Objective:To evaluate the effect of propofol on proliferation, invasion and migration of human melanoma cells and role of cyclooxygenase-2 (COX-2)/prostaglandin E2 (PGE2)/matrix metalloproteinase (MMP) signaling pathway.Methods:SKMEL-5 cells were cultured in vitro and divided into 4 groups ( n=36 each) using the random number table method: control group (group C), propofol group (group P), COX-2 overexpression group (group COX-2), and COX-2 overexpression plus propofol group (group COX-2+ P). Propofol at the final concentration of 60 μmol/L was added in group P. The COX-2 overexpression plasmid pcDNA3.1-COX-2 was transfected into SKMEL-5 cells in group COX-2 and group COX-2+ P, and propofol at the final concentration of 60 μmol/L was added in group COX-2+ P.After incubation for 48 h, the cell proliferation rate was determined by CCK-8 method, the cell invasion and migration ability was determined by Transwell assay, the expression of COX-2 in cells was detected by Western blot, the expression of COX-2 mRNA in cells was detected by quantitative real-time polymerase chain reaction, and the concentrations of serum PGE2, MMP-2 and MMP-9 were determined by enzyme-linked immunosorbent assay. Results:Compared with group C, the cell proliferation rate was significantly decreased, the number of cell invasion and migration was decreased, the expression of COX-2 protein and mRNA was down-regulated, and the concentrations of PGE2, MMP-2 and MMP-9 in the supernatant were decreased in group P, and the cell proliferation rate was significantly increased, and the number of cell invasion and migration was increased, the expression of COX-2 protein and mRNA was up-regulated, and the concentrations of PGE2, MMP-2 and MMP-9 in the supernatant were increased in group COX-2 ( P<0.05). Compared with group P, the cell proliferation rate was significantly increased, and the number of cell invasion and migration was increased, the expression of COX-2 protein and mRNA was up-regulated, and the concentrations of PGE2, MMP-2 and MMP-9 in the supernatant were increased in group COX-2+ P ( P<0.05). Conclusions:Propofol can inhibit the proliferation, invasion and migration of human melanoma cells, and the mechanism may be related to inhibition of the COX-2/PGE2/MMP signaling pathway.

Objective:To evaluate the efficacy of remimazolam combined with alfentanil for gastroscopy in frail elderly patients.Methods:Sixty American Society of Anesthesiologists physical status Ⅱ or Ⅲ elderly patients, aged 65-85 yr, with body mass index of 18-30 kg/m 2, of Clinical Frailty Scale score≥5, scheduled for elective painless gastroscopy, were divided into 2 groups ( n=30 each) using a random number table method: remimazolam combined with alfentanil group (group R) and propofol combined with remifentanil group (group P). A combination of alfentanil 10 μg/kg and remimazolam 0.2 mg/kg was intravenously injected until loss of consciousness in group R. Remifentanil 0.5 μg/kg combined with propofol 1.0-2.0 mg/kg was intravenously injected until loss of consciousness in group P. According to the intraoperative conditions, 1/4 of the initial dose of remimazolam was intravenously injected in group R, and 1/4 of the initial dose of propofol was intravenously injected in group P. The time for gastroscopy, requirement for additional remimazolam or propofol, onset time of anesthesia, emergence time and time of post-anesthesia care unit stay were recorded.Physician′s satisfaction scores, patient′s satisfaction scores and Verbal Pain Scale scores were recorded.The occurrence of injection pain, respiratory depression, bradycardia, hypotension and nausea and vomit was recorded. Results:There was no significant difference in the requirement for additional remimazolam or propofol, onset time of anesthesia, time for gastroscopy, physician′s satisfaction scores, and patient′s satisfaction scores, Verbal Pain Scale scores and incidence of nausea and vomit between two groups ( P>0.05). Compared with P group, the emergence time and time of post-anesthesia care unit stay were significantly shortened, and the incidence of injection pain (0 vs.33%), respiratory depression (0 vs.20%), hypotension (3% vs.23%) and bradycardia (3% vs.23%) was decreased in R group ( P<0.05). Conclusions:Remimazolam combined with alfentanil is safe and effective, with rapid recovery from anesthesia, and provides better efficacy than the combination of propofol and remifentanil when used for gastroscopy in frail elderly patients.

Objective:To evaluate the effect of goal-directed hemodynamic management of muscle oxygen saturation (SmO 2) on the postoperative renal function in hypertensive patients undergoing laparoscopic radical gastrectomy for gastrointestinal tumors. Methods:Eighty-six essential hypertension patients, aged 18-64 yr, with body mass index ≤ 30 kg/m 2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, undergoing elective laparoscopic radical gastrectomy for gastrointestinal tumors under general anesthesia, were divided into 2 groups ( n=43 each) using a random number table method: routine group (group C) and SmO 2 goal-directed group (group S). The fluctuation of mean arterial pressure (MAP) and heart rate (HR) were maintained < 20% of the preoperative baseline value by adjusting infusion speed and vasoactive drugs in group C. SmO 2 was maintained not less than 70% or not less than the baseline value by evaluating cardiac output (CO), HR, stroke volume, stroke volume variation, systemic vascular resistance index and MAP and by adjusting infusion rate and vasoactive drugs in group S. SmO 2, HR, MAP, CO, cardiac index (CI), stroke volume variation and systemic vascular resistance index were recorded before anesthesia induction (T 0, baseline value), at the beginning of surgery (T 1), at 40 min after the start of pneumoperitoneum (T 2), at 5 min after the end of pneumoperitoneum (T 3), and at the end of surgery (T 4). The glomerular filtration rate was measured before surgery and at 24 h after surgery, and the occurrence of decline in postoperative acute renal function was recorded.Intraoperative hypotension, fluid input and output, postoperative tracheal extubation time, length of hospital stay, occurrence of acute kidney injury and transfer to ICU, and the Quality of Recovery-15 scale score at 24 h after operation were recorded. Results:Compared with group C, SmO 2 at T 1-3 and CO and CI at T 3 were significantly increased, SVRI at T 2-4 was decreased, the intraoperative infusion volume and urine volume were increased, the glomerular filtration rate and Quality of Recovery-15 scale score were increased at 24 h after surgery, the incidence of decline in acute renal function was decreased ( P<0.05), and no significant change was found in the incidence of intraoperative hypotension, blood loss, postoperative extubation time, length of hospital stay, incidence of acute kidney injury and rate of transfer to ICU in group S ( P>0.05). Conclusions:SmO 2 goal-directed hemodynamic management can reduce the development of decline in postoperative acute renal function and improve the quality of postoperative recovery of hypertensive patients undergoing laparoscopic radical gastrectomy for gastrointestinal tumors.

Objective:To evaluate the role of connexin43 (Cx43) in sevoflurane anesthesia-induced cognitive dysfunction in aged rats.Methods:Fifty-two healthy male Sprague-Dawley rats, aged 18 months, weighing 400-500 g, were divided into 4 groups ( n=13 each) using a random number table method: control group (C group), sevoflurane group (SEV group), sevoflurane plus sh-NC group (SEV+ sh-NC group) and sevoflurane plus sh-Cx43 group (SEV+ sh-Cx43 group). Sevoflurane anesthesia model was established by inhaling 3% sevoflurane for 6 h. In SEV+ sh-NC group and SEV+ sh-CX43 group, sh-NC 5 nmol and sh-CX43 5 nmol were transfected into the lateral ventricles, respectively, at 1 day before sevoflurane anesthesia.Morris water maze test was performed at 30 min before anesthesia and 1, 2 and 3 days after the end of anesthesia, and the rats were sacrificed at each time point after Morris water maze test, the brains were removed, and the hippocampi were isolated for microscopic examination of the pathological changes and for determination of the expression of Cx43, cleaved caspase-3 and cleaved caspase-9 (by using Western blot), and contents of interleukin-1beta (IL-1β), tumor necrosis factor-alpha (TNF-α) and IL-6 (by enzyme-linked immunosorbent assay). Results:Compared with group C, the escape latency was significantly prolonged, and the number of crossing the original platform was reduced, and the expression of CX43, cleaved caspase-3 and cleaved caspase-9 was up-regulated, and the contents of IL-1β, TNF-α and IL-6 were increased in group SEV ( P<0.05). Compared with group SEV, the escape latency was significantly shortened, the number of crossing the original platform was increased, and the expression of CX43, cleaved caspase-3 and cleaved caspase-9 was down-regulated, the contents of IL-1β, TNF-α and IL-6 were decreased ( P<0.05), and the hippocampal pathological injury was reduced in group SEV+ sh-CX43, and no significant change was found in the indicators mentioned above in group SEV+ sh-NC ( P>0.05). Conclusion:Cx43 is involved in the pathophysiological mechanism of sevoflurane-induced cognitive dysfunction probably by inducing neuroinflammatory responses and cell apoptosis in aged rats.

Objective: The purpose of this cross-sectional survey is to explore the current state of Internet addiction (IA) in Chinese medical students and its connection with medical students’ sleep quality and self-injury behavior. Methods: Respondents were came from Wannan Medical College, China. The Young’s Internet Addiction Test, Pittsburgh Sleep Quality Index (PSQI), Self-Harm Questionnaire were used in this cross-sectional survey. A total of 3,738 medical students were investigated, 1,552 (41.52%) males, 2,186 (58.48%) females. T-test, chi-square test and MANOVA were used for data analysis. Results: Of the 3,738 medical students, 1,054 (28.2%) reported having IA, 1,126 (30.1%) reported having poor sleep quality, 563 (15.1%) having self-harm behaviors. IA tends to be more female, upper grade students. The sleep quality of IA was worse than that of non-IA (χ2=54.882, p<0.001), and the possibility of self-injury was higher than non-IA (χ2=107.990, p<0.001). Conclusion This survey shows that the IA detection rate of medical students was 28.2%. Females, higher grade students had a higher IA detection rate. The low sleep quality and self-injury behavior of medical students are associated with IA.

Objective To evaluate the role of nuclear factor erythroid 2-related factor 2 ( Nrf2 ) signaling pathway in endoplasmic reticulum stress response during lipopolysaccharide ( LPS)-induced acute lung injury ( ALI) in mice. Methods Forty clean-grade healthy male C57BL∕6 mice, aged 6-8 weeks, weighing 22-26 g, were divided into 4 groups ( n=10 each) using a random number table method: control group ( group C) , group ALI, salubrinal group ( group S) and salubrinal plus brusatol group ( group S+B) . Animals were intratracheally instilled with 5 mg∕kg of LPS diluted in normal saline to establish the model of ALI. Animals were intratracheally instilled with 100 μl of normal saline in group C. Mice in group S were intraperitoneally injected with endoplasmic reticulum stress response inhibitor 1 mg∕kg salubrinal at 1 and 24 h after LPS instillation. Mice of group S+B were intraperitoneally injected with brusatol 2 mg∕kg once every other day for 10 days prior to LPS instillation, and the other treatments were similar to those previously de-scribed in group S. Mice were sacrificed at 48 h after LPS administration, and lungs were removed for mi-croscopic examination of the pathological changes of lung tissues which were scored and for determination of contents of IL-17A, tumor necrosis factor-alpha ( TNF-α) and interleukin-6 ( IL-6) in lung tissues ( by en-zyme-linked immunosorbent assay) and expression of Nrf2, CCAAT∕enhancer-binding protein homologous protein (CHOP) and caspase-12 in lung tissues (by Western blot). Lung water content was calculated. Results Compared with group C, the lung water content and contents of IL-17A, TNF-α and IL-6 were significantly increased, the expression of CHOP and caspase-12 in cytoplasma was up-regulated, and the ex-pression of Nrf2 in nuclei was down-regulated in ALI and S+B groups, and the lung water content and con-tents of IL-17A, TNF-α and IL-6 were significantly increased, the expression of Nrf2 in nuclei and CHOP in cytoplasma was up-regulated, and the expression of caspase-12 was down-regulated in group S ( P<0. 05) . Compared with group ALI, the lung water content and contents of IL-17A, TNF-α and IL-6 were significantly decreased, the expression of CHOP and caspase-12 in cytoplasma was down-regulated, the ex-pression of Nrf2 in nuclei was up-regulated ( P<0. 05) , and the pathological changes were significantly at-tenuated in group S. Compared with group S, the lung water content and contents of IL-17A, TNF-α and IL-6 were significantly increased, the expression of CHOP and caspase-12 in cytoplasma was up-regulated, the expression of Nrf2 in nuclei was down-regulated ( P<0. 05) , and the pathological changes of lung tis-sues were accentuated in group S+B. Conclusion Nrf2 signaling pathway is involved in the process of en-doplasmic reticulum stress response during LPS-induced ALI in mice.

Objective To evaluate the effect of thoracic paravertebral block (TPVB) on inflammatory responses in the patients undergoing thoracoscopic radical resection of lung cancer with general anesthesia.Methods Eighty patients of both sexes,aged 18-64 yr,with body mass index of 18-24 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective thoracoscopic radical resection of lung cancer,were divided into 2 groups (n =40 each) using a random number table method:control group (group C) and TPVB group.Ultrasound-guided TPVB was performed with 0.5％ ropivacaine 10 ml which was injected into the paravertebral space of T4,7 at 30 min before anesthesia induction in group T.Patient-controlled intravenous analgesia (PCIA) was performed at the end of surgery.When visual analogue scale score＞3,morphine 5-10 mg was intravenously injected.Venous blood samples were collected immediately before surgery (T0) and at 12,24 and 48 h after surgery (T1-3) for determination of serum interleukin-6 (IL-6) and IL-10 concentrations by enzyme-linked immunosorbent assay.The pressing times of PCIA and total volume of fluid infused were recorded at T2,3.The patients were followed up for 48 h after surgery,the development of nausea and vomiting,somnolence and pruritus was recorded,and the total occurrence of adverse reactions was calculated.Results Compared with group C,the pressing times of PCIA and total volume of fluid infused were significantly decreased at T2,3,the incidence of nausea and vomiting,total incidence of adverse reactions and the number of cases required morphine were decreased,and the serum concentration of IL-6 was decreased and the serum concentration of IL-10 was increased at T1-3 in group T (P＜0.05).Conclusion TPVB can alleviate inflammatory responses in the patients undergoing thoracoscopic radical resection of lung cancer with general anesthesia.

Objective To evaluate the effect of dexmedetomidine on the long-term sensorimotor gating system after sevoflurane anaesthesia in neonatal rats.Methods One hundred forty-four clean-grade healthy male Sprague-Dawley rats,aged 4-6 days,weighing 8-15 g,were divided into 4 groups (n =36 each) using a random number table method:control group (group C),sevofluraue group (group S),dexmedetomidine plus sevoflurane group (group D + S),and dexmedetomidine plus α2 receptor antagonist atipamezole plus sevoflurane group (group D+A+S).In group S,anesthesia was induced with 6％ sevofluraue for 3 min and maintained with 2.1％ sevoflurane,and the anesthesia time was 6 h in total.Dexmedetomidine 25 μg/kg was intraperitoneally injected in group D.In group D +A+ S,dexmedetomidine 25 μg/kg and atipamezole 250 μg/kg were intraperitoneally injected,and the other treatments were similar to those previously described in group S.Twelve rats in each group were randomly selected after anesthesia and sacrificed,and blood samples were collected for determination of serum corticosterone concentrations by enzyme-linked immunosorbent assay.Twenty-four rats were randomly selected in each group,and prepulse inhibition (PPI) of startle test was performed at 70 days after birth.PPI rate (PP3％,PP6％,PP12％) was calculated.The serum corticosterone concentration was measured by restraint stress test on 80 days after birth.Results There was no significant difference in PP6％ or PP12％ among the four groups (P＞0.05).Compared with group C,PP3％ was significantly decreased,and the serum corticosterone concentration was increased after the end of anesthesia and during restraint stress test at 80 days after birth in S and D+A+ S groups (P＜0.05),and no significant change was found in the parameters mentioned above in group D (P＞0.05).Compared with group S,PP3％ was significantly increased,and the serum corticosterone concentration was decreased after the end of anesthesia and during restraint stress test at 80 days after birth in group D (P＜0.05),and no significant change was found in the parameters mentioned above in group D+ A+S (P＞0.05).Compared with group D,PP3％ was significantly decreased,and the serum corticosterone concentration was increased after the end of anesthesia and during restraint stress test at 80 days after birth in group D+A+S (P＜0.05).Conclusion Dexmedetomidine can alleviate the damage to long-term sensorimotor gating system after sevoflurane anesthesia in neonatal rats,and the mechanism may be related to activating central α2 receptors and improving hypothalamic-pituitary-adrenal axis hyperfunction.

Objective To evaluate the effects of hearing disorder factors on analgesic efficacy of propofol. Methods Ninety?five patients with hearing disorders, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged 18-60 yr, with body mass index of 20-30 kg∕m2, scheduled for elective ear surgery, served as test group(group T). Ninety?five patients with normal hearing function, of Ameri?can Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged 18-60 yr, with body mass index of 20-30 kg∕m2, scheduled for elective non?ear surgery, served as control group(group C). Propofol was given at the initial target plasma concentration of 1.2 μg∕ml. When the target plasma concentration was achieved, 1 min later the concentration was increased in increments of 0.3 μg∕ml. When the patients lost eyelash reflex and had no responses to clapping on the shoulder, bispectral index value and target plasma and effect?site concentrations of propofol, consumption of propofol and time for loss of consciousness were recorded. Re?sults Compared with group C, no significant change was found in bispectral index value at baseline or at loss of consciousness(P>0.05), the target plasma and effect?site concentrations and consumption of propofol were significantly decreased, and the time for loss of consciousness was shortened in group T(P<0.05). The consumption of propofol required at loss of consciousness was gradually reduced with the aggra?vated severity of hearing disorders in group T(P<0.05). Conclusion The analgesic efficacy of propofol is enhanced in the patients with hearing disorders.