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Effect of sevoflurane on phosphorylation of connexin 43 at ser368 in ventricular myocardium in isolated hearts of diabetic rats 七氟醚对糖尿病大鼠离体心脏心肌连接蛋白43 ser368磷酸化的影响
Q4 Medicine Pub Date : 2019-09-20 DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.09.011
Zijun Wang, Hong Gao, Guilong Wang, Ying Cao, Jing Yi, Yanqiu Liu
Objective To evaluate the effect of sevoflurane on phosphorylation of connexin 43 (Cx43) at Ser368 (Cx43 Ser368) in ventricular myocardium in isolated hearts of diabetic rats. Methods Twenty-four clean-grade healthy adult male Sprague-Dawley rats, aged 3 months, weighing 180-220 g, were used in this study.The diabetic model was established by intraperitoneally injecting streptozotocin 60 mg/kg.The hearts were rapidly excised and retrogradely perfused with K-H solution saturated with 95% O2-5% CO2 at 37 ℃ in a Langendorff apparatus.Sixteen Langendorff-perfused diabetic hearts were divided into 3 groups (n=8 each) using a random number table method: diabetes mellitus group (group D) and sevoflurane group (group DS). Another 8 Langendorff-perfused normal hearts of rats were selected and served as control group (group C). After 15 min equilibration with K-H solution, the hearts were continuously perfused for 30 min with K-H solution in group C and group D and with K-H solution saturated with 2.5% sevoflurane in group DS.S1S2 program-controlled stimulation was performed at the end of perfusion, the occurrence of induced ventricular arrhythmia (VA) and the maximal pacing cycle length (PCL) of induced VA were recorded, and conduction velocity (CV) was calculated.The expression of phosphorylated Cx43 at Ser368 (p-Cx43 Ser368) in ventricular myocytes was determined by Western blot. Results Compared with group C, the incidence of induced VA was significantly increased, the maximal PCL of induced VA was prolonged, the CV was decreased, and the expression of p-Cx43 Ser368 was up-regulated in group D (P<0.05). Compared with the incidence of induced VA was significantly decreased, the maximal PCL of induced VA was shortened, the CV was increased, and the expression of p-Cx43 Ser368 was down-regulated in group DS (P<0.05). Conclusion The mechanism by which sevoflurane stabilizes the ventricular electrical conduction is associated with decreasing the phosphorylation of Cx43 at Ser368 in diabetic rats. Key words: Anesthetics, inhalation; Diabetes mellitus; Connexins
目的探讨七氟醚对糖尿病大鼠离体心肌连接蛋白43(Cx43)Ser368磷酸化的影响。方法选用24只清洁级健康成年雄性Sprague-Dawley大鼠,年龄3个月,体重180-220g。腹腔注射链脲佐菌素60mg/kg,建立糖尿病模型。在Langendorff装置中,快速切除心脏,并在37℃下用95%O2-5%CO2饱和的K-H溶液逆行灌注。采用随机数表法将16例Langendorff灌注的糖尿病心脏分为3组(每组n=8):糖尿病组(D组)和七氟醚组(DS组)。选择8只Langendorff灌流的正常大鼠心脏作为对照组(C组)。K-H溶液平衡15min后,C组和D组用K-H溶液连续灌注30min,DS组用2.5%七氟醚饱和的K-H溶液持续灌注30min,记录诱发室性心律失常(VA)的发生情况和诱发VA的最大起搏周期长度(PCL)并计算传导速度(CV)。通过蛋白质印迹测定心室肌细胞中Ser368磷酸化Cx43(p-Cx43-Ser368)的表达。结果与C组相比,D组诱导VA的发生率显著增加,诱导VA的最大PCL延长,CV降低,p-Cx43-Ser368表达上调(p<0.05),结论七氟醚稳定心室电传导的机制与降低糖尿病大鼠心室Cx43-Ser368磷酸化有关。关键词:麻醉剂,吸入;糖尿病;连接蛋白
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引用次数: 0
Effect of dexmedetomidine on mitochondrial dynamics in mice with endotoxin-induced acute lung injury 右美托咪定对内毒素致急性肺损伤小鼠线粒体动力学的影响
Q4 Medicine Pub Date : 2019-09-20 DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.09.029
Jia Shi, Li-li Wu, Yanfang Zhang, Shi-Han Du, Li-rong Gong
Objective To evaluate the effect of dexmedetomidine on mitochondrial dynamics in mice with endotoxin-induced acute lung injury (ALI). Methods Thirty clean-grade healthy adult male C57BL/6 mice, weighing 20-25 g, aged 2 months, were divided into 3 groups (n=10 each) using a random number table method: control group (group C), endotoxin-induced ALI group (group LPS) and endotoxin-induced ALI plus dexmedetomidine group (group LPS+ DEX). In LPS and LPS+ DEX groups, lipopolysaccharide (LPS) 10 mg/kg was injected via the caudal vein to establish the model of endotoxin-induced ALI.In group LPS+ DEX, dexmedetomidine 50 μg/kg was intraperitoneally injected at 30 min before injection of LPS, while the equal volume of normal saline was given instead in C and LPS groups.The mice were sacrificed at 6 h after LPS administration, and lung tissues were obtained for examination of the pathological changes (with a light microscope) which were scored and for determination of the level of reactive oxygen species (ROS) and expression of mitochondrial fusion proteins mitofusin 1 (Mfn1), Mfn2, optic atrophy 1 (OPA1), dynamin-related protein 1 (Drp1) and fission protein 1 (Fis1)(using Western blot). Results Compared with group C, the lung injury scores and ROS level in lung tissues were significantly increased, the expression of Mfn1, Mfn2 and OPA1 was down-regulated, and the expression of Drp1 and Fis1 was up-regulated in LPS and LPS+ DEX groups (P<0.05). Compared with group LPS, the lung injury scores and ROS level in lung tissues were significantly decreased, the expression of Mfn1, Mfn2 and OPA1 was up-regulated, and the expression of Drp1 and Fis1 was down-regulated in group LPS+ DEX (P<0.05). Conclusion Dexmedetomidine can reduce endotoxin-induced ALI through maintaining the mitochondrial fusion-fission balance in mice. Key words: Dexmedetomidine; Acute lung injury; Endotoxemia; Mitochondria
目的探讨右美托咪定对内毒素致急性肺损伤(ALI)小鼠线粒体动力学的影响。方法30只2月龄、体重20 ~ 25 g的清洁级健康雄性C57BL/6小鼠,采用随机数字表法分为3组,每组10只:对照组(C组)、内毒素ALI组(LPS组)和内毒素ALI +右美托咪定组(LPS+ DEX组)。LPS组和LPS+ DEX组经尾静脉注射脂多糖(LPS) 10 mg/kg,建立内毒素致ALI模型。LPS+ DEX组在LPS注射前30 min腹腔注射右美托咪定50 μg/kg, C组和LPS组均等量生理盐水替代。LPS给药后6 h处死小鼠,取肺组织,光镜下观察病理变化(记分),测定活性氧(ROS)水平和线粒体融合蛋白mitofusin 1 (Mfn1)、Mfn2、视神经萎缩1 (OPA1)、动力蛋白相关蛋白1 (Drp1)、裂变蛋白1 (Fis1)的表达(Western blot)。结果与C组比较,LPS组和LPS+ DEX组大鼠肺损伤评分和肺组织ROS水平显著升高,Mfn1、Mfn2、OPA1表达下调,Drp1、Fis1表达上调(P<0.05)。与LPS组比较,LPS+ DEX组大鼠肺损伤评分及肺组织ROS水平显著降低,Mfn1、Mfn2、OPA1表达上调,Drp1、Fis1表达下调(P<0.05)。结论右美托咪定可通过维持小鼠线粒体融合-裂变平衡来减轻内毒素诱导的ALI。关键词:右美托咪定;急性肺损伤;内毒素;线粒体
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引用次数: 0
Optimal dose of neostigmine to reverse residual neuromuscular blockade during recovery from anesthesia in patients undergoing hepatectomy 新斯的明在肝切除术患者麻醉恢复期间逆转残留神经肌肉阻滞的最佳剂量
Q4 Medicine Pub Date : 2019-09-20 DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.09.031
Hao Wang, L. Yun, Fang Zhang, Yanlin Zhang, M. Duan, Wanyou Yu
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引用次数: 0
Effects of thoracic paravertebral nerve block at different time points on postoperativelong-term quality of life in patients undergoing thoracoscopic radical resection of lung cancer 不同时间点胸椎旁神经阻滞对癌症胸腔镜根治术患者术后长期生活质量的影响
Q4 Medicine Pub Date : 2019-09-20 DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.09.006
Yao Liu, Bing Li, Xing Meng, Jiaqiang Zhang, Wei Zhang
Objective To evaluate the effect of thoracic paravertebral nerve block (TPVB) at different time points on postoperative long-term quality of life in the patients undergoing thoracoscopic radical resection of lung cancer. Methods One hundred and fifty patients of both sexes, aged 25-64 yr, with body mass index of 18-24 kg/m2, of American Society of Anesthesiologists physical status Ⅰor Ⅱ, scheduled for elective radical resection of lung cancer, were divided into 3 groups (n=50 each) by a random number table method: preoperative TPVB group (P1 group), TPVB at the end of operation group (P2 group) and preoperative TPVB combined with TPVB at the end of operation group (P3 group). In group P1, TPVB was performed at T4, 6 points on the affected side under ultrasound guidance before anesthesia induction, and 0.5% ropivacaine 10 ml was injected in total.In group P2, TPVB was performed at T4, 6 points on the affected side under ultrasound guidance at the end of operation, and 0.5% ropivacaine 10 ml was injected in total.In group P3, TPVB was performed at T4, 6 points on the affected side under ultrasound guidance before anesthesia induction and at the end of operation, and 0.5% ropivacaine 10 ml was injected each time.The analgesia pump was connected at the end of operation in three groups.The patients were followed up after operation, and 5 ml solution extracted from the analgesic pump was intravenously injected when VAS score was greater than or equal to 4.The occurrence of postoperative chronic pain in the 3 groups was recorded though telephone follow-up at 6 and 12 months after surgery, and the effect of pain on daily life and treatment measures were scored.A concise health-related quality of life scale was used to evaluate patients′ quality of life, and the physical and mental health scores were calculated. Results There was no significant difference in the incidence of chronic pain at 6 and 12 months after surgery among the three groups (P>0.05). The physical and mental health scores were significantly decreased at 12 months after surgery than at 6 months after surgery in the three groups (P<0.05). Compared with P1 and P2 groups, the scores of effect of pain on daily life and treatment measures were significantly decreased, and the physical and mental health scores were increased at 12 months after surgery in group P3 (P<0.05). Conclusion The combination of preoperative TPVB and TPVB at the end of operation can effectively improve postoperative long-term quality of life in the patients undergoing thoracoscopic radical resection of lung cancer. Key words: Nerve block; Thoracoscopes; Lung neoplasms; Quality of life
目的评价不同时间点胸椎旁神经阻滞(TPVB)对癌症胸腔镜根治性切除术后长期生活质量的影响。方法采用随机数表法,将美国麻醉医师学会身体状况Ⅰ或Ⅱ级、年龄25~64岁、体重指数18~24kg/m2的癌症择期根治性切除患者150例分为术前TPVB组(P1组),术后TPVB组(P2组),术前TPVB联合TPVB治疗组(P3组)。P1组在麻醉诱导前超声引导下于T4、患侧6点进行TPVB,共注射0.5%罗哌卡因10ml。P2组在T4行TPVB,术后在超声引导下于患侧6点进行,共注射0.5%罗哌卡因10ml。P3组于T4,麻醉诱导前及手术结束时,在超声引导下于患侧6个点进行TPVB,每次注射0.5%罗哌卡因10ml。三组患者术后均连接镇痛泵。术后随访,VAS评分大于或等于4时,静脉注射镇痛泵提取的5ml溶液。术后6个月和12个月,通过电话随访记录3组术后慢性疼痛的发生情况,并对疼痛对日常生活的影响和治疗措施进行评分。使用简明的健康相关生活质量量表来评估患者的生活质量,并计算身心健康评分。结果三组患者术后6个月和12个月的慢性疼痛发生率差异无统计学意义(P>0.05),术后12个月三组患者的身心健康评分均显著低于术后6月(P<0.05),疼痛对日常生活的影响和治疗措施的得分显著降低,结论术前TPVB与术后TPVB联合应用可有效提高癌症胸腔镜根治术患者术后长期生活质量。关键词:神经阻滞;胸腔镜;肺肿瘤;生活质量
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引用次数: 0
A survey of the ten-year implementation of WHO surgical safety checklist in China 世界卫生组织外科手术安全检查表在中国实施十年的调查
Q4 Medicine Pub Date : 2019-09-20 DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.09.005
Bin Zhu, Huan Gao, Xiangyong Zhou, Yu Liu, Yuguang Huang, Jeffrey J Huang
Objective To investigate the current status of the ten-year implementation of the World Health Organization (WHO) surgical safety checklist (SSC) in China. Methods A questionnaire was designed based on the three phases described by the checklist — the period before induction of anaesthesia, the period before skin incision, and the period before patient leaves operating room, taking into account some hotspots and disputes.The questionnaire was sent to the members of the Chinese-based online New Youth Anesthesia Forum through the WeChat platform.Answers were completed by mobile phones or desktop computers.Each WeChat ID number allowed only one answer for each individual participant. Results A total of 3 943 members red the questionnaire invitation, of which 2 121 members completed the questionnaire with an overall completion rate of 53.79%.For checks completed before induction of anesthesia, the percentage of members who routinely practiced checks before induction of anesthesia was 93.35%, the percentage of members who completed each and every element of the checklist was 60.16%, and the percentage of members who selected the element of the checklist the surgeon was not involved in the check was 14.05%.For checks practiced before skin incision, the percentage of members who routinely completed checks before skin incision was 78.22%, the percentage of members who completed each and every element of the checklist was 51.91%, and the percentage of members who selected the element of the checklist surgeons and anesthesiologists routinely stated their own professional key information was 18.24% and 18.81%, respectively.For checks practiced before the patient leaved the operating room, the percentage of members who routinely completed checks before removing the patient from the operating room was 64.26%, and the percentage of members who completed each and every element of the checklist was 44.18%.The percentage of members who was really serious about practicing the checklist was 56.20%.The percentage of members who believed that surgeons should participated in checks practiced before induction of anesthesia was 81.47%.If the member himself or a member of his family needed a surgery, the percentage of members who hoped to implement the checklist was 98.35%.The percentage of members who believed that practicing WHO SSC could reduce the complications of surgery and improve the anesthetic safety of patients was 94.34%. Conclusion The implementing rate of checks practiced before induction of anesthesia is high, while the implementing rates of checks completed before skin incision and before patient leaves operating room are sequentially reduced in China.Although there are some problems with the implementation of WHO SSC, most respondents believe that implementing SSC can improve the anesthetic safety of patients undergoing surgery. Key words: Anesthesia; Surgical safety checklist
目的了解世界卫生组织(世界卫生组织)外科手术安全检查表(SSC)在中国实施十年的现状。方法根据检查表中描述的三个阶段——麻醉诱导前、皮肤切开前和患者离开手术室前,并考虑到一些热点和争议,设计一份问卷。问卷通过微信平台发送给了中国在线新青年麻醉论坛的成员。答案是通过手机或台式电脑完成的。每个微信ID号码只允许每个参与者回答一个问题。结果共有3943名成员接受了问卷邀请,其中2121名成员完成了问卷,总体完成率为53.79%。在麻醉诱导前完成的检查中,常规进行麻醉诱导前检查的成员比例为93.35%,完成检查表中每一个元素的成员比例为60.16%,选择检查表中外科医生未参与检查的元素的成员百分比为14.05%。对于皮肤切开前进行的检查,在皮肤切开前常规完成检查的成员的百分比为78.22%,完成检查表各要素的成员比例为51.91%,选择检查表要素的成员百分比分别为18.24%和18.81%。外科医生和麻醉师定期陈述自己的专业关键信息。对于在患者离开手术室之前进行的检查,在将患者移出手术室之前常规完成检查的成员的百分比为64.26%,完成检查表每一个元素的成员比例为44.18%。真正认真执行检查表的成员比例是56.20%。认为外科医生应该参与麻醉诱导前进行的检查的成员百分比为81.47%。如果成员本人或其家人需要手术,希望实施检查表的会员比例为98.35%,认为实施世界卫生组织SSC可减少手术并发症、提高患者麻醉安全性的会员比例达94.34%,尽管世界卫生组织SSC的实施存在一些问题,但大多数受访者认为,实施SSC可以提高手术患者的麻醉安全性。关键词:麻醉;手术安全检查表
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引用次数: 1
Effect of penehyclidine hydrochloride on TLR4/NF-κВ signaling pathway in non-ventilated lung injury in patients undergoing radical operation for lung cancer 盐酸戊乙奎醚对肺癌根治术后非通气肺损伤TLR4/NF-κВ信号通路的影响
Q4 Medicine Pub Date : 2019-09-20 DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.09.023
Xiuxia Wu, Gang Xu, Xihua Lu
Objective To evaluate the effect of penehyclidine hydrochloride (PHC) on Toll-like receptor 4 (TLR4)/nuclear factor kappa B (NF-κB) signaling pathway in non-ventilated lung injury in the patients undergoing radical operation for lung cancer. Methods A total of 100 patients, aged 40-64 yr, with body mass index 18-27 kg/m2, of American Society of Anesthesiology physical status Ⅱ or Ⅲ, undergoing radical operation for lung cancer, were divided into 2 groups (n=50 each) according to the random number table method: control group (group C) and PHC group.PHC 0.01 mg/kg was intravenously injected at 10 min before anesthesia induction in group PHC, while the equal volume of normal saline was given instead in group C. The peripheral tissues of the removed lung tissues were obtained for determination of wet/dry weight ratio (W/D ratio). The pathological changes and ultrastructure of lung tissues were observed under light microscope, and lung injury was assessed and scored.The expression of TLR4 and NF-κB protein and mRNA was detected by Western blot and real-time polymerase chain reaction, respectively.Before administration (T0), at the onset of one-lung ventilation (T1), at 60 min of one-lung ventilation (T2), immediately after the end of one-lung ventilation (T3), at the end of operation (T4) and at 24 h after operation (T5), blood samples were collected from the internal jugular vein for determination of serum tumor necrosis factor-alpha, interleukin-6 (IL-6) and IL-8 concentrations by enzyme-linked immunosorbent assay. Results Compared with group C, the W/D ratio and lung injury scores were significantly decreased, the expression of TLR4 and NF-κВ protein and mRNA was down-regulated, and the concentrations of tumor necrosis factor-alpha, IL-6 and IL-8 were decreased at T2-T5 in group PHC (P<0.05). The pathological changes and damage to ultrastructure of lung tissues were significantly attenuated in group PHC as compared with group C. Conclusion The mechanism by which PHC attenuates non-ventilated lung injury is related to blocking TLR4/NF-κВ signaling pathway and reducing inflammatory responses in the patients undergoing radical operation for lung cancer. Key words: Cholinergic antagonists; Lung neoplasms; Lung injury; NF-kappa B; Toll-like receptor 4
目的探讨盐酸培乙克利定(PHC)对癌症根治术后非通气性肺损伤Toll样受体4(TLR4)/核因子κB(NF-κB)信号通路的影响。方法100例癌症根治性手术患者,年龄40~64岁,体重指数18~27kg/m2,美国麻醉学会Ⅱ、Ⅲ级,按随机数表法分为对照组(C组)和PHC组。PHC组麻醉诱导前10分钟静脉注射PHC 0.01mg/kg,C组给予等量生理盐水,取肺组织外周组织测定湿干重比(W/D比)。在光学显微镜下观察肺组织的病理变化和超微结构,并对肺损伤进行评估和评分。分别用Western blot和实时聚合酶链式反应检测TLR4和NF-κB蛋白及mRNA的表达。给药前(T0)、单肺通气开始时(T1)、单通气60分钟时(T2)、单肺部通气结束后立即(T3)、手术结束时(T4)和手术后24小时(T5),从颈内静脉采集血样以测定血清肿瘤坏死因子α,白细胞介素-6(IL-6)和IL-8的浓度。结果与C组相比,W/D比和肺损伤评分显著降低,TLR4、NF-κВ蛋白和mRNA表达下调,肿瘤坏死因子α、,结论PHC减轻非通气性肺损伤的机制与阻断TLR4/NF-κВ信号通路和减轻肺组织炎症反应有关癌症根治术。关键词:胆碱能拮抗剂;肺肿瘤;肺损伤;NF-κB;Toll样受体4
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引用次数: 0
Effect of ABCB1 C3435T genetic polymorphism on efficacy of postoperative analgesia ABCB1 C3435T基因多态性对术后镇痛效果的影响
Q4 Medicine Pub Date : 2019-09-20 DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.09.015
Xueying Zhang, Yongxin Liang, Cuili Wen, Jing Xia, Haichen Chu
Objective To evaluate the effect of ATP-binding cassette B subfamily member 1 transporter (ABCB1) C3435T genetic polymorphism on the efficacy of postoperative analgesia. Methods One hundred American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients, aged 18-60 yr, scheduled for elective thoracoscopic lobectomy under general anesthesia, were enrolled in this study.The gene mutation of ABCB1 C3435T was detected, and the patients were divided into 3 groups according to the genotypes: wild homozygote group (CC group), mutation heterozygote (CT group) and mutation homozygote group (TT group). Patient-controlled intravenous analgesia was performed with sufentanil after operation.Visual analogue scale (VAS) scores at 24 and 48 h after operation, postoperative consumption of sufentanil, sleep quality score at 24 h after operation and state-trait anxiety score were recorded. Results Compared with CC group, VAS scores at 24 h after operation and postoperative consumption of sufentanil were significantly decreased in TT and CT groups, and the state-trait anxiety score was significantly decreased in TT group and increased in CT group (P 0.05). Conclusion ABCB1 C3435T genetic polymorphism may be one of the mechanisms of the individual variation in the efficacy of postoperative analgesia. Key words: Polymorphism, single nucleotide; Analgesia; Pain, postoperative
目的探讨ATP结合盒B亚家族成员1转运蛋白(ABCB1)C3435T基因多态性对术后镇痛效果的影响。方法100例美国麻醉师协会身体状况Ⅱ或Ⅲ级患者,年龄18-60岁,计划在全麻下进行选择性胸腔镜肺叶切除术。检测ABCB1 C3435T基因突变,根据基因型将患者分为3组:野生纯合子组(CC组)、突变杂合子组(CT组)和突变纯合子组(TT组)。术后应用舒芬太尼进行患者自控静脉镇痛。记录术后24和48小时的视觉模拟量表(VAS)评分、术后舒芬太尼用量、术后24小时的睡眠质量评分和状态特征焦虑评分。结果TT组和CT组术后24 h VAS评分及舒芬太尼用量均较CC组明显下降,结论ABCB1 C3435T基因多态性可能是术后镇痛效果个体差异的机制之一。关键词:多态性,单核苷酸;镇痛;疼痛,术后
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引用次数: 1
Role of microRNA-125b in ventilator-induced lung injury in mice microRNA-125b在呼吸机诱导小鼠肺损伤中的作用
Q4 Medicine Pub Date : 2019-09-20 DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.09.024
Tianfeng Huang, Ju Gao, Luo-jing Zhou, Ya-li Ge
Objective To evaluate the role of microRNA-125b (miR-125b) on ventilator-induced lung injury (VILI) in mice. Methods Forty healthy male C57BL/6 male mice, weighing 25-30 g, aged 2-3 months, were divided into 4 groups (n=10 each) using a random number table method: sham operation group (group Sham), group VILI, VILI plus miR-125b negative control group (group VILI+ NC), and VILI plus miR-125b overexpression group (group VILI+ miR-125b agomir). In VILI+ NC and VILI+ miR-125b agomir groups, miR-125b negative control and miR-125b agomir transfection complex 50 μl were intratracheally instilled, respectively, and 48 h later VILI model was established.The animals were mechanically ventilated for 4 h with high tidal volume (40 ml/kg) to induce VILI.Blood samples were obtained from the femoral artery at 4 h of mechanical ventilation for detection of PaO2, then animals were sacrificed, lungs were removed for determination of wet to dry weight ratio (W/D ratio) and for examination of pathological changes (with a light microscope), and lung injury was scored.In VILI+ NC and VILI+ miR-125b agomir groups, bronchoalveolar lavage fluid (BALF) was collected to measure the concentrations of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) by enzyme-linked immunosorbent assay.The cell apoptosis of lung tissues was measured using TUNEL, apoptosis index was calculated, the caspase-3 expression was detected by Western blot, and the miR-125b expression was detected by real-time polymerase chain reaction. Results Compared with Sham group, PaO2 was significantly decreased, and W/D ratio and lung injury score were increased in VILI, VILI+ NC and VILI+ miR-125b agomir groups, and the expression of miR-125b was down-regulated in VILI and VILI+ NC groups (P<0.05). Compared with VILI group, PaO2 was significantly increased, W/D ratio and lung injury score were decreased, the expression of miR-125b was up-regulated (P<0.05), the pathological changes of lung tissues were significantly attenuated in group VILI+ miR-125b agomir, and no significant change was found in the parameters mentioned above in group VILI+ NC (P<0.05). Compared with group VILI+ NC, the concentrations of TNF-α and IL-6 in BALF and apoptotic index were significantly decreased, and the expression of caspase-3 was down regulated in group VILI+ miR-125b agomir (P<0.05). Conclusion MiR-125b is involved in the endogenous protective mechanism of VILI in mice. Key words: MicroRNAs; Ventilator-induced lung injury
目的探讨microRNA-125b (miR-125b)在小鼠呼吸机诱导肺损伤(VILI)中的作用。方法40只健康雄性C57BL/6雄性小鼠,体重25 ~ 30 g,年龄2 ~ 3月龄,采用随机数字表法分为4组,每组10只:假手术组(sham组)、VILI组、VILI+ miR-125b阴性对照组(VILI+ NC组)、VILI+ miR-125b过表达组(VILI+ miR-125b agomir组)。VILI+ NC组和VILI+ miR-125b agomir组分别气管内灌注miR-125b阴性对照和miR-125b agomir转染复合物50 μl, 48h后建立VILI模型。采用高潮气量(40 ml/kg)机械通气4 h诱导VILI。机械通气4 h股动脉采血检测PaO2,处死动物,取肺测定干湿比(W/D比),光镜下检查病理变化,并对肺损伤进行评分。VILI+ NC组和VILI+ miR-125b agomir组收集支气管肺泡灌洗液(BALF),采用酶联免疫吸附法测定肿瘤坏死因子-α (TNF-α)和白细胞介素-6 (IL-6)的浓度。TUNEL检测肺组织细胞凋亡,计算细胞凋亡指数,Western blot检测caspase-3表达,实时聚合酶链反应检测miR-125b表达。结果与Sham组比较,VILI、VILI+ NC、VILI+ miR-125b agomir组大鼠PaO2水平显著降低,W/D比升高,肺损伤评分升高,VILI、VILI+ NC组大鼠miR-125b表达下调(P<0.05)。与VILI组比较,VILI+ miR-125b agomir组大鼠PaO2明显升高,W/D比、肺损伤评分降低,miR-125b表达上调(P<0.05),肺组织病理改变明显减弱(P<0.05), VILI+ NC组上述参数无明显变化(P<0.05)。与VILI+ NC组比较,VILI+ miR-125b agomir组BALF中TNF-α、IL-6浓度及凋亡指数均显著降低,caspase-3表达下调(P<0.05)。结论MiR-125b参与小鼠VILI内源性保护机制。关键词:MicroRNAs;呼吸机引起的肺损伤
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引用次数: 0
Efficacy of enhanced recovery after surgery for robot-assisted laparoscopic pyeloplasty in pediatric patients 机器人辅助腹腔镜肾盂成形术增强儿童术后恢复的疗效
Q4 Medicine Pub Date : 2019-09-20 DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.09.021
Ting-ting Wu, Han Guo, Bi-yu Wei, Huixia Zhou, Xuemei Hao, Yaqun Ma
Objective To evaluate the safety and efficacy of enhanced recovery after surgery (ERAS) in robot-assisted laparoscopic pyeloplasty in pediatric patients. Methods Sixty pediatric patients of both sexes with hydronephrosis, aged 3-12 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing robot-assisted laparoscopic pyeloplasty from March 2018 to April 2019, were divided into 2 groups using a random number table method: control group (group C, n=28) and ERAS group (n=32). In ERAS group, preoperative ERAS education was carried out, the time of preoperative food and water deprivation was shortened, pediatric patients drank glucose water at 2 h before surgery, anesthetic regimen was optimized, lung protective ventilation and target-directed fluid therapy were performed, and intraoperative warming and multi-mode antiemetic measures were carried out during operation, and multi-mode analgesic measures were taken after operation, and pediatric patients received water and food intake early through the mouth and got out of bed as soon as possible after operation.In group C, the traditional concept was adopted for perioperative management.Immediately after tracheal intubation, at 30 min and 1 and 2 h after establishing pneumoperitoneum, at 5 min after the end of pneumoperitoneum and at 5 min after extubation, the airway peak pressure and tidal volume were recorded, and blood gas analysis was performed.The occurrence of cardiovascular events was recorded during surgery.The postoperative time of extubation, time of first intake, the first postoperative off-bed time, the first flatus time, time of pulling out the ureter and drainage tube, and length of hospital stay were recorded.The Pediatric Anesthesia Emergence Delirium scale was used to assess the agitation during the recovery period.The Faces Pain Scale-Revised scale was used to assess the degree of pain within 72 h after surgery.When Faces Pain Scale-Revised scale score ≥4, fentanyl 0.25 μg/kg was intravenously injected as rescue analgesic.The requirement for rescue analgesia was recorded.The overall complications were evaluated by using Clavin-Dindo grading, and postoperative complications included nausea and vomiting, abdominal distension, abdominal pain, incision infection, abdominal infection, anastomotic leakage, fever, etc. Results Compared with group C, the preoperative food and water deprivation time was significantly shortened, the time of postoperative extubation was prolonged, the postoperative length of hospital stay, time of first intake, the first postoperative off-bed time, the first flatus time, and time of pulling out the ureter were shortened, airway peak pressure was decreased at 1 and 2 h of pneumoperitoneum, arterial blood lactate concentrations were decreased at each time point of pneumoperitoneum (P 0.05). No intraoperative adverse cardiovascular events were found, and no pediatric patients required rescue analgesia after operation in two groups.
目的评价机器人辅助腹腔镜肾盂成形术后增强恢复(ERAS)的安全性和有效性。方法将2018年3月至2019年4月接受机器人辅助腹腔镜肾盂成形术的60例美国麻醉师学会身体状况为Ⅰ或Ⅱ级、年龄3-12岁的儿童肾盂积水患者,采用随机数表法分为2组:对照组(C组,n=28)和ERAS组(n=32)。ERAS组术前进行ERAS教育,缩短术前断食断水时间,患儿术前2小时饮用葡萄糖水,优化麻醉方案,进行肺部保护性通气和靶向液体治疗,术中采取术中加温和多模式止吐措施,术后采取多模式镇痛措施,患儿术后尽早通过口饮水、进食,并尽快下床。C组采用传统观念进行围手术期管理。气管插管后立即,在建立气腹后30分钟和1、2小时,在气腹结束后5分钟和拔管后5分钟,记录气道峰值压力和潮气量,并进行血气分析。手术期间记录心血管事件的发生情况。记录术后拔管时间、首次进食时间、术后第一次下床时间、第一次排气时间、拔出输尿管和引流管时间、住院时间。儿科麻醉紧急谵妄量表用于评估恢复期的躁动情况。面部疼痛量表修订量表用于评估手术后72小时内的疼痛程度。当Faces疼痛量表修订量表评分≥4时,静脉注射芬太尼0.25μg/kg作为抢救性镇痛药。记录抢救镇痛的要求。采用Clavin Dindo分级评估总体并发症,术后并发症包括恶心呕吐、腹胀、腹痛、切口感染、腹部感染、吻合口瘘、发热等。结果与C组相比,术前断食断水时间明显缩短,延长了术后拔管时间,缩短了术后住院时间、首次进食时间、术后第一次下床时间、第一次排气时间和拔出输尿管时间,气腹1~2h时气道峰值压力降低,两组患者在气腹各时间点动脉血乳酸浓度均下降(P<0.05),术中无心血管不良事件发生,术后无患儿需要抢救性镇痛。结论ERAS可安全、有效地用于儿童腹腔镜肾盂成形术。关键词:围手术期护理;儿童;机器人外科手术
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引用次数: 0
Effect of hydrogen on mitochondrial biosynthesis in hippocampus of mice with sepsis-associated encephalopathy 氢对脓毒症相关脑病小鼠海马线粒体生物合成的影响
Q4 Medicine Pub Date : 2019-09-20 DOI: 10.3760/CMA.J.ISSN.0254-1416.2019.09.025
Yaoqi Wang, Yuzun Wang, Yi Jiang, Man Yang, X. Mao, Hongguang Chen, Yonghao Yu
Objective To evaluate the effect of hydrogen on mitochondrial biosynthesis in the hippocampus of mice with sepsis-associated encephalopathy (SAE). Method Two hundred and twenty-four healthy clean-grade male C57BL/6J mice, aged 6-8 weeks, weighing 20-25 g, were divided into 4 groups (n=56 each) using a random number table method: sham operation group (group SH), sham operation plus hydrogen group (group SH+ H2), group SAE, and SAE plus hydrogen group (group SAE+ H2). The model of SAE was established by cecal ligation and puncture in anesthetized mice.Group SH+ H2 and group SAE+ H2 inhaled 2% hydrogen for 1 h starting from 1 and 6 h after operation, respectively.Twenty mice were selectde to record the postoperative 7-day survival rate.The remaining animals were sacrificed at 24 h after operation, and brain tissues were taken for examination of the pathological changes in hippocampal CA1 region (with a light microscope) and for determination of neuronal apoptosis (by TUNEL), mitochondrial membrane potential (MMP) (by fluorescence spectrophotometry) and ATP content (by a bioluminescence assay). The apoptosis rate was calculated.The expression of peroxisome proliferator-activated receptor gamma coactivator 1α (PGC-1α) in hippocampus was determined by Western blot at 6, 12 and 24 h after operation. Results Compared with group SH, the postoperative 7-day survival rate was significantly decreased, the apoptosis rate of hippocampal neurons was increased, the contents of MMP and ATP were decreased, and the expression of PGC-1α was up-regulated in SAE and SAE+ H2groups (P 0.05). Compared with group SAE, the postoperative 7-day survival rate was significantly increased, and the apoptosis rate of hippocampal neurons was decreased, the contents of MMP and ATP were increased, and the expression of PGC-1α was up-regulated (P<0.05), and the pathological changes of hippocampal tissues were significantly attenuated in group SAE+ H2. Conclusion The mechanism by which hydrogen mitigates SAE may be related to promoting mitochondrial biosynthesis in mice. Key words: Hydrogen; Sepsis-associated encephalopathy; Mitochondria; Biosynthesis
目的探讨氢对脓毒症相关性脑病(SAE)小鼠海马线粒体生物合成的影响。方法采用随机数表法将健康清洁级雄性C57BL/6J小鼠224只,年龄6-8周,体重20-25g,分为4组(每组56只):假手术组(SH组)、假手术加氢组(SH+H2组)、SAE组和SAE加氢组。在麻醉小鼠中通过盲肠结扎和穿刺建立SAE模型。SH+H2组和SAE+H2组分别从术后1h和6h开始吸入2%氢气1h。选择20只小鼠记录术后7天的存活率。术后24小时处死其余动物,取脑组织检查海马CA1区的病理变化(用光学显微镜),并测定神经元凋亡(通过TUNEL)、线粒体膜电位(MMP)(通过荧光分光光度法)和ATP含量(通过生物发光测定)。计算细胞凋亡率。术后6、12和24小时,采用蛋白质印迹法检测海马过氧化物酶体增殖物激活受体γ共激活因子1α(PGC-1α)的表达。结果与SH组相比,SAE组和SAE+H2组术后7天生存率显著降低,海马神经元凋亡率升高,MMP和ATP含量降低,PGC-1α表达上调(P<0.05),SAE+H2组海马神经元凋亡率下降,MMP和ATP含量升高,PGC-1α表达上调(P<0.05),海马组织病理变化明显减轻。结论氢减轻SAE的机制可能与促进小鼠线粒体生物合成有关。关键词:氢;脓毒症相关性脑病;线粒体;生物合成
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中华麻醉学杂志
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