Objective:To explore the mediating effect of medical coping style on psychological resilience and death anxiety in cancer patients.Methods:Using the convenient sampling method, a total of 330 inpatients from 2 cancer hospitals in Beijing were selected as the research objects from June to August 2020. The general information questionnaire, Chinese Version of Templer 's Death Anxiety Scale (C-T-DAS) , Medical Coping Modes Questionnaire (MCMQ) and the Connor-Davidson Resilience Scale (CD-RISC) were used to investigate them. Pearson correlation analysis and multiple linear regression were used to analyze the relationship between death anxiety, medical coping style and psychological resilience in cancer patients. AMOS 21.0 was used to establish the structural equation model and verify the mediation effect. A total of 330 questionnaires were sent out in this study, and 302 were effectively received, with the effective recovery of 91.5%. Results:The score of Chinese Version of Templer's Death Anxiety Scale for 302 cancer patients was (40.12±10.23) , the score of Connor-Davidson Resilience Scale was (70.97±13.43) and the scores of confrontation, avoidance and resighation dimension of Medical Coping Modes Questionnaire were (18.80 ±3.65) , (15.64±3.16) and (8.75±2.84) . The psychological resilience of cancer patients was negatively correlated with death anxiety and the resignation dimension in medical coping styles ( P<0.01) , and positively correlated with the facing and avoiding dimensions in medical coping styles ( P<0.05) . The face and yield dimensions in the medical coping style of cancer patients were positively correlated with death anxiety ( P<0.05) . Medical coping styles played a partial mediating role between psychological resilience and death anxiety, and the mediating effect accounted for 32.47% of the total effect. Conclusions:Clinical medical staff should pay attention to the death anxiety of cancer patients, improve their psychological resilience and encourage patients to actively cope with the disease, so as to reduce their death anxiety level and promote mental health.

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 investigate and analyze the current situation of the nurse anesthetists and their work situation in tertiary hospitals of Guangdong province and provide reference information for the standardization construction of perianesthesia nursing.Methods A self-designed questionnaire was used to survey the nurse anesthetists and their work situation in 53 tertiary hospitals in Guangdong province.Results There were 413 nurse anesthetists in total,and the setting rate of full-time head nurse in a department of anesthesiology was 32％ in 53 tertiary hospitals of Guangdong province.The occupational titles were mainly the primary title,and the constituent ratio was 61.7％;the educational backgrounds were mainly bachelor's degree,and the constituent ratio was 62％;ages mainly ranged from 26 to 39,and the constituent ratio was 55.7％.The main working contents were management of anesthesia supplies (drugs,disposable materials,apparatus and equipment),nursing in postanesthesia care unit,and cooperation and nursing for the anesthesia practice inside or outside the operating room.Conclusion Nurse anesthetists in the tertiary hospitals in Guangdong province are young,and their work involves a wide range with complicated contents,an unbalanced development in different districts has occurred,and thus the standardization construction of perianesthesia nursing should be further strengthened.

BACKGROUNDAtherosclerosis is a kind of disease with multiple risk factors, of which hyperlipidemia is a major classical risk factor resulting in its pathogenesis and development. The aim of this study was to determine the effects of short-term intensive atorvastatin (IA) therapy on vascular endothelial function and explore the possible mechanisms that may help to explain the clinical benefits from short-term intensive statin therapy.

METHODSAfter exposure to high-fat diet (HFD) for 8 weeks, the animals were, respectively, treated with IA or low-dose atorvastatin (LA) for 5 days. Blood lipids, C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), nitric oxide (NO), endothelin-1 (ET-1), and endothelium-dependent vasorelaxation function were, respectively, measured. mRNA and protein expression of CRP, TNF-α, IL-6, macrophage chemoattractant protein-1 (MCP-1), and 5-lipoxygenase (5-LO) were also evaluated in pericarotid adipose tissue (PCAT) and cultured adipocytes.

RESULTSHFD increased serum inflammatory factor levels; induced significant hyperlipidemia and endothelial dysfunction, including imbalance between NO and ET-1; enhanced inflammatory factors and 5-LO expression; and promoted macrophage infiltration into adipose tissue. Five-day IA therapy could significantly decrease serum inflammatory factor levels and their expression in PCAT; restore the balance between NO and ET-1; and improve endothelial function and macrophage infiltration without significant changes in blood lipids. However, all of the above were not observed in LA therapy. In vitro experiment found that lipopolysaccharide (LPS) enhanced the expression of inflammatory factors and 5-LO in cultured adipocytes, which could be attenuated by short-time (6 hours) treatment of high-dose (5 µmol/L) but not low-dose (0.5 µmol/L) atorvastatin. In addition, inhibiting 5-LO by Cinnamyl-3,4-dihydroxy-α-cyanocinnamate (CDC, a potent and direct 5-LO inhibitor) could significantly downregulate the above-mentioned gene expression in LPS-treated adipocytes.

CONCLUSIONShort-term IA therapy could significantly ameliorate endothelial dysfunction induced by HFD, which may be partly due to attenuating inflammation of PCAT through inhibiting 5-LO pathway.

Adipose Tissue ; drug effects ; immunology ; Animals ; Arachidonate 5-Lipoxygenase ; metabolism ; Atorvastatin Calcium ; Heptanoic Acids ; therapeutic use ; Hyperlipidemias ; drug therapy ; immunology ; Inflammation ; drug therapy ; immunology ; Lipid Metabolism ; drug effects ; Male ; Pyrroles ; therapeutic use ; Rabbits

Objective To investigate the effects of dexmedetomidine (DEX) on oxidative stress and inflammatory cytokines caused by tourniquet-induced ischemia-reperfusion injury at limbs.Methods Eighty patients who had been scheduled for lower limb operation with tourniquet were assigned equally by sequence number to use or not use DEX (DEX or control group,n =40).Combined spinal-epidural anesthesia was performed in both groups.In the DEX group,DEX intravenous infusion was started immediately after the femoral vein cannulated at a dose of 1 μg/kg for 10 minutes,followed by 0.5 μg/kg · h until the end of operation,whereas the control group received an equivalent volume of 0.9％ saline.At 10 min before tourniquet inflation (T1),10 min (T2),30 min (T3) and 60 min (T4) after tourniquet release,femoral venous blood samples were obtained to measure heart rate (HR),mean arterial pressure (MAP),saturation of pulse oximetry (SPO2),serum malondialdehyde (MDA),serum superoxide dismutase (SOD),serum tumor necrosis factor-α (TNF-α) and interleukin-8 (IL-8) levels in both groups.Results There were no significant differences in HR,MAP or SPO2 at all time points between the 2 groups (P ＞ 0.05).There were no significant differences in HR,MAP or SPO2 at all time points within either group (P ＞ 0.05).There were no significant differences in serum MDA,SOD,TNF-α and IL-8 levels at T1 between the 2 groups (P＞ 0.05).The serum MDA,TNF-α and IL-8 levels were significantly lower and the serum SOD level significantly higher in the DEX group than in the control group at T2,T3 and T4,respectively (P ＜0.05).In both groups,the serum MDA,TNF-α and IL-8 levels were significantly higher and the serum SOD level significantly lower at T2,T3 and T4 than at T1,respectively (P ＜ 0.05).Conclusion Dexmedetomidine can reduce the oxidative stress and inflammatory cytokine level which are caused by tourniquet-induced ischemia-reperfusion injury.

Objective To observe the incidence and the rate of embolism in patients undergoing hysteroscopy procedures by using the transesophageal echocardiography (TEE), as well as the changes of respiratoric and haemodynamic variables. Methods Fourty ASA Ⅰ~Ⅱ patients undergoing hysteroscopy procedures under general anesthesia received intraoperative TEE monitoring. The systolic pulmonary artery pressure, the incidence of the venous gas embolism (VGE) and the eegmental wall motion abnormality (SWMAs) were observed. Results In the 40 patients, 38 patients received intravenous anesthesia hysteroscopic surgery, with the intraoperative TEE to monitor the intracardiac VGE. The degree of gas embolism was related with the perfusion and the usage of monopolar or bipolar diathermia (P<0.05). The systolic pulmonary artery pressure promoted and SWMAs were also observed. Conclusions The continue TEE monitor during hysteroscopy could detect the intracardiac gas embolism in time , contributing to early diagnosis and avoiding the occurrence of malignant arrhythmias or myocardial ischemic events.

Objective To evaluate the effect ofpropofol on minimum threshold (MT) of the inferior colliculus neuron discharge in rats.Methods Forty-three healthy SPF grade Sprague Dawley (SD) rats,weighing 200-250 g,were chosen in our study and established wakeful animal models by ventilating with animal respirator after infusing vecuronium.A microelectrode was penetrated in the inferior colliculus (ICC),and then,MT of the inferior colliculus neuron discharge was noted using a Tucker-Davis Technologies System 3 before intraperitoneal injection of propofol 100 mg/kg and after administration.Results Characterizing fiequency of the neurons (12.06±8.77 kHz) was positively correlated to depth of the recording electrode (3435.65±651.00 μm; r=0.581,P=0.000); discharge threshold can be determined in 30 of 43 neurons,and the threshold values under awake and anesthetized states were 36.8±20.4 dB SPL and 40.4±20.5 dB SPL,respectively,with significant differences (P＜0.08).The intercept of the linear regression line is significantly more than 0 corresponding to the diagonal one (P＜0.05).Conclusion Propofol affect auditory information transmission by increasing neuronal response MT and reducing excitability in ICC,which is possibly an important factor leading to heating disappear.

Objective To evaluate the effects of pulmonary static inflation with different pressures on postoperative lung function in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Sixty ASA Ⅱ or Ⅲ patients,aged 26-70 yr,weighing 47-78 kg,undergoing elective cardiac valve replacement with CPB,were randomly divided into 2 groups (n =30 each):pulmonary static inflation with 5 cm H2O group (group L) and with 10 cm H2O group (group H).In L and H groups,pulmonary static inflation was performed with the pressure maintained at 5 and 10 cm H2O,respectively,after stopping mechanical ventilation during CPB.Arterial blood samples were taken before skin incision and at 1,3 and 6 h after termination of CPB for blood gas analysis.The alveolar-arterial oxygen pressure difference (D(A-a)O2),respiratory index (RI) and oxy.genation index (OI) were calculated.The indwelling time of endotracheal tube after operation and duration of ICU stay were recorded.Results Compared with group L,D(A-a)O2 and RI were significantly decreased and OI was increased at 1,3 and 6 h after termination of CPB,the incidence of OI less than 300 mm Hg was decreased (P ＜ 0.05),and no significant change was found in the indwelling time of endotracheal tube after operation and duration of ICU stay in H group (P ＞ 0.05).Collusion Pulmonary static inflation with 10 cm H2O can better improve postoperative pulmonary diffusion function than with 5 cm H2O in patients undergoing cardiac valve replacement with CPB.

OBJECTIVETo investigate the expressions of gamma aminobutyric acid transporter 1 (GAT-1) and glutamate decarboxylase 65 (GAD65) mRNA in different brain regions at brain propofol uptake equilibrium in dogs.

METHODSEighteen 12- to 18-month-old healthy hybrid dogs were randomized equally into control group (group C), low dose group (group L), and high dose group (group H). In groups L and H, anesthesia was administered by intravenous injection of 5.5 and 7.0 mg/kg propofol followed by propofol infusion at a constant rate of 55 and 70 mg·kg(-1)·h(-1) for 50 min, respectively. Blood samples were taken from the internal carotid artery and jugular vein to measure plasma propofol concentrations, and the brain tissues of the hypothalamus, sub thalamus, dorsal thalamus, hippocampus, pons, parietal lobe and frontal lobe were examined for GAT-1 and GAD65 mRNA expressions using quantitative real-time PCR.

RESULTSIn groups L and H, propofol infusion at a constant rate for 50 min resulted in comparable plasma propofol concentrations between the internal carotid artery and jugular vein (P>0.05), but the concentrations differed significantly between the two groups (P<0.01). GAT-1 mRNA levels in the hypothalamus and hippocampus were significantly higher in groups L and H than in group C (P<0.05 and P<0.01), but comparable between the former two groups. The variations of GAT-1 mRNA levels between the hypothalamus and hippocampus were similar in both group L [(61.26∓7.17)% and (79.34∓39.95)%, P>0.05] and group H [(74.64∓19.63)% and (97.12∓32.31)%, P>0.05]. GAT-1 mRNA levels in other brain regions showed no significant difference among the 3 groups. GAD65 mRNA levels were similar between group L and group H, but both significantly higher than that in group C (P<0.01). GAD65 mRNA in other brain regions had no significant difference among the 3 groups.

CONCLUSIONGAT-1 mRNA in the hypothalamus and hippocampus and GAD65 mRNA in the dorsal thalamus are upregulated when propofol uptake reaches an equilibrium in the brain of dogs.

Animals ; Brain ; drug effects ; metabolism ; Dogs ; GABA Plasma Membrane Transport Proteins ; genetics ; metabolism ; Glutamate Decarboxylase ; genetics ; metabolism ; Hippocampus ; drug effects ; metabolism ; Hypothalamus ; drug effects ; metabolism ; Propofol ; pharmacology ; RNA, Messenger ; genetics ; Thalamus ; drug effects ; metabolism

Objective To investigate the effects of preconditioning with repeated electroacupuncture (EA)at Shenshu acupoint on renal ischemia-reperfusion (I/R) injury in rats.Methods Fifty adult male Sprague-Dawley rats,weighing 260-320 g,were randomly divided into 4 groups:sham operation group (n =5),I/R group,pentobarbital sodium + I/R group (PB + I/R group) and repeated EA at Shenshu acupoint + I/R group (EA + I/R group).The model of renal I/R injury was established by occlusion of bilateral renal pedicles for 45 min followed by reperfusion.Pentobarbital sodium 30 mg/kg was injected intraperitoneally everyday for 5 consecutive days and I/R was induced 24 h after the last injection in PB + I/R group.The animals received EA at Shenshu acupiont 30min per day for 5 consecutive days under pentobarbital sodium anesthesia and I/R was induced 24 h after the last preconditioning in EA + I/R group.Blood samples were taken at 1,3 and 7 days after I/R to determine the levels of serum blood urea nitrogen (BUN) and creatinine (Cr).The animals were then sacrificed and the kidney was isolated.The histological changes of the kidney was scored.The apoptosis in renal tubular epithelial cells was measured using TUNEL at 3 days after I/R.Apoptosis index (AI) was calculated.The expression of proliferating cell nuclear antigen (PCNA),Bcl-2,Bax,Fas and FasL in renal tubular epithelial cells was measured by immuno-histochemistry at 3 days after I/R.Results Compared with group S,the levels of serum BUN and Cr,and histological score were significantly increased at 1,3 and 7 days after I/R in I/R and PB + I/R groups,and at 1 and 3 days after I/R in EA + I/R group,the expression of PCNA,Bcl-2,Bax,Fas and FasL was up-regulated in I/R,PB + I/R and EA + I/R groups,and Bax/Bcl-2 ratio was significantly increased in I/R and PB + I/R groups (P ＜0.05).Compared with I/R and PB + I/R groups,the levels of serum BUN and Cr,and histological score were significantly decreased at 3 and 7 days after I/R,AI and the expression of Bax,Fas and FasL were significantly decreased,and the expression of PCNA and Bcl-2 was up-regulated in EA + I/R group (P ＜ 0.05).Conclusion Preconditioning with repeated EA at Shenshu acupoint can attenuate the renal I/R injury in rats by promoting the proliferation of renal tubular epithelial cells and reducing the apoptosis in cells.