[Neuroprotective effect of ginsenoside Rb-1 on a rat model of Alzheimer's disease].

Objective: To investigate the protective mechanism of ginsenoside Rb-1 on the brain in a rat model of Alzheimer's disease. Methods: Fifty-six male Sprague-Dawley rats were randomly divided into control group, model group, low-dose Rb-1 group (Rb-1: 25 mg•kg(-1)•d(-1)) and high-dose Rb-1 group (Rb-1:50 mg•kg(-1)•d(-1)). Morris water maze was designed to observe the changes of learning and memory ability in rats. Flow cytometry was used to detect the apoptosis of hippocampal neurons. Immunohistochemistry and Western blot were employed to detect the expression levels of apoptosis-related genes (p53, Bax, cytochrome C (Cyto C), Caspase-3 and caspase-9) and anti-oxidative stress-associated genes (nuclear Factor-E2-related factor 2 (Nrf2), kelch-like ECH-associated protein 1 (keap-1), heme oxygenase 1(HO-1) and NADPH quinone dehydrogenase 1 (NQO1)).The activities of catalase (CAT), glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) were detected by relevant kits. ANOVA and Tukey-Kramer test were used for statistical analysis. Results: The learning and memory ability of rats in the model group was lower than that of the control group (P<0.01).The learning and memory ability of rats in the high-dose Rb-1 treatment group was significantly higher than that of the model group [(80±8) s vs (100±11) s, t=5.390, P<0.01]. The expression levels of apoptosis-related genes (p53, Bax, Cyto C, caspase-3 and caspase-9) in the model group were significantly higher than those in the control group (P<0.01), while the expression levels of these genes in low-dose and high-dose Rb-1 groups were significantly lower than those of the model group (P<0.01). The expression levels of Nrf2, HO-1 and NQO1 genes in the model group were significantly lower than those in the control group (P<0.05), while the expression of these genes in low-dose and high-dose Rb-1 groupswere significantly higher than those of the model group (P<0.01). The activities of CAT, GSH-Px and SOD in the model group were lower than those in the control group (P<0.01), however the activities of CAT, GSH-Px and SOD in low-dose and high-dose Rb-1 groups were higher than those of model group (P<0.05). Conclusions: Both low-dose and high-dose Rb-1 have protective effect on memory and cognitive function of Alzheimer's disease rats by reducing the damage and apoptosis of hippocampal neurons, down-regulating the expression levels of p53, Bax, Cyto C, caspase-3 and caspase-9, up-regulating the expression of Nrf2, HO-1 and NQO1 genes, and increasing the activities of CAT, GSH-Px and SOD. Moreover, the protective effect of Rb-1 on rat brain may be dose-dependent.

[Classification of pregnancy complicating Guillain-Barré syndrome].

Objective: To explore the classification, clinical features, the short-term efficacy of intravenous immunoglobulin (IVIg) for Guillain-Barré syndrome(GBS) and look for predictors of acute motor axonal neuropathy (AMAN) during pregnancy. Methods: The clinical data of 45 hospitalized pregnant patients with GBS recruited from October 2008 to October 2017 at the Tianjin Medical University general hospital, Handan City First Hospital and Nankai University Affiliated Tianjin Fourth Central Hospital, were collected and analyzed retrospectively, and patients were divided into the acute inflammatory demyelinating polyneuropathies (AIDP) group and the AMAN group. The clinical features and efficacy of IVIg were compared between the two groups. Logistic regression analysis was used to analyze the predictors of AMAN. Results: There were 25 cases in the AIDP group and 20 cases in the AMAN group. AIDP usually started with distal limb weakness (P=0.001), and AMAN often started with limb weakness (P=0.001) and mostly accompanied by dyspnea (P=0.042). AIDP was often associated with paresthesia (P=0.001) and autonomic dysfunction (P=0.007). The response days of active treatment in the AIDP group and the AMAN group were (1.6±0.5)d and (2.3±0.8)d (P=0.022), the improvement days were (3.6±0.8)d and (5.9±1.0)d (P=0.000), the basic cure days were (7.7±1.3)d and (9.0±0.8)d (P=0.002), the cure days were (12.3±1.1)d and (12.8±0.9)d (P=0.148). Multivariate Logistic regression analysis revealed that preceding diarrhea (OR=13.750; 95% CI 1.386-136.387), limb weakness(OR=12.000;95% CI 2.359-61.048) and limb weakness with dyspnea (OR=10.000; 95% CI 1.048-95.457) were significantly associated with the AMAN-type GBS. Conclusions: AIDP and AMAN are the main types of pregnancy complicating GBS. Most patients present with a single and benign course of disease. IVIg is generally safe and effective. Preceding diarrhea, limb weakness and limb weakness with dyspnea are the predictors of AMAN-type pregnancy complicating GBS.

[A retrospective study on misdiagnosis and prognosis of acute pregnancy complicating Guillain-Barré syndrome].

Objective: To investigate the factors of first misdiagnosis, treatment and prognosis of acute pregnancy complicating with Guillain-Barré syndrome (GBS) in order to improve the first diagnosed rate. Methods: A total of 45 acute pregnancy complicating with GBS patients were retrospectively analyzed recruited from January 2009 to October 2017 at the Tianjin Fourth Central Hospital.Patients were divided into the first diagnosis group and the first misdiagnosis group, and GBS clinical types were classified into classic and variant types to analyze the misdiagnosis factors of the first diagnosis. All patients received intravenous immunoglobulin (IVIG) treatment, and the therapeutic effect and prognosis were compared and analyzed. Results: There were 20 cases in the first diagnosis group, 25 cases in the first misdiagnosis group, 35 cases in the typical GBS group, and 10 cases in the variant GBS group.There was no statistically significant difference in the baseline data of the patients(P>0.05).The misdiagnosis factors are divided into four categories: physician factors, patient factors, disease itself factors and laboratory factors. Variant GBS is more likely to lead to misdiagnosis in the first diagnosis than typical GBS. The therapeutic effect of the first diagnosis group was better than that of the first misdiagnosis group(P<0.05).Three patients died in the first misdiagnosis group, and the rest of the pregnant patients gave birth normally, and the babies were born without congenital malformation. Conclusions: Pregnancy is one of the inducing factors of GBS. Early diagnosis and correct treatment can improve maternal and infant clinical outcomes.

Comparison of anaesthetic and analgesic effects of emulsified isoflurane used alone or combined with lidocaine and fentanyl in dogs.

AIM: The objective of this study was to investigate the effects of a combination of emulsified isoflurane, lidocaine, and fentanyl (EI-L-F) compared with the efficacy of emulsified isoflurane alone (EI), a combination of emulsified isoflurane and lidocaine (EI-L) or emulsified isoflurane and fentanyl (EI-F) for anaesthetising dogs. METHODS: Eight mongrel dogs were anesthetised with EI (8 mL/kg/hour), EI-L (3 mg/kg/hour lidocaine and 6 mL/kg/hour of emulsified isoflurane), EI-F (1.5 µg/kg/hour fentanyl and 6 mL/kg/hour of emulsified isoflurane), and EI-L-F (5 mL/kg/hour of emulsified isoflurane, 1 µg/kg/hour of fentanyl and 2.4 mg/kg/hour of lidocaine). Each dog received all four treatments and there was a 15-day washout period between the treatments. The dogs' anaesthesia and analgesia scores and physiological parameters were determined before and 5, 10, 20, 30, 40, 50, 60, 70 and 80 minutes after the administration of anaesthetic agents. RESULTS: The dogs in each of the four groups became laterally recumbent within 1 minute. Respiration rate and heart rate increased (p<0.05) during the first 5 minutes of anaesthesia in all groups. Respiration rate in the EI-F-L group was higher (p=0.037) than other groups from 30 to 50 minutes. Heart rate was higher in the EI than EI-F-L group (p=0.018) from 10 to 20 minutes, then returned to near baseline. Arterial oxygen saturation decreased during the period of anaesthesia but was higher (p=0.032) from 10 to 50 minutes in EI-F-L group than in other groups. The total anaesthesia scores in the EI-L-F group were higher than the EI and EI-L groups (p<0.05). The mean time to body movement was 5 (SD 2), 5 (SD 2), 7 (SD 2) and 8 (SD 2) minutes for the EI, EI-L, EI-F and EI-F-L groups, respectively. The mean time to standing was 8 (SD 2), 9 (SD 2), 10 (SD 2) and 13 (SD 3) minutes for the EI, EI-L, EI-F and EI-F-L groups, respectively. No excitement was observed during recovery after anaesthesia. CONCLUSIONS: The EI-F-L combination that was used in this study provided an adequate anaesthesia effect in dogs, which was characterised by adequate analgesia and muscle relaxation without any complications.

Effect of the addition of tramadol to a combination of tiletamine-zolazepam and xylazine for anaesthesia of miniature pigs.

This study investigated the effects of a combination of tiletamine-zolazepam and xylazine plus tramadol (TZXT) and compared the efficacy of this combination with that of tiletaminezolazepam and xylazine (TZX) for providing anaesthesia in Chinese experimental miniature pigs. Fourteen healthy, eight-month-old miniature pigs of both sexes were immobilised with TZXT or TZX on two different occasions. The pigs' immobilisation and analgesia scores and baseline physiological parameters (heart rate, respiratory rate, non-invasive systolic, diastolic and mean arterial blood pressures, arterial haemoglobin oxygen saturation and rectal temperature) were determined before and five, 10, 30, 45, 60, 80 and 100 minutes after the administration of TZXT or TZX. Pigs in both groups became laterally recumbent within three minutes. Some physiological parameters were changed after administration of the drug combinations, but they remained within biologically acceptable limits and were not significantly different between the two treatments. The use of TZXT resulted in better induction time and quality of recovery compared with TZX, with higher scores for sedation, analgesia, muscle relaxation, posture and auditory response. The animals were much calmer during recovery after TZXT immobilisation.

Menopausal symptoms in women undergoing chemotherapy-induced and natural menopause: a prospective controlled study.

BACKGROUND: Women with breast cancer frequently undergo menopause following adjuvant chemotherapy. Here, we investigated whether they have more severe symptoms than women undergoing natural menopause. PATIENTS AND METHODS: Forty-one women who had undergone menopause as a result of chemotherapy and 57 healthy women who had undergone recent natural menopause were evaluated on two occasions 1 year apart. The primary end point was the summed score of the self-report Functional Assessment of Cancer Therapy, endocrine symptoms (FACT-ES) scale. Quality of life was evaluated by the FACT-G questionnaire and fatigue by the FACT-F subscale. RESULTS: There was a strong trend for patients to report worse FACT-ES scores than controls at the first (P = 0.05) and second (P = 0.04) time points. More patients had moderate/severe hot flashes than controls undergoing natural menopause (51% versus 19%, P = 0.003). Patients reported worse fatigue than controls at the first assessment (P = 0.04), with no difference at the second. Menopausal symptoms were associated with fatigue for both groups. There was no difference between patients and controls in the quality-of-life scale, although assessment of patients is likely subject to adaptation and response-shift bias. CONCLUSIONS: Women undergoing chemotherapy-induced menopause may experience worse symptoms than women undergoing natural menopause.

The influence of erythropoietin on cognitive function in women following chemotherapy for breast cancer.

OBJECTIVE: Cognitive dysfunction is a potential side effect of chemotherapy, and erythropoietin might be protective. A previously reported study compared quality-of-life in women undergoing chemotherapy for breast cancer who were randomized to receive epoetin-alpha or standard care. Here, we report a non-randomized sub-study in which cognitive function of participants was evaluated at 12-30 months after chemotherapy. METHODS: The primary endpoint was the proportion of women with moderate-severe cognitive impairment, as measured by the High Sensitivity Cognitive Screen (HSCS). Subjects also completed the Revised Hopkins Verbal Learning Test (HVLT-R), the Functional Assessment of Cancer Therapy--Fatigue (FACT-F) and FACT-G self-report questionnaires for fatigue and quality-of-life, and the Hospital Anxiety and Depression Scale. RESULTS: Of 278 patients receiving adjuvant treatment in the primary study, 87 participated in the sub-study: 45 had received epoetin-alpha and 42 standard care. Groups were well matched for age and type of chemotherapy. Eight patients (9%) had moderate-severe cognitive dysfunction by the HSCS: six of them in the epoietin-alpha group (not significant). There were no significant differences in the HVLT-R, or in fatigue, but patients who had received epoetin-alpha reported better quality-of-life. CONCLUSION: This study failed to demonstrate a protective effect of epoetin-alpha against the development of delayed cognitive dysfunction after chemotherapy.