Background: Blood reperfusion after ischemia is the main measure to restore cell function. This study was aimed to explore the effect of propofol on rat and cell models of liver ischemia-reperfusion (I/R) injury, and to investigate its possible mechanism. Methods: Wistar rats were divided into four groups: control group, sham group, I/R group, and propofol group. Human hepatocyte HL7702 was divided into six groups: control group, I/R group and propofol (5, 10, 20 and 40 µmol/L) groups. After the animal and cell models were established, the alanine aminotransferase (ALT), aspartate aminotransferase (AST), malondialdehyde (MDA) and adenosine triphosphate (ATP) levels in liver tissues and hepatocytes were measured. Cell viability and apoptosis of hepatocytes were respectively determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and flow cytometry.Furthermore, the expressions of apoptosis-related proteins in hepatocytes were determined by Western blot analysis. Results: ALT, AST and MDA levels were all decreased significantly, and the ATP level was increased significantly in propofol group compared with that in I/R group in both liver tissues and hepatocytes.Additionally, cell viability of hepatocytes in propofol group was higher than that in I/R group, while the percentage of apoptotic cells in propofol group was less than that in I/R group. Moreover, the expression of caspase-3 decreased and the expression of Bcl-2 increased significantly after propofol preconditioning.Conclusions: Our findings suggested that propofol preconditioning might be an effective strategy for protecting the liver from I/R injury, which might provide a scientific basis for clinical application.

BackgroundBody temperature (BT) has been used to evaluate the outcomes of patients with various diseases. In this study, patients with diastolic heart failure (DHF) in the intensive care unit (ICU) were examined for a correlation between BT and mortality.MethodsThis was a retrospective cohort study of the Medical Information Mart for Intensive Care (MIMIC)-IV dataset. A total of 4,153 patients with DHF were included. The primary outcomes were 28-day ICU and higher in-hospital mortality rates. BT was used in the analyses both as a continuous variable and as a categorical variable. According to the distribution of BT, the patients were categorized into three groups (hypothermia BT <36.5°C, normal 36.5°C ≤ BT <37.5°C, and hyperthermia BT ≥37.5°C). Multivariate logistic regression analysis was performed to explore the association between BT and patient outcomes.ResultsThe proportions of the groups were 23.6, 69.2, and 7.2%, respectively. As a continuous variable, every 1°C increase in BT was associated with a 21% decrease in 28-day ICU mortality (OR: 0.79, 95% CI: 0.66–0.96, and p = 0.019) and a 23% decrease in in-hospital mortality (OR: 0.77, 95% CI: 0.66–0.91; and p = 0.002). When BT was used as a categorical variable, hypothermia was significantly associated with both 28-day ICU mortality (OR: 1.3, 95% CI: 1.03–1.65; and p = 0.026) and in-hospital mortality (OR: 1.31, 95% CI: 1.07–1.59; and p = 0.008). No statistical differences were observed between 28-day ICU mortality and in-hospital mortality with hyperthermia after adjustment.ConclusionThe first 24-h mean BT after ICU admission was associated with 28-day ICU and in-hospital mortality in patients with DHF. Hypothermia significantly increased mortality, whereas hyperthermia did not.

Background Cervical conization is a brief but painful procedure that can be performed under deep sedation with propofol and opioids. However, this sedation approach comes with a high risk of sedation-related adverse events (SRAEs). Esketamine, an N-methyl-d-aspartate (NMDA) receptor antagonist, has the property of less cardiorespiratory depression than opioids. The aim of this study was to assess the efficacy and safety of adding a low-dose esketamine to propofol and sufentanil sedation as an opioid-reduced regimen. Methods 122 consecutive patients with ASA Ⅰ-Ⅲ, body mass index < 30, STOP-BANG score < 3 who underwent cervical conization were enrolled and randomly divided into group S and group ES. Using a closed-loop target-controlled infusion (TCI) pump with target bispectral index (BIS) value of 60 ± 5, patients in group S were sedated with 0.2µg/kg sufentanil and propofol, while patients in group ES were sedated with 0.15mg/kg esketamine, 0.1µg/kg sufentanil and propofol. The primary endpoint was the composite incidence of SRAEs, while the second endpoints included effectiveness of sedation, awakening time, psychotomimetic side effects, postoperative pain, postoperative nausea and vomiting, and patient and gynecologist satisfaction. Results Data of 120 patients were analyzed. The incidence of composite SRAEs was significantly higher in group S compared to group ES (85.0% vs 56.7%, P < 0.05). Furthermore, the severity of SRAEs was higher in group S compared to group ES (P < 0.001). There were no significant differences in the success of sedation, awakening time, psychotomimetic side effects, postoperative nausea and vomiting, postoperative pain, and patient and gynecologist satisfaction between the two groups. Conclusion Adding a low-dose esketamine to propofol and sufentanil sedation reduces the incidence and severity of SRAEs in patients undergoing cervical conization, with equal sedation efficacy, recovery quality, and no additional psychomimetic side effects. Trial registration ChiCTR2000040457, 28/11/2020

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