ABSTRACT
Cardiac arrest (CA) is a fatal condition with low resuscitation rate and high mortality rate. Most of the survivors have neurological sequelae affecting their quality of life. Targeted temperature management (TTM) has been suggested by a number of studies to increase the survival rate and improve neurological outcome of CA. It is highly recommended by the International Liaison Committee on Resuscitation (ILCOR) for unconscious patients after resuscitation. In this review, we discuss the pathological mechanism of brain injury in CA and applications of TTM in adults with CA, with the aim of providing valuable information for clinical application.
ABSTRACT
The incidence of traumatic spinal cord injury (TSCI) is increasing year by year, and the prognosis of the patients is poor, resulting in seriously deteriorating the health and quality of life. The pathophysiological mechanism of TSCI is complex, and its clinical treatment is not very effective. Although the surgical decompression is an effective treatment for most TSCI patients, the occurrence of relevant complications during the therapeutic period may hinder their treatment and recovery course, thus an individualized treatment plan is necessary to be formulated. Fully understanding the occurrence of various complications in intensive care period of patients with TSCI is beneficial to their treatment. To explore new drugs and therapies may provide references to the TSCI intensive care treatment and its further basic and clinical research.
ABSTRACT
The incidence of traumatic spinal cord injury (TSCI) is increasing year by year, and the prognosis of the patients is poor, resulting in seriously deteriorating the health and quality of life. The pathophysiological mechanism of TSCI is complex, and its clinical treatment is not very effective. Although the surgical decompression is an effective treatment for most TSCI patients, the occurrence of relevant complications during the therapeutic period may hinder their treatment and recovery course, thus an individualized treatment plan is necessary to be formulated. Fully understanding the occurrence of various complications in intensive care period of patients with TSCI is beneficial to their treatment. To explore new drugs and therapies may provide references to the TSCI intensive care treatment and its further basic and clinical research.
ABSTRACT
Morphine is a mainstay for chronic pain treatment, but its efficacy has been hampered by physical tolerance. The underlying mechanism for chronic morphine induced tolerance is complicated and not well understood. PLC(ß3) is regarded as an important factor in the morphine tolerance signal pathway. In this study, we determined intrathecal (i.t.) administration of an antisense oligodeoxynucleotide (ODN) of PLC(ß3) could quicken the on-set antinociceptive efficacy of acute morphine treatment and prolong the maximum effect up to 4h. The antisense could also attenuate the development of morphine-induced tolerance and left shift the ED50 after 7 day of coadministration with morphine. These results probably were contributed by the PLC(ß3) antisense ODN as they successfully knocked down protein expression levels and reduced activity of PLC(ß3) in spinal cord in rats. The mismatch group had no such effects. The results confirmed the important involvement of PLC(ß3) in both acute morphine efficacy and chronic morphine tolerance at spinal level in rats. This study may provide an idea for producing a novel adjuvant for morphine treatment.
Subject(s)
Analgesics, Opioid/pharmacology , Drug Tolerance , Morphine/pharmacology , Oligodeoxyribonucleotides, Antisense/administration & dosage , Phospholipase C beta/antagonists & inhibitors , Animals , Injections, Spinal , Male , Rats , Rats, Sprague-Dawley , Spinal Cord/drug effectsABSTRACT
Objective To investigate the effects of recombinant human erythropeietin(rh-EPO)on Bid mRNA and caspase-3 activity in the brain after hypoxic-ischemic brain damage(HIBD)in neonatal rats and the possible mechanism of the neuroprotective effect of rh-EPO.Methods Ninety 7 day old male SD rats weighing 12-18 g were randomly divided into 3 groups(n=30 each):group Ⅰ sham operation(S);group Ⅱ hypoxia-ischemia group(HI)and group Ⅲ rh-EPO.The animals were anesthetized with ether.Left common carotid artery was ligated with 4-0 silk and 3 days later the animals were placed in a 2 L airtisht vessel filled with 8%O2-92%N2 at 2-3 L/min for 2 h in group Ⅱ and Ⅲ.rh-EPO 3 000 IU/kg in 4 ml/kg normal saline(NS)was administered intraperitoneally after induction of hypoxia-ischemia(HI)in group Ⅲ while in group Ⅱ NS 4 ml/kg was given IP instead.Six animals in each group were killed at 6,12,24,48 and 72 h(T1-5)respectively after IP NS or rh-EPO.Their brains were removed for determination of Bid mRNA expression(by RT-PCR)and caspase-3 activity(by colorimetric method).Results The expression of Bid mRNA was up-regulated and caspase-3 activity was significantly increased in the brain at T1-5 in HIBD group(group Ⅱ)as compared with sham operation group.rh-EPO administration significantly reduced the increase in Bid mRNA expression and caspase-3 activity in the brain induced by hypoxia-ischemia.The expression of Bid mRNA was positively correlated with the caspase-3 activity.Conclusion rh-EPO has protective effects on the brain against hypoxia and ischemia by decreasing the expression of Bid mRNA and caspase-3 activity in the brain.
