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Study design: Animal study. Objectives: Explore the neuroprotective effect of remote limb ischemic postconditioning (Post C) in spinal cord ischemic reperfusion injury (SCII) and related mechanisms. Setting: Anesthesiology Laboratory of Southwest Medical University. Methods: We established a rabbit SCII model and processed it with Post C. To evaluate the neural function, spinal cord tissue was taken 48 h later, normal neurons were evaluated by HE staining, and the expression of ATP-sensitive potassium channel (KATP) marker molecule Kir6.2 was detected by Western blot. Immunofluorescence detection of spinal cord Iba-1 expression, ELISA detection of M1 type microglia marker iNOS and M2 type microglia marker Arg, and Western blot detection of NF-κB and IL-1β expression. Through these experiments, we will explore the protective effect of Post C in SCII, observe the changes in the protective effect after using KATPblockers, and verify that Post C can play a neuroprotective effect in SCII by activating KATP. Results: We observed that Post C significantly improved exercise ability and the number of spinal motor neurons in the SCII model. Microglia are activated and expression of M1microglia in the spinal cord was decreased, while M2was increased. This neuroprotective effect was reversed by the nonspecific KATPinhibitor. Conclusion: Post C has a neuroprotective effect on SCII, and maybe a protective effect produced by activating KATPto regulate spinal microglia polarization and improve neuroinflammation.

Aims To determine the effect of choice of inhalational anaesthetic (sevoflurane vs propofol) on the incidence and severity of postoperative cognitive dysfunction (POCD) in elderly patients (aged ≥ 60 years) with mild cognitive impairment (MCI).Methods Elderly patients with MCI undergoing radical rectal resection were randomly assigned to receive sevoflurane or propofol general anaesthesia. Cognitive function was assessed using neuropsychological testing before and 7 days after surgery. POCD severity was graded as mild, moderate or severe using standard deviation cut-offs.Results At 7 days after surgery, the incidence of POCD was 29.7% in the propofol group (n= 101) and 33.3% in the sevoflurane group (n= 99). There was a significant between-group difference for POCD severity: sevoflurane anaesthesia had a more severe impact on cognitive function than propofol anaesthesia.Conclusions There was no difference in the incidence of POCD at 7 days after radical rectal resection under sevoflurane or propofol-based general anaesthesia. Both propofol and sevoflurane were associated with negative cognitive effects, but sevoflurane had a more severe impact on cognitive function than propofol, in elderly patients with MCI.

In this study, we tested the hypothesis that the alternating of hypoperfusion and full reperfusion (hypoperfusion postconditioning) could improve neuroprotection on cerebral ischemia in rats and explored the role of TAp63 and Np63 in this process. Eighty male Sprague Dawley rats were randomly divided into 4 groups: the sham group, the cerebral ischemicreperfusion group (IR), the hypoperfusion group 1 (HR1), and the hypoperfusion group 2 (HR2). Cerebral ischemia was established by clamping the bilateral common carotid artery with hypotension for 20 minutes. For the rats in the HR1 group, the blood pressure was maintained to 80 to 90 mm Hg in clamping bilateral common carotid artery minutes and then unclamped. For the rats in the HR2 group, the clamping was performed at one side of the common carotid artery and one half of the other side of common carotid artery. Neurologic behavior scores in the IR, HR1, and HR2 groups decreased significantly after cerebral ischemia, and scores in the HR2 group were significantly higher than those in the IR group (P< 0.05). Neuronal densities in the HR1 and HR2 groups were significantly higher than that in the IR group (P< 0.05). Neuronal apoptosis in the HR1 and HR2 groups was significantly lower than that inthe IR group (P< 0.05). TAp63 and S100 concentration decreased, and Np63 increased significantly in the HR1 and HR2 groups as compared with the IR group (P< 0.05). No significant difference in these parameters between the HR1 and HR2 groups (P> 0.05). Alternating of hypoperfusion and normal perfusion postconditioning had neuroprotection function on cerebral ischemia in the rats. This could relate with decreasing expression of TAp63 and increasing expression of Np63 in hippocampal region of the first area in the hippocampal circuit to inhibit neuronal apoptosis.

Background A novel technique of continuous transversus abdominis plane block (TAPB) has been reported to be beneficial to patients undergoing abdominal surgery because it can significantly relieve postoperative pain. The aim of our study is to compare this novel technique with a traditional technique of continuous epidural analgesia (EA).Methods We conducted our meta-analysis in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Only randomized controlled trials (RCTs) that compared the efficacy of continuous TAPB and continuous EA to relieve postoperative pain were included. Patients were classified by nationality (Chinese, non-Chinese) for the subgroup analysis.Results Nine RCTs with 598 patients were included in our study. Pain levels measured by visual analog scale (VAS) scores at rest on postoperative day 1 were equivalent for continuous TAPB groups and continuous EA groups in non-Chinese and Chinese patients. The TAPB groups experienced a lower rate of hypotension, sensorimotor disorder, and nausea compared with the continuous EA group within 48 hours after surgery.Conclusion Continuous TAPB and continuous EA are equally effective in relieving postoperative pain at rest 24 hours after surgery, but EA was associated with more side effects such as hypotension, nausea, and sensorimotor disorder.