Predictive value of stress-induced hyperglycemia on 28 d risk of all-cause death in intensive care patients / 北京大学学报(医学版)

OBJECTIVE@#To investigate the relationship between stress glucose elevation and the risk of 28 d all-cause mortality in intensive care unit (ICU) patients, and to compare the predictive efficacy of different stress glucose elevation indicators.@*METHODS@#ICU patients who met the inclusion and exclusion criteria in the Medical Information Mart for Intensive Care Ⅳ (MIMIC-Ⅳ) database were used as the study subjects, and the stress glucose elevation indicators were divided into Q1 (0-25%), Q2 (>25%- 75%), and Q3 (>75%-100%) groups, with whether death occurred in the ICU and the duration of treatment in the ICU as outcome variables, and demographic characteristics, laboratory indicators, and comorbidities as covariates, Cox regression and restricted cubic splines were used to explore the association between stress glucose elevation and the risk of 28 d all-cause death in ICU patients; and subject work characteristics [receiver operating characteristic (ROC) and the area under curve (AUC)] were used to evaluate the predictive efficacy of different stress glucose elevation indicators, The stress hyperglycemia indexes included: stress hyperglycemia ratio (SHR1, SHR2), glucose gap (GG); and the stress hyperglycemia index was further incorporated into the Oxford acute severity of illness score (OASIS) to investigate the predictive efficacy of the improved scores: the AUC was used to assess the score discrimination, and the larger the AUC indicated, the better score discrimination. The Brier score was used to evaluate the calibration of the score, and a smaller Brier score indicated a better calibration of the score.@*RESULTS@#A total of 5 249 ICU patients were included, of whom 7.56% occurred in ICU death. Cox regression analysis after adjusting for confounders showed that the HR (95%CI) for 28 d all-cause mortality in the ICU patients was 1.545 (1.077-2.217), 1.602 (1.142-2.249) and 1.442 (1.001-2.061) for the highest group Q3 compared with the lowest group Q1 for SHR1, SHR2 and GG, respectively, and The risk of death in the ICU patients increased progressively with increasing indicators of stressful blood glucose elevation (Ptrend < 0.05). Restricted cubic spline analysis showed a linear relationship between SHR and the 28 d all-cause mortality risk (P>0.05). the AUC of SHR2 and GG was significantly higher than that of SHR1: AUCSHR2=0.691 (95%CI: 0.661-0.720), AUCGG=0.685 (95%CI: 0.655-0.714), and AUCSHR1=0.680 (95%CI: 0.650-0.709), P < 0.05. The inclusion of SHR2 in the OASIS scores significantly improved the discrimination and calibration of the scores: AUCOASIS=0.820 (95%CI: 0.791-0.848), AUCOASIS+SHR2=0.832 (95%CI: 0.804-0.859), P < 0.05; Brier scoreOASIS=0.071, Brier scoreOASIS+SHR2=0.069.@*CONCLUSION@#Stressful glucose elevation is strongly associated with 28 d all-cause mortality risk in ICU patients and may inform clinical management and decision making in intensive care patients.

STIP1 correlates with tumor immune infiltration and prognosis as a potential immunotherapy target: a pan-cancer bioinformatics analysis / 南方医科大学学报

OBJECTIVE@#To investigate the correlation of stress-inducible phosphoprotein 1 (STIP1) expression level with prognosis of different cancers and its potential role in immunotherapy.@*METHODS@#TCGA, TARGET and GTEx databases were used for bioinformatic analysis of STIP1 expression level and its prognostic value in different cancers. We also detected STIP1 expression immunohistochemically in 10 pairs of colorectal cancer and adjacent tissues. We further analyzed the correlation of STIP1 expression level with tumor mutational burden, microsatellite instability, immune cell infiltration, immune regulators and outcomes of different cancers. STIP1- related proteins were identified using protein- protein interaction (PPI) network analysis, and functional enrichment analysis was performed to analyze the regulatory pathways involving STIP1.@*RESULTS@#Bioinformatics analysis showed that STIP1 was highly expressed in most tumors compared with the normal tissues (P < 0.05), which was confirmed by immunohistochemistry of the 10 pairs of colorectal cancer tissues. STIP1 expression level was correlated with clinical stages of multiple cancers (P < 0.05), and in some cancer types, an upregulated STIP1 expression was correlated with a poor prognosis of the patients in terms of overall survival, disease-specific survival, disease-free survival and progression-free survival (P < 0.05). STIP1 expression was significantly correlated with tumor mutational burden, microsatellite instability, immune cell infiltration and immunomodulatory factors in most tumors (P < 0.05). PPI network analysis indicated that STIP1-related proteins included HSPA4, HSPA8, and HSP90AA1. KEGG enrichment analysis suggested that the high expression of STIP1 in liver cancer was related mainly with valerate metabolism, tryptophan metabolism, and butyrate metabolism pathways; HALLMARK enrichment analysis suggested high STIP1 expression in liver cancer was involved in bile acid and fatty acid metabolism.@*CONCLUSION@#STIP1 is up-regulated in multiple cancer types and its expression level is correlated with clinical tumor stage, tumor mutational burden, microsatellite instability, immune cell infiltration and immunomodulatory factors.

The Roles of the Canonical Members of Ribonuclease A Family in Tumorigenesis / 中国生物化学与分子生物学报

In human, the ribonuclease A (RNase A) family contains 8 canonical members (RNase 1-RNase 8). Research evidence indicated that all the canonical members of this family, except RNase 8, are involved in the occurrence and development of a variety of tumors, including pancreatic cancer, colorectal cancer, bladder cancer, breast cancer, and skin cancer, etc. During tumorigenesis, the expression of specific RNase increased and glycosylation modifications changed, which are potential markers for tumor diagnosis; They also participate in tumor initiation, growth, and metastasis with a variety of mechanisms, and are potential targets for tumor therapy; Meanwhile, some members have the function of killing tumor cells and inhibiting tumor development, and it is possible to develop into tumor therapeutic drugs. Concretely, RNase 1 suppresses tumor growth by directly killing tumor cells or reducing local inflammation through its ribonuclease activity-dependent cytotoxicity and extracellular RNA degradation functions; however, its binding and activation of ephrin A4 signaling pathway promotes breast cancer initiation. RNase 2 and RNase 3 are important components of eosinophil granule proteins that play an important role in anti-tumor immune defense, and their function of killing tumor cells depends on both cationic nature and ribonuclease activity. RNase 4 and RNase 5 can promote tumorigenesis by inducing angiogenesis, promoting tumor cell proliferation, and inhibiting tumor cell apoptosis. The molecular mechanisms of RNase 5 action include promoting the transcription of 47 S precursor rRNA, activating signaling pro-tumor growth signaling pathways, and generating tRNA-derived stress-induced RNA (tiRNA). Besides, RNase 6 and RNase 7 are related to the occurrence of tumors thought their specific role and mechanism are still unclear. In this review, we summarized the relevance and mechanism of RNase A family members on promoting or inhibiting tumors and analyzed their clinical application potentials.

Stress-induced senescence of tumor cells by chemotherapy, good or bad? / 中国药理学通报

Traditionally it is believed that stress-induced senescence of tumor cells induced by chemotherapy is beneficial to inhibit tumor growth and progression, and has a positive effect on anti-tumor. However, with the longtime observation and clinical study on the anti-tumor effect of chemotherapy in the real world, it is found that tumor cells often show stronger proliferation and invasiveness after chemotherapy or relapse, tumor recurrence and refractoriness become very hot and tricky issues. So, it is necessary to rethink and explore the real process and potential effect of stress-induced senescence by chemotherapy. Here from the perspective of stress-induced senescence of tumor cells by chemotherapy, this study mainly analyzes and discusses the potential negative effects and clinical significance, so as to fully understand its pros and cons in the anti-tumor effect, hoping to provide some new ideas and rationale for improving traditional tumor chemotherapy, developing new anti-tumor drugs and coming out of the current dilemma of chemotherapy.

Diagnosis and treatment of Takotsubo syndrome after liver transplantation and literature review / 器官移植

Objective To summarize the experience of diagnosis and treatment of Takotsubo syndrome (TTS) after liver transplantation. Methods Clinical data of one TTS patient after liver transplantation was retrospectively analyzed. Clinical features, diagnosis and treatment strategies were summarized, and literature review was conducted. Results A 43-year-old female patient successfully underwent split liver transplantation due to primary biliary cirrhosis for 8 years. At postoperative 3 d, the patient developed anxiety, irritation, dyspnea, disorientation, hypotension, N-terminal pro-brain natriuretic peptide (NT-proBNP) of > 35 000 pg/mL, creatine kinase isoenzyme (CK-MB) of 5.9 U/L and troponin I (TnI) of 1.78 μg/L. Electrocardiogram indicated the signs of sinus rhythm. Echocardiography indicated diffuse weakening of the left ventricular wall motion and spherical dilatation of the apex, accompanied with moderate and severe regurgitation of the mitral valve and tricuspid valve. The left ventricular ejection fraction (LVEF) declined to 23%, whereas no abnormal segmental motion of ventricular wall or corresponding electrocardiogram changes were observed. The possibility of acute coronary syndrome was excluded. The InterTAK diagnostic score was 73. The diagnosis of TTS after liver transplantation was considered. Metoprolol, coenzyme Q10, recombinant human brain natriuretic peptide, deacetyl lanatoside and lorazepam were given. Echocardiography at postoperative 10 d showed that the left ventricular function was significantly improved and the LVEF recovered to 50%. The patient was discharged 40 d after liver transplantation. The liver function was recovered well. During postoperative follow-up, she was given with metoprolol till the submission date, and no recurrence was reported. Conclusions TTS after liver transplantation is rare in clinical practice. It is difficult to make the diagnosis. The condition of TTS is severe and clinical prognosis is poor. Prompt diagnosis and interventions should be implemented.

Effects of chemical labyrinthectomy on stress analgesia induced by rotation in mice / 药学实践杂志

Objective To investigate the role of vestibular organs on stress analgesia induced by rotation in mice. Methods Female mice were randomly divided into morphine group and rotation group. After 15 minutes of intraperitoneal injection of naloxone or normal saline, the hot plate latency of mice in each group was observed following morphine injection or rotation (250 r/min, 15 s on with 5 s off). After subcutaneous injecting morphine for 7 consecutive days, tolerance was formed and the hot plate latency in morphine-tolerant mice after rotation was observed. P-aminophenylarsonic acid was injected into the inner ear to damage the vestibular organs of the mice and the hot plate latency was observed in chemically labyrinthectomy mice. Results Compared with the normal saline group, the hot plate latency of mice in the naloxone group did not change significantly after rotation (P>0.05), and the hot plate latency decreased significantly after subcutaneous injection of morphine (P<0.05). The morphine-tolerant mice had no significant change in the hot plate latency after rotation compared with the normal saline group (P>0.05). After injection of p-aminophenylarsonic acid into the inner ear, the recovery time of the righting reflex in mice was significantly increased, and the swimming ability was significantly reduced (P<0.05), and the hot plate latency of mice with chemical labyrinthectomy was significantly shortened after rotation (P<0.05). Conclusion Chemical labyrinthectomy completely blocked the rotation-induced stress analgesia in mice. Vestibular organs play an important role in rotation-induced stress analgesia, and this stress analgesia may be mediated by a non-opioid system.

Effect of acupuncture on serum inflammatory cytokines and intestinal flora in rats with stress-induced gastric ulcer / 针刺研究

OBJECTIVE: To investigate the effect of acupuncture on serum inflammatory cytokines and intestinal flora in rats with stress-induced gastric ulcer (SGU), and to explore the mechanism of acupuncture in the treatment of SGU. METHODS: Sprague-Dawley rats were randomly divided into blank, model, acupuncture, and medication groups, with 7 rats in each group. Restraint water-immersion stress was used to establish the model of SGU. The rats in the acupuncture group were given acupuncture at "Zhongwan"(CV12) and bilateral "Zusanli"(ST36) for 20 min, once a day for 5 days, and those in the medication group were given 2 mL solution of Omeprazole enteric-coated tablets (0.2 mg/kg) by gavage, once a day for 5 days. The Guth method was used to calculate the gastric mucosa damage index, HE staining was used to observe the histopathological changes of the gastric mucosa, ELISA was used to measure the serum levels of interleukin-4 (IL-4) and interleukin-6 (IL-6), and 16S rDNA sequencing method was used to observe the change in intestinal flora. RESULTS: Compared with the blank group, the model group had a significant increase in gastric mucosa damage index (P<0.01), markedly pathological changes of the gastric mucosa shown by HE staining, a significant reduction in the content of serum IL-4 (P<0.01), and a significant increase in the content of serum IL-6 (P<0.01), as well as a significant reduction in Bacteroidetes and Firmicutes at the phylum level. Compared with the model group, the acupuncture group and the medication group had a significant reduction in gastric mucosa damage index (P<0.01, P<0.05). HE staining showed reduced pathological changes of the gastric mucosa, as well as a significant increase in the content of serum IL-4 (P<0.01, P<0.05) and a significant reduction in the content of serum IL-6 (P<0.01, P<0.05). As for the intestinal flora, there was a significant increase in Bacteroidetes. Compared with the medication group, the gastric mucosa damage index was decreased （P<0.05），the content of serum IL-4 was significantly increased （P<0.05）, while the content of serum IL-6 significantly decreased (P<0.05) in the acupuncture group. CONCLUSION: Acupuncture at CV12 and ST36 can down-regulate the content of serum IL-6, up-regulate the content of serum IL-4, maintain the relative homeostasis of inflammatory cytokines, and regulate the community structure of intestinal flora, and thus help to repair the damage of gastric mucosa.

Incontinência urinária em mulheres: fatores de risco segundo tipo e gravidade / Incontinencia urinaria en mujeres: factores de riesgo de acuerdo con el tipo y la gravedad / Urinary incontinence in women: risk factors according to type and severity

RESUMO Objetivo: verificar fatores associados a incontinência urinária em mulheres por tipo e gravidade. Metodologia: estudo transversal, realizado de novembro de 2018 a abril de 2019, com 30 mulheres em um hospital escola de Pernambuco. Foi utilizado o instrumento Gaudenz-Fragebogen para identificar os tipos de incontinência e o Incontinence Severity Index para classificar a gravidade da perda urinária. Utilizou-se o teste Exato de Fisher para analisar variáveis qualitativas e t-Student para variáveis racionais Resultados: incontinência urinária de esforço foi o tipo mais frequente (66,7%), na forma moderada (43,3%) e esteve associada a baixa escolaridade (p<0,001), índice de massa corporal de 28,6 (p=0,043), circunferência abdominal de 103,4 (p<0,001), diabetes (p<0,001), número de partos superior a 4 (p=0,046), cirurgia ginecológica (p=0,023) e falta de atividade física (p=0,001). Considerações Finais: a identificação do tipo, da gravidade e dos principais fatores de risco modificáveis poderá subsidiar intervenções preventivas e curativas mais eficientes e efetivas.

RESUMEN: Objetivo: verificar factores asociados con la incontinencia urinaria en mujeres, por tipo y por gravedad. Metodología: estudio transversal realizado entre noviembre de 2018 y abril de 2019 con 30 mujeres en un hospital escuela de Pernambuco. Se utilizó el instrumento Gaudenz- Fragebogen para identificar los tipos de incontinencia y el Incontinence Severity Index para clasificar la gravedad de la pérdida de orina. Se utilizó la prueba exacta de Fisher para analizar las variables cualitativas, y el t-Student para las variables racionales. Resultados: la incontinencia urinaria por esfuerzo fue el tipo más frecuente (66,7%), en su forma moderada (43,3%) y estuvo asociada a un bajo nivel de escolaridad (p<0,001), a un Índice de Masa Corporal de 28,6 (p=0,043), a una circunferencia abdominal de 103,4 (p<0,001), diabetes (p<0,001), cantidad de partos superior a 4 (p=0,046), cirugía ginecológica (p=0,023) y a la falta de actividad física (p=0,001). Consideraciones finales: identificar el tipo, la gravedad y los principales factores de riesgo modificables podrá ayudar a diseñar intervenciones preventivas y curativas más eficientes y efectivas.

ABSTRACT Objective: To verify factors associated with urinary incontinence in women by type and severity. Methodology: A cross-sectional study conducted from November 2018 to April 2019 with 30 women in a teaching hospital of Pernambuco. The Gaudenz-Fragebogen instrument was used to identify incontinence types, and the Incontinence Severity Index to classify urinary loss severity. Fisher's exact test was used to analyze qualitative variables, and the t-Student test for rational variables. Results: Stress-induced urinary incontinence was the most frequent type (66.7%), in its moderate form (43.3%), and was associated with low schooling (p<0.001), Body Mass Index of 28.6 (p=0.043), abdominal circumference of 103.4 (p<0.001), diabetes (p<0.001), number of deliveries above 4 (p=0.046), gynecological surgery (p=0.023), and lack of physical activity (p=0.001). Final Considerations: Identifying the type, severity, and main modifiable risk factors may support more effective and efficient preventive and curative interventions.

Impact of tuberculosis on glycaemic status: A neglected association

Background & objectives: Diabetes mellitus (DM) is an important risk factor for tuberculosis and has received increasing emphasis. However, the reverse association of tuberculosis impacting blood sugar levels has not been well studied. The present study was conducted to evaluate the prevalence of hyperglycemia in patients with tuberculosis and assess its resolution following successful treatment of tuberculosis. Methods: In this prospective study, a total of 582 patients with tuberculosis were evaluated for hyperglycaemia [DM or impaired glucose tolerance (IGT)] with random blood sugar (RBS) and all patients with RBS >100 mg/dl were subjected to a 75 g oral glucose tolerance test (OGTT). All patients received thrice weekly intermittent Directly Observed Treatment Short Course (DOTS) for tuberculosis. Patients with hyperglycaemia were re-evaluated at the end of anti-tuberculosis treatment with an OGTT and glycated hemoglobin (HbA1c) levels to assess for glycaemic status. Results: In the present study, 41 of the 582 patients were found to have DM [7%, 95% confidence interval (CI) (5.2, 9.4)] while 26 patients were found to have IGT [4.5%, 95% CI (3, 6.5)]. Three patients were lost to follow up. Of the 26 patients with IGT, 17 [65.4%, 95% CI (46.1, 80.7)] reverted to euglycaemic status following successful treatment of tuberculosis, while the blood sugar levels improved in all patients with DM following treatment of tuberculosis. Interpretation & conclusions: Our study results show that tuberculosis adversely impacts glycaemic status with improvement in blood sugar levels at the end of successful treatment of tuberculosis. Longitudinal studies with large sample size are required to confirm these findings.

Nervous Mechanism of Gastric Mucosal Lesion Induced by Restraint Water-immersion Stress in Rats / 胃肠病学

Stress-induced gastric mucosal lesion (SGML) is one of the most common visceral complications after trauma. Restraint water-immersion stress (RWIS) can induce gastric mucosal lesion within a few hours. It has been confirmed that hyperfunction of parasympathetic nervous system contributes to the gastric dysfunction induced by RWIS. The dorsal motor nucleus of vagus, nucleus of solitary tract, hypothalamic supraoptic nucleus, paraventricular nucleus, mediodorsal thalamic nucleus, central amygdaloid nucleus and medial prefrontal cortex are all involved in the formation of SGML. Neurotransmitter/neuromodulation such as substance P, acetylcholine, oxytocin may be involved in the physiological process. This article reviewed the nervous mechanism of gastric mucosal lesion induced by RWIS in rats.

Moxibustion improved gastric ulcer by reducing contents of corticotrophin-releasing hormone and adrenocorticotropic hormone in serum and hypothalamus-pituitary tissues in rats with stress-induced gastric ulcer / 针刺研究

OBJECTIVE: To observe the effect of moxibustion of "Zhongwan" (CV12) and "Zusanli" (ST36) on histopathological changes of the gastric mucosa and contents of corticotropin-releasing hormone(CRH) and adrenocorticotrophic hormone(ACTH) in the serum, hypothalamus and pituitary tissues in rats with stress-induced gastric ulcer(SGU), so as to reveal its mechanisms underlying improvement of SGU. METHODS: A total of 28 male SD rats were randomly divided into blank control, model, moxibustion, and medication groups, with 7 rats in each group. The SGU model was established by water immersion restraint stress for 3 h. Moxibustion was applied to "Zhongwan"(CV12) and bilateral "Zusanli" (ST36) for 20 min, once a day for 5 days, and rats of the medication group were treated by gavage of Omeprazole enteric-coated tablets (0.2 mg/kg) once a day for 5 days. The gastric mucosal damage index (ulcer index, UI) was measured to assess the injury severity according to Guth's me-thods. Histopathological changes of the gastric mucosa were determined by H．E. staining. The contents of CRH in serum and hypothalamus and ACTH in serum and pituitary gland tissue were assayed by using ELISA. RESULTS: Outcomes of H．E. staining showed gastric mucosal epithelia defect, disordered arrangement of glands, obvious mucosal hyperemia and edema, exudation of a large number of red blood cells, swelling of mucosal cells with necrosis of nuclei in the model group. These situations were relatively milder in the moxibustion and medication groups. After modeling, the UI, and the contents of CRH in the serum and hypotha-lamus, and ACTH in the serum and pituitary tissue were significantly increased in comparison with the blank control group (P0.05)．. CONCLUSION: Moxibustion can relieve gastric mucosal injury induced by stress in water immersion restraint stress rats, which may be associated with its effects in down-regulating the levels of CRH and ACTH in se-rum, hypothalamus and pituitary tissues (inhibition of activities of hypothalamic-pituitary-adrenocortical axis)．.

Establishment and evaluation of a stress depression model induced by light and dampness on mice / 中华行为医学与脑科学杂志

Objective@#To establish a novel stress-induced depression model by changing the lighting conditions and continuously damping cushion (L-D).@*Methods@#The L-D stress depression animal model was established in C57BL / 6 mice with body weight of 18-22 g. Seventy-five mice with the horizontal and vertical scores higher than 30 and less than 120 in open field test were employed.In the research of model construction, mice were randomly divided into three groups: control group (n=9), chronic unpredictable mild stress(CUMS) model group (n=10) and L-D model group (n=9). In the drug intervention experiments, mice were randomly divided into five groups: control group (n=9), chronic unpredictable mild stress(CUMS) model group (n=10), L-D model group (n=9), CUMS+ fluoxetine group (n=10) and L-D model+ fluoxetine group (n=9). Open field test, forced swimming test and sucrose preference test were used to evaluate the degree of depression in animals.@*Results@#(1) In the open field test, the horizontal score of CUMS model group (67.20±5.81) and the L-D model group (52.56±19.05) were significantly lower than that of the control group (76.44±9.22) (t=2.645, t=3.387, both P<0.05). And horizontal score of the L-D model was significantly lower than that of the CUMS model (t=2.321, both P<0.05). In forced swimming experiment, compared with the control group ((39.67±21.12)s), the immobility time of the CUMS model group ((60.90±10.34)s) and the L-D model group ((74.89±16.10)s) were significantly prolonged (t=2.831, 3.979, both P<0.05). The immobility time of the L-D model group was also significantly higher than that of the CUMS model group (t=2.278, P<0.05). In the sucrose preference experiment, the percentage of sucrose preference in CUMS model group ((72±7)%) and L-D model group ((65±5)%) was lower than that in the control group ((81±12)%) (t=2.195, 3.875, both P<0.05). The percentage of sucrose preference of L-D model group was significantly higher than that of CUMS model group (t=2.286, P<0.05). (2) After intervention with antidepressants, the horizontal scores of the CUMS model group (65.60±6.43) and the L-D model group (54.33±14.67) were significantly lower than that of the control group (75.78±8.27) in open field test (t=3.011, t=3.861, both P<0.05), and the score of L-D group was lower than that of CUMS group(t=2.235, P<0.05). The vertical score of the L-D model group (33.44±4.54) was significantly lower than that of the control group (39.22±5.56) (t=2.553, P<0.05). There was significant increase in the level score and vertical score of CUMS model and L-D model after fluoxetine intervention (t=3.090, t=2.692, both P<0.05), and significant twist in the vertical score of CUMS model and L-D model (t=2.681, t=2.354; both P<0.05). In the forced swimming experiment, the immobility time of the L-D model((64.11±13.06)s) was significantly longer than that of the control group ((42.00±13.77)s) (t=3.494, P<0.05). The immobility time of CUMS model and L-D model mice was significantly longer than that of non-intervention group (t=2.137, 2.940, both P<0.05). After the intervention of fluoxetine, there was no significant difference between the CUMS group, L-D group, the control group(all P>0.05).@*Conclusion@#Changing the lighting conditions and continuously damping cushion is a new method to establish mice model with depression behavior.Shorter modeling duration and simple operation are the main advantages of this model.

Neurogenic stress cardiomyopathy: What do we need to know

The interaction between the heart and brain is complex and integral to the maintenance of normal cardiovascular function. Even in the absence of coronary disease, acute neuronal injury can induce a variety of cardiac changes. Recent neuroimaging data revealed a network including the insular cortex, anterior cingulate gyrus, and amygdala playing a crucial role in the regulation of central autonomic nervous system. Damage in these areas has been associated with arrhythmia, myocardial injury, higher plasma levels of brain natriuretic peptide, catecholamines, and glucose. Some patients after brain injury may die due to occult cardiac damage and functional impairment in the acute phase. Heart failure adversely influences acute stroke mortality. Troponin and NT-proBNP are elevated in acute brain injury patients, in response to the activated renin–angiotensin–aldosterone system and other neurohumoral changes, as a protective mechanism for sympathoinhibitory activity. Such patients have been shown to be associated with higher short- and long-term mortality. While thrombolysis, neuroprotection, and other measures, alone or in combination, may limit the cerebral damage, attention should also be directed toward the myocardial protection. Early administration of cardioprotective medication aimed at reducing increased sympathetic tone may have a role in myocardial protection in stroke patients. For a full understanding of the brain–heart control, the consequences of disruption of this control, the true incidence of cardiac effects of stroke, and the evidence-based treatment options further research are needed.

Thermal effect of acute and chronic stress on hepatic and renal tissue of the pacific sardine, Sardinops sagax caeruleus (Jenyns, 1842) / Efecto del estrés térmico agudo y crónico sobre el tejido hepático y renal de la sardina del pacífico, Sardinops sagax caeruleus (Jenyns, 1842)

SUMMARY: In the thermal range of the Pacific waters, known for the geographical distribution of Sardinops sagax caeruleus(Jenyns, 1842) (Pacific sardine), could be exposed to a stressing temperature environment with dilated effect. This work examines the liver and kidney of sardines acclimated at different temperatures and exposed to the lethal temperature and critical thermal maximum trials. The liver and kidney tissues of Sardinops sagax caeruleus acclimated for 25 days at 19, 21, 23 and 25 °C were anatomically examined after exposure to acute heat stress (AHS) caused by increasing the water temperature at a rate of 1 °C per min, and the chronic heat stress (CHS) effect by abruptly exposure to constant water temperature different from that of acclimation (AT). We observed in fish exposed to AHS that the liver tissue had vacuolated or necrotic hepatocytes and infiltration of inflammatory blood cells (25 °C) and the kidney tissue showed degenerative changes in the glomeruli and renal tubules and increased melanomacrophage centers. The CHS effect in liver and renal tissues produced damage signs of pyknosis, apoptosis, necrotic areas, and an increase in melanomacrophage centers as well as outbreaks of bacterial infection. The results demonstrate that S. sagax caeruleus did not tolerate an abrupt thermal change of more than 4 °C, independently of the ATs, over 50 % died. The consequences of the experimental acute and chronic thermal stress were histopathological alterations of liver and kidney. It was expected that the chronic stress temperature could produce in fish conspicuous histological changes, and indeed it was the most deleterious.

RESUMEN: En el rango térmico de las aguas del Pacífico, conocido por la distribución geográfica de Sardinops sagax caeruleus (Jenyns, 1842) (sardina del Pacífico), esta especie podría estar expuesta a un ambiente de temperatura estresante con efecto dilatado. Este trabajo examina el hígado y el riñón de las sardinas aclimatadas a diferentes temperaturas y expuestas a la temperaturas letales y crítica máxima. Los tejidos hepático y renal de Sardinops sagax caeruleus aclimatadas durante 25 días a 19, 21, 23 y 25 °C se examinaron anatómicamente después de la exposición al estrés de calor agudo (AHS) causado por el aumento de la temperatura del agua a una velocidad de 1 °C por minuto, y el efecto de estrés de calor crónico (CHS) por la exposición brusca a una temperatura constante del agua diferente a la de la aclimatación (AT). Observamos en peces expuestos a AHS que el tejido hepático tenía hepatocitos vacuolados o necróticos y la infiltración de células sanguíneas (25 °C) y el tejido renal presentaba cambios degenerativos en los glomérulos y túbulos renales y aumento de centros de melanomacrófagos. El efecto CHS en los tejidos hepático y renal produjo signos de daño de picnosis, apoptosis, áreas necróticas y un aumento en los centros de melanomacrófagos, así como brotes de infección bacteriana. Los resultados demuestran que S. sagax caeruleus no toleró un cambio térmico abrupto de más de 4 °C, independientemente de las AT, más del 50 % murió. Las consecuencias del estrés térmico agudo y crónico experimental fueron las alteraciones histopatológicas del hígado y el riñón. Se esperaba que la temperatura de estrés crónica pudiera producir cambios histológicos conspicuos en los peces, y de hecho fue la más perjudicial.

Proteomics study of stress-induced depression in rat model based on the two dimensional electrophoresis / 天津医药

Objective To screen altered proteins of hippocampus in the stress-induced depression (STRID) rat model, and explore the potential molecular mechanism. Methods Twenty Sprague-Dawley rats were randomly divided into the control group and STRID group, 10 rats in each group. Chronic unpredictable mild stress (CUMS) methods including fasting for solids and liquids, electric foot-shock, reversing day and night, cold water swimming, cage tilt, scare stimulation and tail pinch were conducted on STRID rats with no repeats for 28 days to make up the depression animal model. The control group was normally fed during this period. After the stress stimulation, the hippocampus protein samples were used for two dimensional electrophoresis to screen the differentially expressed protein, and then mass spectrum identification and function analyze were conducted. Results Compared with the control group, 34 proteins were altered in STRID group. Among which, 18 were up-regulated, and 16 were down-regulated. The differentially expressed proteins mainly located in cytoplasm, mitochondrion, extracellular exosome and myelin sheath. The involved signaling pathways included metabolic pathway, oxidative phosphorylation pathway, and Alzheimer's disease, Parkinson's disease and Huntington's disease pathways. Conclusion The altered proteins and dysfunction of nerve signaling, and the excess of oxidative phosphorylation in hippocampus of STRID rats may be one of the pathogenesises.

Preventive Effect of Gynostemma pentaphyllum Water Extract on Model Rats with Water Immersion Stress-induced Gastric Ulcer / 中国药房

OBJECTIVE:To investigate the preventive effect of Gynostemma pentaphyllum water extract on model rats with stress-induced gastric ulcer. METHODS:60 rats were randomly divided into normal group,model group,positive group (Sanjiu weitai granules,3.69 g/kg)and G. pentaphyllum water extract high-dose,medium-dose,low-dose groups(4.0,2.0,1.0 g/kg,cal-culated by crude drug),10 in each group. All rats were intragastrically administrated,once a day,for one week. After 2 h of ad-ministration,except for normal group,rats were induced to stress gastric ulcer model by water immersion method in other groups. After 3 h of modeling,ulcer index (UI),ulcer inhibition rate were detected;superoxide dismutase (SOD) and malondialdehyde (MDA)in serum,tumor necrosis factor-α(TNF-α),prostaglandin E2(PGE2),nitric oxide(NO)and endothelin-1(ET-1)levels in gastric mucosal tissue were determined. RESULTS:Compared with normal group,SOD level in model group was decreased, while MDA level was increased in serum(P<0.05);PGE2,NO levels were decreased,TNF-α,ET-1 levels were increased in gas-tric mucosal tissue (P<0.05). Compared with model group,UI in administration groups were obviously decreased,above-men-tioned indexes were obviously improved,which showed certain dose-dependence. And the levels of PEG2,ET-1 of gastric mucosal tissue in G. pentaphyllum water extract high-dose group improved more obviously than positive group,with statistical significances (P<0.05). CONCLUSIONS:G. pentaphyllum water extract plays a role in preventing gastric ulcer by regulating serum SOD-MDA balance,gastric mucosal tissue NO-ET-1 balance and reduce the degree of gastric mucosa injury,etc.

Recurrent fetal postpartum stress induced cardiomyopathy after normal vaginal delivery / 고신대학교의과대학학술지

Stress induced cardiomyopathy is a disease that shows a dysfunction of the ventricle, but it can be rapidly reversible. It often occurs in older women primarily who suffers from emotional or physical stress. There are some case reports about postpartum stress induced cardiomyopathy. Most of the patients are recovered naturally within days to weeks. We report a case of a 37 years-old woman, who had experienced postpartum stress induced cardiomyopathy 8 years ago, revisited hospital because of cardiomyopathy after secondary delivery. Herein we report a rare case of recurrent stress induced cardiomyopathy after secondary normal vaginal delivery.

A Case of Cardiac Arrest due to Multivessel, Diffuse Coronary Spasm in Moyamoya Disease / 고신대학교의과대학학술지

Moyamoya disease is characterized by progressive stenosis of the distal portion of the internal carotid arteries and fragile collateral vessels in the brain. The precise pathogenesis is still not known. Although extracranial vessel involvement is very rare, coronary arterial involvement has recently been reported. Here, we report a case of diffuse, multivessel coronary spasm leading to cardiac arrest and myocardial infarction in a 47-year-old man with moyamoya disease with no underlying emotional or physical stress.

Gender Differences in Clinical Profiles of Stress-Induced Cardiomyopathy

BACKGROUND: Although stress-induced cardiomyopathy (SCMP) is reported to be more common in women, little is known about gender differences in patients with SCMP. The aim of the study was to describe clinical features of patients with SCMP according to gender. METHODS: One hundred and three patients diagnosed with definite SCMP at a single tertiary institute from January 1997 to August 2014 were enrolled. SCMP was more common in women than in men. RESULTS: Age at presentation was not significantly different between the two groups (p = 0.758). Preceding physical stress, especially acute medical illness, was more common in male patients (p = 0.014), whereas emotional stress was more common in female patients (p = 0.016). Severity of medical illness classified by the Acute Physiology and Chronic Health Evaluation (APACHE) II score at the time of SCMP diagnosis was not significantly different between men and women (p = 0.752). Clinical characteristics, including symptoms, laboratory and electrocardiographic findings, were similar. However, pump failure was more severe in men (p = 0.024). Clinical outcomes were not statistically different (p = 0.220). Preceding physical stress and lower left ventricular systolic function after 2 months were independent risk factors for all-cause mortality for both genders. Women with an APACHE II score ≥ 15 and men with reduced left ventricular ejection fraction after 2 months had a greater risk of poor prognosis. CONCLUSION: SCMP was more common in female patients. Female patients more commonly experienced preceding emotional stress, whereas physical stress was more common in male patients. Systolic dysfunction was more severe in men. Long-term clinical outcomes appeared to be similar between men and women.

Research progress and stress-induced variation of DNA methylation in plants / 生物工程学报

Chemical modification of DNA bases in recent years has been one of the hot areas of life science research. DNA methylation is a common epigenetic phenomenon and can change the genetic performance without changing the DNA sequence. Various stress factors can induce the variation of DNA methylation in plants, but the response mechanism is still unknown. In this paper, the progress of DNA methylation in plants was reviewed. In combination with the researchconclusions of our own research group, the DNA methylation variation induced by 7Li ion beam and gamma ray was reported to provide a basis for DNA methylation, which may be involved in the phenotypic plasticity of plants.