Improvement effects of poria acid on insulin resistance in rats with polycystic ovary syndrome and its mechanism / 中国药房

OBJECTIVE To study the improvement effects of poria acid on insulin resistance in rats with polycystic ovary syndrome （PCOS） and its mechanism. METHODS One hundred and twenty-six female rats were randomly separated into blank group， PCOS group， poria acid low-dose group （8.33 mg/kg）， pachymic acid high-dose group （33.32 mg/kg）， ethinylestradiol cyproterone group （positive control group， 0.34 mg/kg）， recombinant rat high mobility group protein B1 protein （rHMGB1） group （8 μg/kg）， and poria acid high dose+rHMGB1 group （33.32 mg/kg poria acid+8 μg/kg rHMGB1）， with 18 rats in each group. Except for the blank group， the rats in all other groups were given Letrozole suspension intragastrically to construct the PCOS model. After successful modeling， administration was performed once a day for 4 weeks. After medication， the fasting blood glucose and fasting insulin levels， and insulin resistance index （HOMA-IR） were measured in rats； the levels of follicle-stimulating hormone （FSH）， luteinizing hormone （LH） and testosterone （T） in rat serum， and the levels of interleukin-1β （IL-1β） and tumor necrosis factor- α （TNF- α） in ovarian tissue were detected； ovarian coefficients of rats were calculated； the pathological changes of ovarian tissue were observed； the expressions of HMGB1， receptor for advanced glycosylation elaine_ tanghong@sina.com end product （RAGE） and phosphorylated nuclear factor κB p65 （p-NF-κB p65） proteins were determined in ovarian tissue of rats. RESULTS Compared with the blank group， the pathological injury of ovarian tissue of rats in the PCOS group was serious， the levels of fasting blood glucose and fasting insulin， HOMA-IR and ovarian coefficient were increased， the levels of serum LH and T were increased， while the levels of FSH were decreased； the levels of IL-1β and TNF-α， the expressions of HMGB1， RAGE and p-NF-κB p65 protein in ovarian tissue were increased， with statistical significance （P＜0.05）. Compared with the PCOS group， pathological damage of ovarian tissue was reduced in poria acid low-dose and high-dose groups and ethinylestradiol cyproterone group， and fasting blood glucose， fasting insulin levels， HOMA-IR and ovarian coefficient were decreased； serum LH and T levels were decreased， while FSH levels were increased； the levels of IL-1β and TNF-α and the expressions of HMGB1， RAGE and p-NF-κB p65 protein in ovarian tissue were decreased， with statistical significance （P＜0.05）. The trend of corresponding indexes in rHMGB1 group was opposite to the above （P＜0.05）. Compared with poria acid high-dose group， the changes of the above indexes were reversed significantly in poria acid high-dose+rHMGB1 group （P＜0.05）. CONCLUSIONS Poria acid may improve insulin resistance and inhibit inflammatory reaction in PCOS rats by inhibiting HMGB1/ RAGE pathway.

Roles and mechanisms of metformin in improving cognitive dysfunction induced by chronic cerebral hypoperfusion in rats / 中华行为医学与脑科学杂志

Objective:To explore the roles and mechanisms of metformin in the improvement of cognitive dysfunction induced by chronic cerebral hypoperfusion in rats.Methods:Total 82 SD male rats (SPF grade) aged 3-4 months were randomly divided into four groups: sham operation control group (Con group, n=15), sham operation with metformin treatment group (Met group, n=20), 2-vessel occlusion group (2VO group, n=22), and 2-vessel occlusion with metformin administration group (2VO+ Met group, n=25). The chronic cerebral hypoperfusion model was established by bilateral common carotid artery ligation, and the carotid arteries of rats in Con group and Met group were only separated without ligation.After 2VO operation, rats in 2VO+ Met group and Met group were given metformin solution in drinking water at a dose of 100 mg/kg per day for 4 weeks.After 4-week continuous intervention with metformin, Morris water maze was performed to test the spatial cognitive function of the rats, in vivo electrophysiological technology was used to detect the long-term potential of the rats, and enzyme-linked immunosorbent assay(ELISA) was used to detect the concentrations of inflammatory factor tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β) and interleukin-6(IL-6) in the hippocampus.The density of dendritic spines of hippocampal neurons was observed by Golgi staining, and the synaptic structure of hippocampal neurons, especially the vesicle density, was observed by transmission electron microscopy.SPSS 16.0 software was used for statistical analysis.Repetitive measurement ANOVA was used for the escape latency data of 7 days repeated learning training in water maze.One-way ANOVA was used for the comparison of other data among multiple groups, and Dunnett's t test was used for further pairwise comparison. Results:Morris water maze results showed that during 7 days of learning training, the time and group interaction for escape latency was not significant in the 4 groups of rats ( F=0.93, P>0.05), but the time main effect ( F=25.90, P<0.05) and group main effect ( F=13.20, P<0.05) were significant.Morris water maze test showed that from the 3rd to 7th day, the escape latencies in 2VO group were significantly longer than those in Con group and 2VO+ Met group(all P<0.05). The short-term memory of rats was detected after 1 day of rest.The results showed that the escape latency in 2VO group was significantly longer than that in Con group and 2VO + Met group( P<0.01). The retention time and crossing times in the platform area of 2VO rats were less than those in Con group and 2VO + Met group ( P<0.01). Electrophysiological results showed that the relative field excitatory postsynaptic potential slope of 2VO group (1.29±0.09) was significantly lower than that in Con group (2.07±0.09) and 2VO + Met group (1.69±0.08)( P<0.01). ELISA results showed that TNF-α level in hippocampal tissue of 2VO group was significantly higher than that in Con group and 2VO+ Met group; IL-1β and IL-6 levels in hippocampal tissue of 2VO group were significantly higher than those in Con group and 2VO + Met group.Density of dendritic spines in hippocampal neurons of 2VO group was significantly lower than that in Con group and 2VO+ Met group.The density and proportion of immature dendritic spines in hippocampal neurons of 2VO group were significantly higher than those in Con group and 2VO + Met group.Synaptic vesicle density of neurons in CA1 area of hippocampus in 2VO group ((230.29±19.44) vescicles/μm 2) was significantly lower than that in the Con group ((414.52±13.17) vescicles/μm 2) and 2VO+ Met group ((313.19±12.42) vescicles/μm 2). Conclusion:Metformin can reduce neuroinflammation of hippocampus with chronic cerebral hypoperfusion and improve synaptic plasticity and cognitive dysfunction.It may have potential application value in the treatment of vascular cognitive dysfunction.

Research progress on mechanism of biotrauma caused by ventilation-induced lung injury / 中华危重病急救医学

Mechanical ventilation is an advanced life support treatment for patients with acute respiratory failure. While stabilizing respiratory function, it also acts as an injury factor to exacerbate or lead to lung injury, that is, ventilation-induced lung injury (VILI). There may be a more subtle form of damage to VILI known as "biotrauma". However, the mechanism of biotrauma in VILI is still unclear. This article intends to review the mechanism of biotrauma of VILI from the aspects of inflammatory response, oxidative stress and complement activation, in order to provide a new strategy for clinical prevention and treatment of biotrauma caused by VILI.

Angiotensin converting enzyme 2 alleviates infectious bronchitis virus-induced cellular inflammation by suppressing IL-6/JAK2/STAT3 signaling pathway / 生物工程学报

The goal of this study was to investigate the regulatory effect of angiotensin converting enzyme 2 (ACE2) on cellular inflammation caused by avian infectious bronchitis virus (IBV) and the underlying mechanism of such effect. Vero and DF-1 cells were used as test target to be exposed to recombinant IBV virus (IBV-3ab-Luc). Four different groups were tested: the control group, the infection group[IBV-3ab-Luc, MOI (multiplicity of infection)=1], the ACE2 overexpression group[IBV-3ab Luc+pcDNA3.1(+)-ACE2], and the ACE2-depleted group (IBV-3ab-Luc+siRNA-ACE2). After the cells in the infection group started to show cytopathic indicators, the overall protein and RNA in cell of each group were extracted. real-time quantitative polymerase chain reaction (RT-qPCR) was used to determine the mRNA expression level of the IBV nucleoprotein (IBV-N), glycoprotein 130 (gp130) and cellular interleukin-6 (IL-6). Enzyme linked immunosorbent assay (ELISA) was used to determine the level of IL-6 in cell supernatant. Western blotting was performed to determine the level of ACE2 phosphorylation of janus kinase 2 (JAK2) and signal transducer and activator of transcription 3 (STAT3). We found that ACE2 was successfully overexpressed and depleted in both Vero and DF-1 cells. Secondly, cytopathic indicators were observed in infected Vero cells including rounding, detaching, clumping, and formation of syncytia. These indicators were alleviated in ACE2 overexpression group but exacerbated when ACE2 was depleted. Thirdly, in the infection group, capering with the control group, the expression level of IBV-N, gp130, IL-6 mRNA and increased significantly (P < 0.05), the IL-6 level was significant or extremely significant elevated in cell supernatant (P < 0.05 or P < 0.01); the expression of ACE2 decreased significantly (P < 0.05); protein phosphorylation level of JAK2 and STAT3 increased significantly (P < 0.05). Fourthly, comparing with the infected group, the level of IBV-N mRNA expression in the ACE2 overexpression group had no notable change (P > 0.05), but the expression of gp130 mRNA, IL-6 level and expression of mRNA were elevated (P < 0.05) and the protein phosphorylation level of JAK2 and STAT3 decreased significantly (P < 0.05). In the ACE2-depleted group, there was no notable change in IBV-N (P > 0.05), but the IL-6 level and expression of mRNA increased significantly (P < 0.05) and the phosphorylation level of JAK2 and STAT3 protein decreased slightly (P > 0.05). The results demonstrated for the first time that ACE2 did not affect the replication of IBV in DF-1 cell, but it did contribute to the prevention of the activation of the IL-6/JAK2/STAT3 signaling pathway, resulting in an alleviation of IBV-induced cellular inflammation in Vero and DF-1 cells.

VASOplegia is Predicted by Preoperative Platelet?LEucocyte conGlomerate Indices in Cardiac Surgery (VASOPLEGICS): A Retrospective Single?Center Study

Background:Post?cardiotomy vasoplegia syndrome (VS) is often linked to an exaggerated inflammatory response to cardiopulmonary bypass (CPB). At the same time, the prognostic role of platelet?leucocyte indices (PLIs) and leucocyte indices (LIs), (platelet?lymphocyte ratio [PLR], systemic immune?inflammation index [SII = platelet neutrophil/lymphocyte], aggregate index of systemic inflammation [AISI = platelet monocyte neutrophil/lymphocyte], and neutrophil?lymphocyte ratio [NLR], systemic inflammation response index [SIRI = monocyte neutrophil/lymphocyte), respectively] has been recently described in diverse inflammatory settings. Methods: The retrospective study was conducted to evaluate the VS predictive performance of PLIs and LIs in 1,045 adult patients undergoing elective cardiac surgery at a tertiary care center. VS was defined by mean blood pressure <60 mmHg, low systemic vascular resistance (SVRI <1,500 dynes.s/cm 5/m2 ), a normal or high CI (>2.5 L/min/m2 ), and a normal or reduced central filling pressure despite high?dose vasopressors. Results: About 205 (19.61%) patients developed VS postoperatively. On univariate analysis, age, diabetes, dialysis?dependent renal failure, preoperative congestive heart failure (CHF), the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II, ejection fraction, NLR, PLR, SII, SIRI, AISI, CPB, and aortic cross clamp (ACC) duration, packed red blood cell (PRBC) transfusion, and time?weighted average blood glucose predicted VS. Subsequent to the multivariate analysis, the predictive performance of EuroSCORE II (OR: 3.236; 95% CI: 2.345–4.468; P < 0.001), CHF (OR: 1.04; 95% CI: 1.02–1.06; P = 0.011), SII (OR: 1.09; 95% CI: 1.02–1.18; P = 0.001), AISI (OR: 1.11; 95% CI: 1.05–1.17; P < 0.001), PRBC (OR: 4.747; 95% CI: 2.443–9.223; P < 0.001), ACC time (OR: 1.003; 95% CI: 1.001–1.005; P = 0.004), and CPB time (OR: 1.016; 95% CI: 1.004–1.028; P = 0.001) remained significant. VS predictive cut?offs of SII and AISI were 1,045 1045×109 /mm3 and 137532×109 /mm3 , respectively. AISI positively correlated with the postoperative vasoactive?inotropic score (R = 0.718), lactate (R = 0.655), mechanical ventilation duration (R = 0.837), and ICU stay (R = 0.757). Conclusions: Preoperative elevated SII and AISI emerged as independent predictors of post?cardiotomy VS.

Prognostic value of pre-operation systemic inflammation response index in decompressive craniectomy for massive cerebral infarction caused by middle cerebral artery embolization / 中国综合临床

Objective:To explore the correlation between systemic inflammatory response index (SIRI) and clinical outcome of patients with massive cerebral infarction (MCI) after craniotomy and decompression.Methods:The clinical data of 50 MCI patients who were treated in the Affiliated Hospital of Qingdao University from January 2016 to December 2020 and underwent craniotomy and decompression were retrospectively analyzed. The measurement data of normal distribution were expressed as xˉ± s, and the measurement data of non normal distribution were expressed as M( Q1, Q3). T-test or rank sum test was used for comparison between the two groups. Multivariate Logistic regression was used to analyze the relationship between SIRI and prognosis of MCI patients and establish a prediction model. The predictive value and optimal cutoff value of SIRI were analyzed by receiver operating characteristic curve (ROC). Results:Among the 50 MCI patients who underwent craniotomy and decompression, 12 (24%, 12/50) had a good prognosis; In the poor prognosis group, 38 cases (76%, 12/50), of which 9 cases (18%, 9/50) died during hospitalization. The age of patients in the good prognosis group and the poor prognosis group ((54±11) years and (63±9) years; t=2.72, P=0.015), body mass index (BMI): ((23.91±2.64) kg/m 2 and (26.72±3.28) kg/m 2, t=3.01, P=0.006)), neutrophil count (7.08 (5.12, 7.38))×10 9/L and 10.59 (8.91,14.64)×10 9/L, Z=5.72, P<0.001), white blood cell count ((9.09±2.80)×10 9/L and (13.20±3.49) ×10 9/L; t=4.16, P<0.001), SIRI (2.49(1.78, 4.75) and 8.34(5.17, 13.61); Z=3.84, P<0.001), Glasgow Coma Score (12(9,14) and 8(6,10); Z=3.36, P=0.002) and lymphocyte count (1.58(0.91, 1.91)×10 9/L and 0.77(0.59,1.02) ×10 9/L; Z=3.30, P=0.001).The difference between the two groups was statistically significant. The prognosis of patients with dominant hemisphere infarction was worse than that of patients with non-dominant hemisphere infarction (22 cases (91.67%, 22/24) vs. 16 cases (61.54%, 16/26); χ 2=6.21, P=0.013). The ICU stay in the good prognosis group was significantly shorter than that in the poor prognosis group (2 (1, 5) days vs. 8 (3, 19) days; Z=2.78, P=0.005). Multivariate Logistic regression analysis showed that SIRI and GCS were correlated with clinical prognosis: SIRI ( OR: 2.378; 95% CI: 1.131-5.003; P=0.022); GCS at admission ( OR: 0.548; 95% CI: 0.307-0.980; P=0.043). The ROC curve analysis of SIRI prediction of poor prognosis: Area under the curve (AUC): 0.871, (95% CI: 0.765-0.976, P<0.001), sensitivity was 78.9%, specificity was 88.3%, and the optimal cut-off value was 4.96. The sensitivity, specificity and AUC of GCS for predicting poor prognosis after MCI craniotomy decompression were 89.5%, 58.3% and 0.791 (95% CI: 0.638~0.943, P=0.003), and the best truncation value was 11.5. Conclusion:SIRI was an effective predictor of clinical outcome for MCI patients underwent Craniotomy for decompression, and SIRI value greater than 4.96 indicates adverse clinical outcome.

Polydatin improves intestinal barrier injury after traumatic brain injury in rats by reducing oxidative stress and inflammatory response via activating SIRT1-mediated deacetylation of SOD2 and HMGB1 / 南方医科大学学报

OBJECTIVE@#To investigate the protective effect against intestinal mucosal injury in rats following traumatic brain injury (TBI) and explore the underlying mechanism.@*METHODS@#SD rat models of TBI were established by fluid percussion injury (FPI), and the specimens were collected at 12, 24, 48, and 72 h after TBI. Another 15 rats were randomly divided into shamoperated group (n=5), TBI with saline treatment (TBI+NS) group (n=5), and TBI with PD treatment (TBI+PD) group (treated with 30 mg/kg PD after TBI; n=5). Body weight gain and fecal water content of the rats were recorded, and after the treatments, the histopathology of the jejunum was observed, and the levels of D-lactic acid (D-LAC), diamine oxidase (DAO), ZO-1, claudin-5, and reactive oxygen species (ROS) were detected. Lipid peroxide (LPO) and superoxide dismutase (SOD) 2 content, jejunal pro-inflammatory factors (IL-6, IL-1β, and TNF- α), Sirt1 activity, SOD2 and HMGB1 acetylation level were also determined after the treatments.@*RESULTS@#The rats showed significantly decreased body weight and fecal water content and progressively increased serum levels of D-LAC and DAO after TBI (P < 0.05) with obvious jejunal injury, significantly decreased expression levels of ZO-1 and claudin-5, lowered SOD2 and Sirt1 activity (P < 0.05), increased expression levels of LPO, ROS, and pro-inflammatory cytokines, and enhanced SOD2 and HMGB1 acetylation levels (P < 0.05). Compared with TBI+NS group, the rats in TBI+PD group showed obvious body weight regain, increased fecal water content, reduced jejunal pathologies, decreased D-LAC and DAO levels (P < 0.05), increased ZO-1, claudin-5, SOD2 expression levels and Sirt1 activity, and significantly decreased ROS, LPO, pro-inflammatory cytokines, and acetylation levels of SOD2 and HMGB1 (P < 0.05).@*CONCLUSION@#PD alleviates oxidative stress and inflammatory response by activating Sirt1-mediated deacetylation of SOD2 and HMGB1 to improve intestinal mucosal injury in TBI rats.

Discussion on Role of Macrophage Polarization in Inflammation of Heart Failure Based on Yin-yang Theory / 中国实验方剂学杂志

Inflammation is the key pathogenic feature of heart failure （HF）， and its overexpression can cause myocardial hypertrophy， apoptosis and fibrosis， aggravating the process of HF. Macrophages are important immune cells in human body with high heterogeneity， which involve in inflammation response and maintain heart homeostasis. Macrophage polarization is a dynamic process. Under the stimulation of different microenvironment， it can polarize two subsets， including classically activated M1 type and alternatively activated M2 type， which are antagonistic to each other. When macrophages polarize into the pro-inflammatory phenotype （M1）， the inflammatory response is initiated， the anti-inflammatory phenotype （M2） plays a role in inhibiting inflammation and repairing tissue. At the same time， in different stages of development of HF， M1 and M2 macrophages can be transformed into each other， which is similar to the connotation of Yin-yang restriction， balance and transformation of traditional Chinese medicine （TCM） theory. Based on this， this paper intends to clarify the relationship between M1 and M2 macrophages by Yin-yang theory， proposing that the clinical prevention and treatment of HF should pay attention to regulating micro and macro inflammatory responses， regulating macrophage polarization， and achieving the balance between anti-inflammatory and pro-inflammation， which is consistent with the balance of Yin-yang in TCM theory. It can provide a new target and direction for TCM treatment of HF.

Advance in IgE-mediated autoimmune disorders and inflammation responses / 国际儿科学杂志

There is accumulating evidence to suggest that immunoglobulin E(IgE)plays a significant role in autoimmunity and inflammation in recent years, and the most concerned is the role of IgE in systemic lupus erythematosus(SLE). Multiple studies demonstrated a pathogenic role of autoreactive IgE in SLE, including direct damage on tissue-containing autoantigens, activation and migration of basophils to lymph nodes, and induction of type Ⅰ interferon responses from plasmacytoid dendritic cells(pDCs). It is now recognized that autoimmune diseases such as bullous pemphigoid(BP), chronic spontaneous urticaria(CSU)and hyperthyroid Graves′ disease are partly mediated by IgE.The situations in other conditions with increased IgE levels, such as autoimmune uveitis, multiple sclerosis, as far less clear and some studies have pointed towards IgE autoantibodies as the main culprit.Now anti-human IgE monoclonal antibody is approved for use in asthma and CSU.And autoreactive IgE and FcεRI-bearing effector cells are as new promising therapeutic targets in autoimmune diseases.In this review, the mechanism and clinical effects of IgE mediated inflammation and autoimmune response will be discussed.

Research progress of itaconate on the regulation of macrophage inflammation / 中华危重病急救医学

Macrophages are important innate immune cells. Under inflammatory stimulation, macrophages rapidly respond and subsequently produce large amounts of cellular metabolites through metabolic reprogramming. Itaconate is an immunomodulatory derivative from the tricarboxylic acid cycle which has antioxidative and anti-inflammatory effects. In recent years, it has been reported that itaconate promotes the transition of macrophage phenotype from M1 to M2 and the underlying mechanism may include the activation of nuclear factor E2-related factor 2 (Nrf2) by alkylation of Kelch-like ECH-associated protein 1 (Keap1), inhibition of succinate dehydrogenase (SDH) and reactive oxygen species (ROS), blockade of the inhibitor ζ of nuclear factor-κB (IκBζ) translation and inhibition of aerobic glycolysis. In this review, we describe the metabolic pathways of itaconate, clarify the relationship between itaconate and the immune response, and summarize the latest researches about the roles of itaconate on regulating the inflammatory response in macrophages in order to provide the basis for the clinical use of itaconate and new strategies for the treatment of inflammatory diseases.

Preliminary Study on Improvement Effect of Tiarella polyphylla Ethanol Extract on CCl 4-induced Hepatic Fibrosis in Mice and Its Mechanism / 中国药房

OBJECTIVE：To investigate the improvement effect of Tiarella polyphylla ethanol extract （TPME）on CCl 4-induced hepatic fibrosis in mice ，and to explore its possible mechanism preliminarily. METHODS ：Totally 60 male Kunming mice were randomly divided into normal group ，model group ，positive control group （colchicine 0.1 mg/kg），TPME low-dose ，medium-dose and high-dose groups （250，500，1 000 mg/kg）according to body weight ，with 10 mice in each group. Except for normal group ， other groups were given 20％ CCl4 olive oil solution intraperitoneally to induce hepatic fibrosis ，twice a week ，for consecutive 8 weeks. From the fifth week after modeling ，administration groups were given relevant medicine intragastrically ，normal group and model group were given constant volume of normal saline intragastrically ，once a day ，for consecutive 4 weeks. Twelve hours after last administration ，the liver weight of mice in each group was measured and the liver index was calculated. The serum contents of ALT，AST，SOD，MDA，PC-Ⅲ，C-Ⅳ，LN，TNF-α and IL- 6 were determined. Western blot assay was used to detect the protein expression of α-SMA，TGF-β1 and Smad 3 in liver tissue. HE and Masson staining were used to observe the pathological changes of hepatic tissue. RESULTS ：Compared with normal group ，the liver index ，the activities of ALT and AST and the contents of MDA ， LN，PC- Ⅲ ，C- Ⅳ ，LN，TNF-α and IL- 6 in serum were increased significantly ， while the activity of SOD was 6011） decreased significantly in model group （P＜0.01）；the protein expression of α-SMA，TGF-β1 and Smad 3 in liver tissues were hfjsznd8@126.com increased significantly （P＜0.01）. Obvious fibrosis lesions was observed in liver tissue. Compared with model group ，the live indexes ，the activities of ALT and AST ，the contents of MDA，PC-Ⅲ，C-Ⅳ，LN，TNF-α and IL-6 in serum were decreased significantly in positive control group and TPME groups ， while the activities of SOD were increased significantly （P＜0.05 or P＜0.01）. The protein expression of α-SMA，TGF-β1 and Smad3 in liver tissue were decreased significantly （P＜0.05 or P＜0.01），and liver fibrosis was improved to different extent. Compared with TPME low-dose group ，the contents of PC- Ⅲ，LN and IL- 6 in serum ，protein expression of TGF-β1 and Smad 3 in liver tissue were decreased significantly in TPME high-dose group （P＜0.05）. CONCLUSIONS ：TPME can improve hepatic fibrosis induced by CCl 4 in mice ，the mechanism of which may be associated with the inhibition of collagen synthesis and oxidative stress，the reduction of inflammatory factors ，and the down-regulation of the expression α-SMA and relative proteins of TGF-β1/ Smad signal pathway.

Effect of minimally invasive techniques for removing impacted wisdom teeth on local inflammatory response and pain / 局解手术学杂志

Objective To explore the effect of minimally invasive techniques for removing impacted wisdom teeth on local inflammation and pain. Methods A total of 110 patients with impacted wisdom teeth removed in our department from June 2016 to February 2018 were divided into observation group(55 cases,minimally invasive removal) and control group (55 cases, traditional chisel) according to the surgical method. The operative status, the inflammatory mediators and pain mediators in the gingival sulcus before and after the treatment, and the therapeutic effects of the two groups were compared. Results The operative time of the observation group was shorter than that of the control group,the intraoperative blood loss was less than that in the control group, the differences were significant(P ＜ 0. 05). The levels of PTX3, cells in the gingival sulcus adhesion of cytokine 1 (ICAM1),peroxidase (MPO),prostaglandin E2 (PGE2) levels,pain mediator 5-hydroxytryptamine(5-HT), calcitonin gene-related peptide(CGRP), substance P(SP), galanin(Gla) and adenosine triphosphate(ATP) in the observation group after treatment was lower than those in the control group, the differences were significant(P ＜ 0. 05); The degree of mouth opening restriction, facial swelling and visual analog scale score(VAS) in the observation group were lower than those in the control group, the differences were significant(P ＜ 0. 05). Conclusion Compared with traditional chisel in extraction of impacted wisdom teeth, the minimally invasive wisdom tooth extraction can relieve the inflammatory response and pain sensation of patients,and the clinical treatment effect is significant.

Role of inflammation in perioperative neurocognitive disorders and its therapeutic implication / 中华危重病急救医学

Perioperative neurocognitive disorder (PND) is one of the most common complications after operations in elderly patients. Occurrence of PND not only affects the quality of life but also increases the burden of medical care, as well as the post-operation disability and mortality rate. Previous studies have shown that the inflammatory response in central nervous system can lead to PND, however, its pathogenesis is undetermined. In this work, the role of neuro-inflammatory response and immune cell activation in the development of PND is reviewed, and the potential treatment is introduced, in order to provide insight for future research and clinical decision.

Role of inflammation in perioperative neurocognitive disorders and its therapeutic implication / 中华危重病急救医学

Perioperative neurocognitive disorder (PND) is one of the most common complications after operations in elderly patients. Occurrence of PND not only affects the quality of life but also increases the burden of medical care, as well as the post-operation disability and mortality rate. Previous studies have shown that the inflammatory response in central nervous system can lead to PND, however, its pathogenesis is undetermined. In this work, the role of neuro-inflammatory response and immune cell activation in the development of PND is reviewed, and the potential treatment is introduced, in order to provide insight for future research and clinical decision.

COX-2 pathway changes in hippocampus and cortex of rat offsprings following maternal inflammation during pregnancy / 中国药理学通报

Aim: To observe the COX-2 pathway changes in hippocampus and cortex of rat offsprings following maternal inflammation during pregnancy. Methods: Female SD rats were randomly divided into control group and lipopolysaccharide (LPS) group. Rats in LPS group were intraperitonealy injected with LPS 300 μug · kg-1 on 11th, 14th and 18th day of pregnancy, while those in control group were given normal saline. Body weight of offspring rats on 3th, 10th, 20th and 30th day was recorded; on 30th day, the development of nervous system of the offspring rats was tested using water maze test, open field test and spontaneous activity test and so on; the histopathological changes of the hippocampus and cortex were detected by hematoxylineosin staining; the levels of inflammatory factors were measured by ELISA; the protein expression of COX-2 was measured by Western blot. Results: There were no significant differences in the body weight of offspring rats between NS group and LPS group (P >0. 05). In LPS group, it was found that the learning and memory function of rats were impaired, and horizontal movement and spontaneous activities were significantly reduced (P < 0. 05); the hippocampus and cortex neurons showed a significant nuclear pyknosis (P < 0. 05, P<0.01); the levels of PGD2, PGE2, PGI2, TNF- a, IL6 and IL-1 [J in hippocampus and cortex significantly increased (P < 0. 05, P < 0. 01); the protein expression of COX-2 in hippocampus and cortex significantly increased (P<0.01). Conclusions: COX-2 and downstream pathway are involved in the mechanism of brain injury in offsprings of pregnancy inflammation rats.

Effects of combined natural hirudin and hyperbaric oxygen therapy on survival of transplanted random-pattern skin flap in rats / 中国修复重建外科杂志

Objective: To investigate the effect of natural hirudin combined with hyperbaric oxygen therapy on the survival of transplanted random-pattern skin flap in rats.

Comparison of lung protection for hydrochloric acid or oleic acid induced rat acute respiratory distress syndrome models pretreated with penehyclidine / 中华危重病急救医学

Objective To compare the lung protection roles of intraperitoneal pre-injection with penehyclidine for two kinds of rat models with pulmonary and extrapulmonary acute respiratory distress syndrome (ARDSp and ARDSexp). Methods Forty healthy adult Sprague-Dawley (SD) rats were randomly divided into five groups (each n = 8): the rats in sham group received only tracheotomy; the ARDS rat models were reproduced by intratracheal inhalation of 0.1 mol/L hydrochloric acid (HCl) 2 mL/kg to simulate ARDSexp (HCl group) and 0.15 mL/kg oleic acid (OA) intravenous injection to simulate ARDSp (OA group) after tracheotomy; and the rats in two intervention groups were intraperitoneal injected with penehyclidine 0.5 mg/kg. All rats were received mechanical ventilation immediately after model reproduction. Carotid arterial blood was collected 4 hours after model reproduction for determining the arterial partial pressure of oxygen (PaO2), and oxygenation index (PaO2/FiO2) was calculated. Carotid venous blood and lung tissues were harvested, and the levels of myeloperoxidase (MPO), interleukin-8 (IL-8) and nuclear factor-κB (NF-κB) in serum and lung tissue were determined by enzyme linked immunosorbent assay (ELISA). Pulmonary pathology was observed under optical microscope, and pathological score of Smith was calculated. Results Under optical microscope, a large number of inflammatory cells infiltration in lung tissue, obvious alveolar collapse, fibrous exudation in alveolar and alveolar hyaline were found in HCl group. In OA group, however, microvascular congestion and interstitial pulmonary edema were the main pathological changes, with alveolar structure being kept relatively intact. Compared with sham group, pathological score of Smith in HCl and OA groups were increased, oxygenation was lowered, and inflammatory factors levels in serum and lung tissue were increased with levels in lung tissue being higher than those in serum, without significant difference between the two models. When pretreated with penehyclidine, however, pathological injury induced by HCl or OA was alleviated, and pathological score of Smith was also decreased as compared with that of corresponding model groups (5.48±1.76 vs. 9.69±2.02, 3.97±2.14 vs. 8.71±2.18, both P < 0.05), PaO2/FiO2was raised significantly [mmHg (1 mmHg = 0.133 kPa): 323±55 vs. 211±27, 307±56 vs. 207±31, both P < 0.05], the inflammatory factors levels in serum and lung tissue were obviously decreased [MPO (μg/L): 11.91±1.55 vs. 14.82±1.25, 12.75±1.16 vs. 16.97±2.06 in serum, 25.80±3.36 vs. 35.18±4.01, 24.23±1.24 vs. 33.94±1.43 in lung tissue; IL-8 (ng/L): 358±30 vs. 459±25, 377±38 vs. 427±34 in serum, 736±53 vs. 866±51, 701±53 vs. 809±39 in lung tissue; NF-κB (ng/L):483±68 vs. 632±73, 514±83 vs. 685±78 in serum, 984±75 vs. 1 217±123, 944±90 vs. 1 163±105 in lung tissue;all P < 0.05]. But all parameters above were similar between the two pretreatment groups (all P > 0.05). Conclusions Inflammatory cell infiltration and alveolar collapse mainly happened in HCl induced ARDSp, while pulmonary interstitial edema and hemorrhage was mostly seen in ARDSexp rats induced by OA intravenous injection. There was no significant difference in oxygenation and inflammatory response between the two models of rats. Pre-intraperitoneal injection of penehyclidine equally improved oxygenation state, inhibited lung inflammation response, and reduced lung injury in the two kinds of ARDS, but there was no difference in protective role between two models pretreated with penehyclidine.

Effect of systemic inflammation response index on clinical prognosis of patients with glioma and its relationship with IDH1 mutation / 实用肿瘤学杂志

Objective The objective of this study was to investigate the effect of systemic inflammation response index(SI-RI)on clinical prognosis of patients with glioma and its relationship with dehydrogenase 1(IDH1)mutation.Methods Eighty patients with glioma who underwent surgery in the department of Neurosurgery were collected from August 2006 to November 2015.The best clinical cutoff value for SIRI was determined using operating characteristic curve(ROC)and grouped accordingly.The Kaplan-Meier and log-rank methods were used to analyze the postoperative survival of the two groups of patients.The independent clinical prognos-tic factors were evaluated by Cox′s proportional hazards regression model.The IDH1 mutation was detected by immunohistochemistry and DNA sequencing.Results SIRI was an independent prognostic factor of glioma,and the best clinical cutoff value was 0.67 × 109/L.The median progress free survival(PFS)and overall survival(OS)of patients with low SIRI group were 46.90 months and 57.90 months,and the median PFS and OS of patients with high SIRI group were 31.78 months and 47.22 months,respectively.There was significant difference between the two groups in the median survival time of PFS and OS by log-rank method(P<0.05).Univa-riate and multivariate analysis showed that age,gender,type of surgery,WHO stage,SIRI and IDH1 mutation were the independent prognostic factors in neurostein stromal tumors.Patients with low-grade SIRI and glioma with IDH1 mutation have a better prognosis than other conditions.Conclusion SIRI is an independent prognostic factor of glioma.It is simple,convenient and reproducible,and may be used to predict the prognosis of patients with glioma.

Pretreatment systemic inflammation response index as an independent prognostic indicator for prostate cancer patients treated with maximal androgen blockade / 中华泌尿外科杂志

Objective To investigate the efficacy of pretreatment systemic inflammation response index (SIRI) in predicting the prognostic of prostate cancer (PCa) patients treated with maximal androgen blockade (MAB).Methods The data of 351 PCa patients who had undergone MAB as first-line therapy between January 2010 and June 2015,were retrospectively analyzed.The age of patients in our cohort ranged from 51 to 89 years old,mean 76 years old.The median value of PSA was 91.60ng/ml,ranging 0.11-1 000.00 ng/ml.39 cases had a Gleason score of 6,47 cases had a score of 3 + 4,89 cases had a score of 4 +3,107 cases had a score of 8,and 69 cases had a score of 9-10.158 cases had bone metastasis.Patients were categorized in two groups using a cut-off point of 1.2 as calculated by the receiver-operating curve analysis.Correlations between SIRI and clinical characteristics were analyzed.Meanwhile,univariate and multivariate cox regression analyses were performed to determine the associations of SIRI with progression-free survival (PFS),cancer-specific survival (CSS) and overall survival (OS).Results The median follow-up duration was 43.0 months,ranging 9-75 months.The disease progression occurred in 162 patients,91 patients died,including 75 who died because of PCa at the end of the last follow-up.The differences of age,Gleason score and incidence of metastasis between low SIRI group (＜ 1.2) and high SIRI group (≥1.2) were not significant (P ＞0.05).But the patients in high SIRI group had higher PSA (P =0.046).Multivariate analyses identified SIRI,Gleason score and metastasis as independent prognostic factors for PFS,CSS and OS.Conclusions Pretreatment SIRI ≥ 1.2 was an independent predictor for poor prognosis in PCa patients treated with MAB.

Effect of patient-controlled intravenous analgesia with dezocine combined with sufentanil on inflammatory response and pain after laparoscopic hepatectomy for hepatocellular carcinoma / 临床麻醉学杂志

Objective To observe the effect of patient-controlled intravenous analgesia (PCIA)with dezocine combined with sufentanil on inflammatory response and pain after laparoscopic hepatectomy for hepatocellular carcinoma.Methods Sixty patients (43 males,17 females,aged 18-60 years,ASA grade Ⅰ or Ⅱ) scheduled for laparoscopic hepatectomy for hepatocellular carcinoma were divided into sufentanil group (group S) and dezocine+sufentanil group (group DS) according to the random number table,n=30 each.Patients in group S were given 100 ml normal saline containing sufentanil 2.0 μg/kg and tropisetron 5 mg.Patients in group DS were given 100 ml normal saline containing sufentanil 2.0 μg/kg,dezocine 0.5 mg/kg and tropisetron 5 mg.VAS scores and numeric sedation scale (NSS) scores were recorded at 4,24,48 h after operation and patients' satisfaction scores were recorded at 48 h after operation.The levels of serum tumor necrosis factor-α (TNF-α),interleukin-2 (IL-2),interleukin-6 (IL-6) in blood samples harvested before induction of anesthesia and 0,4,24 and 48 h after operation were measured by ELISA.The times of efficient injection and incidence of adverse effect within 48 h after operation were recored.Results Compared with group S,the VAS scores in group DS were decreased significantly while the satisfaction of patients to analgesia were increased significantly at 4,24,48 h after operation (P<0.05).There were no obvious differences in NSS scores between two groups.Compared with before induction of anesthesia,the concentrations of TNF-α and IL-6 were increased significantly while the concentrations of IL-2 was decreased significantly in both groups at 4,24,48 h after operation (P<0.05).Compared with group S,the concentrations of TNF-α and IL-6 were decreased significantly while the concentrations of IL-2 was increased significantly in group DS at 24,48 h after operation (P<0.05).The times of efficient injection in group DS were less than that in group S significantly within 48 h after operation [(2.0±0.7) times vs.(7.2±1.3) times] (P<0.05).There were no obvious differences in adverse effects between two groups.Conclusion PCIA with dezocine 0.5 mg/kg combined with sufentanil 2.0 μg/kg can alleviate the inflammatory response to some extent in patients after laparoscopic hepatectomy for hepatocellular carcinoma,and it can offer a safe and effective analgesic effect.