Sarmentol H derived from Sedum sarmentosum Bunge directly targets FXR to mitigate cholestasis by recruiting SRC-1.

BACKGROUND: Farnesoid X receptor (FXR) is a vital receptor for bile acids and plays an important role in the treatment of cholestatic liver disease. In addition to traditional bile acid-based steroidal agonists, synthetic alkaloids are the most commonly reported non-steroidal FXR agonists. Sarmentol H is a nor-sesquiterpenoid obtained from Sedum sarmentosum Bunge, and in vitro screening experiments have shown that it might be related to the regulation of the FXR pathway in a previous study. PURPOSE: To investigate the therapeutic effects of sarmentol H on cholestasis and to determine whether sarmentol H directly targets FXR to mitigate cholestasis. Furthermore, this study aimed to explore the key amino acid residues involved in the binding of sarmentol H to FXR through site-directed mutagenesis. METHODS: An intrahepatic cholestasis mouse model was established to investigate the therapeutic effects of sarmentol H on cholestasis. In vitro experiments, including Co-Ip and FXR-EcRE-Luc assays, were performed to assess whether sarmentol H activates FXR by recruiting the receptor coactivator SRC1. CETSA, SIP, DARTS, and ITC were used to determine the binding of sarmentol H to FXR protein. The key amino acid residues for sarmentol H binding to FXR were analyzed by molecular docking and site-directed mutagenesis. Finally, we conducted in vivo experiments on wild-type and Fxr-/- mice to further validate the anticholestatic target of sarmentol H. RESULTS: Sarmentol H had significant ameliorative effects on the pathological conditions of cholestatic mice induced with ANIT. In vitro experiments suggested that it is capable of activating FXR and regulating downstream signaling pathways by recruiting SRC1. The target validation experiments showed that sarmentol H had the ability to bind to FXR as a ligand (KD = 2.55 µmol/L) and enhance the stability of its spatial structure. Moreover, site-directed mutagenesis revealed that THR292 and TYR365 were key binding sites for sarmentol H and FXR. Furthermore, knockout of the Fxr gene resulted in a significantly higher degree of ANIT-induced cholestatic liver injury than that in wild-type cholestatic mice, and the amelioration of cholestasis or regulatory effects on FXR downstream genes by sarmentol H also disappeared in Fxr-/- cholestatic mice. CONCLUSION: Sarmentol H is an FXR agonist. This is the first study to show that it exerts a significant therapeutic effect on cholestatic mice, and can directly bind to FXR and activate it by recruiting the coactivator SRC1.

Entecavir versus tenofovir for prevention of hepatitis B virus-associated hepatocellular carcinoma after curative resection: study protocol for a randomized, open-label trial.

BACKGROUND: Entecavir and tenofovir disoproxil fumarate (TDF) are standard first-line treatments to prevent viral reactivation and hepatocellular carcinoma (HCC) in individuals chronically infected with the hepatitis B virus (HBV), but the long-term efficacy of the two drugs remains controversial. Also unclear is whether the drugs are effective at preventing viral reactivation or HCC recurrence after hepatectomy to treat HBV-associated HCC. This trial will compare recurrence-free survival, overall survival, viral indicators and adverse events in the long term between patients with HBV-associated HCC who receive entecavir or TDF after curative resection. METHODS: This study is a randomized, open-label trial. A total of 240 participants will be randomized 1:1 into groups receiving TDF or entecavir monotherapy. The two groups will be compared in terms of recurrence-free and overall survival at 1, 3, and 5 years after surgery; adverse events; virological response; rate of alanine transaminase normalization; and seroreactivity at 24 and 48 weeks after surgery. DISCUSSION: This study will compare long-term survival between patients with HBV-associated HCC who receive TDF or entecavir monotherapy. Numerous outcomes related to prognosis will be analyzed and compared in this study. TRIAL REGISTRATION: ClinicalTrials.gov NCT02650271. Registered on January 7, 2016.

Polyethylene microplastics alter soil microbial community assembly and ecosystem multifunctionality.

Although pervasive microplastics (MPs) pollution in terrestrial ecosystems invites increasing global concern, impact of MPs on soil microbial community assembly and ecosystem multifunctionality received relatively little attention. Here, we manipulated a mesocosm experiment to investigate how polyethylene MPs (PE MPs; 0, 1%, and 5%, w/w) influence ecosystem functions including plant production, soil quality, microbial community diversity and assembly, enzyme activities in carbon (C), nitrogen (N) and phosphorus (P) cycling, and multifunctionality in the maize-soil continuum. Results showed that PE MPs exerted negligible effect on plant biomass (dry weight). The treatment of 5% PE MPs caused declines in the availability of soil water, C and P, whereas enhanced soil pH and C storage. The activity of C-cycling enzymes (α/ß-1, 4-glucosidase and ß-D-cellobiohydrolase) was promoted by 1% PE MPs, while that of ß-1, 4-glucosidase was inhibited by 5% PE MPs. The 5% PE MPs reduced the activity of N-cycling enzymes (protease and urease), whereas increased that of the P-cycling enzyme (alkaline phosphatase). The 5% PE MPs shifted soil microbial community composition, and increased the number of specialist species, microbial community stability and networks resistance. Moreover, PE MPs altered microbial community assembly, with 5% treatment decreasing dispersal limitation proportion (from 13.66% to 9.96%). Overall, ecosystem multifunctionality was improved by 1% concentration, while reduced by 5% concentration of PE MPs. The activity of α/ß-1, 4-glucosidase, urease and protease, and ammonium-N content were the most important predictors of ecosystem multifunctionality. These results underscore that PE MPs can alter soil microbial community assembly and ecosystem multifunctionality, and thus development and implementation of practicable solutions to control soil MPs pollution become increasingly imperative in sustainable agricultural production.

Effectiveness of percutaneous balloon compression (PBC) in improving physical function and quality of life in trigeminal neuralgia: a retrospective study.

OBJECTIVE: To evaluate the effectiveness of percutaneous balloon compression (PBC) in treating trigeminal neuralgia (TN) and determine improvements in quality of life (QoL) and daily functional status. METHODS: Data from primary TN (pTN) patients treated with PBC from December 2018 to April 2021 were retrospectively analyzed. Short-Form 36 (SF-36) Health Survey and Functional Independence Measure (FIM) assessments were used to evaluate patients' QoL and physical function every 6 months after surgery, and facial pain was evaluated every 3 to 6 months post-surgery. RESULTS: A total of 80 pTN patients were enrolled for analysis. The Barrow Neurological Institute (BNI) scores of I-II were achieved in 67 (83.8%) patients immediately after the surgery. The estimated rates of BNI I-II pain relief at one, two, and three years were 94.2%, 87.6%, and 83.2%, respectively. All aspects of the SF-36 questionnaire were significantly improved after the PBC, especially in terms of role physical (RP), bodily pain (BP), and social functioning (SF). Patients' functional outcomes measured by FIM at the 6-month follow-up examination were 108.6 ± 9.9, which was significantly improved compared with the pretreatment scores (90.8 ± 12.7). There was no difference between the severity of facial numbness in FIM and any item of the SF-36 except RP (P = 0.004) at 6 months after surgery. There was also no difference in SF-36 and FIM between patients with or without facial hyperalgesia. CONCLUSIONS: PBC can produce long-term and stable pain relief and significantly improve the patient's QoL and physical function. However, further well-designed, high-level, evidence-based studies are needed to precisely assess the efficacy of PBC for pTN patients.

Acid rain reduces plant-photosynthesized carbon sequestration and soil microbial network complexity.

Acid rain threatens the structure and function of terrestrial ecosystems; however, the mechanisms by which acid rain affects the photosynthesized carbon (C) fluxes and soil microbial communities are far less understood, thus impeding accurate projections of regional C flux in the plant-soil-atmosphere system. In this study, we performed an isotopic 13C labeling experiment to trace C footprints in a maize-soil system under acid rain pollution (pH 4.5 and 3.0; SO42-/NO3-= 2:1). Our results showed that acid rain exerted a negligible effect on total plant biomass as well as shoot biomass. Acid rain of pH 3.0 inhibited plant 13C assimilation and the flow of fixed 13C to the soil. Acid rain decreased soil total C and organic nitrogen (N) but increased inorganic N (i.e., nitrate-N) content. The acid rain of pH 3.0 enhanced soil bulk density, led to soil acidification, and promoted soil microbial diversity. However, acid rain reduced the connectivity and complexity of soil microbial network. Soil 13C content was mainly regulated by soil pH, ammonium-N, and root biomass. Our findings demonstrated that acid rain reduces photosynthesized C sequestration of maize-soil system and soil microbial taxa interactions.

Decompression versus decompression plus fusion for treating degenerative lumbar spinal stenosis: A systematic review and meta-analysis.

BACKGROUND: Degenerative lumbar spinal stenosis (DLSS) is a complex clinical syndrome that leads to spinal compression. Decompression with fusion has been the most commonly used surgical procedure for treating DLSS symptoms for many years. However, the exact role of fusion and its effectiveness in DLSS therapy has recently been debated. OBJECTIVE: The main purpose of this study was to compare the efficacy and safety of decompression alone and decompression plus fusion in the treatment of DLSS with or without spondylolisthesis. STUDY DESIGN: A systematic review and meta-analysis of the therapeutic effects of decompression for DLSS with or without the combination of fusion. METHODS: A literature search in five relevant databases, including Web of Science, PubMed, Embase, Medline, and Cochrane Library was performed from the inception of the database to March 2022. Only randomized controlled trials (RCTs) assessing the comparison between decompression and decompression plus fusion for DLSS were included. RESULTS: A total of seven studies, 894 patients were analyzed in this meta-analysis. Among these, 443 patients were included in the decompression plus fusion group while 451 patients were included in the decompression alone group. Pooled analysis showed that the combination of decompression with fusion had no superior benefits to decompression alone in terms of Oswestry Disability Index (ODI) score in the first 2 years and long-term follow-up after surgery, also no significant difference in the improvement of back and leg pain was found between two groups. Adding fusion to decompression was associated with a longer operation time, higher complication rate, more blood loss, and extended hospital stay. Furthermore, there was no difference in reoperation rates and patients' satisfaction between the two groups at the last follow-up. CONCLUSION: Decompression plus fusion may not be associated with a better clinical outcome in ODI scores and back or leg pain improvement but with a longer duration of operation time, extended hospital stay, and more blood loss.

Molecular Mechanisms Underlying Metabolic Resistance to Cyflumetofen and Bifenthrin in Tetranychus urticae Koch on Cowpea.

Tetranychus urticae Koch (T. urticae) is one of the most tremendous herbivores due to its polyphagous characteristics, and is resistant to most acaricides. In this study, enzyme-linked immunosorbent assay (ELISA), transcriptome sequencing (RNA-seq) and quantitative real-time PCR (qRT-PCR) were carried out to analyze the mechanisms of T. urticae metabolic resistance to cyflumetofen and bifenthrin on cowpea. The enzyme activity of UDP-glucuronosyltransferases (UGTs) and carboxylesterases (CarEs) in the cyflumetofen-resistant (R_cfm) strain significantly decreased, while that of cytochrome P450 monooxygenases (P450s) significantly increased. Meanwhile, the activities of glutathione-S-transferases (GSTs), CarEs and P450s in the bifenthrin-resistant (R_bft) strain were significantly higher than those in the susceptible strain (Lab_SS). According to the Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) analyses, in the R_cfm mite strain, two carboxyl/cholinesterase (CCE) genes and two P450 genes were upregulated and one gene was downregulated, namely CYP392E7; in the R_bft mite strain, eleven CCE, nine UGT, two P450, four GST and three ABC genes were upregulated, while four CCE and three P450 genes were downregulated. Additionally, 94 differentially expressed genes (DEGs) were common to the two resistant groups. Specifically, TuCCE46 and TuCCE70 were upregulated in both resistant groups. Furthermore, the qRT-PCR validation data were consistent with those from the transcriptome sequencing analysis. Specifically, TuCCE46 (3.37-fold) was significantly upregulated in the R_cfm strain, while in the R_bft strain, TeturUGT22 (5.29-fold), teturUGT58p (1.74-fold), CYP392A11 (2.89-fold) and TuGSTd15 (5.12-fold) were significantly upregulated and TuCCE01 (0.13-fold) and CYP392A2p (0.07-fold) were significantly downregulated. Our study indicates that TuCCE46 might play the most important role in resistance to cyflumetofen, and TuCCE01, teturUGT58p, teturUGT22, CYP392A11, TuGSTd15, TuGSTm09 and TuABCG-13 were prominent in the resistance to bifenthrin. These findings provide further insight into the critical genes involved in the metabolic resistance of T. urticae to cyflumetofen and bifenthrin.

Effects of Sedi Herba (Sedum sarmentosum) on attenuating cholestasis by the activation of the farnesoid x receptor (FXR)-mediated signaling.

Sedum sarmentosum (Sedi Herba) has traditionally been used to treat jaundice and various types of liver disease. This study aimed to clarify the anti-cholestatic efficacy and the mechanism of S. sarmentosum ethyl acetate extract (SDEAE), as well as to screen the potential compounds with FXR activation. SDEAE effectively ameliorated ANIT-induced cholestasis in rats, as evidenced by the ameliorative histopathology of the liver and the significant decrease in biochemical markers (ALT, AST, ALP, GGT, TBIL, DBIL and TBA). The analysis of bile acid profile by LC-MS indicated that SDEAE decreased the toxic bile acid levels (TCA, TMCA and CA). Western blotting indicated that SDEAE activated FXR-associated pathway, thereby upregulating FXR, SHP, BSEP and UGT2B4 expression, and downregulating CYP7A1 and NTCP expression. Twenty-three compounds (7 nor-sesquiterpenoids, 13 flavonoids, 1 lignin, 1 sterol and 1 anthraquinone) were isolated and identified from SDEAE by comparing NMR data with the literature. The HPLC profiles of SDEAE and isolated compounds were also compared. High-content analysis showed that eight compounds (6, 7, 8, 11, 12, 13, 14 and 23) could activate FXR and compound 8 exhibited the most potent activity (p < 0.01). Molecular docking suggested that the main binding modes between these active compounds and FXR were hydrogen bonding and van der Waals forces, and compound 8 had the highest docking score 6.34. The activation of compound 8 on FXR-mediated signaling was validated in L02 cells. After siRNA down-regulation of FXR, compound 8 significantly elevated FXR, SHP, BSEP and UGT2B4 expression, and reduced CYP7A1 and NTCP expression.

Unraveling consequences of the co-exposure of polyethylene microplastics and acid rain on plant-microbe-soil system.

Emerging microplastics (MPs) pollution and continuing acid rain (AR) co-exist in terrestrial ecosystems, and are considered as threats to ecosystems health. However, few data are available on MPs-AR interactions in plant-microbe-soil systems. Here, a microcosm experiment was manipulated to elucidate the co-exposure of polyethylene MPs (PE MPs; 1%, 5% and 10%) and AR (pH 4.0) on soil-lettuce system, in which the properties of soil and lettuce, and their links were explored. We found that 10% PE MPs increased soil CO2 emission and its temperature sensitivity (Q10) in combination with AR, while 1% PE MPs reduced soil CO2 emission irrespective of AR. PE MPs addition did not influence lettuce production (total biomass) though its photosynthesis was affected. PE MPs exerted negative impact on soil water availability. PE MPs treatments increased NH4+-N content of soil without AR, and dissolved organic carbon content of soil sprayed with AR. 10% PE MPs combined with AR reduced soil microbial biomass, while soil microbial community diversity was not affected by PE MPs or AR. Interestingly, 10% PE MPs addition altered soil microbial community structure, and promoted the complexity and connectivity of soil microbial networks. 5% and 10% PE MPs addition decreased soil urease activity under AR, but this was not the case without AR. These findings highlight the critical role of AR in regulating PE MPs impacts on plant-microbe-soil ecosystems, and the necessity to incorporate other environmental factors when evaluating the actual impacts or risks of MPs pollution in terrestrial ecosystems.

Treatments of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus: Current Status and Controversy.

The proportions of patients with hepatocellular carcinoma (HCC) involving portal vein tumor thrombus (PVTT) varies greatly in different countries or regions, ranging from 13% to 45%. The treatment regimens for PVTT recommended by HCC guidelines in different countries or regions also vary greatly. In recent years, with the progress and development of surgical concepts, radiotherapy techniques, systematic therapies (for example, VEGF inhibitors, tyrosine kinase inhibitors and immune checkpoint inhibitors), patients with HCC involving PVTT have more treatment options and their prognoses have been significantly improved. To achieve the maximum benefit, both clinicians and patients need to think rationally about the indications of treatment modalities, the occurrence of severe adverse events, and the optimal fit for the population. In this review, we provide an update on the treatment modalities available for patients with HCC involving PVTT. Trials with large sample size for patients with advanced or unresectable HCC are also reviewed.

Effect of polyethylene microplastics and acid rain on the agricultural soil ecosystem in Southern China.

The increasing microplastics (MPs) pollution and continuous acid rain coincide in many areas of the world. However, how MPs interact with acid rain is still unclear. Herein, we conducted a microcosm experiment to decipher the combined effect of polyethylene (PE) MPs (1%, 5%, and 10%) and acid rain (pH 4.0) on the agricultural soil ecosystem of Southern China, in which edaphic property, microbial community, enzymatic activity and CO2 emission were investigated. The results showed that PE MPs significantly decreased soil water retention and nitrate nitrogen content regardless of acid rain. Soil total nitrogen significantly decreased under the co-exposure of 10% PE MPs and acid rain. However, PE MPs did not alter soil microbial biomass, i.e., the content of microbial biomass carbon, total phospholipid fatty acids, with or without acid rain. 10% PE MPs and acid rain treatment significantly increased the activity of catalase and soil CO2 emission. PE MPs addition did not affect the temperature sensitivity (Q10) of soil CO2 emission regardless of acid rain. These findings suggest that MPs may interact with acid rain to affect soil ecosystems, thus underscoring the necessity to consider the interaction between MPs and ambient environmental factors when exploring the impact of MPs on the soil biodiversity and function.

Immunoenhancement and antioxidative damage effects of Polygonum Cillinerve polysaccharide on RAW264.7 cells.

OBJECTIVES: The effects of Polygonum Cillinerve polysaccharide (PCP) on the immune and antioxidant activity were studied. METHODS: The effects of PCP on cell proliferation, phagocytic activity, cell uptake, the secretion of NO, iNOS, IL-6, IL-12, CAT and POD, intracellular ROS, cell apoptosis and antioxidative mechanism were measured by MTT, ELISA, fluorescence staining, flow cytometry and western blot. KEY FINDINGS: The results showed that PCP had no toxic effect at 31.25-1.95 µg/ml, could improve the uptake of neutral red and fluorescein isothiocyanate-labelled ovalbumin and promote the release of nitric oxide and nitric oxide synthase. Moreover, PCP also could promote the secretion of IL-6 and IL-12. The damage of RAW264.7 cells induced by hydrogen peroxide was significantly alleviated by PCP at 15.63-0.975 µg/ml. The mechanism of antioxidative damage might be that PCP inhibited the upstream p38 and the phosphorylation of JNK and ERK proteins, and down-regulated caspase 3 and up-regulated the protein expressions of cytochrome C and Bcl-2, finally PCP improved the antioxidative capacity and protected the oxidative damage of cells. CONCLUSIONS: These results indicated that PCP had the better immunopotentiation and antioxidative damage activity.

Immune Checkpoint Inhibitors in Hepatocellular Carcinoma: Current Progresses and Challenges.

Hepatocellular carcinoma (HCC) is one of the most common malignant tumor in the world and its incidence is increasing in many countries. In recent years, with the deepening understanding of the immune and pathological mechanisms of HCC, immunotherapy based on the regulation of tumor immune microenvironment has become a new treatment choice for patients with HCC. Immune checkpoint inhibitors (ICIs) targeting programmed death protein-1, programmed death protein-ligand-1, or cytotoxic T-lymphocyte-associated antigen 4 are the most widely used. Instead of general immune-enhancing therapies, ICIs can reactivate anti-tumor immune responses by disrupting co-inhibitory T cell signaling. In this review, the research progress and existing problems of ICIs in the treatment of HCC in recent years are reviewed.

Neuropathic pain releasing calcitonin gene related peptide protects against stroke in rats.

Neuropathic pain (NPP) is deemed as a potential risk of stroke; however, recent pieces of evidence showed that calcitonin gene-related peptide is involving in pain progression as well as organ protection. The mechanisms underlying the neuroprotection of calcitonin gene-related peptide are yet poorly described with respect to stroke. The present study showed that the elevated level of calcitonin gene-related peptide-induced by NPP exerts a protective effect against stroke in rats, which was further confirmed in vivo and vitro via mitigation of inflammatory response, inhibition of neuronal cell apoptosis, and increase in regional cerebral blood flow. Repetitive transcranial magnetic stimulation at trigeminal ganglion was performed to simulate to facilitate the release of calcitonin gene-related peptide for a similar neuroprotective effect. Together, these findings posit that the release of calcitonin gene-related peptide-induced by NPP or repetitive transcranial magnetic stimulation protects against stroke in rats. Thus, repetitive transcranial magnetic stimulation could have high application prospects for the prevention and treatment of stroke.

Laboratory selection, resistance risk assessment, multi-resistance, and management of Tetranychus urticae Koch to bifenthrin, bifenazate and cyflumetofen on cowpea.

BACKGROUND: Tetranychus urticae (T. urticae) Koch is an important pest of vegetable crops worldwide. In this study, bioassays were carried out to analyze the resistance risk, multi-resistance and management of T. urticae Koch to bifenthrin, bifenazate and cyflumetofen on cowpea. RESULTS: The resistance ratios of the adult T. urticae population to bifenthrin (G16), bifenazate (G12) and cyflumetofen (G12) were 31.29, 9.38 and 5.81, respectively. Realized heritability (h 2 ) analysis showed that, under a selection pressure of 50-90% mortality, the generations needed to increase 10-fold LC50 values of bifenthrin, bifenazate and cyflumetofen were 3.64-8.05, 5.75-12.71, and 10.93-24.15, respectively. No obvious multi-resistance among these three acaricides was observed. Synergist bioassay results showed that microsomal multifunctional oxidase (MFO) was involved in bifenthrin resistance of T. urticae, with a synergistic ratio of 22.38. However, MFO and GSTs were not the main factors conferring the resistance to bifenazate. MFO, glutathione S-transferases(GSTs), together with esterase contributed to the development of the resistance to cyflumetofen. Additionally, the toxicity selection index test showed that bifenazate was safe to the natural enemy Neoseiulus barkeri (N. barkeri) with a toxicity selection index (TSI) >484.85, while bifenthrin was the least safe (TSI = 0.92). CONCLUSIONS: These results demonstrated the T. urticae developed higher resistance risk to bifenthrin compared to bifenazate and cyflumetofen and no obvious multi-resistance among these three acaricides, providing guidance for designing appropriate strategies for the effective application of bifenthrin, bifenazate and cyflumetofen in the field and delaying the development of insecticide resistance. © 2019 Society of Chemical Industry.

Cytotoxicity of chemical constituents from Torricellia tiliifolia DC. on Spodoptera litura (SL-1) cells.

In this study, we evaluated cytotoxicity of chemicals isolated from Torricellia tiliifolia DC. on Spodoptera litura (SL-1) cell line. Among the isolated compounds, 4-hydroxy-3-methoxycinnamaldehyde, 3,5-dimethoxy-4-hydroxycinnamaldehyde, and syringaresinol inhibited SL-1 cell survival in both dose- and time-dependent manners. Meanwhile, the in vivo insecticidal activity test revealed that 4-hydroxy-3-methoxycinnamaldehyde and 3,5-dimethoxy-4-hydroxycinnamaldehyde showed obvious insecticidal activities. These two compounds exhibited toxicity to SL-1 cells by inducing cellular morphological changes including shape change, cell shrinkage, vacuolation, cell membrane blebbing and chromatin condensation and apoptosis. 4-hydroxy-3-methoxycinnamaldehyde and 3,5-dimethoxy-4-hydroxycinnamaldehyde showed the most effect on mitochondrial membrane depolarization at 24h and 72h respectively and induced the apoptosis at a late time point 72h. Our results suggest that 4-hydroxy-3-methoxycinnamaldehyde and 3,5-dimethoxy-4-hydroxycinnamaldehyde inhibit SL-1 survival by inducing apoptosis.

Trigeminal neuralgia increases cerebral blood flow in a focal cerebral ischemic model in rats.

OBJECTIVE: To investigate the influences of trigeminal neuropathic pain on the cerebral blood flow in a ET-1 focal cerebral ischemia model. METHODS: Male Sprague-Dawley (SD) rats (220-260 g) were randomly divided into a model group (trigeminal neuralgia, TN group) and a sham operation group (sham group). The TN group received bilateral infraorbital nerve chronic constriction surgery, and the sham group only underwent exposure of the infraorbital nerve. The mechanical pain threshold of the rats was continuously monitored for 30 days post surgery. On postoperative day 30, the animals were anesthetized, and 3 µL (120 pM/µL) ET-1 was injected into the surroundings of the middle cerebral artery (MCA) to establish a cerebral focal ischemia-reperfusion injury model in rats. The changes in cerebral blood flow of these two groups were monitored 30 min after the injection of ET-1. RESULTS: The mechanic pain threshold values between rats in the two groups were not significantly different (P>0.05). The threshold value in the TN group on postoperative day 9 significantly decreased compared with that before surgery (P<0.01). Between postoperative days 9 and 30, the pain threshold values in the TN group were significantly lower than those in the sham group (P<0.01). From postoperative day 10, the mean arterial pressure in the TN group significantly increased compared with that before surgery (P<0.05), and the blood pressure (BP) in the TN group was higher than that in the sham group between postoperative days 10 and 30 (P<0.05). After 75 min of ET-1 microinjection, the cerebral blood flow in the rat frontal cortex exhibited reperfusion, and the cerebral blood flow in the TN group was significantly higher than that in the sham group (P<0.05). In addition, the content of calcitonin gene-related peptide (CGRP) in the blood of rats in the TN group was significantly higher than that in the sham group (P<0.05). CONCLUSIONS: Trigeminal neuropathic pain may increase the mean arterial pressure and the content of CGRP in the plasma of rats, thus increasing the cerebral blood flow in the frontal cortex of the ET-1 ischemia-reperfusion model.

Efficacy of dexmedetomidine on postoperative shivering: a meta-analysis of clinical trials.

PURPOSE: Shivering is a frequent complication in the postoperative period. The aim of the current meta-analysis was to assess the efficacy of dexmedetomidine on postoperative shivering. METHODS: Two researchers independently searched PubMed, EMBASE and the Cochrane Central Register of Controlled Trials for controlled clinical trials. The meta-analysis was performed by Review Manager. RESULTS: Thirty-nine trials with 2,478 patients were included in this meta-analysis. Dexmedetomidine reduced postoperative shivering compared with placebo (risk ratio [RR] = 0.26; 95% confidence interval [CI]: 0.20 to 0.34), with a minimum effective dose of 0.5 µg·kg(-1) (RR = 0.36; 95% CI: 0.21 to 0.60). The anti-shivering effect can be achieved both intravenously and epidurally when administered within two hours prior to the end of surgery. The efficacy of dexmedetomidine was similar to widely used anti-shivering agents, such as fentanyl, meperidine, tramadol, clonidine and so on; however, dexmedetomidine may increase the incidence of sedation, hypotension, bradycardia and dry mouth. CONCLUSIONS: The present meta-analysis indicates that dexmedetomidine shows superiority over placebo, but not over other anti-shivering agents. Therefore, considering its high price and potential adverse events, dexmedetomidine may not be appropriate solely for the purpose of the prevention of postoperative shivering.

Applications of pressure control ventilation volume guaranteed during one-lung ventilation in thoracic surgery.

OBJECTIVE: To explore the effects of ventilatory mode "pressure controlled ventilation-volume guaranteed" (PCV-VG) on the inspiratory pressures, oxygenation parameters and hemodynamics of patients during one lung ventilation (OLV) for thoracic surgery, compared with volume controlled ventilation (VCV). METHODS: Twenty participants were recruited and equally assigned into two groups in a controlled, randomized, crossover design. Group A: VCV was performed initially and changed into PCV-VG after 30 min; Group B: In the reverse order. Blood gas analysis, peak inspiratory pressure (Ppeak), mean inspiratory pressure (Pmean), plateau inspiratory pressure (Plateau) were measured at four different time points: (1) 30 min after total lung ventilation (TLV); (2) 30 min after one lung ventilation (VCV or PCV-VG); (3) 30 min after shifting to the other ventilatory mode, and (4) 30 min after reconstruction of TLV. RESULTS: The Ppeak, Plateau, and Pmean were significantly lower in PCV-VG compared with VCV. There was significant increase in arterial partial pressure of oxygen under PCV-VG. CONCLUSION: In patients undergoing thoracic surgery with OLV, pressure controlled volume guaranteed mode of ventilation may have better effects by decreasing inspiratory pressure parameters and improving arterial oxygenation than volume controlled ventilation.