Group RP Research Articles

Effect of preoperative visiting operation room on emergence agitation in preschool children under sevoflurane anesthesia

BackgroundEmergence agitation (EA) is a common complication in children during recovery from sevoflurane anesthesia with an high incidence. The main objective of this study was to compare the effects of preoperative visiting operation room (PVOR) to administration of propofol at the end of anesthesia on EA in preschool children under sevoflurane anesthesia. MethodsSixty-nine preschool children aged from 3 to 6 years scheduled for tonsillectomy under sevoflurane anesthesia were randomly allocated to one of the three groups to receive either PVOR (Group PV), routine preoperative visit (Group RV) or routine preoperative visit plus propofol (Group RP), 23 patients were included in each group. General anesthesia was induced and maintained with sevoflurane. Parental separation status score, mask acceptance score, Aono's four point score and pediatric anesthesia emergence delirium (PAED) score and incidence of EA were recorded. PAED score >10 were regarded as EA. Recovery profile and adverse events were also recorded. ResultParental separation status score and mask acceptance score in group PV was significantly lower than that in group RV and group RP (P < 0.05); Aono's four point score, PAED score and incidence of EA in group PV and group RP was significantly lower than that in group RV (P < 0.05); Time to extubation and time to interaction in group PV and group RV was significantly shorter than that in group RP (P < 0.05); POV and rescue by fentanyl in group PV and group RP was significantly lower than that in group RV(P < 0.05). ConclusionPVOR can effectively reduce the incidence of EA as well as administration of propofol without additional medical expenses and other adverse effects.

A Comparative Study To Evaluate The Effectiveness Of Timing Principle And Priming Principle For Tracheal Intubation Using Rocuronium

The present study is to compare the Timing principle and the Priming principle for tracheal intubation using rocuronium during balanced anesthesia by assessing the Intubating conditions and Hemodynamic changes during intubation. The succinylcholine is considered to be the best drug for rapid tracheal intubation because of its rapid onset and ultrashort duration of the action. The “priming technique” uses a sub-paralyzing dose of non-depolarizing muscle relaxant where 20% of ED 95 or 10% of the intubating dose was administered 2 to 4 min before administering an intubating dose. This technique has been proved to accelerate the onset of action by 30 to 60 seconds(5). In “timing principle” a single bolus of non-depolarizing muscle relaxant was given followed by the administration of the induction agent after the first sign of the onset of clinical weakness. The “high – dose regimen” was used when tracheal intubation has to be accomplished in less than 60 – 90 seconds(6). The study was conducted in Madras Medical College, Chennai The groups were comparable based on age and weight. Males were more in Group RP. Using the “Timing principle” with rocuronium 0.6 mg/kg consistently provides good to excellent intubating conditions at 60 seconds after the induction of anesthesia. Using the Priming principle with rocuronium 0.06 mg/kg followed by rocuronium 0.54 mg/kg consistently provides fair to good intubating conditions at 60 seconds after induction of anesthesia.

Dependencies between some traits of sperm production of boars at different age

The aim of the study was to establish correlation and regression dependencies between some traits of sperm production of terminal boars (Large White x Pietrain). The analyzed material consisted of 347 ejaculates, received in the period from 2011 to 2014. The boars were divided in three groups according to the age the ejaculate was obtained at (up to 12 months, from 12 to 24 months, and above 36 months). A moderate and negative correlation was established (rp=-0.34, p&lt;0.001) between the volume of the ejaculate and the concentration of the sperms in the second age group. With the youngest boars we established poor and positive correlation (rp=0.29, p&lt;0.05) between the volume of the semen and the motility of the sperm. The correlations between the traits concentration and motility are poor in the third (rp=0.18, p&lt;0.05), and moderate in the second age group (rp=0.49, p&lt;0.001). Between the motility from one side and the agglutinated and dead sperms from the other, they are within the range of rp =-0.46 to rp=-0.87, p&lt;0.001. The correlations between the agglutinated and dead sperms are positive, from moderate to high and reliable (p&lt;0.001) in all three age classes. The regression trend between the traits of sperm production are almost the same in all three age groups with the exception of volume of the ejaculate to the concentration of sperms.

Effect of Different Sedation Regimes on Cognitive Functions in Colonoscopy.

Aim:To compare the effects of propofol/remifentanil and meperidine/midazolam on postprocedure cognitive function.Materials and methods:A total of 100 American Society of Anesthesiologists (ASA) score I to III patients undergoing elective colonoscopy were taken into the study and divided into two groups. Exclusion criteria were patient refusal, mini mental test (MMT) <26, The Amsterdam Preoperative Anxiety and Information Scale (APAIS) >10, advanced cardiopulmonary or psychiatric disease, chronic alcohol abuse, morbid obesity, and known allergy to study drugs. In group MM, 2 mg midazolam and 20 mg meperidine was given intravenously and additional 1 to 2 mg midazolam and 20 mg meperidine (with a maximum total of 5 mg midazolam and 50 mg meperidine) was given when bispectral index (BIS) was >80. In group RP, 100 μg/kg/minute propofol infusion and 1 μg/kg remifentanil bolus was administered and additional 0.5 μg/kg remifentanil bolus was given when BIS was >80. Observer’s Assessment of Alertness/Sedation scale (OAA/S) and Facial Pain Score (FPS) values were recorded. Cognitive function was measured by Trieger Dot Test (TDT) and Digit Symbol Substitution Test (DSST).Results:The study was concluded with 100 patients. Heart rate was slower and BIS values were lower in group RP throughout the procedure. Blood pressure was lower in group RP without clinical significance. There was no difference concerning recovery time and visual analog scores (VASs). In group MM, TDT scores were higher and DSST scores were lower. Satisfaction was higher in group RP.Conclusion:Propofol/remifentanil combination is better than meperidine/midazolam combination concerning cognitive function in sedation for colonoscopy.Clinical significance:The addition of BIS monitorization to evaluate the depth of sedation and the negative effects of midazolam meperidine combination on postprocedural cognitive function.How to cite this article: Ekmekci P, Erkan G, Yilmaz H, Kazbek BK, Koksoy UC, Doganay G, Tüzüner F. Effect of Different Sedation Regimes on Cognitive Functions in Colonoscopy. Euroasian J Hepato-Gastroenterol 2017;7(2):158-162.

Toxicity analysis of ocular prosthesis acrylic resin with or without pigment incorporation in human conjunctival cell line

The aim of this study was to evaluate the influence of pigment incorporation on the cytotoxicity of ocular prosthesis N1 color acrylic resin. Nine samples were manufactured by heat-polymerization in water bath and divided into 3 groups: acrylic resin without pigment incorporation (group R), acrylic resin with pigment incorporation (group RP), and acrylic pigment (group P). Eluates formed after 72h of sample immersion in medium were incubated with conjunctival cell line (Chang conjunctival cells) for 72h. The negative control group consisted in medium without samples (group C). The cytotoxic effect from the eluates was evaluated using MTT assay (cell proliferation), ELISA assay (quantification of IL1β, IL6, TNF α and CCL3/MIP1α) and RT-PCR assay (mRNA expression of COL IV, TGF β and MMP9). Data were submitted to ANOVA with Bonferroni post-tests (p<0.05). All groups were considered non-cytotoxic based on cell proliferation. However, resin with pigment incorporation showed significant IL6 quantity increase. Resin without pigment incorporation exhibited higher mRNA expression of COL IV, MMP9 and TGF β, however it was also observed for the negative control group. The materials exhibited divergent biological behavior. Despite the pigment incorporation that resulted in an increase of IL6, no cytotoxicity was observed based on cell proliferation.

Micro–Computed Tomography Study of Filling Material Removal from Oval-shaped Canals by Using Rotary, Reciprocating, and Adaptive Motion Systems

IntroductionThis study evaluated filling material removal from distal oval-shaped canals of mandibular molars with rotary, reciprocating, and adaptive motion systems by using micro–computed tomography. MethodsAfter cone-beam computed tomography scanning, 21 teeth were selected, prepared up to a size 40 file, root filled, and divided into 3 groups (n = 7) according to the filling material removal technique: group PTUR, ProTaper Universal Retreatment combined with ProTaper Universal F2, F3, F4, and F5 files; group RP, Reciproc R50 file; and group TFA: TF Adaptive 50.04 files. The specimens were scanned preoperatively and postoperatively to assess filling material removal by using micro–computed tomography imaging, and the percent volume of residual filling material was calculated. ResultsThe statistical analysis showed the lowest percent volume of residual filling material at the coronal third in all groups (P < .05). There was no significant difference among the systems in the coronal third (P > .05). In the middle third, group TFA (31.2 ± 10.1) showed lower volume of residual filling material than group RP (52.4 ± 14.1) (P < .05). In the apical third, groups TFA (44.8 ± 20.6) and PTUR (48.6 ± 16.8) presented a lower percent volume of filling material than group RP (70.6 ± 7.2) (P < .05), as confirmed by the qualitative analysis. ConclusionsThe use of the adaptive motion increased the amount of root filling removed in the middle and apical thirds compared with the reciprocating motion. However, no technique was able to completely remove the filling material from the canals.

Effect of remifentanil preconditioning on myocardial ischemia-reperfusion injury in aged rats

Objective To evaluate the effect of remifentanil preconditioning on myocardial ischemia-reperfusion (I/R) injury in aged rats. Methods Twenty-four healthy male Sprague-Dawley rats, aged 15-18 months, weighing 465-580 g, were randomly divided into 3 groups (n = 8 each) using a random number table: sham operation group (group S), group I/R and remifentanil preconditioning group (group RP). The animals were anesthetized with intraperitoneal 10% chloral hydrate 300 mg/kg.Myocardial I/R was induced by 30 min occlusion of anterior descending branch of left coronary artery followed by 120 min reperfusion in group I/R.In group RP, remifentanil 10 μg · kg-1· min-1 was infused intravenously for 20 min followed by 10 min washout before myocardial I/R.In group S, the anterior descending branch was only exposed but not ligated.At 30 min before ligation and 120 min of reperfusion, the activities of serum lactate dehydrogenase (LDH) and creatine kinase-MB (CK-MB) were determined.The hearts were removed at 120 min of reperfusion for determination of myocardial infarct size, the percentage of myocardial infarct size was calculated, and myocardial specimens were obtained for observing myocardial ultrastructure. Results Compared with group S, the activities of serum LDH and CK-MB were significantly increased at 120 min of reperfusion in I/R and RP groups.Compared with group I/R, the activities of serum LDH and CK-MB were significantly decreased, the percentage of myocardial infarct size was decreased, and the pathological changes were attenuated in group RP. Conclusion Remifentanil preconditioning can attenuate myocardial I/R injury in aged rats. Key words: Piperidines; Ischemic preconditioning; Myocardial reperfusion injury; Aged

Effects of remifentanil post-conditioning on aquaporin-1 expression during myocardial ischemia-reperfusion injury in rats

Objective To evaluate the effects of remifentanil post-conditioning on aquaporin-1 (AQP-1) expression during myocardial ischemia-reperfusion (I/R) injury in rats.Methods Twenty-four male.SpragueDawley rats,weighing 250-300 g,were randomly divided into 3 groups (n =8 each) using a random number table:sham operation group (group S),group I/R,and remifentanil post-conditioning group (group RP).Myocardial I/R was induced by 45 min occlusion of left anterior descending branch of coronary artery followed by 24 h reperfusion.Remifentanil 10 μg· kg-1· min-1 was infused over 10 min starting from 10 min before reperfusion in group RP,while the equal volume of normal saline was given instead in S and I/R groups.At the end of reperfusion,all the rats were sacrificed and their myocardial specimens from left ventricles were obtained for microscopic examination of thepathological changes and for determination of AQP-1 mRNA (using real-time fluorescent quantitative PC R) and AQP-1 protein (by Western blot) expression in the ischemic area and myocardial water content.Results Compared with S group,myocardial water content was significantly increased in the other two groups,AQP-1 mRNA and protein expression was up-regulated in group I/R,and no significant change was found in AQP-1 mRNA and protein expression in RP group.Compared with I/R group,myocardial water content was significantly reduced,and AQP-1 mRNA and protein expression was down-regulated in RP group.Conclusion Remifentanil post-conditioning reduces myocardial I/R injury possibly through down-regulating AQP-1 expression in myocardial tissues of rats. Key words: Piperidines; Myocardial reperfusion injury; Aquaporin 1

A metabolic profiling analysis of the acute toxicological effects of the realgar (As2S2) combined with other herbs in Niuhuang Jiedu Tablet using 1H NMR spectroscopy

Ethnopharmacological relevanceNiuhuang Jiedu Tablet (NJT), composed of Realgar (As2S2), Bovis Calculus Artificialis, Borneolum Synthcticum, Gypsum Fibrosum, Rhei Radix et Rhizoma (RR), Scutellariae Radix (SR), Platycodonis Radix (PR) and Glycyrrhizae Radix et Rhizoma (GR), is an effective formula of traditional Chinese medicine (TCM) used in treating acute tonsillitis, pharyngitis, periodontitis and mouth ulcer. In the formula, significant level of realgar (As2S2) as a potentially toxic element is contained. In our pervious experiments, NJT was significantly less toxic than realgar (As2S2), and the material bases of toxicity alleviation effect to realgar (As2S2) were RR, SR, PR and GR. However, the toxicity alleviation effect of each above mentioned four herbs to realgar (As2S2) and their synergistic detoxification effects to realgar (As2S2) were still obscure. Materials and methodsMale Wistar rats were divided into 11 groups: control, group R (treated with Realgar), group RRSPG (treated with Realgar, RR, SR, PR and GR), group RRSP (treated with Realgar, RR, SR and PR), group RRSG (treated with Realgar, RR, SR and GR), group RRPG (treated with Realgar, RR, PR and GR), group RSPG (treated with Realgar, SR, PR and GR), group RR (treated with Realgar and RR), group RS (treated with Realgar and SR), group RP (treated with Realgar and PR) and group RG (treated with Realgar and GR). Based on 1H NMR spectra of urine and serum from rats, PCA and PLS-DA were performed to identify different metabolic profiles. Liver and kidney histopathology examinations and serum clinical chemistry analysis were also performed. ResultsThe metabolic profiles of groups RR, RS, RP and RG were similar to those of group R, while the metabolic profiles of groups RRSPG, RRSP, RRSG, RRPG and RSPG were almost in line with those of control group. Statistics results were confirmed by the histopathological examination and biochemical assay. ConclusionThe present work suggested that the toxicity alleviation effects of RR, SR, PR and GR to realgar (As2S2) were not obvious when combined with realgar (As2S2) respectively, but they had synergistic detoxification effects on realgar (As2S2) mutually.

Effects of rapamycin pretreatment on lung injury caused by hepatic cold ischemia-reperfusion injury in rats

Objective To evaluate the effects of rapamycin pretreatment on lung injury caused by hepatic cold ischemia-reperfusion (I/R) injury in rats.Methods Twenty-four healthy male Sprague-Dawley rats,aged 8-10 weeks,weighing 220-250 g,were randomly divided into 3 groups (n =8 each):sham operation group (S group),lung injury caused by hepatic cold I/R injury group (I/R group),and rapamycin pretreatment group (RP group).Laparotomy was performed,and hepatic lobes and related blood vessels were only isolated in group S.Hepatic cold I/R was induced in I/R and RP groups.Rapamycin 10 mg· kg-1 ·d-1 was injected through a gastric tube into stomach for 3 consecutive days before surgery in RP group.The rats were sacrificed at 12 h of reperfusion,and lungs were removed to detect the levels of malondialdehyde (MDA),superoxide dismutase (SOD)and nitric oxide (NO),iNOS mRNA expression (by RT-PCR),tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) expression (by immuno-histochemistry) in lung tissues and for examination of the pathological changes of lungs with light microscope.Results Compared with S group,the levels of MDA,NO,iNOS mRNA,TNF-α and IL-6 were significantly increased and the SOD activity was decreased in I/R and RP groups (P ＜0.05).The SOD activity was significantly higher,and the levels of MDA,NO,iNOS mRNA,TNF-α and IL-6 wee lower in group RP than in I/R group (P ＜ 0.05).The pathological changes of lungs were significantly attenuated in RP group as compared with I/R group.Conclusion Rapamycin pretreatment can reduce lung injury caused by hepatic cold I/R injury in rats,and inhibition of iNOS expression,reduction of NO product and decrease in inflammatory responses are involved in the mechanism. Key words: Sirolimus; Liver; Respiratory distress syndrome, adult; Reperfusion injury

PNU-282987 Improves the Hemodynamic Parameters by Alleviating Vasopermeability and Tissue Edema in Dogs Subjected to a Lethal Burns Shock

Excessive inflammation and high vasopermeability can lead to blood volume loss and tissue edema, which can affect the resuscitation and prognosis for serious burn patients. In this experiment, we investigated the effect of PNU-282987, an α7 nicotine cholinergic receptor agonist on the hemodynamic parameters and survival rate by inhibiting vasopermeability and tissue edema during the fluid resuscitation for lethal burn shock. Forty Beagle dogs with intubation of the carotid artery and jugular vein 24 hours before the injury were subjected to 50% TBSA full-thickness burns, and were randomly divided into following four groups: no resuscitation group (group NR), venous fluid resuscitation group (group R), PNU-282987 treatment group (group P), and fluid resuscitation group plus PNU-282987 group (group RP), with 10 dogs in each group. Hemodynamic variables and biochemical parameters were determined with animals in a conscious and cooperative state. The plasma volume and the vasopermeability were determined by indocyanine green and fluorescein isothiocyanate-dextran, respectively. The level of tumor necrosis factor-α and interleukin-1β in plasma, and the water content of different organs were also determined. The mean arterial pressure, cardiac output, and plasma volume of all dogs decreased significantly, and the lung extravascular water index and pulmonary vascular permeability index increased remarkably after burn. The hemodynamic parameters deteriorated continually in group N dogs, and then anuria, hyperlactacidemia, and multiple organ dysfunctions developed. The mean arterial pressure and cardiac output of dogs in group R and group RP returned to preinjury levels at 48 hours postburn. The lung extravascular water index and pulmonary vascular permeability in group R were higher than those before preinjury. The dogs in group RP were found to have a significant increase in plasma volume and urine output, and a remarkable decrease in the levels of tumor necrosis factor-α, interleukin-1α, lactic acid, and organ functions compared with those of group R (P <.05). The survival rate of RP group (100%; 10/10) was significantly higher than that of group N (0; 0/10), group P (20%; 2/10), and group R (60%; 6/10). PNU-282987 combined with intravenous fluid resuscitation significantly improved hemodynamics and the survival rate in the early period after this lethal burn shock. The mechanism may be attributable to the lowering of the level of proinflammatory mediators, amelioration of vasopermeability-induced visceral edema, less of blood volume loss, and protection of vital organs through activation of cholinergic anti-inflammatory pathway.

Single file reciprocating technique using conventional nickel–titanium rotary endodontic files

This study was aimed to evaluate the applicability of a reciprocating movement technique with conventional nickel-titanium files for root canal preparation. Forty-four simulated canals in resin blocks were used in this study and divided as following four groups according to the instruments used and preparation methods. Group CP (n = 12) and CR (n = 12) were instrumented with continuous rotation using four files of ProFile and RaCe, respectively. Group RP (n = 10) and RR (n = 10) were instrumented with a reciprocation movement by using a single ProFile and RaCe file, respectively. The resin blocks were scanned before and after instrumentation, and the images were superimposed. To compare the efficiency of canal shaping, the preparation time, and centering ratio were calculated. Morphologic changes of tested files were examined by scanning electron microscopy (SEM). Data were analyzed by ANOVA and Duncan's post hoc test at p < 0.05. The preparation time was markedly shorter in Groups RP and RR than in Groups CP and CR. No significant difference in the centering ratio was noted between groups. Although the files used for Groups CP and CR showed no distortion under the SEM evaluation, the files used for Groups RP and RR had considerable torsional distortion. This study suggests that the reciprocating instrumentation technique using conventional nickel-titanium rotary file systems might have a comparable efficacy for the root canal shaping with reduced shaping time. Although the reciprocating technique seems to be an effective alternative to the conventional rotation technique, the risk of torsional distortion and fracture should be considered before clinical application.

Effect of propofol anesthesia on expression of β-secretase 1 and content of anyloid beta protein 1-42 in neonatal rat hippocampus

Objective To investigate the effect of propofol anesthesia on the expression of β-secretase 1 (BACE1) and content of anyloid beta protein 1-42 (Aβ1-42) in the neonatal rat hippocampus.Methods Ninety Sprague-Dawley rats,aged 7 days,weighing 12-16 g,were randomly divided into 3 groups ( n =30 each):control group (group C),single dose of propofol anesthesia group (group SP),and repeated doses of propofol anesthesia group (group RP).Group C received intraperitoneal normal saline 7.5 ml/kg once a day for 7 consecutive days.Group SP received normal saline 7.5 ml/kg once a day for 6 consecutive days and propofol 75 mg/kg on 7th day.Group RP received propofol 75 mg/kg once a day for 7 consecutive days.Six rats in each group were chosen at 15 min after the end of injection on 7th day and blood samples were taken from the left ventricle for determination of the blood glucose level and for blood gas analysis.Eight animals in each group were sacrificed on 1st,3rd and 7th day after the end of injection on 7th day to determine the expression of BACE1 (using Western blot) and content of Aβ1-42 in the hippocampus (by ELISA).Results Compared with groups C and SP,the expression of BACE1 was up-regulated and the content of Aβ1-42 was significantly increased at each time point in group RP ( P ＜ 0.01 ).There was no significant difference in the expression of BACE1 and content of Aβ1-42 at each time point between groups C and SP ( P ＞ 0.05).Conclusion Repeated doses of propofol up-regulate the expression of BACE1 and increase the content of Aβ1-42 in neonatal rat hippocampus,which may be one of the mechanisms by which propofol leads to long-term cognitive dysfunction.Single dose of propofol does not have the effect. Key words: Propofol; Hippocampus; Amyloid beta-protein; Infant, newborn; β-secretase 1

Effects of combined vagus nerve electric stimulation postconditioning and limb remote ischemic postconditioning on myocardial ischemia-reperfusion injury in rats

Objective To evaluate the effects of combined vagus nerve electric stimulation postconditioning and limb remote ischemic postconditioning on myocardial ischemia-reperfusion (I/R) injury in rats.Methods One hundred male SD rats aged 8 weeks weighing 250-350 g were randomly allocated into 5 groups ( n =20 each):sham operation group (group S); I/R group; vagus nerve electric stimulation postconditioning group (group POES) ; limb remote ischemic postconditioning group (group RP) and vagus nerve electric stimulation postconditioning + limb remote ischemic postconditioning group (group POES-RP).Myocardial I/R was induced by occlusion of left anterior descending branch (LAD) of coronary artery for 30 min followed by 120 min reperfusion in groups I/R,POES,RP and POES-RP.In groups POES and POES-RP,right cervical vagus nerve trank was stimulated for 30 min with continuous electric rectangular pulses (2 ms,10 Hz) starting from 15 min of myocardial ischemia.The voltage of the pulses was adjusted to decrease HR by 10％ of the baseline HR before stimulation.In groups RP and POES-RP the animals underwent 10 min ischemia of bilateral hind limbs starting from 20 min of myocardial ischemia.Arterial blood samples were collected from 10 rats in each group at 120 min of reperfusion for determination of serum concentrations of cTnI,CK-MB,TNF-α,high mobility group box 1 protein (HMGB1),intercellular adhesion molecule-1(ICAM-1),IL-1,IL-6 and IL-10 (by ELISA).The animals were then sacrificed and myocardial infarct size was measured by Evans blue and TTC staining.Another 10 rats were sacrificed at 120 min of reperfusion for determination of myocardial contents of TNF-α,HMGB-1,ICAM-1,IL-1,ID6 and IL-10 (by ELISA).Results I/R induced myocardial infarct and significantly increased serum concentrations of cTnI,CK-MB,TNF-α,HMGBi,ICAM-1,IL-1 and IL-6 and increased myocardial contents ofTNF-α,HMGB1,ICAM-1,IL-1,IL-6 and IL-10 in both ischemic and non-ischemic regions in group I/R as compared with group S.Vagus nerve electric stimulation postconditioning,limb remote ischemic postconditioning and vagus nerve electric stimulation postconditioning + limb remote ischemic postconditioning significantly decreased myocardial infarct size and serum concentrations of cTnI,CK-MB,TNF-α,HMGB1,ICAM-1,IL-1 and IL-6 and decreased myocardial contents of TNF-α,HMGB1,ICAM-1,IL-1,IL-6 in groups POES,RP and POES-RP as compared with group I/R.Compared with group I/R,myocardial IL-10 content in both ischemic and non-ischemic regions was significantly increased in groups POES and POES-RP.Compmared with group POES,myocardial infarct size,serum concentrations of cTnI,CK-MB,TNF-α,ICAM-1 and myocardial contents of ICAM-1 and IL-6 in ischemic region were significantly decreased,while myocardial content of IL-10 in non-ischemic region was increased in group POES-RP.Compared with group RP,myocardial infarct size,serum concenuations of cTnI,CK-MB,TNF-α,HMGB1,ICAM-1,IL-1,IL-6 and myocardial contents of TNF-α,ICAM-1,IL-1 and IL-6 in ischemic region were significantly decreased,myocardial content of IL-10 in ischemic region was increased and HMGB1,ICAM-1,IL-1 and IL-6 contents were decreased,IL-10 content was increased in myocardial of ischemic region in group POES-RP.Conclusion Myocardial I/R injury is attenuated and myocardial protection is enhanced by combination of vagus nerve electric stimulation postconditioning and limb remote ischemic postconditioning in rats by inhibiting inflammatory response in rats. Key words: Electric stimulation; Vagus nerve; Hindlimb; Myocardial reperfusion injury; Ischemic postconditioning

Effect of ropivacaine preconditioning on toxicity of ropivacaine to ND7/23 cells

Objective To investigate the effect of ropivacaine preconditioning on the toxicity of ropivacaine to ND7/23 cells.Methods ND7/23 cells were cultured in DMEM culture medium at 37℃ in 5% CO2 incubator for 24 h at a concentration of 1 × 106/ml. The cells were randomly divided into 3 groups ( n = 3 each) ;control group (group C), ropivacaine group (group R) and ropivacaine preconditioning group (group RP). In group R, the cells were exposed to 1% ropivacaine 100 μl and incubated for 1 h. In group RP, the cells were exposed to 0.02% ropivacaine 100 μl for 15 min, after ropivacaine was washed out, 1% ropivacaine 100 μl was then added and the cells were incubated for 1 h. The cell viability was measured using CCK-8 assay and apoptosis using Annexin-V/PI staining.Results Compared with group C, the cell viability was significantly decreased, while the early apoptotic rate and late apoptotic rate were significantly increased in groups R and RP ( P ＜ 0.05). Compared with group R, the cell viability was significantly increased, while the early apoptotic rate and late apoptotic rate were significantly decreased in group RP (P ＜ 0.05) .Conclusion Ropivacaine preconditioning can protect ND7/23 cells from bupivacaine-induced cytotoxicity through inhibiting apoptosis. Key words: Amides; Ischemic preconditioning; Drug toxicity

Intrathecal hyperbaric or isobaric bupivacaine and ropivacaine with fentanyl for elective caesarean section

Objective. We aimed to investigate the efficacy of either plain or hyperbaric solutions of intrathecal bupivacaine and ropivacaine on maternal block characteristics, complications, side effects and neonatal parameters to find out which is superior in a single study.Methods. One hundred and three term parturients were randomly assigned to receive intrathecal 10 mg hyperbaric bupivacaine (Group Bh), 10 mg plain bupivacaine (Group Bp), 15 mg hyperbaric ropivacaine prepared with dextrose 30% (Group Rh) or 15 mg plain ropivacaine (Group Rp) coadministered with fentanyl 20 μg. Sensory and motor block characteristics, analgesia duration, ephedrine consumption, and neonatal and maternal parameters were recorded.Results. Time to maximum cephalad spread of sensory block was longer in Group Rp than both bupivacaine groups. Time to achieve sensory block at T6 dermatome was similar between both hyperbaric groups (Group Bh:4.5 ± 1.6, Group Rh:4.6 ± 1.1, p > 0.05) but Group Rp needed significantly longer time (7.5 ± 5.5 min, p = 0.003) than both hyperbaric groups. Duration of motor block was shorter in ropivacaine groups (Group Rh: 90.6 ± 17.3, Group Rp 121.6 ± 33.7) vs. bupivacaine groups (Group Bh: 140.2 ± 33.3, Group Bp: 149.7 ± 46.0); Group Rh being shorter than Group Rp (p < 0.05). Ephedrine consumption was less in Groups Rh (20.0 ± 11.9 mg) and Rp (18.3 ± 12.4 mg) vs. Groups Bh (30.0 ± 14.9 mg) and Bp (27.8 ± 15.4 mg) (p = 0.006).Conclusions. Intrathecal hyperbaric ropivacaine 15 mg with fentanyl 20 μg for CSE is suitable since it provides early motor recovery leading to faster patient ambulation, rapid onset of sensory block with less ephedrine.

Effects of four intraoperative ventilatory strategies on respiratory compliance and gas exchange during laparoscopic gastric banding in obese patients

Respiratory function is impaired in obese patients undergoing laparoscopic surgery. This study was performed to determine whether repeated lung recruitment combined with PEEP improves respiratory compliance and arterial partial pressure of oxygen (Pa(O2)) in obese patients undergoing laparoscopic gastric banding. Sixty patients with BMI >30 kg m(-2) were randomized, after induction of pneumoperitoneum, to receive either PEEP of 10 cm H2O (Group P), inspiratory pressure of 40 cm H2O for 15 s once (Group R), Group R recruitment followed by PEEP 10 cm H2O (Group RP), or Group RP recruitment but with the inspiratory manoeuvre repeated every 10 min (Group RRP). Static respiratory compliance and Pa(O2) were determined after intubation, 10 min after pneumoperitoneum (before lung recruitment), and every 10 min thereafter (after recruitment). Results are presented as mean (SD). Pneumoperitoneum decreased respiratory compliance from 48 (3) to 30 (1) ml cm H2O(-1) and decreased Pa(O2) from 12.4 (0.3) to 8.8 (0.3) kPa in all groups (P<0.01). Immediately after recruitment, compliance was 32 (1), 32 (2), 40 (2), and 40 (1) ml cm H2O(-1) and Pa(O2) was 9.1 (0.3), 9.1 (0.1), 11.9 (0.1), and 11.9 (0.1) kPa in Groups P, R, RP, and RRP, respectively (P<0.01). Ten and 20 min later, Pa(O2) in Group R decreased to 9.2 (0.1) kPa and compliance in Group PR decreased to 33 (2) ml cm H2O(-1), respectively (P<0.01). Group RRP recruitment strategy was associated with the best intraoperative respiratory compliance and Pa(O2) in obese patients undergoing laparoscopic gastric banding.

Adequate dietary calcium restores vertebral trabecular bone microarchitecture and strength and improves femur calcium concentration following calcium depletion in young female rats

To determine whether dietary calcium deficiency during adolescence permanently reduces lifetime potential to attain peak bone mass and strength, female Sprague‐Dawley rats were separated into groups (n=10) and fed an AIN‐93G‐based diet containing 20% (1000 mg Ca/kg) of the calcium requirement from weaning until 105 d of age (DEF); switched near sexual maturity (63 d of age) to 100% of the requirement (5000 mg Ca/kg) (RP); or pairfed (5000 mg Ca/kg) throughout to group RP (PF). At 105 d of age, Ca repletion restored L4 trabecular bone volume fraction (RP: 27.0 ± 1.1%; PF: 28.1 ± 1.2%; p = 0.46) and strength (estimated by force to compression with finite element analysis) (RP: 11.51 ± 0.87 N; PF: 11.9 ± 1.42 N; p =0.83). In femurs, Ca repletion increased (DEF: 176 ± 1; RP: 214 ± 3; p &lt; 0.0001) but did not completely restore (RP: 214 ± 3; PF: 243 ± 8 mg Ca/g; p &lt; 0.0001) femur calcium concentration. However, cortical thickness (measured at midshaft of femur diaphysis) was completely restored by Ca repletion (RP: 0.6; PF: 0.6 mm; p = NS). Findings from this animal model suggest that the deleterious effects of calcium deficiency during adolescence can be reversed with proper dietary Ca intakes.

The Combined Use of the Timing Principle and LMA to Secure Airway Patency

Background: The timing principle uses a single bolus dose of nondepolarizing neuromuscular blocker followed by an induction drug to reduce airway patency secure time. If anesthetic depth is adequate, the laryngeal mask airway (LMA) can be inserted with or without a low dose nondepolarizing neuromuscular blocker. So we investigated the combined use of the timing principle and LMA to secure airway patency. Methods: One hundred and two patients were randomly allocated into three groups. Group RP (n = 34) patients received rocuronium followed by propofol and then a LMA was inserted. Group PR (n = 36) patients received propofol followed by rocuronium and group PS (n = 31) patients received propofol followed by succinylcholine before LMA insertion. Accelerographic response to single twitch and train-of-four (TOF) stimulation were measured. LMA insertional conditions were measured using the degree of jaw relaxation, gagging, cough, and aeration. Results: Single twitch and TOF ratio were lower in the RP group than in the PR group. The LMA insertional conditions were similar for the group RP and PS, but were poor for group PR. One patient in group PR recalled discomfort during LMA insertion. Conclusions: The combined use of the timing principle and LMA is effective at securing airway patency.

Impact of the initial doses of rocuronium and pancuronium on subsequent maintenance for neuromuscular block

To determine the impact of the neuromuscular blocking agent given for intubation on the duration of effect of multiple maintenance doses of pancuronium and rocuronium. Seventy-eight subjects were randomly assigned to receive one of four dosing combinations for intubation and neuromuscular maintenance: rocuronium for intubation and maintenance, rocuronium for intubation and pancuronium for maintenance, pancuronium for intubation and rocuronium for maintenance, or pancuronium for both. Each time that the first twitch response returned to 25% of the baseline value, the duration of the dose was determined and another maintenance dose was administered. The duration of action of the maintenance doses was compared between the groups. Twitch suppression from the first maintenance dose was shorter for subjects who received rocuronium for both doses (Group RR) compared with that for subjects that received pancuronium (Groups PR & PP) as their intubation dose (17.6 vs 34 & 59.8 min, respectively, P < 0.05). Subjects who received rocuronium followed by pancuronium (Group RP) showed a shorter duration of twitch suppression after the first maintenance dose than the group that received pancuronium for both doses (Group PP) (21.3 vs 59.8 min, P < 0.05). By the third maintenance dose, the influence of the intubating dose on the maintenance dose duration had essentially diminished. For combinations of rocuronium and pancuronium, the duration of twitch suppression after a maintenance dose is only dependent on the first agent given for the first two maintenance doses administered.