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1.
Brain Behav Immun ; 119: 220-235, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38599497

RESUMEN

Postpartum depression (PPD) is a severe mental disorder that affects approximately 10---20% of women after childbirth. The precise mechanism underlying PPD pathogenesis remains elusive, thus limiting the development of therapeutics. Gut microbiota dysbiosis is considered to contribute to major depressive disorder. However, the associations between gut microbiota and PPD remain unanswered. Here, we established a mouse PPD model by sudden ovarian steroid withdrawal after hormone-simulated pseudopregnancy-human (HSP-H) in ovariectomy (OVX) mouse. Ovarian hormone withdrawal induced depression-like and anxiety-like behaviors and an altered gut microbiota composition. Fecal microbiota transplantation (FMT) from PPD mice to antibiotic cocktail-treated mice induced depression-like and anxiety-like behaviors and neuropathological changes in the hippocampus of the recipient mice. FMT from healthy mice to PPD mice attenuated the depression-like and anxiety-like behaviors as well as the inflammation mediated by the NOD-like receptor protein (NLRP)-3/caspase-1 signaling pathway both in the gut and the hippocampus, increased fecal short-chain fatty acids (SCFAs) levels and alleviated gut dysbiosis with increased SCFA-producing bacteria and reduced Akkermansia in the PPD mice. Also, downregulation of NLRP3 in the hippocampus mitigated depression-like behaviors in PPD mice and overexpression of NLRP3 in the hippocampal dentate gyrus induced depression-like behaviors in naïve female mice. Intriguingly, FMT from healthy mice failed to alleviate depression-like behaviors in PPD mice with NLRP3 overexpression in the hippocampus. Our results highlighted the NLRP3 inflammasome as a key component within the microbiota-gut-brain axis, suggesting that targeting the gut microbiota may be a therapeutic strategy for PPD.


Asunto(s)
Depresión Posparto , Modelos Animales de Enfermedad , Disbiosis , Trasplante de Microbiota Fecal , Microbioma Gastrointestinal , Hipocampo , Proteína con Dominio Pirina 3 de la Familia NLR , Animales , Femenino , Disbiosis/metabolismo , Hipocampo/metabolismo , Ratones , Microbioma Gastrointestinal/fisiología , Proteína con Dominio Pirina 3 de la Familia NLR/metabolismo , Trasplante de Microbiota Fecal/métodos , Depresión Posparto/metabolismo , Ratones Endogámicos C57BL , Depresión/metabolismo , Enfermedades Neuroinflamatorias/metabolismo , Conducta Animal/fisiología , Ansiedad/metabolismo , Eje Cerebro-Intestino/fisiología , Inflamación/metabolismo , Ovariectomía
2.
Development ; 146(2)2019 01 25.
Artículo en Inglés | MEDLINE | ID: mdl-30635284

RESUMEN

Protein modification by ubiquitin and ubiquitin-like proteins (UBLs) regulates numerous biological functions. The UFM1 system, a novel UBL conjugation system, is implicated in mouse development and hematopoiesis. However, its broad biological functions and working mechanisms remain largely elusive. CDK5RAP3, a possible ufmylation substrate, is essential for epiboly and gastrulation in zebrafish. Herein, we report a crucial role of CDK5RAP3 in liver development and hepatic functions. Cdk5rap3 knockout mice displayed prenatal lethality with severe liver hypoplasia, as characterized by delayed proliferation and compromised differentiation. Hepatocyte-specific Cdk5rap3 knockout mice suffered post-weaning lethality, owing to serious hypoglycemia and impaired lipid metabolism. Depletion of CDK5RAP3 triggered endoplasmic reticulum stress and activated unfolded protein responses in hepatocytes. We detected the in vivo interaction of CDK5RAP3 with UFL1, the defined E3 ligase in ufmylation. Notably, loss of CDK5RAP3 altered the ufmylation profile in liver cells, suggesting that CDK5RAP3 serves as a novel substrate adaptor for this UBL modification. Collectively, our study identifies CDK5RAP3 as an important regulator of ufmylation and suggests the involvement of ufmylation in mammalian development.


Asunto(s)
Hígado/embriología , Hígado/metabolismo , Proteínas/metabolismo , Ubiquitina-Proteína Ligasas/metabolismo , Animales , Proteínas de Ciclo Celular , Diferenciación Celular , Proliferación Celular , Pérdida del Embrión/patología , Embrión de Mamíferos/metabolismo , Embrión de Mamíferos/patología , Retículo Endoplásmico/metabolismo , Eliminación de Gen , Células Hep G2 , Hepatocitos/citología , Hepatocitos/metabolismo , Homeostasis , Humanos , Hígado/patología , Ratones Noqueados , Unión Proteica , Especificidad por Sustrato , Proteínas Supresoras de Tumor
3.
Int J Mol Sci ; 23(8)2022 Apr 18.
Artículo en Inglés | MEDLINE | ID: mdl-35457258

RESUMEN

The reversal of loss of the critical size of skeletal muscle is urgently required using biomaterial scaffolds to guide tissue regeneration. In this work, coaxial electrospun magnetic nanofibrous scaffolds were fabricated, with gelatin (Gel) as the shell of the fiber and polyurethane (PU) as the core. Iron oxide nanoparticles (Mag) of 10 nm diameter were added to the shell and core layer. Myoblast cells (C2C12) were cultured on the magnetic scaffolds and exposed to the applied magnetic fields. A mouse model of skeletal muscle injury was used to evaluate the repair guided by the scaffolds under the magnetic fields. It was shown that VEGF secretion and MyoG expression for the myoblast cells grown on the magnetic scaffolds under the magnetic fields were significantly increased, while, the gene expression of Myh4 was up-regulated. Results from an in vivo study indicated that the process of skeletal muscle regeneration in the mouse muscle injury model was accelerated by using the magnetic actuated strategy, which was verified by histochemical analysis, immunofluorescence staining of CD31, electrophysiological measurement and ultrasound imaging. In conclusion, the integration of a magnetic scaffold combined with the extra magnetic fields enhanced myoblast differentiation and VEGF secretion and accelerated the defect repair of skeletal muscle in situ.


Asunto(s)
Nanofibras , Animales , Diferenciación Celular , Campos Magnéticos , Fenómenos Magnéticos , Ratones , Músculos , Ingeniería de Tejidos/métodos , Andamios del Tejido , Factor A de Crecimiento Endotelial Vascular/genética
4.
BMC Anesthesiol ; 21(1): 33, 2021 02 02.
Artículo en Inglés | MEDLINE | ID: mdl-33530942

RESUMEN

BACKGROUND: The blood saving efficacy of TXA in cardiac surgery has been proved in several studies, but TXA dosing regimens were varied in those studies. Therefore, we performed this study to investigate if there is a dose dependent in-vivo effect of TXA on fibrinolysis parameters by measurement of fibrinolysis markers in adults undergoing cardiac surgery with CPB. METHODS: A double-blind, randomized, controlled prospective trial was conducted from February 11, 2017 to May 05, 2017. Thirty patients undergoing cardiac valve surgery were identified and randomly divided into a placebo group, low-dose group and high-dose group by 1: 1: 1. Fibrinolysis parameters were measured by plasma levels of D-Dimers, plasminogen activator inhibitor-1 (PAI-1), thrombin activatable fibrinolysis inhibitor (TAFI), plasmin-antiplasmin complex (PAP), tissue plasminogen activator (tPA) and thrombomodulin (TM). Those proteins were measured at five different sample times: preoperatively before the TXA injection (T1), 5 min after the TXA bolus (T2), 5 min after the initiation of CPB (T3), 5 min before the end of CPB (T4) and 5 min after the protamine administration (T5). A Thrombelastography (TEG) and standard coagulation test were also performed. RESULTS: Compared with the control group, the level of the D-Dimers decreased in the low-dose and high-dose groups when the patients arrived at the ICU and on the first postoperative morning. Over time, the concentrations of PAI-1, TAFI, and TM, but not PAP and tPA, showed significant differences between the three groups (P <  0.05). Compared with the placebo group, the plasma concentrations of PAI-1 and TAFI decreased significantly at the T3 and T4 (P <  0.05); TAFI concentrations also decreased at the T5 in low-dose group (P < 0.05). Compared with the low-dose group, the concentration of TM increased significantly at the T4 in high-dose group. CONCLUSIONS: The in-vivo effect of low dose TXA is equivalent to high dose TXA on fibrinolysis parameters in adults with a low bleeding risk undergoing valvular cardiac surgery with cardiopulmonary bypass, and a low dose TXA regimen might be equivalent to high dose TXA for those patients. TRIAL REGISTRATION: ChiCTR-IPR-17010303 , Principal investigator: Zhen-feng ZHOU, Date of registration: January 1, 2017.


Asunto(s)
Antifibrinolíticos/farmacología , Procedimientos Quirúrgicos Cardíacos/métodos , Puente Cardiopulmonar/métodos , Fibrinólisis/efectos de los fármacos , Ácido Tranexámico/farmacología , Adulto , Antifibrinolíticos/administración & dosificación , Método Doble Ciego , Válvulas Cardíacas/cirugía , Humanos , Proyectos Piloto , Estudios Prospectivos , Ácido Tranexámico/administración & dosificación , Resultado del Tratamiento
5.
Anal Chem ; 92(24): 15927-15935, 2020 12 15.
Artículo en Inglés | MEDLINE | ID: mdl-33275415

RESUMEN

Electrochemical in situ sensing of small signal molecules released from living cells has an increasing significance in early diagnosis, pathological analyses, and drug discovery. Here, a living cell-fixed sensing platform was built using the BC@DNA-Mn3(PO4)2 nanozyme, in which a highly biocompatible bacterial cellulose riveted with very tiny Mn3(PO4)2; it not only delivers high catalytic activity toward superoxide anions but possesses excellent biocompatibility for cell adsorption and growth. Additionally, the experimental results suggested that fixing the living cells on the surface of the sensing platform facilitates tiny Mn3(PO4)2 activity centers to capture and detect O2•- very quickly and simultaneously has great potential in miniaturization, cost reduction, and real-time monitoring.


Asunto(s)
Materiales Biocompatibles/química , Celulosa/química , ADN/química , Nanoestructuras/química , Compuestos Organometálicos/química , Superóxidos/análisis , Materiales Biocompatibles/síntesis química , Técnicas Biosensibles , Electrodos , Humanos , Tamaño de la Partícula , Superóxidos/metabolismo , Propiedades de Superficie , Factores de Tiempo , Células Tumorales Cultivadas
6.
BMC Neurosci ; 20(1): 28, 2019 06 17.
Artículo en Inglés | MEDLINE | ID: mdl-31208343

RESUMEN

BACKGROUND: Neuropathic pain (NP) is a prevalent disease, which badly impairs the life quality of patients. The underlying mechanism of NP is still not fully understood. It has been reported that spinal Annexin A10 (ANXA10) contributes to NP. This study aims at exploring the underlying mechanisms of spinal ANXA10 in regulating NP in rats. METHODS: Spinal nerve ligation (SNL) was adopted to establish a NP model in rats. After SNL, paw withdrawal threshold and paw withdrawal latency were recorded to measure pain behaviors, RT-PCR was used to check the change of the expression of spinal ANXA10 mRNA, western blot analysis was used to detect the change of the protein level of ANXA10, nuclear factor kappa B (NF-κB), and maisrix metalloproteinase-9 (MMP-9) in the spinal cord. The levels of proinflammatory cytokines, including tumor necrosis factor-α (TNF-α), interleukine-1ß (IL-1ß), and interleukine-6 (IL-6), were explored by ELISA kits. The effects of both knockdown of spinal ANXA10 and inhibition of NF-κB on pain behaviors and the expression of MMP-9 and proinflammatory cytokines were investigated. RESULTS: Our present findings highlighted that SNL caused pain hypersensitivity and increased the expression of spinal ANXA10/pNF-κB, TNF-α, IL-1ß, and IL-6 both in the early and late phase of NP in rats, while spinal MMP-9 was only slightly increased in the early phase of NP. Knockdown of ANXA10 at the spinal cord level suppressed the SNL-induced hyperalgesia and blocked the activation of NF-κB, TNF-α and IL-1ß both in the early and late phase of NP. Spinal ANXA10 knockdown could prevent the upregulation of spinal MMP-9 in the early phase and inhibit IL-6 expression in the late phase of SNL-induced NP. CONCLUSIONS: In conclusion, spinal ANXA10/NF-κB/MMP-9 pathway, along with the activation of proinflammatory cytokines, was involved in the SNL-induced NP. MMP-9 may act as the downstream target of ANXA10/NF-κB pathway in the development rather than the maintenance of NP.


Asunto(s)
Anexinas/fisiología , Metaloproteinasa 9 de la Matriz/fisiología , FN-kappa B/biosíntesis , Neuralgia/fisiopatología , Transducción de Señal/fisiología , Traumatismos de la Médula Espinal/fisiopatología , Animales , Anexinas/genética , Técnicas de Silenciamiento del Gen , Mediadores de Inflamación/metabolismo , Ligadura , Masculino , Metaloproteinasa 9 de la Matriz/genética , FN-kappa B/antagonistas & inhibidores , Dimensión del Dolor , Ratas , Médula Espinal/metabolismo
7.
Nanomedicine ; 17: 1-12, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30654184

RESUMEN

Taking advantage of the mesoporous structure of bismuth sulfide nanostars (Bi2S3 NSs), a chemotherapeutic drug of doxorubicin (DOX) and a photosensitizer of chlorin e6 (Ce6) were concurrently loaded in the PEGylated Bi2S3 NSs to formulate a multifunctional nanocomplex (BPDC NSs) for tumor theranostics. BPDC NSs have excellent photothermal conversion efficiency and a capacity of yielding reactive oxygen species (ROS) upon laser irradiation, and can realize on-demand drug release by either pH-activation or thermal induction. Accumulation of the nanodrug could be monitored in real-time by infrared thermal imaging, fluorescence imaging and computed tomography (CT). More importantly, the combination effects of photothermal therapy (PTT), photodynamic therapy (PDT) and chemotherapy were demonstrated to dramatically suppress solid tumors without recurrence in vivo. Featuring low systemic toxicity and high biocompatibility, this nanoplatform could be a promising derivative of Bi2S3 NSs for imaging-guided theranostics of cancer.


Asunto(s)
Antibióticos Antineoplásicos/administración & dosificación , Doxorrubicina/administración & dosificación , Neoplasias/diagnóstico por imagen , Neoplasias/terapia , Fármacos Fotosensibilizantes/administración & dosificación , Porfirinas/administración & dosificación , Animales , Antibióticos Antineoplásicos/uso terapéutico , Bismuto/uso terapéutico , Línea Celular Tumoral , Clorofilidas , Preparaciones de Acción Retardada/uso terapéutico , Doxorrubicina/uso terapéutico , Hipertermia Inducida , Ratones , Nanopartículas/uso terapéutico , Nanopartículas/ultraestructura , Imagen Óptica , Fotoquimioterapia , Fármacos Fotosensibilizantes/uso terapéutico , Polietilenglicoles/uso terapéutico , Porosidad , Porfirinas/uso terapéutico , Sulfuros/uso terapéutico , Nanomedicina Teranóstica , Tomografía Computarizada por Rayos X
8.
Mol Pain ; 14: 1744806918816850, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30444177

RESUMEN

Metabotropic glutamate receptor 5 (mGluR5) and transient receptor potential vanilloid subtype 1 (TRPV1) have been shown to play critical roles in the transduction and modulation of cutaneous nociception in the central nervous system. However, little is known regarding the possible involvement of mGluR5 and TRPV1 in regulating visceral nociception from the uterine cervix. In this study, we used a rat model of uterine cervical distension to examine the effects of noxious stimuli to the uterine cervix on expression of spinal mGluR5 and TRPV1. Our findings included the following: (1) uterine cervical distension resulted in a stimulus-dependent increase in electromyographic, spinal c-Fos signal, and expression of mGluR5 and TRPV1 in the spinal cord; (2) intrathecal administration of the mGluR5 antagonist 2-methyl-6-(phenylethynyl)-pyri-dine significantly reduced the increased TRPV1 and c-Fos expression induced by uterine cervical distension; (3) the TRPV1 inhibitor SB-366791 inhibited increased spinal c-Fos expression but had no effect on the expression of mGluR5 in response to uterine cervical distension. Our findings indicate that the spinal mGluR5-TRPV1 pathway modulates nociceptive transmission in uterine cervical distension-induced pathological visceral pain.


Asunto(s)
Cuello del Útero/patología , Nocicepción , Receptor del Glutamato Metabotropico 5/metabolismo , Canales Catiónicos TRPV/metabolismo , Vísceras/patología , Anilidas/administración & dosificación , Anilidas/farmacología , Animales , Cinamatos/administración & dosificación , Cinamatos/farmacología , Modelos Animales de Enfermedad , Electromiografía , Femenino , Nocicepción/efectos de los fármacos , Proteínas Proto-Oncogénicas c-fos/metabolismo , Piridinas , Ratas Sprague-Dawley , Reproducibilidad de los Resultados , Asta Dorsal de la Médula Espinal/efectos de los fármacos , Asta Dorsal de la Médula Espinal/patología
9.
Biomed Microdevices ; 20(3): 68, 2018 08 09.
Artículo en Inglés | MEDLINE | ID: mdl-30094581

RESUMEN

Temperature is a critical extrinsic physical parameter that determines cell fate. Hyperthermia therapy has become an efficient treatment for tumor ablation. To understand the response of tumor cells under thermal shocks, we present a paper-based photothermal array that can be conveniently coupled with commercial 96-well cell culture plates. This paper chip device was fabricated in one step using Parafilm® and Kimwipers® based on a heat lamination strategy. Liquid was completely adsorbed and confined within the cellulose fibres of hydrophilic regions. Then, Prussian blue nanoparticles (PB NPs) as the photothermal initiator were introduced into the loading wells, and thermal energy was generated via near infrared (NIR) laser irradiation. After assembling the paper device with a 96-well plate, the temperature of each well could be individually controlled by varying the loading amount of PB NPs and laser irradiation time. As a proof-of-concept study, the effects of local thermal shocks on HeLa cells were investigated using MTT cell viability assay and Live/Dead cell staining. The variation of cell viability could be monitored in situ with controllable temperature elevation. The proposed paper photothermal array loaded with thermal initiators represents an enabling tool for investigating the hyperthermia responses of biological cells. Moreover, the facile fabrication technique for paper patterning is advantageous for customizing high-throughput microfluidic paper-based analytical devices (µPADs) with extremely low cost.


Asunto(s)
Hipertermia Inducida , Parafina/química , Colorimetría , Ferrocianuros/química , Células HeLa , Humanos , Rayos Láser , Terapia por Luz de Baja Intensidad , Células MCF-7 , Nanopartículas/química , Neoplasias/terapia , Papel , Temperatura
10.
Diabetologia ; 60(12): 2443-2452, 2017 12.
Artículo en Inglés | MEDLINE | ID: mdl-28836014

RESUMEN

AIM/HYPOTHESIS: Abnormal activation of hepatic gluconeogenesis leads to hyperglycaemia. However, the molecular mechanisms underlying dysregulated hepatic gluconeogenesis remain to be fully defined. Here, we explored the physiological role of Krüppel-like factor 10 (KLF10) in regulating hepatic glucose metabolism in mice. METHODS: Hepatic KLF10 expression in wild-type C57BL/6J mice, the db/db mouse model of diabetes, the ob/ob mouse model of obesity and high-fat-diet-induced obese (DIO) mice was measured. Adenoviruses expressing Klf10 or Klf10-specific short-hairpin RNA were injected into wild-type C57BL/6J mice, db/db or DIO mice. Expression of gluconeogenic genes in the liver and blood glucose levels were measured. GTTs and pyruvate tolerance tests were performed. The molecular mechanism by which KLF10 regulates hepatic glucose metabolism was explored. RESULTS: Hepatic KLF10 expression was regulated by nutritional status in wild-type mice and upregulated in diabetic, obese and DIO mice. Overexpression of KLF10 in primary hepatocytes increased the expression of gluconeogenic genes and cellular glucose output. C57BL/6J mice with KLF10 overexpression in the liver displayed increased blood glucose levels and impaired glucose tolerance. Conversely, hepatic KLF10 knockdown in db/db and DIO mice decreased blood glucose levels and improved glucose tolerance. Furthermore, luciferase reporter gene assay and chromatin immunoprecipitation analysis indicated that KLF10 activates Pgc-1α (also known as Ppargc1a) gene transcription via directly binding to its promoter region. CONCLUSIONS/INTERPRETATION: KLF10 is an important regulator of hepatic glucose metabolism and modulation of KLF10 expression in the liver may be an attractive approach for the treatment of type 2 diabetes.


Asunto(s)
Glucemia/metabolismo , Factores de Transcripción de la Respuesta de Crecimiento Precoz/metabolismo , Factores de Transcripción de Tipo Kruppel/metabolismo , Hígado/metabolismo , Adenoviridae/genética , Animales , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/metabolismo , Factores de Transcripción de la Respuesta de Crecimiento Precoz/genética , Regulación de la Expresión Génica , Hepatocitos/metabolismo , Factores de Transcripción de Tipo Kruppel/genética , Ratones , Ratones Endogámicos C57BL , Ratones Transgénicos , Coactivador 1-alfa del Receptor Activado por Proliferadores de Peroxisomas gamma/genética , Coactivador 1-alfa del Receptor Activado por Proliferadores de Peroxisomas gamma/metabolismo
11.
Opt Lett ; 41(22): 5222-5225, 2016 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-27842098

RESUMEN

We have experimentally demonstrated midinfrared (MIR) supercontinuum (SC) generation in a low-loss Te-based chalcogenide (ChG) step-index fiber. The fiber, fabricated by an isolated extrusion method, has an optical loss of 2-3 dB/m at 6.2-10.3 µm and 3.2 dB/m at 10.6 µm, the lowest value reported for any Te-based ChG step-index fiber. A MIR SC spectrum (∼1.5 to 14 µm) is generated from the 23-cm fiber pumped by a 4.5 µm laser (∼150 fs, 1 kHz). To the best of our knowledge, this is the first SC experimental demonstration in Te-based ChG fiber and the broadest MIR SC generation pumped in the normal dispersion regime in the optical fibers.

12.
Neurochem Res ; 41(7): 1651-61, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-26961890

RESUMEN

Evidence has suggested that cerebrospinal fluid-contacting nucleus (CSF-contacting nucleus) is correlated with the development and recurrence of pain. A recent research showed that the CSF-contacting nucleus acts as a component of the descending 5-hydroxytryptamine (5-HT) system and plays a role in descending pain inhibition. However, limited studies are conducted to investigate the relationship between the CSF-contacting nucleus and pain. In present study, we explored the effect of CSF-contacting nucleus on nociceptive behaviors in both normal and neuropathic rats via targeted ablation of the CSF-contacting nucleus in the brainstem, using cholera toxin subunit B-saporin (CB-SAP), a cytotoxin coupled to cholera toxin subunit B. The CB-SAP-treated rats showed aggravated thermal hyperalgesia and mechanical allodynia. Also, results from immunohistochemical experiments showed that rostral ventromedial medulla (RVM) received fiber projection from the CSF-contacting nucleus, which disappeared after ablation of the CSF-contacting nucleus, and the CB-SAP treated rats showed downregulation of c-Fos expression in the RVM as compared with the rats receiving i.c.v. injection of phosphate buffer saline (PBS). A significant downregulation of 5-HT-labeled neurons and tryptophan hydroxylase 2 (TPH2) as the marker of 5-HT cells in the RVM, and 5-HT expression in spinal dorsal horn in both normal and chronic constriction injury (CCI) rats after i.c.v. injection of CB-SAP was observed. These results suggested that RVM may be involved in descending pain modulation originating from the CSF-contacting nucleus.


Asunto(s)
Bulbo Raquídeo/química , Bulbo Raquídeo/fisiología , Dolor/metabolismo , Dolor/patología , Tractos Piramidales/química , Tractos Piramidales/fisiología , Animales , Hiperalgesia/metabolismo , Hiperalgesia/patología , Masculino , Ratas , Ratas Sprague-Dawley
13.
Healthc Manage Forum ; 28(1): 24-27, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25838567

RESUMEN

The Nurse Practitioner (NP) role possesses a high value to Fee-For-Service (FFS) practices in the primary healthcare system. A case study evaluation of the NP roles in three FFS clinics showed positive impacts on patient satisfaction and physician experience. Physicians' FFS expenditures increased 12% after the NP implementation. Although NP services could provide cost savings to the acute care system, financial sustainability of the NP role in FFS practice remains a challenge.

14.
Int J Gynaecol Obstet ; 165(2): 806-812, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-37984372

RESUMEN

OBJECTIVE: To explore the impact of a novel multidisciplinary cooperation model in obstetric medical quality control. METHODS: This quasi-experimental study analyzed the quality indicators of full-term pregnant women who underwent vaginal trial labor in Zibo Maternal and Child Health Hospital between July 2021 and June 2022. The pregnant women were divided into two groups based on implementation of novel multidisciplinary cooperation: multidisciplinary and non-multidisciplinary. We compared the rate of labor analgesia, postpartum hemorrhage in vaginal delivery, transfer to cesarean section, and the 5-min Apgar score ≤7 in full-term neonates. RESULTS: A total of 3751 pregnant women were enrolled into the study, of whom 2004 were included in the non-multidisciplinary group and 1747 in the multidisciplinary group. The analgesic rate of delivery of the multidisciplinary group was higher than that of the non-multidisciplinary group (P = 0.000). We established that the rate of postpartum bleeding (P = 0.040), transfer cesarean section (P = 0.003) and the incidence of Apgar score ≤7 in 5 min of full-term neonates (P = 0.038) of the multidisciplinary group was lower than that of the non-multidisciplinary group. There was no significant difference in the mean ages (29.40 ± 3.99 vs. 29.90 ± 4.27 years; P = 0.126), mean delivery gestational ages (39.65 ± 0.87 vs. 39.64 ± 1.06; P = 0.221), mean gravidity values (1.93 ± 1.09 vs. 2.00 ± 1.18; P = 0.586) and mean parity (1.40 ± 0.56 vs. 1.42 ± 0.59; P = 0.635) of the women in the two groups. CONCLUSION: Multidisciplinary cooperation in delivery management can significantly improve some quality indicators. We established the analgesic rate of delivery can be increased and the rate of postpartum bleeding, transfer cesarean section and the incidence of Apgar score ≤7 in 5 min of full-term neonates can be decreased with the implementation of novel multidisciplinary cooperation.


Asunto(s)
Trabajo de Parto , Hemorragia Posparto , Recién Nacido , Niño , Embarazo , Femenino , Humanos , Cesárea , Parto Obstétrico , Esfuerzo de Parto , Hemorragia Posparto/epidemiología , Hemorragia Posparto/prevención & control , Analgésicos , Estudios Retrospectivos
15.
World J Clin Cases ; 12(22): 4932-4939, 2024 Aug 06.
Artículo en Inglés | MEDLINE | ID: mdl-39109037

RESUMEN

BACKGROUND: Collision tumor are neoplasms, including two histologically distinct tumors that coexist in the same mass without histological admixture. The incidence of collision tumor is low and is rare clinically. AIM: To investigate ultrasound images and application of ovarian-adnexal reporting and data system (O-RADS) to evaluate the risk and pathological characteristics of ovarian collision tumor. METHODS: This study retrospectively analyzed 17 cases of ovarian collision tumor diagnosed pathologically from January 2020 to December 2023. All clinical features, ultrasound images and histopathological features were collected and analyzed. The O-RADS score was used for classification. The O-RADS score was determined by two senior doctors in the gynecological ultrasound group. Lesions with O-RADS score of 1-3 were classified as benign tumors, and lesions with O-RADS score of 4 or 5 were classified as malignant tumors. RESULTS: There were 17 collision tumors detected in 16 of 6274 patients who underwent gynecological surgery. The average age of 17 women with ovarian collision tumor was 36.7 years (range 20-68 years), in whom, one occurred bilaterally and the rest occurred unilaterally. The average tumor diameter was 10 cm, of which three were 2-5 cm, 11 were 5-10 cm, and three were > 10 cm. Five (29.4%) tumors with O-RADS score 3 were endometriotic cysts with fibroma/serous cystadenoma, and unilocular or multilocular cysts contained a small number of parenchymal components. Eleven (64.7%) tumors had an O-RADS score of 4, including two in category 4A, six in category 4B, and three in category 4C; all of which were multilocular cystic tumors with solid components or multiple papillary components. One (5.9%) tumor had an O-RADS score of 5. This case was a solid mass, and a small amount of pelvic effusion was detected under ultrasound. The pathology was high-grade serous cystic cancer combined with cystic mature teratoma. There were nine (52.9%) tumors with elevated serum carbohydrate antigen (CA)125 and two (11.8%) with elevated serum CA19-9. Histological and pathological results showed that epithelial-cell-derived tumors combined with other tumors were the most common, which was different from previous results. CONCLUSION: The ultrasound images of ovarian collision tumor have certain specificity, but diagnosis by preoperative ultrasound is difficult. The combination of epithelial and mesenchymal cell tumors is one of the most common types of ovarian collision tumor. The O-RADS score of ovarian collision tumor is mostly ≥ 4, which can sensitively detect malignant tumors.

16.
Ann Med ; 56(1): 2329259, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38738380

RESUMEN

Opioids are the most prescribed drugs for the alleviation of pain. Both clinical and preclinical studies have reported strong evidence for sex-related divergence regarding opioid analgesia. There is an increasing amount of evidence indicating that gonadal hormones regulate the analgesic efficacy of opioids. This review presents an overview of the importance of gonadal steroids in modulating opioid analgesic responsiveness and focuses on elaborating what is currently known regarding the underlyingmechanism. We sought to identify the link between gonadal hormones and the effect of oipiod antinociception.


Gonadal hormones contribute to the sexual dimorphism of opioid antinociception.Generally, oestradiol is a negative modulator of opioid analgesia via both non-genomic and genomic effects.Testosterone facilitates opioid analgesia mainly through the transcriptional activities of androgen receptors.Under normal physiological conditions, progestin and oestrogen exist in parallel and have a combined effect. However, progestin alone could promote opioid analgesia by increasing the expression of opioid receptors.


Asunto(s)
Analgésicos Opioides , Hormonas Gonadales , Dolor , Analgésicos Opioides/farmacología , Humanos , Animales , Hormonas Gonadales/metabolismo , Masculino , Dolor/tratamiento farmacológico , Dolor/metabolismo , Femenino
17.
J Clin Anesth ; 97: 111533, 2024 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-38880002

RESUMEN

STUDY OBJECTIVE: Spinal anesthesia often causes hypotension, with consequent risk to the fetus. The use of vasopressor agents has been highly recommended for the prevention of spinal anesthesia-induced hypotension during caesarean delivery. Many studies have shown that norepinephrine can provide more stable maternal hemodynamics than phenylephrine. We therefore tested the hypothesis that norepinephrine preserves fetal circulation better than phenylephrine when used to treat maternal hypotension consequent to spinal anesthesia. DESIGN: Prospective, randomized, double-blinded study. SETTING: Operating room. PATIENTS: We recruited 223 parturients with uncomplicated singleton pregnancies who were scheduled for elective caesarean section under combined spinal-epidural anesthesia. INTERVENTIONS: The patients received prophylactic intravenous infusion of either 0.08 µg/kg/min norepinephrine or 0.5 µg/kg/min phenylephrine for prevention of spinal anesthesia-induced hypotension. MEASUREMENTS: Changes in fetal heart rate and fetal cardiac output before and after spinal anesthesia were measured using noninvasive Doppler ultrasound. MAIN RESULTS: 90 subjects who received norepinephrine infusion and 93 subjects who received phenylephrine infusion were ultimately analyzed in the present study. The effects of norepinephrine and phenylephrine on the change of fetal heart rate and fetal cardiac output at 3 and 6 min after spinal block were similar. Although there was a statistically significant decrease in fetal cardiac output at 6 min after subarachnoid block initiation in both the norepinephrine group (mean difference 0.02 L/min; 95% CI, 0-0.04 L/min; P = 0.03) and the phenylephrine group (mean difference 0.02 L/min; 95% CI, 0-0.04 L/min; P = 0.02), it remained within the normal range. CONCLUSIONS: Prophylactic infusion of comparable doses of phenylephrine or norepinephrine has similar effects on fetal heart rate and cardiac output changes after spinal anesthesia. Neither phenylephrine nor norepinephrine has meaningful detrimental effects on fetal circulation or neonatal outcomes.

18.
Adv Sci (Weinh) ; 11(22): e2400485, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38552151

RESUMEN

Immunotherapy is showing good potential for colorectal cancer therapy, however, low responsive rates and severe immune-related drug side effects still hamper its therapeutic effectiveness. Herein, a highly stable cerasomal nano-modulator (DMC@P-Cs) with ultrasound (US)-controlled drug delivery capability for selective sonodynamic-immunotherapy is fabricated. DMC@P-Cs' lipid bilayer is self-assembled from cerasome-forming lipid (CFL), pyrophaeophorbid conjugated lipid (PL), and phospholipids containing unsaturated chemical bonds (DOPC), resulting in US-responsive lipid shell. Demethylcantharidin (DMC) as an immunotherapy adjuvant is loaded in the hydrophilic core of DMC@P-Cs. With US irradiation, reactive oxygen species (ROS) can be effectively generated from DMC@P-Cs, which can not only kill tumor cells for inducing immunogenic cell death (ICD), but also oxidize unsaturated phospholipids-DOPC to change the permeability of the lipid bilayers and facilitate controlled release of DMC, thus resulting in down-regulation of regulatory T cells (Tregs) and amplification of anti-tumor immune responses. After intravenous injection, DMC@P-Cs can efficiently accumulate at the tumor site, and local US treatment resulted in 94.73% tumor inhibition rate. In addition, there is no detectable systemic toxicity. Therefore, this study provides a highly stable and US-controllable smart delivery system to achieve synergistical sonodynamic-immunotherapy for enhanced colorectal cancer therapy.


Asunto(s)
Neoplasias Colorrectales , Inmunoterapia , Linfocitos T Citotóxicos , Linfocitos T Reguladores , Neoplasias Colorrectales/terapia , Neoplasias Colorrectales/inmunología , Inmunoterapia/métodos , Animales , Ratones , Linfocitos T Reguladores/inmunología , Linfocitos T Citotóxicos/inmunología , Modelos Animales de Enfermedad , Humanos , Liposomas/química , Nanopartículas/química , Línea Celular Tumoral , Sistemas de Liberación de Medicamentos/métodos
19.
Sci Rep ; 14(1): 10206, 2024 05 03.
Artículo en Inglés | MEDLINE | ID: mdl-38702334

RESUMEN

Cardiovascular function and adipose metabolism were markedly influenced under high altitudes. However, the interplay between adipokines and heart under hypoxia remains to be elucidated. We aim to explore alterations of adipokines and underlying mechanisms in regulating cardiac function under high altitudes. We investigated the cardiopulmonary function and five adipokines in Antarctic expeditioners at Kunlun Station (4,087 m) for 20 days and established rats exposed to hypobaric hypoxia (5,000 m), simulating Kunlun Station. Antarctic expeditioners exhibited elevated heart rate, blood pressure, systemic vascular resistance, and decreased cardiac pumping function. Plasma creatine phosphokinase-MB (CK-MB) and platelet-endothelial cell adhesion molecule-1 (sPecam-1) increased, and leptin, resistin, and lipocalin-2 decreased. Plasma leptin significantly correlated with altered cardiac function indicators. Additionally, hypoxic rats manifested impaired left ventricular systolic and diastolic function, elevated plasma CK-MB and sPecam-1, and decreased plasma leptin. Chronic hypoxia for 14 days led to increased myocyte hypertrophy, fibrosis, apoptosis, and mitochondrial dysfunction, coupled with reduced protein levels of leptin signaling pathways in myocardial tissues. Cardiac transcriptome analysis revealed leptin was associated with downregulated genes involved in rhythm, Na+/K+ transport, and cell skeleton. In conclusion, chronic hypoxia significantly reduced leptin signaling pathways in cardiac tissues along with significant pathological changes, thus highlighting the pivotal role of leptin in regulation of cardiac function under high altitudes.


Asunto(s)
Altitud , Hipoxia , Leptina , Transducción de Señal , Leptina/metabolismo , Leptina/sangre , Animales , Ratas , Masculino , Hipoxia/metabolismo , Hipoxia/fisiopatología , Humanos , Mal de Altura/metabolismo , Mal de Altura/fisiopatología , Miocardio/metabolismo , Miocardio/patología , Adulto , Corazón/fisiopatología
20.
Pain ; 2024 Aug 06.
Artículo en Inglés | MEDLINE | ID: mdl-39106454

RESUMEN

ABSTRACT: Menopausal and postmenopausal women, characterized by a significant reduction in ovarian hormones, have a high prevalence of chronic pain with great pain intensity. However, the underlying mechanism of hyperalgesia induced by ovarian hormone withdrawal remains poorly understood. Here, we report that decreases in the activity and excitability of GABAergic neurons in the dorsal raphe nucleus (DRN) are associated with hyperalgesia induced by ovariectomy in mice. Supplementation with 17ß-estradiol, but not progesterone, is sufficient to increase the mechanical pain threshold in ovariectomized (OVX) mice and the excitability of DRN GABAergic (DRNGABA) neurons. Moreover, activation of the DRNGABA neurons projecting to the lateral parabrachial nucleus was critical for alleviating hyperalgesia in OVX mice. These findings show the essential role of DRNGABA neurons and their modulation by estrogen in regulating hyperalgesia induced by ovarian hormone withdrawal, providing therapeutic basis for the treatment of chronic pain in physiological or surgical menopausal women.

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