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Objective To observe the impacts of acupuncture and moxibustion on kelch like epichlorohydrin related protein 1(Keap1)and nuclear factor E2 related factor 2(Nrf2)signal pathway in kidney tissue of cisplatin(DDP)-induced kidney injury model mice,and to explain the protective mechanism of acupuncture and moxibustion on improving kidney injury caused by DDP.Methods Forty SPF male KM rats were randomly divided into 4 groups,with 10 rats in each group.One day before the start of treatment,the three groups of mice outside the blank group were intraperitoneally injected with cisplatin 10 mg·kg-1 according to their body weight,and the blank group was injected with the same dose of 0.9%NaCl solution.The model was established 24 hours later.Both acupuncture group and moxibustion group selected"Dazhui"(GV14),"Ganshu"(BL18),"Shenshu"(BL23)and"Zusanli(Housanli)"(ST36)for acupuncture and moxibustion respectively,once a day for 5 days.The other two groups were fixed every day without treatment.After fasting for 1 day,the contents of BUN,Scr,CysC and NGAL in serum and Keap1 and Nrf2 in renal tissue were detected by ELISA;Western blot and Real-time PCR were used to detect the protein expression and gene transcription of Keap1 and Nrf2 in the kidney tissue of mice in each group.Results Compared with the blank group,the content of Keap1 protein,protein expression and relative expression of mRNA in the model group increased(P<0.05),the content of Nrf2 protein,protein expression decreased(P<0.05),Nrf2 relative expression of mRNA increased(P<0.05);Compared with the model group,the content of Keap1 protein,the expression of Keap1 protein and the relative expression of Keap1 mRNA in the kidney of mice in the acupuncture and moxibustion groups decreased(P<0.05);Nrf2 protein content,protein expression and relative mRNA expression increased(P<0.05).Conclusion Acupuncture and moxibustion can improve the renal function of DDP renal injury model mice and enhance their antioxidant stress ability,so as to improve the renal injury caused by DDP chemotherapy.Its mechanism may be related to Keap1/Nrf2 signal pathway.
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Objective:To assess the changes of cardiac output (CO)-related indices in healthy term reproductive age pregnant women during labor.Methods:A prospective longitudinal study was conducted, involving 208 pregnant women at term who were at an reproductive age and admitted to the labor ward of Tianjin Central Hospital of Obstetrics and Gynecology from October 2020 to March 2021. The internal diameter of the aortic root, velocity-time integral of aortic valve flow, and heart rate were obtained through transthoracic echocardiography during uterine contractions period and the intervals between contractions in the latent phase, active phase, and the second stage of labor, as well as at one hour after delivery. Stroke volume (SV), CO, and cardiac index (CI) were then calculated. Comparisons among groups were performed using t-test, analysis of variance, or Wilcoxon test. CO-related indices during contractions periods and intervals between contractions were compared using paired t-test, those in each stage of labor using repeated measurement analysis of variance. Results:(1) CO-related indices in contractions periods vs intervals between contractions during labor: In the latent phase, maternal heart rate [79(72 -84) vs 76(70 -85) bpm, Z=－2.03, P<0.05], SV [(77.9±13.4) vs (71.1±12.8) ml, t=－13.98, P<0.05], CO [(6.1 ±1.2) vs (5.5 ±1.1) L/min, t=－14.19, P<0.05], and CI [(3.5 ±0.7) vs (3.1 ±0.6) L/(min·m 2), t=－14.29, P<0.05] during contractions were higher than those during the intervals. These parameters during contractions in the active phase and the second stage of labor were all higher than those during the intervals in the same stage (all P<0.05). (2) CO-related indices in each period of labor: Heart rate, CO, and CI during the intervals between contractions gradually increased along with labor progression and reached the peak at the second stage followed by a decrease at one hour after delivery, and a similar trend was also observed for these parameters during contractions in the whole labor (all P<0.05). No significant changes in the maternal SV during intervals between contractions were observed during the labor( P=0.366), while the figure during contractions showed a decreased trend along with the course of labor and declined to a nadir in the second stage (all P<0.05). Conclusions:Cardiac output related indices change significantly in healthy term reproductive age pregnant women during labor, especially in the second stage of labor. Therefore, correct monitoring and management of hemodynamic changes during labor are of great importance in the stability of cardiovascular function throughout labor.