Lung protection effect of EIT-based individualized protective ventilation strategy in patients with partial pulmonary resection.

OBJECTIVE: This study aimed to evaluate the lung protection effect of an individualized protective ventilation strategy based on lung impedance tomography (EIT) technology in patients with partial pulmonary resection. PATIENTS AND METHODS: Eighty patients of any gender, American Society of Anesthesiologists (ASA) classification I-II, age 30-64 years and body mass index (BMI) 18-28 kg/m2 who underwent elective thoracoscopic partial lung resection were selected and divided into 2 groups (n=40) using the random number table method: [positive end-expiratory pressure (PEEP) by electrical impedance tomography (EIT)] PEEPEIT group (experimental group) and control group. The PEEPEIT group used volume-controlled ventilation after one-lung ventilation, setting a tidal volume of 6 ml/kg and titrating the optimal PEEP value by EIT. Group C used volume-controlled ventilation after one-lung ventilation, setting a tidal volume of 6 ml/kg and a PEEP of 5 cm H2O. Clinical data were collected and recorded at 5 min after double lung ventilation (T0), single lung ventilation, 30 min after PEEP setting (T1), 60 min after PEEP setting (T2), the end of surgery, 10 min after resumption of double lung ventilation (T3) and 10 min after removal of the tracheal tube (T4), and serum surface active substance-associated protein-A (SP-A) concentrations were measured at T0, T3 and 1 d after surgery (T5). RESULTS: PEEP values were higher in the PEEPEIT group than in the control group at T1 and T2 (p-value <0.05); oxygenation index (OI) was higher in the PEEPEIT group compared to the control group at T2 and T3 (p-value <0.05); pulmonary dynamic compliance (Cdyn) was higher in the PEEPEIT group compared to the control group at T1 and T2 (p-value <0.05); intrapulmonary shunt rate (Qs/Qt) was lower in the PEEPEIT group compared to the control group at T1, T2 and at T3, the intrapulmonary shunt rate (Qs/Qt) was reduced in the PEEPEIT group compared to group C (p-value <0.05); at T5, the SP-A protein was reduced in the PEEPEIT group compared to group C. There was no statistically significant difference in the incidence of postoperative pulmonary complications between the two groups (p-value >0.05). CONCLUSIONS: The EIT-guided individualized protective ventilation strategy has a lung-protective effect in patients undergoing thoracoscopic partial lung resection.

Tirofiban combined with rt-PA intraarterial thrombolysis improves the recanalization rate of acute middle cerebral artery occlusion in rabbits.

OBJECTIVE: To investigate the curative effect of tirofiban combined with recombinant tissue-plasminogen activator (rt-PA) selective intra-arterial thrombolysis on acute middle cerebral artery occlusion (MCAO). MATERIALS AND METHODS: A total of 60 adult male Japanese white rabbits weighing 2.5-3.0 kg were selected, and the acute cerebral infarction model was established via autologous thromboembolism of middle cerebral artery. Rabbits were randomly divided into 4 groups: tirofiban group (Ti group, 5 µg/kg, n=15), rt-PA group (rt-PA group, 2 mg/kg, n=15), tirofiban + rt-PA group (Ti + rt-PA group, 3 µg/kg Ti + 1 mg/kg rt-PA, n=15), and control group (Co group, n=15). The vascular recanalization rate of intra-arterial thrombolysis was observed via digital subtraction angiography (DSA), relative apparent diffusion coefficient (rADC) was observed via diffusion-weighted imaging (DWI), and neurologic impairment was observed via modified Bederson's scoring method. Rabbits were executed after 24 h, then the volume of cerebral infarction was measured via triphenyl tetrazolium chloride (TTC) staining, pathological examinations were performed using the optical microscope and electron microscope, and immunohistochemical examination was performed for brain-derived neurotrophic factor (BDNF). RESULTS: In Ti + rt-PA group, the vascular recanalization rate was 91.7%, and there was no significant bleeding in pathological examination. The rADC value, neurologic impairment score and cerebral infarction area in Ti + rt-PA group were superior to those in Co group, Ti group and rt-PA group. Immunohistochemical results of BDNF showed that the expression of BDNF in Ti + rt-PA group was increased compared with those in Co group, Ti group and rt-PA group. In Ti group and rt-PA group, there were neuronal degeneration, moderate organelle swelling, moderate mitochondrial swelling, enlarged volume and decreased number of cristae, and rupture and disappearance of some mitochondrial cristae. In Co group, neuronal karyopyknosis, nuclear chromatolysis and disappearance of cellular structure could be seen. Results of electron microscopy showed that the shape of neuronal nuclei in Ti + rt-PA group was basically normal, and there were mild mitochondrial swelling and enlarged volume of cristae. CONCLUSIONS: Early application of tirofiban combined with rt-PA in intra-arterial thrombolysis for ultra-early cerebral ischemia can improve the recanalization rate of cerebral artery. The time of cerebral ischemia and hypoxia is short, and the neuronal ischemia-reperfusion injury is mild, whose thrombolysis effect is better than the single application of tirofiban or rt-PA.

Intermedin1-53 protects cardiac function in rats with septic shock via inhibiting oxidative stress and cardiomyocyte apoptosis.

OBJECTIVE: To investigate the protective effect of intermedin1-53 (IMD1-53) on cardiac function in rats with septic shock and its underlying mechanism. MATERIALS AND METHODS: Twenty-four male Sprague-Dawley (SD) rats were randomly assigned into three groups, namely the control group (NC group), septic shock group (ET group) and IMD1-53 treatment group (IMD group), with 8 rats in each group. Levels of hemodynamic indicators, blood glucose, lactate acid, CK-MB (creatine kinase-MB) and cTnI (cardiac troponin I) in rats were determined. Cardiac tissues of rats were collected for TUNEL (terminal dexynucleotidyl transferase (TdT)-mediated dUTP nick end labeling) staining. Protein levels of caspase-3, caspase-9, Bax, Bcl2, iNOS (inducible nitric oxide synthase) and COX-2 (cyclooxygenase-2) in cardiac tissues were detected by Western blot. Moreover, activities of SOD (superoxide dismutase), CAT (catalase) and MDA (malondialdehyde) in myocardial homogenate were determined, thereby exploring the effect of IMD1-53 on oxidative stress and cardiomyocyte apoptosis in rats with septic shock induced by endotoxin. RESULTS: Lower levels of mean arterial blood pressure (MABP), maximum rate of left ventricular diastolic pressure (+LVdp/dtmax) and left ventricular systolic pressure (LVSP) were observed in ET group than those of NC group (p < 0.05). Levels of lactic acid, blood glucose, CK-MB and cTnI in ET group were remarkably increased than those of NC group (p < 0.05). Moreover, activities of SOD and CAT in myocardial homogenate of ET group were remarkably reduced in comparison with those of NC group (p < 0.05). Protein levels of caspase-3, caspase-9, Bcl-2, Bax, iNOS and COX-2 in ET group were all remarkably elevated than those of NC group (p < 0.05). The above indicators were all significantly improved in IMD group than those of ET group (p < 0 05). CONCLUSIONS: IMD1-53 can protect cardiac function in rats with septic shock via inhibiting oxidative stress and cardiomyocyte apoptosis.

Positive Association Between Betatrophin and Diabetic Retinopathy Risk in Type 2 Diabetes Patients.

Betatrophin is a recently identified protein that has been shown to be associated with lipid metabolism and insulin resistance. This study aimed to measure serum betatrophin concentrations in patients with type 2 diabetes (T2DM) and evaluate the association of betatrophin with diabetic retinopthy (DR). Serum betatrophin concentrations were compared between (1) gender-, age- and body mass index-matched T2DM patients with (n=17) or without (n=33) DR; (2) gender-, age-, and body mass index-matched healthy subjects (n=31), newly-diagnosed T2DM patients before treatment (n=24), and T2DM patients under antidiabetic treatment (n=35). Serum betatrophin concentrations were determined by the enzyme-linked immunosorbent assay. Multivariate logistic regression was performed to assess the association between betatrophin concentration and DR. Serum betatrophin concentration was significantly associated with DR in T2DM patients under treatment (Odds Ratio 2.01; 95% Confidence Interval 1.12-3.60; p=0.019). Betatrophin concentrations were significantly increased in treated T2DM patients compared to the healthy subjects (4.17±0.60 vs. 0.54±0.07 ng/ml; p<0.001). Serum betatrophin concentrations are increased in T2DM patients under antidiabetic treatment and positively associated with diabetic retinopathy.

Estimated PBDE and PBB Congeners in soil from an electronics waste disposal site.

This study estimated PBDE and PBB congener emissions into the environment from three different e-waste disposal sites that consisted of rude broilers (RB), acid baths (AB) and end-up dumps (ED). Different PBDE and PBB congener profiles were analyzed, and some of their emission sources were discussed. For the examined sites, the levels of SigmaPBB and SigmaPBDE were highest at ED (SigmaPBB 1943.86 ng/g, dw; SigmaPBDE 990.87 ng/g, dw), followed by RB (SigmaPBB 704.58 ng/g, dw; SigmaPBDE 799.27 ng/g, dw) and finally AB (SigmaPBB 108.78 ng/g, dw; SigmaPBDE 171.18 ng/g, dw). PBE-209 (AB 48.67 ng/g, 28.43%; RB 160.23 ng/g, 20.05%; ED 234.12 ng/g, 23.63%) and PBE-203 (AB 51.23 ng/g, 29.93%; RB 130.34 ng/g, 16.31%; ED 93.41 ng/g, 9.43%) exhibited the highest concentrations when compared to the other congeners. Furthermore, high levels of deca-BDE (BDE-209) were observed in AB (48.67 ng/g, 28.43%) and RB sites (160.23 ng/g, 20.05%), which was in accordance with the large amount of these materials in electronics products in China.

Slow-cooling protocols for microcapsule cryopreservation.

The relatively large size (300-400 microm) and fragile semi-permeable membrane of microcapsules makes them particularly prone to cryodamage. This study investigated slow-cooling protocols for the cryopreservation of microcapsules. Instead of a programmable freezing-machine, slow cooling was carried out directly within a -80 degrees C refrigerator. A range of increasing cryoprotectant (DMSO and EG) concentrations with slow cooling was investigated. The results showed that 2.8 M (20% v/v) DMSO and 2.7 M (15% v/v) EG were optimal for microcapsule cryopreservation, resulting in approximately 55-60% of the microcapsules remaining intact, with a relatively high post-thaw cell viability of 80-85%. Post-thaw cell viability and microcapsule integrity were consistently higher at equivalent molarities of DMSO compared to EG. Hence, all subsequent studies utilized only DMSO. Post-thaw cell viability upon slow cooling with 2.8 M (20% v/v) DMSO was significantly improved in the presence of 0.25 M sucrose (> 95%), but there was no enhancement in microcapsule integrity. Neither post-thaw cell viability nor microcapsule integrity was improved with multi-step exposure and removal of sucrose, compared to a single-step protocol. There was also no improvement in either post-thaw cell viability or microcapsule integrity in the presence of 20% (w/v) Ficoll. Hence, the optimal condition for microcapsule cryopreservation by slow-cooling is with 2.8 M (20% v/v) DMSO and 0.25 M sucrose.