Research advances in the prevention and treatment of hepatic ischemia-reperfusion injury with traditional Chinese medicine components / 临床肝胆病杂志

Hepatic ischemia-reperfusion injury (HIRI) is a very common complication of liver transplantation, liver resection, and shock. At present, many studies have been conducted on HIRI, but there is still a lack of drugs for radical treatment in clinical practice. Many factors, such as related cells, molecular mechanisms and signaling pathways, reactive oxygen species and oxidative stress response, nitric oxide, and mitochondria, mediate the development and progression of HIRI, which leads to the decline of patients' quality of life and even endangers their life safety. Based on the pathogenesis of HIRI and related articles, this article summarizes the research advances in the prevention and treatment of HIRI with traditional Chinese medicine components, so as to provide theoretical support for basic research and clinical research on HIRI.

Research advances in targeting autophagy to alleviate hepatic ischemia-reperfusion injury / 临床肝胆病杂志

Hepatic ischemia-reperfusion injury (HIRI) is a common clinical problem after hepatectomy and liver transplantation and is the main cause of liver dysfunction and liver failure after transplantation. In recent years, autophagy-mediated pathways have become a research hotspot in alleviating HIRI. Autophagy refers to the process in which a large number of substrates such as cytoplasm and damaged organelles are transported into lysosomes for digestion and degradation, so as to constantly renew, reshape, and reuse cells. This article summarizes the research advances in the mechanism of targeting autophagy to alleviate HIRI from the aspects of gene, protein, signaling pathway, inflammatory response, oxidative stress, and mitochondrial and endoplasmic reticulum stress, as well as existing problems and prospects in research, in order to provide theoretical support for the future research on alleviating HIRI by targeting autophagy.

Efficacy and Safety of Benralizumab for Severe Eosinophilic Asthma ：A Meta-analysis / 中国药房

OBJECTIVE：To systematic ally ev aluate the efficacy and safety of benralizumab in the treatment of severe eosinophilic asthma ，and to provide evidenced-based reference for clinical treatment. METHODS ：Retrieved from PubMed ， Embase，Cochrane Library ，ClinicalTrials.gov，CNKI，VIP and Wanfang database ，randomized controlled trials （RCTs）about benralizumab+routine treatment （trial group ）versus placebo+routine treatment （control group ）were collected during the inception to Dec. 2020. The relevant references were also retrieved manually. After data extraction ，the quality of included literatures was evaluated with bias risk evaluation tool 2.0 recommended by Cochrane systematic evaluator manual 6.1. Meta-analysis was conducted by using Rev Man 5.4 software. RESULTS ：Totally 5 studies involving 2 646 patients were included. Results of Meta-analysis showed that acute exacerbation rate of asthma [RR ＝0.67，95％ CI（0.61，0.74），P＜0.000 01]，asthma control questionnaire score [MD ＝－0.29，95％CI（－0.37，－0.21），P＜0.000 01] and the incidence of severe adverse event [RR ＝0.67，95％CI （0.53，0.84），P＝0.000 6] in trial group were significantly lower than control group. FEV 1[MD＝0.13，95％CI（0.09，0.17），P＜0.000 01] and asthma quality of life questionnaire score [MD ＝0.23，95％CI（0.13，0.33），P＜0.000 01] in trial group were significantly higher than control group. There was no statistical significance in the incidence of adverse event between 2 groups [RR ＝0.97，95％CI （0.92，1.02），P＝0.28]. CONCLUSIONS ：Benralizumab is effective and safe in the treatment of severe eosinophilic asthma. Due to the relatively limited data ，this conclusion needs to be confirmed by more studies.

Efficacy of minimally invasive percutaneous intervertebral disc approach for treatment of sympathet-ic cervical spondylosis / 中华麻醉学杂志

Objective To evaluate the efficacy of minimally invasive percutaneous intervertebral disc approach for treatment of sympathetic cervical spondylosis. Methods Fifty?six patients diagnosed as having sympathetic cervical spondylosis from January 2009 to August 2014, aged 22-64 yr, with the dis?ease course ranged from 6 months to 15 yr and a follow?up period of 6 months, were enrolled in the study. The related minimally invasive approach was selected according to the height of the diseased intervertebral space. When the ratio of the height of diseased intervertebral space∕normal intervertebral space≤1∕3, per?cutaneous radiofrequency ablation was used ( groupⅠ, n=19); when the ratio within the range of 1∕3-2∕3, percutaneous laser disk decompression was used ( groupⅡ, n=12); when the ratio≥2∕3, low?tem?perature plasma radiofrequency ablation was used ( group Ⅲ, n=25) . Before operation, at 2 weeks after operation, and at 1, 3 and 6 months after operation, the sympathetic symptoms were evaluated using the 20?point score. At 2 weeks and 6 months after operation, the patients′ subjective satisfaction was assessed and graded ( excellent, good, medium and poor ) . Results All the patients were followed up for 6 months. The sympathetic symptom scores were significantly lower at each time point after operation in Ⅰand Ⅲ groups and at 2 weeks and 3 and 6 months after operation in group Ⅱ than those before operation ( P<0.05) . The excellent and good rate of patients′subjective satisfaction was 67.9% at 2 weeks after op?eration, and 76.8% in the last follow?up period at 6 months after operation. Conclusion The minimally invasive percutaneous intervertebral disc approach has a marked short?term effect on sympathetic cervical spondylosis.

Efficacy of percutaneous laser disc decompression combined with injection of collagenase through a target location for treatment of lumbar intervertebral disc protrusion / 中华麻醉学杂志

Objective To investigate the efficacy of percutaneous laser disc decompression(PLDD)combined with injection of collagenase through a target location for treatment of lumbar intervertebral disc protrusion.Methods Ninety patients with lumbar intervertebral disc protrusion scheduled for discolysis,aged 31-52 yr,weighing 58-70 kg,were randomly divided into 3 groups: PLDD group(group P,n = 29),collagenase injection group(group C,n = 31),PLDD combined with injection of collagenase through a target location group(group PC,n = 30).The puncture was performed under the guidance of CT.Group P was treated using PLDD.Group C was treated with collagenase injection.Group PC was treated with injection of collagenase after PLDD was completed.The therapeutic effect was assessed before operation and on day 7,30,60 and 90 after operation using M-JOA score.Results M-JOA grade was significantly higher at the each time point after operation in group P and PC,and on day 30,60 and 90 after operation in group C than that before operation(P ＜ 0.05).M-JOA grade was significantly lower on day 30 after operation in group P,while higher on day 30,60 and 90 after operation in group C and PC than that on day 7 after operation(P ＜ 0.05).M-JOA grade was significantly lower at the each time point after operation in group P and C than in group PC.Conclusion The therapeutic effect of PLDD combined with collagenase injection through a target location is stable for treatment of lumbar intervertebral disc herniation and better than that of PLDD or collagenase injection alone.

The role of peripheral nerve TNF? content in the development of neuropathic pain produced by chronic constriction injury of peripheral nerve in rats / 中华麻醉学杂志

Objective To investigate the changes in TNF? content of sciatic nerve induced by chronic constriction injury (CCI) of sciatic nerve to determine the role of TNFa in the development of neuropathic pain. Methods Eight-four female health SD rats weighing 250-300g were anesthetized with sodium barbiturate. Unilateral sciatic nerve was exposed and ligated at the middle of thigh. Three ligatures (chromic catgut 4.0) were placed around the sciatic nerve and tied. The distance between the two ligatures was about 1 mm. Sham operation was performed on the contralateral thigh. The sciatic nerve was exposed and mobilized but not ligated. The thermal nociceptive threshold was determined by measuring the withdrawal latency of hindpaw placed on a 58℃ hot plate on days 0.5, 1, 3, 5, 7, 9, 11, 13 and 14 after surgery. Animals were sacrificed on days 0.5, 1, 3, 7, 10 and 14 after surgery. Sciatic nerves were removed from both thighs and frozen at - 80℃ for determination of TNF? content. Sciatic nerve from healthy animals was used as control. The percentage of maximal possible response (% MPR) , was determined for each group (CCI, sham operation, control) % MPR= (new withdrawal latency- average baseline latency)/( 15-average baseline latency) . The distribution of TNF? between supernatant and sediment was also determined. Results The average baseline nociceptive threshold (withdrawal latency) was (7.9?0.2)s. There was significant different in %MPR between the two hindpaws on days 1, 3, 5, 7, 9 and 11 after surgery. The TNF? content of sciatic nerve from healthy rats was (40.62? 0.24) pg/mg protein. The TNF? content of the ligated sciatic nerve was elevated abruptly in 12h after ligation, then abruptly declined to a plateau but was still significantly higher than that of sham-operated side on days 1 and 3. There was no significant difference in TNF? content of sciatic nerve between control group and sham-operation group. The relative content of TNF? content in the sediment of ligated sciatic nerve gradually increased and reached the peak on day 7 and then gradually decreased. Conclusion The TNF? content of peripheral nerves plays an important role in the development of neuropathic pain. Membrane-combined TNF? is involved in the process of nerve repairing.

The influence of isoflurane on excitatory amino acid and cerebral oxygen supply consumption during cardiopulmonary bypass / 中华麻醉学杂志

0.05). But the CaO2-CjO2 and jugular vein Glu level at D in group I were significantly lower than those at D in group C. In group C CaO2-CjO2 and jugular vein glutamate level at D were significantly higher than those at B (P