Lipoxin A4 ameliorates lipopolysaccharide-induced lung injury through stimulating epithelial proliferation, reducing epithelial cell apoptosis and inhibits epithelial-mesenchymal transition.

BACKGROUND: Acute respiratory distress syndrome (ARDS) is characterized by alveolar epithelial disruption. Lipoxins (LXs), as so-called "braking signals" of inflammation, are the first mediators identified to have dual anti-inflammatory and inflammatory pro-resolving properties. METHODS: In vivo, lipoxinA4 was administrated intraperitoneally with 1 µg/per mouse after intra-tracheal LPS administration (10 mg/kg). Apoptosis, proliferation and epithelial-mesenchymal transition of AT II cells were measured by immunofluorescence. In vitro, primary human alveolar type II cells were used to model the effects of lipoxin A4 upon proliferation, apoptosis and epithelial-mesenchymal transition. RESULTS: In vivo, lipoxin A4 markedly promoted alveolar epithelial type II cells (AT II cells) proliferation, inhibited AT II cells apoptosis, reduced cleaved caspase-3 expression and epithelial-mesenchymal transition, with the outcome of attenuated LPS-induced lung injury. In vitro, lipoxin A4 increased primary human alveolar epithelial type II cells (AT II cells) proliferation and reduced LPS induced AT II cells apoptosis. LipoxinA4 also inhibited epithelial mesenchymal transition in response to TGF-ß1, which was lipoxin receptor dependent. In addition, Smad3 inhibitor (Sis3) and PI3K inhibitor (LY294002) treatment abolished the inhibitory effects of lipoxinA4 on the epithelial mesenchymal transition of primary human AT II cells. Lipoxin A4 significantly downregulated the expressions of p-AKT and p-Smad stimulated by TGF-ß1 in primary human AT II cells. CONCLUSION: LipoxinA4 attenuates lung injury via stimulating epithelial cell proliferation, reducing epithelial cell apoptosis and inhibits epithelial-mesenchymal transition.

The effect of labor epidural analgesia on maternal-fetal outcomes: a retrospective cohort study.

PURPOSE: To evaluate the impact of labor epidural analgesia on maternal-fetal safety outcomes in a signal Chinese academic medical center. METHODS: A single-intervention impact study was conducted at The Second Affiliated Hospital, Wenzhou Medical University. The study period was divided into three phases: (1) baseline phase: from January 1 and June 30, 2009 when no analgesic method was routinely employed during labor; (2) phase-in period: the epidural analgesia was implemented 8 a.m.-5 p.m. during weekdays; and (3) the post-No Pain Labor N'Delivery phase when the labor epidural was applied 24 h a day, 7 days a week, from June 1, 2010 and June 30, 2011. The maternal-fetal safety outcomes of delivery were compared between the different periods. RESULTS: There were 15,415 deliveries with 42.3% of nulliparous parturients in the 31-month study period. As the primary outcomes, the labor epidural analgesia rate increased from 0 to 57%, the vaginal delivery rate increased, and cesarean delivery rate decreased by 3.5% after full implementation. As the secondary outcomes, the rate of episiotomy and severe perineal injury after the implementation periods were significant decreased. The rate of postpartum oxytocin administration was decreased by 17.8%. No significant difference between the baseline and implementation periods was found in the rate of postpartum hemorrhage, Apgar scores less than 7 at both 1 and 5 min, 7-day mortality, and the overall neonatal intensive care unit admission rate. CONCLUSION: Implementation of labor epidural analgesia increased the vaginal delivery rate and use of labor epidural analgesia is safe to parturients and fetus.

Anatomic variations of neck vessels and the course of pediatric internal jugular veins.

BACKGROUND: Landmark-guided internal jugular vein cannulation is difficult for pediatric patients but useful, especially when ultrasound equipment is unavailable. Therefore, it is important to define the adjacent anatomic characteristics of the pediatric internal jugular vein. METHODS: In 210 children the course of the internal jugular vein, and common carotid and vertebral arteries was measured from the level of the cricoid cartilage to the supraclavicular area using ultrasound. RESULTS: From the level of the cricoid cartilage to the supraclavicular area, vessel diameter increased with internal jugular vein increasing by 12%, and common carotid and vertebral arteries increasing by 5% each. From the level of the cricoid cartilage to the supraclavicular area, the number of patients with a medial common carotid artery position relative to the internal jugular vein increased, whereas those with a lateral position decreased; the number of patients with nonoverlapped common carotid artery-internal jugular vein increased, and those with totally overlapped decreased. In contrast, the overlapping status of vertebral artery-internal jugular vein changes oppositely. More than 97.14% of the vertebral artery lies lateral to the internal jugular vein at these levels. The minimal vertebral artery-internal jugular vein depth decreased from 0.46±0.20 to 0.37±0.19 cm. The angle from the internal jugular vein line to the horizontal line of the body was 83.35±9.04 degrees. CONCLUSION: The common carotid artery and internal jugular vein are farther apart as one moves down the neck, whereas the vertebral artery and internal jugular vein are getting together. Additionally, the diameter of the internal jugular vein increased.

Deficiency of CDKN1A or both CDKN1A and CDKN1B affects the pubertal development of mouse Leydig cells.

Cyclin-dependent kinase inhibitors p21(Cip1) (CDKN1A) and p27(Kip1) (CDKN1B) are expressed in Leydig cells. Previously, we reported that Cdkn1b knockout in the mouse led to increased Leydig cell proliferative capacity and lower steroidogenesis. However, the relative importance of CDKN1A and CDKN1B in these regulations was unclear. In the present study, we examined the relative importance of CDKN1A and CDKN1B in regulation of Leydig cell proliferation and steroidogenesis by whole-body knockout of CDKN1A (Cdkn1a(-/-)) and CDKN1A/CDKN1B double knockout (DBKO). The cell number, 5-bromo-2-deoxyuridine incorporation rate, steroidogenesis, and steroidogenic enzyme mRNA levels and activities of Leydig cells were compared among wild-type (WT), Cdkn1a(-/-), and DBKO mice. Relative to WT mice, Leydig cell number per testis was doubled in the DBKO and unchanged in the Cdkn1a(-/-) mice. Testicular testosterone levels and mRNA levels for luteinizing hormone receptor (Lhcgr), steroidogenic acute regulatory protein (Star), cholesterol side-chain cleavage enzyme (Cyp11a1), 17alpha-hydroxylase/17,20-lyase (Cyp17a1), and 17beta-hydroxysteroid dehydrogenase 3 (Hsd17b3) and their respective proteins were significantly lower in the DBKO mice. However, testicular testosterone level was unchanged in the Cdkn1a(-/-) mice, although Lhcgr mRNA levels were significantly lower relative to those in the WT control. We conclude that Cdkn1a(-/-) did not increase Leydig cell numbers (although a defect of Leydig cell function was noted), whereas DBKO caused a significant increase of Leydig cell numbers but a decrease of steroidogenesis.

In vitro and in vivo characterization of 13 CYP2C9 allelic variants found in Chinese Han population.

Our previous study detected totally 35 CYP2C9 allelic variants in 2127 Chinese subjects, of whom 21 novel alleles were reported for the first time in Chinese populations. The aim of the present study was to characterize the 13 CYP2C9 allelic variants both in vitro and in vivo. Different types of CYP2C9 variants were highly expressed in COS-7 cells, and 50 µM tolbutamide was added as the probing substrate to evaluate their metabolic abilities in vitro. Subsequently, the concentrations of tolbutamide and its metabolite in the plasma and urine within individuals with different types of genotypes were determined by HPLC to evaluate the catalytic activity of the 13 mutant CYP2C9 proteins in vivo. Our results showed that compared with *1/*1 wild-type subjects, subjects with *1/*40 genotype showed increased oral clearance (CL/F), whereas individuals with *1/*3, *1/*13, *3/*3, *3/*13, *1/*16, *1/*19, *1/*34, *1/*42, *1/*45, *1/*46, and *1/*48 genotype exhibited significantly decreased CL/F, and those with *1/*27, *1/*29, *1/*40, and *1/*41 genotype presented similar CL/F value. When expressed in COS-7 cells, the CYP2C9 variants showed similar pattern to the results in clinical study. The study suggests that, besides two typical defective alleles, *3 and *13, seven CYP2C9 allelic variants (*16, *19, *34, *42, *45, *46, and *48) cause defective effects on the enzymatic activities both in vitro and in vivo. In clinic, patients with these defective alleles should be paid close attention to.

Impact of CYP2C9 polymorphism found in the Chinese population on the metabolism of propofol in vitro.

The microsomal CYP2C9 alleles involved in the biotransformation of propofol, a widely used anesthetic agent, were investigated in vitro. To examine the enzymatic activity of the CYP2C9 alleles, kinetic parameters for propofol 4-hydroxylation were determined in recombinant human P450s CYP2C9 microsomes from Sf21 insects cells carrying CYP2C9*1 and other variants. Some of the variants showed decreased enzyme activity compared with the wild type, as previously reported. Two variants (CYP2C9*36 and *56) were found substantially to increase intrinsic clearance relative to the wild type variant. Most variants significantly (p<0.05) decreased intrinsic clearance of propofol compared with the wild type, except *11, *47, and *54. This study is the first to report these rare alleles for propofol metabolism, providing fundamental data for further clinical studies on CYP2C9 alleles for propofol metabolism in vivo.

The effect of clopidogrel on pharmacokinetics of ivabradine and its metabolite in rats.

The present study aimed to investigate the effect of clopidogrel (CLO) on pharmacokinetics of ivabradine (IVA) and its metabolite in rats and develop a reliable method to determine IVA and its metabolite N-demethyl ivabradine in serum. Healthy male SD rats were randomized to be given 0.8 mg/kg IVA or IVA combined with 8 mg/kg CLO. Blood samples were collected at 0.083, 0.16, 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24 h after administration. The serum concentrations of IVA and N-demethyl ivabradine were determined by ultra-performance liquid chromatography-mass spectrometry and pharmacokinetic parameters were calculated using DASver3.0 software. The parameters of AUC(0 - t), AUC(0 - ∞), and Cmax for IVA in the group of IVA + CLO were significantly higher than those in the group of IVA (p < 0.01); the half-time (t1/2) in the IVA + CLO group was extended compared to IVA (p < 0.01) and CL/F was dropped obviously (p < 0.01). The decreases in AUC(0 - t), AUC(0 - ∞), and Cmax for N-demethyl ivabradine in the group of IVA + CLO was significantly compared to the group of IVA (p < 0.01). CL/F was higher than IVA (p < 0.01) and the t1/2 was slightly increased. In this study, we find that CLO restrains the metabolism of IVA into N-demethyl ivabradine, which may be related to its competitive inhibition effect on cytochrome P450 isoform 3A4(CYP3A4).

Establishment of a rat model of type II diabetic neuropathic pain.

OBJECTIVE: To establish a rat model of type II diabetic neuropathic pain. METHODS: Sixty Sprague Dawley rats were randomly divided into two groups: group A (N = 10) was fed a normal diet, and group B (N = 50) was fed a high-fat and high-sugar diet. After 8 weeks, the body weight of all rats was recorded, and rats in both groups had their fasting plasma glucose, insulin concentration, and insulin sensitivity index measured and calculated. Subsequently, the rats in group B were randomly divided into three subgroups that were each given different doses of streptozotocin (STZ) by a single intraperitoneal injection (subgroup B1 received 30 mg/kg, subgroup B2 received 35 mg/kg, and subgroup B3 40 mg/kg). Two weeks after the STZ injection, the four groups of rats had their insulin sensitivity index, mechanical withdrawal threshold, and thermal withdrawal latency assessed, allowing us to establish a rat model of type II diabetic neuropathic pain and to determine the optimum dose of STZ. Four weeks after STZ injection (2 weeks after the model was established), the pain threshold was measured in the rats in group A and the group treated with the most effective STZ dose. We also measured the expression of phosphorylated extracellular signal-regulated kinase (p-ERK), phosphorylated cyclic AMP response element-binding protein (p-CREB), and phosphorylated N-methyl d-aspartate receptor subtype B (p-NR2B) in the dorsal root ganglion (DRG) and spinal cord dorsal horn regions, which are closely related to neuropathic pain, and also recorded the TTX-R sodium currents in the acutely isolated DRG neurons. RESULTS: After 8 weeks of a high-fat, high-sugar diet, the body weight of the rats in group B was significantly increased. Although the fasting blood glucose levels did not change significantly, the fasting insulin levels were slightly elevated, and the insulin sensitivity index was significantly reduced. Two weeks after STZ injection, the blood glucose levels of the rats in subgroup B1 were elevated but did not remain so for a prolonged period. In contrast, the rats in subgroup B3 had elevated blood glucose that was accompanied by a high mortality rate, while the blood glucose levels of the rats in subgroup B2 were moderately elevated and relatively stable. In addition, the pain threshold was significantly decreased (P < 0.05), and the mortality was low in this group. Because of this, the dose of STZ that was used in group B2 was considered the most effective dose of STZ for induction of diabetes. Four weeks after STZ injection, the pain threshold in the rats of group B2 was still significantly decreased, and the expression of p-ERK, p-CREB, and p-NR2B in the dorsal root ganglion (DRG) and spinal cord dorsal horn was significantly increased. The tetrodotoxin-resistant sodium current density in DRG neurons was also significantly elevated (P < 0.05). CONCLUSIONS: A rat model of type II diabetic neuropathic pain can be established by feeding rats a high-fat, high-sugar diet for 8 weeks, in combination with intraperitoneal injection of 35 mg/kg STZ. This model can be stably maintained for at least 2 weeks.

Dose requirements of remifentanil for intubation in nonparalyzed Chinese children.

BACKGROUND: The objective of this study was to determine ED50 and ED95 of remifentanil for intubation combined with propofol in nonparalyzed Chinese children. METHODS: Forty-seven American Society of Anesthesiologists Class I children aged 4-11 years weighing 14-33.5 kg underwent general anesthesia with 2.5 mg·kg(-1) of intravenous propofol followed by remifentanil in Wenzhou, China. The initial dose of remifentanil was 2.5 µg·kg(-1) injected over 60 s. Intubation was attempted 30 s after the completion of remifentanil injection. Level of difficulty to intubate was graded on a scoring system. If the initial intubation condition was deemed satisfactory, subsequent remifentanil doses were decreased by 0.25 µg·kg(-1). If the intubating condition was deemed unsatisfactory, subsequent remifentanil doses were increased by 0.25 µg·kg(-1). Mean arterial pressure, heart rate, and pulse oximetry were documented before and after induction, immediately after intubation, and 1 min after intubation. RESULTS: The ED50 of remifentanil used to render a satisfactory intubating condition used in combination with 2.5 mg·kg(-1) of propofol in nonparalyzed Chinese children was 2.30 µg·kg(-1) (95% confidence interval: 2.28-2.31 µg·kg(-1)), and the ED95 is 2.75 µg·kg(-1) (95% confidence interval: 2.59-3.35 µg·kg(-1)). These doses were lower than previously reported. CONCLUSION: When used in combination with 2.5 mg·kg(-1) of intravenous propofol, ED50 and ED95 of remifentanil for adequate intubation in nonparalyzed children were lower than previously reported, at 2.30 and 2.75 µg·kg(-1), respectively.

Time-course changes of steroidogenic gene expression and steroidogenesis of rat Leydig cells after acute immobilization stress.

Leydig cells secrete testosterone, which is essential for male fertility and reproductive health. Stress increases the secretion of glucocorticoid (corticosterone, CORT; in rats), which decreases circulating testosterone levels in part through a direct action by binding to the glucocorticoid receptors (NR3C1) in Leydig cells. The intratesticular CORT level is dependent on oxidative inactivation of glucocorticoid by 11ß-hydroxysteroid dehydrogenase 1 (HSD11B1) in Leydig cells. In the present study, we investigated the time-course changes of steroidogenic gene expression levels after acute immobilization stress in rats. The plasma CORT levels were significantly increased 0.5, 1, 3 and 6 h after immobilization stress, while plasma testosterone levels were significantly reduced 3 and 6 h, after stress and luteinizing hormone (LH) did not change. Immobilization stress caused the down-regulation of Scarb1, Star and Cyp17a1 expression levels in the rat testis starting at the first hour of stress, ahead of the significant decreases of plasma testosterone levels. Other mRNA levels, including Cyp11a1, Hsd3b1 and Hsd17b3, began to decline after 3 h. Hsd11b1 and Nos2 mRNA levels did not change during the course of stress. Administration of glucocorticoid antagonist RU486 significantly restored plasma testosterone levels. In conclusion, Scarb1, Star and Cyp17a1 expression levels are more sensitive to acute stress, and acute immobilization stress causes the decline of the steroidogenic pathway via elevating the levels of glucocorticoid, which binds to NR3C1 in Leydig cells to inhibit steroidogenic gene expression.

Lipoxin A(4) activates alveolar epithelial sodium channel, Na,K-ATPase, and increases alveolar fluid clearance.

Edema fluid resorption is critical for gas exchange, and both alveolar epithelial sodium channel (ENaC) and Na,K-ATPase are accredited with key roles in the resolution of pulmonary edema. Alveolar fluid clearance (AFC) was measured in in situ ventilated lungs by instilling isosmolar 5% BSA solution with Evans Blue-labeled albumin tracer (5 ml/kg) and measuring the change in Evans Blue-labeled albumin concentration over time. Treatment with lipoxin A4 and lipoxin receptor agonist (5(S), 6(R)-7-trihydroxymethyl 17 heptanoate) significantly stimulated AFC in oleic acid (OA)-induced lung injury, with the outcome of decreased pulmonary edema. Lipoxin A4 and 5(S), 6(R)-7-trihydroxymethyl 17 heptanoate not only up-regulated the ENaC α and ENaC γ subunits protein expression, but also increased Na,K-ATPase α1 subunit protein expression and Na,K-ATPase activity in lung tissues. There was no significant difference of intracellular cAMP level between the lipoxin A4 treatment and OA group. However, the intracellular cGMP level was significantly decreased after lipoxin A4 treatment. The beneficial effects of lipoxin A4 were abrogated by butoxycarbonyl-Phe-Leu-Phe-Leu-Ph (lipoxin A4 receptor antagonist) in OA-induced lung injury. In primary rat alveolar type II epithelial cells stimulated with LPS, lipoxin A4 increased ENaC α and ENaC γ subunits protein expression and Na,K-ATPase activity. Lipoxin A4 stimulated AFC through activation of alveolar epithelial ENaC and Na,K-ATPase.

Mono-carbonyl curcumin analogues as 11ß-hydroxysteroid dehydrogenase 1 inhibitors.

A series of structurally novel mono-carbonyl curcumin analogues have been synthesized and biologically evaluated to test their inhibitory potencies and the structure-activity relationship (SAR) on human and rat 11ß-hydroxysteroid dehydrogenase isoform (11ß-HSD1) activities. 11ß-HSD1 selective inhibitors have been discovered and compound A10 is discovered as a very potent with an IC50 value of 97 nM without inhibiting 11ß-HSD2.

Contribution of CFTR to alveolar fluid clearance by lipoxin A4 via PI3K/Akt pathway in LPS-induced acute lung injury.

The lipoxins are the first proresolution mediators to be recognized and described as the endogenous "braking signals" for inflammation. We evaluated the anti-inflammatory and proresolution bioactions of lipoxin A4 in our lipopolysaccharide (LPS-)induced lung injury model. We demonstrated that lipoxin A4 significantly improved histology of rat lungs and inhibited IL-6 and TNF- α in LPS-induced lung injury. In addition, lipoxin A4 increased alveolar fluid clearance (AFC) and the effect of lipoxin A4 on AFC was abolished by CFTRinh-172 (a specific inhibitor of CFTR). Moreover, lipoxin A4 could increase cystic fibrosis transmembrane conductance regulator (CFTR) protein expression in vitro and in vivo. In rat primary alveolar type II (ATII) cells, LPS decreased CFTR protein expression via activation of PI3K/Akt, and lipoxin A4 suppressed LPS-stimulated phosphorylation of Akt. These results showed that lipoxin A4 enhanced CFTR protein expression and increased AFC via PI3K/Akt pathway. Thus, lipoxin A4 may provide a potential therapeutic approach for acute lung injury.

[Effects of lipoxinA4 on endoplasmic reticulum stress during myocardial ischemia reperfusion injury in rats].

OBJECTIVE: To explore the protective effect of lipoxin (LX)A4 during myocardial ischemia reperfusion injury (MIRI) and discuss the molecular mechanism of excessive endoplasmic reticulum stress (ERS) in rats. METHODS: Seventy-two male SD rats were divided into 6 groups, according to random number table, 12 in each group: sham operation group (group sham)1, 2: injected with normal saline (NS) 2 ml/kg before and after coronary artery threading. MIRI group (group I/R)1, 2: injected with NS 2 ml/kg before and after MIRI. Group LX1, LX2: injected with LXA4 100 µg/kg in 2 ml/kg NS before and after MIRI treatment. After the rat MIRI model was established, the serum concentrations of troponin I (cTnI) were measured in each group before open-chest operation (T1) and at the end of the experiment (T2). Besides, expressions of GRP-78, caspase-12 protein and mRNA were test. At the same time, myocardial cell apoptosis, the myeloperoxidase (MPO), superoxide dismutase (SOD) activation and malondialdehyde (MDA) content were detected while the HE and ultrastructural changes of cardiac muscle were observed. RESULTS: The expression levels of GRP-78, caspase-12 protein and mRNA, apoptotic index, serum cTnI concentrations (T2) and MPO, SOD activation, MDA content were all significantly higher in groups I/R and LX than those in group sham 1 and sham 2 (all P < 0.05). The expression levels of GRP-78, caspase-12 protein in group LX1 (compared with group I/R1) and in group LX2 (compared with group I/R2) were all significantly lower (all P < 0.05). Besides, the expression of GRP-78, caspase-12 mRNA in group LX1 were significantly less than those in group I/R1 ((0.86 ± 0.06)×10(5) vs (1.95 ± 0.65)×10(5), (12.35 ± 4.15)×10(5) vs (23.76 ± 6.57) ×10(5), both P < 0.05), so were those in groups LX2 and I/R2 ((0.64 ± 0.05)×10(5) vs (2.36 ± 0.57)×10(5), (7.04 ± 0.81)×10(5) vs (26.49 ± 6.82)×10(5), both P < 0.05). The apoptotic index, the serum concentrations of cTnI (T2), MPO activation and MDA content were all significantly lower in group LX1 than those in group I/R1 (34.6% ± 5.7% vs 52.5% ± 6.4%, (293 ± 22) vs (581 ± 44) ng/L, (176 ± 47) vs (331 ± 94) U/g tissue, (1549 ± 238) vs (2403 ± 439) nmol/g protein, both P < 0.05), so were those in groups LX2 and I/R2(26.5% ± 4.6% vs 54.8% ± 6.3%, (207 ± 29) vs (593 ± 61) ng/L, (99 ± 24) vs (329 ± 92) U/g tissue, (1055 ± 237) vs (2422 ± 518) nmol/g protein, all P < 0.05). In addition, the activity of SOD in groups LX1 and LX2 were both significantly higher respectively than those in groups I/R1 and I/R2 (both P < 0.05). Moreover, compared with groups I/R1 and I/R2, the neutrophils infiltration were significantly less than those in groups LX1 and LX2 respectively, and the ultrastructure damage were also much milder. CONCLUSIONS: Before and after MIRI, application of LXA4 may significantly inhibit neutrophil infiltration and attenuate myocardial oxidative injury. LXA4 play its role in myocardial protection via down-regulating the expression of GRP-78, caspase-12 and the inhibition of excessive ERS.

[Comparison of efficacy for laryngeal mask airway-Supreme(TM) versus common laryngeal mask airway in children].

OBJECTIVE: To compare the efficacy of laryngeal mask airway-Supreme(TM) versus common laryngeal mask airway in children with general anesthesia. METHODS: With local research ethics committee's approval and written informed parental consent, 100 children were randomly divided into groups L (size 2.0 common laryngeal mask airway) and S (size 2.0 laryngeal mask airway-Supreme(TM)) according to random number (n = 50 each). After anesthesia induction, a common laryngeal mask airway or laryngeal mask airway-Supreme(TM) was inserted and mechanically ventilated. Time and ease for insertion, insertion success rate, airway leak pressure, success rate and ease of disposal sputum collecting tube insertion in group S, quality of airway during anesthetic maintenance, abdominal circumference changes and complications within 24 h post-operation were measured. RESULTS: Compared with group L, abdominal circumference increased less in group S (0.90 ± 0.35 vs 0.43 ± 0.18 cm, n = 46, P < 0.01). No significant inter-group differences existed for other measurements. Disposal sputum collecting tube was successfully placed in group S(100%). CONCLUSION: In children with mechanical ventilation, laryngeal mask airway-Supreme(TM) can be effectively applied to maintain a good airway. And the incidence of gastric insufflation is lower. It is particularly useful for those requiring evacuation of gastric contents during general anesthesia.

[Protective effect of curcumin against Aß25-35-induced neurotoxicity in differentiated PC12 cells].

OBJECTIVE: To explore the effects of curcumin on the expression of high mobility group box1 (HMGB1) , cell viability and morphology in a cellular model of Alzheimer's disease (AD). METHODS: Cultured PC12 cells in logarithmic growth phase were divided into 5 groups: normal cell group (A, non-treatment), model control group (B, 20 µmol/L Aß25-35), curcumin treatment group (C, 20 µmol/L Aß25-35+1 µmol/L Cur), Aß25-35+rHMG1 (D, 20 µmol/L Aß25-35+500 ng/ml HMGB1) and solvent control group (E, 20 µmol/L Aß25-35+1 µl/ml DMSO). Cell viability was examined by methyl thiazolyl tetrazolium (MTT). And the cellular expression and distribution of HMGB1 were detected by immunofluorescence and Western blot 24 hours later. RESULTS: Compared with group A, the levels of cell viability in groups B, D and E significantly declined (0.76 ± 0.06, 0.63 ± 0.02, 0.75 ± 0.03 vs 1.22 ± 0.06, P < 0.05) while the expression of HMGB1 increased (1.19 ± 0.14, 1.12 ± 0.16, 1.16 ± 0.09 vs 0.85 ± 0.04, P < 0.05). Compared with group B, cell viability in group C significantly increased by 33% (1.01 ± 0.05, P < 0.05) while the expression of HMGB1 declined by 31% (0.78 ± 0.03, P < 0.05). A larger amount of extracellular HMGB1 was released in group B compared with group A. And the extracellular release of HMGB1 declined less in group C versus group B. CONCLUSION: Curcumin may reduce Aß25-35-induced cytotoxicity through a down-regulated expression of HMGB1 and an inhibition of extracellular release of HMGB1 in PC12 cell.

Effects of breviscapine on pulmonary inflammatory response and lung injury in children undergoing open heart surgery.

This study examined the effects of breviscapine (1) on pulmonary inflammatory response and lung function in pediatric patients undergoing open heart surgery. Forty-five children (ASA II or III, aged 2-72 months) were randomly assigned to control group (saline, Group C), low dose 1 group (0.5 mg/kg, Group Bre0.5), and high dose 1 group (1.0 mg/kg, Group Bre1.0), 15 cases each group. Plasma concentrations of procalcitonin (PCT) and neutrophil elastase (NE) were measured and compared at different time points. Plasma concentrations of PCT and NE were increased after cardiopulmonary bypass (CPB) induction, and the concentrations were lower in 1-treated groups. The present results indicated that continuous infusion of 1 before the CPB suppressed the production of PCT and NE attenuated systemic inflammatory response, which could result in lung protective effect in children undergoing open heart surgery.

[Application of ultrasound guidance for ilioinguinal or iliohypogastric nerve block in pediatric inguinal surgery].

OBJECTIVE: To evaluate the efficacy of ultrasound guidance for ilioinguinal or iliohypogastric nerve block in pediatric outpatients undergoing inguinal surgery. METHODS: The present study was approved by the ethics committee of our hospital. One hundred children with ASA status I, aged 4 - 8 years old, scheduled for unilateral inguinal surgery were randomly divided into ultrasound group (Group U) and traditional group (Group T) (n = 50 each). Upon entering operation room, they were monitored by electrocardiography (ECG), heart rate (HR) and oxygen saturation (SpO(2)). After an induction of general anesthesia, intravenous access was established and laryngeal mask inserted with spontaneous breathing. Intraoperative anesthesia was maintained with 2% sevoflurane in 50% nitrous oxide with 50% oxygen. Children in Group U received an ilioinguinal or iliohypogastric block under ultrasonic guidance with a mixture of 0.8% lidocaine and 0.25% levobupivacaine at 0.2 ml/kg while those in Group T performed according to the traditional method of anatomical localization with the same local anesthetic at 0.3 ml/kg. During surgery, the vital signs of HR, respiratory rate (RR), SpO(2), partial pressure of end-tidal carbon dioxide (P(ET)CO(2)) and exhaled sevoflurane concentration were recorded. Additional intraoperative analgesic requirements were recorded. Face legs activity cry consolability (FLACC) score was used to assess the pain score postoperatively at recovery time, 2 and 4 h postoperation respectively. If the pain score was above 3, the child received acetaminophen rectally. The number of postoperative rectal acetaminophen was recorded. The degrees of parental satisfaction were investigated at 2 and 4 h postoperation. Intra-or postoperative adverse events were also recorded. RESULTS: HR at skin incision and sac traction in Group U was significantly lower than those in Group T (P < 0.05). Six children (12%) needed to increase inhaled sevoflurane concentration during operation in Group U versus 17 (34%) in Group T (P < 0.05). The pain score at recovery time, 2 and 4 h postoperation in Group U was significantly lower than those in T group (P < 0.05). Only 4 children (8%) needed postoperative rectal acetaminophen in Group U versus 13 (26%) in Group T (P < 0.05). The degree of parental satisfaction at 2 h postoperation was significantly higher in Group U than that in Group T (P < 0.05). One case in Group T had needle puncturing into blood vessels. No other adverse event was observed in two groups. CONCLUSION: The method of ultrasonic guidance for ilioinguinal or iliohypogastric nerve block is both feasible and effective. It can not only enhance the effect of nerve block, reduce the occurrences of complications, lower the quantity of local anesthetic and alleviate the medicinal toxicity.

[Influence of P2Y12 receptor inhibitor on pain threshold and spinal p38MAPK in rat bone cancer pain model].

OBJECTIVE: To investigate the role of P2Y12 receptor in rat bone cancer pain model and its influence on p38MAPK (Mitogen-activated protein kinase). METHOD: A total of forty female SD rats, weighting 200 - 250 g, were randomly divided into 5 groups (n = 8): normal group (group N), sham group (group S), vehicle group (group DA), cancer group (group A), and analgesia group (group MA). Rats in group N were untreated, rats in group S were injected with Hank's solution 10 µl into the left tibial metaphysis; rats in group DA, group A and group MA were injected with Walker 256 cancer cells (10 µl, 2×107 cells/ml) into the left tibial metaphysic to establish the model of bone cancer pain. Catheterization was simultaneously made in four groups between L3 and L4 vertebra except group N. Saline (0.9%, 15 µl) was injected in group S and group A, DMSO (5%, 15 µl) was injected in group DA, and MRS2395 (400 pmol/µl, 15 µl) was injected in group MA on day 9 to 12 post-inoculation. Mechanical withdrawal thresholds were measured on left hind paw before and every 10 min after intrathecal injection. Rats were euthanized after measuring mechanical withdrawal threshold at day 12 post-inoculation. L4-6 sections of spinal cord were collected to determine the expression of p-p38MAPK by immunohistochemistry and immunofluorescent. RESULT: Compared to that in group N (36.1 g ± 4.0 g) and group S (38.9 g ± 5.2 g), mechanical withdrawal thresholds in group MA (19.8 g ± 5.0 g) were decreased on day 9 post-inoculation (P < 0.01), and the expression of p-p38MAPK in spinal cord was increased on day 12 (P < 0.01). Compared to that in group DA (17.7 g ± 3.0 g) and group A (19.1 g ± 2.5 g), mechanical withdrawal threshold in group MA was obviously increased after intrathecal injection, peaked at (26.5 g ± 4.7 g) (P < 0.05); compared with group DA (number 43.4 ± 3.8, IOD 569 ± 27) and group A(number 45.0 ± 2.6, IOD 594 ± 22), the expression level of p-p38MAPK in spinal cord in group MA at day 12 was significantly decreased (number 20.9 ± 2.2, IOD 246 ± 25) (P < 0.01); Mechanical withdrawal threshold in group MA was still lower than group N and group S, while the expression of p-p38MAPK was higher than group N (number 9.9 ± 2.4, IOD 82 ± 28) and group S (number 10.9 ± 2.2, IOD 109 ± 25) (P < 0.01). Immunofluorescent showed that p-p38MAPK was colocalized with microglia in spinal dorsal horn, but not with neurons and astrocytes. CONCLUSIONS: These results demonstrate rat bone cancer pain could partially relieved after intrathecal injection of P2Y12 receptor inhibitor MRS2395 through inhibiting the phosphorylation of p38MAPK in spinal dorsal horn.

Morphological and proteomic analysis of early stage of osteoblast differentiation in osteoblastic progenitor cells.

Bone remodeling relies on a dynamic balance between bone formation and resorption, mediated by osteoblasts and osteoclasts, respectively. Under certain stimuli, osteoprogenitor cells may differentiate into premature osteoblasts and further into mature osteoblasts. This process is marked by increased alkaline phosphatase (ALP) activity and mineralized nodule formation. In this study, we induced osteoblast differentiation in mouse osteoprogenitor MC3T3-E1 cells and divided the process into three stages. In the first stage (day 3), the MC3T3-E1 cell under osteoblast differentiation did not express ALP or deposit a mineralized nodule. In the second stage, the MC3T3-E1 cell expressed ALP but did not form a mineralized nodule. In the third stage, the MC3T3-E1 cell had ALP activity and formed mineralized nodules. In the present study, we focused on morphological and proteomic changes of MC3T3-E1 cells in the early stage of osteoblast differentiation - a period when premature osteoblasts transform into mature osteoblasts. We found that mean cell area and mean stress fiber density were increased in this stage due to enhanced cell spreading and decreased cell proliferation. We further analyzed the proteins in the signaling pathway of regulation of the cytoskeleton using a proteomic approach and found upregulation of IQGAP1, gelsolin, moesin, radixin, and Cfl1. After analyzing the focal adhesion signaling pathway, we found the upregulation of FLNA, LAMA1, LAMA5, COL1A1, COL3A1, COL4A6, and COL5A2 as well as the downregulation of COL4A1, COL4A2, and COL4A4. In conclusion, the signaling pathway of regulation of the cytoskeleton and focal adhesion play critical roles in regulating cell spreading and actin skeleton formation in the early stage of osteoblast differentiation.