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1.
Pain Res Manag ; 2021: 7582494, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33880135

RESUMO

Objective: This experiment was designed to determine whether erythropoietin-producing human hepatocellular carcinoma (Eph) receptors were involved in the development of visceral pain. Methods: Adult male Sprague-Dawley rats were randomly divided into three groups receiving different treatments (n = 16 per group): intracolonic vehicle (control group), intracolonic 2, 4, 6-trinitrobenzene sulfonic acid (TNBS) (TNBS group), and intracolonic TNBS and intrathecal EphB1 receptor blocking reagent (TNBS + EphB2-Fc group). Visceral hyperalgesia was evaluated with quantification of visceral pain threshold induced by colorectal distention. The spinal expressions of EphB1 and ephrinB2 and levels of their phosphorylated forms (p-EphB1 and p-ephrinB2) were assessed by Western blotting and immunohistochemistry. Results: The TNBS-treated rats developed significant visceral hyperalgesia. The spinal expressions of EphB1, p-EphB1, ephrinB2, and p-ephrinB2 were significantly increased in the TNBS group compared with the control group, but visceral hyperalgesia and elevation of spinal EphB1 and p-EphB1 expressions were evidently alleviated by intrathecal administration of EphB2-Fc in the TNBS + EphB2-Fc group. The number of EphB1- and p-EphB1-immunopositive cells, the average optical (AO) value of EphB1, and its phosphorylated form in the spinal dorsal horn were significantly increased in the TNBS group than in the control group, but they were obviously reduced by intrathecal administration of EphB2-Fc. There were no significant differences in the number of ephrinB2- and p-ephrinB2-immunopositive cells and the AO value of ephrinB2 and its phosphorylated form between the TNBS and TNBS + EphB2-Fc groups. Conclusion: EphB1 receptors in the spinal dorsal horn play a pivotal role in the development of visceral pain and may be considered as a potential target for the treatment of visceral pain.

2.
Sci Total Environ ; 781: 146730, 2021 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-33798882

RESUMO

Previous studies demonstrated that microcystin-leucine-arginine (MC-LR) disrupted testosterone (T) synthesis, but the underlying mechanisms are not entirely elucidated. This study aims to explore the role of reactive oxygen species (ROS)-mediated GCN2/eIF2α activation on MC-LR-induced disruption of testicular T synthesis. Male mice were intraperitoneally injected with MC-LR (0 or 20 µg/kg) daily for 5 weeks. Serum T was decreased in MC-LR-exposed mice (0.626 ± 0.122 vs 24.565 ± 8.486 ng/ml, P < 0.01), so did testicular T (0.667 ± 0.15 vs 8.317 ± 1.387 ng/mg protein, P < 0.01). Steroidogenic proteins including StAR, CYP11A1 and CYP17A1 were downregulated in MC-LR-exposed mouse testes and TM3 cells. Mechanistically, p-GCN2 and p-eIF2α were elevated in MC-LR-exposed TM3 cells. GCN2iB attenuated MC-LR-induced GCN2 and eIF2α phosphorylation in TM3 cells. Moreover, GCN2iB attenuated MC-LR-induced downregulation of steroidogenic proteins in TM3 cells. Further analysis found that cellular ROS were elevated and HO-1 was upregulated in MC-LR-exposed TM3 cells. PBN rescued MC-LR-induced activation of GCN2/eIF2α signaling in TM3 cells. Additionally, pretreatment with PBN attenuated MC-LR induced downregulation of steroidogenic proteins and synthases in TM3 cells. These results suggest that ROS-mediated GCN2/eIF2α activation contributes partially to MC-LR-caused downregulation of steroidogenic proteins and synthases. The present study provides a new clue for understanding the mechanism of MC-LR-induced endocrine disruption.

3.
Medicine (Baltimore) ; 99(16): e19704, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32311952

RESUMO

General anesthesia with double-lumen endobronchial intubation is considered mandatory for thoracoscopic bullectomy. We assessed the safety and feasibility of thoracoscopic bullectomy for treatment of primary spontaneous pneumothorax (PSP) under intubating laryngeal mask airway (ILMA) with spontaneous breathing sevoflurane anesthesia combined with thoracic paravertebral block (TPB).From January 2018 to December 2018, some 34 consecutive patients with PSP were treated by thoracoscopic bullectomy under ILMA with spontaneous breathing sevoflurane anesthesia combined with TPB (study group). To evaluate the safety and feasibility of this new technique, these patients were compared with the control group consisting of 34 consecutive patients with PSP who underwent thoracoscopic bullectomy using tracheal intubation with controlled ventilation from January 2017 to December 2017. The demographic characteristics, intraoperative surgical and anesthetic results, and postoperative results were assessed.The 2 groups had comparable anesthetic time, operation time, chest drainage time, postoperative hospital stays, and hospitalization cost. Visual analogue score (VAS) scores at 3 hours at rest and at coughing were significantly lower in the study group than in the control group (mean, 0.9 vs 2.0 and 1.8 vs 4.0, P = .024 and P = .006, respectively). No differences were seen in PaO2 values between the 2 groups in the intraoperative stage and postoperative stage (P > .05, respectively). The pH value was significantly lower in the intraoperative stage (mean, 7.28 vs 7.40, P = .01) and higher in the postoperative stage (mean, 7.35 vs 7.33, P = .014) in the study group than in the control group. The PaCO2 value was significantly higher in the intraoperative stage in the study group than in the control group (mean, 57.0 mm Hg vs 42.0 mm Hg, P = .015). In the study group, no cough reflex was found, and the level of collapse of the operative lung was excellent in 31 cases and good in 3 cases.Our study demonstrated that thoracoscopic bullectomy for treatment of PSP can be safely and feasibly performed in highly selected patients under ILMA with spontaneous breathing sevoflurane anesthesia combined with TPB.


Assuntos
Intubação Intratraqueal , Pneumotórax/cirurgia , Respiração Artificial , Toracoscopia , Anestésicos Inalatórios/uso terapêutico , Estudos de Viabilidade , Feminino , Humanos , Intubação Intratraqueal/métodos , Pulmão/cirurgia , Masculino , Bloqueio Nervoso , Segurança do Paciente , Respiração Artificial/métodos , Sevoflurano/uso terapêutico , Toracoscopia/métodos , Resultado do Tratamento , Adulto Jovem
5.
Medicine (Baltimore) ; 97(24): e11181, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29901652

RESUMO

BACKGROUND: Patients undergoing thoracotomy frequently experience acute pain and chronic post-thoracotomy pain (CPTP). There are few articles relating to the investigations on the effects of preoperative single-dose thoracic paravertebral block (PSTPVB) on acute pain and CPTP. We tested the hypothesis that adding PSTPVB to intravenous (IV) patient-controlled analgesia (PCA) would reduce acute pain scores and decrease the incidence and intensity of CPTP. METHODS: Fifty-six patients undergoing elective thoracotomy were randomized to receive PSTPVB in addition to IV PCA (group T) or IV PCA alone (group C). A single 20-mL injection of 0.50% ropivacaine plus 10 mg dexamethasone in saline was administered preoperatively under ultrasound guidance; sufentanil was used for IV PCA. The acute pain intensity at rest and at coughing based on verbal rating scale, postoperative sufentanil consumption, and complications were evaluated at 6, 24, 48, and 72 hours after surgery. The incidence and intensity of CPTP were evaluated at 3 months after surgery. RESULTS: Group T had significantly less acute pain compared with group C at all measurement times both at rest and at coughing (P < .05). The PCA cumulative sufentanil consumption, complications, and the incidence of CPTP between the 2 groups was not statistically significant (P > .05). The intensity of CPTP was significantly higher in group C than in group T (P < .05). CONCLUSION: This study indicated that adding PSTPVB to IV PCA improved acute postoperative pain and chronic pain in patients undergoing thoracotomy, but did not reduce the incidence of CPTP.


Assuntos
Anestésicos Intravenosos/administração & dosagem , Bloqueio Nervoso/métodos , Dor Pós-Operatória/tratamento farmacológico , Sufentanil/administração & dosagem , Toracotomia/efeitos adversos , Adulto , Idoso , Anestésicos Intravenosos/efeitos adversos , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Bloqueio Nervoso/efeitos adversos , Medição da Dor , Cuidados Pré-Operatórios/métodos , Sufentanil/efeitos adversos , Resultado do Tratamento
6.
J Cardiothorac Surg ; 10: 126, 2015 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-26466895

RESUMO

BACKGROUND: Intraoperative cell salvage (ICS), hereby referred to 'mechanical red cell salvage', has been widely used and proven to be an effective way to reduce or avoid the need for allogeneic red blood cells (RBCs)transfusion and its associated complications in surgeries involving major blood loss. However, little is known about the influence of this technique on the functional state of salvaged RBCs. Furthermore, there are no articles that describe the change of free hemoglobin (fHb) in salvage blood during storage, which is a key index of the quality control of salvaged blood. Therefore, in this study, the influence of ICS on the function of salvaged RBCs and the changes of salvaged RBCs during storage were studied with respect to the presence of oxyhemoglobin affinity (recorded as a P50 value) and the level of 2, 3-diphosphoglycerate (2, 3-DPG) and fHb by comparing salvaged RBCs with self-venous RBCs and 2-week-old packed RBCs. METHODS: Fifteen patients undergoing off-pump coronary artery bypass grafting (OPCAB) surgery were enrolled. Blood was collected and processed using a Dideco Electa device. The level of P50, 2, 3-DPG and fHB from salvaged RBCs, venous RBCs and 2-week-old packed RBCs was measured. We also measured the changes of these indicators among salvaged RBCs at 4 h (storage at 21-24 °C) and at 24 h (storage at 1-6 °C). RESULTS: The P50 value of salvaged RBCs at 0 h (28.77 ± 0.27 mmHg) was significantly higher than the value of venous RBCs (27.07 ± 0.23 mmHg, p=0.000) and the value of the 2-week-old packed RBCs (16.26 ± 0.62 mmHg, p=0.000). P50 value did not change obviously at 4 h (p=0.121) and 24 h (p=0.384) compared with the value at 0 h. The 2, 3-DPG value of salvaged RBCs at 0 h (17.94 ± 6.91 µmol/g Hb) was significantly higher than the value of venous RBCs (12.73 ± 6.52 mmHg, p = 0.007) and the value of the 2-week-old packed RBCs (2.62 ± 3.13 mmHg, p=0.000). The level of 2, 3-DPG slightly decreased at 4 h (p=0.380) and 24 h (p=0.425) compared with the value at 0 h. Percentage of hemolysis of the salvaged blood at 0 h(0.51 ± 0.27 %) was significantly higher than the level of venous blood (0.07 ± 0.05 %, p=0.000) and the value of 2-week-old packed RBCs (0.07 ± 0.05 %, p=0.000), and reached 1.11 ± 0.42 % at 4 h (p=0.002) and 1.83 ± 0.77 % at 24 h (p=0.000). CONCLUSIONS: The oxygen transport function of salvaged RBCs at 0 h was not influenced by the cell salvage process and was better than that of the venous RBCs and 2-week-old packed RBCs. At the end of storage, the oxygen transport function of salvaged RBCs did not change obviously, but percentage of hemolysis significantly increased.


Assuntos
Ponte de Artéria Coronária sem Circulação Extracorpórea , Transfusão de Eritrócitos/métodos , Recuperação de Sangue Operatório , Oxigênio/sangue , 2,3-Difosfoglicerato/sangue , Idoso , Feminino , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
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