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Purpose: To study the influence of various doses of ropivacaine (Ropi) on postoperative analgesia, incidence of complications and stress factors in patients undergoing total knee arthroplasty (TKA). Methods: One hundred and fifty (150) patients who received TKA treatment in Ganzhou Hospital of Traditional Chinese Medicine from January 2017 to January 2019 were randomly assigned to low-dose Ropi (0.15%, group A), medium-dose Ropi (0.20%, group B) and high-dose Ropi (0.30%, group C), with 50 patients in each group. Changes in visual analogue scale (VAS) scores, MMSE scores, cognitive dysfunction, serum cortisol (Cor) and adverse reactions were determined before and after surgery. Results: Compared with group A, scores on rest visual analogue scale (RVAS) and passive visual analogue scale (PVAS) were significantly higher in low-dose and high-dose Ropi groups 24 and 48 h postoperatively (p < 0.05). Serum Cor levels in low-dose Ropi-treated patients were significantly lower than those in the other groups at 24 and 48 h after surgery (p < 0.05). The MMSE scores at 48 and 72 h after surgery were significantly higher in low-dose Ropi-treated patients than in the other 2 groups. The number of patients with cognitive impairment after surgery (POCD) was significantly higher in groups B and C than in A (p < 0.05). Conclusion: Low-dose Ropi exerts significant analgesic effect on elderly patients undergoing TKA, and improves their cognitive function without increasing stress response. Therefore, it should be further investigated on a larger scale for its potential as a candidate analgesic for patients after TKA. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effect of Wuling powder (WP) on the pharmacokinetics of valproic acid (VPA) in epileptic rats. Methods: A model of epilepsy was established in SD rats by intraperitoneal injection of pentylenetetrazole (PTZ). Twelve epileptic rats were randomly divided into two groups: control group given oral VPA alone at a dose of 180 mg/kg VPA, and drug combination group orally given VPA (180 mg/kg) co-administered with WP at a dose of 200 mg/kg. Blood sample (0.5 mL) was collected at 15, 30, 60, 120, 240 and 720 min after drug administration for measurement of plasma concentrations of VPA using ultraperformance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Results: The AUC (0-480min) and maximum plasma concentrations (Cmax) of VPA in the drug combination group were significantly higher than those in the control group (p < 0.01). The half-time (t1/2) and time taken to attain maximum plasma VPA concentration (Tmax) in the combination group were extended, when compared to control group (p < 0.05). Conclusion: These results demonstrate that WP increases the plasma concentration of VPA and affects the pharmacokinetic properties of VPA in epileptic rats. Thus, the pharmacodynamic influence of this interaction should be taken into consideration while prescribing WP to epileptic patients already taking VPA. [ABSTRACT FROM AUTHOR]

Purpose: To determine the inhibitory effects of Wuling mycelia, alone and in combination with valproic acid (VPA) on pentylenetetrazol (PTZ)-induced epileptic seizure in rats, and their protective effects on cognitive impairment. Methods: Sprague-Dawley rats were randomly divided into five groups: control (sham), model, Wuling mycelia, VPA and combination groups. Rats in Wuling mycelia group were given oral Wuling mycelia alone at a dose of 594 mg/kg, while those in VPA group were given oral VPA alone at a dose of 189 mg/kg. In the combination group, rats received oral VPA at a dose of 189 mg/kg co-administered with Wuling mycelia at a dose of 594 mg/kg. One hour after the treatments, the control group was injected with physiological saline intraperitoneally, while the other four groups were injected with PTZ solution once a day for 28 days. Subsequently, seizure intensity, cognitive impairment, neuronal loss and hippocampal expressions of IL-1β, NF-ΚB/p65 and TLR4 were determine in all groups. Results: Combined use of Wuling mycelium and VPA significantly reduced the frequency and the grade of seizures (p <0.01), and also decreased the degree of cognitive impairment (p <0.05). There were marked increases in neuronal damage and hippocampal expression levels of NF-ΚB/p65, TLR4 and IL- 1β (inflammatory cytokines) in the model group (p < 0.05). However, these changes were reversed in the combination treatment group (p < 0.05). Conclusion: Wuling mycelia is a potentially effective adjunct drug for the treatment of refractory epilepsy. The underlying mechanism might involve downregulations of NF-ΚB/p65, TLR4 and IL-1β. [ABSTRACT FROM AUTHOR]