Objective:To evaluate the effect of electroacupuncture on the heme oxygenase-1 (HO-1)/PTEN-induced putative kinase 1 (PINK1)/Parkin signaling pathway during acute kidney injury in endotoxemic rats.Methods:Twenty-four SPF healthy male Sprague-Dawley rats, aged 6-8 weeks, weighing 180-220 g, were divided into 4 groups ( n=6 each) by a random number table method: control group(group C), endotoxemia group(group E), acupoint electroacupuncture+ endotoxemia group(group EE), and non-acupoint electroacupuncture+ endotoxemia group(group NE). The endotoxemia model was developed by intraperitoneal injection of lipopolysaccharide 10 mg/kg. The equal volume of normal salinewas injected in group C. LPS 10 mg/kg was intraperitoneally injected in group E. In group EE, 30-min electroacupuncture was performed at bilateral Zusanli and Shenshu acupoints using disperse-dense waves with a frequency of 2/15 Hz to induce slight muscle tremor once a day starting from 5 days before developing the model, and the needle was retained until 6 h after injection. Electroacupuncture was performed at the points 0.5 cm lateral to the acupoints of Zusanli and Shenshu in group NE. The rats were anesthetized at 6 h after lipopolysaccharide injection, and blood samples from the femoral vein were obtained for determination of the serum creatinine (Cr) and urea nitrogen (BUN) concentrations(with a biochemical analyzer) and concentrations of neutrophil gelatinase-associated lipid transport protein (NGAL), interleukin-6 (IL-6), tumor necrosis factor (TNF-α) and kidney injury molecule-1(KIM-1) in serum (by enzyme-linked immunosorbent assay). Then the rats were sacrificed and kidney tissues were taken for determination of histological score of kidneys (HSK, using HE staining) and expression of HO-1, PINK1, Parkin, mitochondrial fusion protein 2(Mfn2), optic atrophy protein 1(OPA1) and mitochondrial dynamic-related protein 1 (Drp1) (by Western blot). Results:Compared with group C, serum concentrations of Cr, BUN, KIM-1, NGAL, IL-6 and TNF-α and HSK score of renal tissues were significantly increased, the expression of HO-1, PINK1, Parkin and Drp1 was up-regulated, and the expression of Mfn2 and OPA1 was down-regulated in E, EE and NE groups ( P<0.05). Compared with group E, serum concentrations of Cr, BUN, KIM-1, NGAL, IL-6 and TNF-α and HSK score of renal tissues were significantly decreased, and the expression of HO-1, PINK1, Parkin, Mfn2 and OPA1 was up-regulated, and Drp1 expression was down-regulated in group EE( P<0.05), and no significant change was found in the parameters mentioned above in group NE ( P>0.05). Conclusions:The mechanism by which electroacupuncture alleviates acute kidney injury is associated with activation of HO-1/PINK1/Parkin signaling pathway in endotoxemic rats.

Objective:To investigate the postoperative analgesic effect of ultrasound-guided continuous thoracic paravertebral nerve block combined with flurbiprofen axetil intravenous analgesia pump for thoracoscopic lobectomy and segmentectomy.Methods:The clinical data of 68 cases who underwent thoracoscopic lobectomy and segmentectomy in Shanxi Province Cancer Hospital between January 2021 and June 2021 were retrospectively analyzed. According to the postoperative analgesia methods, all patients were divided into the control group (36 cases) and the experimental group (32 cases). The patients in the control group received ultrasound-guided single thoracic paravertebral nerve block combined with sufentanil and flurbiprofen axetil intravenous analgesia pump, and the patients in the experimental group received ultrasound-guided continuous thoracic paravertebral nerve block combined with flurbiprofen axetil intravenous analgesia pump. The pressing times of intravenous analgesia pump, visual simulation score (VAS) during rest and activity, vitality status and adverse reactions of the two groups were compared at 2 d after operation.Results:There were no statistically significant differences in VAS during rest and activity and analgesia pump pressing times between the control group and the experimental group (all P > 0.05). The vitality status at postoperative day 2 was better than that at postoperative day 1 ( P < 0.05); while, the differences in the vitality status at postoperative day 1 and day 2 as well as the pressing times of analgesia pump in the experimental group were not statistically significant (both P > 0.05). The VAS during rest and activity on postoperative day 2 was lower than that on postoperative day 1 among patients in the control group and experimental group (both P < 0.05). In the control group, 5 cases had nausea and headache, and 2 cases had dizziness; in the experimental group, 1 case had dizziness; the difference in the adverse reaction incidence of both groups was statistically significant ( χ2 = 4.00, P = 0.045). Conclusions:Continuous thoracic paravertebral nerve block shows a favorable analgesic effect comparable with that of intravenous oxycodone in the analgesia after thoracoscopic lobectomy, and the former has less adverse reactions.

Objective:To systematically evaluate the effect of melatonin on postoperative sleep quality.Methods:Databases such as PubMed, Embase, Cochrane library, Web of Science, ClinicalTrials.gov, China National Knowledge Infrastructure, Wanfang Database, China Biomedical Literature Database and China Science and Technology Journal Database were searched from inception to January 30, 2022 for randomized controlled trials (RCTs) comparing the effects of melatonin versus placebo on postoperative sleep quality.The outcomes analyzed were visual analog scale (VAS) score, sleep quality scale score, subjective sleep scale score, St.Mary′s Hospital sleep questionnaires score, sleep latency, total sleep time, number and duration of awakenings, and incidence of postoperative sleep disturbance.Statistical analysis was performed using the RevMan 5.4 software and Stata 16 software, and the trial sequential analysis (TSA) was conducted using the TSA 0.9.5.10 Beta software. Results:Eleven RCTs involving 822 patients were finally enrolled, with 431 patients in melatonin group and 391 patients in placebo group.The results of meta-analysis showed that melatonin significantly decreased postoperative VAS and sleep quality scale scores, and increased the postoperative subjective sleep scale and St.Mary′s Hospital sleep questionnaires scores, a daily dose of melatonin 6 mg produced a better efficacy, and it also prolonged the postoperative total sleep time and decreased the incidence of postoperative sleep disorders ( P<0.05), However, it had no effect on postoperative sleep latency and the number and duration of awakenings ( P>0.05). The results of TSA showed that although the actual sample size did not reach the expected sample size, the accumulated Z value crossed the traditional boundary value and the TSA boundary value, which indicated that the results of this meta-analysis had stability and further confirmed the efficacy of melatonin in improving postoperative sleep quality. Conclusions:Melatonin can improve postoperative sleep quality and a daily dose of melatonin 6 mg exerts a better efficacy.

Objective: To analyze the correlations between intraoperative ultrasound and MRI metrics of the spinal cord in degenerative cervical myelopathy and identify novel potential predictive ultrasonic indicators of neurological recovery for degenerative cervical myelopathy. Materials and Methods: Twenty-two patients who underwent French-door laminoplasty for multilevel degenerative cervical myelopathy were followed up for 12 months. The Japanese Orthopedic Association (JOA) scores were assessed preoperatively and 12 months postoperatively. Maximum spinal cord compression and compression rates were measured and calculated using both intraoperative ultrasound imaging and preoperative T2-weight (T2W) MRI. Signal change rates of the spinal cord on preoperative T2W MRI and gray value ratios of dorsal and ventral spinal cord hyperechogenicity on intraoperative ultrasound imaging were measured and calculated. Correlations between intraoperative ultrasound metrics, MRI metrics, and the recovery rate JOA scores were analyzed using Spearman correlation analysis. Results: The postoperative JOA scores improved significantly, with a mean recovery rate of 65.0 ± 20.3% (p < 0.001). No significant correlations were found between the operative ultrasound metrics and MRI metrics. The gray value ratios of the spinal cord hyperechogenicity was negatively correlated with the recovery rate of JOA scores (ρ = -0.638, p = 0.001), while the ventral and dorsal gray value ratios of spinal cord hyperechogenicity were negatively correlated with the recovery rate of JOA-motor scores (ρ = -0.582, p = 0.004) and JOA-sensory scores (ρ = -0.452, p = 0.035), respectively. The dorsal gray value ratio was significantly higher than the ventral gray value ratio (p < 0.001), while the recovery rate of JOA-motor scores was better than that of JOA-sensory scores at 12 months post-surgery (p = 0.028). Conclusion For degenerative cervical myelopathy, the correlations between intraoperative ultrasound and preoperative T2W MRI metrics were not significant. Gray value ratios of the spinal cord hyperechogenicity and dorsal and ventral spinal cord hyperechogenicity were significantly correlated with neurological recovery at 12 months postoperatively.

Objective:To evaluate the effect of electroacupuncture (EA) on pyroptosis in renal tubular epithelial cells of rats with acute kidney injury (AKI) induced by endotoxin.Methods:Twenty-four healthy clean-grade Sprague-Dawley rats of either gender, aged 6-8 weeks, weighing 160-182 g, were divided into 4 groups ( n=6 each) using a random number table method: control group (group C), group AKI, EA plus AKI group (group EA), sham EA at non-acupoint plus AKI group (group SEA). The model of endotoxemia was established by intraperitoneally injecting 10 mg/kg lipopolysaccharide.Bilateral 30 min EA stimulation of Zusanli and Shenyu (according to atlas of animal acupoint) was performed starting from 5 days before establishing the model (once a day) and at 30 min before lipopolysaccharide administration on the day of establishing the model, with disperse-dense waves, frequency of 15 Hz, and the needle was kept until 6 h after injection of LPS in group EA.EA was performed at the points 0.5 cm lateral to the acupoints of Zusanli and Shenyu in group SEA.At 6 h after LPS injection, blood was taken from the heart, and the concentrations of serum blood urea nitrogen (BUN) and creatinine (Cr) were detected by an automatic biochemical analyzer, and the serum concentrations of neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) by enzyme-linked immunosorbent assay.The rats were then sacrificed, and the left renal cortex was obtained for determination of pyroptosis rate of renal tubular epithelial cells (by TUNEL). The right renal cortex was obtained to detect the expression of caspase-1 and IL-1β by Western blot, and the expression of caspase-1 mRNA and IL-1β mRNA was detected by real-time polymerase chain reaction. Results:Compared with group C, the concentrations of BUN, Cr, NGAL, KIM-1, TNF-α, and IL-6 were significantly increased, the pyroptosis rate of renal tubular epithelial cells was increased, the expression of caspase-1 and IL-1β protein and mRNA in the renal cortex was up-regulated in group AKI ( P<0.05). Compared with group AKI, the concentrations of BUN, Cr, NGAL, KIM-1, TNF-α, and IL-6 were significantly decreased, the pyroptosis rate of renal tubular epithelial cells was decreased, the expression of caspase-1 and IL-1β protein and mRNA in the renal cortex was down-regulated in group SEA ( P>0.05). Conclusion:The mechanism by which EA reduces AKI may be related to inhibiting pyroptosis in renal tubular epithelial cells of rats.

Objective: To analyze the correlations between intraoperative ultrasound and MRI metrics of the spinal cord in degenerative cervical myelopathy and identify novel potential predictive ultrasonic indicators of neurological recovery for degenerative cervical myelopathy. Materials and Methods: Twenty-two patients who underwent French-door laminoplasty for multilevel degenerative cervical myelopathy were followed up for 12 months. The Japanese Orthopedic Association (JOA) scores were assessed preoperatively and 12 months postoperatively. Maximum spinal cord compression and compression rates were measured and calculated using both intraoperative ultrasound imaging and preoperative T2-weight (T2W) MRI. Signal change rates of the spinal cord on preoperative T2W MRI and gray value ratios of dorsal and ventral spinal cord hyperechogenicity on intraoperative ultrasound imaging were measured and calculated. Correlations between intraoperative ultrasound metrics, MRI metrics, and the recovery rate JOA scores were analyzed using Spearman correlation analysis. Results: The postoperative JOA scores improved significantly, with a mean recovery rate of 65.0 ± 20.3% (p < 0.001). No significant correlations were found between the operative ultrasound metrics and MRI metrics. The gray value ratios of the spinal cord hyperechogenicity was negatively correlated with the recovery rate of JOA scores (ρ = -0.638, p = 0.001), while the ventral and dorsal gray value ratios of spinal cord hyperechogenicity were negatively correlated with the recovery rate of JOA-motor scores (ρ = -0.582, p = 0.004) and JOA-sensory scores (ρ = -0.452, p = 0.035), respectively. The dorsal gray value ratio was significantly higher than the ventral gray value ratio (p < 0.001), while the recovery rate of JOA-motor scores was better than that of JOA-sensory scores at 12 months post-surgery (p = 0.028). Conclusion For degenerative cervical myelopathy, the correlations between intraoperative ultrasound and preoperative T2W MRI metrics were not significant. Gray value ratios of the spinal cord hyperechogenicity and dorsal and ventral spinal cord hyperechogenicity were significantly correlated with neurological recovery at 12 months postoperatively.

Objective:To evaluate the effect of sufentanil on activation of Schwann cells after peripheral nerve injury in mice.Methods:Eighty healthy pathogen-free male Balb/c mice, aged 6-8 weeks, weighing 18-22 g, were divided into 4 groups ( n=20 each) using a random number table method: peripheral nerve injury group (group PNI), high dose sufentanil group (group H), medium dose sufentanil group (group M) and low dose sufentanil group (group L). The model of unilateral sciatic nerve transaction was established in ketamine-anesthetized mice.Immediately after establishment of the model, sufentanil 10, 5 and 2.5 μg/kg was injected intraperitoneally once a day for 3 consecutive days in H, M and L groups, respectively, while the equal volume of normal saline was given instead in group PNI.Sciatic function index (SFI) was calculated at 4, 8 and 12 weeks after establishment of the model.At 2, 4, 8 and 12 weeks, 5 mice in each group were sacrificed, and segments of the injuried ipsilateral sciatic nerve were removed for examination of the ultrastructure of the sciatic nerve (with a transmission electron microscope) and for detection of the expression of glial fibrillary acidic protein (GFAP) of sciatic nerve (by immunohistochemistry). Results:Compared with group PNI, SFI was significantly increased, and the expression of GFAP was up-regluated at each time point after establishment of the model in H and M groups ( P<0.05) and no significant change was found in SFI and GFAP expression after establishment of the model in group L ( P>0.05). Compared with group L, SFI was significantly increased, and GFAP expression was up-regluated in H and M groups ( P<0.05). There was no significant difference in SFI and GFAP expression between group H and group M ( P>0.05). The thickness of myelin lamellae was dense, and the proliferation of Schwann cells was not marked in H and M groups.The thickness of myelin lamellae was thin, and the proliferation of Schwann cells was marked in L and MO groups. Conclusion:The mechanism by which sufentanil improves repair after peripheral nerve injury may be related to promoting activation of Schwann cells in mice.

Postoperative nausea and vomiting ( PONV) is a common complication after anaesthesia, which hinders the rapid recovery of patients. Aprepitant, one of neurokinin-1 (NK-1) receptor antagonists is mainly used to prevent nausea and vomiting by blocking the binding of substance P to NK-1 receptor. It has the advantages of high selectivity, strong affinity and long half-life, and its new antiemetic target pro-vides a new choice for prophylactic treatment of PONV. This article summarize studies on the prophylaxis of aprepitant in treatment of PONV.

Objective To evaluate the effect of sufentanil on apoptosis in spinal cord neurons of mice with peripheral nerve injury. Methods One hundred and fifty clean-grade healthy male BALB∕c mice, aged 6-8 weeks, weighing 18-22 g, were divided into 3 groups ( n=50 each) using a random number table method: sham operation group (group Sham), peripheral nerve injury group (group PNI) and sufentanil group ( group SF) . The model of unilateral sciatic nerve injury was established in PNI and SF groups. After establishing the model, sufentanil 5. 0 μg∕kg was intraperitoneally injected once a day for 3 consecutive days in group SF, while the equal volume of normal saline was given instead of sufentanil in Sham and PNI groups. Five mice in each group were sacrificed at days 1, 3, 7, 14 and 28 after surgery ( T0-4 ) , and L4-6 segments of the injure ipsilateral spinal cord were removed for examination of pathological changes ( with a light microscope) and for determination of neuronal apoptosis ( by TUNEL assay) . The ap-optosis index ( AI) was calculated. Five mice in each group were sacrificed at T0-4 , and L4-6 segments of the injured ipsilateral spinal cord were removed for detection of the expression of Bcl-2, Bax and cleaved caspase-3 by Western blot. The ratio of Bcl-2 expression to Bax expression ( Bcl-2∕Bax ratio) was calculat-ed. Results Compared with group Sham, the AI was significantly increased, the expression of Bcl-2 pro-tein was down-regulated, and the expression of cleaved caspase-3 and Bax was up-regulated in PNI and SF groups ( P<0. 05) . Compared with group PNI, the AI was significantly decreased, the expression of Bcl-2 protein was up-regulated, the expression of cleaved caspase-3 and Bax was down-regulated, the Bcl-2∕Bax ratio was increased (P<0. 05), and the pathological changes were significantly attenuated in group SF. Conclusion Sufentanil can inhibit apoptosis in spinal cord neurons of mice with peripheral nerve injury.

Objective To investigate the predictive value of plasma homocysteine (Hcy) on contrast-induced nephropathy after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) .Methods Totally 156 patients with AMI receiving PCI in Beijing Electric Power Hospital from January 2014 to December 2015 were enrolled for the study and divided into contrast-induced nephropathy group and non-contrast-induced nephropathy group .Baseline data ,perioperative data and auxilia-ry examination results were compared between two groups .The single factor analysis and multivariate Logistic regression were used to analyze the influencing factors .Results In all 156 patients ,32 cases occurred contrast-induced nephropathy after PCI ,and the in-cidence was 20 .5% .The plasma Hcy level in contrast-induced nephropathy group was (21 .3 ± 8 .7)μmol/L ,significantly higher than (13 .3 ± 6 .1) μmol/L in non-contrast-induced nephropathy group (P< 0 .05) .Multiple Logistic regression analysis results showed that plasma Hcy levels was the independent risk factors of contrast-induced nephropathy (OR=2 .254 ,95% CI:1 .359 -3 .737 ,P=0 .002) .Conclusion About 1/5 of patients with AMI occur contrast-induced nephropathy after PCI ,and preoperative plasma Hcy level can well predict the risk of contrast-induced nephropathy ,which is worthy of clinical application .