RÉSUMÉ
Objective The purpose of this study was to explore a suitable method to model no-reflow phenomenon following ischemic stroke and to evaluate perfusion decrease from multiple perspectives.Methods Laser scatter contrast imaging and two-photon live imaging were used to compare transient middle cerebral artery occlusion in C57BL/6 and BALB/c mice and perfusion alterations in BALB/c mice with 1 or 1.5 h of ischemia.Several imaging techniques including laser scatter contrast imaging,low and higher magnification images of perfused brain slices and two-photon microscopy to monitor erythrocyte flow rate and flux were used to assess in vivo dynamics as well as whole brain sections and microvasculature for decreased cerebral perfusion after transient middle cerebral artery occlusion.Infarct size and behavioral deficits were assessed with microtubule-associated protein 2 staining and behavioral scoring.Results In C57BL/6 mice,most capillaries in the middle cerebral artery region remained flowing during ischemia,whereas most capillaries were blocked in BALB/c mice.In addition,cortical perfusion at 24 h of recanalization was significantly reduced to 76.1%of baseline following 1.5 h of ischemia in BALB/c mice(P=0.046 compared with the sham group),whereas for it was reduced to 79.9%following 1h of ischemia which was not significantly different from the sham group(P=0.299).Transient middle cerebral artery occlusion in BALB/c mice for 1.5 h resulted in a reduction in whole-brain perfusion to 75.1%(P＜0.001 compared with the sham group),and erythrocyte flow rate assessed by two-photon live-imaging of erythrocyte flow on the cortical surface of the middle cerebral artery basin was reduced to 50.3%of baseline levels at 24 h of recanalization(P=0.010 compared with the sham group),and erythrocyte flux decreased to 38.9%of baseline levels(P= 0.010 compared with the sham group);high-magnification imaging of sections assessed an approximately 76%reduction in the length of capillaries with perfusion(P=0.0001 compared with the sham group),and a reduction in the fraction of the total volume occupied by perfused capillaries by an approximately 76%reduction(P＜0.001 compared with the sham-operated group).Microtubule-associated protein 2 staining suggested that transient middle cerebral artery occlusion for 1.5 h in BALB/c mice resulted in infarcts that accounted for approximately 36%of the total cerebral area and behavioral scores elevated to 9,suggesting behavioral deficits.Conclusion Transient ischemia in BALB/c mice for 1.5 h resulted in a significant decrease in cerebral perfusion as well as capillary no-reflow and thus can model the no-reflow phenomenon following ischemic stroke.The combination of laser scatter contrast imaging,low magnification and higher magnification images of perfused brain slices,and two-photon microscopy live imaging allows for a multifaceted assessment of perfusion changes.
RÉSUMÉ
In recent years, it has been common for heart disease patients to undergo urological surgery.The requirements for specialized doctors to accurately assess the risk of perioperative heart disease thrombosis are also increasing. In order to conduct multi-disciplinary disease analysis and discussion in a more standardized profile and promote clinical work progress in a safer manner, this article provides a systematic review and summary of the basic characteristics of antithrombotic drugs, the bleeding risks of urological surgery, the risk identification standards for arteriovenous thrombosis, as well as the withdrawal conditions, bridging selection, and restart treatment of perioperative antithrombotic drugs, based on the constantly updated clinical researches and guideline consensuses in recent years.
RÉSUMÉ
【Objective】 To compare the outcomes of robot-assisted laparoscopic transperitoneal and retroperitoneal operation for huge (>6 cm) adrenal tumors. 【Methods】 The clinical data of 45 patients with huge adrenal tumors who underwent robotic surgery during Jan.2017 and Dec.2021 were retrospectively analyzed, including 28 cases via the transperitoneal approach and 17 cases via the retroperitoneal approach. 【Results】 No patients were converted to open operations. There were no significant differences in postoperative drainage time (2.24±0.44 vs. 2.36±0.49) d, operation time (130.88±5.96 vs. 136.61±8.39) min, blood loss (189.41±13.91 vs. 192.5±12.36) mL and postoperative hospital stay (7.06±0.56 vs. 7.46±0.69) d between the retroperitoneal and transperitoneal approaches. Retroperitoneal approach was better than transperitoneal approach in early postoperative feeding [(38.82±6.75 vs. 74.14±6.57) h, P<0.01] . 【Conclusion】 Robotic surgery is safe and effective in the treatment of large adrenal tumors. The choice of surgical approach should be based on patients’ condition, tumor volume and location.
RÉSUMÉ
Objective:To evaluate the effect of ultrasound guided modified-subcostal approach to anterior quadratus lumborum block (MSC-AQLB) on postoperative pain relief in open gynecological tumor surgery.Methods:Fifty patients with open gynecological tumor surgery admitted to the Changsha Central Hospital from June 2022 to March 2023 were selected, aged 35-70 years old, with American Society of Anesthesiologist (ASA) grades Ⅰ-Ⅱ. They were randomly divided into two groups using a random number table: an improved subcostal lumbar quadratus anterior block combined with general anesthesia group (MQ group) and a simple general anesthesia group (GA group), with 25 patients in each group. Before induction of general anesthesia, the MQ group received bilateral MSC-AQLB under ultrasound guidance, with 20 ml of 0.4% ropivacaine administered to both sides; The GA group did not receive nerve block. Both groups received intravenous inhalation combined with general anesthesia during the surgery, and both groups received patient-controlled intravenous analgesia (PCIA) with sufentanil after the surgery. The block plane of the MQ group at 5 and 15 minutes after block was recorded, as well as the resting and active (cough) Visual Analogue Scale (VAS) of patients in both groups at extubation (T 1), departure from post anesthesia care unit (PACU) (T 2), postoperative 6 hours (T 3), 12 hours (T 4), 24 hours (T 5), and 48 hours (T 6), the effective and total compressions of the analgesic pump within 48 hours after surgery, the analgesic recovery rate, and postoperative patient satisfaction, the incidence of nausea and vomiting, complications related to nerve block (local anesthetic poisoning, muscle weakness, pneumothorax, bleeding, accidental entry into the abdominal cavity, kidney damage, etc.)were also recorded. Resultsl:The highest and lowest blocking planes of bilateral MSC-AQLB under ultrasound guidance were T 6 and L 1 (at 5 minutes), T 5 and L 2 (at 15 minutes), respectively. The resting and active VAS scores of the MQ group at T 1 to T 6 were significantly lower than those of the GA group (all P<0.05), and the effective press frequency, total press frequency, and analgesic recovery rate of the analgesic pump within 48 hours were significantly lower than those of the GA group (all P<0.05). The postoperative analgesic satisfaction score was higher than that of the GA group ( P<0.05), and the incidence of nausea and vomiting within 48 hours after surgery was significantly lower than that of the GA group ( P<0.05). The MQ group of patients did not experience complications related to nerve block such as kidney injury and muscle weakness. Conclusions:In open gynecological tumor surgery, ultrasound guided MSC-AQLB can effectively reduce postoperative pain scores, reduce the dosage of postoperative analgesics, reduce the incidence of nausea and vomiting, and significantly improve patient satisfaction with pain relief.
RÉSUMÉ
Objective:To investigate the effect of ultrasound-guided lumbar quadratus muscle plane block combined with general anesthesia on the analgesic effect during and after laparoscopic colon cancer radical surgery in elderly patients.Methods:A prospective study was conducted on 61 elderly patients who underwent radical colon cancer surgery at the Changsha Central Hospital Affiliated to South China University from May 2022 to February 2023, with American Society of Anesthesiologist (ASA) grades Ⅱ to Ⅲ. They were randomly divided into SA and GA groups using a random number table method, with 31 patients in the SA group and 30 patients in the GA group. The SA group received ultrasound-guided plane block of the upper lumbar quadratus muscle in the arcuate ligament combined with general anesthesia, while the GA group received simple general anesthesia. Record the mean artery pressure (MAP) and heart rate (HR) of two groups of patients at the time of entering the operating room (T 0), 5 minutes before skin incision (T 1), at skin incision (T 2), 30 minutes after surgery (T 3), at surgery end (T 4), and during anesthesia resuscitation and extubation (T 5); The Visual Analogue Scale (VAS) of two groups of patients at T 5, upon returning to the ward (T 6), 6 hours (T 7), 12 hours (T 8), 24 hours (T 9), and 48 hours (T 10) after surgery were recorded; The dosage of sufentanil, remifentanil, and propofol used during surgery, anesthesia recovery time, total number of analgesic pump presses within 48 hours after surgery, Lovett muscle strength score, early postoperative recovery, and adverse reactions within 48 hours after surgery were also recorded. Resultsl:The MAP and HR of the SA group were lower than those of the GA group at T 1-5 (all P<0.05); The VAS score of the SA group was lower than that of the GA group at T 5-10 (all P<0.05); The intraoperative dosage of propofol, remifentanil, and sufentanil in the SA group was lower than that in the GA group (all P<0.05); The anesthesia recovery time and first time out of bed in the SA group were earlier than those in the GA group (all P<0.05); The total number of times the analgesic pump was pressed within 48 hours after surgery was less than that of the GA group ( P<0.05); The incidence of nausea and vomiting within 48 hours after surgery in the SA group was lower than that in the GA group ( P<0.05). There was no statistically significant difference in postoperative Lovett muscle strength score, hospital stay, and dizziness incidence between the two groups of patients (all P>0.05). Conclusions:Ultrasound-guided lumbar quadratus muscle plane block on the arcuate ligament can significantly reduce the dosage of intraoperative general anesthesia drugs and postoperative analgesics in elderly patients undergoing laparoscopic colon cancer surgery, reduce postoperative pain scores, effectively alleviate postoperative pain, and thus advance the patient′s first time out of bed activity, reduce postoperative complications, and promote rapid recovery.
RÉSUMÉ
Chronic spontaneous urticaria (CSU) is characterized by recurrent wheals with severe itching,and greatly affects the life quality of patients.The European guideline on chronic urticaria recommends the anti-IgE monoclonal antibody omalizumab as the only third-line therapy for patients with CSU whose condition can not be controlled by high doses of antihistamines.Although a lot of researches have shown that omalizumab is effective and safe for the treatment of CSU,its therapeutic mechanisms have not yet been fully elucidated.This review summarizes therapeutic mechanisms of omalizumab in the treatment of CSU,and indices for predicting and monitoring its clinical efficacy.
RÉSUMÉ
Chronic spontaneous urticaria (CSU) is characterized by recurrent wheals with severe itching, and greatly affects the life quality of patients. The European guideline on chronic urticaria recommends the anti-IgE monoclonal antibody omalizumab as the only third-line therapy for patients with CSU whose condition can not be controlled by high doses of antihistamines. Although a lot of researches have shown that omalizumab is effective and safe for the treatment of CSU, its therapeutic mechanisms have not yet been fully elucidated. This review summarizes therapeutic mechanisms of omalizumab in the treatment of CSU, and indices for predicting and monitoring its clinical efficacy.
RÉSUMÉ
AIM:Chronic exposure to elevated levels of free fatty acids (FFAs) in type 2 diabetes patients is toxic to pancreatic β-cells.Thioredoxin (Trx)-interacting protein (TXNIP), an endogenous Trx-inhibiting protein, is up-regulated by glucose and is a critical mediator of hyperglycemia-induced β-cell apoptosis in diabetes.However, the effects of FFAs on TXNIP are unknown.In this experiment we observed the effect of palmitate on TXNIP expression in cultured INS-1 islet cells and the pathways involved were analyzed meanwhile.METHODS:After the full basis of preliminary experiment of incubating INS-1 cells with palmitate at different concentrations for different time, INS-1 islet cells were cultured with 0.5 mmol/L palmitate for 24 h.TXNIP expression, cell apoptosis, and expression of transcription factors related to TXNIP transcriptional regulation were determined.RESULTS:Compared with control group, the expression of TXNIP at mRNA and protein levels in palmitate group was significantly up-regulated (P<0.01).Cleaved caspase-3/caspase-3 ratio was increased in palmitate group (P<0.05), and the apoptosis of the INS-1 cells was also significantly increased (P<0.01).Palmitate enhanced the phosphorylation of nuclear factor-κB (NF-κB) (P<0.01), and the NF-κB inhibitors, PDTC and SN50, both blocked the palmitate-induced up-regulation of TXNIP expression.CONCLUSION:Saturated fatty acid palmitate enhances the expression of TXNIP.The mechanism of palmitate-induced TXNIP expression may be associa-ted with the increase in NF-κB phosphorylation.
RÉSUMÉ
It has been widely verified by various sorting methods that cancer stem cells (CSCs) exist in different types of tumor cells or tissues. However, due to lack of specific stem cell surface markers, CSCs are very difficult to be separated from some cancer cells, which becomes the key barrier of functional studies of CSCs. The sorting method by side population cells (SP) lays a solid foundation for in-depth and comprehensive study of CSCs. To identify the existence of SP in prostate cancer cell lines, we applied flow cytometry sorting by SP to cultures of prostate cancer cell lines (TSU, LnCap, and PC-3), and the cancer stem-like characteristics of SP were verified through experiments in vitro and in vivo. The proportion of SP in TSU cells was calculated to be 1.60%±0.40% [Formula: see text], and that in PC-3 and LnCap cells was calculated to be 0.80%±0.05% and 0.60%±0.20%, respectively. The colony formation assay demonstrated that the colony formation rate of SP to non-SP sorted from TSU via flow cytometry was 0.495±0.038 to 0.177±0.029 in 500 cells, 0.505±0.026 to 0.169±0.024 in 250 cells, and 0.088±0.016 to 0.043±0.012 in 125 cells respectively. In the in vivo experiments, tumors were observed in all the mice on the 10th day after injecting 50 000 cells subcutaneously in SP group, whereas when 5×10(6) cells were injected in non-SP group, tumors were developed in only 4 out of 8 mice until the 3rd week before the end of the experiment. Our results revealed that prostate cancer cells contain a small subset of cells, called SP, possessing much greater capacity of colony formation and tumorigenic potential than non-SP. These suggest that SP in prostate cancer cells may play a key role in the self-renewal and proliferation, and have the characteristics of cancer stem-like cells. Dissecting these features will provide a new understanding of the function of prostate CSCs in tumorigenicity and transformation.
RÉSUMÉ
It has been widely verified by various sorting methods that cancer stem cells (CSCs) exist in different types of tumor cells or tissues. However, due to lack of specific stem cell surface markers, CSCs are very difficult to be separated from some cancer cells, which becomes the key barrier of functional studies of CSCs. The sorting method by side population cells (SP) lays a solid foundation for in-depth and comprehensive study of CSCs. To identify the existence of SP in prostate cancer cell lines, we applied flow cytometry sorting by SP to cultures of prostate cancer cell lines (TSU, LnCap, and PC-3), and the cancer stem-like characteristics of SP were verified through experiments in vitro and in vivo. The proportion of SP in TSU cells was calculated to be 1.60%±0.40% [Formula: see text], and that in PC-3 and LnCap cells was calculated to be 0.80%±0.05% and 0.60%±0.20%, respectively. The colony formation assay demonstrated that the colony formation rate of SP to non-SP sorted from TSU via flow cytometry was 0.495±0.038 to 0.177±0.029 in 500 cells, 0.505±0.026 to 0.169±0.024 in 250 cells, and 0.088±0.016 to 0.043±0.012 in 125 cells respectively. In the in vivo experiments, tumors were observed in all the mice on the 10th day after injecting 50 000 cells subcutaneously in SP group, whereas when 5×10(6) cells were injected in non-SP group, tumors were developed in only 4 out of 8 mice until the 3rd week before the end of the experiment. Our results revealed that prostate cancer cells contain a small subset of cells, called SP, possessing much greater capacity of colony formation and tumorigenic potential than non-SP. These suggest that SP in prostate cancer cells may play a key role in the self-renewal and proliferation, and have the characteristics of cancer stem-like cells. Dissecting these features will provide a new understanding of the function of prostate CSCs in tumorigenicity and transformation.
Sujet(s)
Humains , Mâle , Lignée cellulaire tumorale , Cellules souches tumorales , Anatomopathologie , Tumeurs de la prostate , Anatomopathologie , Cellules de population latérale , AnatomopathologieRÉSUMÉ
Objective To investigate the incidence,pathogenetic factors,prognosis and correlation factors of acute kidney injury(AKI) in the hospitalized elderly patients. Methods The clinical data of 4781 elderly patients (aged 65 years and over) in our hospital from June 2008 to December 2009 were collected in this study using the hospital information system(HIS).The patients with AKI were picked out and were retrospectively analyzed. Results Among 4781patients,515cases (10.8％) suffered from AKI and the incidence of AKI increased with growing age. Single factorial analysis of etiology showed that infections (39.2％) was the most common causes of AKI.Multifactorial analysis revealed that the major causes of AKI were infections (81.0％),followed by hypovolemia (67.2 ％ ),nephrotoxic drugs (64.1％ ),cardiovascular diseases (32.3 ％),respiratory failure(17.7％) and neoplasm (9.5％). Multivariate logistic analysis and cox proportional hazard models indicated multiple organ dysfunction syndrome(MODS),gastrointestinal bleeding,mechanical ventilation and malnutrition were independent risk factors inducing end events such as dialysis or death and influencing time of live. Conclusions There is high incidence of AKI in the elderly hospitalized patient.Infections,hypovolemia,nephrotoxic drugs and cardiovascular diseases are the common causes of AKI.Active treatment of primary diseases,early diagnosis and prevention are beneficial for improving the prognosis of AKI.
RÉSUMÉ
Objective To analysis and compare the proteomic differences between neural stem cells and motor neurons in embryonic spinal cord in rat and discover the key different proteins. Methods Separating the protein of cells by the 2-D fluorescence difference gel electrophoresis, and to analyse the differences of protein expression with DeCyder software, and to identify with high performance liquid chromatography-electrospray tandem mass spectrometry. Results About 1 300 protein spots from the cells were gained after gel analysis. Eighty-seven protein spots were selected for mass spectrometry analysis. Fourty-four differently expressed proteins (24 in neural stem cells and 20 in motor neurons) were identified by mass spectrometry analysis.Conclusion Differently expressed proteins between neural stem cells and motor neurons were identified and it is helpful to find the new targets in neural stem cells differentiation into motor neurons.
RÉSUMÉ
To investigate the role of immediate-early gene c-fos in sodium selenite-induced apoptosis and its position in a possible cascade of apoptogenic genes, we compared the time-courses of expression for 5 related genes, including c-fos, during the apop- tosis induced by sodium selenite with or without blockage of c-fos expression by adding c-fos antisense oligodeoxynucleotide ( ASO) in cultured cortical neurons. The results showed that: (1) in control experiments without c-fos ASO adding, 0. 5 μmol/ L sodium selenite-induced apoptosis as revealed by electrophoretic and flow cytometric examinations; at the same time, sodium selenite also induced down-regulation of bcl-2 mRNA expression and up-regulations of mRNAs related to bax, c-fos, p53, and acetylcholinesterase (AChE) genes; (2) in similar experimental conditions with c-fos ASO cotreatment, the sodium selenite-in- duced apoptosis was blocked with the up-regulation of p53 expression still emerging as before, while the changes in expressions of bcl-2, bax, AChE genes were reversed at the same time. The results suggest that c-fos ASO could play a protective role upon cortical neurons from suffering apoptosis induced by sodium selenite, and there might exist a cascade of gene expressions with p53 and c-fos genes being regulated upstream and then bcl-2, bax, and AChE genes being regulated downstream.
RÉSUMÉ
Objective To examine DNMT1,?-catenin and P-GSK-3? expressions in tissues of colon carcinoma compared with tumor clinicopathological parameters including differentiation and metastasis.Methods SYBR Green real-time PCR and immunoblotting method were used to detect these gene expressions in 62 tissues of colon carcinoma and 21 tissues of normal colon.Results Overexpressions of DNMT1,?-catenin,and P-GSK-3? were found in colon carcinoma tissues.The expression of DNMT1 was found to be higher in poorly differentiated tissues.The results also demonstrated statistical significance in the expression of ?-catenin involving differentiation and metastasis,but no statistical significance in the expression of P-GSK-3?.Conclusion These results show that DNMT1,?-catenin and P-GSK-3? expressions are regulated throughout colon cancer progression.