AIM: To investigate the protective effect of ginsenoside Rb1 on brain through Cav-1 in mice with cerebral ischemia-reperfusion injury. METHODS: One hundred and twenty C57/B6 mice were randomly divided into sham operation group, model group, model + ginsenoside Rb1 group, ginsenoside Rb1+ Cav-1 siRNA group, ginsenoside Rb1+siNC group, 24 in each group. The model of cerebral ischemia-reperfusion injury in mice was established by middle cerebral artery occlusion (MCAO). The ginsenoside Rb1 group received intraperitoneally injection of ginsenoside Rb1 (40 mg/kg); the sham operation group and model group were intraperitoneally injected with an equal amount of physiological saline immediately after modeling. For the ginsenoside Rb1+ cav-1 siRNA group and the ginsenoside Rb1+siNC group, cav-1 siRNA and siNC were injected into the lateral ventricle 24 h before molding, respectively, and the other operations were the same as the ginsenoside Rb1 group. The neurobehavioral scores of the mice in each group were measured at 24 h after reperfusion, and the water content of brain tissue, cerebral infarction volume, Cav-1 mRNA and Cav-1, Bcl-2 and Bax protein expressions in the cerebral cortex penumbra were measured in each group. RESULTS:Compared with the sham operation group, the neurobehavioral scores, cerebral infarction volume and brain tissue water content in the model group were significantly increased (P<0.05), and the expressions of Cav-1 mRNA and Cav-1 protein, and the Bcl-2 /Bax ratio were significantly decreased (P<0.05). Compared with the model group, the neurobehavioral scores, cerebral infarction volume and brain tissue water content in the ginsenoside Rb1 group were significantly decreased, and the expressions of Cav-1 mRNA and Cav-1 protein, and the Bcl-2 /Bax ratio were significantly increased (P<0.05). Compared with the ginsenoside Rb1 group, the neurobehavioral scores, cerebral infarction volume and brain tissue water content in the ginsenoside Rb1 + cav-1 siRNA group were significantly increased, and the expressions of Cav-1 mRNA and Cav-1 protein, and the Bcl-2 /Bax ratio were significantly decreased (P<0.05). CONCLUSION: Ginsenoside Rb1 can protects brain for mice with cerebral ischemia-reperfusion injury. After Cav-1 siRNA decreased the expression of Cav-1 protein in the brain tissue of mice, it significantly reverses the cerebral protective effect of ginsenoside Rb1, indicating that Cav-1 protein mediated the cerebral protective effect of ginsenoside Rb1 on cerebral ischemia reperfusion injury mice.

Objective To investigate the effect and safety of dexmedetomidine combined with dorsal penile nerve block for circumcision in children .Methods 130 children with circumcision were divided into the observation group and the control group according to the digital table ,65 cases in each group .The control group received total inhalation of seven halothane anesthesia ,and the observation group received dexmedetomidine combined with dorsal penile nerve block anesthesia .The efficacy and safety of the two groups were compared .Results In the observation group after induction,the mean arterial pressure[(69.89 ±5.24)mmHg],awake and mean arterial pressure[(70.14 ± 5.30)mmHg],rhythm of the heart after induction [(100.36 ±10.67)times/min],the rhythm of the heart when they woke up[(102.64 ±10.58) times/min],blood oxygen saturation after induction [(98.25 ±0.63)％],awake and blood oxygen saturation[(98.64 ±0.66)％]and other signs of vital signs had no statistically significant differences compared with the control group (F=0.130,0.215,0.548,0.613,0.106,0.257,all P>0.05).In the observation group,the eyelash reflex disappearing time , operation time, awakening time were ( 23.16 ±2.13 ) s, ( 9.70 ± 1.24)min,(10.03 ±1.27)min,respectively,which in the control group were(27.98 ±3.87)s,(11.88 ±2.87)min, (11.89 ±3.87) min,respectively,there were statistically significant differences between the two groups ( t=8.797, 5.621,6.633,all P<0.05).In the observation group,the postoperative agitation score ,sedation score,pain score were(2.75 ±1.25)points,(1.11 ±0.13)points,(5.26 ±1.44)points,respectively,which in the control group were (6.78 ±2.89) points,(1.11 ±0.13) points,(8.97 ±3.64) points,respectively,there were statistically significant differences between the two groups (t =10.318,17.236,10.318,all P <0.05).Conclusion Application of dexmedetomidine combined with penile dorsal nerve block anesthesia in pediatric circumcision takes effect quickly , children with stable vital signs ,less postoperative agitation ,it is worthy of popularization and application in clinic .

Objective:To investigate the effects of paravertebral muscle block assisted general anesthesia on postoperative cognitive function in older adult patients undergoing lumbar spine fracture surgery.Methods:The clinical data of 68 older adult patients with lumbar spine fractures who underwent surgical treatment at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2018 to December 2022 were retrospectively analyzed. The patients were divided into a control group ( n = 34 cases) and an observation group ( n = 34 cases) depending on anesthesia methods used. The control group received general anesthesia, while the observation group received paravertebral muscle block assisted general anesthesia. Intraoperative anesthesia-related adverse reactions, postoperative pain relief, and the incidence of postoperative cognitive dysfunction were compared between the two groups. Results:The incidence of anesthesia-related adverse reactions in the observation group was 6% (2/34), which was significantly lower than that in the control group [26% (9/34), χ2 = 5.31, P = 0.022]. Compared with before anesthesia, the Numerical Rating Scale scores of both groups decreased after surgery. At 24, 48, and 72 hours after surgery, the Numerical Rating Scale scores of the observation group were (2.63 ± 0.42) points, (3.14 ± 0.55) points, and (4.35 ± 0.76) points, respectively, which were significantly lower than those of the control group [(3.52 ± 0.63) points, (4.58 ± 0.71) points, (5.83 ± 0.92) points, t = 6.85, 9.35, 7.23, all P < 0.001]. At 24, 48, and 72 hours after surgery, the frequency of rescue analgesia in the observation group was (3.42 ± 0.38), (5.40 ± 0.72), and (6.93 ± 1.07), respectively, which were significantly lower than those in the control group [(6.97 ± 0.87), (8.26 ± 1.27), and (10.38 ± 1.36), t = 21.80, 8.78, 9.02, all P < 0.001]. Compared with before anesthesia, the Mini-Mental State Examination scores in each group decreased significantly after surgery. At 24, 48, and 72 hours after surgery, the Mini-Mental State Examination scores in the observation group were (25.27 ± 1.11) points, (25.06 ± 1.01) points, and (27.50 ± 1.23) points, respectively, which were significantly higher than those in the control group [(19.40 ± 0.84) points, (23.17 ± 0.96) points, (24.60 ± 1.12) points, t = 24.59, 7.91, 10.17, all P < 0.001]. Conclusion:For older adult patients with lumbar spine fractures, the use of paravertebral muscle block assisted general anesthesia can reduce the incidence of adverse reactions associated with anesthesia during surgery, improve postoperative analgesic effect, reduce the incidence of postoperative cognitive dysfunction, and is highly safe.