A Case Report of Primary Hypertrophic Osteoarthropathy / 罕见病研究

Primary hypertrophic osteoarthropathy(PHO) is a rare disease also known as pachydermoperiostosis. We reported a painless case whose diagnosis was confirmed by genetic test. A 24-year-old male presented a series of symptoms that first began at 14. He suffered from progressive clubbed-fingers accompanied by swelling of the wrist and ankle joints. Facial skin concentric thickening and alar nose broadening appeared simultaneously and increased progressively. He was also prone to acne and hyperhidrosis. X-rays showed thickening of the metacarpal and phalangeal bones, as well as symmetrical periosteal ossification of both the tibia and fibula. Clinical diagnosis of PHO is difficult because of the variable features. With acromegaly excluded, the diagnosis was confirmed by a genetic test. Whole exome sequencing revealed a heterozygous SLCO2A1 c.611C > T(p.Ser204Lue) and SLCO2A1 c.1602C > A(p.Asn534Lys) mutation from each parent. It suggests that primary hypertrophic osteoarthropathy should be considered for young limb hypertrophic patients especially when periosteal thickening signs were showed in X-ray. A confirmatory diagnosis can be made through the genetic test.

Effect of ginseng polysaccharide on the expression of prostaglandin E2/6-keto-prostaglandin 1alpha in traumatic osteoarthritis model rats / 中国组织工程研究

BACKGROUND:Ginseng extracts have been found to significantly improve osteoarthritis,but the therapeutic effects of ginseng polysaccharide extracts on osteoarthritis have not been reported. OBJECTIVE:To investigate the effect of ginseng polysaccharide on the expression of prostaglandin E2/6-keto-prostaglandin F1α in traumatic osteoarthritis model rats. METHODS:Sixty male Sprague-Dawley rats were selected and randomly divided into healthy group,model group,ginseng polysaccharide low-dose group,ginseng polysaccharide medium-dose group,ginseng polysaccharide high-dose group and dexamethasone group.Except for 10 rats in the healthy group,the other rats were taken to establish traumatic osteoarthritis models.The healthy group and model group were given 0.2 mL of normal saline intraperitoneally.The low-,medium-,and high-dose groups were intraperitoneally injected with 0.1,0.25,0.5 μg/mL ginseng polysaccharide,respectively.In the dexamethasone group,0.2mg/kg dexamethasone(0.2 mL)was injected intraperitoneally.Injections were given once every 3 days,for 4 consecutive weeks.Serum prostaglandin E2 and 6-keto-prostaglandin F1α levels were detected by ELISA.The bone and joint function of rats were assessed by the Mankin's score.Hematoxylin-eosin staining was used to observe the pathologic morphology of the knee joints of rats.Western blot and PCR were used to detect the protein and mRNA expression of tumor necrosis factor α and interleukin-1β,interleukin-10 in articular cartilage tissue,respectively. RESULTS AND CONCLUSION:Compared with the model group,serum prostaglandin E2 levels were decreased in the medium-dose group and dexamethasone group,while serum 6-keto-prostaglandin F1α levels were increased(P<0.05).Compared with the medium-dose group and dexamethasone group,the above-mentioned indicators were significantly improved in the high-dose group,and there was no significant difference between the medium-dose group and dexamethasone group(P>0.05).Compared with the model group,the Mankin's score was reduced in the medium-dose group and dexamethasone group(P<0.05),but there was no significant difference between the medium-dose group and dexamethasone group(P>0.05).Compared with the medium-dose group and dexamethasone group,the Mankin's score was significantly reduced in the high-dose group(P<0.05).The cartilage tissue layer of rats in the model and low-dose groups was significantly thinned,the cracks and chondrocytes deep into the bone layer were largely lost,the tide line was seriously broken and blurred,the collagen fibers in the synovial layer were increased and thickened,and a large number of chondrocytes were destroyed and arranged irregularly.These pathological changes were improved in the medium-dose group and dexamethasone group compared with the model group as well as improved in the high-dose group compared with the medium-dose group.Compared with the model group,the expression of tumor necrosis factor-α and interleukin-1β was reduced,while the expression of interleukin-10 was increased in the medium-dose group and dexamethasone group(P<0.05).These indicators in the joint were significantly improved in the high-dose group compared with the medium-dose group and dexamethasone group(P<0.05),but there was no significant difference between the medium-dose group and dexamethasone group(P>0.05).To conclude,ginseng polysaccharide can improve the inflammatory level and pathological morphology of traumatic osteoarthritis rats and reduce the Mankin's score.Its mechanism may be related to the regulation of prostaglandin E2/6-keto-prostaglandin F1α levels.

Expression levels of serum high-mobility group box 1， soluble CD163， and prostaglandin E2 in patients with hepatitis B virus-related chronic-on-acute liver failure and their value in predicting prognosis / 临床肝胆病杂志

ObjectiveTo investigate the expression levels of serum high-mobility group box 1 （HMGB1）， soluble CD163 （sCD163）， and prostaglandin E2 （PGE2） in patients with hepatitis B virus-related chronic-on-acute liver failure （HBV-ACLF）， and to evaluate the value of the three indicators used alone or in combination in predicting prognosis. MethodsA total of 76 patients with HBV-ACLF who were hospitalized in Department of Infectious Diseases， The First Affiliated Hospital of Xinxiang Medical University， from July 1， 2022 to September 30， 2023 were enrolled， and according to the 28-day prognosis， they were divided into survival group with 48 patients and death group with 28 patients. General data were collected， Model for End-Stage Liver Disease （MELD） score was calculated， and ELISA was used to measure the serum levels of HMGB1， sCD163， and PGE2. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test was used for comparison of categorical data between two groups. The Spearman rank correlation test was used to analyze the correlation of HMGB1， sCD163， and PGE2 with MELD score； the receiver operating characteristic （ROC） curve was used to analyze the value of HMGB1， sCD163， and PGE2 used alone or in combination in predicting the prognosis of HBV-ACLF patients. ResultsThere were significant differences between the two groups in total bilirubin， white blood cell count， the percentage of neutrophils， procalcitonin， serum amyloid A， interleukin-6， serum sodium， and serum creatinine （all P<0.05）. Compared with the survival group， the death group had significantly higher serum levels of HMGB1 （Z=-2.997， P=0.003） and sCD163 （Z=-2.972， P=0.003）， a significantly higher MELD score （t=-6.997， P<0.001）， and a significantly lower serum level of PGE2 （Z=-4.909， P<0.001）. The Spearman rank correlation test showed that HMGB1 and sCD163 were positively correlated with MELD score （r=0.431 and 0.319， both P<0.05）， while PGE2 was negatively correlated with MELD score （r=-0.412， P<0.05）. The ROC curve analysis showed that HMGB1， sCD163， and PGE2 used alone had an area under the ROC curve （AUC） of 0.717， 0.716， and 0.856， respectively， while the combination of the three indicators had the highest predictive value， with an AUC of 0.930， a sensitivity of 0.778， and a specificity of 0.920. ConclusionSerum HMGB1， sCD163， and PGE2 used alone or in combination have a good reference value in predicting the prognosis of HBV-ACLF patients， and the combination of the three indicators has the highest predictive value， which holds promise for further observation and research.

The impact of lipids on the cancer-immunity cycle and strategies for modulating lipid metabolism to improve cancer immunotherapy

Lipids have been found to modulate tumor biology, including proliferation, survival, and metastasis. With the new understanding of tumor immune escape that has developed in recent years, the influence of lipids on the cancer-immunity cycle has also been gradually discovered. First, regarding antigen presentation, cholesterol prevents tumor antigens from being identified by antigen presenting cells. Fatty acids reduce the expression of major histocompatibility complex class I and costimulatory factors in dendritic cells, impairing antigen presentation to T cells. Prostaglandin E2 (PGE2) reduce the accumulation of tumor-infiltrating dendritic cells. Regarding T-cell priming and activation, cholesterol destroys the structure of the T-cell receptor and reduces immunodetection. In contrast, cholesterol also promotes T-cell receptor clustering and relative signal transduction. PGE2 represses T-cell proliferation. Finally, regarding T-cell killing of cancer cells, PGE2 and cholesterol weaken granule-dependent cytotoxicity. Moreover, fatty acids, cholesterol, and PGE2 can improve the activity of immunosuppressive cells, increase the expression of immune checkpoints and promote the secretion of immunosuppressive cytokines. Given the regulatory role of lipids in the cancer-immunity cycle, drugs that modulate fatty acids, cholesterol and PGE2 have been envisioned as effective way in restoring antitumor immunity and synergizing with immunotherapy. These strategies have been studied in both preclinical and clinical studies.

Efficacy of modified surgery in the treatment of breast abscess and its effects on inflammatory reaction and pain-related factors / 中国基层医药

Objective:To investigate the efficacy of modified surgery in the treatment of breast abscess and its effects on inflammatory reaction and pain-related factors.Methods:A total of 100 patients with breast abscess who were treated in Zhoushan Women and Children's Hospital from December 2019 to October 2022 were included in this study. They were divided into an observation group and a control group ( n = 50 per group) using the random number table. The control group received vacuum assisted rotary resection, while the observation group underwent modified surgery. Operation conditions, postoperative complications, and postoperative conditions were recorded in each group. Before and 24 hours after surgery, inflammatory reaction and pain-related factors were compared between the two groups. Results:There was no significant difference in operative time between the two groups ( P > 0.05). The intraoperative bleeding volume in the observation group was (23.14 ± 4.53) mL, which was significantly lower than (36.52 ± 7.18) mL in the control group ( t = 11.14, P < 0.001). The incidence of complications in the observation group was 6.00% (3/50), which was significantly lower than 20% (10/50) in the control group ( χ2 = 4.33, P < 0.05). The observation group had significantly lower postoperative visual analogue scale score [(2.42 ± 0.78) points], fewer dressing changes [(5.26 ± 1.34) times], and lower scar degree [(6.82 ± 1.27) mm] compared with the control group [(3.56 ± 0.89) points, (7.43 ± 1.62) times, (9.12 ± 1.54) mm, t = 6.81, 7.30, 8.15, all P < 0.001]. At 24 hours after surgery, high-sensitivity C-reactive protein, interleukin-1 β, and tumor necrosis factor-α in the observation group were (14.52 ± 3.37) mg/L, (182.13 ± 23.32) ng/L, and (20.08 ± 2.89) ng/L, respectively, which were significantly lower than (29.94 ± 5.45) mg/L, (231.24 ± 16.56) ng/L, and (29.98 ± 4.36) ng/L in the control group ( t = 17.02, 12.14, 13.38, all P < 0.001). At 24 hours after surgery, prostaglandin E 2 and substance P in the observation group were (97.14 ± 18.78) ng/L and (175.18 ± 24.37) μg/L respectively, which were significantly lower than (148.65 ± 20.06) ng/L and (265.41 ± 27.86) μg/L in the control group ( t = 13.26, 17.24, both P < 0.001). Conclusion:The modified surgical treatment for breast abscess shows significant effects with fewer complications and minimal impact on inflammatory response, effectively inhibiting the release of pain-related factors.

Research progress of manganese exposure on abnormal GnRH release in hypothalamus affecting reproductive function / 环境与职业医学

Manganese plays an important physiological role in the organism, and excessive manganese exposure can cause impairment of neurological and reproductive functions. Gonadotropin-releasing hormone secreted by the hypothalamus acts as an initiator to regulate reproductive functions, such as gonadal development, onset of puberty, and gonadal hormone release. But the mechanism by which manganese damages the hypothalamus leading to abnormal gonadotropin-releasing hormone release is still unclear yet. Kisspeptin, prostaglandin E2, and nitric oxide may act as stimulators to increase the release of gonadotropin-releasing hormone, while the stimulatory or inhibitory effect of γ-aminobutyric acid on the release of gonadotropin-releasing hormone is controversial. Based on current research, manganese has been less studied with Kisspeptin, and studies with prostaglandin E2, nitric oxide, and γ-aminobutyric acid mainly focused on inflammation, oxidative stress, and neurotransmitter transmission. Therefore, taking Kisspeptin, prostaglandin E2, γ-aminobutyric acid, and nitric oxide as the breakthrough points, this paper introduced the mechanism of manganese affecting the release of gonadotropin-releasing hormone in the hypothalamus through the above four pathways, and proposed that the abnormal release of gonadotropin-releasing hormone in the hypothalamus may be one of the mechanisms by which manganese regulates reproductive function, providing a new direction for the prevention and treatment of manganese-induced reproductive damage in the future.

The effect of adeno⁃associated virus delivery of shRNA against EP3 receptors in the bilateral lateral parabrachial nucleus of rats on fever / 安徽医科大学学报

Objective @#To investigate the effect of adeno⁃associated virus ( AAV) delivery of short hairpin RNA ( shRNA) against the Ptger3 gene in the lateral parabrachial nucleus (LPB) on the fever induced by microinjection of prostaglandin E2 (PGE2 ) into the LPB and the intraperitoneal injection of lipopolysaccharide (LPS) .@*Methods@#AAV2⁃shRNA⁃Ptger3(EP3) ⅣEGFP ( shRNA⁃EP3) and AAV2⁃ CMV⁃ EGFP ( shRNA⁃control) viruses were constructed and transfected the rat LPB by stereotaxic injection. Four weeks later, the transfection efficiency of AAV viruses was observed by fluorescence microscopy , and the knockdown efficiency was determined by real⁃time PCR of EP3 receptor mRNA on the LPB. The effects of microinjection of saline or PGE2 in the LPB or intraperitoneal injection of LPS on body temperature (Tcore ) and energy expenditure (EE) of shRNA⁃control group and shRNA⁃EP3 group were monitored using an animal monitoring system with temperature telemetry.@*Results @# AAV virus transfecnificant difference in basal body temperature between shRNA⁃control group and shRNA⁃EP3 group. Tcore and EE were briefly and slightly increased after microinjection of saline in the LPB , but there was no significant difference between the two groups. Compared with the shRNA⁃control group , the febrile response induced by LPB PGE2 was attenuated in the shRNA⁃EP3 group (P < 0. 05) . Furthermore , the knockdown of EP3 receptor of LPB also attenuated the LPS⁃induced fever, and the Tcore 5. 5 h post⁃LPS in the shRNA⁃EP3 rats increased compared with the baseline (P < 0. 05) , which was lower than that in the shRNA⁃control rats ( P < 0. 01) . @*Conclusion @#EP3 receptor knockdown in LPB attenuates the febrile response induced by microinjection of PGE2 in the LPB and intraperitoneal injection of LPS , suggesting that EP3 receptors of LPB mediate the pyrogenic action of LPB PGE2 and partly participate in LPS⁃induced fever.

An in vitro anti-inflammatory effect of Thai propolis in human dental pulp cells

Abstract Objective To explore the potential for development of Thai propolis extract as a pulp capping agent to suppress pulpal inflammation from dental pulp infections. This study aimed to examine the anti-inflammatory effect of the propolis extract on the arachidonic acid pathway, activated by interleukin (IL)-1β, in cultured human dental pulp cells. Methodology Dental pulp cells, isolated from three freshly extracted third molars, were first characterized for their mesenchymal origin and treated with 10 ng/ml of IL-1β in the presence or absence of non-toxic concentrations of the extract from 0.08 to 1.25 mg/ml, as determined by the PrestoBlue cytotoxic assay. Total RNA was harvested and analyzed for mRNA expressions of 5-lipoxygenase (5-LOX) and cyclooxygenase-2 (COX-2). Western blot hybridization was performed to investigate COX-2 protein expression. Culture supernatants were assayed for released prostaglandin E2 levels. Immunofluorescence was conducted to determine involvement of nuclear factor-kappaB (NF-kB) in the inhibitory effect of the extract. Results Stimulation of the pulp cells with IL-1β resulted in the activation of arachidonic acid metabolism via COX-2, but not 5-LOX. Incubation with various non-toxic concentrations of the propolis extract significantly inhibited upregulated COX-2 mRNA and protein expressions upon treatment with IL-1β (p<0.05), resulting in a significant decrease in elevated PGE2 levels (p<0.05). Nuclear translocation of the p50 and the p65 subunits of NF-kB upon treatment with IL-1β was also blocked by incubation with the extract. Conclusions Upregulated COX-2 expression and enhanced PGE2 synthesis upon treatment with IL-1β in human dental pulp cells were suppressed by incubation with non-toxic doses of Thai propolis extract via involvement of the NF-kB activation. This extract could be therapeutically used as a pulp capping material due to its anti-inflammatory properties.

Efectos antirresortivos y antimicrobianos de los antiinflamatorios no esteroideos en lesiones periapicales / Antiresorptive and antimicrobial effects of nonsteroidal anti-inflammatory drugs in periapical lesion

Los antiinflamatorios no esteroideos (AINE) son un grupo de fármacos que han sido comúnmente prescritos por sus propiedades antiinflamato- rias, antipiréticas y analgésicas, mismas que se deben a la inhibición de la formación de prostaglandinas. Este mecanismo ha sido ampliamente respaldado en la literatura; sin embargo, en la actualidad poco se co- noce sobre las propiedades adicionales de estos medicamentos como el efecto antirresortivo y antimicrobiano. La función antirresortiva se debe principalmente al bloqueo de la producción de prostaglandinas en específico la PGE2, que posee gran potencial osteoclastogénico, esencial para la aparición de lesiones periapicales; asimismo, la acción antimicrobiana de los AINE está relacionada con la afectación directa de la perpetuación de biopelícula, potencian la acción de los antibióticos, entre otros. Dichos efectos combinados podrían contribuir en la cura- ción de lesiones periapicales. El objetivo de este estudio es recopilar información actualizada sobre estas funciones agregadas de los AINE, con el fin de dar a conocer a los profesionales estos beneficios en la terapéutica de las lesiones periapicales (AU)

Non-steroidal anti-inflammatory (NSAIDs) are a group of drugs that have been commonly prescribed for their anti-inflammatory, antipyretic and analgesic properties, which are due to the inhibition of prostaglandin formation. This mechanism has been widely supported in the literature; however, currently little is known about the additional properties of these drugs such as the antiresorptive and antimicrobial effect. The antiresorptive function is mainly due to the blockage of prostaglandin production, specifically PGE2, which has great osteoclastogenic potential, and is essential for the appearance of periapical lesions; likewise, the antimicrobial action of NSAIDs is related to the fact that they directly affect the perpetuation of biofilms, enhance the action of antibiotics, among others. These combined effects could contribute to the healing of periapical lesions. The aim of this study is to gather updated information on these added functions of NSAIDs, in order to inform professionals about these benefits in the therapy of periapical lesion (AU)

Metabolomics study of rat tail vibration model / 环境与职业医学

Background The metabolites and metabolic pathways of hand-arm vibration syndrome have not yet been elucidated. Objective To investigate the effect of local vibration on endogenous metabolites in rat serum by metabolomic analysis, to preliminarily explore the potential metabolic pathway of endogenous metabolites, so as to provide evidence for further research on the mechanism of hand-arm vibration syndrome. Methods Thirty-two SPF male SD rats, (211.3±11.1) g, 7−8 weeks of age, were selected and randomly divided into three groups: control group (14 rats, without vibration), 7 d vibration group (9 rats, continuously vibration for 7 d), and 14 d vibration group (9 rats, continuous vibration for 14 d). The vibration rats were vibrated every day for 4 h, the frequency weighted acceleration was 4.9 m·s−2, the vibration frequency was 125 Hz, and the vibration direction was one-way vertical vibration. The control group had the same conditions except not contacting vibration. After the vibration exposure, the blood samples taken from the abnormal aorta of rats were collected, and the changes of rat serum metabolome were analyzed by ultra-performance liquid chromatography-tandem time-of-flight mass spectrometry. Principal components analysis (PCA) was used to explore changes in rat serum metabolic profile, and orthogonal partial least squares-discriminant analysis (OPLS-DA) was used to screen out differential metabolites. Combined with online databases, a metabolic pathway enrichment analysis of differential metabolites was performed. Results The PCA analysis showed that compared with the control group, the rat serum metabolic profiles in the 7 d group and the 14 d group were clearly differentiated, and the rat serum metabolic profiles in the 7 d group and the 14 d group partially overlapped. The OPLS-DA analysis showed significant differences between groups. The main parameters were: model interpretation rate R2Y=0.914, model predictive ability Q2=0.58. The OPLS-DA analysis screened out 26 and 119 differential metabolites from the 7 d group and the 14 d group respectively, and there were 24 common differential metabolites between the 7 d group and the 14 d group. The metabolomic pathway analysis showed that local vibration-induced changes in rat serum metabolism were mainly related to arachidonic acid metabolism in the 14 d group, among which the metabolites with significant effects were arachidonic acid, prostaglandin E2, and prostaglandin D2. Conclusion Local vibration could affect the normal metabolism in rats, and the metabolic pathway with significant influence is arachidonic acid metabolism after a 14 d exposure and the involved metabolites are arachidonic acid, prostaglandin E2, and prostaglandin D2.

Screening of prostaglandin E2 receptor 4 antagonist from active compounds of Baeckea frutescens L. and its anti-rheumatoid arthritis effect in vivo / 中国药科大学学报

@#The objectives of the study were to screen prostaglandin E2 receptor 4 antagonist from active compounds of Baeckea frutescens L. and to explore its anti-rheumatoid arthritis effect.The HEK293T-EP4 cell antagonist screening model was established in vitro. Homogeneous time-resolved fluorescence (HTRF) technique was used to screen the active compounds of Baeckea frutescens L..SPF grade ICR male mice were randomly divided into control group, model group, methotrexate group, and Baeckea frutescens L.compound BF-2 (100, 50 and 25 mg/kg) groups. The collagen-induced arthritis (CIA) mouse model was established in vivo. The swelling volume of the toes of mice was measured, and the pathological examination was analyzed by staining with hematoxylin and eosin.SPF grade ICR mice, male, were randomly divided into control group, BF-2 (100, 50 and 25 mg/kg) group, and aspirin group.The acetic acid-induced body writhing test was observed.The EP4 in vitro antagonist screening model was successfully established.The preliminary screening results found that BF-2, BF-20, BF-11 and BF-12 had strong EP4 antagonistic activity [(102.11 ± 3.45)%, (90.31 ± 3.59)%, (75.72 ± 1.79)% and (76.84 ± 1.64)%], and BF-2 had the strongest antagonistic activity (IC50 = 0.99 ± 0.08 μg/mL).BF-2 could significantly inhibit the toe swelling of CIA mice, and relieve the degradation of articular cartilage matrix and inflammatory cell infiltration.At the same time, compared with the control group, the writhing times of the mice in each dose of BF-2 were significantly reduced.In this study, BF-2 of Baeckea frutescens L.was selected as an EP4 antagonist, which has potential anti-rheumatoid arthritis activity.

The effect of ultrasound-guided stellate ganglion block on serum immune inflammatory response, PGE 2, SP, 5-HT expression and brain protection in patients undergoing radical mastectomy for breast cancer / 中国医师杂志

Objective:To investigate the effect of ultrasound-guided stellate ganglion block (SGB) in patients undergoing radical mastectomy, and to provide an effective reference for the selection of clinical anesthesia.Methods:A total of 86 patients undergoing radical mastectomy for breast cancer in the First Affiliated Hospital of Hunan Traditional Chinese Medicine College from January 2018 to December 2019 were selected as the research objects and randomly divided into two groups, with 43 cases in each group. On the basis of conventional general anesthesia, the observation group was treated with ultrasound-guided SGB intervention at the level of the sixth cervical vertebra on the left, and 0.5% ropivacaine was injected with 7 ml. The control group was treated with ultrasound-guided injection of equal volume normal saline at the same site. The hemodynamics and serum inflammatory factors, cellular immunity, prostaglandin E 2 (PGE 2), substance P (SP), serotonin (5-HT) expression, cerebral oxygen metabolism indexes before anesthesia induction (T 1), before intubation (T 2), immediately after intubation (T 3), during skin incision (T 4) and extubation (T 5), and cognitive function score before and after surgery of the two groups were measured respectively. Results:⑴ Hemodynamics: the heart rate (HR) and mean arterial pressure (MAP) of the observation group at T 2, T 3, T 4 were lower than those of the control group ( P<0.05), and there was no significant difference between the two groups at T 1, T 5 ( P>0.05). ⑵ Inflammation and immune status: there was no significant difference in interleukin (IL)-2, IL-18, tumor necrosis factor-α (TNF-α), CD3 + , CD4 + and CD8 + between the two groups at T 1, T 5 ( P>0.05); the IL-2, IL-18, TNF-α and CD8 + at T 2, T 3 and T 4 in the observation group were lower than those in the control group, while the CD3 + and CD4 + were higher than that in the control group ( P<0.05). ⑶ Pain mediators and cerebral oxygen metabolism indexes: there was no significant difference in the levels of PGE 2, SP, 5-HT, SjvO 2, Da-jvO 2 and CEO 2 between the two groups at T 1 and T 5 ( P>0.05); The levels of PGE 2, SP, 5-HT, Da-jvO 2 and CEO 2 in the observation group at T 2, T 3 and T 4 were lower than those in the control group, and the SjvO 2 was higher than those in the control group ( P<0.05). ⑷ Cognitive function: there was no significant difference in Mini Mental State Examination (MMSE) scores between the two groups at 1 day before and 5 days after operation ( P>0.05). At 1 and 3 days after operation, the MMSE score of the observation group was higher than that of the control group ( P<0.05). Conclusions:Ultrasound-guided SGB has a good application effect in patients undergoing radical mastectomy and can reduce the fluctuation of intraoperative hemodynamics, intraoperative inflammatory stress and immunosuppressive effects of the body, reduce the release of pain mediators, and at the same time improve cerebral oxygen metabolism, and promote postoperative cognitive function recovery.

Chemical Constituents and Biological Activities of Mitrella Kentii (Blume) Miq. Leaf Oil (Komponen Kimia dan Aktiviti Biologi Minyak Daun Mitrella Kentii (Blume) Miq.) / Jurnal Sains Kesihatan Malaysia

@#Chemical constituents and biological activities of the Mitrella kentii leaf oil were investigated in this study. Gas chromatography (GC) and gas chromatography-mass spectrometry (GC-MS) were used to determine the chemical constituents of the oil. The oil was evaluated for its ability to inhibit prostaglandin E2 (PGE2 ) and thromboxane B2 (TXB2 ) productions in human whole blood using a radioimmunoassay technique. Its inhibitory effect on plateletactivating factor (PAF) receptor binding with rabbit platelets using 3 H-PAF as a ligand and its free radical scavenging effect on DPPH were also investigated. Caryophyllene oxide (33.8%w/w), E,Z-farnesol (6.9%), benzyl benzoate (6.5%w/w) and viridiflorol (6.5%w/w) were among the major components of the oil. Even though weak inhibitory activities were observed in both PGE2 and TXB2 assays, significant results were obtained in both PAF receptor binding inhibition and 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging effect with IC50 value of 6.6 µg/mL and 155.6 µg/mL respectively. These promising activities warrant the development of the oil as an anti-inflammatory agent.

Comparative study on cervical ripening and labour induction with dinoprostone versus foley’s catheter with extra amniotic saline infusion

Background: Induction of labour is defined as initiation of uterine contractions before spontaneous onset of labour. This observational study compares the effect of prostaglandin E2 (PGE2) and extra amniotic saline infusion (EASI) for pre-labour ripening of unfavourable uterine cervix.Methods: This was a prospective study conducted on 100 pregnant women with gestational age ≥37 weeks during a year period in the department of obstetrics and gynaecology of government TD medical college, Alappuzha, Kerala. The period of study was for one year from June 2002 to July 2003. All patients were divided into two groups. Group-1 contains 47 patients who received intracervical PGE2, (Dinoprostone gel, 0.5 mg). Group-2 contains 53 patients who were induced with EASI. The main outcome variables were the number of subjects with favourable Bishop's score, mode of delivery, maternal complications and neonatal outcomes.Results: Majority of the patients in both the groups were in the age of 21-30 years. There was significant difference in age, parity and gestational age of both groups. In this study it was found significant difference in the occurrence of hyper stimulation among PGE2 and EASI; whereas, there was no significant difference in the occurrence of maternal pyrexia among two groups. High incidence of caesarean section was found in EASI. APGAR score of new born babies was high in labour induced with PGE2.Conclusions: PGE2 and EASI have similar efficacy in induction of labour, but EASI is associated with more side effects. Cost wise EASI is more cost effective than PGE2.

Signs of alveolar bone damage in early stages of periodontitis and its prevention by stimulation of cannabinoid receptor 2. Model in rats / Signos de daño óseo alveolar en estadios tempranos de periodontitis y su prevención por estimulación del receptor cannabinoide 2. Modelo en ratas microcisalhamento do cimento resinoso

ABSTRACT The aims of the present study were, first, to identify signs of alveolar bone damage in early stages of experimental periodontitis (EP) and, second, to assess its possible prevention by treatment with cannabinoid receptor 2 agonist HU 308. Experimental periodontitis was induced by injections of lipopolysaccharide (LPS) (1mg/ml) in gums surrounding maxillary and mandibular first molar, 3 days per week, and untreated controls were kept for comparison. Then, a 3-week study was conducted including eighteen new rats (six rats per group): 1) controls; 2) experimental periodontitis rats; and 3) experimental periodontitis rats treated daily with HU 308 (500 ng/ml). After euthanasia, alveolar bone loss was assessed by morphometric and histomorphometric techniques, and the content of prostaglandin E2 (PGE2) in gingival tissue was evaluated by radioimmunoassay. The first signs of alveolar bone loss were apparent at 3 weeks of experimental periodontitis (ρ<0.05) in the mandibular first molar, but there was no detectable change at 1 week, leading us to establish 3 weeks as an early stage of experimental periodontitis. Rats subjected to 3-week experimental periodontitis showed less interradicular bone volume, less whole bone perimeter and fewer bone formation areas, and higher periodontal space height, bone resorption areas, number of osteoclasts and gingival content of prostaglandin E2 than controls, while HU 308 prevented, at least partially, the deleterious effects (ρ<0.001). We can conclude that a 3-week term of lipopolysaccharide-induced periodontitis in rats provides a valid model of the early stage of the disease, as emerging damage is observed in bone tissue. Furthermore, harmful effects at 3 weeks could be prevented by local stimulation of cannabinoid receptor 2, before greater damage is produced.

RESUMEN El objetivo del presente trabajo fue, en primer lugar, identificar signos de daño óseo alveolar en estadios tempranos de periodontitis experimental y, en segundo lugar, evaluar su posible prevención mediante el tratamiento con el agonista del receptor cannabinoide 2, HU 308. La periodontitis experimental fue inducida por inyecciones de lipopolisacárido (1mg/ml) en la encía circundante al primer molar maxilar y mandibular, 3 días por semana, en tanto que controles no tratados fueron mantenidos para la comparación. Posteriormente, un estudio de 3 semanas con dieciocho nuevas ratas (seis por grupo) fue desarrollado: 1) controles; 2) ratas con periodontitis experimental, y 3) ratas con periodontitis experimental tratadas diariamente con HU 308 (500ng/ml). Luego de la euthanasia, la pérdida ósea alveolar fue evaluada por técnicas morfométricas e histomorfométricas, y el contenido de prostaglandina E2 en el tejido gingival fue determinado por radioinmunoensayo. Los primeros signos de pérdida ósea alveolar fueron evidentes a las 3 semanas de inducción de periodontitis experimental (ρ<0.05) en el primer molar mandibular, mientras que no hubo cambios detectables luego de 1 semana de inducción, hecho que nos condujo a establecer a las 3 semanas como un estadio temprano de periodontitis experimental, Las ratas sometidas a perdiodontitis experimental de 3 semanas mostraron menor volumen óseo interradicular, menor perímetro óseo y menos áreas de formación ósea, y mayor altura del espacio periodontal, más áreas de reabsorción ósea, mayor número de osteoclastos y mayor contenido gingival de prostaglandina E2, en comparación a los controles, mientras que el tratamiento con HU 308 previno, al menos parcialmente, los efectos deletéreos (ρ<0.001). Podemos concluir que el término de 3 semanas de periodontitis inducida por lipopolisacárido es un modelo válido de estadio inicial de la enfermedad experimental, dado que se evidencia daño emergente en el tejido óseo. Asimismo, los efectos deletéreos de 3 semanas podrían ser prevenidos por la estimulación local del receptor cannabinoide 2, antes que un daño mayor sea producido.

A prospective randomized comparison of mifepristone with misoprostol and prostaglandin E2 gel with misoprostol for medical termination of pregnancy between 13-20 week of gestation

Background: Worldwide mid-trimester abortion constitutes 10-15% of all induced abortions. Similar trend is seen in India where mid-trimester abortion accounts for 12.9% of all abortions. Prostaglandins have been used for therapeutic termination of pregnancy from 9-22 weeks of gestation since 1970s. The ideal method for mid-trimester abortion with best efficacy and acceptability and least side effects are still to be found. Objective of this study was to compare two drug regimens for mid trimester abortion using mifepristone with intra-vaginal misoprostol and prostaglandin E2 (PGE2) gel with intra-vaginal misoprostol for efficacy and side effects.Methods: This prospective randomized comparative clinical study was conducted on 50 women seeking mid trimester abortion, in two groups. One group received PGE2 gel and misoprostol, second group received mifepristone and misoprostol. Induction abortion interval, side effects were compared between two groups.Results: The mean induction-abortion interval in Group 1 was 6.50±3.54 hours and in Group 2 was 7.33±2.5 hours. In Group 1, success rate at 15 hours was 88%. In Group 2, success rate was 92% both at 15 and 24 hours. Surgical evacuation was required in 8% women in both groups.Conclusions: Both regimens are safe and has a few minor side effects. There was no major side effect and blood loss was within acceptable limits in both groups. The cost of abortifacients and hospital stay was lessor in group1 (prostaglandin gel and misoprostol) making it more economical.

A comparative study of the effect of induction of labour with vaginal misoprostol versus prostaglandin E2 gel on the incidence of pathological cardiotocography tracing

Background: The objective of the present study was to compare the two most commonly used agents for induction of labor-vaginal misoprostol and intracervical dinoprostone gel in terms of the incidence of cardiotocography (CTG) abnormalities and its correlation with fetal distress and fetomaternal outcome.Methods: This is prospective case-control study conducted in department of obstetrics and gynecology, RIMS, Ranchi over a period of 15 months. 112 women requiring induction were randomly assigned to two groups of 56 each, Group M received vaginal misoprostol and Group D received intracervical dinoprostone E2 gel. 56 women with spontaneous labor served as control group. Groups were compared in terms of the incidence of suspicious or pathological CTG tracings, fetal distress, induction to vaginal delivery time, vaginal delivery rates, dose requirements, rate of emergency cesarean.Results: Misoprostol was associated with shorter induction to delivery time (9.54 hours) than dinoprostone gel (13.54 hours), higher vaginal delivery rates (80.35% versus 62.5%), higher delivery rates (73.9%) with single dose itself unlike Group D, where 47.22% required more than one dose. Incidence of suspicious CTG was higher in group M (15.68%) versus 10.25% in Group D. Incidence of pathological CTG was also highest in Group M (7.8%) followed by Group D (2.56%) and Group C (7.8%). Dinoprostone gel lead to failed induction in 25% women, and hence higher caesarean rates.Conclusions: While misoprostol is a better agent for induction when compared with dinoprostone E2 gel in terms of induction-delivery time, higher vaginal delivery rates, less dose requirement, it is associated with greater incidence of non-reassuring/pathological CTG. There was justified improvement in perinatal outcome due to preparedness beforehand with use of CTG.

Maternal and fetal outcomes with the use of prostaglandins E2 as a cervical ripening agent for induction of labour

Background: In modern medicine induction of labour is required in patients for a good feto-maternal outcome. PGE2 is a prostaglandin analogue which has been used as a cervical ripening agent to improve bishops score. Objective of this study was to evaluate the efficacy of intravaginal PGE2 gel as a cervical ripening agent in unfavourable cervix for induction of labor and any complications associated with its use.Methods: This study comprised of 90 women who required labor induction. Singleton pregnancy above 37 weeks, live intrauterine fetus, Cephalic presentation, Bishop score of 1-6, reactive FHR pattern were included. Women who required only single induction were categorized as Group 1. Those requiring more than one dose after reassessment of bishops scoring at 6, 12 and 18 hours belonged to Group 2.Results: Group1 had more of younger population below 30 years consisting more primigravidas with > 80% women having gestational age of > 39 weeks. Most common indication for induction of labour in both groups was post-dated pregnancy. 65 patients received one dose of cerviprime gel forming Group 1. In Group 2, 72% received 2 doses and 28%, 3 doses of gel. Initial bishops score mean was 4.2 in Group 1 and 4.1 in Group 2. Mean change in bishop score was analysed after 6, 12, and 18 hours of instillations of PGE2 gel. Significant p value was obtained in all groups requiring one, two and three doses of gel. In Group 1, 12.3% and in Group 2, 16% had LSCS. Maternal side effects were minimal and neonatal outcome was good.Conclusions: The study showed that intravaginal application of PGE2 is effective, safe and acceptable method as a cervical ripening agent for labor induction in women with poor bishops score. It reduces caesarean delivery rate without increasing maternal and neonatal morbidity.

Immunomodulatory characteristics of mesenchymal stem cells mediated by inflammatory factors / 中国组织工程研究

BACKGROUND: Mesenchymal stem cells possess strong immunomodulatory capacity, mainly involved in the proliferation, differentiation and functional status of immune cells, and the secretion of inflammatory factors. The immunomodulatory capacity of mesenchymal stem cells is regulated by inflammatory factors. As the type and level of inflammatory factors in the microenvironment change, the immune regulation function of mesenchymal stem cells also changes. OBJECTIVE: To review the research progress of inflammatory factor intervention in the immune regulation of mesenchymal stem cells. METHODS: A computer-based retrieval of PubMed, Elsevier and CNKI databases was performed. The keywords were “mesenchymal stem cells, immune regulation, plasticity, interferon gamma, transforming growth factor beta, interleukin-17, interleukin-35, prostaglandins E2” in Chinese and English, respectively. The articles concerning the effects of inflammatory factor intervention on the immune regulation of mesenchymal stem cells were included. RESULTS AND CONCLUSION: After intervention and pre-treatment of interferon-γ, transforming growth factor-β, interleukin-17, interleukin-35 and prostaglandin E2, the biological characteristics of mesenchymal stem cells have also changed. The interventions cannot only reshape the tissue microenvironment and affect the inflammatory response, but also reconstruct the immune balance, which further treats or alleviates the disease progression. Reasonable individualized and differentiated treatments will be performed at different disease stages according to inflammatory and immunological reaction of the disease. All of them are expected to further improve the therapeutic effect of mesenchymal stem cells on immuno-inflammatory diseases.

Root canal contamination or exposure to lipopolysaccharide differentially modulate prostaglandin E 2 and leukotriene B 4 signaling in apical periodontitis

Abstract Purpose To evaluate the kinetics of apical periodontitis development in vivo , induced either by contamination of the root canals by microorganisms from the oral cavity or by inoculation of bacterial lipopolysaccharide (LPS) and the regulation of major enzymes and receptors involved in the arachidonic acid metabolism. Methodology Apical periodontitis was induced in C57BL6 mice (n=96), by root canal exposure to oral cavity (n=48 teeth) or inoculation of LPS (10 µL of a suspension of 0.1 µg/µL) from E. coli into the root canals (n= 48 teeth). Healthy teeth were used as control (n=48 teeth). After 7, 14, 21 and 28 days the animals were euthanized and tissues removed for histopathological and qRT-PCR analyses. Histological analysis data were analyzed using two-way ANOVA followed by Sidak's test, and qRT-PCR data using two-way ANOVA followed by Tukey's test (α=0.05). Results Contamination by microorganisms led to the development of apical periodontitis, characterized by the recruitment of inflammatory cells and bone tissue resorption, whereas inoculation of LPS induced inflammatory cells recruitment without bone resorption. Both stimuli induced mRNA expression for cyclooxygenase-2 and 5-lipoxygenase enzymes. Expression of prostaglandin E 2 and leukotriene B 4 cell surface receptors were more stimulated by LPS. Regarding nuclear peroxisome proliferator-activated receptors (PPAR), oral contamination induced the synthesis of mRNA for PPARδ, differently from inoculation of LPS, that induced PPARα and PPARγ expression. Conclusions Contamination of the root canals by microorganisms from oral cavity induced the development of apical periodontitis differently than by inoculation with LPS, characterized by less bone loss than the first model. Regardless of the model used, it was found a local increase in the synthesis of mRNA for the enzymes 5-lipoxygenase and cyclooxygenase-2 of the arachidonic acid metabolism, as well as in the surface and nuclear receptors for the lipid mediators prostaglandin E2 and leukotriene B4.