Objective To investigate the role of hippocampal protein kinase Mζ (PKMζ)/potassium-chloride cotransporter-2 (KCC2) pathway in propofol postconditioning-induced long-term cerebral protection following cerebral ischemia-reperfusion (I/R) in rats.Methods Sixty adult male Sprague-Dawley rats, weighing 250-280 g, were randomly divided into 5 groups (n =12 each): sham operation group (group S), cerebral I/R group (group I/R), propofol post-conditioning group (group P) , PKMζ inhibitor ZIP+cerebral I/R group (group Z+I/R) , and ZIP + propofol postconditioning group (group Z + P).Cerebral ischemia was induced by 1 h middle cerebral artery occlusion, followed by reperfusion in anesthetized rats.Propofol 20 mg · kg-1 · h-1was intravenously infused for 2 h in P and Z+P groups, and the equal volume of normal saline was given for 2 h in I/R and Z+I/R groups.In Z+P and Z+ I/R groups, ZIP 0.5 μmol/L was injected intravenously at 15 min before reperfusion.Modified Neurological Severity Score (mNSS) was assessed at 28 days of reperfusion.After the end of behavioral tests, the hippocampi were removed for determination of GABAergic interneurons GAD67/KCC2 positive neuron count in the hippocampal CA1 region (by using immunofluorescent staining), and PKMζ and phosphorylated KCC2 (p-KCC2) expression (by Western blot).Results Compared with group S, mNSS was significantly increased, GAD67/KCC2 positive neuron count was decreased, and the expression of PKMζ and p-KCC2 was down-regulated in I/R, P and Z+P groups (P＜0.05).Compared with group I/R, mNSS was significantly decreased, GAD67/KCC2 positive neuron count was increased, and the expression of PKMζ and p-KCC2 was up-regulated in group P, and mNSS was significantly increased, GAD67/KCC2 positive neuron count was decreased, and the expression of PKMζ and p-KCC2 was down-regulated in group Z+I/R (P＜0.05).Compared with group P, mNSS was significantly increased, GAD67/KCC2 positive neuron count was decreased, and the expression of PKMζ and p-KCC2 was down-regulated in group Z+P (P＜0.05).Conclusion The mechanism underlying propofol postconditioning-induced long-term cerebral protection following cerebral I/R may be related to activation of hippocampal PKMζ/KCC2 pathway in rats.

Objective To evaluate the effect of propofol post-conditioning on hippocampal neuronal K+-Cl-co-transporter 2 (KCC2) expression in the rats with cerebral ischemia/reperfusion (I/R) injury.Methods Seventy-two male Sprague-Dawley rats,aged 7-8 weeks,weighing 250-280 g,were randomly divided into 3 groups (n =24 each):sham operation group (group S),cerebral I/R (group I/R) and propofol post-conditioning group (group PP).The model of focal cerebral I/R injury was established by occlusion of the right middle cerebral artery.Propofol 20 mg· kg-1 · h-1 was infused over 2 h starting from the onset of reperfusion through the femoral vein in group PP.The equal volume of normal saline was given in S and I/R groups.Modified neurological severity score (mNSS) was used to evaluate the impairment of neurological function.The animals were then sacrificed and brains were removed for determination of the number of neurons (by Nissl' s staining) and expression of KCC2 (by immunofluorescence and Western blot) in hippocampal CA3 region.Results Compared with group S,the scores of mNSS were significantly increased,and the number of neurons and expression of KCC2 in hippocampal CA3 region were decreased in I/R group,and mNSS scores were increased,and no significant changes were found in the other parameters in group PP.Compared with group I/R,the mNSS scores were significantly decreased,and the number of neurons and expression of KCC2 in hippocampal CA3 region were increased in group PP.Conclusion The mechanism by which propofol post-conditioning reduces cerebral I/R injury is related to up-regulated expression of hippocampal KCC2 in rats.

Objective To evaluate the effects of alcohol dependence (AD) on the expression of spinal neuronal K+-Cl cotransporter 2 (KCC2) in rats.Methods Forty-eight healthy male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 2 groups (n =24 each) using a random number table:control group (group C) and group AD.An orogastric tube was inserted and alcohol was administered through the tube into the stomach to establish the model of AD.The concentration of ethanol was 5％,10％ and 20％ at 1st,2nd and 3rd weeks,respectively,and the concentration of ethanol was 35％ at 4th week and later.Alcohol was given at 10 ml · kg-1 · d-1,lasting for 8 weeks.The rats received drinking water containing no ethanol at 10 ml · kg-1 · d-1 instead of alcohol in group C.All the rats were allowed ad libitum access to food and water.Before the last administration,an elevated plus-maze test was performed for all the rats to observe their state of anxiety,which was used to evaluate the success of AD model.At the end of the last administration,the model of incisional pain was established.A 1-cm longitudinal incision was made through skin,fascia and muscle of the plantar aspect of the hindpaw in sevoflurane-anesthetized rats.At 2,6,24 and 48 h after operation,the mechanical and thermal paw withdrawal thresholds were measured.At 48 h after operation,the lumbar segment of the spinal cord was removed for determination of the expression of KCC2 by using immunofluorescence and Western blot.Results Compared with group C,the number of open arm entries was significantly reduced,the time spent on the open arms was shortened,the number of closed arm entries was increased,the time spent on the closed arms was prolonged,the mechanical and thermal paw withdrawal thresholds were decreased,and the expression of KCC2 was down-regulated in group AD.Conclusion Down-regulated expression of spinal neuronal KCC2 is involved in the mechanism of hyperalgesia in rats with AD.

Objective To investigate the sleep disorder in the stroke inpatients for rehabilitation and research the strategy to improve the sleep disorder.Methods The sleep statuses of 168 stroke inpatients were investigated and recorded.The sleep disorder was set into 4 forms,insomnia,sleep interrupted,over-sleep and sleep reversed.Those with sleep disorder were given certain intervention,including improving the environments,eliminating body discomfort and mental disorder,medicines,and reset the sleep cycle.Their sleep statuses were evaluated again 2 weeks later.Results The incidence of sleep disorder was 60.7%,among which 32.3% for insomnia,22.5% for sleep interrupted,25.5% for over-sleep and 16.7% sleep reversed.It was 32.1% after intervention(P<0.05).Conclusion It is frequent of sleep disorder in stroke patients for rehabilitation.Comprehensive intervention can improve the sleep of them.

Objective: Objective To explore the role of the Er: YAG laser in periodontal surgery. Methods : Twenty patients with chronic periodontitis in two quadrants were selected for this study. One quadrant was subjected to pure periodontal flap surgery, whereas the other was subjected to flap surgery with an adjunctive Er: YAG laser. The preoperative and 3- and 6-month postoperative clinical parameters, including the probing depth, clinical attachment level, gingival recession, plaque index, gingival index and tooth mobility, were recorded. Results: Significant differences were not observed between the open flap surgery + Er: YAG laser-assisted treatment group and the open flap surgery group except for the gingival index after 3 months (0.36 ± 0.26 vs. 0.58 ± 0.29, t=3.831, P < 0.001) and 6 months (0.60 ± 0.23 vs. 0.83 ± 0.22, t=4.013, P < 0.001). Conclusion Er:YAG as an auxiliary treatment for periodontal flaps, does not significantly reduce the depth of periodontal pockets, nor could it improve the clinical adhesion level and the gingival recession, but it can improve the recovery of gingival inflammation and accelerate the healing of tissue.

Objective To evaluate the effects of different ratios of medicine dosage for propofol and sevoflurane on postoperative cognitive function in elderly patients with mild cognitive impairment.Methods Ninety-six patients of both sexes,aged 65-75 yr,weighing 60-80 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective lower limb fracture operation under general anesthesia,with mild cognitive impairment before surgery,were assigned into 4 groups (n =24 each) using a random number table:propofol group (group P),sevoflurane group (group S) and different ratios of medicine dosage for propofol and sevoflurane groups (group PS1 and group PS2).Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were used to evaluate the cognitive function of patients at 1 day before operation (T0) and 7 days after operation (T1).Venous blood samples were collected at T0 and T1 for determination of the concentrations of plasma apolipoprotein J (ApoJ) and soluble CD14 (sCD14) by enzyme-linked immunosorbent assay.Results Compared with group S,MMSE and MoCA scores were significantly increased and plasma concentrations of ApoJ and sCD14 were decreased at T1,and the incidence of postoperative cognitive dysfunction was decreased in P,PS1 and PS2 groups (P＜0.05).Compared with group PS1,MMSE and MoCA scores were significantly decreased and the plasma concentrations of ApoJ and sCD14 were increased at T1,and the incidence of postoperative cognitive dysfunction was increased in P and PS2 groups (P＜0.05).MMSE and MoCA scores were significantly lower and plasma concentrations of ApoJ and sCD14 were higher at T1 than at T0 in S,P and PS2 groups (P＜0.05),and there was no significant difference in the parameters mentioned above between T1 and T0 in group PS1 (P＞0.05).Conclusion Combination of propofol 1.2 μg/ml given by target-controlled infusion and 0.7-1.2％ sevoflurane inhalation for maintenance of anesthesia does not aggravate the postoperative cognitive dysfunction in elderly patients with mild cognitive impairment.