Objective To evaluate the effects of limb ischemic preconditioning (LIP) on the intestinal injury during release of hepatic portal occlusion (RHPO) in rats.Methods Thirty-six male Sprague-Dawley rats,aged 6-7 weeks,weighing 200-250 g,were randomly divided into 3 groups using a random number table:sham operation group (group S,n =12),RHPO group (n =39) and LIP+ RHPO group (n =20).Hepatic ischemia/ reperfusion was produced by occluding portal vein and hepatic artery for 30 min followed by 6 h reperfusion according to Pringle's method.LIP was produced by tourniquet occlusion of the right femoral artery and vein for 10 min followed by 24 h reperfusion before hepatic ischemia.The animals were sacrificed at 6 h after hepatic portal occlusion was released and the mucous membrane of small intestine was obtained for microscopic examination and for determination of malondialdehyde (MDA) content,superoxide dismutase (SOD) activity,myeloperoxidase (MPO)activity,total antioxidant capacity (T-AOC) and intercellular adhesion molecule-1 (ICAM-1) mRNA and protein expression.The degree of damage to intestinal mucous membrane was scored according to Chiu.Results Compared with group S,Chiu's score and levels of MDA and MPO were significantly increased,SOD activity and TAOC were decreased,and ICAM-1 mRNA and protein expression was up-regulated in group RHPO (P ＜ 0.05 or 0.01).Compared with group RHPO,Chiu's score and levels of MDA and MPO were significantly decreased,SOD activity and T-AOC were increased,and ICAM-1 mRNA expression was down-regulated in group LIP + RHPO (P ＜ 0.05).Conclusion LIP can alleviate the intestinal injury during RHPO in rats by enhancing the antioxidant function and down-regulating the expression of ICAM-1.

Objective To investigate the changes in myocardial proteomics in the late phase of limb ischemic preconditioning (LIP) in rats.Methods Twelve pathogen-free adult male Sprague-Dawley rats,aged 8-9 weeks,weighing 260-280 g,were randomly assigned into LIP group (n=6) and control group (group C,n=6) using a random number table.Limb ischemia was preceded by 3 cycles of 5-min ischemia which was induced by ligation of the root of the right hindlimb with a rubber band followed by 5-min reperfusion in group LIP.At 24 h after LIP,the tissues were obtained from the left ventricle,and the isobaric tags for relative and absolute quantification technique and liquid chromatography-mass spectrometry were applied to detect the differences in protein expression profiles between the two groups (the difference in expression between the two groups＞ 1.2 times and P＜0.05).The identified differentially expressed proteins were analyzed using the bioinformatics,and some were further verified by Western blot.Results A total of 55 proteins were identified to be differentially expressed,and among the 55 proteins,the expression of 35 proteins was up-regulated,and the expression of 20 proteins was down-regulated.Bioinformatics analysis showed that most of the 55 proteins were organelles,cell membrane or macromolecular compounds,were involved in the process such as metabolism,biological regulation,stress response and signal transduction,and showed functions such as the binding affinity to molecules,catalytic activity,anti-oxidant activity,and modulation of the activity of enzyme.The results verified by Western blot were consistent with those shown by using the isobaric tags for relative and absolute quantification analysis.Conclusion The late phase of LIP can induce changes in the expression of the 55 proteins involving regulation of energy metabolism,anti-oxidant action,regulation of gene expression,and protein folding and degradation in the myocardium,which may be the mechanism of myocardial protection in rats.

Objective To evaluate the effects of limb ischemic preconditioning on intestinal injury and brain injury induced by hepatic ischemia?reperfusion(I∕R)in rats. Methods Healthy male Wistar rats, aged 6-8 weeks, weighing 200-250 g, were divided into 3 groups(n=16 each)using a random number table: sham operation group(Sham group), hepatic I∕R group(I∕R group)and limb ischemic preconditioning group(LIP group). In LIP group, the lower limb blood flow was blocked for 10 min with an elastic rubber tourniquet at the right groin followed by 30?min reperfusion through releasing the tourni?quet. Hepatic I∕R injury was induced by occlusion of the portal vein, hepatic artery and common bile duct for 30 min followed by reperfusion in I∕R and LIP groups. Eight rats in each group were selected at 6 h of reperfusion and samples from the cardiac apex were taken for determination of plasma concentrations of tumor necrosis factor?alpha(TNF?α)and interleukin?10(IL?10)by radioimmunoassay. Then the rats were sacrificed and the small intestine tissues and brain tissues were removed. Intestinal damage was as?sessed and scored according to Chiu. The activity of myeloperoxidase(MPO)in intestinal mucosa was de?tected by colorimetric method. The pathological changes of brain tissues were examined under a light micro?scope. The ultrastructure of brain tissues was observed under an electron microscope. Eight rats in each group were randomly selected at 6 h of reperfusion, and Evans blue(EB)2 mg∕kg was injected through the caudal vein over 1 min. Then the rats were sacrificed, brain tissues were removed for measurement of EB content, and the brain water content was calculated. Results Compared with Sham group, Chiu′s score and MPO activity in intestinal tissues were significantly increased, the brain water content and EB content were increased, and the concentrations of TNF?α and IL?10 in plasma were increased in I∕R group and LIP group(P <0.05). Compared with I∕R group, Chiu′s score and MPO activity in intestinal tissues were significantly decreased, the brain water content and EB content were decreased, and plasma IL?10 concentrations were increased(P <0.05), no significant change was found in plasma TNF?α concentra?tions(P>0.05), and the pathological changes of brain tissues were significantly attenuated in LIP group. Conclusion Limb ischemic preconditioning can attenuate intestinal injury and brain injury induced by he?patic I∕R, and the mechanism may be related to inhibiting systemic inflammatory responses of rats.

OBJECTIVETo observe the clinical effect of ear point embedding on plasma and effect site concentrations of propofol-remifentanil in elderly patients who underwent abdominal external hernia surgery at the time of consciousness and pain disappearing by target-controlled infusion (TCI) and bispectral index (BIS).

METHODSFifty patients who underwent elective abdominal hernia surgery were randomly assigned into an observation group and a control group, 25 cases in each one. In the observation group, 30 minutes before anesthesia induction, Fugugou (Extra), Gan (CO), Pizhixia (AT), and Shenmen (TF) were embedded by auricular needles until the end of surgery, 10 times of counter press each point. In the control group, the same amount of auricular tape was applied until the end of surgery at the same points without stimulation 30 minutes before anesthesia induction. Patients in the two groups were given total intravenous anesthesia, and BIS was monitored by BIS anesthesia depth monitor. Propofol was infused by TCI at a beginning concentration of 1.5μg/L and increased by 0.3μg/L every 30s until the patients lost their consciousness. After that, remifentanil was infused by TCI at a beginning concentration of 2.0μg/L and increased by 0.3μg/L every 30s until the patients had no body reaction to pain stimulation (orbital reflex). Indices were recorded, including mean arterial pressure (MAP), heart rate (HR) and the BIS values, at the time of T(entering into the operation room), T(losing consciousness) and T(pain relief), the plasma and effect site concentrations of propofol at T, the plasma and effect site concentrations of remifentanil at T. After surgery we recorded the total amounts of propofol and remifentanil, surgery time and anesthesia time.

RESULTSAt Tand T, MAP and HR of the observation group were higher than those of the control group (<0.05,<0.01). At T, the plasma and effect site concentrations of propofol in the observation group were significantly lower than those in the control group (<0.05,<0.01). At T, the plasma and effect site concentrations of remifentanil in the observation group were significantly lower than those in the control group (<0.05,<0.01). There was no significant difference in BIS values at Tand Tbetween the two groups (both>0.05). There was no significant difference in operation time and anesthesia time between the two groups (both>0.05). The total amount of remifentanil in the observation group was significantly lower than that in the control group (<0.01). There was no significant difference in the total amount of propofol between the two groups (>0.05).

CONCLUSIONSEar points embedding combined with propofol-remifentanil TCI could reduce the plasma and effect site concentrations of propofol and remifentanil and the total amount of remifentanil in elderly patients with extra-abdominal hernia surgery, and had the effect of assisting sedation and analgesia.