Volume Of Normal Saline Research Articles

Experimental study of cardioprotective effects of Cinnamomi Ramulus and Cinnamomi Cortex formula granules on myocardial ischemia/reperfusion injury in rats based on efficacy of "warming and coordinating heart Yang"

This study aimed to parallelly investigate the cardioprotective activity of Cinnamomi Ramulus formula granules(CRFG) and Cinnamomi Cortex formula granules(CCFG) against acute myocardial ischemia/reperfusion injury(MI/RI) and the underlying mechanism based on the efficacy of "warming and coordinating the heart Yang". Ninety male SD rats were randomly divided into a sham group, a model group, CRFG low and high-dose(0.5 and 1.0 g·kg~(-1)) groups, and CCFG low and high-dose(0.5 and 1.0 g·kg~(-1)) groups, with 15 rats in each group. The sham group and the model group were given equal volumes of normal saline by gavage. Before modeling, the drug was given by gavage once a day for 7 consecutive days. One hour after the last administration, the MI/RI rat model was established by ligating the left anterior descending artery(LAD) for 30 min ischemia followed by 2 h reperfusion except the sham group. The sham group underwent the same procedures without LAD ligation. Heart function, cardiac infarct size, cardiac patho-logy, cardiomyocyte apoptosis, cardiac injury enzymes, and inflammatory cytokines were determined to assess the protective effects of CRFG and CCFG against MI/RI. The gene expression levels of nucleotide-binding oligomerization domain-like receptor family pyrin domain protein 3(NLRP3) inflammasome, apoptosis-associated speck-like protein containing a CARD(ASC), cysteinyl aspartate specific proteinase-1(caspase-1), Gasdermin-D(GSDMD), interleukin-1β(IL-1β), and interleukin-18(IL-18) were determined by real-time quantitative polymerase chain reaction(RT-PCR). The protein expression levels of NLRP3, caspase-1, GSDMD, and N-GSDMD were determined by Western blot. The results showed that both CRFG and CCFG pretreatments significantly improved cardiac function, decreased the cardiac infarct size, inhibited cardiomyocyte apoptosis, and reduced the content of lactic dehydrogenase(LDH), creatine kinase MB isoenzyme(CK-MB), aspartate transaminase(AST), and cardiac troponin Ⅰ(cTnⅠ). In addition, CRFG and CCFG pretreatments significantly decreased the levels of IL-1β, IL-6, and tumor necrosis factor-α(TNF-α) in serum. RT-PCR results showed that CRFG and CCFG pretreatment down-regulated the mRNA expression levels of NLRP3, caspase-1, ASC, and downstream pyroptosis-related effector substances including GSDMD, IL-18, and IL-1β in cardiac tissues. Western blot revealed that CRFG and CCFG pretreatments significantly decreased the protein expression levels of NLRP3, caspase-1, GSDMD, and N-GSDMD in cardiac tissues. In conclusion, CRFG and CCFG pretreatments have obvious cardioprotective effects on MI/RI in rats, and the under-lying mechanism may be related to the inhibition of NLRP3/caspase-1/GSDMD signaling pathway to reduce the cardiac inflammatory response.

Effect of dexmedetomidine on postoperative cognitive dysfunction in elderly patients undergoing orthopaedic surgery: study protocol for a randomized controlled trial

AimsThis trial aims to assess whether dexmedetomidine can reduce the incidence of postoperative cognitive dysfunction in elderly orthopaedic patients and explore the specific mechanism.BackgroundPostoperative cognitive dysfunction is a common complication after orthopaedic surgery that results in poor prognosis and increases the length of hospital stays and costs. Dexmedetomidine has been confirmed as a drug that can improve postoperative cognitive dysfunction in some studies. However, to date, the specific mechanism by which dexmedetomidine improves postoperative cognitive dysfunction is still elusive.Methods/designA single-centre, prospective, double-blinded, randomized controlled trial will be conducted at Hebei General Hospital. Ninety-six elderly patients who undergo total hip or knee replacement will be studied in this trial and randomly divided into two groups. Patients in the experimental group will receive a loading dose of 0.5 μg/kg dexmedetomidine for 10 min and then a maintenance dose of 0.5 μg/kg/h dexmedetomidine until 30 min before the end of the operation, and patients in the control group will be infused with an equal volume of normal saline. The incidence of postoperative cognitive dysfunction will be the primary outcome. Changes in the balance of T helper 17 cell and regulatory T cell; the levels of matrix metalloproteinase 9, S-100β, IL-17A, and IL-10; perioperative complications; hospitalization duration; and intraoperative blood loss will be the secondary outcomes.DiscussionThe consequences of this trial will show that dexmedetomidine can improve postoperative cognitive dysfunction in elderly orthopaedic patients, which may be related to the balance of T helper 17/regulatory T cells.Trial registrationChinese Clinical Trial Registry ChiCTR2200055802. Registered on 20 January 2022

Cisplatin causes erectile dysfunction by decreasing endothelial and smooth muscle content and inducing cavernosal nerve senescence in rats.

Cisplatin (cis-diamminedichloroplatinum II, CDDP), a drug widely used for cancer worldwide, may affect erectile function, but its side effects have not received enough attention. To investigate the effect of CDDP on erectile function and its possible mechanism. Sprague-Dawley rats were intraperitoneally administered CDDP (CDDP group) or the same volume of normal saline (control group). Erectile function was evaluated after a one-week washout. Then, histologic changes in the corpus cavernosum and cavernous nerve (CN) were measured. Other Sprague-Dawley rats were used to isolate the major pelvic ganglion and cavernous nerve (MPG/CN). RSC96 cells were then treated with CDDP. SA-β-gal staining was used to identify senescent cells, and qPCR was used to detect the senescence-associated secretory phenotype (SASP). Finally, the supernatant of RSC96 cells was used to culture MPG/CN. Erectile function was measured after administration of CDDP. The cavernosum levels of α-SMA, CD31, eNOS, and γ-H2AX, the apoptosis rate and the expression of p16, p21 and p53 in CN were also assayed. The senescent phenotype of RSC96 cells treated with CDDP was identified, and neurite growth from the MPG/CN was photographed and measured. The CDDP group had a significantly lower ICP/MAP ratio than the control group. Compared to the control group, the CDDP group exhibited significantly lower α-SMA, CD31 and eNOS levels and significantly higher γ-H2AX and apoptosis rates in corpus cavernosum. In addition, CDDP increased some senescence markers p16, p21 and p53 in CN. In vitro, CDDP induced RSC96 senescence and SASP, and the supernatant of senescent cells slowed neurite outgrowth of MPG/CN. CDDP treatment could induce erectile dysfunction, by affecting the content of endothelial and smooth muscle and causing SASP in CN. The results indicate that CDDP treatment should be considered as a risk factor for ED. Clinicians should pay more attention to the erectile function of cancer patients who receive CDDP treatment.

Dexpramipexole ameliorates cognitive deficits in sepsis-associated encephalopathy through suppressing mitochondria-mediated pyroptosis and apoptosis.

This study was aimed at evaluating the effects of dexpramipexole (DPX) - a mitochondrial protectant that sustains mitochondrial function and energy production - on cognitive function in a mouse model of sepsis-associated encephalopathy (SAE) induced by peripheral administration of lipopolysaccharide (LPS) and examining the potential mechanisms. C57BL/6 male mice were randomized into one of four treatment protocols: Con+Sal, Con+DPX, LPS+Sal or LPS+DPX. The mice were intraperitoneally (i.p.) injected with LPS or equivalent volumes of normal saline once daily for 3 consecutive days. To evaluate the protective effects of DPX, we administered DPX or normal saline i.p. to the mice once daily for 6 consecutive days. Six mice in each group were decapitated on day 7, and each brain was rapidly removed and separated into two halves for biochemical and histochemical analysis. The remaining surviving mice in each group were subjected to behavioral tests from days 7 to 10. Peripheral administration of LPS to mice led to learning and memory deficits in behavioral tests, which were associated with mitochondrial impairment and ATP depletion in the hippocampus. Repeated DPX treatment protected the mitochondria against LPS-induced morphological and functional impairment; inhibited the activation of the Nod-like receptor pyrin domain-containing 3 (NLRP3) inflammasome-caspase-1-dependent pyroptosis pathway and cytochrome c (Cyt-c)-caspase-3-dependent apoptosis pathway; and attenuated LPS-induced neuroinflammation and cell death in the hippocampus in SAE mice. Mitochondria-mediated pyroptosis and apoptosis are involved in the pathogenesis of cognitive deficits in a mouse model of SAE and DPX protects mitochondria and suppresses the mitochondria-medicated pyroptosis and apoptosis pathways, and ameliorates LPS-induced neuroinflammation and cognitive deficits. This study provides theoretical evidence supporting DPX for the treatment of SAE.

Black Lycium barbarum polysaccharide attenuates LPS-induced intestine damage via regulation gut microbiota.

Lycium barbarums are traditionally used as a homology of medicinal plants in China with a potent role in metabolism and immunomodulation. The current study was performed to explore the attenuation effect and microbiota regulation of Lycium barbarum polysaccharide (BLBP) on lipopolysaccharide (LPS)-induced intestine damage in mice. A total of 70 mice were randomly divided into five groups; negative control (GA), LPS (GB), both treated with an equal volume of normal saline, and BLBP treatment groups GC (100 mg/kg), GD (200 mg/kg), and GE (400 mg/kg) via gavage for 19 days. On Day 19, mice in groups GB, GC, GD, and GE were treated with 10 mg/kg LPS for 24 h and euthanized to collect intestine samples for pathological examination and microbiota sequencing. The results showed a non-significant difference in body weight gain among the five mouse groups; however, mice in the GC and GE groups showed decreased weight gain. An H&E examination revealed that the integrity of intestinal villi was destroyed by LPS, while BLBP supplement alleviated intestinal damage with an increase in villus height and a decrease in crypt depth. A total of over 59,000, 40,000, 50,000, 45,000, and 55,000 raw sequences were found in groups GA, GB, GC, GD, and GE, respectively. LPS challenge decreased alpha diversity indexes significantly (p < 0.05), while a non-significant difference was found between different BLBP treatment groups and the GA group. A total of 8 phyla and 13 genera were found among five mouse groups, and BLBP partly restored the bacterial abundance in mice. LPS changed 282 metabolic pathways in KEGG L2, 77 metabolic pathways in KEGG L3, and 205 metabolic pathways in MetaCyc, respectively. The BLBP-supplemented groups, especially GE, showed reverse effects on those metabolic pathways. The current study revealed that BLBP can effectively decrease intestinal damage through the regulation of intestinal microbiota, which may provide new insights for the prevention of intestinal disease using food and medicine homologous of Lycium ruthenicum.

Effects of alfaxalone on induction quality of inhalation anesthesia in domestic pigeons (Columba livia domestica).

Several studies have documented the effects of anesthesia on pigeons. However, previous studies using pigeons have not examined a combination of injection and inhalation anesthesia. This study aimed to evaluate the effects of intramuscular (IM) administration of alfaxalone in conjunction with mask induction on the quality of isoflurane anesthesia in healthy domestic pigeons (Columba livia domestica). In a randomized, double-blind, crossover study consisting of two phases, six healthy adult pigeons were anesthetized twice with a washout period of 7 days. In each phase, the pigeons were randomly assigned IM administration of either alfaxalone (4 mg/kg) or an equal volume of normal saline. After 20 min, anesthesia was induced with isoflurane through a face mask. Once voluntary movement of the limbs and eyelids ceased, the face mask was removed, and the trachea was intubated. The quality of anesthesia was assessed by scoring sedation prior to anesthetic induction, induction, and recovery. Heart rate, respiratory rate, cloacal temperature, and noninvasive systolic, diastolic, and mean arterial pressure were recorded before the IM injection (baseline) and during the procedure. The minimum anesthetic concentration of isoflurane was determined using the "bracketing" method. Moderate sedation (sedation scores of 2 and 3) was observed only with alfaxalone administration. In the alfaxalone group, the induction score was significantly higher (better induction quality) than in the control group (P=0.041). The combination of alfaxalone and mask induction was effective for inhalation anesthesia in pigeons.

Intraoperative infusion of dexmedetomidine for prevention of postoperative delirium in elderly patients undergoing craniotomy: a protocol of randomised clinical trial

IntroductionPostoperative delirium (POD) is a common surgical complication. The incidence is 19% in neurological procedures, and advanced age is a risk factor for neurological procedures. Many studies have shown that...

Effects of Hederin (Hed) on Alveolar Bone Microstructure During Tooth Movement in Rats

Purpose: To discuss effects of Hederin (Hed) to tooth movement process in rats. Materials and methods: 54 rats were divided into Model and Hed groups at 7 d, 14 d and 21 d, establishment of rat tooth movement model, the Hed and Model group injected Hed [5 mg/(kg· d)] and equal volume normal saline intraperitoneally respectively, Take the medicine regularly every night. After 14 days, 9 rats in each group were killed, BV/TV, Tb. SP and trabecular number (Tb. N) were measured by Mirco CT. Using TRAP staining and HE staining to observe osteoclasts number and pathology change. The relative protein expressions were measured by SP staining. Results: Compared with Model group, BV/TV and Tb.N were significantly down-regulation and Tb.Sp was significantly up-regulation in Hed group (P &lt; 0.05, respectively); meanwhile, tooth movement and osteoclast number were significantly improved in Hed groups at 7 d, 14 d and 21 d (P &lt;0.05, respectively). By SP staining, compared with Model group, ADRB2 and RANKL proteins expression were significantly enhanced at 7 d, 14 d and 21 d (P &lt;0.05, respectively). Conclusion: Hed could promote alveolar bone resorption and increase the expression of ADRB2 and RANKL during orthodontic tooth movement.

Analysis of anesthetic effect of dexmedetomidine in femoral shaft fracture surgery

To investigate the effect of dexmedetomidine (DEX) on hemodynamics and recovery period after femoral shaft fracture surgery. Fifty-two patients, aged 3 to 7 years, who underwent femoral shaft fracture reduction surgery in our hospital in 2019 were randomly divided into the experimental group (n = 26) and the control group (n = 26). Both groups were given routine propofol combined with remifentanil by intravenous anesthesia. The experimental group was continuously pumped with DEX after induction of anesthesia, while the control group was continuously pumped with the same volume of normal saline. The mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia induction (T0), when laryngeal mask was inserted (T1), when skin was cut (T2), when intramedullary needle was inserted (T3), and when laryngeal mask was removed (T4). Extubation time after anesthesia withdrawal was recorded in the 2 groups. According to the Pediatric Anesthesia Emergence Delirium score, the agitation and the incidence of agitation were recorded immediately after extubation (T5), 10 minutes after entering the recovery room (T6) and 30 minutes after entering the recovery room (T7). There was no significant difference in MAP and HR between the 2 groups at T0 and T1 time points (P > .05). The MAP and HR of the experimental group at T2 to T4 were significantly lower than those of the control group (P < .05). The extubation time of the experimental group was longer than that of the control group (P < .05), but the Pediatric Anesthesia Emergence Delirium score and the incidence of agitation in the recovery period of the experimental group were lower than those of the control group (P < .05). In femoral shaft fracture surgery, intravenous anesthesia combined with continuous pumping DEX can effectively stabilize the hemodynamics of patients, and the incidence of postoperative agitation during anesthesia recovery is low.

Effects of preoperative nasal spray esketamine on separation anxiety and emergence agitation in pediatric strabismus surgery: A randomized clinical trial

To investigate the effects of preoperative nasal spray esketamine on separation anxiety and postoperative emergence agitation in pediatric strabismus surgery. Ninety children aged 3 to 6 years who underwent elective strabismus surgery were randomly divided into 3 groups that received 0.5 mg/kg (group S1), 1 mg/kg of esketamine (group S2), and the same volume of normal saline (group C) by nasal spray 10 minutes before surgery. The observation indicators of this test include the Ramsay sedation score, separation anxiety score, mask induction score, and the incidences of postoperative emergence agitation. Patient's heart rate, blood oxygen, post anesthesia care unit stay time, and any adverse events were recorded. The Ramsay sedation score was significantly lower in group C than those in groups S1 and S2 (P < .001). The separation anxiety scores and the mask induction scores were significantly higher in group C than those in groups S1 and S2 (P < .001). The incidences of emergence agitation in groups S1 and S2 were significantly lower than that in C group (P < .001). No obvious clinical complication was observed. Preoperative nasal spray esketamine reduced the preoperative separation anxiety and decrease emergence agitation in pediatric strabismus surgery.

Low-dose esketamine for the prevention of emergency agitation in children after tonsillectomy: A randomized controlled study.

Background: Emergency agitation is a common postoperative complication in pediatric patients after general anesthesia. The aim of this study was to explore the effects of a low dose of esketamine on emergency agitation in children following tonsillectomy. Materials and Methods: Eighty children were recruited prospectively to this study and divided into the esketamine group and the control group (40 cases in each group). The induction and maintenance of anesthesia were the same in both groups. At the end of surgery, the esketamine group received 0.25μg/kg esketamine, while the control group received the same volume of normal saline. The extubation time, time to eye opening, Ramsay sedation scale and time to discharge from the post-anesthesia care unit (PACU) were recorded during post-anesthesia care unit. Postoperative complications, such as emergency agitation, respiratory depression, hypertension, tachycardia, nightmares, nausea, and vomiting, were also recorded. Results: The incidence of emergency agitation was lower in the esketamine group compared with that in the control group (5% vs. 27.5%, p = 0.006). The time to eye opening was longer in the esketamine group than in the control group (17.2 ± 2.7 vs. 15.5 ± 2.3min, p = 0.005). However, the extubation time and time to discharge from PACU were similar between the two groups. Conclusion: Low-dose of esketamine decreases the incidence of emergency agitation in children after tonsillectomy without delaying extubation time and increasing the postoperative side effects. (www.chictr.org.cn, registration number: ChiCTR2100054178).

Effects of Nd(2)O(3) exposure of rare earth particles on C57 BL/6J male mice sex hormone secretion and CYP11A1/PLZF/STRA8 protein expression

Objective: To explore the effects of Nd(2)O(3) exposure to rare earth particles on the secretion of sex hormones, cytochrome P450 family member 11A1 (CYP11A1) , spermatogenesis markers promyelocytic leukemia zinc finger protein (PLZF) and retinoic acid stimulating gene 8 (STRA8) protein in C57 BL/6J male mice. Methods: In March 2021, Forty-eight male C57 BL/6J mice aged 6-8 weeks divided into control group and Nd(2)O(3) exposure low, medium and high dose groups (exposing doses of 62.5, 125.0, 250.0 mg/ml Nd(2)O(3)) , 12 per group. The mice in the Nd(2)O(3) groups were perfused with different doses of Nd(2)O(3) suspension by a one-time non-exposing tracheal instillation method, and the control group was perfused with an equal volume of normal saline, with a volume of 0.1 ml, to establish a mouse reproductive function injury model. After 28 days of exposure, the mice's body weight, testes and epididymis were weighed, and the organ coefficients were calculated; the two epididymis were taken to make a sperm suspension to determine the sperm count, survival rate, and deformity rate; inductively coupled plasma mass spectrometry (ICP-MS) method was used to detect the content of Nd in mouse testis tissue; HE staining was used to detect testicular tissue pathological changes and quantitative analysis; enzyme-linked immunosorbent assay (ELISA) method was used to detect serum luteinizing hormone (LH) and follicle stimulating hormone (FSH) and testosterone (T) content; western blot was used to detect the protein levels of CYP11A1, PLZF and STRA8 in testicular tissues. Results: Compared with the control group, with the increase of the exposure dose, the Nd content in the testis of the mice showed an increasing trend, the sperm survival rate and LH showed a decreasing trend, and the sperm deformity rate showed an increasing trend (P<0.05) ; Pathological showed that the number of sperm in the seminiferous tubules of the testicular tissue in the Nd(2)O(3) medium and high dose groups was significantly reduced, and the germinal epithelial disintegration, intraepithelial vacuolization, and exfoliation of spermatogenic cells and supporting cells occurred; The height of germinal epithelium was significantly reduced, and the percentage of damaged seminiferous tubules showed an increasing trend (P<0.05) ; FSH and T levels in serum in the middle and high dose groups of Nd(2)O(3), and CYP11A1, PLZF and STRA8 proteins in testicular tissues showed a downward trend with increasing dose (P<0.05) . Conclusion: The rare earth particulate Nd(2)O(3) may interfere with the expression of CYP11A1, PLZF and STRA8 protein, thereby causing the disorder of sex hormone secretion in the body, the maintenance of spermatogonia and the obstruction of the process of meiosis, causing reproductive function damage.

Effect of Dexmedetomidine on Inflammatory Response in Aortic Dissection.

To study the effect of dexmedetomidine (Dex) on perioperative inflammatory response in aortic dissection (AD) patients. From June 2020 to June 2022, 50 patients with Stanford type B AD underwent endovascular stent-graft exclusion (EVAR) at our hospital. They randomly were assigned to two groups (N = 25): the control group (C group) and the Dex group. Patients in the Dex group received 0.5ug/kg Dex intravenously 10 minutes before induction of anesthesia and 0.5µg/kg/h Dex during the intervention until 15 minutes before the end of surgery. In contrast, the C group received the same volume of normal saline at the same time points. The two groups were induced and maintained with the same anesthetic agents. Venous blood samples were taken 3 days before operation (T1), 1 day before operation (T2), 1 day after operation (T3) and 3 days after operation (T4) to detect levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell count (WBC). At T3 and T4, CRP and ESR in the Dex group were significantly improved compared with those in the C group. Dexmedetomidine can reduce the inflammatory reaction of aortic dissection.

Effect of Codonopsis Radix and Polygonati Rhizoma on the regulation of the IRS1/PI3K/AKT signaling pathway in type 2 diabetic mice.

Codonopsis Radix and Polygonati Rhizoma (CRPR) has a good hypoglycemic effect. The aims of the present study were to investigate the effect of CRPR on high-fat/high-sugar diet (HFHSD)- and streptozotocin (STZ)-induced type 2 diabetes mellitus (T2DM) mice as well as to investigate the involved mechanism. A T2DM mouse model was generated by combining HFHSD and STZ. After the model was established, normal and model groups received the same volume of normal saline intragastrically, and the negative control group was treated with metformin (200 mg/kg·BW). The low, medium, and high CRPR groups received four consecutive weeks of oral gavage with CRPR doses of 2.5, 5, and 10 g/kg·BW, respectively, during the course of the study. Body weight and fasting blood glucose (FBG) were measured on a weekly basis. Enzyme-linked immunosorbent assay (ELISAs) were used to evaluate the serum and liver samples. Hematoxylin and eosin (H&E) staining was utilized to observe the pathological status of the liver and pancreas. Western blot (WB) analysis was performed to evaluate the protein expression levels of PI3K, p-PI3K, AKT, and p-AKT. Compared to model mice, each treatment group had significantly elevated levels of FBG, total cholesterol (TC), and triacylglycerol (TG) (P<0.01 and P<0.05, respectively). The levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were significantly reduced in the treatment groups compared to the model group (P<0.01). Compared to the model group, fasting insulin (FINS) levels were elevated in all groups of CRPR (P<0.05), and there were significantly higher levels of high-density lipoprotein cholesterol (HDL-C) in both the low-dose and high-dose CRPR groups (P<0.05). H&E staining indicated that CRPR treatment reduced organ enlargement, improved liver lipid accumulation, and repaired islet injury in T2DM mice. Moreover, WB analysis demonstrated that all CRPR groups significantly upregulated the protein expression of IRS1, p-GSK3β, PI3K, p-Akt and p-FOXO1(P<0.05) as well as significantly downregulated p-IRS1 and FOXO1 protein expression (P<0.05). The present study demonstrated that CRPR effectively improves the metabolic disturbance of lipids, repairs damaged liver tissues, repairs damaged pancreatic tissues, and reduces insulin resistance (IR) in T2DM mice. The mechanism of action may be associated with upregulation of the IRS1/PI3K/AKT signaling pathway and inhibition of IRS1 phosphorylation.

Dexmedetomidine administration during brain tumour resection for prevention of postoperative delirium: a randomised trial

BackgroundDelirium is common, especially after neurosurgery. Dexmedetomidine might reduce delirium by improving postoperative analgesia and sleep quality. We tested the primary hypothesis that dexmedetomidine administration during intracerebral tumour resection reduces the incidence of postoperative delirium. MethodsThis randomised, double-blind, placebo-controlled trial was conducted in two tertiary-care hospitals in Beijing. We randomised 260 qualifying patients to either dexmedetomidine (n=130) or placebo (n=130). Subjects assigned to dexmedetomidine were given a loading dose of 0.6 μg kg−1 followed by continuous infusion at 0.4 μg kg−1 h−1 until dural closure; subjects in the placebo group were given comparable volumes of normal saline. The primary outcome was the incidence of delirium, which was assessed with the Confusion Assessment Method twice daily during the initial 5 postoperative days. ResultsThe average (standard deviation) age of participating patients was 45 (12) yr, duration of surgery was 4.2 (1.5) h, and patients assigned to dexmedetomidine were given an average of 126 (45) μg of dexmedetomidine. There was less delirium during the initial 5 postoperative days in patients assigned to dexmedetomidine (22%, 28 of 130 patients) than in those given placebo (46%, 60 of 130 patients) with a risk ratio of 0.51 (95% confidence interval: 0.36–0.74, P<0.001). Postoperative pain scores with movement, and recovery and sleep quality were improved by dexmedetomidine (P<0.001). The incidence of safety outcomes was similar in each group. ConclusionsProphylactic intraoperative dexmedetomidine infusion reduced by half the incidence of delirium during the initial 5 postoperative days in patients recovering from elective brain tumour resection. Clinical trial registrationNCT04674241.

The Effect of Trigeminal Ganglion Block on Trigeminocardiac Reflex in Elderly Patients with Trigeminal Neuralgia Undergoing Percutaneous Balloon Compression: A Randomized Controlled Study.

Trigeminal neuralgia (TN) is a facial neuropathic pain, which is defined as unilateral brief shock-like paroxysmal pain. Percutaneous balloon compression (PBC) was widely used to treat TN under general anesthesia. However, trigeminocardiac reflex (TCR) as a brainstem reflex can induce bradycardia or even cardiac arrest during PBC, which may result in catastrophic consequences in elderly patients. The aim of the present study was to investigate the effect of trigeminal ganglion block on TCR in elderly patients with TN during PBC. Eighty-two elderly patients undergoing PBC were recruited to this randomized controlled study. The participants were randomly allocated to the control group (C group, n=41) and study group (S group, n=41). After anesthesia induction, 2% lidocaine 0.5 mL or an equal volume of normal saline was injected into Meckel's cave. HR and MAP were recorded at seven time-points, and the TCR incidence was compared. HR decreased in the C group at the time of foramen ovale puncture (T5) and at the time of ganglion compression (T6) compared with that at the moment of needle puncture (T4) (P<0.05), but almost no change in the S group. HR was lower in the C group compared with the S group at T5 and T6 (P<0.05). MAP increased significantly at T5 and T6 compared with that at T4 in the C group (P<0.05), but almost no increase in the S group. Compared with the C group, MAP was lower at T5 and T6 in the S group (P<0.05). There were no significant differences in HR and MAP between the two groups at T1, T2, T3, T4 and T7. The incidence of bradycardia was higher in the C group than that in the S group (P<0.05). Trigeminal ganglion block was an effective approach to prevent TCR in elderly patients during PBC.

Evaluation of Propofol-Sparing Effect of Intravenous Lignocaine in Patients Undergoing Daycare Upper Gastrointestinal Endoscopic Procedures.

Background Propofolis the most commonsedativefor endoscopies. Propofol alonemay require larger doses for adequate level of sedation. Lignocaine is known for its anesthetic-sparing effect. We tested whether the addition of intravenous lignocaine to propofol-based sedation reduces its dose. Methods Thisprospective, randomized study was performed on 90 patients of 18 to 60 years of age, of either sex of the American Society of Anesthesiologists (ASA) Grade-I & II, and was divided into two groups. Group L + P received IV bolus of 1.5 mg/kg 2% lignocaine over 10 minutes followed by 1.5 mg/ kg/ h infusion andgroup NS + P- received the equivalent volumes of normal saline in bolus and infusion. Patients were induced with fentanyl (2 µg/kg) and propofol (1 mg/kg).To maintain an adequate sedation level, a supplemental bolus of 0.5 mg /kg propofol was administered. Theoutcomes recorded werethe totaland supplemental amount of propofol administered, as well as recovery time. Results The mean supplemental propofolfor group L + P and group NS + P- 37.00 ± 29.93 and 58.67 ± 19.49 mg, respectivelyandmean total propofol consumption was 98.22 ± 34.00 mg and 131.11 ± 23.18 mg, respectively, (p < 0.001). Mean recovery time in group L + P was also shorter (5.22 ± 2.14 versus 9.96 ± 2.14). The incidence of adverse events like gag reflux, upper airway obstruction, pain on injection, and hypotension was significantly lower in group L + P (p < 0.05). Conclusion The addition of lignocaine to propofol-based sedation reduced the overall propofol requirement at the same time maintaining hemodynamic stability, spontaneous respiration, and early recovery.

The effects of elemene emulsion injection on rat fecal microbiota and metabolites: Evidence from metagenomic exploration and liquid chromatography-mass spectrometry.

Elemene emulsion injection (EEI) has been approved for interventional and intracavitary chemotherapy in treating malignant ascites in China, but few studies have focused on the effects of EEI on gut microbiota and metabolites. In this study, we investigated the effects of EEI on the fecal microbiota and metabolites in healthy Sprague-Dawley (SD) rats. We randomly assigned 18 male SD rats to three groups (n = 6 in each group): the sham group (group S), the low-concentration EEI group (L-EEI), and the high-concentration EEI group (H-EEI). The L-EEI and H-EEI rats were administered 14 days of consecutive EEI, 20 mg/kg, and 40 mg/kg intraperitoneally (IP). Group S rats were administered the same volume of normal saline. On day 14, each animal's feces were collected for metagenomic sequencing and metabolomic analysis, and the colonic contents were collected for 16S rRNA sequencing. EEI could alter the β-diversity but not the α-diversity of the fecal microbiota and induce structural changes in the fecal microbiota. Different concentrations of EEI affect the fecal microbiota differently. The effects of different EEI concentrations on the top 20 bacteria with significant differences at the species level among the three groups were roughly divided into three categories: (1) A positive or negative correlation with the different EEI concentrations. The abundance of Ileibacterium Valens increased as the EEI concentration increased, while the abundance of Firmicutes bacteria and Clostridium sp. CAC: 273 decreased. (2) The microbiota showed a tendency to increase first, then decrease or decrease first, and then increase as EEI concentration increased-the abundance of Prevotella sp. PCHR, Escherichia coli, and Candidatus Amulumruptor caecigallinarius tended to decrease with L-EEI but significantly increased with H-EEI. In contrast, L-EEI significantly increased Ruminococcus bromii and Dorea sp. 5-2 abundance, and Oscillibacter sp. 1-3 abundance tended to increase, while H-EEI significantly decreased them. (3) L-EEI and H-EEI decreased the abundance of bacteria (Ruminococcaceae bacterium, Romboutsia ilealis, and Staphylococcus xylosus). Fecal metabolites, like microbiota, were sensitive to different EEI concentrations and correlated with fecal microbiota and potential biomarkers. This study shows that intraperitoneal EEI modulates the composition of rat fecal microbiota and metabolites, particularly the gut microbiota's sensitivity to different concentrations of EEI. The impact of changes in the microbiota on human health remains unknown, particularly EEI's efficacy in treating tumors.

Role of Dexmedetomidine Infusion on Renal Dysfunction in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Control Trial

Objective: To find out the effect of Dexmedetomidine infusion on renal function in patients undergoing Coronary Artery Bypass Graft (CABG) surgery.&#x0D; Study Design: Randomized control trial (RCT- NCT05375188).&#x0D; Place and Duration of Study: The research was conducted in the Department of Anesthesia, National Institute of Cardiovascular Diseases Karachi Pakistan, from Jun to Sep 2021.&#x0D; Methodology: 60 patients were allocated randomly into two groups. In Group-D, Dexmetedomidine was given as an infusion of 0.4 μg/kg/h from induction of anesthesia for 24 hours. In Group-C, patients were receiving an equal volume of normal saline. The primary outcome of the study was Serum Creatinine (mg/dl) which was measured 24 hours before the surgery as baseline and then 24 hours and 48 hours after surgery. &#x0D; Results: In Group-C Serum Creatinine was found to be 0.96 +/- 0.21mg/dl at baseline, 1.02 +/- 0.35 mg/dl after 24 hours and 1.38 +/- 0.47 mg/dl after 48 hours of surgery. In Group-D Serum Creatinine was found to be 0.76 +/- 0.12 mg/dl at baseline,0.85 +/- 0.17 mg/dl after 24 hours and 0.82+/- 0.24 mg/dl after 48 hours of surgery. p-value was found to be &lt;0.001 after 48hours of surgery.&#x0D; Conclusion: Dexmetedomidine infusion significantly reduced incidence of acute kidney injury in patients undergoing coronary artery bypass graft surgery.

Protective Effects of Glycyrrhiza Total Flavones on Liver Injury Induced by Streptococcus agalactiae in Tilapia (Oreochromis niloticus)

Clinical studies have confirmed that Glycyrrhiza total flavones (GTFs) have good anti-hepatic injury, but whether they have a good protective effect on anti-hepatic injury activity induced by Streptococcus agalactiae in tilapia (Oreochromis niloticus) is unknown. The aims of this study were to investigate the protective effects of Glycyrrhiza total flavones on liver injury induced by S. agalactiae (SA) and its underlying mechanism in fish. A total of 150 tilapia were randomly divided into five groups, each with three replicates containing 10 fish: normal control group, S. agalactiae infection group, and three Glycyrrhiza total flavone treatment groups (addition of 0.1, 0.5, or 1.0 g of GTF to 1 kg of feed). The normal control group was only fed with basic diet, after 60 d of feeding, and intraperitoneal injection of the same volume of normal saline (0.05 mL/10 g body weight); the S. agalactiae infection group was fed with basic diet, and the S. agalactiae solution was intraperitoneally injected after 60 d of feeding (0.05 mL/10 g body weight); the three GTF treatment groups were fed with a diet containing 0.1, 0.5, or 1.0 g/kg of GTF, and the S. agalactiae solution was intraperitoneally injected after 60 d of feeding (0.05 mL/10 g body weight). After 48 h injection, blood and liver tissues were collected to measure biochemical parameters and mRNA levels to evaluate the liver protection of GTFs. Compared with the control group, the serum levels of glutamic oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT), alkaline phosphatase (AKP) and glucose (GLU) in the streptococcal infection group increased significantly, while the levels of total antioxidant capacity (T-AOC), superoxide dismutase (SOD), catalase (CAT) and reduced glutathione (GSH) decreased significantly; observations of pathological sections showed obvious damage to the liver tissue structure in response to streptococcal infection. S. agalactiae can also cause fatty liver injury, affecting the function of fatty acid β-oxidation and biosynthesis in the liver of tilapia, and also causing damage to function of the immune system. The addition of GTFs to the diet could improve oxidative stress injury caused by S. agalactiae in tilapia liver tissue to different degrees, promote the β-oxidation of fatty acids in the liver, accelerate the lipid metabolism in the liver, and repair the damaged liver tissue. GTFs have a good protective effect on liver injury caused by streptococcus.