Liraglutide Nano-Preparation on Perioperative Neurocognitive Dysfunction in Aged Mice.

At present, there is not enough research about the application of liraglutide nano preparations in perioperative neurocognitive dysfunction. Therefore, the purpose of this study is the mechanism of the effect of liraglutide nano preparations on perioperative neurocognitive dysfunction in aged mice. In this study, 140 male SD rats aged 6-8 weeks were used as the research object, and were divided into 4 groups (n=24) according to the random number table method, which were group C (control group), group S (model group), and treatment. Group (low-dose liraglutide pretreated control group) and DS2 group (high-dose liraglutide pretreated control group) were treated with liraglutide anesthesia to establish a cognitive dysfunction model. Morris water maze experiment was conducted 4 days after anesthesia to compare the escape latency and the number of crossings of the original platform in each group; after 4 days of anesthesia, 18 old mice were randomly selected from each group for fluorescence quantitative polymerase chain reaction (RealTimePCR) and protein Western blotting (Western.Blot) was used to determine the mRNA and protein levels of Caspase-3, Bax and Bcl-2 in the hippocampus; the remaining 6 old mice in each group were taken to observe the pathological changes of the hippocampus neurons by transmission electron microscopy . Compared with saline-treated group, the levels of NF-KB, TNF-a and IL-1ß protein in mice treated with liraglutide decreased and IkB increased significantly (p<0.05). Liraglutide intervention may alleviate non-alcoholic fatty liver in diabetic mice by reducing the expression of inflammatory genes in liver tissue, thereby improving neurocognitive dysfunction in mice.

[Sequence analysis for a case with Para-Bombay AB blood type].

OBJECTIVE: To explore the molecular basis for a rare case with Para-Bombay AB blood type. METHODS: Serological method was used to determine the blood type of the proband. Exons 6 and 7 of the ABO gene and the coding regions of FUT1 and FUT2 genes were analyzed by direct sequencing. RESULTS: Serological results showed that the proband was a Para-Bombay AB subtype. His genotype was determined as ABO*A1.02/B.01. The proband was also found to harbor c.551-552delAG and c.881-882delTT of the FUT1 gene. For his four children, there were three type B and one type A, though the expression of the H type was normal. CONCLUSION: The double deletions in the coding region of the FUT1 gene probably underlay the Para-Bombay blood type in the proband. Carrier of single-strand deletions may have a normal ABO phenotype.

Application of a sub-specialties management model improves quality control in a central sterile supply department.

BACKGROUND: The management of medical devices is crucial to safe, high-quality surgical care, but has received little attention in the medical literature. This study explored the effect of a sub-specialties management model in the Central Sterile Supply Department (CSSD). METHODS: A traditional routine management model (control) was applied from September 2015 through April 2016, and a newly developed sub-specialties management model (observation) was applied from July 2016 through February 2017. Health personnel from various clinical departments were randomly selected to participate as the control (n = 86) and observation (n = 90) groups, respectively. The groups were compared for rates of personnel satisfaction, complaints regarding device errors, and damage of medical devices. RESULTS: The satisfaction score of the observation group (95.8 ± 1.2) was significantly higher than that of the control (90.2 ± 2.3; P = 0.000). The rate of complaints of the observation group (3.3%) was significantly lower than that of the control (11.6%; P = 0.035). The quality control regarding recycle and packing was significantly higher during the observation period than the control period, which favorably influenced the scores for satisfaction. The rate of damage to specialist medical devices during the observation period (0.40%) was lower than during the control period (0.61%; P = 0.003). The theoretical knowledge and practical skills of the CSSD professionals improved after application of the sub-specialties management model. CONCLUSIONS: A management model that considers the requirements of specialist medical devices can improve quality control in the CSSD.

Effects of dexmedetomidine as an adjuvant in thoracic paravertebral block on EC50 of propofol for successful laryngeal mask insertion: a randomized controlled trial.

BACKGROUND: Dexmedetomidine as an adjuvant can improve the duration and the quality of thoracic paravertebral block (TPVB); however, its quantitative effect on propofol infusion is unclear. This study aimed to investigate the effect of dexmedetomidine as an adjuvant in TPVB on the medium effective concentration (EC50) of propofol for successful laryngeal mask insertion. METHODS: Sixty breast cancer patients who underwent elective modified radical mastectomy were enrolled and randomized at a 1:1 ratio into control group (Group C, n=30) or dexmedetomidine group (Group D, n=30). Ultrasound-guided T3 paravertebral block was performed before induction of anesthesia. In Group C, 0.5% ropivacaine 0.3 mL/kg was injected into T3 paravertebral space, while subjects in Group D received 0.5% ropivacaine 0.3 mL/kg with dexmedetomidine (1 µg/kg). Propofol target-controlled infusion (TCI) was performed, with an initial target effect-site concentration of 5 µg/mL determined for both groups. The laryngeal mask was inserted once the effect chamber achieved the target concentration. Subsequent target concentrations were adjusted by Dixon up-down sequential method, where dose modifications were performed by 0.5 mg/mL intervals, based on the success of the laryngeal mask insertion. Probit analysis was used to determine the propofol EC50. Mean arterial pressure (MAP), heart rate (HR), bispectral index (BIS) and application of atropine or ephedrine was recorded. Participants, TPVB giver, and data recorder were blinded to group assignment. RESULTS: Propofol EC50 for successful laryngeal mask insertion were statistically significant, with 5.256 µg/mL (95% CI: 4.833, 5.738 µg/mL) in Group C and 3.172 µg/mL (95% CI: 2.701, 3.621 µg/mL) in Group D. Both groups displayed significantly lower MAP and HR, post propofol TCI (P<0.05). However, subjects in Group D exhibited lower MAP and HR levels compared to patients in Group C (P<0.05). Application of atropine (0% vs. 10%) and ephedrine (20.0% vs. 13.3%) were not significantly different between two groups. CONCLUSIONS: Dexmedetomidine, administered as an adjuvant in TPVB, can reduce the TCI concentration of propofol for successful laryngeal mask placement in females. The target concentration of propofol requires adjustment and close monitoring of hemodynamic changes, post induction is warranted. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR1800016614.

Abnormalities of peripheral blood system in patients with COVID-19 in Wenzhou, China.

BACKGROUND: In December 2019, coronavirus disease 2019 (COVID-19) was first found in Wuhan, China and soon was reported all around the world. METHODS: All confirmed cases with COVID-19 in Wenzhou from January 19 to February 20, 2020, were collected and analyzed. Of the 116 patients with COVID-19, 27 were diagnosed as severe cases. Among severe cases, 9 were treated in ICU. The data of blood routine examination were analyzed and compared among common patients (as common group), severe patients admitted to intensive care unit (as severe ICU group) and severe patients not admitted to ICU (as severe non-ICU group). The blood routine examination results were dynamically observed in the above groups after admission. RESULTS: Patients with COVID-19 have lower counts of leucocytes, lymphocytes, eosinophils, platelets, and hemoglobin, but have higher neutrophil-lymphocyte ratio (NLR) and monocyte-lymphocyte ratio (MLR), which were compared with controls (P < 0.001). In severe ICU group, patients have the lowest count of lymphocytes, but the highest neutrophil count and NLR among the above three groups (all P values < 0.05); NLR and MLR indicators were combined for diagnostic efficacy analysis of severe COVID-19, and its area under the curve reached 0.925. The odds ratio of the delay in days to the start of the increase of eosinophil count for predicting the outcome of patients with severe COVID-19 was 2.291 after age adjusted. CONCLUSIONS: Patients with COVID-19 have abnormal peripheral blood routine examination results. Dynamic surveillance of peripheral blood system especially eosinophils is helpful in the prediction of severe COVID-19 cases.

[Study on Serological Blood Group Conversion in BM Empty Phase of ABO-incompatible Allogeneic Stem Cell Transplantation].

OBJECTIVE: To explore the regularity of serological conversion of blood group in BM empty phase of ABO-incompatible allogeneic stem cell transplantation so as to provide the basis for selecting the blood components in blood transfusion. METHODS: Before hematpoietic stem cell transplantation (HSCT), the ABO and RhD blood groups of recipients and donors were identified by salt medium tube method and microcolumn gel method; after transplantation the changes of antigen intensity and antibody titer of ABO blood group in patients were periodically detected. RESULTS: After blood group shift of 33 patients received ABO-incompatible allo-HSCT, the consistent rate of positive and regative types in major ABO incompatible group was 100%; the consistent rate of positive and negative types in minor ABO-incompatible group was 33%, no-consistent rate was 66.7%; the consistent rate of positive and negative types in bidirextional ABO incompatible group was 20%, the no-consistent rate was 80%. CONCLUSION: After ABO-incompatible allo-HSCT, blood group antgen of patients shifts to the blood group of donors, there is a significant difference in the serological indicators between the minor and bidireetional ABO-incompatible patients and normal people.

miR-326 targets antiapoptotic Bcl-xL and mediates apoptosis in human platelets.

Platelets play crucial roles in hemostasis, thrombosis, wound healing, inflammation, angiogenesis, and tumor metastases. Because they are anucleated blood cells, platelets lack nuclear DNA, but they do contain mitochondrial DNA, which plays a key role in regulating apoptosis. Recent evidence has suggested that miRNAs are also involved in regulating gene expression and apoptosis in platelets. Our previous study showed that the expression of miR-326 increased visibly when apheresis platelets were stored in vitro. The antiapoptotic Bcl-2 family regulator Bcl-xL has been identified as a putative target of miR-326. In the present study, dual reporter luciferase assays were used to characterize the function of miR-326 in the regulation of the apoptosis of platelet cells. These assays demonstrated that miR-326 bound to the 3'-translated region of Bcl-xL. To directly assess the functional effects of miR-326 expression, levels of Bcl-xL and the apoptotic status of stored apheresis platelets were measured after transfection of miR-326 mimic or inhibitor. Results indicated that miR-326 inhibited Bcl-xL expression and induced apoptosis in stored platelets. Additionally, miR-326 inhibited Bcl-2 protein expression and enhanced Bak expression, possibly through an indirect mechanism, though there was no effect on the expression of Bax. The effect of miR-326 appeared to be limited to apoptosis, with no significant effect on platelet activation. These results provide new insight into the molecular mechanisms affecting differential platelet gene regulation, which may increase understanding of the role of platelet apoptosis in multiple diseases.

[Effect of ABO-incompatible allogeneic stem cell transplantation on erythroid lineage hematopoiesis].

This study was purposed to investigate the effect of ABO-incompatible allogeneic hematopoietic stem cell transplantation (allo-HSCT) on erythroid lineage hematopoiesis. The changes of ABO group, IgM and IgG antibody in 16 patients received ABO-incompatible allo-HSCT were detected. The results showed that ABO-incompatible allo-HSCT were successfully engrafted in 16 patients, and there was no difference in reconstitution of platelets and neutrophils between ABO-incompatible and ABO-compatible transplantation (p > 0.05). The time of erythroid lineage reconstitution was prolonged (p < 0.05), the disappearance time of isoagglutinins against donor-type RBC in major and bidirectional ABO-incompatible recipients was correlated with the time of erythroid lineage reconstitution. It is concluded that ABO-incompatible allo-HSCT may lead to prolong recovery of erythroid lineage hematopoiesis. Before transplantation, the removal of anti-donor isoagglutinins by plasmapheresis or transfusion of donor's erythrocytes for neutralizing the isoagglutinins against donor's erythrocytes in the recipients may facilitate RBC engraftment and reduce erythrocyte transfusion.