Objective To evaluate the efficacy of hydromorphone for patient-controlled intravenous analgesia (PCIA) after hip replacement in elderly patients.Methods Seventy patients, aged 65-75 yr, weighing 40-70 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , undergoing elective unilateral hip replacement, were randomly divided into either analgesia with hydromorphone group (group H, n =35) or analgesia with fentanyl group (group F, n=35).After a loading dose of 20 μg/kg of hydromorphone was injected at the beginning of skin closure, a PCA pump was connected, and the PCIA solution contained hydromorphone 0.25 mg/kg and tropisetron 10 mg in 120 ml of normal saline in group H.After a loading dose of 1 μg/kg of hydromorphone was injected at the beginning of skin closure, a PCA pump was connected, and the PCIA solution contained fentanyl 25 μg/kg and tropisetron 10 mg in 120 ml of normal saline in group F.The PCA pump was set up with a 0.5 ml bolus dose, a 15 min lockout interval and the background infusion at a rate of 2 ml/h in both groups.Tramadol 0.5 mg/kg was injects intravenously as rescue analgesic, and visual analogue scale score was maintained ≤ 3.The Ramsay sedation score,the number of attempts and the number of tramadol administration were recorded at 24 and 48 h after operation.The adverse effects within 48 h after operation and patient's satisfaction with analgesia were recorded.Results There was no significant difference in the Ramsay sedation score, the number of attempts and the number of Tramadol administration between H and F groups.Compared with group F, the incidence of adverse effects such as postoperative nausea, vomiting, respiratory depression, drowsiness, urinary retention, was significantly decreased, and the level of satisfaction with analgesia was increased in group H.Conclusion Hydromorphone provides accurate efficacy for PCIA after hip replacement in elderly patients, with fewer adverse effects and higher level of patient' s satisfaction.

ObjectiveTo investigate the effect of cardiopulmonary bypass (CPB) on the secretory function of islet cells in rabbits.MethodsTwenty adult New Zealand white rabbits of both sexes,weighing 2.5-3.0kg,were randomly divided into 2 groups ( n =10 each):sham operation group (group S) and CPB group.The rabbits were anesthetized with 3％ pentobarbital sodium 30 mg/kg.Blood samples were collected from the left femoral artery at 5 min after anesthesia (T1),immediately before CPB (T2 ),immediately after aortic clamping (T3 ),and at 5,35 and 75 min after aortic unclamping (T4-6) in the two groups for determination of levels of blood glucose,insulin and glucagons.Insulin resistance index was calculated.ResultsCompared with group S,the blood glucose concentration and levels of insulin and glucagons and insulin resistance index at T3-6 were significantly increased in group CPB ( P ＜ 0.05).ConclusionAlthough increase in blood glucose enhances the secretion of insulin in islet β cells,hyperglycemia cannot be compensated completely by the increased insulin during CPB in rabbits.The increase in blood glucose may be related to islet α cell resistance.

ObjectiveTo investigate the effects of propofol on calcium/calmodulin-dependent protein kinase Ⅱ α ( CaMK Ⅱ α) activity in hippocampus in mentally depressed rats after electroconvulsive therapy (ECT).MethodsHealthy adult male SD rats aged 2-3 months weighing 180-220 g were used in this study.Mentally depressed model was induced by chronic unpredictable mild stress.Forty mentally depressed rats were randomly divided into 4 groups (n =10 each): mental depression group (group D),propofol group (group P),ECT group (group E),propofol + ECT group (group DPE).Groups D and P received intraperitoneal normal saline 8 ml/kg or propofol 80 mg/kg once a day for 7 consecutive days respectively.Group E received ECT once a day for 7 consecutive days.Group DPE received propofol 80 mg/kg + ECT once a day for 7 consecutive days.Sucrose preference test was performed at 1 d before and 1 d after treatment,and Morris water maze test was performed at 1 d before and 3 d after treatment.The rats were sacrificed after Morris water maze test,and hippocampi were removed for determination of CaMK Ⅱ α and phosphorylated CaMK Ⅱ α(pCaMK Ⅱ α )expression,and pCaMK Ⅱ α/CaMK Ⅱ α ratio was caculated.ResultsCompared with group D,the sucrose preference percentage was significantly increased in groups E and DPE,the escape latency prolonged and space exploration time shortened,and the expression of CaMK Ⅱ α and pCaMK Ⅱ α down-regulated,pCaMK Ⅱ α/CaMK Ⅱ α ratio decreased in group E,the escape latency was significantly shortened and space exploration time prolonged,and the expression of pCaMK Ⅱ α up-regulated in group DPE ( P ＜ 0.05).Compared with group E,the escape latency was significantly shortened,space exploration time prolonged,and the expression of CaMK Ⅱ α and pCaMK Ⅱ α up-regulated,and pCaMK Ⅱ α/CaMK Ⅱ α ratio increased in group DPE ( P ＜ 0.05).ConclusionPropofol can reduce the cognition impairment induced by ECT in mentally depressed rats through enhancing CaMK Ⅱ α activity in hippocampus.

Objective: To evaluate the effect of exogenous insulin on endoplasmic reticulum stress in myocardial tissues during insulin resistance in the rabbits undergoing cardiopulmonary bypass (CPB). Methods: Forty healthy adult New Zealand white rabbits of both sexes, weighing 2.5-3.0 kg, were divided into 4 groups (n=10 each) using a random number table method: control group (group C), CPB group, CPB plus insulin group (group I) and CPB plus normal saline group (group NS). Group C received no treatment.An insulin resistance model was established in group CPB.Insulin was continuously infused (the infusion rate was adjusted according to the blood glucose) starting from establishing CPB to 1 day after operation in group I. The equal volume of normal saline was given starting from establishing CPB to 1 day after operation in group NS.Blood samples were collected from the left femoral artery, and myocardial tissues obtained before CPB (T₁) and at 15, 30 and 60 min after aortic opening (T_2-4). The level of blood glucose was determined using oxidase method, the level of glucagon was detected by the radioimmunoassay method, and the insulin resistance index was calculated.The expression of inositol-requiring protein-1α(IRE1α), XBP1 and caspase-12 was measured by Western blot.The expression of IRE1α, XBP1 and caspase-12 mRNA was measured by fluorescent quantitative real-time polymerase chain reaction.Cell apoptosis was detected by TUNEL. Results: Compared with group C, blood glucose and glucagon levels at T_2-4 and insulin resistance index at T₄ were significantly increased, and the expression of inositol-requiring protein-1α(IRE1α), XBP1 and caspase-12 protein and mRNA was up-regulated at T₄ in CPB, I and NS groups (P<0.05). Compared with group CPB, blood glucose and glucagon levels at T_2-4 and insulin resistance index at T₄ were significantly decreased, and the expression of IRE1α, XBP1 and caspase-12 protein and mRNA was down-regulated at T₄ in group I (P<0.05). Conclusion Exogenous insulin significantly improves insulin resistance in myocardial tissues, and the mechanism is related to inhibiting endoplasmic reticulum stress and reducing cell apoptosis in the rabbits undergoing CPB.

Objective To evaluate the effect of exogenous insulin on inositol-requiring protein 1α (IRE1α)-X-box-binding protein 1 (XBP1) signaling pathways in pancreatic tissues during cardiopulmonary bypass (CPB)-caused insulin resistance in rabbits.Methods Forty healthy adult New Zealand white rabbits of both sexes,weighing 2.5-3.0 kg,were divided into 4 groups (n =10 each) using a random number table method:control group (group C),group CPB,insulin group (group I),and normal saline control group (group NS).CPB was established in group CPB.Insulin was intravenously infused in a dose of 1.2 ml/h from establishing CPB to 1 day after operation,and the infusion rate of insulin was regulated according to the blood glucose (maintaining at 7.2-8.3 mmol/L) in group I.CPB was established,and normal saline was intravenously infused from the beginning of operation to 1 day after operation in group NS.Before CPB (T1) and at 15,30 and 60 min after aortic opening (T2-4),blood samples were collected from the left femoral artery,the plasma was separated,the blood glucose level was detected by oxidase method,the level of glucagon was detected by the radioimmunoassay method,and the insulin resistance index was calculated.Animals were sacrificed at T4,and pancreatic tissues were obtained for determination of the expression of IRE1α,XBP1,c-Jun N-terminal kinase (JNK) and caspase-12 protein and mRNA (by Western blot or fluorescent quantitative real-time polymerase chain reaction) and for examination of the pathological changes (by haematoxylin and eosin staining).Results Compared with group C,blood glucose and glucagon concentrations and insulin resistance index were significantly increased at T2-4,and the expression of IRE1α,XBP1,JNK and caspase-12 was up-regulated at T4 in CPB,I and NS groups (P＜0.05).Compared with group CPB or group NS,blood glucose and glucagon concentrations and insulin resistance index were significantly decreased at T2-4,the expression of IRE1α,XBP1,JNK and caspase-12 was down-regulated at T4 (P＜0.05),and the pathological changes of pancreatic tissues were significantly attenuated in group I.There was no significant difference in the parameters mentioned above between group CPB and group NS (P＞0.05).Conclusion The mechanism by which exogenous insulin reduces CPB-caused insulin resistance may be related to inhibiting IRE1α-XBP1 signaling pathways in pancreatic tissues of rabbits.

Objective:To understand the current situation of spiritual nursing needs in elderly patients with primary glaucoma and its influencing factors, and to analyze its relationship with self-perceived burden and perceived social support, so as to provide a theoretical basis for reducing their spiritual distress and pain and meeting their spiritual nursing needs.Methods:A total of 218 elderly patients with primary glaucoma who were hospitalized in the department of ophthalmology of the First Hospital of Jilin University from March to September, 2022 were selected by convenience sampling. They were investigated by using general information questionnaire, the Nurse Spiritual Therapeutics Scale, the Self-Perceived Burden Scale, and the Perceived Social Support Scale. And multiple linear regression was used to analyze the influencing factors of spiritual nursing needs among elderly patients with primary glaucoma.Results:The total score of spiritual nursing needs of elderly patients with primary glaucoma was (30.73 ± 4.85). The highest dimension of item average score was "building a good atmosphere" (3.02 ± 0.59), and the lowest dimension was "helping religious practice" (1.95 ± 0.63). The total scores of spiritual nursing needs and self-perceived burden were negatively correlated ( r=-0.423, P<0.01), and positively correlated with the total scores of perceived social support ( r=0.515, P<0.01). Multivariate linear regression analysis showed that age, religious belief, educational level, treatment duration, residence, self-perceived burden, and perceived social support were the main influencing factors of spiritual care needs of elderly patients with primary glaucoma, ( t values were -5.23-7.04, all P<0.01), which could explain 44.5% of the total variation. Conclusions:The spiritual nursing needs of elderly patients with primary glaucoma were at a medium level. Therefore, it is recommended that nurses should carry out targeted spiritual nursing for them according to the differences and characteristics of different patients, to reduce their self-perceived burden, and to improve perceived social support level, in order to meet their spiritual nursing needs.

Objective:To assess the risk of venous thromboembolism (VTE) and anticoagulation-related bleeding of acute critical emergency patients staying in the emergency department at least 72 h, so as to improve the ability of emergency physicians to identify risk factors of VTE and their awareness of safety prevention in these patients.Methods:Multicenter emergency internal medicine patients meeting the inclusion criteria at the same time were collected. Padua and Caprini scores were used to evaluate the risk of VTE and the HAS-BLED score was used to assess the risk of anticoagulation-related bleeding.Results:A total of 930 emergency patients from 7 medical centers were enrolled in our study from January 15, 2021 to March 15, 2021. The proportion of high-risk population with VTE was 50.22% with Padua score and 78.49% with Caprini score, respectively. The proportion of high-risk bleeding (HAS-BLED score) was 40.43%.Conclusions:More than half of the acute critical ill patients who stay in emergency department for more than 72 h are at high risk of VTE. This group of patients have a relatively low risk of anticoagulation-related bleeding.

BACKGROUND:Conductive biomaterials are considered potential candidates for transmitting electrical signals for myocardial repair.Combining cell-based or cell-free strategies with conductive biomaterials to replenish cardiomyocytes and/or restore electrical signaling pathways is a promising approach for cardiac repair. OBJECTIVE:To evaluate the effect of polypyrrole-chitosan conductive composite hydrogel on cardiac function in rats with myocardial ischemia-reperfusion injury. METHODS:The polypyrrole-chitosan conductive composite hydrogel was prepared by chemical oxidative polymerization.The micromorphology,biocompatibility and conductivity of the hydrogels were characterized.Thirty adult SD rats were selected to establish a myocardial ischemia-reperfusion injury model by clamping the left anterior descending branch of the heart and then releasing it.After 21 days of modeling,the rats were divided into three groups by the random number table method:Normal saline was injected into the left ventricular infarction area and infarction margin area in the blank group.Chitosan hydrogel was injected into the left ventricular infarction area and infarction margin area in the ordinary hydrogel group.The polypyrrole-chitosan conductive composite hydrogel was injected into the left ventricular infarction area and infarction margin area,with 10 rats in each group.The corresponding time points after modeling were set,and cardiac mechanical function(echocardiogram,pressure-volume analysis),cardiac electrophysiology(electrocardiogram,programmed electrical stimulation,optical mapping technology,microelectrode array technology,eight-lead electrocardiogram,and electrical resistivity of the scar area)and cardiac histology were detected. RESULTS AND CONCLUSION:(1)There were a lot of pores on the surface of the conductive composite hydrogel,and the conductivity was(3.19±0.03)×10-3 mS/cm,which had good biocompatibility co-cultured with smooth muscle cells.(2)After 105 days of modeling,echocardiogram and pressure-volume analysis showed that compared with the blank group and the ordinary hydrogel group,the conductive composite hydrogel could significantly improve the contractile function of the heart of rats with myocardial ischemia-reperfusion injury.The results of electrocardiogram,programmed electrical stimulation,optical mapping technology,microelectrode array technology,eight-lead electrocardiogram,and electrical resistivity of the scar area examination at 105 days after modeling displayed that,compared with the blank group and the ordinary hydrogel group,the conductive composite hydrogel could significantly improve the electrical conduction function of the heart of rats with myocardial ischemia-reperfusion injury and reduce the occurrence of arrhythmia.Masson staining of heart tissue at 105 days after modeling exhibited that there were different degrees of fibrosis in the myocardial infarction area of the three groups.Compared with the normal saline group and the ordinary hydrogel group,the conductive hydrogel group had more normal myocardial tissue and less fibrosis in the myocardial infarction area.(3)The results verify that polypyrrole-chitosan conductive composite hydrogel may promote the repair of infarcted heart after ischemia-reperfusion injury by increasing the electrical conduction velocity of infarct scar area tissue,increasing scar thickness,enhancing synchronous cardiac contraction,and reducing damaged tissue.

Objective: To investigate the function of primary cilium as an oxygen sensor in PC12 cells. Methods: The PC12 cells were transfected with IFT88 siRNA. The nuclear translocation of hypoxia inducible factor-1α (HIF-1α), nuclear factor erythroid-2 related factor 2 (Nrf2), and ciliogenesis were observed by immunofluorescence staining; and the mRNA expressions of HIF-1α, Nrf2, vascular endothelial growth factor (VEGF) and superoxide dismutase (SOD) were detected by real-time RT-PCR. Results: The ciliogenesis was inhibited in PC12 cells transfected with IFT88 siRNA. In hypoxia group and scramble control group, nuclear translocations of HIF-1α and Nrf2 were observed and mRNA expressions of HIF-1α, Nrf2, VEGF were increased, and those of SOD were decreased. While in PC12 cells transfected with IFT88 siRNA, nuclear translocations of HIF-1α and Nrf2 were not observed, and mRNA expressions of HIF-1α, Nrf2, VEGF were inhibited, and mRNA expression of SOD was increased. Conclusion: Primary cilia may act as an oxygen sensor to transfer the information related to hypoxia and oxidative stress into cells, activating intracellular defense mechanism against the hypoxic injuries.
Animals ; Cilia ; metabolism ; Gene Expression Regulation ; drug effects ; Oxygen ; metabolism ; PC12 Cells ; Rats