瑞芬太尼联合丙泊酚麻醉对腹腔镜胆囊切除术患者炎性应激因子水平的影响

目的:探究瑞芬太尼联合丙泊酚麻醉在腹腔镜胆囊切除术中对患者炎性应激因子水平的影响。方法:选取行腹腔镜胆囊切除术的84例患者为研究对象,随机分为观察组和对照组各42例。对照组接受芬太尼联合丙泊酚麻醉;观察组接受瑞芬太尼联合丙泊酚麻醉。比较两组体征水平、炎性应激因子水平及不良反应发生率。结果:气腹后,观察组患者收缩压(SBP)、舒张压(DBP)、心率(HR)水平低于对照组(P<0.05);气腹后,观察组肿瘤坏死因子(TNF)-α、C-反应蛋白(CRP)、血浆皮质醇(COr)水平明显低于对照组(P<0.05);观察组不良反应发生率低于对照组(P<0.05)。结论:在腹腔镜胆囊切除术中实施瑞芬太尼联合丙泊酚麻醉可以稳定患者的生命体征水平,同时降低其炎性应激水平,不良反应较少。

腹腔镜胃修补术治疗急性胃穿孔患者的效果

目的:观察腹腔镜胃修补术治疗急性胃穿孔患者的效果。方法:回顾性分析2021年8月至2023年8月该院收治的102例急性胃穿孔患者的临床资料,依据手术方法不同将其分为观察组(n=51)和对照组(n=51)。观察组行腹腔镜胃修补术治疗,对照组行开腹胃修补术治疗,比较两组围术期指标水平,手术前后胃肠激素指标[胃泌素(GAS)、胃蛋白酶原(PG)Ⅰ、PGⅡ、胃动素(MTL)]水平、炎性应激因子[白细胞介素-8(IL-8)、去甲肾上腺素(NE)、前列腺素E_(2)(PGE_(2))、C反应蛋白(CRP)]水平、疼痛程度[视觉模拟评分法(VAS)]评分,以及术后1周并发症发生率。结果:观察组手术时间、住院时间、首次排气时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);术后3 d,观察组GAS、PGⅠ、MTL和PGⅡ水平均高于对照组,差异有统计学意义(P<0.05);术后3 d,观察组IL-8、NE、CRP和PGE_(2)水平均低于对照组,差异有统计学意义(P<0.05);术后1、3 d,观察组VAS评分均低于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:腹腔镜胃修补术治疗急性胃穿孔患者可提高胃肠激素指标水平,降低围术期指标水平、炎性应激因子水平和疼痛程度评分,效果优于开腹胃修补术治疗。

Antidepressant effects of Yuanzhi (Polygalae Radix) extract on chronic unpredictable mild stress-induced depression in rats: modulation of the NLRP3 inflammasome and NF-κB pathway

Objective To investigate the antidepressant effects of Yuanzhi(Polygalae Radix;PR)aqueous extract on chronic unpredictable mild stress(CUMS)-induced depression rat models and the underlying mechanisms.Methods A total of 40 male Sprague Dawley(SD)rats were randomly divided into control;model;low dose of PR(PR-L;0.5 g/kg);high dose of PR(PR-H;1 g/kg);and fluoxetine(10 mg/kg)groups;with 8 rats in each group.Except for the rats in control group;those in the other four groups underwent CUMS-induced depression modeling.PR and fluoxetine were administered intragastrically once daily;30 min prior to the CUMS procedure;for 14 consecu-tive days until the behavioral tests were performed.After CUMS modeling;the sucrose prefer-ence test(SPT);open field test(OFT);novelty-suppressed feeding test(NSFT);forced swim test(FST);and tail suspension test(TST)were employed to assess the pharmacological ef-fects of PR on the mitigation of depressive-like behaviors in rat models.Additionally;the en-zyme-linked immunosorbent assay(ELISA)was utilized to quantify the serum levels of tumor necrosis factor(TNF)-α;interleukin(IL)-6;and IL-1βin the rats.Western blot analysis was al-so conducted to evaluate the protein expression levels of nuclear factor kappa-B(NF-κB);in-ducible nitric oxide synthase(iNOS);cyclooxygenase-2(COX-2);nucleotide-binding oligomerization domain(NOD)-like receptor family pyrin domain containing 3(NLRP3);apoptosis-associated speck-like protein containing caspase recruitment domain(ASC);and caspase-1 in the hippocampal tissues of the rats.Immunofluorescence staining was per-formed to observe the morphological changes in ionized calcium-binding adapter molecule 1 positive(Iba-1+)cells in the dentate gyrus(DG)of rats with CUMS-induced depression.Results(i)Treatment with PR-H and fluoxetine resulted in significant enhancements in both the total distance and time the rats moved during tests(P<0.01 and P<0.05;respectively).Post-administration of PR-H and fluoxetine also led to statistically significant increase in su-crose preference among rats(P<0.05).Besides;PR-L;PR-H;and fluoxetine treatment markedly decreased the latency of ingestion(P<0.05;P<0.05;and P<0.01;respectively).As observed from the FST;PR-L;PR-H;and fluoxetine presented antidepressant effects on rats with CUMS-induced depression;leading to the reduction in time of their immobility(P<0.05;P<0.01;and P<0.01;respectively).The results of TST indicated reduced immobility time in rats receiving PR-H and fluoxetine treatment as well(P<0.01).(ii)Rats in model group showed an increase in the levels of Iba-1+microglia in their left and right brains in compari-son with control group(P<0.01).However;such increase was negated post PR treatment(P<0.01).Treatment with PR-L;PR-H;and fluoxetine considerably reduced the levels of inflam-matory factors(TNF-α;IL-1β;and IL-6;P<0.01).In addition;treatment of PR-L and PR-H ef-fectively counteracted the elevated levels of NLRP3;ASC;and caspase-1;and markedly down-regulated the expression levels of phosphorylated p65(p-p65);COX-2;and iNOS in rats’hip-pocampus(P<0.01).Conclusion Collectively;these findings indicate that PR exerts an antidepressant effect on rats with CUMS-induced depression partially through the modulation of the NLRP3 and NF-κB signaling pathways.

肠内营养液联合益生菌对结肠造瘘患者营养状态的影响研究

目的:探讨肠内营养液联合益生菌对改善结肠造瘘患者营养状态,促进胃肠功能恢复的效果。方法:从2019年1月—2021年12月河北省中医院行结肠造瘘的患者中,根据研究纳入条件筛选符合条件的80例患者资料展开回顾性分析。根据治疗方法将患者分为对照组、观察组,对照组给予常规肠内营养液治疗,观察组则在肠内营养液支持基础上,联合益生菌治疗。收集并对比2组患者治疗前、治疗后炎性应激因子、肠道菌群水平以及营养指标变化情况,同时统计患者营养不良发生情况。结果:治疗后,观察组血清白细胞介素1β、肿瘤坏死因子-α、超敏C反应蛋白等炎性应激因子水平低于对照组(P<0.05);观察组血清总蛋白、白蛋白、转铁蛋白等营养指标水平高于对照组(P<0.05)。同时,治疗后观察组双歧杆菌、肠球菌、乳酸杆菌数量高于对照组(P<0.05);2组营养不良发生率对比,差异无统计学意义(χ^(2)=2.267,P=0.132)。结论:益生菌用于辅助肠内营养液对结肠造瘘患者进行营养支持治疗,有助于调节肠道微生态平衡、减轻炎性应激,继而促进肠道对营养的吸收。