Objective To investigate the effect of volume therapy with 6％ hydroxyethyl starch (HES) 130/0.4 on mesenteric microcirculation in a rabbit model of hypovolemia.Methods Sixty-four adult male rabbits,weighing 2.0-2.3 kg,were randomly divided into 4 groups( n =16 each):control group (group C),hypovolemia group (group HM),Ringer's solution group (group RS) and 6％ HES 130/0.4 group (group HES).The animals were anesthetized with sodiun pentobarbital 3.0-3.5 mg/kg.Femoral artery,femoral vein and right internal jugular vein were cannulated for MAP monitoring,blood withdrawing and fluid adminstration.Hypovolemia was induced by withdrawing blood from femoral vein of 30％ blood volume in 30 min in groups HM,RS and HES.In group C,no blood was withdrawed.In group RS,Ringer's solution 3 times of the volume of blood withdrawn was infused,while 6％ HES 130/0.4 equal volume of blood withdrawn was infused via right internal jugular vein immediately at the end of blood withdrawing.MAP and HR were recorded and femoral artery and femoral vein blood samples were taken before blood withdrawing (T0),immediately at the end of blood withdrawing(T1 ),immediately at the end of volume therapy(T2 ) and 30 min after volume therapy(T3 ).DO2,VO2 and ERO2 were calculated.Diameter and blood flow speed of microvessel were determined.Results Compared with group C,HR was significantly increased,MAP decreased,diameter and blood flow speed of microvessel were decreased at T1～3,DO2 was increased　at T1 in group HM.Compared with group HM,MAP was significantly increased at T2,HR decreased at T2,3,DO2and VO2 were increased at T1～3,diameter of arteriole was increased at T2 whlie decreased at T3,diameter of veinule　and blood flow speed of microvessel were increased at T2,3 in group RS,MAP was significantly increased at T2,HR　was decreased whlie DO2 and VO2 were decreased,VO2,ERO2,diameter and blood flow speed of microvessel were　increased at T2,3 in group HES.Compared with group RS,DO2,VO2 and ERO2 were significantly decreased at T3　in group HES.Conclusion Volume therapy with 6％ HES 130/0.4 can improve mesenteric microcirculation,organ perfusion and oxygen metabolic in a rabbit model of hypovolemia.

Objective To investigate the effect of asiatic acid(AA)on the apoptosis of HT-22 cells induced by sevoflurane(SEVO)by regulating phosphatidylinositol 3-kinase/protein kinase B(PI3K/AKT)signaling pathway.Methods Different concentrations of AA(0,5,10,15,20,30 μmol/L)were used to treat HT-22 cells induced by sevoflurane for 24 hours,and CCK-8 was used to detect HT-22 cell viability;HT-22 cells were divided into control group,sevoflurane(SEVO)group,AA low concentration(AA-L,10 μmol/L)group,AA medium concentration(AA-M,15 μmol/L)group,AA high concentration(AA-H,20 μmol/L)group,and AA high concentration+PI13K pathway inhibitor LY294002(AA-H+LY294002,20 μmol/L AA+5 μmol/L LY294002)group.Inverted microscopy was applied to observe changes of cell morphology,ELISA was applied to detect the levels of inflammatory factors TNF-α and IL-6,oxidative stress indicators SOD,GSH-Px,and MDA,ROS detection kit was applied to detect ROS levels,TUNEL kit was applied to detect HT-22 apoptosis,JC-1 method was applied to detect mitochondrial membrane potential,ATP content detection kit was applied to detect ATP content,and Western blot was applied to detect the expressions of Bcl-2,Bax,Caspase-3,p-PI3K,PI3K,p-AKT,and AKT proteins.Results Compared with 0 μmol/L,the activity of HT-22 cells treated with 5-30 μmol/L AA increased in a concentration-dependent manner(P<0.05),concentrations of 10 μmol/L,15 μmol/L,and 20 μmol/L of AA were selected for subsequent experiments.Compared with the SEVO group,the levels of TNF-α,IL-6,MDA,ROS,cell apoptosis rate,and expressions of Bax and Caspase-3 proteins in the AA-L,AA-M,and AA-H groups were reduced,the levels of SOD and GSH-Px,red/green JC-1 fluorescence ratio,content of ATP,the expression of Bcl-2 protein,the phosphorylation levels of PI3K and AKT were increased(P<0.05),and were concentration dependent.LY294002 was able to reverse the protective effect of AA on HT-22 cell damage induced by sevoflurane(P<0.05).Conclusion AA protects HT-22 cells from damage induced by sevoflurane by activating the PI3K/AKT signaling pathway,which provides a theoretical reference for the development of novel drugs to reduce sevofluran-induced neurotoxicity.

Objective To investigate the effects of perioperative goal-directed fluid therapy(GDFT)on hemodynamics,postoperative recovery,and complications in elderly patientswith gastric cancer radical surgery complicated by hypertension.Methods A total of 88 elderly patients with gastric cancer radical surgery complicated by hypertension were enrolled and randomly divided into treatment group and control group,with 44 patients in each group.The treatment group received GDFT during the perioperative period,while the control group received conventional fluid therapy.The mean arterial pressure,heart rate,and central venous oxygen saturation(ScvO2)at different time points,as well as postoperative exhaust time,postoperative hospital stay,and postoperative complica-tion rates were compared between the two groups.Results The time effects(F=60.488,49.789,39.423),intergroup effects(F=17.317,12.969,10.101),and interaction effects(F=26.415,22.546,17.294)of mean arterial pressure,heart rate,and ScvO2 in the two groups showed statistically significant difference(P＜0.05).After surgery,the mean arterial pressure,heart rate,and ScvO2 in the treatment group were higher than those before anesthesia and the control group(P＜0.05).The postoperative exhaust time and hospital stay in the treatment group were(2.25±0.61)and(10.29±1.96)days,respectively,which were shorter than(2.82±0.71)and(12.36±2.29)days in the control group(P＜0.05).The total incidence of postoperative complications in the treatment group was lower than that in the control group(11.36％versus 29.54％,P＜0.05).Conclusion Applying GDFT during the perioperative period for elderly patients with gastric cancer radical surgery complicated by hypertension can provide a more stable hemodynamic environment,improve tissue perfusion,accelerate postoperative recovery,and reduce postoperative complications.

Objective To investigate the effects of perioperative goal-directed fluid therapy(GDFT)on hemodynamics,postoperative recovery,and complications in elderly patientswith gastric cancer radical surgery complicated by hypertension.Methods A total of 88 elderly patients with gastric cancer radical surgery complicated by hypertension were enrolled and randomly divided into treatment group and control group,with 44 patients in each group.The treatment group received GDFT during the perioperative period,while the control group received conventional fluid therapy.The mean arterial pressure,heart rate,and central venous oxygen saturation(ScvO2)at different time points,as well as postoperative exhaust time,postoperative hospital stay,and postoperative complica-tion rates were compared between the two groups.Results The time effects(F=60.488,49.789,39.423),intergroup effects(F=17.317,12.969,10.101),and interaction effects(F=26.415,22.546,17.294)of mean arterial pressure,heart rate,and ScvO2 in the two groups showed statistically significant difference(P＜0.05).After surgery,the mean arterial pressure,heart rate,and ScvO2 in the treatment group were higher than those before anesthesia and the control group(P＜0.05).The postoperative exhaust time and hospital stay in the treatment group were(2.25±0.61)and(10.29±1.96)days,respectively,which were shorter than(2.82±0.71)and(12.36±2.29)days in the control group(P＜0.05).The total incidence of postoperative complications in the treatment group was lower than that in the control group(11.36％versus 29.54％,P＜0.05).Conclusion Applying GDFT during the perioperative period for elderly patients with gastric cancer radical surgery complicated by hypertension can provide a more stable hemodynamic environment,improve tissue perfusion,accelerate postoperative recovery,and reduce postoperative complications.