Objective To investigate effects of permissive hypercapnia ventilation on cerebral oxygen metabolism and postoperative cognitive function in laparoscopy in elderly patients with mild COPD.Methods Sixty elderly patients with mild obstructive pulmonary disease undergoing elective laparoscopy under general anesthesia were randomly divided into routine ventilation group (group N) and permissive hypercapnia ventilation group(group H).Blood samples were collected to implement blood gas analysis at 10 min(T0) after endotracheal intubation,50 min (T1) and 100 min (T2) after pneumoperitoneum,and 10 min after exhaust (T3).Blood oxygen content differences of arterial-internal jugular vein (Da-jv02) and cerebral oxygen extraction rate (CERO2) were calculated at the same time.Cerebral oxygen saturation (rSO2) was monitored all the time.Cognitive function was assessed by Montreal Cognitive Assessment Scale (MoCA) at 1 d before operation,and 1d and 3d after operation.Results Compared with group N,p(CO2) and rSO2were significantly increased,and pH value,Da-jvO2 and CERO2 were significantly decreased,MoCA score was significantly increased after operation,and the incidence of post-operative cognitive dysfunction was significantly decreased after operation (P ＜ 0.05).Compared with the baseline value at T0,Da-jvO2 and CERO2 were significantly decreased,rSO2 were significantly increased,and MoCA scores at 1 to 3 d were reduced in two groups.Compared with baseline at To,group H had increased p(CO2),rSO2,increased pH value,Da-jvO2 and CERO2,at T1 ～3 (P ＜ 0.05).Conclusion Permissive hypercapnia ventilation can improve the cerebral oxygen metabolism during laparoscopic surgery,and reduce post-operative cognitive dysfunction in the elderly patients with mild chronic obstructive pulmonary disease.

Objective To investigate effects of permissive hypercapnia ventilation on cerebral oxygen metabolism and postoperative cognitive function in laparoscopy in elderly patients with mild COPD.Methods Sixty elderly patients with mild obstructive pulmonary disease undergoing elective laparoscopy under general anesthesia were randomly divided into routine ventilation group (group N) and permissive hypercapnia ventilation group(group H).Blood samples were collected to implement blood gas analysis at 10 min(T0) after endotracheal intubation,50 min (T1) and 100 min (T2) after pneumoperitoneum,and 10 min after exhaust (T3).Blood oxygen content differences of arterial-internal jugular vein (Da-jv02) and cerebral oxygen extraction rate (CERO2) were calculated at the same time.Cerebral oxygen saturation (rSO2) was monitored all the time.Cognitive function was assessed by Montreal Cognitive Assessment Scale (MoCA) at 1 d before operation,and 1d and 3d after operation.Results Compared with group N,p(CO2) and rSO2were significantly increased,and pH value,Da-jvO2 and CERO2 were significantly decreased,MoCA score was significantly increased after operation,and the incidence of post-operative cognitive dysfunction was significantly decreased after operation (P ＜ 0.05).Compared with the baseline value at T0,Da-jvO2 and CERO2 were significantly decreased,rSO2 were significantly increased,and MoCA scores at 1 to 3 d were reduced in two groups.Compared with baseline at To,group H had increased p(CO2),rSO2,increased pH value,Da-jvO2 and CERO2,at T1 ～3 (P ＜ 0.05).Conclusion Permissive hypercapnia ventilation can improve the cerebral oxygen metabolism during laparoscopic surgery,and reduce post-operative cognitive dysfunction in the elderly patients with mild chronic obstructive pulmonary disease.

OBJECTIVETo investigate the effects of Xinfeng Capsule (XFC) on pulmonary function and related mechanism in adjuvant-induced arthritis (AA) rats.

METHODSThe rats were randomly divided into five groups: normal control (NC), model control (MC) groups, methotrexate (MTX), tripterygium glycosides tablet (TPT) and Xinfeng capsule (XFC) treatment groups. The adjuvant-induced arthritis model was established by intracutaneous injection of 0.1 mL Freund ' s complete adjuvant in the right paw of rats; the drugs were given 19 d after model establishment. The toe swelling degree (E), arthritis index (AI), pulmonary function, peripheral blood Treg levels, pathological changes of lung tissue and expression of Foxp3, TGF-β1, Smad3, Smad7 proteins in lung tissue were measured 30 d after drug administration.

RESULTSCompared to NC group, the levels of E, AI, alveolitis score, TGF-β1 and Smad3 were significantly increased (P <0.05 or P <0.01); maximum expiratory flow 25% of vital capacity (FEF25),50% maximal expiratory vital capacity flow (FEF50), maximum expiratory flow at 75% of vital capacity (FEF75), maximum mid-expiratory flow (MMF), force peak expiratory flow (PEF), CD4+ CD25+ Treg, Foxp3 and Smad7 were significantly decreased in MC group (P <0.05 or P < 0.01). Compared to MC group,the expression of E, AI, TGF-β1 and Smad3 were reduced, while FEF50, FEF75, MMF, PEF, Treg, Foxp3 and Smad7 were elevated in XFC group (P <0.05 or P <0.01). Compared to XFC group, the level of body mass,FEF25,FEF50, FEF75, MMF and Treg were lower in MTX and TPT groups (P <0.05 or P <0.01).

CONCLUSIONThere are inflamed joints and reduced pulmonary function in rats of adjuvant-induced arthritis. XFC can inhibit paw edema degrees, reduce arthritis response, and improve pulmonary function, which is associated with up-regulating expression of Treg and Foxp3, down-regulating the expression of TGF-β1 and adjusting TGF-β1/Smads signal pathway.

Animals ; Arthritis, Experimental ; drug therapy ; metabolism ; physiopathology ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Forkhead Transcription Factors ; metabolism ; Lung ; drug effects ; pathology ; physiopathology ; Male ; Rats ; Rats, Wistar ; Smad3 Protein ; metabolism ; Smad7 Protein ; metabolism ; T-Lymphocytes, Regulatory ; metabolism ; Transforming Growth Factor beta1 ; metabolism