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Objective:To investigate the effect of maternal serum vitamin D on fetal long bone development.Methods:A retrospective collection of 1 193 first-time pregnant women who visited our hospital′s prenatal diagnosis center from July 2018 to June 2020 was conducted. All underwent prenatal fetal ultrasound examination and serum vitamin D level detection. Based on the dosage of vitamin D administered after the first vitamin D test, participants were divided into the basic dosage group(vitamin D 3, 1 600 IU/d, orally) and the adequate supplementation group(vitamin D 2 injection 600 000 IU/2 weeks, intramuscular injection). The serum 25-(OH)D levels of the two groups of pregnant women were compared at 12 and 24 weeks of treatment, as well as the long bone growth of their fetuses. Multivariable logistic regression analysis was used to analyze the factors influencing fetal long length. Results:Compared to the basic dosage group, the adequate supplementation group showed a significant increase in serum 25-(OH)D levels in pregnant women at 8 weeks, 12 weeks, and 24 weeks of treatment. The adequate supplementation group also significantly increased fetal long bone length at 12 weeks[(4.93±0.75) cm vs(4.61±0.73) cm, P<0.05] and 24 weeks of treatment [(7.92±0.84) cm vs(7.25±0.92) cm, P<0.05], with the difference between the two groups being more pronounced at 24 weeks of treatment. Maternal height, basal vitamin D level, and vitamin D level at 24 weeks of gestation were positively correlated with fetal long bone length. Conclusion:Pregnant women should maintain a relatively high level of basal vitamin D, and pay attention to the effect of vitamin D level on the fetus. A sufficient amount of vitamin D supplementation is of great significance for the long bone development of the fetus.
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Abstract Background: Acid-sensing ion channel 1a (ASIC1a) plays a critical role in physiological and pathological processes. To further elucidate the biological functions of ASICs and their relationships with disease occurrence and development, it is advantageous to investigate and develop additional regulatory factors for ASICs. Methods: In this study, cation exchange chromatography was used to separate seven chromatographic components from Naja naja atra venom. Capillary electrophoresis was employed to detect that Ⅶ peak component containing a main protein Ⅶ-2, which could bind to ASIC1a. The analgesic effects of Ⅶ-2 protein were determined using hot plate methods, and ASIC1a expression in spinal cord tissue from rats with inflammatory pain was detected using western blot. Results: The purified Ⅶ-2 protein named Naja naja atra venom-Ⅶ-2 (NNAV-Ⅶ-2) was obtained by Sephadex G-50 gel filtration, which exhibited a single band on sodium dodecyl sulfate-polyacrylamide gel electrophoresis with a molecular weight of 6.7 kD. Remarkably, the NNAV-Ⅶ-2 protein demonstrated a significant analgesic effect and downregulated ASIC1a expression in the spinal cord tissue of rats with inflammatory pain. Conclusions: The analgesic mechanism of the NNAV-Ⅶ-2 protein may be associated with its binding to ASIC1a, consequently downregulating ASIC1a expression in neural tissues.
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Purpose: Stroke is an acute cerebrovascular disease. Astragaloside IV (AS-IV) is an active ingredient extracted from Astragalus membranaceus with an established therapeutic effect on central nervous system diseases. This study examined the neuroprotective properties and possible mechanisms of AS-IV in stroke-triggered early brain injury (EBI) in a rat transient middle cerebral artery occlusion (MCAO) model. Methods: The neurological scores and brain water content were analyzed. 2,3,5-triphenyl tetrazolium chloride (TTC) staining was utilized to determine the infarct volume, neuroinflammatory cytokine levels, and ferroptosis-related genes and proteins, and neuronal damage and molecular mechanisms were evaluated by terminal deoxynucleotidyl transferase dutp nickend labeling (TUNEL) staining, western blotting, and real-time polymerase chain reaction. Results: AS-IV administration decreased the infarct volume, brain edema, neurological deficits, and inflammatory cytokines TNF-α, interleukin-1ß (IL-1ß), IL-6, and NF-κB, increased the levels of SLC7A11 and glutathione peroxidase 4 (GPX4), decreased lipid reactive oxygen species (ROS) levels, and prevented neuronal ferroptosis. Meanwhile, AS-IV triggered the Nrf2/HO-1 signaling pathway and alleviated ferroptosis due to the induction of stroke. Conclusion: Hence, the findings of this research illustrate that AS-IV administration can improve delayed ischemic neurological deficits and decrease neuronal death by modulating nuroinflammation and ferroptosis via the Nrf2/HO-1 signaling pathway.
الموضوعات
Animals , Rats , Saponins , Brain Injuries/therapy , Plant Extracts/administration & dosage , Astragalus Plant/chemistry , NF-E2-Related Factor 2/analysis , Neuroimmunomodulation , Stroke/complications , Ferroptosisالملخص
Abstract Background: UVB irradiation can cause acute damage such as sunburn, or photoaging and melanoma, all of which are major health threats. Objective: This study was designed to investigate the mechanism of skin photoaging induced by UVB radiation in mice through the analysis of the differential expression of miRNAs. Methods: A UVB irradiation photoaging model was constructed. HE and Masson special stains were used to examine the modifications in the epidermis and dermis of mice. The miRNA expression profiles of the mouse skin model exposed to UVB radiation and the normal skin of mice were analyzed using miRNA-sequence analysis. GO and Pathway analysis were employed for the prediction of miRNA targets. Results: A total of 23 miRNAs were evaluated for significantly different expressions in comparison to normal skin. Among them, 7 miRNAs were up-regulated and 16 were down-regulated in the skin with photoaging of mice exposed to UVB irradiation. The differential expression of miRNA is related to a variety of signal transduction pathways, among which mmu-miR-195a-5p and mitogen-activated protein kinase (MAPK) signal pathways are crucial. There was a significant differential expression of miRNA in the skin of normal mice in comparison with the skin with photoaging induced by UVB irradiation. Study limitations: Due to time and energy constraints, the specific protein level verification, MAPK pathway exploration, and miR-195a-5p downstream molecular mechanism need to be further studied in the future. Conclusions: UVB-induced skin photoaging can be diagnosed and treated using miRNA.
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@#Root fracture is a kind of dental trauma involving dentin, cementum, pulp tissue, periodontal membrane ligament and even the surrounding alveolar bone. It occurs frequently between the ages of 10-20, mostly in the area of the maxillary anterior teeth with high aesthetic requirements. The treatment goal for root fracture in permanent teeth is to maintain the physiological and functional integrity of the tooth as much as possible and to reduce the incidence of complications. Clinicians usually classify the affected teeth according to the position of the root fracture, including the apical, mid-root, cervical-mid-root and cervical segments, since it determines the treatment plan and the prognosis of the affected teeth. CBCT examination can avoid misdiagnosis and missed diagnosis of root fracture to the greatest extent. The sequential treatment plan of root fracture after permanent anterior tooth trauma includes initial emergency treatment, pulp vitality monitoring and complication management during follow-up. Emergency treatment mainly includes local anesthesia and repositioning, if displaced, the coronal segment of the tooth as soon as possible. Then, after checking its position radiographically, adjustment occlusion and flexible splinting for 4 weeks (4 months for cervical root fracture). The process of root fracture repair includes many tissues and is affected by many clinical factors. Timely and standardized treatment and close follow-up according to the Dental Trauma Guideline guarantee a good prognosis of root fracture. The closer the root fracture line is to the apex, the higher the survival rate is. In addition to the location of the root fracture line, the prognosis is affected by many other clinical factors, such as the displacement of the coronal fragment of the root fracture, the pathological state of the dental pulp, patient age, developmental stage of the root, timely and good replacement of the root fracture, splinting method, and the presence of other dental trauma complications. Pulp vitality should be monitored regularly, and root canal therapy of the coronal segment should be carried out only when infection of the pulp is established. This article reviews the classification, diagnosis, emergency treatment, sequential follow-up treatment, and prognostic assessment of root fracture trauma to provide suggestions for clinicians to manage root fracture trauma in permanent teeth.
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Yersinia pestis, the cause of plague and a potential biological weapon, has always been a threatening pathogen. Some strains of Y. pestis have varying degrees of antibiotic resistance. Thus, this systematic review was conducted to alert clinicians to this pathogen’s potential antimicrobial resistance. A review of the literature was conducted for experimental reports and systematic reviews on the topics of plague, Y. pestis, and antibiotic resistance. From 1995 to 2021, 7 Y. pestis isolates with 4 antibiotic resistance mechanisms were reported. In Y. pestis 17/95, 16/95, and 2180H, resistance was mediated by transferable plasmids. Each plasmid contained resistance genes encoded within specific transposons. Strain 17/95 presented multiple drug resistance, since plasmid 1202 contained 10 resistance determinants. Strains 16/95 and 2180H showed single antibiotic resistance because both additional plasmids in these strains carried only 1 antimicrobial determinant. Strains 12/87, S19960127, 56/13, and 59/13 exhibited streptomycin resistance due to an rpsl gene mutation, a novel mechanism that was discovered recently. Y. pestis can acquire antibiotic resistance in nature not only via conjugative transfer of antimicrobial-resistant plasmids from other bacteria, but also by gene point mutations. Global surveillance should be strengthened to identify antibiotic-resistant Y. pestis strains by whole-genome sequencing and drug susceptibility testing.
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Objective:To study the resources and medicinal use of Tibetan medicine Codonopsis canescens，analyze its suitable habitat，and protect its wild resources，in order to provide an important reference basis for further rational development and utilization. Method:Combined investigation methods of literature textual research，visiting investigation and on-the-spot investigation were adopted. Result:In this paper，we investigated the resources and medicinal use of C. canescens in 27 cities and counties of Sichuan，Qinghai and Tibet. Compared with historical records of C. canescens，the results showed that there was no obvious change in the distribution range，and the distribution was uneven in different places. Ganzi Prefecture， Sichuan， boasts rich resources； in particular， Luhuo county has as high as 90-120 plants/100 m2， it is estimated that the reserves per unit area of root C. canescens in this area were 3 445.32 g·m-2，which totaled 1 279.18 ton（1 ton=1 000 kg）. In history，the root is the main medicinal part. However， in recent years，in order to protect resources，the aboveground part is frequently used. The clinical efficacy of Tibetan medicine is mainly to tonify Qi and activate blood circulation. It can be combined with other drugs to treat rheumatism，sores，furuncle，carbuncle and other diseases. However，the plants of Codonopsis are mixed with C. canescens in each Tibetan area，and the mixed varieties are determined according to the growing varieties of the same genus in this area. Conclusion:The reserves of wild resources of C. canescens are decreasing with the increase of clinical use and market demand of Tibetan medicine. There is serious mixture of Codonopsis plants in Tibetan areas. It is suggested paying attention to resource protection，carrying out artificial planting，establishing the standard for the medicinal use of Tibetan medicine，and promote rational and sustainable utilization of resources.
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Objective:To analyze the clinical studies on sacral nerve stimulation based on PubMed database and summarize its research status and clinical characteristics. Methods:Literatures about sacral nerve stimulation were collected from PubMed database before December 31, 2019. HistCite software was used to analyze the published year, published periodicals, published country and research institutions. Pajek software principal path analysis was used to identify the evolution direction of hot topics. The spectrum of diseases, therapeutic outcomes, stimulation methods and stimulation parameters were summarized. Results:A total of 96 articles were included. The number of publications increased significantly since 2000 and reached its peak in 2014 to 2015. The literatures with most influence were published in 2000 to 2001. All the literatures published in 32 journals, the top two were Urology and Diseases of the Colon & Rectum, which published 17 and 22 articles, respectively. The literatures came from 16 countries, and the top three were the United State (17 articles), the Netherlands (13) and the United Kingdom (13). Among the 211 institutes involved, Aarhus University Hospital (Denmark, twelve articles) and St. Marks Hospital (United Kingdom, nine) were the top two. The study involved 16 diseases, mainly about fecal incontinence, urinary incontinence and urination, shifted from urinary system diseases to digestive system diseases. 91.67% of the study corroborated the benefit of sacral nerve stimulation. Implanted stimulation (77 articles) was the most used, and transdermal stimulation (10 articles) was the second. The parameters were depending on the disease and the mode of stimulation. Conclusion:Sacral nerve stimulation can effectively improve the function of pelvic floor, which may be focused for a long time. Non-implantable sacral nerve stimulation would become the new research topic.
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Objective:To construct the database of Tibetan medicine prescriptions for "Gnyan-rims" disease， and to explore the invisible medication law of Tibetan medicine in the treatment of "Gnyan-rims" disease， such as prescription compatibility and combination of drug properties. Method:The prescriptions for treating "Gnyan-rims" were retrieved from four Tibetan medical literatures such as <italic>The Four Medical Tantras</italic>，<italic> Kong-sprul-zin-tig，</italic> <italic>Phyag-rdor-gso-rig-phyogs-bsgrigs</italic> and <italic>Sman-sbyor-lag-len-phyogs-bsgrigs</italic>， and the database was constructed under Python code， and the Apriori algorithm and the vector structure model of taste property flavor transformation were used for analysis. Result:According to the characteristics of Tibetan medicine prescription data， with six fields of prescription name， formula， dosage， efficacy， source and original text as the core， a Tibetan medicine treatment "Gnyan-rims" prescription database with functions of cleaning， searching and exporting was established. A total of 7 602 prescriptions were included in the database， among which 598 prescriptions had therapeutic effects of "Gnyan" and "Rims". The results of compatibility analysis showed that Shexiang， Hezi， Honghua， Mukuer Moyao， Tiebangchui， Tianzhuhuang and Bangga were the most frequently used drugs， while the correlation degrees of Shexiang-Mukuer Moyao， Honghua-Tianzhuhuang， Shexiang-Hezi and Shexiang-Tiebangchui were the strongest， and all the drug composition of Wuwei Shexiang pills appeared in the top ten correlations. According to the property analysis of 40 prescriptions containing high-frequency drugs， 19 prescriptions were found to have excessive bitter taste， followed by 9 prescriptions such as Sanchen powders with excessive sweetish taste， and the ratios of sweetish and bitter tastes in six tastes were >35%. The total of sweetish and bitter prescriptions accounted for 70% of the total prescriptions. Among the three flavors， the bitter flavor was the most abundant. The cool effect， dull effect and heavy effect were prominent among the seventeen effects. Conclusion:The prescription database of Tibetan medicine for "Gnyan-rims" can promote the high-quality development of research on prevention and treatment of plague with ethnic medicine. Tibetan medicine treatment of "Gnyan-rims" focuses on the composition of Wuwei Shexiang pills， with the property combination of "cool-bitter and sweet-bitter flavor-cool， dull and heavy"， which mainly treats diseases such as "heat sharp light-mkhris pa-heat". These studies can provide data basis and theoretical reference for the selection of Tibetan medicine prescription and its composition for treating plague.
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To identify Glycyrrhizae Radix et Rhizoma from different geographical origins, spectrum and image features were extracted from visible and near-infrared(VNIR, 435-1 042 nm) and short-wave infrared(SWIR, 898-1 751 nm) ranges based on hyperspectral imaging technology. The spectral features of Glycyrrhizae Radix et Rhizoma samples were extracted from hyperspectral data and denoised by a variety of pre-processing methods. The classification models were established by using Partial Least Squares Discriminate Analysis(PLS-DA), Support Vector Classification(SVC) and Random Forest(RF). Meanwhile, Gray-Level Co-occurrence matrix(GLCM) was employed to extract textural variables. The spectrum and image data were implemented from three dimensions, including VNIR and SWIR fusion, spectrum and image fusion, and comprehensive data fusion. The results indicated that the spectrum in SWIR range performed better classification accuracy than VNIR range. Compared with other four pre-processing methods, the second derivative method based on Savitzky-Golay(SG) smoothing exhibited the best performance, and the classification accuracy of PLS-DA and SVC models were 93.40% and 94.11%, separately. In addition, the PLS-DA model was superior to SVC and RF models in terms of classification accuracy and model generalization capability, which were evaluated by confusion matrix and receiver operating characteristic curve(ROC). Comprehensive data fusion on SPA bands achieved a classification accuracy of 94.82% with only 28 bands. As a result, this approach not only greatly improved the classification efficiency but also maintained its accuracy. The hyperspectral imaging system, a non-invasively, intuitively and quickly identify technology, could effectively distinguish Glycyrrhizae Radix et Rhizoma samples from different origins.
الموضوعات
Drugs, Chinese Herbal , Hyperspectral Imaging , Technologyالملخص
In order to establish a rapid and non-destructive evaluation method for the identification of Armeniacae Semen Amarum and Persicae Semen from different origins, the spectral information of Armeniacae Semen Amarum and Persicae Semen in the range of 898-1 751 nm was collected based on hyperspectral imaging technology. Armeniacae Semen Amarum and Persicae Semen from different origins were collected as research objects, and a total of 720 Armeniacae Semen Amarum samples and 600 Persicae Semen samples were used for authenticity discrimination. The region of interest(ROI) and the average reflection spectrum in the ROI were obtained, followed by comparing five pre-processing methods. Then, partial least squares discriminant analysis(PLS-DA), support vector machine(SVM), and random forest(RF) method were established for classification models, which were evaluated by the confusion matrix of prediction results and receiver operating characteristic curve(ROC). The results showed that in the three sample sets, the se-cond derivative pre-processing method and PLS-DA were the best model combinations. The classification accuracy of the test set under the 5-fold cross-va-lidation was 93.27%, 96.19%, and 100.0%, respectively. It was consistent with the confusion matrix of the predicted results. The area under the ROC curve obtained the highest values of 0.992 3, 0.999 6, and 1.000, respectively. The study revealed that the near-infrared hyperspectral imaging technology could accurately identify the medicinal materials of Armeniacae Semen Amarum and Persicae Semen from different origins and distinguish the authentication of these two varieties.
الموضوعات
Drugs, Chinese Herbal , Hyperspectral Imaging , Least-Squares Analysis , Semen , Support Vector Machine , Technologyالملخص
Objective@#Testicular germ cell tumors (TGCT) are the most common cancer among men aged 15 to 39 years. Previous studies have considered factors related to TGCT survival rate and race/ethnicity, but histological type of the diagnosed cancer has not yet been thoroughly assessed.@*Methods@#The data came from 42,854 eligible patients from 1992 to 2015 in the Surveillance Epidemiology and End Results 18. Frequencies and column percent by seminoma and nonseminoma subtypes were determined for each covariates. We used Cox proportional hazard regression to assess the impact of multiple factors on post-diagnostic mortality of TGCT.@*Results@#Black males were diagnosed at a later stage, more commonly with local or distant metastases. The incidence of TGCT in black non-seminoma tumors increased most significantly. The difference in survival rates between different ethnic and histological subtypes, overall survival (OS) in patients with non-seminoma was significantly worse than in patients with seminoma. The most important quantitative predictor of death was the stage at the time of diagnosis, and older diagnostic age is also important factor affecting mortality.@*Conclusion@#Histological type of testicular germ cell tumor is an important factor in determining the prognosis of testicular cancer in males of different ethnic groups.
الموضوعات
Adult , Humans , Male , Health Status Disparities , Neoplasms, Germ Cell and Embryonal/pathology , Prognosis , Risk Factors , SEER Program/statistics & numerical data , Seminoma/pathology , Survival Rate/trends , Testicular Neoplasms/pathology , United States/ethnologyالملخص
ABSTRACT Purpose To investigate the effect of ferulic acid (FA) on spinal cord injury (SCI)-induced motor dysfunction and to explore the possible pharmacological mechanisms. Methods Adult male Wistar rats were used in our study. SCI was achieved by clipping the spinal cord T9 of the rat by a vascular clip for 2 minutes. The motor function of the rat was evaluated by Basso, Beattie, and Bresnahan scoring method (BBB) and inclined plane test. Hematoxylin and eosin (HE) staining, NISSL staining, and transmission electron microscopic examination were used to evaluate alterations at the histological level. Polymerase chain reaction (PCR), Western blots, and enzyme-linked immunosorbent assays (ELISA) were employed in biochemical analysis. Results The BBB score and inclined plane test score significantly decreased after SCI surgery, whereas chronic FA treatment (dose of 90 mg/kg, i.g.) for 28 days improved SCI-induced motor dysfunction. HE staining showed that SCI surgery induced internal spinal cord edema, but the structural changes of the spinal cord could be reversed by FA treatment. NISSL staining and transmission electron microscopic examination confirmed the improvement of the effect of FA on the injury site. In the biochemical analysis, it could be found that FA inhibitedSCI-induced mRNA and protein overexpression of pro-inflammatory cytokines (IL-1β, IL-6, TNF-α), as well as iNOS and COX-2 via the modulation of NF-κB level in the spinal cord of SCI rat. Moreover, the SCI-induced decrease of Bcl-2/Bax ratio was also reversed by FA treatment. However, the effect of FA on the expression of Beclin-1 was not statistically significant. Conclusions FA showed a therapeutic effect on SCI, which may be associated with the regulation of neuroinflammation and apoptosis.
الموضوعات
Animals , Male , Rats , Spinal Cord Injuries/drug therapy , Spinal Cord , Rats, Wistar , Rats, Sprague-Dawley , Apoptosis , Coumaric Acids , Recovery of Functionالملخص
Prolactin (PRL) plays critical roles in regulation of biological functions with the binding of specific prolactin receptor (PRLR). Revealing the expression patterns of PRLR at different developmental stages is beneficial to better understand the role of PRL and its mechanism of action in striped hamsters. In this study, the cDNA sequence of PRLR (2866-base-pairs) was harvested from the pituitary of mature female striped hamsters (Cricetulus barabensis) that contains an 834-base-pair 5′-untranslated region (1-834 bp), a 1848-base-pair open reading frame (835-2682 bp), and a 184-base-pair 3′-untranslated region (2683-2866). The 1848-base-pair open reading frame encodes a mature prolactin-binding protein of 592 amino acids. In the mature PRLR, two prolactin-binding motifs, 12 cysteines, and five potential Asn-linked glycosylation sites were detected. Our results showed that the PRLR mRNA quantity in the hypothalamus, pituitary, ovaries, or testis was developmental-stage-dependent, with the highest level at sub-adult stage and the lowest level at old stage. We also found that PRLR mRNAs were highest in pituitary, medium level in hypothalamus, and lowest in ovaries or testis. PRLR mRNAs were significantly higher in males than in females, except in the hypothalamus and pituitary from 7-week-old striped hamsters. Moreover, the PRLR mRNAs in the hypothalamus, pituitary, and ovaries or testis were positively correlated with the expression levels of GnRH in the hypothalamus. These results indicated that the PRLR has conserved domain in striped hamster, but also possesses specific character. PRLR has multiple biological functions including positively regulating reproduction in the striped hamster.
الموضوعات
Animals , Male , Female , Prolactin/genetics , Receptors, Prolactin/genetics , Receptors, Prolactin/metabolism , Pituitary Gland/metabolism , Cricetinae , Sequence Analysis , DNA, Complementary/geneticsالملخص
Abstract Background and objectives Preoperative use of flurbiprofen axetil (FA) is extensively adopted to modulate the effects of analgesia. However, the relationship between FA and sedation agents remains unclear. In this study, we aimed to investigate the effects of different doses of FA on the median Effective Concentration (EC50) of propofol. Methods Ninety-six patients (ASA I or II, aged 18-65 years) were randomly assigned into one of four groups in a 1:1:1:1 ratio. Group A (control group) received 10 mL of Intralipid, and groups B, C and D received 0.5 mg.kg−1, 0.75 mg.kg−1 and 1 mg.kg−1 of FA, respectively, 10 minutes before induction. The depth of anesthesia was measured by the Bispectral Index (BIS). The "up-and-down" method was used to calculate the EC50 of propofol. During the equilibration period, if BIS ≤ 50 (or BIS > 50), the next patient would receive a 0.5 µg.mL−1-lower (or -higher) propofol Target-Controlled Infusion (TCI) concentration. The hemodynamic data were recorded at baseline, 10 minutes after FA administration, after induction, after intubation and 15 minutes after intubation. Results The EC50 of propofol was lower in Group C (2.32 µg.mL−1, 95% Confidence Interval [95% CI] 1.85-2.75) and D (2.39 µg.mL−1, 95% CI 1.91-2.67) than in Group A (2.96 µg.mL−1, 95% CI 2.55-3.33) (p = 0.023, p = 0.048, respectively). There were no significant differences in the EC50 between Group B (2.53 µg.mL−1, 95% CI 2.33-2.71) and Group A (p > 0.05). There were no significant differences in Heart Rate (HR) among groups A, B and C. The HR was significantly lower in Group D than in Group A after intubation (66 ± 6 vs. 80 ± 10 bpm, p < 0.01) and 15 minutes after intubation (61 ± 4 vs. 70 ± 8 bpm, p < 0.01). There were no significant differences among the four groups in Mean Arterial Pressure (MAP) at any time point. The MAP of the four groups was significantly lower after induction, after intubation, and 15 minutes after intubation than at baseline (p < 0.05). Conclusion High-dose FA (0.75 mg.kg−1 or 1 mg.kg−1) reduces the EC50 of propofol, and 1 mg.kg−1 FA reduces the HR for adequate anesthesia in unstimulated patients. Although this result should be investigated in cases of surgical stimulation, we suggest that FA pre-administration may reduce the propofol requirement when the depth of anesthesia is measured by BIS.
Resumo Justificativa e objetivos A administração pré‐operatória de Flurbiprofeno Axetil (FA) é amplamente usada para a modulação da analgesia. No entanto, a relação entre FA e fármacos sedativos permanece obscura. Neste estudo, nosso objetivo foi investigar os efeitos de diferentes doses de FA na Concentração Efetiva mediana (CE50) do propofol. Métodos Noventa e seis pacientes (ASA I ou II, com idades de 18-65 anos) foram alocados aleatoriamente em quatro grupos na proporção de 1:1:1:1. Dez minutos antes da indução, o Grupo A (grupo controle) recebeu 10 mL de Intralipid, enquanto os grupos B, C e D receberam FA na dose de 0,5 mg.kg‐1; 0,75 mg.kg‐1 e 1 mg.kg‐1, respectivamente. A profundidade da anestesia foi medida pelo Índice Bispectral (BIS). O método up‐and‐down foi usado para calcular a CE50 do propofol. Durante o período de equilíbrio, se o valor do BIS fosse ≤ 50 ou BIS > 50, o próximo paciente tinha a infusão de propofol ajustada para uma concentração alvo‐controlada 0,5 µg.mL‐1 inferior ou superior, respectivamente. Os dados hemodinâmicos foram registrados no início do estudo, 10 minutos após a administração de FA, após a indução, após a intubação e 15 minutos após a intubação. Resultados A CE50 do propofol foi menor no Grupo C (2,32 µg.mL‐1, Intervalo de Confiança de 95% [95% IC] 1,85-2,75) e D (2,39 µg.mL‐1, 95% IC 1,91-2,67) do que no Grupo A (2,96 µg.mL‐1; 95% IC 2,55-3,33) (p = 0,023, p = 0,048, respectivamente). Não houve diferenças significantes na CE50 entre o Grupo B (2,53 µg.mL‐1, 95% IC 2,33-2,71) e o Grupo A (p > 0,05). Não houve diferenças significantes na Frequência Cardíaca (FC) entre os grupos A, B e C. A FC foi significantemente menor no grupo D do que no grupo A após a intubação (66 ± 6 vs. 80 ± 10 bpm, p < 0,01) e 15 minutos após a intubação (61 ± 4 vs. 70 ± 8 bpm, p < 0,01). Não houve diferenças significantes entre os quatro grupos na Pressão Arterial Média (PAM) em qualquer momento. A PAM dos quatro grupos foi significantemente menor após a indução, após a intubação e 15 minutos após a intubação do que na linha de base (p < 0,05). Conclusão FA em altas doses (0,75 mg.kg‐1 ou 1 mg.kg‐1) reduz a CE50 do propofol, e 1 mg.kg‐1 de FA reduz a FC durante níveis adequados de anestesia em pacientes não estimulados. Embora esse resultado deva ser investigado na presença de estimulação cirúrgica, sugerimos que a pré‐administração de FA pode reduzir a necessidade de propofol durante anestesia cuja profundidade seja monitorada pelo BIS.
الموضوعات
Humans , Male , Female , Adult , Aged , Young Adult , Propofol/administration & dosage , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Flurbiprofen/analogs & derivatives , Hypnotics and Sedatives/administration & dosage , Anesthesia , Pain, Postoperative/prevention & control , Phospholipids/administration & dosage , Blood Pressure/drug effects , Soybean Oil/administration & dosage , Drug Administration Schedule , Confidence Intervals , Flurbiprofen/administration & dosage , Elective Surgical Procedures , Electroencephalography/drug effects , Emulsions/administration & dosage , Fat Emulsions, Intravenous/administration & dosage , Remifentanil/administration & dosage , Heart Rate/drug effects , Analgesics, Opioid , Middle Agedالملخص
Abstract Introduction: Diffuse coronary artery disease (CAD) has a poor prognosis and many patients are ineligible for conventional coronary artery bypass grafting (CABG). This study evaluated the 12-month outcomes of coronary artery reconstruction and surgical patch angioplasty of the coronary artery for diffuse CAD. Methods: A retrospective cohort study of patients who underwent CABG with surgical patch angioplasty of the coronary artery (reconstruction group) or standard CABG alone (standard group) at the Cardiovascular Surgery Department of the local Hospital between January 2014 and January 2016. Follow-up was censored at 12 months after surgery. Results: Cardiopulmonary bypass and aortic cross-clamping durations were longer in the reconstruction group (n=32) than in the standard group (n=125) (P<0.05). There were no differences in graft blood flow and postoperative levels of cardiac markers between the two groups (P>0.05). In the reconstruction group, one patient died; a vein graft showed occlusion. In the standard group, two patients died; one left internal mammary artery graft and three vein grafts showed occlusion. There were no significant differences in mortality, major adverse cardiovascular and cerebrovascular events, and patency between the two groups (P>0.05). Conclusion: Coronary artery reconstruction and surgical patch angioplasty of the coronary artery can be performed for diffuse CAD. Patient outcomes were not significantly different from those of patients who underwent standard CABG.
الموضوعات
Humans , Male , Coronary Artery Disease/surgery , Coronary Artery Disease/diagnostic imaging , Angioplasty , Stroke Volume , Retrospective Studies , Follow-Up Studies , Ventricular Function, Leftالملخص
Objective@#To discuss the application of digital technology in the education of implant dentistry.@* Methods@#According to the teaching method that combines case-, problem- and team-based learning, a course on implant theory was carried out in a class of 20 students. Then, all the students in this class were divided into two groups to receive two clinical operation training courses. The first was the training of a free-hand implant, and the second was an implant operation under a digital template. The courses introduced digital technology into preclinical education and simulated implant training. After the two courses, students were organized to analyze the accuracy of the implant, the operation time and the experiences of these two courses. Through the comparison of students′ operations of free-hand and template implants, students could analyze their own faults and propose a method of improvement. The students scored the two classes. @*Results @# Through the two classes, all the students completed the implant operation under the guidance of a template and free-hand method and found their own problems and solutions. The combination of theory and practice deepened the students′ understanding of the teaching content. Finally, the classes were graded comprehensively by students, showing that the students′ satisfaction with the digital template class was higher than that with the free-hand class (P < 0.05).@*Conclusion@#The addition of a digital implant technology class significantly improved students′ comprehensive assessment, improved the teaching effect and was more acceptable to students in terms of gaining additional professional skills.
الملخص
OBJECTIVE: To investigate the effect of Tongli Shuji acupuncture on the behavioristics, the percentage of cerebral infarct volume, and the expression of Jagged2 and Notch2 proteins in the hippocampus of the ischemic hemisphere in rats with permanent ischemia of the right middle cerebral artery, as well as the mechanism of Tongli Shuji acupuncture in improving ischemic cerebrovascular disease. METHODS: Sprague-Dawley rats were randomly divided into sham-operation group, model control group, medication group, routine acupuncture group, and Tongli Shuji group, with 10 rats in each group. The suture method was used to establish a model of permanent ischemia of the right middle cerebral artery. The rats in the medication group were given Citicoline (0.4 mg/kg) by gavage, those in the routine acupuncture group were given acupuncture at"Baihui"(GV20) and"Dazhui" (GV14) 15 minutes per day, and those in the Tongli Shuji group were given acupuncture at "Zhengying "(GB17), "Tianjing"(SJ10), and"Huantiao"(GB30) at the left side. The neurological deficit score was determined on days 1, 7, 14, 21 and 28 after surgery, the percentage of cerebral infarct volume was measured after treatment, and Western blot was used to measure the protein expression of Jagged2 and Notch2 in the right hippocampal tissue. RESULTS: Compared with the sham-operation group, the model control group had significant increases in the neurological deficit score on day 1 after surgery (P<0.001). Compared with the model control, medication and routine acupuncture groups, the Tongli Shuji group had significant reductions in the neurological deficit score on day 21 after surgery (P<0.01). Compared with the sham-operation group, the model control group had a significant increase in the percentage of cerebral infarct volume(P<0.05)．The Tongli Shuji group had a significant reduction in the percentage of cerebral infarct volume compared with the medication groups (P<0.05). Compared with the model control group, the routine acupuncture group had a significant increase in the expression of hippocapmal Jagged2(P<0.01)．Compared with the model control, medication and routine acupuncture groups, the Tongli Shuji group had significant increases in the expression of hippocampal Jagged2 and Notch2 (P<0.01). CONCLUSION: Acupuncture can improve the behavioral manifestations of neurological deficit in rats with permanent ischemia of the right middle cerebral artery. Tongli Shuji acupuncture can significantly up-regulate the protein expression of Jagged2 and Notch2 in the hippocampal tissue of the ischemic region, possibly by activating the Notch signaling pathway to exert a neuroprotective effect.
الملخص
Autophagy is a highly conserved intracellular degradation pathway in eukaryotic cells that responds to environmentalchanges. Genetic analyses have shown that more than 40 autophagy-related genes (ATG) are directly involved in thisprocess in fungi. In addition to Atg proteins, most vesicle transport regulators are also essential for each step of autophagy.The present study showed that one Endoplasmic Reticulum protein in Saccharomyces cerevisiae, Tip20, which controlsGolgi-to-ER retrograde transport, was also required for starvation-induced autophagy under high temperature stress. Intip20 conditional mutant yeast, the transport of Atg8 was impaired during starvation, resulting in multiple Atg8 punctadispersed outside the vacuole that could not be transported to the pre-autophagosomal structure/phagophore assembly site(PAS). Several Atg8 puncta were trapped in ER exit sites (ERES). Moreover, the GFP-Atg8 protease protection assayindicated that Tip20 functions before autophagosome closure. Furthermore, genetic studies showed that Tip20 functionsdownstream of Atg5 and upstream of Atg1, Atg9 and Atg14 in the autophagy pathway. The present data show that Tip20,as a vesicle transport regulator, has novel roles in autophagy
الملخص
Objective@#To explore the clinical effect of the multi-point, multi-level suspension as well as fixation using midfacial soft-tissue spaces for midface lifting.@*Methods@#A total of 65 patients with aging midface were admitted at the First Affiliated Hospital of Fujian Medical University from October 2017 to February 2019. Among them, 47 patients underwent primary blepharoplasty and midface lifting. Eighteen patients, including 5 patients with lower eyelid retraction or ectropion after blepharoplasty, underwent secondary midface lifting after blepharoplasty. The preseptal space was separated under orbicularis oculi muscle by palpebral margin incision. The orbicularis retaining ligament and the tear trough ligament were severed through preperiosteal plane. The preseptal space was connected with premaxillary space and prezygomatic space. The malar fat pad and superficial fascia were vertically suspended and fixed on the periosteum of infraorbital ridge by selected medial, middle and lateral points. The orbicularis oculi muscle was suspended and superolaterally fixed at lateral orbital periosteum. Therefore, the midface could be lifted by multi-point, multi-level suspension and fixation.@*Results@#All incision healed in the first stage. Eyelid separation occurred to 1 patient, around 1 month after the operation. Tarsal strip lateral canthoplasty was performed for repair. Local protuberance of lateral lower eyelid occurred to another patient shortly after the operation, but improved after 3 months by lid massaging. No other complication was observed in the rest of the cases. All patients were followed up for 1 to 8 months and the results were satisfactory.@*Conclusions@#It is simple and practicable to utilize midfacial soft-tissue spaces. This method could benefit patient of less trauma, bleeding, and complications, and good clinical effect. It is a good choice for rejuvenation of the midface, especially for secondary midface rejuvenation after blepharoplasty, or complicated with lower eyelid retraction and ectropion.