Objective To evaluate the effect of dexmedetomidine sedation on acute lung injury induced by trauma and endotoxemia two-hit in rats.Methods Twenty-four adult male Sprague-Dawley rats,aged 6-8 weeks,weighing 150-200 g,were randomized into 3 groups (n =8 each) using a random number table:control group (group C),two-hit group (group T) and dexmedetomidine group (group D).Bilateral middle femoral shaft fractures were produced using hemostatic forceps.In group D,dexmedetomidine 2.5 tμg· kg-1· h-1 was infused via the caudal vein immediately after fractures,while the equal volume of normal saline was infused for 8 h in C and T groups.Lipopolysaccharide 2.5 mg/kg was injected via the caudal vein at 4 h after fractures in T and D groups.All the animals were monitored for 24 h with a continuous glucose monitoring system.Blood glucose concentrations were recorded within 24 h after fractures,and mean amplitude of glucose excursions (MAGE) was calculated.The arterial blood samples were collected at 24 h after fractures for blood gas analysis.The lungs were then harvested for determination of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) contents in lung tissues and for microscopic examination of pathological changes which were scored.Results Compared with group C,MAGE,PaCO2,TNF-α and IL-6 contents and pathological scores were significantly increased,and pH value and PaO2 were decreased in T and D groups.Compared with group T,MAGE,TNF-α and IL-6 contents and pathological scores were significantly decreased,and pH value and PaO2 were increased,and no significant change was found in PaCO2 in D group.Conclusion Dexmedetomidine sedation can mitigate acute lung injury induced by trauma and endotoxemia two-hit,and the mechanism is related to reduced stress and inflammatory responses in rats.

Objective To explore the effect of μ-opioid receptor agonist on acute lung injury in-duced by trauma-LPS two hits in rat model.Methods Thirty-two aduld SD rats,were randomized in four groups(n=8):normal control group(group N),blank control group(group B),DAMGO group (group D)and DAMGO+CTOP group(group DC).A rat model was made by intraperitoneal injection of LPS at 6 hours after fracturing bilateral thighbone.Group N didn’t receive trauma and LPS,only anesthesia.The rats in group D received 200 μg/kg of DAMGO,group DC received 600 μg/kg of CTOP and 200 μg/kg of DAMGO,group B obtained the same amount of saline.6 hours after treat-ment,the arterial blood was collected for blood gas analysis,the lungs was harvested to observe lung tissue pathology change and dry-weight/wet-weight ratio,and the levels of MDA,TNF-α,IL-6,SOD activities in lung tissue were determined.Results The results of pathological observation showed that there was obvious inflammatory reaction in lung tissues after two-hits.Compared with group D, PaO2 ,pH and dry-weight/wet-weight ratio were significantly lower in group B and group DC(P <0.05),The score of Smith were significantly increased(P <0.05).The levels of MDA,TNF-α,IL-6 in lung tissue were significantly reduced in group D than those in group B and group DC(P <0.05), SOD activities in group D were significantly higher than those in group B and group DC(P <0.05 ). Conclusion μ-Opioid receptor DAMGO agonist has protective effect on acute lung injury induced by trauma-LPS two hits in rat model.

0 05). CI, SvO 2 , DO 2 were decreased significantly in the early 5min of the anhepatic stage( P

Objective This study was to investigate the management of hemodynamics during operation in patients undergoing orthotopic liver transplantation. Method Hemodynamic parameters were monitored during operation. Norepinephrine, epinephrine or dopamine, as well as nitroglycerin or PGE 1 were used in 21 cases to maintain a stable hemodynamics. Results Our data demonstrated that rational use of norepinephrine and epinephrine was beneficial in maintaining vital organ perfusion and improving tissue oxygenation. Compared with PGE 1, nitroglycerin was shown to be more controllable in lowering pulmonary artery hypertension, and notably, it significantly increased renal blood flow. Conclusion The results of this sudy indicated that in addition to fluid resuscitation, different combinations of vasoactive agents were beneficial in maintaining hemodynamic stability

Objective To observe the effects of propofol on the cytokine release from human monocytic cell line (THP1) induced by lipopolysaccharide (LPS). Methods THP1 cells cultured in vitro, and they were divided into 3 groups: 0 ?g/ml LPS group, 1 ?g/ml LPS group and 1?g/ml LPS+50?mol/L propofol group, respectively, and incubated for 12 hours. Then the supernatant was collected from each culture for the determination of the levels of granulocyte/macrophage colony stimulating factor (GM-CSF), interferon-? (IFN-?), tumor necrosis factor-? (TNF-?) and interleukin (IL)-1?, IL-2, IL-4, IL-6, IL-8, IL-10, and IL-12 by using LiquiChip system. Propol was added to the culture fluid of THP1 cells in the final concentrations of 0, 12.5, 25, 50 and 100?mol/L (for the groups B, C, D, E and F, respectively), with 1?g/ml LPS. 12 hours later the supernatants were collected to detect the levels of IL-6, IL-8, TNF-?. Culture fluid without LPS and propofol (group A) was used as control. Results The levels of IL-1?, IL-6, IL-8 and TNF-? were elevated obviously in group L than that in control group (P0.05). In group L+P, levels of IL-6, IL-8 and TNF-? were significantly lower than that in group L (P

Objective To investigate the changes in gastrointestinal circulation during the operation of orthotopic liver transplantation. Methods In 15 patients undergoing orthotopic liver transplantation, PgCO2 and PaCO2 were determined and the values of Pg-aCO_2 and pHi were calculated at the time points as follows: pre-operation (T0), 30min before anhepatic phase (T1), 30min of anhepatic phase (T2), and 5min (T3), 30min (T4) and 90min (T5) after reperfusion of the transplanted liver, and at the end of the operation(T6). Results Compared with that of pre-operation, PgCO2 and Pg-aCO2 increased significantly at the following time points: 30min before anhepatic phase, 30min of anhepatic phase, as well as 5min and 30min after reperfusion of the transplanted liver (P0.05). The values of pHi decreased significantly at 30min before anhepatic phase, 30min of anhepatic phase, and 5min and 30min in neohepatic phase (P

Objective To determine the effect of ulinastatin on improving gastric mucosal perfusion during orthotopic liver transplantation. Methods Thirty patients undergoing orthotopic liver transplantation were randomly divided into control group (group C,n=15) and ulinastatin group (group U,n=15). In ulinastatin group,patients were intravenously administrated 4000U/kg ulinastatin immediately after entering the operating room and then the administration was continued with an injection pump with a dose of ulinastatin of 2000U/(kg?h) till the end of operation. Normal saline in the same volume and infusion rate was given to patients in control group. Blood pressure (BP),heart rate (HR),cardiac output (CO) and introgastric pH value (i-pH) plus Pg-aCO2 were measured before the operation (T0),20min of preanhepatic phase (T1),5 min of anhepatic phase (T2),30min of anhepatic phase (T3),5min of new hepatic phase (T4),30min of new hepatic phase (T5) and the end of operation (T6),respectively. Results Compared with the measurement at the time point of T0,mean artery pressure (MAP),central venous pressure (CVP) and CO were significantly decreased and complicated with a marked increase of HR at the time point of T2 in all patients of two groups (P

BACKGROUND:Previous literature reported that the fusion cage moved more than 2 mm from its original position,which means that the fusion cage moved backward.At present,clinical observation has found that the factors leading to the displacement of the fusion cage are complex,and the relationship between these factors and the cage retropulsion is not clear. OBJECTIVE:To explore the risk factors related to cage retropulsion after lumbar interbody fusion. METHODS:Retrospective analysis was conducted in 200 patients who underwent transforaminal lumbar interbody fusion surgery with a polyetheretherketone interbody fusion from February 2020 to February 2022.According to the distance from the posterior edge of the vertebral fusion cage to the posterior edge of the vertebral body after the operation(the second day after the removal of the drainage tube)and 1,3,6 and 12 months after the operation,patients were divided into cage retropulsion group(≥2 mm)and cage non-retropulsion group(<2 mm).The factors that may affect cage retropulsion,such as age,gender,body mass index,bone mineral density,operation time,bleeding,endplate injury,preoperative and postoperative interbody height,cage implantation depth,cage size,and segmental anterior convexity angle,were analyzed by univariate and logistic regression analysis. RESULTS AND CONCLUSION:(1)Posterior displacement of the fusion cage occurred in 15 cases(15/200).The differences in basic information such as age and body mass index between the two groups were not statistically significant.(2)The results of the univariate analysis were that gap height difference,time to wear a brace,segmental anterior convexity angle difference,bone mineral density,and age were related to posterior migration of the cage.(3)The results of logistic regression analysis were that cage size,endplate injury condition,and depth of cage implantation were risk factors for cage retropulsion.(4)These findings suggest that cage retropulsion after lumbar interbody fusion is caused by multiple factors,including segmental anterior convexity angle difference,bone mineral density,cage size,endplate damage,time to wear a brace,and depth of cage implantation.