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1.
J Pain Res ; 17: 1413-1422, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38618294

RESUMO

Purpose: This study aimed to assess the current status of clinical practice of refractory cancer pain (RCP) among a sample of physicians specializing in cancer pain management in Shanghai. Methods: From 2019 to 2021, a questionnaire survey was conducted among physicians engaged in diagnosis and treatment of cancer pain through the questionnaire WJX network platform in Shanghai, China. Results: A total of 238 responses participated in the survey. This survey reports physicians' understanding and incidence rate of breakthrough cancer pain (BTCP). The choice of analgesics and satisfaction of analgesic effect were investigated. We also investigated doctors' knowledge of the diagnostic criteria for RCP and their tendency to choose analgesics. Oral immediate-release morphine and intravenous or subcutaneous morphine injection have been the common treatment approach for transient cancer pain exacerbations. The main barriers to pain management are lack of standardized treatment methods for RCP, lack of knowledge related to RCP, and single drug dosage form. Doctors believe the most necessary measures to improve the current situation of poor cancer pain control include improving medical staff's understanding and treatment techniques for RCP, updating treatment techniques and methods, and improving the configuration of drug types in medical institutions. Clinicians expect to improve understanding and treatment techniques through systematic training. Conclusion: Despite multiple available analgesic measures, the treatment of RCP remains challenging. Improving the understanding of medical staff towards RCP, improving treatment techniques, and increasing the accessibility of multiple drug types are important ways to improve the satisfaction of cancer pain management in the future.

2.
Mol Pain ; 19: 17448069231152125, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36604795

RESUMO

Nerve injury can induce aberrant changes in ion channels, enzymes, and cytokines/chemokines in the dorsal root ganglia (DRGs); these changes are due to or at least partly governed by transcription factors that contribute to the genesis of neuropathic pain. However, the involvement of transcription factors in neuropathic pain is poorly understood. In this study, we report that transcription factor (TF) ETS proto-oncogene 1 (ETS1) is required for the initiation and development of neuropathic pain. Sciatic nerve chronic constrictive injury (CCI, a clinical neuropathic pain model) increases ETS1 expression in the injured male mouse DRG. Blocking this upregulation alleviated CCI-induced mechanical allodynia and thermal hyperalgesia, with no apparent effect on locomotor function. Mimicking this upregulation results in the genesis of nociception hypersensitivity; mechanistically, nerve injury-induced ETS1 upregulation promotes the expression of histone deacetylase 1 (HDAC1, a key initiator of pain) via enhancing its binding activity to the HDAC1 promotor, leading to the elevation of spinal central sensitization, as evidenced by increased expression of p-ERK1/2 and GFAP in the dorsal spinal horn. It appears that the ETS1/HDAC1 axis in DRG may have a critical role in the development and maintenance of neuropathic pain, and ETS1 is a potential therapeutic target in neuropathic pain.


Assuntos
Neuralgia , Traumatismos dos Nervos Periféricos , Animais , Masculino , Camundongos , Gânglios Espinais/metabolismo , Histona Desacetilase 1/metabolismo , Histona Desacetilase 1/farmacologia , Hiperalgesia/metabolismo , Neuralgia/metabolismo , Neurônios Aferentes/metabolismo , Traumatismos dos Nervos Periféricos/metabolismo , Proto-Oncogenes , Ratos Sprague-Dawley , Fatores de Transcrição/metabolismo , Ratos
3.
Cell Cycle ; 21(3): 289-303, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34964696

RESUMO

Osteoarthritis is a degenerative joint disease and a leading cause of adult disability. Our previous study has reported that mesenchymal stem cell-derived exosomes (MSC-Exo) mediated long non-coding RNA KLF3-AS1 improves osteoarthritis. This study aims to investigate the molecular mechanism of KLF3-AS1 in osteoarthritis. Chondrocytes were treated with IL-1ß to induce chondrocyte injury, followed by MSC-Exo treatment. We found that MSC-Exo enhanced KLF3-AS1 expression in IL-1ß-treated chondrocytes. IL-1ß treatment reduced cell viability and enhanced apoptosis in chondrocytes. MSC-Exo-mediated KLF3-AS1 promoted cell viability and repressed apoptosis of IL-1ß-treated chondrocytes. Rapamycin (autophagy activator) promoted cell viability and suppressed apoptosis of chondrocytes by activating autophagy. Moreover, KLF3-AS1 interacted with YBX1 in chondrocytes. MSC-Exo-mediated KLF3-AS1 activated PI3K/Akt/mTOR signaling pathway, which was abrogated by YBX1 silencing. MSC-Exo-mediated KLF3-AS1 repressed autophagy and apoptosis of chondrocytes by activating PI3K/Akt/mTOR signaling pathway. In conclusion, our data demonstrate that MSC-Exo-mediated KLF3-AS1 inhibits autophagy and apoptosis of IL-1ß-treated chondrocyte through PI3K/Akt/mTOR signaling pathway. KLF3-AS1 activates PI3K/Akt/mTOR signaling pathway by targeting YBX1 to improve the progression of osteoarthritis. Thus, this work suggests that MSC-Exo-mediated KLF3-AS1 may be a potential therapeutic target for osteoarthritis.


Assuntos
Exossomos , Células-Tronco Mesenquimais , Osteoartrite , RNA Longo não Codificante , Apoptose/genética , Autofagia/genética , Condrócitos/metabolismo , Exossomos/metabolismo , Humanos , Fatores de Transcrição Kruppel-Like/genética , Fatores de Transcrição Kruppel-Like/metabolismo , Células-Tronco Mesenquimais/metabolismo , Osteoartrite/genética , Osteoartrite/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , RNA Longo não Codificante/genética , RNA Longo não Codificante/metabolismo , Serina-Treonina Quinases TOR/metabolismo
4.
Gels ; 7(4)2021 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-34842664

RESUMO

Carcinoembryonic antigen (CEA) is an important broad-spectrum tumor marker. For CEA detection, a novel type of metal-organic framework (MOF) was prepared by grafting CEA aptamer-incorporated DNA tetrahedral (TDN) nanostructures into PCN-222 (Fe)-based MOF (referred as CEAapt-TDN-MOF colloid nanorods). The synthesized CEAapt-TDN-MOF is a very stable detection system due to the vertex phosphorylated TDN structure at the interface, possessing a one-year shelf-life. Moreover, it exhibits a significant horseradish peroxidase mimicking activity due to the iron porphyrin ring, which leads to a colorimetric reaction upon binding toward antibody-captured CEA. Using this method, we successfully achieved the highly specific and ultra-sensitive detection of CEA with a limit of detection as low as 3.3 pg/mL. In addition, this method can detect and analyze the target proteins in clinical serum samples, effectively identify the difference between normal individuals and patients with colon cancer, and provide a new method for the clinical diagnosis of tumors, demonstrating a great application potential.

5.
J Cell Mol Med ; 23(6): 3855-3866, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30955246

RESUMO

As fracture healing is related to gene expression, fracture healing is prospected to be implicated in long non-coding RNAs (lncRNAs). This study focuses on the effects of epigenetic silencing of long non-coding RNA maternally expressed gene 3 (lncRNA MEG3) on fracture healing by regulating the Wnt/ß-catenin signalling pathway. Genes expressed in fracture were screened using bioinformatics and the subcellular location of MEG3 was determined using FISH. Next, we successfully established tibia fracture (TF) models of C57BL/6J and Col2a1-ICAT mice and the effect of silencing lncRNA MEG3 on fracture healing was detected after TF mice were treated with phosphate buffer saline (PBS), MEG3 siRNA and scramble siRNA. X-ray imaging, Safranin-O/fast green and haematoxylin-eosin (HE) staining and histomorphometrical and biomechanical analysis were adopted to observe and to detect the fracture healing conditions. Additionally, the positive expression of collagen II and osteocalcin was examined using immunohistochemistry. At last, in the in vitro experiment, the relationship of MEG3 and the Wnt/ß-catenin signalling pathway in fraction healing was investigated. MEG3 was located in the cell nucleus. In addition, it was found that MEG3 and the Wnt/ß-catenin signalling pathway were associated with fraction healing. Moreover, silencing MEG3 was proved to elevate callus area and maximum bending load and to furthermore enhance the recanalization of bone marrow cavity. Finally, MEG3 knockdown elevated levels of Col10a1, Runx2, Osterix, Osteocalcin, Wnt10b and ß-catenin/ß-catenin whereas it reduced p-GSK-3ß/GSK-3ß levels. Taken together, our data supported that epigenetic silencing of lncRNA MEG3 could promote the tibia fracture healing by activating the Wnt/ß-catenin signalling pathway.


Assuntos
Consolidação da Fratura/genética , Glicogênio Sintase Quinase 3 beta/metabolismo , RNA Longo não Codificante/metabolismo , Fraturas da Tíbia/metabolismo , Via de Sinalização Wnt/genética , Animais , Calo Ósseo/metabolismo , Colágeno Tipo II/metabolismo , Subunidade alfa 1 de Fator de Ligação ao Core/metabolismo , Modelos Animais de Doenças , Regulação para Baixo , Consolidação da Fratura/fisiologia , Inativação Gênica , Glicogênio Sintase Quinase 3 beta/química , Glicogênio Sintase Quinase 3 beta/genética , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Osteocalcina/metabolismo , Interferência de RNA , RNA Longo não Codificante/genética , Fator de Transcrição Sp7/metabolismo , Fraturas da Tíbia/genética , Análise Serial de Tecidos , Regulação para Cima , beta Catenina/metabolismo
6.
Biochem J ; 475(22): 3629-3638, 2018 11 28.
Artigo em Inglês | MEDLINE | ID: mdl-30341166

RESUMO

The present study was designed to explore whether exosomal lncRNA-KLF3-AS1 derived from human mesenchymal stem cells (hMSCs) can serve as a positive treatment for osteoarthritis (OA). hMSCs and MSC-derived exosomes (MSC-exo) were prepared for morphological observation and identification by transmission electron microscopy and flow cytometry. IL-1ß-induced OA chondrocytes and collagenase-induced rat model of OA were established for the further experiments. Lentivirus-mediated siRNA targeting KLF3-AS1 was transfected into MSCs for silencing KLF3-AS1. The real-time quantitative PCR and western blotting analysis were performed to examine the mRNA and protein levels of type II collagen alpha 1 (Col2a1), aggrecan, matrix metalloproteinase 13 and runt-related transcription factor 2. Cell proliferation, apoptosis and migration were evaluated by CCK-8 assay, flow cytometry and transwell assay. HE (hematoxylin and eosin) staining and immunohistochemistry were used for histopathological studies. MSC-exo ameliorated IL-1ß-induced cartilage injury. Furthermore, lncRNA KLF3-AS1 was markedly enriched in MSC-exo, and exosomal KLF3-AS1 suppressed IL-1ß-induced apoptosis of chondrocytes. Further in vivo investigation indicated that exosomal KLF3-AS1 promoted cartilage repair in a rat model of OA. Exosomal KLF3-AS1 promoted cartilage repair and chondrocyte proliferation in a rat model of OA, which might be an underlying therapeutic target for OA.


Assuntos
Artrite Experimental/genética , Cartilagem/metabolismo , Proliferação de Células/genética , Condrócitos/metabolismo , Células-Tronco Mesenquimais/metabolismo , RNA Longo não Codificante/genética , Agrecanas/genética , Agrecanas/metabolismo , Animais , Apoptose/efeitos dos fármacos , Apoptose/genética , Artrite Experimental/patologia , Artrite Experimental/terapia , Cartilagem/patologia , Proliferação de Células/efeitos dos fármacos , Células Cultivadas , Condrócitos/citologia , Técnicas de Cocultura , Exossomos/genética , Expressão Gênica/efeitos dos fármacos , Humanos , Interleucina-1beta/farmacologia , Masculino , Células-Tronco Mesenquimais/citologia , Interferência de RNA , Ratos Sprague-Dawley
7.
Cell Cycle ; 17(21-22): 2411-2422, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30324848

RESUMO

BACKGROUND: Exosomes secreted by human mesenchymal stem cells (hMSCs) have been shown to promote cartilage regeneration. This study aimed to explore whether exosomal lncRNA-KLF3-AS1 derived from hMSCs can promote chondrocyte proliferation via miR-206/GIT1 axis in osteoarthritis (OA). METHODS: hMSCs and MSC-derived exosomes (MSC-exo) were prepared for morphological observation and identification by transmission electron microscopy (TEM) and flow cytometry. IL-1ß-induced OA chondrocytes and collagenase-induced mouse OA model were established for the further experiments. Luciferase activity assay was performed to test whether miR-206 could bind to KLF3-AS1 or GIT1. Cell proliferation and apoptosis were evaluated by CCK-8 assay and flow cytometry, respectively. RESULTS: MSC-Exos increased chondrogenic genes Col2a1 (type II collagen alpha 1) and aggrecan, decreased hondrocyte hypertrophy markers MMP-13 (matrix metalloproteinase-13) and Runx2 (runt-related transcription factor 2) in chondrocytes isolated from OA model mice. Furthermore, MSC-Exos attenuated IL-1ß-induced chondrocyte proliferation inhibition and apoptosis induction. Moreover, MSCKLF3-AS1-Exos (exosomes derived from KLF3-AS1-overexpressing-MSCs) ameliorated IL-1ß-induced chondrocyte injury. Results also demonstrated that KLF3-AS1 acted as a competitive endogenous RNA (ceRNA) by sponging miR-206 to facilitate GIT1 expression. In addition, miR-206 overexpression and GIT1 knockdown reversed MSCKLF3-AS1-Exos-mediated attenuation of chondrocyte injury. CONCLUSION: Exosomal KLF3-AS1 derived from MSCs involved in MSC-Exos-mediated chondrocyte proliferation induction and chondrocyte apoptosis inhibition via miR-206/GIT1 axis. Abbreviation: G-protein-coupled receptor kinase interacting protein-1 (GIT1).


Assuntos
Apoptose , Artrite Experimental/cirurgia , Proteínas de Ciclo Celular/metabolismo , Proliferação de Células , Condrócitos/metabolismo , Exossomos/transplante , Proteínas Ativadoras de GTPase/metabolismo , Articulações/cirurgia , Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais , MicroRNAs/metabolismo , RNA Longo não Codificante/metabolismo , Animais , Artrite Experimental/genética , Artrite Experimental/metabolismo , Artrite Experimental/patologia , Proteínas de Ciclo Celular/genética , Células Cultivadas , Condrócitos/patologia , Condrogênese , Técnicas de Cocultura , Exossomos/genética , Exossomos/metabolismo , Exossomos/ultraestrutura , Proteínas Ativadoras de GTPase/genética , Humanos , Articulações/metabolismo , Articulações/patologia , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Mesenquimais/ultraestrutura , Camundongos Endogâmicos C57BL , MicroRNAs/genética , RNA Longo não Codificante/genética , Transdução de Sinais
8.
Eur J Anaesthesiol ; 35(11): 848-855, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30015795

RESUMO

BACKGROUND: The use of sedation is becoming more commonplace. Although pulse oximetry is a standard monitoring procedure during sedation, it cannot accurately detect early hypoventilation. End-tidal carbon dioxide (EtCO2) monitoring can be an earlier indicator of airway compromise; however, the existing literature is limited to a few studies with varying outcomes. OBJECTIVES: To evaluate whether EtCO2 monitoring decreases the incidences of CO2 retention and apnoeic events in propofol-based sedation. DESIGN: Randomised controlled study. SETTING: A tertiary hospital. PATIENTS: Two hundred women (aged 18 to 65 years, ASA physical status 1 or 2) who were scheduled for breast lumpectomy between June 2017 and August 2017. INTERVENTIONS: Patients were allocated randomly to receive either standard monitoring or standard monitoring and EtCO2 monitoring. MAIN OUTCOME MEASURES: The primary outcome was the incidence of CO2 retention. The secondary outcomes were the number of actions taken to restore ventilation, variations in PaCO2 and pH, the frequency of apnoea and the recovery time. RESULTS: CO2 retention occurred significantly less often in the EtCO2 monitoring group (10 vs. 87%; P < 0.0001). In the standard monitoring group, the mean PaCO2 was more than 6 kPa (45 mmHg) and the pH was less than 7.35 at 5, 10, 20 and 30 min after induction of anaesthesia and at the end of the procedure. Both values were within the normal range in the EtCO2 monitoring group. The number of airway interventions performed was significantly higher in the EtCO2 monitoring group (9.8 ±â€Š1.8 vs. 1.9 ±â€Š1.0; P < 0.0001). Apnoea occurred significantly less often in the EtCO2 monitoring group (0 vs. 10%; P < 0.0001) and recovery time was shorter (9.9 ±â€Š1.4 vs. 11.4 ±â€Š2.1 min; P = 0.048). CONCLUSION: The addition of EtCO2 monitoring to standard monitoring during propofol-based sedation can improve patient safety by decreasing the incidence of CO2 retention, and therefore the risk of hypoxaemia through early recognition of apnoea, and can also shorten recovery time. TRIAL REGISTRATION: This trial is registered with http://www.chictr.org.cn (ChiCTR-INR-17011537).


Assuntos
Anestésicos Intravenosos/administração & dosagem , Dióxido de Carbono/análise , Mastectomia Segmentar/normas , Monitorização Intraoperatória/normas , Segurança do Paciente/normas , Propofol/administração & dosagem , Adulto , Anestésicos Intravenosos/efeitos adversos , Feminino , Humanos , Mastectomia Segmentar/métodos , Pessoa de Meia-Idade , Monitorização Intraoperatória/métodos , Propofol/efeitos adversos , Estudos Prospectivos
9.
Am J Transl Res ; 9(3): 1162-1172, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28386342

RESUMO

OBJECTIVES: The inhaled general anesthetic isoflurane has been shown to induce caspase-3 activation in vitro and in vivo. The underlying mechanisms and functional consequences of this activity remain unclear. Isoflurane can induce caspase-3 activation by causing accumulation of reactive oxygen species (ROS), mitochondrial dysfunction, and reduction in adenosine triphosphate (ATP) levels. This study aimed to investigate the protective effect of hydrogen, a novel antioxidant, against isoflurane-induced caspase-3 activation and cognitive impairment. METHODS: H4 human neuroglioma cells overexpressing human amyloid precursor protein were treated with saline or hydrogen-rich saline (HS, 300 µM), with or without 2% isoflurane, for 6 h or 3 h. Western blot analysis, fluorescence assays, and a mitochondrial swelling assay were used to evaluate caspase-3 activation, levels of ROS and ATP, and mitochondrial function. The effect of the interaction of isoflurane (1.4% for 2 h) and HS (5 mL/kg) on cognitive function in mice was also evaluated using a fear conditioning test. RESULTS: We found that HS attenuated isoflurane-induced caspase-3 activation. Moreover, HS treatment mitigated isoflurane-induced ROS accumulation, opening of mitochondrial permeability transition pores, reduction in mitochondrial membrane potential, and reduction in cellular ATP levels. Finally, HS significantly alleviated isoflurane-induced cognitive impairment in mice. CONCLUSIONS: Our results suggest that HS attenuates isoflurane-induced caspase-3 activation and cognitive impairment via inhibition of isoflurane-induced oxidative stress, mitochondrial dysfunction, and reduction in ATP levels. These findings warrant further research into the underlying mechanisms of this activity, and indicate that HS has the potential to attenuate anesthesia neurotoxicity.

10.
Mol Immunol ; 77: 184-92, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27522478

RESUMO

Cytokines and chemokines are involved in chronic pain syndromes, and their expression is altered in injury-induced neuronal pain pathways. However, the exact cytokines/chemokines involved and their mechanism of action remain to be determined. In this study, we investigated the role of interleukin-4 and the chemokine/chemokine receptor pair CCL3/CCR5 in a mouse model of chronic constriction injury (CCI)-induced neuropathic pain. Neuropathic pain was induced by surgical ligation of the sciatic nerve and assessed by measuring thermal hyperalgesia and mechanical allodynia using a plantar test and a dynamic plantar esthesiometer. The underlying mechanisms were investigated by real-time quantitative reverse transcription polymerase chain reaction, western blotting, immunohistochemistry, ELISA, and histopathology. CCI-induced neuropathic pain was associated with CCL3 and CCR5 upregulation and microglial activation. Intrathecal injection of the anti-inflammatory cytokine interleukin-4 or CCL3-neutralizing antibody alleviated CCI-induced inflammation, suppressing the CCI-induced upregulation of tumor necrosis factor-α and interleukin-1ß in the serum and spinal cord, restoring the CCI-induced upregulation of CCL3 and CCR5, and suppressing the CCI-induced activation of p38 mitogen-activated protein kinase. Knockout of CCR5 also suppressed CCI-induced neuropathic pain. Since the upregulation of chemokines and cytokines is directly or indirectly involved in chronic pain after nerve injury, these molecules are potential therapeutic targets in the treatment of neuropathic pain.


Assuntos
Quimiocina CCL3/metabolismo , Interleucina-4/metabolismo , Neuralgia/metabolismo , Receptores CCR5/metabolismo , Animais , Western Blotting , Quimiocina CCL3/imunologia , Dor Crônica , Modelos Animais de Doenças , Ensaio de Imunoadsorção Enzimática , Citometria de Fluxo , Hiperalgesia/imunologia , Hiperalgesia/metabolismo , Imuno-Histoquímica , Interleucina-4/imunologia , Ligadura , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Microglia/metabolismo , Neuralgia/imunologia , Reação em Cadeia da Polimerase , Receptores CCR5/imunologia , Nervo Isquiático/lesões
11.
Int J Clin Exp Med ; 8(11): 20092-6, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26884922

RESUMO

OBJECTIVE: to observe the therapeutic effects of percutaneous bilateral splanchnic nerves block in patients with intractable pain due to pancreatic cancer. METHODS: twenty-fourpatients (advanced pancreatic cancer) with intractable pain were enrolled in the research. Through approach of the edge of T11 vertebral body with double-needle technique, the researchers carried out the bilateral lesion of the greater and the lesser splanchnic nerve with absolute ethyl alcohol under X-ray guidance. Follow-up was six months. Numerical rating scale (NRS) and quality of life (QOL) were all assessed pre- and post-procedure (1 d, 1 w, 2 w, 1 m, 2 m, 3 m, 4 m, 5 m, 6 m). The daily morphine consumption was recorded. RESULTS: NRS and daily morphine consumption decreased when compared to pre-procedure while QOL increased. These differences were found to be statistically significant (P<0.05). 9 patients suffered from diarrhea temporally and recoveredin one week. CONCLUSION: Percutaneous bilateral splanchnic nerves lesion under X-ray guidancecan treat intractable pain caused by pancreatic cancer and improve patients'life quality with minor complication.

12.
Int J Clin Exp Med ; 7(10): 3467-72, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25419384

RESUMO

Sex differences in opioid analgesia have been confirmed both in clinical and experimental studies. Gonadal hormones (estrogens in particular) have a great role in this process. However, the mechanisms that underlie these sex differences are not very clear. In this study, we used K(+)-Cl(-) cotransporter 2 (KCC2) as a molecule target to investigate the mechanism underlying the phenomenon. Sprague-Dawley rats were randomly assigned to ovariectomy (OVX)+morphine group, OVX+Saline group, sham surgery (OVX-sham)+morphine group and OVX-sham+saline group. All the rats received SNI surgery three weeks after ovariectomy. We used von Frey values as a sign of neuropathic pain. On PO day 14, 1 µg morphine or the vehicle saline was administered intrathecally via a PE-10 catheter formerly implanted. Hindpaw withdrawal threshold was determined before and 30, 60, 90, 120, 150, 180 min after drugs injection. The L4-L5 segments of the spinal cord were removed and immunoblotted for KCC2 protein at the time of 2 and 3 h after drugs administration. We find that ovariectomy can regulate the sensitivity to morphine analgesia of neuropathic pain and KCC2 protein level will change in the spinal dorsal horn.

13.
Int J Med Sci ; 10(4): 355-61, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23471586

RESUMO

AIMS: To investigate the reasonable dose of Voluven for rapid plasma volume expansion during the anaesthesia induction patients receiving gastrointestinal surgery. METHODS: Sixty patients were randomly divided into three groups (n=20): Group A (5 ml/kg), Group B (7 ml/kg) and Group C (9 ml/kg). HES 130/0.4 was intravenously transfused at a rate of 0.3 ml/kg/min) at 30 min before anaesthesia induction. Besides standard haemodynamic monitoring, cardiac index (CI), systemic vascular resistance index (SVRI) and stroke volume variation (SVV) was continuously detected with the FloTrac/Vigileo system. Haemodynamic variables were recorded immediately before fluid transfusion (T0), immediately before induction (T1), immediately before intubation (T2), immediately after intubation (T3) and 5 min, 10 min, 20 min and 60 min after intubation (T4-T7). Arterial and venous blood was collected for blood gas analysis, Hb and Hct before volume expansion (t0), immediately after volume expansion (t1) and at 1 h after volume expansion (t2). Oxygen delivery (DO2), oxygen extraction ratio (ERO2) and volume expansion rate were calculated. RESULTS: 1) MAP and CI decreased in Group A in T2~T7 and remained changed in Group B and C. 2) CVP increased in three groups after fluid infusion without significant difference. 3) The decrease in SVRI was more obvious in Group B and C than that in Group A after induction and more obvious in Group C than in Group B in T2-T4 and T6~T7. 4) SVV was lower in Group B and C than that in Group A after intubation, and lower in Group C than that in Group B in T3-T6. 5) Hb and Hct decreased after fluid infusion, and the decrease in Hb and Hct was in the order of C>B>A. 6) Volume expansion rate was in the order of C>B>A. 7) ScvO2, PaO2 and DO2 increased in three groups after fluid infusion and the increase in DO2 was in the order of C>B>A. CONCLUSIONS: Rapid plasma volume expansion with Voluven at 7-9 ml/kg can prevent haemodynamic fluctuation during anaesthesia induction, maintain the balance between oxygen supply and oxygen consumption during gastrointestinal surgery, and Voluven at 9 ml/kg can improve the oxygen delivery.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório , Trato Gastrointestinal/cirurgia , Derivados de Hidroxietil Amido/administração & dosagem , Substitutos do Plasma/administração & dosagem , Adulto , Anestesia , Feminino , Hemodinâmica/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Consumo de Oxigênio/efeitos dos fármacos , Volume Plasmático/efeitos dos fármacos
14.
Int J Med Sci ; 10(2): 148-55, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23329886

RESUMO

BACKGROUND: Stroke volume variation (SVV) has been shown to be a reliable predictor of fluid responsiveness. However, the predictive role of SVV measured by FloTrac/Vigileo system in prediction of fluid responsiveness was unproven in patients undergoing ventilation with low tidal volume. METHODS: Fifty patients undergoing elective gastrointestinal surgery were randomly divided into two groups: Group C [n(1)=20, tidal volume (V(t)) = 8 ml/kg, frequency (F) = 12/min] and Group L [n(2)=30, V(t)= 6 ml/kg, F=16/min]. After anesthesia induction, 6% hydroxyethyl starch130/0.4 solution (7 ml/kg) was intravenously transfused. Besides standard haemodynamic monitoring, SVV, cardiac output, cardiac index (CI), stroke volume (SV), stroke volume index (SVI), systemic vascular resistance (SVR) and systemic vascular resistance index (SVRI) were determined with the FloTrac/Vigileo system before and after fluid loading. RESULTS: After fluid loading, the MAP, CVP, SVI and CI increased significantly, whereas the SVV and SVR decreased markedly in both groups. SVI was significantly correlated to the SVV, CVP but not the HR, MAP and SVR. SVI was significantly correlated to the SVV before fluid loading (Group C: r = 0.909; Group L: r = 0.758) but not the HR, MAP, CVP and SVR before fluid loading. The largest area under the ROC curve (AUC) was found for SVV (Group C, 0.852; Group L, 0.814), and the AUC for other preloading indices in two groups ranged from 0.324 to 0.460. CONCLUSION: SVV measured by FloTrac/Vigileo system can predict fluid responsiveness in patients undergoing ventilation with low tidal volumes during gastrointestinal surgery.


Assuntos
Líquidos Corporais/fisiologia , Gastroenteropatias/cirurgia , Volume Sistólico/fisiologia , Equilíbrio Hidroeletrolítico , Adulto , Idoso , Feminino , Gastroenteropatias/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Curva ROC , Volume de Ventilação Pulmonar/fisiologia
15.
Shock ; 39(2): 197-203, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23324890

RESUMO

Hepatic ischemia-reperfusion (I/R) injury contributes to hepatic dysfunction and failure after liver transplantation, major hepatic resection, trauma, and hypovolemic shock. Therefore, reducing I/R injury is an important goal to improve the outcome of these procedures. Recently, high-mobility group box 1 protein (HMGB1) has been identified as a pathogenic mediator in several inflammatory diseases, including hepatic I/R. PNU-282987, a selective α7 nicotinic acetylcholine receptor agonist, prevents nuclear factor κB (NF-κB) activation and thereby inhibits cytokine secretion through a specific cholinergic anti-inflammatory pathway. Our study was designed to evaluate whether PNU-282987 would inhibit HMGB1 expression and prevent I/R-induced liver damage. C57BL/6 mice were randomly divided into 3 groups as follows: sham group, vehicle plus I/R group, and PNU-282987 plus I/R group. Mice were subjected to 70% partial hepatic I/R for 60 min and pretreated with either vehicle or with PNU-282987, and blood and hepatic tissue samples were collected at 3, 6, and 12 h following reperfusion. The results showed that pretreatment with PNU-282987 decreased serum transaminase levels and ameliorated liver injury after hepatic I/R. Moreover, pretreatment with PNU-282987 suppressed NF-κB activation, cytokine production (tumor necrosis factor α, interleukin 1ß), and HMGB1 expression in liver after hepatic I/R. These observations suggest that PNU-282987 protects the liver from I/R injury possibly by inhibiting HMGB1 expression, suppressing cytokine production, and preventing NF-κB activation in mice.


Assuntos
Benzamidas/farmacologia , Compostos Bicíclicos com Pontes/farmacologia , Proteína HMGB1/antagonistas & inibidores , Hepatopatias/prevenção & controle , NF-kappa B/metabolismo , Agonistas Nicotínicos/farmacologia , Traumatismo por Reperfusão/prevenção & controle , Animais , Citocinas/metabolismo , Fígado/irrigação sanguínea , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Receptores Nicotínicos/metabolismo , Receptor Nicotínico de Acetilcolina alfa7
16.
Immunopharmacol Immunotoxicol ; 32(1): 110-5, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19811108

RESUMO

BACKGROUND AND AIM: The effects of methanol extract of Phellodendri cortex on acute airway inflammation induced by intranasal administration of lipopolysaccharide (LPS, 300mug/kg) were investigated in female BALB/c mice. MATERIALS AND METHODS: At 2 h after LPS exposure, mice were treated orally with methanol extract of Phellodendri cortex (100, 200 and 400 mg/kg). At the end of this study, bronchoalveolar lavage fluids (BALF) were collected and number of total cells, macrophages and neutrophils, protein concentration were analyzed. Tumor necrosis factor-alpha (TNF-alpha), macrophage inflammatory protein (MIP-2), IL-10 levels and nitric oxide (NO) production in BALF were also determined. RESULTS: Methanol extract of Phellodendri cortex dose-dependently alleviated LPS-induced acute airway inflammation via decreasing the infiltration of inflammatory cells and the release of inflammatory mediators. CONCLUSION: The relief of airway inflammation provides a possible therapeutic application of Phellodendri cortex for the treatment of infectious pulmonary diseases.


Assuntos
Phellodendron , Fitoterapia , Extratos Vegetais/uso terapêutico , Pneumonia/tratamento farmacológico , Doença Aguda , Animais , Relação Dose-Resposta a Droga , Feminino , Lipopolissacarídeos/toxicidade , Camundongos , Camundongos Endogâmicos BALB C
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