Psychosocial crisis intervention for coronavirus disease 2019 patients and healthcare workers / 中南大学学报(医学版)

OBJECTIVES@#Shelter hospital was an alternative way to provide large-scale medical isolation and treatment for people with mild coronavirus disease 2019 (COVID-19). Due to various reasons, patients admitted to the large shelter hospital was reported high level of psychological distress, so did the healthcare workers. This study aims to introduce a comprehensive and multifaceted psychosocial crisis intervention model.@*METHODS@#The psychosocial crisis intervention model was provided to 200 patients and 240 healthcare workers in Wuhan Wuchang shelter hospital. Patient volunteers and organized peer support, client-centered culturally sensitive supportive care, timely delivery of scientific information about COVID-19 and its complications, mental health knowledge acquisition of non-psychiatric healthcare workers, group activities, counseling and education, virtualization of psychological intervention, consultation and liaison were exhibited respectively in the model. Pre-service survey was done in 38 patients and 49 healthcare workers using the Generalized Anxiety Disorder 7-item (GAD-7) scale, the Patient Health Questionnaire 2-item (PHQ-2) scale, and the Primary Care PTSD screen for the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (PC-PTSD-5). Forty-eight healthcare workers gave feedback after the intervention.@*RESULTS@#The psychosocial crisis intervention model was successfully implemented by 10 mental health professionals and was well-accepted by both patients and healthcare workers in the shelter hospital. In pre-service survey, 15.8% of 38 patients were with anxiety, 55.3% were with stress, and 15.8% were with depression; 16.3% of 49 healthcare workers were with anxiety, 26.5% were with stress, and 22.4% were with depression. In post-service survey, 62.5% of 48 healthcare workers thought it was very practical, 37.5% thought more practical; 37.5% of them thought it was very helpful to relief anxiety and insomnia, and 27.1% thought much helpful; 37.5% of them thought it was very helpful to recognize patients with anxiety and insomnia, and 29.2% thought much helpful; 35.4% of them thought it was very helpful to deal with patients' anxiety and insomnia, and 37.5% thought much helpful.@*CONCLUSIONS@#Psychological crisis intervention is feasible, acceptable, and associated with positive outcomes. Future tastings of this model in larger population and different settings are warranted.

Cesarean section under spinal anesthesia seven years after heart-lung transplantation: a case report / 中华围产医学杂志

This article reported a successful cesarean section performed on a woman with 37 +6 weeks of gestation after heart-lung transplantation (HLTx) at the Second Xiangya Hospital of Central South University. The patient was a 29-year-old woman with singleton pregnancy who underwent HLTx seven years ago. During pregnancy, she was treated with azathioprine and tacrolimus to suppress immune rejection. The patient was in New York Heart Association (NYHA) class Ⅰ and had no fever or shortness of breath. Prenatal examinations indicated that the mother and the fetus were in good condition. A baby girl was delivered successfully at full term by a transverse lower-segment cesarean section under spinal anesthesia. Both the mother and the child were healthy at follow-up of 42 d after discharge.

Airway management strategies under the situation of prevention and control of nosocomial infections for coronavirus disease 2019 / 中南大学学报(医学版)

Since the outbreak of COVID-19, the prevention and control of nosocomial infections has been highly valued. Airway management, including endotracheal intubation, extubation, and suction, has been considered as the high-risk virus-spreading procedures, which can put the health providers at a high risk of nosocomial infections. As hospitals at all levels will gradually resume their routine medical work, effective managements for the airway of the silent asymptomatic carriers and patients with delayed symptoms, treatment for severe patients, and prevention of cross infection in hospital have become the focus for the current prevention and control of nosocomial infections. Under the guidance of partitioned and graded prevention and differential control strategies at this stage, we comprehensively analyzed four main intubation methods used in the current clinical work including rapid sequence intubation, laryngeal mask insertion, intubation guided by video flexible intubating scope and awake tracheal intubation. Furthermore, we discussed and summarized intubation and protection strategies for 3 categories of patients during the COVID-19 pandemic, providing evidence for protecting medical stuff in operating room and ICU against severe acute respiratory syndrome coronavirus 2 infection.

Effect of hypothalamic nerve growth factor precursor on field potential of paraventrucular nucleus during rat cardiopulmonary bypass / 临床麻醉学杂志

Objective To evaluate the effect of cardiopulmonary bypass (CPB) on the expression of hypothalamic nerve growth factor precursor (proNGF) and the influence of hypothalamic proNGF on the sympathetic output of paraventrucular nucleus. Methods Forty-two male SD rats, aged 3-4 months, weighing 350-500 g, were divided into control group, CPB group and ischemia reperfusion (IR) group. At the end of CPB for 110 min, hypothalamus and dorsal root ganglion (DRG) were taken to measure the levels of proNGF mRNA and hypothalamic proNGF protein. Mini pipe was put into bilateral paraventrucular nucleus (PVN) and human recombination proNGF protein was injected into PVN for 7 d before the local field potentials (LFP) of RVLM was recoreded. Human recombination proNGF protein was administrated into lateral ventricle, the prior-administration-LFP of PVN and post-administration-LFP were recorded and compared. At the end of the experiment, hypothalamus was taken to measure the levels of glutamate and gammer amino butyric acid (GABA). Results Hypothalamic proNGF protein in CPB group and IR group was higher than that in the control group (P ＜ 0.05); NGF mRNA of hypothalamus and DRG in CPB and IR group were higher than those of control group (P ＜ 0.05). In PVN and RVLM, after the administration of proNGF protein, the power of delta band significantly decreased and other bands increased (P ＜ 0.05). The hypothalamic GABA level decreased (P ＜ 0.05) with no change of hypothalamic glutamate after proNGF was injected into lateral ventricle. Conclusion CPB increases the expression of proNGF in the hypothalamus contributing to the changes of hypothalamic sympathetic output.

Progress in the study on bone morphogenetic protein 2/4 in central nervous system / 中南大学学报(医学版)

As a member of transforming growth factor β (TGF-β) family,bone morphogenetic proteins (BMPs) are multi-functional factors and play critical roles in heart,cartilage,neural development and postnatal bone formation.It has been demonstrated that among the family,BMP2/4 have been reported to be especially important for the developmental and maturation of central nervous system (CNS).It has different,even opposite functions,in certain given circumstances,which could be a potential risk for BMPs' clinical use.

Effects of aroma therapy and music intervention on pain and anxious for breast cancer patients in the perioperative period / 中南大学学报(医学版)

To investigate the effect of the aroma therapy and music intervention on anxious and pain for the breast cancer patients in the perioperative period and the potential mechanisms.
 Methods: A total of 100 breast cancer patients who received surgical treatment in the comprehensive hospitals of Hunan province were recruited for this study. Patients were assigned randomly into a control group, an aroma therapy group, a music intervention group, and a joint-therapy group (n=25 per group). The patients in the control group received regular post-surgical nursery, while the patients from other groups received aroma therapy, music intervention, or both in addition to the regular nursery. The scale of anxiety and pain were measured. The measurements were carried at three time points, namely 30 min before the surgery (T1), 30 min after the recovery period of anesthesia (T2), and 4 hours after the removal of anesthesia tubing (T3). Repeated ANOVA was used to perform statistic analysis.
 Results: The scale of pain was significantly increased at the post-operation (T2, T3) compared to pre-surgery (T1). The therapeutic group showed significant decrease in pain at post-operation (T3) comparing with the control group (P<0.05). The scale of anxiety was the highest at pre-surgery (T1). During anaesthesia recovery, the anxiety of patients at post-operation T2 and T3 in the therapeutic groups significantly decreased compared with the control group (P<0.05).
 Conclusion: Both the aroma therapy and the music therapy can decrease the stress-responsive anxiety and pain for the breast cancer patients in the perioperative period.

Role of the autophagy in the treatment of neuropathic pain with pulsed radiofrequency / 中南大学学报(医学版)

Objective:To detect the effect of pulse radiofrequency (PRF) treatment on the neuropathic pain established by L5-spinal nerve ligation (SNL) on rats,and to investigate if PRF treatment would affect the expression of autophagy related protein LC3 and autophagy related receptor P62 at the dorsal horn.Methods:A total of 36 male Sprague-Dawley rats were randomly divided into 3 groups:a Sham group,a SNL group,and a SNL+PRF group.The 50％ paw withdrawal mechanical threshold (PWMT) was detected at 1 day before and 1,3,7,14 and 28 days post-operation by using Von-Frey filaments.The autophagy related protein LC3 and autophagy related receptor P62 were investigated by Western blot.Results:Compared with the Sham group,the PWMT significantly decreased in the SNL group at each time points (P＜0.05);in SNL+PRF group,PRF treatment could elevate the PWMT at the 1st day post-operation and lasted for 28 days (P＜0.05).What's more,SNL could elevate the LC3-Ⅱ and P62 levels at the 7th day post-operation (P＜0.05),which were decreased by the PRF treatment (P＜0.05).Conclusion:PRF treatment could improve SNL-induced the neuropathic pain,which might be partly due to the regulatory effects on the autophagy levels at the spinal dorsal horn.

Analysis of influencing factors on the hardness of papillary thyroid carcinoma diagnosed by virtual touch tissue quantification technology / 中华医学超声杂志（电子版）

Objective To analyse the influencing factors diagnosed by the virtual touch tissue quantification (VTQ) technology on the hardness of papillary thyroid carcinoma (PTC).Methods From May 2011 to March 2014,a total of 266 PTCs in 266 patients confirmed by pathology were enrolled in Shanghai Tenth People's Hospital.The shear wave velocity (SWV) values of PTCs were measured by VTQ.PTCs were divided into 2 groups including SWV ≥ 2.87 rn/s and SWV ＜ 2.87 rn/s.The x2 test was used to compare the basic clinical data,ultrasound features and immunohistochemical results between 2 groups.The influencing factors of SWV values of PTCs were analyzed by forward stepwise Logistic regression analysis.Results Of the 266 PTCs,183 were SWV ≥ 2.87 m/s and 83 were SWV ＜ 2.87 m/s.The x2 test showed that the ultrasound features of PTCs such as single or multiple,with or without central lymph node metastasis,location,size,shape,with or without posterior acoustic attenuation,with or without calcification,with or without capsule invasion,whether close to the trachea between the 2 groups were significant different (x2=4.233,4.740,9.910,4.988,4.416,4.737,7.154,8.559,all P ＜ 0.05 or 0.01).Logistic regression analysis demonstrated that nodules were single or multiple,location,with or without posterior acoustic attenuation,with or without calcification,whether close to the trachea were influencing factors of SWV value of PTCs.The regression equation was defined as Y=-2.507 + 0.670X1 (nodules were single or multiple) + 0.800X3 (location of nodules) + 0.851X6 (with or without posterior acoustic attenuation) + 0.628X7 (with or without calcification) + 1.106X9 (whether close to the trachea).Conclusions Multiple nodules,central lymph node metastasis,located isthmus,nodules size ＞ 10 mm,irregular shape,posterior acoustic attenuation,calcification,capsule invasion,close to the trachea were correlated with the diagnosis of PTC by VTQ technology.The more characteristics of nodules appeared,such as multiple nodules,located isthmus,posterior acoustic attenuation,calcification,close to the trachea,the harder PTCs were.

Inhibiting Cytochrome C Oxidase Leads to Alleviated Ischemia Reperfusion Injury

BACKGROUND AND OBJECTIVES: The overall purpose of this study was to investigate the role of cytochrome C oxidase (CcO) in preventing ischemia reperfusion-induced cardiac injury through gaseous signaling molecule pathways. MATERIALS AND METHODS: We used CcO inhibitor, potassium cyanide (KCN) to mimic the pre-treatment of gaseous signaling molecules in a global ischemia/reperfusion (IR) injury model in rats. Intracellular reactive oxygen species (ROS) was determined by measuring mitochondrial H2O2 and mitochondrial complex activity. RESULTS: KCN pre-treatment led to decreased infarction area after IR injury and improved cardiac function. KCN pre-treated group challenged with IR injury was associated with reduced ROS production through inhibition of activity and not downregulation of CcO expression. In addition, KCN pre-treatment was associated with enhanced expression and activity of mitochondrial antioxidase, suggesting the role of CcO in regulating IR injury through oxidative stress. CONCLUSION: KCN pre-treatment reduced the severity of IR injury. The potential mechanism could be increased endogenous anti-oxidase activity and consequently, the enhanced clearance of ROS.

Limb remote ischemic preconditioning attenuates liver ischemia reperfusion injury by activating autophagy via modulating PPAR-γ pathway / 中南大学学报(医学版)

OBJECTIVE@#To investigate the effect of limb remote ischemic preconditioning (RIPC) on hepatic ischemia/reperfusion (IR) injury and the underlying mechanisms.
@*METHODS@#Rats were subjected to partial hepatic IR (60 min ischemia followed by 24 hours reperfusion) with or without RIPC, which was achieved by 3 cycles of 10 min-occlusion and 10 min-
reperfusion at the bilateral femoral arteries interval 30 min before ischemia. Some rats were treated with a new PPAR-γ inhibitor, T0070907, before RIPC.
@*RESULTS@#At the end of reperfusion, liver injury was significantly increased (increases in Suzike's injury score, AST and ALT release), concomitant with elevated oxidative stress (increases in MDA formation, MPO activity, as well as the decrease in SOD activity) and inflammation (increases in TNF-α and IL-6 levels, decrease in IL-10 content). RIPC improved liver function and reduced histologic damage, accompanied by the increased PPAR-γ activation and autophagosome formation as well as the reduced autophagosome clearance. The beneficial effects of RIPC were markedly attenuated by T0070907, an inhibitor of PPAR-γ.
@*CONCLUSION@#RIPC exerts the protective effects on liver by activation of autophagy via PPAR-γ.

Clinical studies on patient-controlled intravenous analgesia for postoperative pain relief in breast cancer patients with radical mastectomy / 中国医师杂志

Objective To investigate the analgesic effect and adverse reactions of patient-controlled intravenous analgesia (PCIA) in breast cancer patients with radical mastectomy.Methods A total of 210 breast cancer patients who underwent radical mastectomy was randomly divided into two groups,experimental (group A) and control (group B) groups (n =105 cases per group).Patients in group A was used PCIA for 48 hours analgesia,while group B weas applied routine intramuscular injections of pethidine.Visual analogue score (VAS) at 4,8,12,24,and 48 hours after operation were recorded.Pulse,respiration,and blood pressure were monitored and side effects e.g.existed skin itching,nausea,vomiting,and respiratory repression were observed.Results The VAS of group A patients on 4,8,12,24,and 48 hours were2.02 ± 1.47,1.73 ± 1.38,1.68 ± 0.91,1.44 ± 0.65,and 1.21 ± 0.61,respectively;and the VAS of group B patients were 6.95 ± 1.96,6.42 ± 1.57,5.63 ± 1.66,4.99 ± 1.62,and 3.72 ± 1.46,respectively.The VAS was significantly lower in group A patients than in group B (P ＜ 0.05).The incidence of skin itching,nausea,vomiting,and respiratory repression was also distinctly decreased in group A than in group B (P ＜0.05).The overall satisfaction of patients in group A (96.2％) was remarkably higher than in group B (67.6％) (P ＜0.01).Conclusions Patient-controlled intravenous analgesia pump can more effectively alleviate the degree of pain,reduce the incidence of skin itching,nausea,vomiting and respiratory repression,improve the satisfactory degree for analgesia in breast cancer patients with radical mastectomy compared to traditional intramuscular way.

Novel technique of virtual touch tissue imaging quantification shear wave elastography in differential diagnosis of thyroid nodules:initial experience / 中华医学超声杂志（电子版）

Objective To evaluate diagnostic value of the novel virtual touch tissue imaging quantification (VTIQ) technique of acoustic radiation force impulse (ARFI) shear wave elastography in the differential diagnosis between benign and malignant thyroid lesions. Methods From June to July 2014, the imaging data of 82 thyroid lesions in 75 patients proven by fine needle aspiration cytology (FNAC) biopsy on conventional ultrasound and VTIQ were retrospectively analyzed. The thyroid nodules were examined by conventional ultrasound firstly and then the lesions were classified by thyroid imaging report and data system (TI-RADS). The maximum, minimum, median and average of shear wave velocity (SWV) values were obtained from multiple SWV measurement under the VTIQ speed mode. The region of interest (ROI) was determined according to the VTIQ quality mode after the patients holding the breath. According to the FNAC cytology results, ROC curve were plotted to determine the most accurate SWV value and the cut-off value for differential diagnosis. Results According to the FNAC results, grading≥5 level was set as the positive results and FNAC<5 level as the negative results. There were 28 positive nodules and 54 negative nodules in 82 thyroid nodules. The positive rates of TI-RADS classification were consistent with the theoretical results. The SWVmax, SWVmin, SWVmedian, and SWVmean on VTIQ of negative and positive thyroid nodules were (3.2±0.6), (2.2±0.4), (2.7±0.4), (2.6±0.4) m/s, and (4.6±1.7), (3.1±0.8), (3.5±1.0), (3.6±1.1) m/s. There were significant differences between positive and negative thyroid nodules in SWVmax, SWVmin, SWVmedian, and SWVmean on VTIQ (t=3.53, 3.68, 3.32, 3.81, all P<0.01). Based on the area under curve of ROC, the SWVmean value in the nodule was the best value in comparison with other SWV values. The cut-off value of VTIQ mean was 2.9 m/s. According to ROC curve analysis, the sensitivity, specificity and Youden index for VTIQ were 70.6%, 88.5%, 0.59, respectively. Conclusion The study proved that VTIQ elastography technique plays an important role in differential diagnosis of thyroid nodules and the VTIQ SWVmean is the best parameter for differential diagnosis.

Efficacy of ketamine in preventing postpartum depression in patients undergoing cesarean section / 中华麻醉学杂志

Objective To evaluate the efficacy of ketamine in preventing postpartum depression in patients undergoing cesarean section.Methods One hundred and twenty ASA physical status Ⅰ patieuts,aged 18-38 yr,with body mass index ＜35 kg/m2,scheduled for elective cesarean section,were equally and randomly divided into 2 groups using a random number table:control group (group C) and ketamine group (group K).Postoperative analgesia was performed with sufentanil 100 μg in 100 ml of normal saline,and sufentanil was infused at 2 ml/h (bolus dose 5 μg,lockout interval 15 min) in both groups.In group K,ketamine 4 mg/kg was added to analgesic pump.VAS score was maintained＜3.Before surgery and at 1,3,5 and 42 days after surgery,depressive symptoms were measured using the Edinburgh Postpartum Depression Survey (EPDS),and postpartum depression was defined as EPDS score ≥ 13.Postpartum depression and ketamine-related complications occurred within 3 days after surgery in group K were recorded.Results Compared with group C,EPDS scores were significantly decreased at 1,3 and 5 days after surgery,and the incidence of postpartum depression was decreased in group K.Ketamine-related complications were not found in group K.Conclusion Ketamine (infused starting from the end of operation,lasting for 48 h,total amount 4 mg/kg) for postoperative analgesia can prevent postpartum depression to some extent in patients undergoing cesarean section.

Prospective validation of the thyroid imaging reporting and data system on thyroid nodules / 中华医学超声杂志（电子版）

Objective To prospectively validate the feasibility and usefulness of the thyroid imaging reporting and data system (TI-RADS) suggested by Kwak. Methods According to the TI-RADS published in Radiology by Kwak et al in 2011, the TI-RADS score of 810 thyroid nodules in 415 patients whose pathologic diagnoses were available were categorized . According to TI-RADS and pathologic results, receiver operating characteristic (ROC) curve was plotted, and the probability of malignancy in each category was calculated. Results Eight hundred and ten pathologically proven thyroid nodules included 649 benign and 161 malignant lesions. Among them, 11 nodules were categorized as TI-RADS 2 (all benign nodules);370 nodules were categorized as TI-RADS 3 (368 benign nodules and 2 malignant nodules);150 nodules were categorized as TI-RADS 4a (143 benign nodules and 7 malignant nodules);116 nodules were categorized as TI-RADS 4b (87 benign nodules and 29 malignant nodules); 146 nodules were categorized as TI-RADS 4c (39 benign nodules and 107 malignant nodules);17 nodules were categorized as TI-RADS 5 (1 benign nodules and 16 malignant nodules). The area under the curve of TI-RADS was 0.89, and the probability of malignancy in nodules with a classiifcation of TI-RADS 2, 3, 4a, 4b, 4c and 5 was 0, 0.5%, 4.6%, 25.0%, 73.0%and 94.0%, respectively. Conclusions The TI-RADS suggested by Kwak has great diagnostic value in diagnosing thyroid nodules. The actual probability of malignancy conforms with the theoretical risk of malignancy.

The experimental study of effect of electric vagal stimulation on the gene expression of injured myocardium from ischemia/reperfusion rat model / 中国医师杂志

Objectives To investigate the effect of electric vagal stimulation on the gene expression of injured myocardium from ischemia/reperfusion rat model and explore the involved molecular mechanism.Methods Twenty Sprague Dawley male rats were randomly selected and divided into 2 groups evenly:ischemia/reperfusion group (I/R group),and vagus nerve stimulation group (STM group).The left anterior descending coronary artery (LAD) was ligated and subjected to 30 min of myocardial ischemia followed by 2 h of reperfusion.In addition,10 min before reperfusion,left cervical vagus nerve of STM group was subjected to electronic stimulation at 5 V,2 ms and 1 Hz for 20 min.After 120 min of reperfusion,every group was randomly divided into two parts.One part that myocardium was collected from left ventricle was applied to determine the area of myocardial infarction.The RNA isolated from another part of the ischemic myocardium collected from left ventricle was hybridized to get gene expression profiles and the quality of hybridized RNA from both I/R and STM group was assessed and analyzed.GeneSpring software was applied to screen out the genes,which show significant difference between groups I/R and STM.Real-time polymerase chain reaction (RT-PCR) was applied to analyze the expression of important genes.Results (1)The area of myocardial infarction of STM (25.5 ± 3.9) ％ was significant reduced relative to L/R group (45.5 ± 4.8) ％ (P ＜ 0.05).(2)The expression levels of 186 genes were changed significantly,and analyzed by Gene ontology (GO) software,there were 3 kinds of genes were affected.The upregulated genes were reported to show protective effect on myocardium.The downregulated gene was relative to inflammation.(3)The RT-PCR result confirmed the genechip assay.Conclusions Electric vagal stimulation can reduce myocardial I/R injury in rats.Significant change of the gene expression was detected between groups I/R and STM.The results suggest that activation of cholinergic anti-inflammatory pathway be involved in the mechanism.

Construction of RNAi vector of dopamine D1 receptor and identification of its silencing effects / 中南大学学报(医学版)

OBJECTIVE@#To construct dopamine D1 receptor (DRD1) expression interference vectors to study the role of DRD1 in nerve cells and lay a foundation for drug development in anti-convulsion.@*METHODS@#Based on DRD1 gene sequence in GenBank, 10 interfere vectors of DRD1 were designed. Liposomal was used to transfect NG-108-15 and the transfect effect was assayed by GFP. With realtime PCR and Western blot, the DRD1 expression was detected.@*RESULTS@#The 10 constructed interfere vectors transfected into NG-108-15 cells by liposomal method and inhibited DRD1 mRNA and protein expression. DRD1 mRNA expression in NG-108-15 cells transfected with pGPU6-GFP-Neo-si-DRD1-5 was the lowest whereas DRD1 protein expression in NG-108-15 cells transfected with pGPU6-GFP-Neo-si-DRD1-1, -2, -6, -7 was the lowest.@*CONCLUSION@#DRD1 expression interference vector is successfully constructed.

Effect of captopril and isoflurane preconditioning on cell apoptosis during myocardial ischemia/reperfusion in rabbits / 中华麻醉学杂志

Objective To evaluate the effect of captopril and isoflurane preconditioning on cell apoptosis during myocardial ischemia/reperfusion (I/R) in rabbits.Methods Forty New Zealand white rabbits of both sexes,weighing 1.8-2.5 kg,were randomly divided into 5 groups (n =8 each) using a random number table:sham operation group (group S),group I/R,isoflurane preconditioning group (group I),captopril preconditioning group (group C) and captopril and isoflurane preconditioning group (group C + I).The animals were anesthetized with 3％ pentobarbital sodium 30 mg/kg.Myocardial ischemia was induced by occlusion of the left anterior descending branch of coronary artery for 30 min followed by 120 min of reperfusion.1.1％ isoflurane was inhaled for 30 min followed by 15 min washout before myocardial ischemia in group I.Captopril 25 mg/kg was given through a gastric tube into the stomach at 24 h before myocardial ischemia in group C.Captopril 25 mg/kg was given through a gastric tube into the stomach,24 h later 1.1％ isoflurane was inhaled for 30 min followed by 15 min washout,and then myocardial ischemia was performed in group C + I.The rabbits were sacrificed at the end of reperfusion and myocardial specimens were removed for microscopic examination and observation of ultrastructure,and for determination of the expression of Bcl-2 and Bax proteins (by Western blot).The apoptosis rate was detected by flow cytometry.Bcl-2/Bax ratio was calculated.Results Compared with group S,the apoptosis rate was significantly increased,the expression of Bcl-2 and Bax proteins was up-regulated,and Bel-2/Bax ratio was decreased in I/R,I,C and C + I groups (P ＜ 0.05).Compared with I/R,I and C groups,the apoptosis rate was significantly decreased,Bcl-2 protein expression was up-regulated,Bax protein expression was down-regulated,and Bcl-2/Bax ratio was increased (P ＜ 0.05),and the pathological changes were significantly attenuated in group C + I.Conclusion Regulation of Bcl-2/Bax ratio and inhibition of apoptosis in myocardial cells are involved in the mechanism by which isoflurane and captopril preconditioning reduces I/R injury in rabbits.

Effect of electric vagal stimulation on myocardial ischemia-reperfusion injury in rats / 中华麻醉学杂志

Objective To evaluate the effect of electric vagal stimulation on myocardial ischemia-reperfu-sion (I/R) injury in rats.Methods Forty-five male Sprague-Dawley rats,aged 4-5 months,weighing 180-220 g,were randomly divided into 3 groups (n =15 each):sham operation group (S group),I/R group,electric vagal stimulation group (EVS group).Myocardial I/R was induced by occlusion of left anterior descending branch of coronary artery for 30 min followed by 120 min reperfusion in I/R and EVS groups.In group EVS,the left cervical vagus nerve trank was stimulated for 30 min with continuous electric pulses (5 V,2 ms,10 Hz) starting from 10 min before reperfusion until 10 min of reperfusion.The animals were sacrificed at the end of 120 min reperfusion and the hearts were removed for determination of the infarct size,TNF-α and IL-6 contents and myeloperoxidase (MPO) activity in myocardial tissues.Results Compared with group S,the infarct size was significantly enlarged,and TNF-α and IL-6 contents and MPO activity were increased in I/R and EVS groups (P ＜ 0.05).The infarct size was significantly smaller,TNF-α and IL-6 contents and MPO activity were lower in EVS group than in I/R group (P ＜ 0.05).Conclusion Electric vagal stimulation can reduce myocardial I/R injury in rats and activation of cholinergic anti-inflammatory pathway is involved in the mechanism.

Silencing of MST1 expression by siRNA diminishes TNF-α- mediated human umbilical vein endothelial cell apoptosis / 中南大学学报(医学版)

OBJECTIVE@#To elucidate the effects of mammalian sterile 20-like kinase 1 (MST1) gene on tumor necrosis factor (TNF)-α-mediated human umbilical vein endothelial cell (HUVEC) apoptosis.@*METHODS@#Cultured HUVECs were treated with either vehicle or TNF-α (1-100 ng/mL) for 24 hours. Cell apoptosis was measured by TUNEL staining, and MST1 activity was analyzed by Western blot. In order to knock down MST1 expression in HUVECs, cells were transfected with 100 nmol/L MST1 small interference RNA (siRNA) using Lipofectamine 2000 for 24 hours, and the transfection efficiency was analyzed by Western blot. MST1 siRNA-transfected cells were treated with 10 ng/mL TNF-α for an additional 24 hours. Cell apoptosis was measured by TUNEL staining and caspase-3 activity was detected by Western blot.@*RESULTS@#MST1 activity was stimulated in a dose-dependent manner after TNF-α treatment (10, 40, 100 ng/mL) and reached the maximal effect at 100 ng/mL. MST1 activity also paralleled the onset of apoptosis as determined by TUNEL staining (P<0.001). Transfection with MST1 siRNA markedly diminished MST1 gene expression in a dose-dependent manner. MST1 siRNA (100 nmol/L) significantly silenced MST1 gene (P<0.05) and reduced TNF-α-induced endothelial cells apoptosis (P<0.05) by way of inhibiting MST1 gene activation and, accordingly, suppressing caspase-3 activity.@*CONCLUSION@#Silencing of MST1 expression by siRNA diminishes TNF-α-mediated human umbilical vein endothelial cell apoptosis by inhibiting the cascade effect of caspase-3.

Changes of TGF-β1 and CTGF in rats with increased blood flow-induced pulmonary artery hypertension / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the role of transforming growth factor-β1 (TGF-β1) and connective tissue growth factor (CTGF) in the pathogenesis of pulmonary artery hypertension, we observed the dynamic expression of TGF-β1 and CTGF in rats with high blood flow.@*METHODS@#Fifty adult male SD rats were randomly divided into 5 groups: a sham group (group S) and groups with right pneumonectomy for 1, 2, 4 and 6 weeks (PE1, PE2, PE4 and PE6 group), 10 rats per group. The mean pulmonary arterial pressure (mPAP), vessel morphometry and right ventricle hypertrophy index (RVHI) were measured. TGF-β1 and CTGF protein expression in the lung tissues were determined with immunohistochemistry and Western blot. The expression of TGF-β1 mRNA and CTGF mRNA in the lung tissues was evaluated by RT-PCR.@*RESULTS@#Compared with group S, the mPAP and RVHI in the rats were significantly increased in group PE1, PE2, PE4, and PE6 (P<0.05); the indicators of vascular remodeling [(MA+PMA)%, RMT, and RMA] were markedly elevated in group PE4 and PE6 (P<0.05), but not in group PE1 and PE2. Immunohistochemical staining of TGF-β1 and CTGF were more prominent in all of the right pneumonectomy groups than in the sham group. Western blot showed that the level of TGF-β1 protein was significantly increased in all of the right pneumonectomy groups (P<0.01), and the peak was observed in group PE2, whereas the level of CTGF protein was markedly elevated in group PE4 and PE6 (P<0.05), but no change was noticed in group PE1 and PE2. Compare to group S, the mRNA level of TGF-β1 was dramatically increased in all right pneumonectomy groups (P<0.01), peaked at group PE2, and remained high in group PE4 and PE6. In contrast, the elevation of mRNA level of CTGF was not significant in group PE1, but group PE2, PE4 and PE6 demonstrated significant mRNA level of CTGF (P<0.01). Correlation analysis showed that the protein and mRNA levels of CTGF were positively correlated with RMT and RMA ( r=0.743, r=0.906; P<0.05), while no correlation between the protein and mRNA level of TGF-β1 with RMT or RMA. There was no correlation between the mRNA level of TGF-β1 and CTGF.@*CONCLUSION@#TGF-β1 and CTGF play a role in the pathogenesis of increased pulmonary blood flow-induced pulmonary hypertension.