High-flow nasal cannula oxygen therapy and noninvasive ventilation for preventing extubation failure during weaning from mechanical ventilation assessed by lung ultrasound score: A single-center randomized study / 世界急诊医学杂志（英文）

@#BACKGROUND: We sought to demonstrate the superiority of a targeted therapy strategy involving high-flow nasal cannula oxygen (HFNCO2) therapy and noninvasive ventilation (NIV) using lung ultrasound score (LUS) in comparison with standard care among patients in the intensive care unit (ICU) who undergo successful weaning to decrease the incidence of extubation failure at both 48 hours and seven days. METHODS: During the study period, 98 patients were enrolled in the study, including 49 in the control group and 49 in the treatment group. Patients in the control group and patients with an LUS score <14 points (at low risk of extubation failure) in the treatment group were extubated and received standard preventive care without NIV or HFNCO2. Patients with an LUS score ≥14 points (at high risk of extubation failure) in the treatment group were extubated with a second review of the therapeutic optimization to identify and address any persisting risk factors for postextubation respiratory distress; patients received HFNCO2 therapy combined with sessions of preventive NIV (4-8 hours per day for 4-8 sessions total) for the first 48 hours after extubation. RESULTS: In the control group, 13 patients had the LUS scores ≥14 points, while 36 patients had scores <14 points. In the treatment group, 16 patients had the LUS scores ≥14 points, while 33 patients had scores <14 points. Among patients with the LUS score ≥14 points, the extubation failure rate within 48 hours was 30.8% in the control group and 12.5% in the treatment group, constituting a statistically significant difference (P<0.05). Conversely, among patients with an LUS score <14 points, 13.9% in the control group and 9.1% in the treatment group experienced extubation failure (P=0.61). The length of ICU stay (9.4±3.1 days vs. 7.2±2.4 days) was significantly different and the re-intubation rate (at 48 hours: 18.4% vs. 10.2%; seven days: 22.4% vs. 12.2%) significantly varied between the two groups (P<0.05). There was no significant difference in the 28-day mortality rate (6.1% vs. 8.2%) between the control and treatment groups. CONCLUSIONS: Among high-risk adults being weaned from mechanical ventilation and assessed by LUS, the NIV+HFNCO2 protocol does not lessen the mortality rate but reduce the length of ICU stay, the rate of extubation failure at both 48 hours and seven days.

Effect of Electro-acupuncture on Expression of IRS-1/PI3K/GLUT4 Pathway in Ovarian Granulosa Cells of Infertile Patients with Polycystic Ovary Syndrome-Insulin Resistance of Phlegm-Dampness Syndrome / 中国结合医学杂志

OBJECTIVE@#To evaluate the effect of electro-acupuncture (EA) in infertile patients with phlegm-dampness polycystic ovary syndrome-insulin resistance (PCOS-IR).@*METHODS@#Seventy-six PCOS-IR patients who underwnet in vitro fertilization and embryo transfer (IVF-ET) were equally assigned to two groups according to a random digital table: the EA group and the control group, with 38 cases in each group. Before undergoing IVF, the two groups were treated with EA or pseudo-acupuncture, respectively, for 3 menstrual cycles. The intervention was 25 min twice a week until the day of oocyte collection. The selected acupoints were Zhongwan (RN 12), Tianshu (ST 25), Daheng (SP 15), Daimai (GB 26), Qihai (CV 6), Guanyuan (CV 4), and bilateral points including Xuehai (SP 10), Fenglong (ST 40), Zusanli (ST 36), and Yinlingquan (SP 9). Evaluation of phlegm-dampness syndrome score and IR score were carried out before and after treatment. Additionally, the number of oocytes retrieved, transplantable embryo rate, high-quality embryo rate, clinical pregnancy rate and live birth rate were compared between the two groups. Real-time polymerase chain reaction analysis was used to monitor the mRNA expression of the insulin receptor substrate (IRS-1), phosphatidylinositiol 3-kinase (PI3K) and glucose transport factor 4 (GLUT4) in ovarian granulosa cells.@*RESULTS@#EA treatment reduced the phlegm-dampness syndrome score as well as the IR scores compared with the control group (P0.05). Moreover, the transplantable embryo rate [49.0% (284/580) vs. 41.9% (273/652)], high-quality embryo rate [36.6% (104/284) vs. 27.8% (76/273)], and live birth rate [50% (19/38) vs. 26.3% (10/38)] in the EA group were significantly higher than in the control group (P<0.05). Gene expression analyses revealed significantly elevated IRS-1, PI3K and GLUT4 mRNA in ovarian granulosa cells of the EA group compared with the control group (P<0.05).@*CONCLUSIONS@#EA may ameliorate the effects of phlegm-dampness syndrome and ovarian IR in PCOS-IR patients. Mechanistically, this effect might be through an upregulation of the IRS-1/PI3K/GLUT4 signaling pathway, which may result in improved oocyte quality and embryonic development potential. (Registration No. ChiCTR1800015453).

Effects of Electroacupuncture on Expression of PI3K/Akt/Foxo3a in Granulosa Cells from Women with Shen (Kidney) Deficiency Syndrome Undergoing in vitro Fertilization-Embryo Transfer / 中国结合医学杂志

OBJECTIVE@#To observe the effects of electroacupuncture (EA) on reproductive outcomes in women with Shen (Kidndy) deficiency syndrome after in vitro fertilization-embryo transfer (IVF-ET), and explore the underlying molecular mechanism.@*METHODS@#Sixty-six infertile patients with Shen deficiency syndrome undergoing IVF-ET were divided into EA or control groups according to a random table, 33 cases in each group. Before undergoing IVF, patients in the EA and control groups received EA therapy and placebo needle puncture, respectively, for 3 menstrual cycles. Shen deficiency syndrome scores were assessed. Other outcome measures included the number of retrieved oocytes and fertilization, high-quality embryo and clinical pregnancy rates. Follicular fluid was collected on the day of oocyte retrieval, and granulosa cell expression of phosphatidylinositide 3-kinases (PI3K), serine-threonine kinase (Akt) and forkhead box O3 (Foxo3a) mRNA were measured by reverse transcribed and quantitative real-time polymerase chain reaction.@*RESULTS@#Syndrome scores for pre- versus post-treatments decreased significantly (16.53±1.75 to 8.67±1.61) in the EA group (P<0.05), but showed no significant change in the control group (17.18±1.58 to 14.74±1.58). A significant difference in score change was found between the EA and control groups (P<0.05). High-quality embryo and clinical pregnancy rates were both increased in the EA group compared with the control group [69.15% (195/282) vs. 60.27% (176/292) and 66.67% (22/33) vs. 42.42% (14/33), respectively, P<0.05]. The fertilization rate was equivalent in EA and control groups. No difference was found in the number of retrieved oocytes between the two groups. Granulosa cell expression levels of PI3K and Akt mRNA were significantly increased in the EA group compared with the control group, while the expression of Foxo3a was reduced (all P<0.05).@*CONCLUSIONS@#For infertile patients with Shen deficiency syndrome undergoing IVF, EA for tonifying Shen as an adjunct treatment may alleviate clinical symptoms and improve the high-quality embryo rate. The EA-induced mechanism may involve regulation of PI3K/Akt/Foxo3a expression in granulosa cells to improve the developmental microenvironment of oocytes and inhibit granulosa cell apoptosis, possibly contributing to the improved clinical pregnancy rate (Registration No. ChiCTR 1800016217).

Enhancement of sodium taurocholate to the absorption of cefquinome

The objective of the research was to detect the enhancement effect of sodium taurocholate on the absorption of cefquinome both in Caco-2 cells and rats. The absorption efficiency of cefquinome was determined by high performance liquid chromatography and calculated with apparent permeability coefficients [Papp] after Caco-2 cell monolayers treated odium taurocholate [2 mmol/L] and cefquinome. The results showed that the absorption of cefquinome in Caco-2 cell monolayers was significantly increased with the sodium taurocholate [2mmol/L]. Similar results were also detected in the rats orally administrated with 1 mL PBS of cefquinome [20mg/mL] containing different concentration of sodium taurocholate [5 mmol/L, 10mmol/L and 20mmol/L] respectively. Compared with control group, sodium taurocholate at 10 and 20 mmol/L increased the absorption of cefquinome in rats from 0.26 +/- 0.04micro g/mL to 0.57 +/- 0.03micro g/mL, 0.78 +/- 0.07micro g/mL respectively. These results indicated that sodium taurocholate could increase the intestinal permeability in a concentration-dependent mode, which will be useful for clinical treatment

Improvement of the oocyte quality with electroacupuncture in infertility patients of kidney deficiency pattern / 中国针灸

<p><b>OBJECTIVE</b>To explore the impact and effect mechanism of electroacupuncture (EA) on oocyte quali ty in the patients with infertility of kidney deficiency pattern.</p><p><b>METHODS</b>Sixty-six cases differentiated as kidney de ficiency and with in vitro fertilization-embryo transplantation (IVF-ET), aged fromnt 35 to 42 years were rando- mized into an observation group and a control group, 33 cases in each one. The IVF-ET therapy of the long proto- col with gonadotrophin releasing hormone agonist was adopted in the two groups. In the observation group. on the 5th day of menstruation in IVF cycle, EA was applied to Sanyinjiao (SP 6). Zigong (EX CA 1), Zhongji (CV 3) and Guanyuan (CV 4). In the control group, the sham-acupuncture was applied to the same acupoints. The treatment was given once every two days till the date of egg collection and the needles were retained for 30 min each time. The change in the score of kidney deficiency syndrome, the high-quality oocyte rate, the high-quality embryo rate and clinical pregnant rate were observed in the two groups. The levels of insulin-like growth factor-i (IGF-1) and IGF-2 in follicular fluid and the serum β-endorphin β-EP) on the date of egg collection and the correlation with oocyte quality were compared bIetween the two groups.</p><p><b>RESULTS</b>1) In the observation group, the kidney deficiency syndrome score after treatment was reduced apparently as compared with that before treatment (P<0. 05), the score after treatment in the observation group was reduced much more apparently as compared with the control group (P<0.05). 2) The high-quality egg rate and the high-quality embryo rate in the observation group were both higher than those in the control group [81.3% (161/198) vs 57.6% (98/170), 59.8% (58/97) vs 37.7% (26/69), both P<0.05]. 3) Compared with the control group. the levels of IGF-1 and IGF-2 in follicular fluid and serum β-EP on the day of egg collection were all increased obviously in the observation group (all P<0. 05). 4) The levels of IGF-1 and IGF-2 in follicular fluid and serum β-EP presented the linear positive correlation with the high-quality egg rate.</p><p><b>CONCLUSION</b>EA effectively improves the expressions of IGF in follicular fluid and serum β-EP, increases the high-quality egg rate and high-quality embryo rate and relieves the symptoms of kidney deficiency.</p>

Involvement of stress-induced hippocampal synaptic potentiation in the novelty acquisition / 生理学报

To study the influence of behavioral stress on hippocampal spatial learning and memory, we used the freely moving rats that had undergone chronic implantation of a recording electrode in the hippocampus CA1 region and a bipolar stimulating electrode in the ipsilateral Schaffer collateral-commissural pathway. The field excitatory postsynaptic potentials (fEPSPs) were recorded in the absence of exogenous induction of high-frequency stimulation (HFS) or low-frequency stimulation (LFS) and reflected the effect of stress on the hippocampal spatial learning. And we also investigated the change of hippocampal synaptic plasticity when rats were re-exposed to the same environment at 24 h after novelty acquisition. We found that exploration of a novel environment induced the hippocampal synaptic depression in the rats with stress-adaption, whereas exposure to the novel environment induced the hippocampal synaptic potentiation in the behavioral stress rats. Furthermore, re-exposure to the same environment no longer elicited the hippocampal synaptic potentiation or depression at 24 h after the first novel acquisition in the behavioral stress rats. These results demonstrate that behavioral stress induces the hippocampal synaptic potentiation under novelty acquisition and further damages the hippocampal spatial learning and memory. However, the stress can be adapted by re-exposure to the novelty and thus does not further damage the hippocampal spatial learning and memory.

Dopamine-dependent long-term depression in hippocampus of rat induced by exposure to spatial novelty / 生理学报

To study the role of long-term depression (LTD) in the mechanisms of learning and memory in hippocampus of rat, recordings were taken from freely moving animals that had undergone chronic implantation of a recording electrode in the hippocampus CA1 region and a bipolar stimulating electrode in the ipsilateral Schaffer collateral-commissural pathway. The recording electrode was inserted 3.8 mm posterior to bregma and 2.8 mm right of the midline, and the stimulating electrode was inserted 4.8 mm posterior to bregma and 3.8 mm right of the midline via holes drilled through the skull. The entire assembly was connected with a rubber socket on the animal's head and then stabilized with dental cement. The correct placement of the electrodes into the hippocampal CA1 area was confirmed via electrophysiological criteria and postmortem histological analysis. After 2 weeks of surgery recovery, the rats were placed in the familiar recording chamber for 3 days. The field excitatory postsynaptic potentials (fEPSPs) were evoked by stimulating with a square wave constant current pulse of 0.2 ms duration, at a frequency of 0.033 Hz and at a stimulation intensity adjusted to given an fEPSP amplitude of 50% of the maximum, and the baseline of fEPSPs were recorded for 3 days in the familiar recording environment at the same time each day. A novelty environment that was made of clear Perspex (40 cm x 40 cm x 40 cm) was prepared and we examined whether exposure to a novelty spatial environment facilitated the expression of activity-dependent persistent decrease in synaptic transmission (namely LTD) at CA1 synapses in the rat hippocampus. The results showed that brief exposure to a novelty environment for 10 min facilitated the expression of LTD in the hippocampal CA1 area under no other exogenous high- or low-frequency stimulation protocol. This facilitatory effect was dependent on the activation of D1/D5 receptors: the D1/D5 receptors antagonist SCH23390 prevented the decrease of synaptic transmission in the hippocampus during the novelty exploration. These data provided important evidence that LTD may underlie certain forms of learning and memory and that dopamine participates in the synaptic plasticity in the process of hippocampal spatial information storage.

Characteristics of vestibular-ocular reflex in guinea pigs during eccentric sinusoidal rotation / 中国应用生理学杂志

<p><b>AIM</b>To observe the characteristics of vestibular-ocular reflex (VOR) of guinea pigs during eccentric sinusoidal rotation in different frequencies and radius, and compare them with that during axis rotation, obtain the parameters which reflect otolith functions, and provide experimental evidence for the establishment of otolith function test.</p><p><b>METHODS</b>Guinea pigs were placed in axis of rotation and in an heading out eccentric position apart from rotation axis of 330 mm, 660 mm and 990 mm respectively, their VOR were recorded and compared under stimulus of sinusoidal rotations in the frequencies of 0.1, 0.2, 0.3, 0.4, 0.5 and 0.6 Hz with the peak velocity of 60 degrees/s in each position.</p><p><b>RESULTS</b>Both frequency and eccentric radius had significant effects on the VOR gain, it increased with the increase of frequencies and radius. The largest increase of the gain occurred at the frequencies of 0.3 and 0.4Hz, and no significant changes were observed above these frequencies.</p><p><b>CONCLUSION</b>Enhancement ratio (ER) of VOR gain can reflect the extent of its increase with radius, and can be used as an index of otolith function, the stimulus profile of eccentric rotation at frequency of 0.4Hz and radius of 990mm is recommended as the stimulus profile for the otolith function test.</p>

Basic fibroblast growth factor alleviates brain injury following global ischemia reperfusion in rabbits / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

The aim of this study was to explore the protective effect of basic fibroblast growth factor (bFGF) on brain injury following global ischemia reperfusion and its mechanisms. Brain injury following global ischemia was induced by four vessels occlusion and systemic hypotension. Twenty-four rabbits were randomized into three groups: group A, only dissection of vessels; group B, intravenous infusion of normal saline after reperfusion for 6 h; group C, 30 microg/kg bFGF injected intravenously at the onset of reperfusion, then infused with 10 microg/(kg.h) for 6 h. Serum neuron specific enolase (NSE), S-100B, tumor necrosis factor-alpha (TNF-alpha), interleukin-1 (IL-1), interleukin-8 (IL-8) were measured before ischemia, 30 min after ischemia, 0.5, 1, 3, 6 h after reperfusion. Brain water content was determined and cerebral histopathological damages were compared. NSE and S-100B were increased 1 h after reperfusion and reached their peaks 6 h after reperfusion, but were much higher in group B than those in group C 3, 6 h after reperfusion. In groups B and C, TNF-alpha was increased after ischemia and IL-1 and IL-8 were increased significantly 0.5 h after reperfusion, then reached their peaks 6 h, 3 h, 6 h after reperfusion respectively. TNF-alpha and IL-8 at the time points of 1 h and 3 h and IL-1 at 3 h and 6 h in group C were correspondingly lower than those in group B. These indices in group A were nearly unchanged. There were less severe cerebral histopathological damages in group C compared with group B, but no difference in brain water content. It could be concluded that bFGF alleviates brain injury following global ischemia and reperfusion by down-regulating expression of inflammatory factors and inhibiting their activities.