Dexmedetomidine alleviates LPS­induced acute lung injury via regulation of the p38/HO­1 pathway.

Acute lung injury (ALI) is a common critical illness in clinical anesthesia and the intensive care unit that can cause acute hypoxic respiratory insufficiency. Despite various therapeutic regimes having been investigated, there is currently no effective pharmacotherapy available to treat ALI. Previous studies have reported that the NOD­like receptor protein 3 (NLRP3) signaling pathway plays an important role in the inflammatory response and is involved in the pathogenesis of ALI. Moreover, dexmedetomidine (Dex), an α2­adrenergic receptor activating agent, has been routinely used as an adjuvant therapy in treating inflammatory diseases, including ALI. However, the precise pathological mechanisms of Dex in ALI remain to be elucidated. Thus, the present study aimed to investigate the effects of the p38/heme oxygenase 1 (HO­1) signaling pathways in the pathological mechanisms of Dex in ALI. Newborn male Sprague­Dawley rats (n=48) were randomly divided into four groups (n=12 each), and an intravenous injection of lipopolysaccharide (LPS) was used to successfully induce the ALI model, with increased pulmonary damage, cell apoptosis, interleukin­1ß (IL­1ß) secretion and edema fluid in lungs. Moreover, the mRNA and protein expression levels of NLRP3 were significantly upregulated, while that of HO­1 were downregulated by LPS treatment. Furthermore, the levels of phosphorylated p38 were also upregulated in ALI rats. It was demonstrated that Dex administration significantly alleviated LPS­induced ALI, downregulated the secretion of IL­1ß, decreased the expression of NLRP3, inhibited the phospho­activation of p38 and increased HO­1 expression. In addition, pharmacological inhibition of p38 using the inhibitor SB20380 further enhanced the effect of Dex. Collectively, these preliminarily results identified the effects of Dex intervention on the pathogenesis of ALI via the regulation of p38/HO­1 signaling pathways, which impacted the inflammatory effects, thus providing a theoretical basis and novel evidence for the development of new targets for clinical treatment of ALI.

Dexmedetomidine Effect on Emergence Agitation and Delirium in Children Undergoing Laparoscopic Hernia Repair: a Preliminary Study.

Objective To evaluate the safety and efficacy of dexmedetomidine (Dex) to prevent emergence agitation (EA) and delirium (ED) in children undergoing laparoscopic hernia repair under general anesthesia. Methods 100 children (1-5 years, 10-25 kg) were randomized into four groups: controls (saline) and intravenous Dex at 0.25, 0.5, and 1.0 µg/kg (D1, D2, D3, respectively). Dex/saline infusion was started following anesthesia. EA and ED were evaluated on a 5-point scale. Results For the C, D1, D2, and D3 groups, respectively, EA frequencies were 45.8%, 30.4%, 12%, 4%; ED frequencies 29.1%, 13%, 4%, 4%; CHIPPS scores 8, 6, 3, 3; sevoflurane doses from 13.2 ± 3.4 (controls) to 9.4 ± 3.5 ml (D3). Intervals until mask removal/spontaneous eye opening were significantly longer for D2 and D3 than controls. PACU stay was longer for D3. Conclusions There was significantly less postoperative EA and pain, with less sevoflurane required, using Dex.

Clinical efficacy of dexmedetomidine in the diminution of fentanyl dosage in pediatric cardiac surgery.

BACKGROUND: This study aims to explore the clinical efficacy of dexmedetomidine (DEX) in the diminution of fentanyl dosage in pediatric cardiac surgery based on some clinical and biochemical parameters. METHODS: Fifty pediatric patients (American Society of Anesthesiologists II), 1-6 years old, were randomly allocated into two groups: group F (control group), in which patients received normal saline and high dosage of fentanyl (30 µg/kg), and group D, in which patients were given DEX and low dosage of fentanyl (15 µg/kg). Some hemodynamic and clinical parameters of the two groups were recorded. Furthermore, stress hormone (serum cortisol, norepinephrine, blood glucose) levels and cytokine (interleukin 6, tumor necrosis factor alpha) levels in the two groups were compared with each other. RESULTS: Stress hormone levels, cytokine levels, hemodynamic parameters and the consumption of sevoflurane did not differ between the two groups. Meanwhile, the extubation time was significantly shorter in Group D than F (P<0.05). CONCLUSIONS: The results indicated that low dosage of fentanyl supplemented with DEX almost had the same anesthesia effects and inflammation extent compared with high dose of fentanyl, which suggested that infusion DEX might decrease fentanyl consumption in pediatric cardiac surgery.

Wireless sensor networks for heritage object deformation detection and tracking algorithm.

Deformation is the direct cause of heritage object collapse. It is significant to monitor and signal the early warnings of the deformation of heritage objects. However, traditional heritage object monitoring methods only roughly monitor a simple-shaped heritage object as a whole, but cannot monitor complicated heritage objects, which may have a large number of surfaces inside and outside. Wireless sensor networks, comprising many small-sized, low-cost, low-power intelligent sensor nodes, are more useful to detect the deformation of every small part of the heritage objects. Wireless sensor networks need an effective mechanism to reduce both the communication costs and energy consumption in order to monitor the heritage objects in real time. In this paper, we provide an effective heritage object deformation detection and tracking method using wireless sensor networks (EffeHDDT). In EffeHDDT, we discover a connected core set of sensor nodes to reduce the communication cost for transmitting and collecting the data of the sensor networks. Particularly, we propose a heritage object boundary detecting and tracking mechanism. Both theoretical analysis and experimental results demonstrate that our EffeHDDT method outperforms the existing methods in terms of network traffic and the precision of the deformation detection.

[Clinical observation of sternoclavicular joint dislocation fixed by clavicular hook plate].

OBJECTIVE: To analyze the treatment of the sternoclavicular joint dislocation by clavicular hook plate and investigate its clinical value to find a therapy with more safety and stability. METHODS: Between January 2003 and January 2007, 15 patients with sternoclavicular joint dislocation were involved, among whom there were 12 males and 3 females, aged 28-45 years old (34 on average). There were 12 cases of falling injury and 3 cases of vehicle accident injury. The course of disease was 1-12 hours. A total of 2 cases were on the left side and 13 were on the right side. There were 14 cases of anterior dislocation and 1 of posterior dislocation. Two patients were complicated by acromioclavicular joint dislocation with no pneumothorax, and 2 patients had a little pleural effusion without any special treatment. As to the damage degree, according to the Grade system, there were 2 cases of type II and 13 cases of type III. RESULTS: All patients' incisions obtained healing by first intention after operation. The X-ray films showed that the reduction of joint dislocation and the location of internal fixation were good. All the 15 patients were followed up for 6-18 months (14 months on average). All cases were scored by Rockwood after the operation to assess the curative effect, with 12 excellent, 2 good and 1 fair. There was no wound infection, neurovascular injury, hemopneumothorax, internal fixation failure, redislocation or other side injuries. The anatomical structure as well as appearances and functions were restored. CONCLUSION: The fixation of clavicular hook plate in treating sternoclavicular joint dislocation has superiority over other methods with more stability, less risk and small chances of cardiovascular injury. Besides, the patients can do functional exercises early and the shoulder joint function can be improved to the maximal degree.