Objective To investigate the effects of sevoflurane and propofol on postoperative cognitive function after abdominal surgery for elderly patients with diabetes. Methods Seventy diabetic patients (aged 60~75 yr, ASAⅠorⅡ) underwent abdominal surgery and are included in the research. Diabetic patients were randomly divided into two groups (n=35): sevoflurane group(group DS) and propofol group (group DP). MMSE score, the attachment test, words memory test and Stroop color word test were carried and the results were recorded before operation (T1), postoperative 24 h (T2), 48 h (T3) and 1 w (T4). Results Compared with T1, patients′ MMSE score reduced at T2 and T3. Time spent in attachment test is longer at T2 and T3. Mistaken incidences in Stroop color words test 1, 2 and 3 are higher and time longer at T2. Time spent on Stroop color words test 2 and 3 is longer in T3. Words memory test reveals decline at T2 and T3, whose difference is statistically significant (P < 0.05). Cognitive dysfunction incidence in the two groups shows no statistical significance (P > 0.05). Conclusion Sevoflurane and propofol can result in postoperative cognitive dysfunction for elderly patients with diabetes within 48 h after abdominal surgery, there were no difference between the effects of them.

Objective To evaluate the effect of propofol on proliferation of human liver cancer cell line HepG2.Methods HepG2 cells were seeded in 96-well plates (100μl/hole) with a density of 1 × 105/ml and randomly divided into 5 groups (n =33 each)∶ control group (group C),group intralipid (group Ⅰ),and propofol 30,60 and 120μg/ml groups (groups P1-3).In groups P1-3,propofol 30,60 and 120 μg/ml were added to the culture medium and then the cells were cultured for 72 h.In group Ⅰ,10％ intralipid was added to the culture medium and then the cells were cultured for 72 h.The morphology of cells was observed with the light microscope after 24 h of incubation with propofol.The proliferation of the cells was determined at 0,24,48 and 72 h of incubation with propofol.The expression of Fas was determined at 48 h of incubation with propofol.Results The number of the cells was gradually smaller in groups P1-3.The proliferation of the cells was significantly higher in group Ⅰ,while lower in groups P1-3 than in group C (P ＜ 0.05).There was no significant difference in the expression of Fas between group Ⅰ and group C (P ＞ 0.05).The expression of Fas was significantly higher in groups P1-3 than in group C (P ＜ 0.05).The proliferation of the cells was significantly lower,and the expression of Fas was significantly higher in group P3 than in group P1 or group P2 (P ＜ 0.05).Conclusion Propofol can inhibit the proliferation of human liver cancer cell line HepG2 in a concentration-dependent manner and up-regulation of the expression of Fas is involved in the mechanism.

Objective To investigate the effect of propofol on the invasion of human liver cancer cell line HepG2.Methods HepG2 cell were seeded in 96-well plates (100μl/hole) with a density of 1 × 105/ml and randomly divided into 5 groups (n =9 each):control group (group C),intralipid group (group Ⅰ),and propofol 30,60 and 120 μg/ml groups (groups P1-3).Propofol 30,60 and 120 μg/ml were added to the culture medium in groups P1-3,respectively,and then the cells were cultured for 48 h.In group Ⅰ,10％ intralipid was added to the culture medium and then the cells were cultured for 48 h.The invasion of cells was measured by Transwell invasion assay at 48 h of incubation.The expression of matrix metalloproteinases-2 (MMP-2) and mRNA and matrix metalloproteinases-9 (MMP-9) and mRNA was determined at 48 h of incubation.Results Compared with group C,the invasion of HepG2 cells was significantly decreased and the expression of MMP-2,MMP-9 and MMP-2 mRNA and MMP-9 mRNA was down-regulated in groups P1-3 (P ＜ 0.05),and no significant change was found in the parameters mentioned above in group Ⅰ (P ＞ 0.05).The invasion of HepG2 cells was gradually decreased and the expression of MMP-2,MMP-9 and MMP-2 mRNA and MMP-9 mRNA was gradually down-regulated in groups P1-3 (P ＜0.05).Conclusion Propofol can inhibit the invasion of HepG2 cells in a concentration-dependent manner and down-regulation of the expression of MMP-2 and MMP-9 may be involved in the mechanism.

Objective To observe the effect of acute normovolemic hemodilution(ANH)combined with enhanced recovery after surgery(ERAS)on immune function in patients undergoing hepatic lobectomy. Methods 80 patients were divided into two groups:ERAS group(group E),ANH combined with ERAS group(group AE). bleeding volume,blood transfusion,infused fluid volume,urine output during operation and clinical index after surgery were recorded. Exhaust and defecation time ,fluid intake time and hospitalization duration were also record-ed. Blood samples were obtained from the patients at 30 min before anesthesia induction(T1),immediately(T2), 24 h(T3),3 d(T4)and 7 d(T5)after the end of operation for determination of the expression of CD3+,CD4+, CD8+ on T cells and natural killer cell. Results In group E ,CD3+,CD4+ T-lymphocytes and NK cells at T2-3 decreased as compared with T0. Compared with group E ,no allogeneic blood transfusion cases were found and clinical index duration was shorter in group AE. CD3+,CD4+T-lymphocytes and NK cells at T2-3 increased in group AE as compared with those in Group E. The difference is significant (P < 0.05). Conclusion ANH combined with ERAS can decrease allogenic blood transfusion and increase post-operation immunologic function ,shorten the postoperative hospitalization time.

Objective To investigate the effects of sevoflurane on HIF-1α/epithelial mesenchymal transition (EMT)pathway activity and invasion of lung cancer in rats undergoing one lung ventilation (OLV). Methods Lung cancer model of SD rats was established. Rats were randomly divided into 4 groups:group control(group C), group two lungs ventilation(TLV)(group T),group one lungs ventilation(group O),and group sevoflurane +one lungs ventilation(group SO). Two lung ventilation was performed after endotracheal intubation for 2.5 h in group T. OLV was performed after endotracheal intubation for 2 h in group O and SO. The end-expiratory concentration of sevoflurane of rats in group SO was maintained 2.6% during OLV period. Left lung cancer tissues were harvested at 0.5 h of TLV. The protein levels of HIF-1α,Vimentin and Fibronectin in lung cancer were determined by Western blot. The mRNA levels of MMP-2 and MMP-9 in lung cancer were evaluated by RT-PCR. Results The expres-sions of HIF-1α,Vimentin,Fibronectin,MMP-2,and MMP-9 in group O and group SO were significantly higher than those in group C and group T(P<0.05). The expressions of HIF-1α,Vimentin,Fibronectin,MMP-2,and MMP-9 were decreased significantly in group SO as compared with group O(P<0.05). Conclusion Sevoflurane inhibits the elevation of HIF-1α/EMT pathway activity and invasion ability induced by OLV.

Objective To evaluate the role of phosphatidylinositol 3?kinase(PI3K)∕serine?threo?nine kinase(Akt)signaling pathway in propofol?induced invasion of human liver cancer cell line HepG2. Methods HepG2 cells were cultured in RPMI 1640 medium supplemented with 10% fetal bovine serum in a 5% CO2incubator at 37℃. HepG2 cells at the logarithmic growth phase were divided into 6 groups(n=18 each)using a random number table: control group(group C), propofol group(group P), PI3K∕Akt signaling pathway agonist IGF?1 group(group IGF), PI3K∕Akt signaling pathway inhibitor LY294002 group(group LY), IGF?1 plus propofol group(group IGF+P)and LY294002 plus propofol group (group LY + P). Propofol 120 μg∕ml was added in group P. IGF?1 10 nmol∕L was added in group IGF. LY294002 10 μmol was added in group LY. In group IGF+P, 10 nmol∕L IGF?1 was added, cells were in?cubated for 24 h, and then 120 μg∕ml propofol was added. In group LY+P, 10 μmol LY294002 was add?ed, cells were incubated for 24 h, and then 120 μg∕ml propofol was added. The invasion of cells was measured by Transwell invasion assay at 24 h of incubation. The expression of PI3K and Akt mRNA in cells was determined by real?time polymerase chain reaction. The expression of Akt, PI3K and phosphorylated Akt(p?Akt)was detected by using Western blot. Results Compared with group C, the invasive cell count was significantly reduced, the expression of PI3K protein and mRNA was down?regulated, p?Akt∕Akt ratio was decreased, and the expression of Akt mRNA was down?regulated in P, P+IGF, LY and P+LY groups, and the invasive cell count was significantly increased, the expression of PI3K protein and mRNA was up?regulated, p?Akt∕Akt ratio was increased, and the expression of Akt mRNA was up?regulated in group IGF(P<0.05). Compared with group P, the invasive cell count was significantly increased, the expression of PI3K protein and mRNA was up?regulated, p?Akt∕Akt ratio was increased, and the expres?sion of Akt mRNA was up?regulated in group P+IGF, and the invasive cell count was significantly reduced, the expression of PI3K protein and mRNA was down?regulated, p?Akt∕Akt ratio was decreased, and the ex?pression of Akt mRNA was down?regulated in group P+LY(P<0.05). The invasive cell count was signifi?cantly reduced, the expression of PI3K protein and mRNA was down?regulated, p?Akt∕Akt ratio was de?creased, and the expression of Akt mRNA was down?regulated in group P+IGF as compared with group IGF (P<0.05)and in group P+LY as compared with group LY(P<0.05). Conclusion The mechanism by which propofol inhibits invasion of HepG2 cells is related to inhibiting activation of PI3K∕Akt signaling path?ways.

Objective To evaluate the efficacy of ultrasound-guided anterior quadratus lumborum block combined with general anesthesia for laparoscopic radical resection of rectal carcinoma. Methods A total of 80 patients of both sexes, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged 40-64 yr, scheduled for elective laparoscopic radical resection of rectal carcinoma, were divided into 2 groups ( n=40 each) using a random number table method: anterior quadratus lumborum block combined with general anesthesia group ( group QG) and general anesthesia group ( group G) . In group QG, anteri-or quadratus lumborum block was performed with 0. 33％ ropivacaine 25 ml and dexamethasone 5 mg under ultrasound guidance before operation, and the same procedure was performed on the other side. Combined intravenous-inhalational anesthesia was applied, propofol 3-5μg∕ml and remifentanil 3-5 ng∕ml were given by target-controlled infusion, and cisatracurium was intermittently injected in two groups. Patient-controlled intravenous analgesia with sufentanil 2μg∕kg was used for postoperative analgesia. The analgesic pump was set up to deliver a 2 ml bolus dose with a 15-min lockout interval. Bruggrmann comfort scale ( BCS) scores were recorded at 1, 6, 12, 24 and 48 h after operation ( T1-5 ) . Tramadol was used for rescue analgesic after operation. The consumption of remifentanil and sufentanil, requirement for tramadol, occurrence of adverse reactions and patients' satisfaction with postoperative analgesia were recorded. The emergence time, first ambulation time, time to first flatus∕poo and length of hospital stay were also recorded. The develop-ment of anterior quadratus lumborum block-related complications was recorded. Results Compared with group G, BCS scores were significantly increased at T4,5 , the consumption of remifentanil, requirement for tramadol and incidence of nausea and vomiting were decreased, patients' satisfaction with postoperative an-algesia was increased, and the emergence time, first ambulation time, time to first flatus∕poo and length of hospital stay were shortened in group QG (P<0. 05). Conclusion Ultrasound-guided anterior quadratus lumborum block combined with general anesthesia can reduce the consumption of opioids in the perioperative period and is helpful in improving outcomes when used for laparoscopic radical resection of rectal carcinoma.

Objective:To investigate the effect of microRNA-27b-3p (miR-27b-3p)/nuclear factor-E2-related factor 2 (Nrf2) on metabolic memory impairment of human retinal pigment epithelial (RPE) cells and to explore its regulatory mechanism.Methods:ARPE-19 cells were divided into normal control group, metabolic memory group, miR-27b-3p control group, miR-27b-3p inhibitor group, and liraglutide group.Cells in normal control group were cultured in 5.5 mmol/L normal glucose medium for 6 days.Cells in metabolic memory group were cultured in 30 mmol/L glucose for 3 days and changed to 5.5 mmol/L for 3 days.Cells in miR-27b-3p inhibitor group were added with puromycin after lentiviral transfection to select the successfully transfected cells, and were cultured in 30 mmol/L glucose for 3 days then 5.5 mmol/L glucose for 3 days.Cells in liraglutide group were cultured in 30 mmol/L glucose with liraglutide for 3 days then 5.5 mmol/L glucose for 3 days.The regulatory relationship between miR-27b-3p and Nrf2 was verified by lentiviral transfection.Expressions of miR-27b-3p, Nrf2, NAD(P)H dehydrogenase[quinone]1 (NQO1), heme oxygenase-1 (HO-1) mRNA and protein levels were analyzed by real-time quantitative PCR.Total and nuclear Nrf2 protein expressions were detected by Western blot.The cell proliferation rates of various groups were determined by cell counting kit-8 (CCK-8).The reactive oxygen species (ROS) level was detected by the DHE kit.Results:The miR-27b-3p mRNA relative expression of normal control group, metabolic memory group, miR-27b-3p control group, miR-27b-3p inhibitor group was 1.000±0.000, 1.881±0.034, 1.683±0.088 and 0.111±0.008, respectively, with a statistically significant difference ( F=850.815, P<0.001).The miR-27b-3p mRNA relative expression level was lower in normal control group than in metabolic memory group, lower in miR-27b-3p inhibitor group than in normal control group, and the differences were statistically significant (both at P<0.01).The expression levels of Nrf2 mRNA, total protein, and nuclear protein were decreased in metabolic memory group in comparison with normal control group and were significantly increased in miR-27b-3p inhibitor group in comparison with miR-27b-3p control group, showing statistically significant differences (all at P<0.01).The NQO1 and HO-1 mRNA expressions were decreased in metabolic memory group in comparison with normal control group, and were significantly higher in miR-27b-3p inhibitor group compared with miR-27b-3p control group, showing statistically significant differences (all at P<0.01).The fluorescence intensity of Nrf2, NQO1, and HO-1 was lower in metabolic memory group than in normal control group, and was higher in miR-27b-3p inhibitor group than in miR-27b-3p control group, showing statistically significant differences (all at P<0.01).Compared with metabolic memory group, the relative expression of miR-27b-3p mRNA declined in liraglutide group, with a statistically significant difference ( P<0.05).The relative expression levels of Nrf2 mRNA, NQO1 mRNA, HO-1 mRNA, total and nuclear Nrf2 protein of liraglutide group were enhanced in comparison with metabolic memory group, with statistically significant differences (all at P<0.05).The fluorescence intensity of Nrf2, NQO1, and HO-1 was enhanced in liraglutide group in comparison with metabolic memory group, and the differences were statistically significant (all at P<0.05).Compared with normal control group and liraglutide group, the cell proliferation viability was decreased in metabolic memory group, and the differences were statistically significant (both at P<0.01).The relative content of ROS was higher in metabolic memory group than in normal control group and liraglutide group, and the difference was significant (all at P<0.01). Conclusions:Liraglutide reverses the inhibition of metabolic memory on Nrf2, NQO1, and HO-1 by downregulating miR-27b-3p.