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Objective To evaluate the role of autophagy in cerebral ischemia-reperfusion (I/R) injury in diabetic mice and the relationship with histone deacetylase 3 (HDAC3)/Bmal1 signaling pathway.Methods Healthy clean-grade male C57BL/6 mice were used in the study.Diabetes mellitus was induced by intraperitoneal injection of streptozotocin.Thirty-six mice with diabetes mellitus after being fed for 8 weeks were divided into 3 groups (n =12 each) using a random number table method:sham operation group (group S),I/R group and I/R plus HDAC3 inhibitor group (group I/R-H).Cerebral I/R was induced by middle cerebral artery occlusion for 1 h,followed by 24-h reperfusion in anesthetized mice.Specific HDAC3 inhibitor RGFP966 10 mg/kg was subcutaneously injected at 30 min before establishing the model in group I/R-H.Brain tissues were obtained at 24 h of reperfusion for microscopic examination and for determination of cerebral infarct size (by TTC),cell apoptosis (by TUNEL),activities of superoxide dismutase (SOD) and reactive oxygen species (ROS) and malondialdehyde (MDA) content (by colorimetric assay),expression of autophagy-related protein Beclin-1 and LC3B (by immunofluorescence),and expression of HDAC3,Bmal1,GSK-3β and p62 (by Western blot).Apoptosis index (AI) was calculated.Results Compared with group S,the cerebral infarct size was significantly increased,the activities of SOD and ROS and content of MDA in brain tissues were decreased,the expression of Bmal1,p-GSK-3β and HDAC3 was down-regulated,and AI was increased in group I/R (P＜0.05).Compared with group I/ R,the cerebral infarct size was significantly increased,the activities of SOD and ROS and content of MDA in brain tissues were increased,the expression of Bmall,p-GSK-3β,Beclin-1 and LC3B was up-regulated,AI was decreased,and the expression of HDAC3 and p62 was down-regulated in group I/R-H (P＜ 0.05).Conclusion HDAC3/Bmal1 signaling pathway exerts endogenous protective effect through activating autophagy and increasing the antioxidant capacity following cerebral I/R in diabetic mice.
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Objective To compare the effects of different anesthetics on the recovery of neurologi-cal function after intracranial aneurysm embolization. Methods One hundred patients of both sexes with aneurysmal subarachnoid hemorrhage, aged more than 18 yr, with body mass index of 18. 5-24. 0 kg∕m2 , of American Society of Anesthesiologists physical status Ⅱ or Ⅲ and WFNS grade Ⅰ-Ⅳ, with the thick-ness of subarachnoid hemorrhage more than 4 cm, were divided into 2 groups (n= 50 each) using a random number table: propofol group (group P) and sevoflurane group (group S). After anesthesia induction, group P received intravenous infusion of propofol 100-300 μg·kg-1 ·min-1 , while the end-tidal sevoflu-rane concentration was maintained at 1. 4％-3. 5％ in group S. Immediately before induction (T0 ), imme-diately after the end of induction (T1 ), immediately after successful embolization of aneurysm (T2 ) and at 1, 2, 3 and 5 days after surgery (T3-6 ), central venous blood samples were collected for determination of plasma neuron-specific enolase and S100β protein concentrations by enzyme-linked immunosorbent assay. The development of postoperative cerebral vasospasm and delayed ischemic neurological deficit was recorded. The patients were followed up, and the Glasgow outcome score and occurrence of newly developed cerebral infarction were recorded within 6 months after surgery. Results There was no significant difference in the concentrations of plasma neuron-specific enolase and S100β protein at each time point, incidence of postop-erative cerebral vasospasm and delayed ischemic neurological deficit, or Glasgow outcome score and inci-dence of newly developed cerebral infarction within 6 months after surgery between two groups (P>0. 05). Conclusion Propofol and sevoflurane exert no effect on the recovery of neurological function after intracra-nial aneurysm embolization.
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Objective To evaluate the treatment effects of the olecranon comminuted fracture by the angle stability prin-ciple combined with support under the articular surface. Methods From November 2008 to June 2012, 13 patients (7 male and 6 female, aged from 20 to 77 years) suffered from olecranon comminuted fracture were treated with Synthes anatomy locking com-pression plate and screws combined with Kirschner wires supporting under the articular surface through the posterior median ap-proach. Fractures occurred in the left elbow in 9 and in the right elbow in 4. According to the Mayo classification, 11 cases were classified as Mayo type IIB and 2 as IIIB. According to the Schatzker-Schmeling classification, 2 fractures were type A2, 9 type C, and 2 type D. One patient with type C fracture also had type I coronoid fracture according to Regan and Morrey classification. The Mayo elbow performance index (MEPI) and the shortened disabilities of the arm shoulder and hand (Quick-DASH) were employed to evaluate the functions. All patients took the satisfaction survey and X-ray during the follow-up. Results All patients were fol-lowed-up for 8 to 41 months. The mean ROM of the elbow joint was 112° (range, 65°-140° ), and the mean rotation angle of the forearm was 170° (range, 150°-180°). The mean score for the MEPI was 96 (range, 85-100), excellent 12, good 1. The mean score for the Quick-DASH was 6.2 (range, 0-16.7). In the satisfaction survey, 8 patients were very satisfied, 4 satisfied, 1 common level. All patients took the X-ray during the follow-up and all of them had achieved fracture union completely with the mean time period as 12.7 weeks (range, 11-24 weeks). No cubitus varus, valgus, and instability were found in all patients. No complication, such as infection, ulnar nerve injuries and etc. was found. Five patients complained about mild discomfort caused by internal fixation at 3 months after surgery. Three of them were diagnosed as joint stiffness because of ROM within 100° . One case in 3 elbow stiffness patients developed osteoarthritis after eight months, but no pain during joint activity. Internal fixation was removed in one case;an-other young patient took the operation for removal of internal fixation and release of medial ligament;the third patient refused oper-ation. Conclusion Angle stability principle (Synthes anatomy locking compression plate and screws) combined with supporting under the articular surface (Kirschner wires) can achieve stable fixation in treating olecranon comminuted fracture. It may realize the early exercise of the elbow joint with excellent clinical results. Therefore, it may be an optional choice in clinical practice.