepatic I/R plus dimethyl sulfoxide (DMSO) group (group I/R+ DMSO, n=10), and hepatic I/R plus caspase-1 inhibitor Ac-YVAD-cmk group (group I/R+ YVAD, n=10). Hepatic I/R was produced by occluding the left hepatic artery and portal vein for 90 min followed by 6-h reperfusion in anesthetized rats.At 2 h before reperfusion, Ac-YVAD-cmk 5 mg/kg was intraperitoneally injected in group I/R+ YVAD, and the equal volume of DMSO was given instead in group I/R+ DMSO.Hippocampal and cortical samples were obtained at the end of reperfusion for determination of reactive oxygen species (ROS) content (using DCFH-DA fluorescence probe), malondialdehyde (MDA) content (using thiobarbituric acid method), superoxide dismutase (SOD) activity (by xanthine oxidase method), expression of NLRP3, cleaved-caspase-1 and apoptosis-associated speck-like protein containing a CAR (ASC) (by Western blot), nucleotide-binding domain, leucine rich family (NLR) pyrin domain containing 3 (NLRP3) expression (by immunohistochemical staining), and concentrations of IL-1β, IL-18, S100-β protein and neuron-specific enolase (NSE) in serum (by enzyme-linked immunosorbent assay). \u0000 \u0000 \u0000Results \u0000Compared with group S, the contents of ROS and MDA in hippocampus and cortex were significantly increased, the activity of SOD in hippocampus and cortex was decreased, the expression of NLRP3, cleaved-caspase-1 and ASC was up-regulated, and the concentrations of IL-1β, IL-18, S-100β protein and NSE in serum were increased in group I/R+ DMSO (P<0.05). Compared with group I/R+ DMSO, the contents of ROS and MDA in hippocampus and cortex were significantly decreased, the activity of SOD in hippocampus and cortex was increased, the expression of NLRP3, cleaved-caspase-1 and ASC was down-regulated, and the concentrations of IL-1β, IL-18, S-100β protein and NSE in serum were decreased in group I/R+ YVAD (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Pyroptosis is involved in the pathophysiological mechanism of brain injury induced by hepatic I/R injury in rats. \u0000 \u0000 \u0000Key words: \u0000Pyroptosis; Reperfusion injury; Liver; Brain injuries","PeriodicalId":10053,"journal":{"name":"中华麻醉学杂志","volume":"39 1","pages":"1058-1061"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48484861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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