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ObjectiveTo study the brain network during balance control tasks in older adults. MethodsFrom January to April, 2022, 22 healthy young adults and 20 healthy older adults were recruited from the Fifth Affiliated Hospital of Guangzhou Medical University and communities. They were asked to finish standing tasks on the plantar pressure plate with eyes opening and closing, while the functional connectivities (FC) of prefrontal cortex (PFC) and primary motor cortex (PMC) were measured with functional near-infrared spectroscopy. ResultsCompared with the young adults, the area of the ellipse (Z = -2.884, P < 0.01) and the maximum swing (Z = -2.481, P < 0.05) increased in the older adults as eyes closing. During the standing task, the intra-FC of left (t = 2.978, P < 0.01) and right (Z = -3.123, P < 0.01) PFC decreased in the older adults, and the inter-FC of right PMC to left PFC (t = 2.087, P < 0.05) and right PFC to left PFC (t = 3.471, P < 0.001) decreased, too. ConclusionThe FC of PFC decreased in healthy older adults during balance control tasks, which may be a indicator for aging brain.
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Objective:To evaluate the efficacy of continuous infusion of lidocaine via urinary catheter for postoperative analgesia in patients undergoing urological surgery.Methods:Forty male American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients, aged 65-75 yr, with body mass index of 18-25 kg/m 2, scheduled for elective percutaneous nephrolithotomy, were divided into 2 groups ( n=20 each) using a random number table method: continuous infusion of lidocaine through urinary catheter group (group L) and patient controlled intravenous analgesia (PCIA) group (group PCIA). All the patients underwent total intravenous anesthesia, and a matched type of sterile urethral irrigation catheter was inserted after the operation.In group L, 0.5% lidocaine was continuously infused at a rate of 5 ml/h via the urinary catheter, while the equal volume of 0.9% normal saline was continuously infused via the urinary catheter, and PCIA was connected in group PCIA.PCIA solution contained sufentanil 125 μg (diluted to 250 ml in normal saline), and the PCA pump was set up with a 5 ml bolus dose, a 15 min lockout interval and background infusion at a rate of 5 ml/h.When visual analogue score was>4, sufentanil 0.05 μg/kg was injected intravenously as rescue analgesic.The development and severity of catheter-related bladder discomfort (CRBD) were recorded immediately at the end of the operation (T 1), and at 6 h (T 2), 24 h (T 3) and 48 h (T 4) after the operation, respectively.Riker sedation-agitation scale (SAS) score was recorded at T 1, 2, and QoR-9 scale was recorded at T 3, 4.The concentrations of serum cortisol (Cor), norepinephrine (NE), epinephrine (E) and blood glucose (Glu) were measured by enzyme linked immunosorbent assay.First off-bed time, exhaust time, length of hospital stay after surgery, and the requirement for rescue analgesia and adverse reactions (nausea and vomiting, respiratory depression, hypotension, skin itching) within 48 h after the operation were recorded. Results:Compared with group PCIA, the incidence of CRBD and the severity were significantly decreased at T 1-4, SAS score was decreased at T 1, 2, QoR-9 score was increased at T 3, 4, Cor, NE, E and Glu concentrations were decreased at T 1-4, the incidence of postoperative rescue analgesia was decreased, first off-bed time, exhaust time and length of hospital stay after surgery was shortened, and the incidence of postoperative nausea and vomiting, respiratory depression, hypotension, skin itching was decreased in group L ( P<0.05). Conclusion:Continuous infusion of lidocaine through the urinary catheter can provide good postoperative analgesia, reduce postoperative stress response and adverse reactions, and facilitate early postoperative recovery in patients undergoing urological surgery.
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Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on inflammatory responses during intestinal mucosal barrier damage caused by gastrointestinal surgery in the rats.Methods:Forty-five healthy male Sprague-Dawley rats, aged 7-8 weeks, weighing 220-260 g, were divided into 3 groups ( n=15 each) by a random number table method: control group (C group), gastrointestinal surgery group (S group), and TEAS group (T group). Rats underwent pylorectomy and Roux-en-Y gastrojejunal anastomosis to establish gastrointestinal surgery models in S and T groups, while group C received no treatment.In group T, bilateral Zusanli and Hegu acupoints were stimulated with disperse-dense waves, current intensity 5 mA, frequency 2 Hz, from 30 min before surgery until the end of operation.Only electrode patches were applied, but no stimulation was applied in group S. Five rats were randomly selected from each group and sacrificed at 12, 24 and 48 h after surgery (T 1-3), and ileal tissues were taken after anesthesia.The pathological changes of ileal tissues were observed with a light microscope and scored according to Chiu.Enzyme-linked immunosorbent assay was used to determine contents of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), diamine oxidase (DAO) and intestinal fatty acid-binding protein (I-FABP). Western blot was used to detect the expression of occludin, claudin-3 and ZO-1.The immunohistochemical method was used to determine the percentage of occludin, claudin and zonula occludens-1 (ZO-1) positive cells. Results:Compared with group C, Chiu′s scores and contents of ileal IL-6, TNF-α, DAO and I-FABP were significantly increased, the percentage of occludin, claudin-3 and ZO-1 protein positive cells was decreased, and the expression of occludin, claudin-3 and ZO-1 was down-regulated at T 1-3 in group S and group T ( P<0.05). Compared with group S, Chiu′s scores and contents of ileal IL-6, TNF-α, DAO and I-FABP were significantly decreased, the percentage of occludin, claudin-3 and ZO-1 protein positive cells was increased, and the expression of occludin, claudin-3 and ZO-1 was up-regulated at T 1-3 in group T ( P<0.05). Conclusion:TEAS can reduce the intestinal mucosal barrier damage caused by gastrointestinal surgery by inhibiting the inflammatory response in rats.
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Objective@#To evaluate the efficacy of transcutaneous electrical acupoint stimulation (TEAS) for general anesthesia preserving spontaneous breathing in the patients undergoing thoracoscopic surgery.@*Methods@#Forty patients of both sexes, aged 18-67 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with Mallampati physical status Ⅰ or Ⅱ, scheduled for elective thoracoscopic lobectomy, were divided into 2 groups (n=20 each) using a random number table method: general anesthesia preserving spontaneous breathing group (group GS) and TEAS plus general anesthesia preserving spontaneous breathing group (group TE+ GS). Anesthesia was routinely induced and maintained, a laryngeal mask was placed, and patients kept spontaneous breathing in two groups.The bispectral index value was maintained at 45-60.Patient-controlled intravenous analgesia was used after operation, and visual analogue scale score was maintained<4 points.In group TE+ GS, Xinshu and Feishu acupoints ipsilateral to the operated side and bilateral Hegu and Neiguan acupoints were stimulated with a disperse-dense wave, frequency 2/100 Hz and intensity 5-15 mA starting from 30 min before anesthesia induction until the end of surgery.The mean arterial pressure (MAP), heart rate (HR) and respiratory rate (RR) were recorded before induction of anesthesia, immediately after start of operation, during thoracic exploration, immediate after lobectomy , and at 30 min and 1 h after lobectomy.The intraoperative MAP, HR, and RR were recorded when clinically significant events occurred in two groups.Central venous blood samples were simultaneously collected for determination of concentrations of cortisol, norepinephrine, epinephrine, and blood glucose in serum (by enzyme-linked immunosorbent assay). The highest value of PETCO2, the lowest value of SpO2, and consumption of anesthetic drugs were recorded.Duration of post-anesthesia care unit stay, time to first flatus, ambulation time, occurrence of nausea and vomiting, chest tube drainage time, development of surgical complications, length of postoperative hospital stay and hospitalization expenses were recorded.@*Results@#MAP, HR and RR all fluctuated within the normal range, and no clinically significant events occurred in two groups.Compared with group GS, the highest value of PETCO2 was significantly decreased, the lowest value of SpO2 was increased, the MAP and HR were decreased, the consumption of propofol and remifentanil was decreased, the cortisol, norepinephrine, epinephrine, and blood glucose concentrations in serum were decreased, the time to first flatus, ambulation time, chest tube drainage time and length of postoperative hospital stay were shortened, and the incidence of nausea and vomiting and hospitalization expenses were decreased in group TE+ GS (P<0.05).@*Conclusion@#TEAS can reduce the amount of opioids consumed in the perioperative period, effectively inhibits intraoperative stress responses, and is helpful in improving the early outcomes when used for general anesthesia preserving spontaneous breathing in the patients undergoing thoracoscopic surgery.
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Objective To evaluate the efficacy of transcutaneous electrical acupoint stimulation (TEAS) for general anesthesia preserving spontaneous breathing in the patients undergoing thoracoscopic surgery.Methods Forty patients of both sexes,aged 18-67 yr,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,with Mallampati physical status Ⅰ or Ⅱ,scheduled for elective thoracoscopic lobectomy,were divided into 2 groups (n =20 each) using a random number table method:general anesthesia preserving spontaneous breathing group (group GS) and TEAS plus general anesthesia preserving spontaneous breathing group (group TE+GS).Anesthesia was routinely induced and maintained,a laryngeal mask was placed,and patients kept spontaneous breathing in two groups.The bispectral index value was maintained at 45-60.Patient-controlled intravenous analgesia was used after operation,and visual analogue scale score was maintained＜4 points.In group TE+GS,Xinshu and Feishu acupoints ipsilateral to the operated side and bilateral Hegu and Neiguan acupoints were stimulated with a disperse-dense wave,frequency 2/100 Hz and intensity 5-15 mA starting from 30 min before anesthesia induction until the end of surgery.The mean arterial pressure (MAP),heart rate (HR) and respiratory rate (RR) were recorded before induction of anesthesia,immediately after start of operation,during thoracic exploration,immediate after lobectomy,and at 30 min and 1 h after lobectomy.The intraoperative MAP,HR,and RR were recorded when clinically significant events occurred in two groups.Central venous blood samples were simultaneously collected for determination of concentrations of cortisol,norepinephrine,epinephrine,and blood glucose in serum (by enzyme-linked immunosorbent assay).The highest value of PETCO2,the lowest value of SpO2,and consumption of anesthetic drugs were recorded.Duration of post-anesthesia care unit stay,time to first flatus,ambulation time,occurrence of nausea and vomiting,chest tube drainage time,development of surgical complications,length of postoperative hospital stay and hospitalization expenses were recorded.Results MAP,HR and RR all fluctuated within the normal range,and no clinically significant events occurred in two groups.Compared with group GS,the highest value of PETCO2 was significantly decreased,the lowest value of SpO2 was increased,the MAP and HR were decreased,the consumption of propofol and remifentanil was decreased,the cortisol,norepinephrine,epinephrine,and blood glucose concentrations in serum were decreased,the time to first flatus,ambulation time,chest tube drainage time and length of postoperative hospital stay were shortened,and the incidence of nausea and vomiting and hospitalization expenses were decreased in group TE +GS (P＜0.05).Conclusion TEAS can reduce the amount of opioids consumed in the perioperative period,effectively inhibits intraoperative stress responses,and is helpful in improving the early outcomes when used for general anesthesia preserving spontaneous breathing in the patients undergoing thoracoscopic surgery.
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Coculture between mesenchymal stem cells (MSCs) and chondrocytes has significant implications in cartilage regeneration. However, a conclusive understanding remains elusive. Previously, we reported that rabbit bone marrow-derived MSCs (rbBMSCs) could downregulate the differentiated phenotype of rabbit articular chondrocytes (rbACs) in a non-contact coculture system for the first time. In the present study, a systemic investigation was performed to understand the biological characteristics of chondrocytes in coculture with MSCs. Firstly, cells (MSCs and chondrocytes) from different origins were cocultured in transwell system. Different chondrocytes, when cocultured with different MSCs respectively, consistently demonstrated stimulated proliferation, transformed morphology and declined glycosaminoglycan secretion of chondrocytes. Next, cell surface molecules and the global gene expression of rbACs were characterized. It was found that cocultured rbACs showed a distinct surface molecule profile and global gene expression compared to both dedifferentiated rbACs and rbBMSCs. In the end, cocultured rbACs were passaged and induced to undergo the chondrogenic redifferentiation. Better growth and chondrogenesis ability were confirmed compared with control cells without coculture. Together, chondrocytes display comprehensive changes in coculture with MSCs and the cocultured rbACs are beneficial for cartilage repair.
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Cartilage , Chondrocytes , Chondrogenesis , Coculture Techniques , Gene Expression , Mesenchymal Stem Cells , Phenotype , Population Characteristics , RegenerationABSTRACT
Objective To develop a nomogram for the use of predicting renal outcomes of Chinese lupus nephritis (LN) patients.Methods From January 1,2005 to October 1,2015,513 patients with biopsy-proven LN in the First Affiliated Hospital of Sun Yat-Sen University were enrolled into this study.Renal outcomes were defined as end-stage renal disease or doubling of serum creatinine.Demographic characteristics,laboratory data,and pathologic data were recorded and included for analysis.Nomograms were designed using multivariate Cox proportional hazards regression to predict the non-outcome renal survival in 5 and 8 year according to the Akaike information criterion (AIC) and continuous reclassification net improvement (cNRI).Predictive accuracy and discriminative ability of the models were determined by concordance index (C-index) and calibration curve.Results During a median follow up of 48 (24,71) months,44 patients (8.58％) reached the endpoint.1-year,5-year and 8-year non-outcome renal survival were 97.57％,92.89％,79.89％ respectively.According to multivariate Cox regression,four nomograms including index for baseline renal function,pathologic severity,and response to treatment were designed.The best model,within which included eGFR was lower than 30 ml · min-1 · (1.73 m2)-1(HR=4.44,95％ CI 2.16-9.13,P ＜ 0.01),percentage of global glomerulosclerosis was higher (HR=12.28,95％CI 3.58-42.13,P ＜ 0.01) and partial remission occurred after 6-month induction treatment (HR=9.16,95％ CI 4.71-17.82,P ＜ 0.01) demonstrated good discrimination to predict 5-year and 8-year non-outcome renal survival [C-index,0.80(95％CI 0.81-0.91),0.76(95％CI 0.68-0.85),respectively].The nomogram based on above model also performed good calibration.Conclusion The nomogram based on patients' baseline eGFR,percentage of global glomerulosclerosis,and treatment reaction after 6-month induction therapy can accurately predict 5-year and 8-year non-outcome renal survival in Chinese lupus nephritis patients.