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Effect of low sound pressure level infrasound on chemokine-mediated inflammatory response in spinal cord of neuropathic pain model in rat

Haichao SI ; Qiong SONG ; Jieyu MA ; Xiaomeng SI

The Journal of Clinical Anesthesiology.2017;33(9):885-889.

Objective To investigate the effect of low sound pressure level infrasound on che-mokine-mediated inflammatory response in spinal cord in rats with neuropathic pain.Methods Seven-ty-two healthy male SD rats were randomly divided into sham operation group (group Sham),neuro-pathic pain group (group NP)and low sound pressure level infrasound intervention group (group LNP),24 in each.The sciatic nerve injury models were established.3 d after the model constructed, the rats in group LNP started to receive low sound pressure level infrasound therapy,4 h per day, continued for 21 d.1 d before surgery (T0 )and 3 d after surgery (T1 ),all rats were detected me-chanical paw withdrawal threshold (MWT).Respectively,after treated for 7 d (T2 ),14 d (T3 )and 21 d (T4 ),eight rats were randomly selected from each group and their MWT was measured.The ex-pressions of MCP-1 mRNA,CCR2 mRNA,TNF-αmRNA,IL-1βmRNA,and IL-6 mRNA in spinal cord in rats were detected using quantitative PCR,the expressions of MCP-1 protein and CCR2 protein in spinal cord in rats were detected by using Western blot.Results MWT in groups NP and LNP at T1-T4 was lower than that of group Sham,and that in group LNP at T3-T4 were higher than that of group NP,respectively (P <0.05).Compared with group Sham,the relative expression levels of MCP-1 mRNA,CCR2 mRNA,TNF-αmRNA,IL-1βmRNA,and IL-6 mRNA in spinal cord tis-sues in groups NP and LNP at T2-T4 were increased (P <0.05);compared with group NP,the rela-tive expression levels of MCP-1 mRNA,CCR2 mRNA,TNF-αmRNA,IL-1βmRNA,and IL-6 mR-NA in spinal cord were decreased in group LNP at T3-T4 (P <0.05 ).Western blot analysis showedthat the relative expression levels of MCP-1 protein and CCR2 proteinin spinal cord in groups NP and LNP at T2-T4 were higher than that of group Sham,while relative expression levels of MCP-1 protein and CCR2 proteinin spinal cord in group LNP at T3-T4 were lower than that of group NP. Conclusion The low sound pressure level infrasound could effectively reduce neuropathic pain in rats, possibly via inhibiting chemokine-mediated cascade inflammatory reaction.

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Role of AMP-activated protein kinase in hydrogen sulfide postconditioning protecting on type 2 diabetic rats with myocardial ischemia reperfusion injury

Bo SUN ; Chen WANG ; Wenjie ZHAO ; Shigang QIAO

The Journal of Clinical Anesthesiology.2017;33(9):881-884.

Objective To investigate the effect of hydrogen sulfide (H 2 S or NaHS)on myo-cardial ischemia reperfusion injury induced in type 2 diabetic rats in vivo and the role of AMP-activated protein kinase (AMPK)signal pathway.Methods The induced type 2 diabetic rat models were anesthetized,left thoracotomy were performed.All the models were randomly divided into six groups (n = 14):group Sham;group IR:the left anterior descending artery was ligated 30 min, reperfused for 4 hours;group CC:prior to thoracotomy,compound c was intraperitoneally injected 250 μg/kg,then received the same treatment as group IR;group DMSO received the same treatment as compound c group but DMSO was injected intraperitoneally as control;group NaHS:the left ante-rior descending artery was injected NaHS 0.05 mg/kg then reperfused for 4 hours;group CC +NaHS:prior to thoracotomy,compound c was intraperitoneally injected 250 μg/kg,then NaHS 0.05 mg/kg injected intravenously and reperfused 4 hours.All the rat models euthanatized,infarcted area was detected by TTC assay.The AMPK,LC3 and p62 were analyzed by Western blot.Results Com-pared with group Sham,the infarcted area and concentration of AMPK,LC3 and p62 were increased in other groups (P <0.05).Compared with group IR,the infarcted area and concentration of LC3, p62 markablely decreased in group NaHS (P < 0.05 ).Compared with group NaHS,the infarcted area and concentration of LC3,p62 significantly increased but AMPK down-regulated in group CC+NaHS (P <0.05).Conclusion Hydrogen sulfide could alleviate myocardial infraction via AMPK sig-nal pathway in type 2 diabetic rats'IR models.

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Efficacy analysis of ketamine on the patients with depression of modified electric convulsive therapy

Fengmei MEI ; Wei YUE ; Qiong ZENG ; Shanshan WU ; Xiaoning GAO ; Meihua ZHU

The Journal of Clinical Anesthesiology.2017;33(9):864-867.

Objective To observe the effects of ketamine on the patients with depression re-ceiving modified electric conulsive therapy (MECT).Methods Sixty patients with depression were randomly divided into ketamine group and propofol group (n =30 each group).Atropine 0.5-1.0 mg, propofol 1.0 mg/kg or ketamine 0.8 mg/kg i.v.were given before MECT,Scoline 0.7-1.0 mg/kg i. v.was given after the eyelash reflex disappeared.Hamilton Depression Rating Scale (HAMD)was completed after the 2 nd ,4 th and 6 th MECT,the time of convulsion,twitch index,energy percentage, respiratory recovery time and adverse reactions were recorded.Results The total score of HAMD was significantly decreased with the increasing times of MECT in both groups,compared with propo-fol group,ketamine group's HAMD total score decreased faster,especially after the 4th MECT,the score decreased significantly in ketamine group (P <0.05).The time of convulsion,twitch index,en-ergy percentage, respiratory recovery time, adverse reactions all had no statistical significance between the two groups.Conclusion Compered with propofol,ketamine,as an anesthetic of MECT, can effectively lower the score of HAMD.

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Application of solving difficulty of pediatric patients into the operating room by using combined inhalation anesthesia induction device

Kangyan ZHENG ; Shanshan LIU ; Tieliang CAI ; Zhengdi ZHANG ; Hongqiang HU

The Journal of Clinical Anesthesiology.2017;33(9):860-863.

Objective To discuss the feasibility and safety of sevoflurane inhale anesthesia with portable combined inhalation anesthesia induction device in solving the difficulty of children entering the operation room.Methods One hundred pediatric patients were enrolled into the study.The pediatric patients were randomly divided into two groups,50 cases in each group.Group A was fraught with a new mode of administration,using portable combined inhalation anesthesia induction device with sevoflurane 2 ml before entering the operation room;group B was fraught with a traditional mode of administration,using in-tramuscular injection with ketamine 4-5 ml/kg before entering the operation room.The analog scale of anes-thetic effect,the number of body movement,adverse reaction were compared between the two groups. Results Compared with group B,time of falling asleep and retention time in the operating room was signif-icantly shorter (P <0.01).And body movement during vein puncture decreased significantly (P <0.01). Moreover,the incidence of adverse affect showed significant reduce compared with group B (P < 0.05 ). Conclusion The combined inhalation anesthesia induction device is simple to produce and easy to carry.To solve the difficulty of convoying children into the operating room,combined inhalation anesthesia induction device with sevoflurane is more effective, safer and more humanized way when compared with the traditional one.

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Effect of preoperative blood pressure control on postoperative cardiovascularevents in patients with hy-pertension and gastrointestinal surgery

Chenyue GUO ; Yi LI ; Shengjin GE ; Changhong MIAO

The Journal of Clinical Anesthesiology.2017;33(9):856-859.

Objective To study the effect of preoperative blood pressure control on postoperative cardiovascular events in patients with hypertension and gastrointestinal surgery. Methods A total of 238 hypertensive patients who underwent gastrointestinal surgery were selected and divided into control group (n =118)and non-control group (n =120)according to thehypotensor treatment.During the operation,the same anesthetic regimen was used.The use of vasoactive drugs was recorded during anesthesia.Bladder chalone C (Cys C)and cardiac troponin T (cTnT)were de-tected in blood before and after the operation,and so were N-terminal B type natriuretic peptide (NT-proBNP)level on the 1st and 5th day after the operation.The postoperative hospitalization time,fol-low-up of cardiovascular events 28 and 90 days after discharge were recorded.Results Compared with the non-control group,the total dosage of ephedrine in the control group was significantly re-duced [(3.41±1.04)mg vs (7.46 ± 3.29)mg,P <0.05 ],total dose of phenylephrinewas signifi-cantly reduced [(0.17±0.10)mg vs (0.46 ±0.16)mg,P <0.05],postoperative hospital stay was significantly shorter [(5.92±1.15)d vs (9.65±1.61)d,P <0.05],NT-proBNP level in the control group on the 1st day after the operation [(108.00 ± 47.11 )pg/L vs (250.38 ± 62.92 )pg/L,P <0.01]and 5 days after the operation [(62.07 ±25.31)pg/L vs (199.02 ± 60.32)pg/L,P <0.01 ] was obviously reduced.There was no statistical difference in Cys C andcTnT between the two group-safter operation.The incidence of cardiovascular adverse events in the control group was significantly lower than that in the non-control group (28 d:13.6% vs 62.7%,90 d:23.3% vs 23.3%,P <0.05).Conclusion Strict control of preoperative blood pressure control in patients with hypertension can significantly reduce the incidence of cardiovascular events.

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Precision medicine is ammunition for anesthesiologists to improve patient outcomes during the perioperative period:genetic variability of beta-blockers and opioids

Spencer CHRISTOPHER ; Yang JIANJUN ; Zuo ZHIYI

The Journal of Clinical Anesthesiology.2017;33(9):918-924.

The evolving practice of precision medicine allows physicians to make disease treat-ments and prevention decisions based on a patient's individual genetic and molecular profile.In recent years,gene sequencing and related techniques are becoming more affordable and more accessible to healthcare providers,and their use in various medical fields continues to expand.In particular,there are numerous opportunities for the use of precision medicine in the perioperative setting.For example, individual polymorphisms in alpha and beta adrenergic receptors can improve the efficacy of beta blockade,or predispose a patient to adverse drug reactions including hypotension and bradycardia. Likewise,particular polymorphisms in opioid receptors can increase or decrease the effectiveness of various opioid medications for achieving adequate postoperative analgesia.In addition,mutations in the cytochrome P4502D6 (CYP2D6)enzyme can drastically affect the clinical response to a particular subset of beta blockers and opioids by accelerating or decelerating their metabolism and clearance. Preoperative genetic testing would allow anesthesiologists to identify these and other relevant molecu-lar characteristics in their patients,and choose appropriate perioperative therapies accordingly in order to maximize clinical outcomes while minimizing the incidence of adverse events.It is the time for anes-thesiologists and perioperative care providers to practice precision medicine.

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Effects of propofol on cognitive function in type 2 diabetic rats

Bing LIANG ; Tieli DONG

The Journal of Clinical Anesthesiology.2017;33(9):904-908.

Objective To explore the effects and mechanism of propofol on cognitive function of type 2 diabetic rats.Methods Ten of fifty adult male SD rats were fed with basic diet and allocated to control group.Another forty rats were fed with high sugar and high fat for 8 weeks and composite intraperitoneal injection of 1% streptozotocin (STZ)to establish model and then divided into four groups:diabetes group;low dose,middle dose and high dose of propofol group (diabetic rats were given intraperitoneal injection of 1% propofol 10,30,75 mg·kg-1·d-1 for 5 consecutive days).The cognitive functions were examined by Morris water maze from the first day after intraperitoneal injec-tion with propofol.The hippocampus were isolated for observing histopathologic alterations by HE staining and for the determinations of SOD,MDA,CAT,GSH and GSH-PX by colorimetry. Western blot was used to detect the expression of AGEs and RAGE.Results Compared to the control group,there was an obvious increased escape latent period,decreased the frequency of crossing platform,increased hippocampal neurons damage and MDA,decreased levels of SOD, CAT,GSH and GSH-PX,as well as the protein levels of AGEs and RAGE in diabetes group (P <0.05).There was no significant difference between diabetes group and low dose propofol of group on behavior ability and detection index.However,middle dose and high dose of propofol group showed more serious cognitive dysfunction,aggravated hippocampal neurons cells loss,increased oxidative stress as well as enhanced expression of AGEs and RAGE (P <0.05 ).Conclusion Multiple given sedative or anesthetic doses of propofol can aggravate the cognitive dysfunction and oxidative stress in type 2 diabetic rats,which may be related to increase the expression of AGEs and RAGE in brain tis-sue.

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Pulmonary protective effects of dexmedetomidine in septic rats induced by LPS

Juan DENG ; Yachun LI ; Tao ZHU

The Journal of Clinical Anesthesiology.2017;33(9):899-903.

Objective To assess the role of intervention of dexmedetomidine in lung tissue and plasma of septic rats induced by lipolysaccharide.Methods Forty SD rats weighing 250-300 g were divided into 4 groups:control group (n =10)with saline (1 ml·kg-1·h-1 )infused through the tail veins of rats for 6 h;dexmedetomidine (DEX)group (n =10)with dexmedetomidine,injected 6.5 μg ·kg-1·h-1 for 10 min followed by 5 μg·kg-1·h-1 ,continuously infused through tail veins for 6 h;li-polysaccharide (LPS)group (n = 10 )with lipolysaccharide (7.5 mg/kg)infused through the tail veins of rats;LPS+DEX group (n =10),after infusion of LPS,rats were treated with dexmedeto-midine (bolus 6.5 μg·kg-1·h-1 ,10 min;5 μg·kg-1·h-1 ,continuous infusion)through the tail veins for 6 h.ELISA and Western blot were performed to assess the protein expression of IL-1,IL-6, TNF-αand TLR4;the wet/dry ratio (W/D)of lung tissue in each group was measured and the injury scores were recorded through the Murakami method.Results There was no statistical significance between the control group and DEX group in plasma level of inflammatory factors,pulmonary TLR4 expression,wet/dry ratio and injury score of lung tissues,however,compared to the control group, there was a significant elevation in the above-mentioned biomarkers,W/D and injury score of lung tis-sue (P <0.01).Compared to the control group,there was no statistical significance in the LPS+DEX group.Compared to the LPS+DEX group,the biomarkers mentioned above,W/D and injury score of lung tissues were significantly elevated in the LPS group (P <0.01).Conclusion The irrita-tion of LPS can trigger the elevation of inflammatory factors in plasma,TLR4 expression in lung tis-sues in rats,while the intervention of dexmedetomidine can significantly alleviate this tendency. Dexmedetomidine can suppress the inflammatory reaction and pulmonary edema in septic rats.

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Effects of penehychdine hydrochloride on severe acute pancreatitis associated acute lung injury in rats

Lili QIU ; Fang DENG ; Rongtao ZHU ; Yanpeng ZHANG

The Journal of Clinical Anesthesiology.2017;33(9):894-898.

Objective To investigate the effect of penehychdine hydrochloride (PHCD)on acute lung injury induced by acute severe acute pancreatitis and the expression of hypoxia inducible factor-1α(HIF-1α)in rats.Methods Forty healthy adult male SD rats were used and randomly divided into 3 groups, group S of sham operation,group ALI of pancreatitis-associated acute lung injury (PALI)and group P of PALI with PHCD.Rats of group ALI and group P were the model established of acute lung injury associated with SAP by retrograde injection of 4% sodium taurocholate into biliopancreatic duct.Rats of group P of acute lung injury with SAP were immediately given PHCD after SAP.Rats of group S and group ALI were injected the same amount of 0.9% sodium chloride solution.After modeling,the rats were sacri-ficed at 12 h.The wet/dry weight ratio (W/D)of lung tissue was calculated.Pathological changes of pan-creatic and lung tissues were scored.HIF-1α,IL-1β,IL-6 of lung tissues and serum amylase were detected by ELISA.The expression of TLR4,NF-κB p65 in lung tissue was detected by Western blot.Results Ex-tensive infiltration of neutrophils,alveolar hemorrhage and necrosis and fat necrosis with pancreatic tissue were observed in group PALI and group P.Pancreatic tissue injury score was significantly higher than that of group S (P <0.01).However,there was no statistically significant difference between the level of serum amylase in group P and group ALI.The W/D ratio of lung tissue in rats of group ALI and group P was sig-nificantly higher than those in group S (P <0.05).Compared with those of group ALI,the lung tissue pathological changes of group P were significantly improved,and the lung W/D value was significantly lower than that of group ALI (P <0.05).Compared with group S,the expression of TLR4,NF-κB p65,HIF-1αin lung tissue of group ALI and group P was significantly higher (P <0.01),and the expression of TLR4, NF-κB p65,HIF-1α,IL-1βand IL-6 in group P was significantly lower than that in group ALI (P <0.05).Conclusion PHCD could not alleviate the damage of pancreatic tissue of SAP.It suppressed the expression of HIF-1α,IL-1βand IL-6 and reduced the acute lung injury induced by SAP in rats,which might be depen-ded on suppressing the expression of inflammatory factors,such as HIF-1α.

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Effect of microinjection of orexin-A and orexin-B into cerebral ventricle on the release of histamine in hypothalamus

Long LI ; Zhihua WANG ; Lina ZHANG ; Hailong DONG

The Journal of Clinical Anesthesiology.2017;33(9):890-893.

Objective To provide new evidences for understanding the mechanisms of promo-tive role of orexins in anesthetic emergence and the effect of microinjection of orexin-A/orexin-B into cerebral ventricle on the release of histamine.Methods Male SD rats were randomly divided into sa-line (control ), orexin-A and orexin-B groups. The microdialysis probe was inserted into hypothalamus under stereotaxic apparatus.The perfused fluid from the area of hypothalamic tube-romammillary nucleus was collected using in vivo microdialysis at 1 h,2 h and 3 h after 1 nmol or 5 nmol orexin-A or orexin-B microinjection into the cerebral ventricle (n =5 each).The concentrations of histamine at each time point in dialysates of perfused fluid were detected by high performance liquid chromatography (HPLC)to analyze its dynamic changes.After one week,each group was microin-jected with 10 nmol,15 nmol and 20 nmol orexin-A and orexin-B (n =5)into the cerebral ventricle respectively,dialysates was collect and histamine was detected at 1 h to analyze its dosage response. After one week,each group was microinjected 0.3 μl saline orexin-A and orexin-B (n =6)into the tu-beromammillary nucleus.Results Compared with the control group,microinjection of 1 nmol orexin-A significantly increased histamine release at 1 h,but the same dose of orexin-B had no such effect,5 nmol of orexin-A or orexin-B injections significantly facilitated histamine release at 2 h and 3 h (P <0.01).Microinjection of 10 nmol,15 nmol and 20 nmol orexin-A and orexin-B into ventricle caused an significant increase of histamine release at 1 h while the effect was the strongest in 20 nmol (P <0.05).Compared with the control group,microinjection of orexin-A significantly decreased time of the righting reflex (P <0.01),but the same dose of orexin-B had no such effect.Conclusion Micro-injection of both orexin-A or orexin-B into cerebral ventricle could promote the release of histamine, while the effect of orexin-A was stronger.Microinjection orexin-A into tuberomammillary nucleus sig-nificant facilitated recovery from isoflurane.

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