Effectiveness of intraoperative cell salvage combined with a modified leucocyte depletion filter in metastatic spine tumour surgery.

BACKGROUND: To compare the effectiveness of intraoperative cell salvage (IOCS) combined with a modified leucocyte depletion filter (MLDF) with IOCS combined with a regular leucocyte depletion filter (RLDF) in eliminating tumour cells from blood salvage during metastatic spine tumour surgery (MSTS). METHODS: Patients with a known primary epithelial tumour who underwent MSTS were recruited for this study. Blood samples were collected in 5 stages: from the patients' vein before anaesthesia induction (S1), from the operative field at the time of maximum tumour manipulation (S2), and from the operative blood after IOCS processing (S3) and after IOCS+RLDF (S4) and IOCS+MLDF (S5) processing. The polyploids of tumour cells in the blood samples were collected and counted with immunomagnetic separation enrichment and fluorescence in situ hybridization. RESULTS: We recruited 20 patients. Tumour cells were detected in 14 patients (70%) in S1, 16 patients (80%) in S2, 13 patients (65%) in S3, and 12 patients (60%) in S4. MLDF was added in 8 patients. Tumour cells were detected in only 1 of 8 patients in S5 (12.5%). There were significantly fewer tumour cells in the samples collected after MLDF processing (S5) than in the samples collected after RLDF (S4) and around the tumour (S2) (P = 0.016 and P = 0.039, respectively). Although no significant difference was observed between S4 and S1, a downward trend was observed after IOCS+RLDF processing. CONCLUSIONS: Tumour cells could be removed by IOCS combined with RLDF from blood salvaged during MSTS, but residual tumour cells remained. The findings support the notion that MLDF eliminates tumour cells more effectively than RLDF. Hence, this technique can be applied to MSTS. TRIAL REGISTRATION: ChiCTR1800016162 Chinese Clinical Trial Registry.

Inhibition of visfatin alleviates sepsis-induced intestinal damage by inhibiting Hippo signaling pathway.

BACKGROUND: The aim of this study is to investigate role of Visfatin, one of the pro-inflammatory adipokines, in sepsis-induced intestinal injury and to clarify the potential mechanism. METHODS: C57BL/6 mice underwent cecal ligation and puncture (CLP) surgery to establish sepsis model in vivo. Intestinal epithelial cells were stimulated with LPS to mimic sepsis-induced intestinal injury in vitro. FK866 (the inhibitor of Visfatin) with or without XMU-MP-1 (the inhibitor of Hippo signaling) was applied for treatment. The expression levels of Visfatin, NF-κB and Hippo signaling pathways-related proteins were detected by western blot or immunohistochemistry. The intestinal cell apoptosis and intestinal injury were investigated by TUNEL staining and H&E staining, respectively. ELISA was used to determine the production of inflammatory cytokines. RESULTS: The expression of Visfatin increased in CLP mice. FK866 reduced intestinal pathological injury, inflammatory cytokines production, and intestinal cell apoptosis in sepsis mice. Meanwhile, FK866 affected NF-κB and Hippo signaling pathways. Additionally, the effects of FK866 on inflammatory response, apoptosis, Hippo signaling and NF-κB signaling were partly abolished by XMU-MP-1, the inhibitor of Hippo signaling. In vitro experiments also revealed that FK866 exhibited a protective role against LPS-induced inflammatory response and apoptosis in intestinal cells, as well as regulating NF-κB and Hippo signaling, whereas addition of XMU-MP-1 weakened the protective effects of FK866. CONCLUSION: In short, this study demonstrated that inhibition of Visfatin might alleviate sepsis-induced intestinal injury through Hippo signaling pathway, supporting a further research on Visfatin as a therapeutic target.

[Fluorescent Dissolved Organic Matter and Its Correlation with Water Quality in a Urban River: A Case Study of the Lujiang River in Beilun, Ningbo].

Excitation-emission matrix fluorescence spectroscopy combined with fluorescence regional integration (FRI) analysis were adopted to analyze the water samples collected from the Lujiang River, which flows through the rapidly urbanizing areas of Beilun, Ningbo, in order to illuminate the composition and characteristics of the spatial distribution of fluorescent dissolved organic matter (FDOM), and further to explain its correlation with water quality in the urban river. The results showed that FDOM was composed of tyrosine-like, tryptophan-like, soluble microbial by-product-like, fulvic-like, and humic-like materials, and FDOM was dominated by protein-like components, accounting for 83.8% of the total fluorescence intensity, while humic-like components accounted for much less. The concentrations of the water quality parameters, such as total nitrogen, total phosphorus, and metals, were linearly correlated with the total fluorescence intensity of all components, indicating that FDOM was significantly related to the removal and transformation of nitrogen and phosphorus. The distribution of FDOM in different areas has the following characteristics:FDOM was low and not distinctly influenced by human activities in the upstream, while in the downstream, FDOM was high and showed the characteristics typical of that in urbanized rivers. Therefore, anthropogenic activities can greatly influence river water quality and the concentration and composition of FDOM.

[Characteristics of Dissolved Organic Matter (DOM) and Relationship with Dissolved Heavy Metals in a Peri-urban and an Urban River].

Dissolved organic matter (DOM) is ubiquitous in the aquatic environment, playing an important role in the fate of heavy metals in aquatic systems. In this study, we characterized the DOM and heavy metals and their distribution in a peri-urban river and an urban river in Ningbo city. In addition, the relationship between DOM and dissolved heavy metals was also determined. Results showed that higher DOC, CDOM, and FDOM concentrations were found in the river with the higher urbanization level. Four fluorescence peaks were identified in the excitation-emission matrix (EEM) of DOM, including fulvic acid-like fluorescence peaks A and C and protein-like fluorescence peaks B and T. The higher fluorescence intensities of peak B and T were found in the urban river, and similar trends were also found for the degree of humification and aromaticity of DOM. Similarly, concentrations of heavy metals, such as As, Cu, and Mn, were significantly higher in the urban river. Moreover, DOM had significant positive correlations with Cu, Cr, Mn, As, Zn, and Pb in the urban river, while DOM only exhibited significant positive correlations with Mn, Pb, and Cu in the peri-urban river. In conclusion, urbanization level influenced the characteristics and concentrations of CDOM in rivers which were closely related to the distribution of heavy metals.

[Rocuronium anesthesia induced anaphylactic shock: a case report].

Anaphylaxis is an acute and fatal systemic allergic reaction to an allergen, and it could be an unpredictable and life-threatening cause during anesthesia. The main purpose of this paper is to report a case of anaphylactic shock during the anesthesia induction and to review the prophylaxis and treatment of anaphylactic reactions and anaphylactoid reactions during the anesthesia period. A 63-year-old man, with a mass on his adrenal, was scheduled to a laparoscopic adrenal tumor excision. During the anesthesia induction period, after administrated sulfentanil, propofol and rocuronium, the blood pressure was decreased and the heart rate was increased. Then, the patient had rash on his whole body and developed an anaphylactic shock. After being treated with the anti-allergic agents and norepinephrine, the rash disappeared and the vital sign become stable. The patient felt nothing uncomfortable during the two weeks'follow-up. Anaphylactic reactions and anaphylactoid reactions are not rare during the anesthesia period. The most common inducements are muscle relaxant, latex and antibiotics. Anaphylactic reactions in the perioperative period are often serious and potentially life-threatening conditions, involving multiple organ systems in which the clinical manifestations are the consequence of the release of preformed mediators from mast cells and basophils. Before anesthesia, we should acquire the allergic history. During the anesthesia period, the vital sign and the skin should be observed carefully.