Role of the Voltage-Gated Proton Channel Hv1 in Nervous Systems / 神经科学通报·英文版

Hv1 is the only voltage-gated proton-selective channel in mammalian cells. It contains a conserved voltage-sensor domain, shared by a large class of voltage-gated ion channels, but lacks a pore domain. Its primary role is to extrude protons from the cytoplasm upon pH reduction and membrane depolarization. The best-known function of Hv1 is the regulation of cytosolic pH and the nicotinamide adenine dinucleotide phosphate oxidase-dependent production of reactive oxygen species. Accumulating evidence indicates that Hv1 is expressed in nervous systems, in addition to immune cells and others. Here, we summarize the molecular properties, distribution, and physiological functions of Hv1 in the peripheral and central nervous systems. We describe the recently discovered functions of Hv1 in various neurological diseases, including brain or spinal cord injury, ischemic stroke, demyelinating diseases, and pain. We also summarize the current advances in the discovery and application of Hv1-targeted small molecules in neurological diseases. Finally, we discuss the current limitations of our understanding of Hv1 and suggest future research directions.

Identification of surgical patients at high risk of OSAS using the Berlin Questionnaire to detect potential high risk of adverse respiratory events in post anesthesia care unit / 医学前沿

Obstructive sleep apnea syndrome (OSAS) increases the risk of post-surgery complications. This study uses Berlin Questionnaire (BQ) to identify Chinese adult surgical patients who are at a high risk of OSAS and to determine if the BQ could be used to detect potential high risk of adverse respiratory events in the post anesthesia care unit (PACU). Results indicated that only 11.4% of the patients were considered at a high risk of OSAS. Age and body mass index are the key factors for the risk of OSAS prevalence in China and also gender specific. Furthermore, the incidence of adverse respiratory events in the PACU was higher in patients with high risk of OSAS than others (6.8% vs. 0.9%, P < 0.001). They also stayed longer than others in the PACU (95 ± 28 min vs. 62 ± 19 min, P < 0.001). Age, high risk for OSAS, and smoking were independent risk factors for the occurrence of adverse respiratory events in the PACU. The BQ may be adopted as a screening tool for anesthesiologists in China to identify patients who are at high risk of OSAS and determine the potential risk of developing postoperative respiratory complications in the PACU.

Incidence and risk factors of chronic post-surgical pain and its effect on quality of life: a large sample prospective study / 中华麻醉学杂志

Objective To investigate the incidence and risk factors of chronic post-surgical pain (CPSP) and its effects on the quality of life in a large sample prospective study.Methods A total of 1098 patients of either sex,aged 18-70 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective surgery,were enrolled in the study.Data regarding patient age,gender,body mass index,educational level,marital status,living situations,occupation,pre-surgical pain in the site of surgery,complications,type of surgery,surgery time and anesthesia method were recorded.The highest numeric rating scale scores within 3 days after surgery were also recorded.The patients were followed up at 3,6 and 12 months after surgery to record the development of CPSP.The patients were divided into CPSP group and non-CPSP group according to whether or not CPSP developed.Multivariable logistic regression analysis was performed to identify the risk factors for CPSP,and the quality of life was scored.Results A total of 981 patients completed the 1 year follow-up after surgery,the incidence of CPSP was 35.7％,and the constituent ratio of the distribution of the course was as follows:3 months ≤ postsurgical course ＜ 6 months was 33.1％;6 months ≤ postsurgical course ＜ 12 months was 16.8％;postsurgical course ≥ 12 months was 50.1％.Female,no diabetes mellitus and pre-surgical pain in the site of surgery were the independent risk factors for CPSP (P＜ 0.05).Compared with non-CPSP group,the physiological function score,professional function score,body pain score,vitality score,social function score,mental health score and general health score were significantly decreased (P＜0.01),and no significant change was found in the emotional function score in CPSP group (P＞0.05).Conclusion The probability of development of CPSP is high and the course is long,and the quality of life score is decreased;female,no diabetes mellitus and pre-surgical pain in the site of surgery are the independent risk factors for CPSP.

Perioperative airway management for pediatric anesthesia / 中华麻醉学杂志

Due to the characteristics of anatomy and physiology,children might experience more risk of respiratory complications than adults.We provided some skills and strategies for the three stages of anesthesia including preoperative assessment,anesthesia induction and maintenance and post-anesthesia recovery to optimize the perioperative airway management of pediatric anesthesia.Preoperative airway evaluations,anesthesia induction methods and corresponding airway management modalities,the common airway adverse events and their prevention and treatment were described in detail.

Methylprednisolone in patients undergoing cardiopulmonary bypass (SIRS): a randomised, double-blind, placebo-controlled trial

BACKGROUND:Cardiopulmonary bypass initiates a systemic inflammatory response syndrome that is associated with postoperative morbidity and mortality. Steroids suppress inflammatory responses and might improve outcomes in patients at high risk of morbidity and mortality undergoing cardiopulmonary bypass. We aimed to assess the effects of steroids in patients at high risk of morbidity and mortality undergoing cardiopulmonary bypass.METHODS:The Steroids In caRdiac Surgery (SIRS) study is a double-blind, randomised, controlled trial. We used a central computerised phone or interactive web system to randomly assign (1:1) patients at high risk of morbidity and mortality from 80 hospital or cardiac surgery centres in 18 countries undergoing cardiac surgery with the use of cardiopulmonary bypass to receive either methylprednisolone (250 mg at anaesthetic induction and 250 mg at initiation of cardiopulmonary bypass) or placebo. Patients were assigned with block randomisation with random block sizes of 2, 4, or 6 and stratified by centre. Patients aged 18 years or older were eligible if they had a European System for Cardiac Operative Risk Evaluation of at least 6. Patients were excluded if they were taking or expected to receive systemic steroids in the immediate postoperative period or had a history of bacterial or fungal infection in the preceding 30 days. Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcomes were 30-day mortality and a composite of death and major morbidity (ie, myocardial injury, stroke, renal failure, or respiratory failure) within 30 days, both analysed by intention to treat. Safety outcomes were also analysed by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00427388...

Effects of propofol, etomidate and ethanol on GPCR mRNA expression in Daphnia pulex / 生物医学工程学杂志

The mechanisms of general anesthesia, which was introduced about 170 years ago, remain poorly under- stood. Even less well understood are the effects of general anesthesia on the human body. Recently we identified 18 G-protein coupled receptor (GPCR) genes of Daphnia pulex, an invertebrate model organism. Phylogenetic analysis identified these genes to be the homologs of the human γ-aminobutyric acid, type B (GABAB) receptor, metabotropic glutamate receptors (mGluR), adrenergic receptor, serotonin (5-HT) receptor, dopamine receptor and muscarinic acetylcholine receptor (mAChR). Using reverse transcription and quantitative PCR techniques, we systematically measured the effects of propofol, etomidate and ethanol on these 18 GPCR mRNA expressions in Daphnia pulex.

Gender determines the effect of atracurium priming technique in a randomized study.

OBJECTIVE: To evaluate the effect of priming atracurium over onset time and intubating time of general anesthesia between different genders. METHODOLOGY: Sixty-six male and sixty-four female patients, ASA I-II, aged 18-65 years, were randomly divided into four groups: group M1: male patients with saline priming; group M2: male patients with priming atracurium dose of 0.05 mg/kg; group F1: female patients with saline priming; group F2: female patients with priming atracurium dose of 0.05 mg/kg. General anesthesia was induced with midazolam(0.1 mg*kg(-1)) propofol(0.75 mg*kg(-1)), intubation dose of atracurium (0.5 mg*kg(-1)), fentanyl (3 µg*kg(-1)). The incidences of dizziness, diplopia, heavy eyelids and dyspnea were observed. Neuromuscular tension was quantified by using TOF-Guard neuromuscular monitor, and intubating time was defined as the duration from the infusion of intubation dose of atracurium to the time when T4/T1=0. RESULTS: The intubating time of group F2 was shorter than that of group F1. There was no significant difference between group M1 and group M2. The incidences of dizziness, diplopia and heavy eyelids in group F2 were higher than those in group M2. CONCLUSION: Atracurium priming technique could shorten the intubation time of female patients, but not for male patients, and the gender plays a key role in affecting the clinical outcome of atracurium priming.

Effect of preamputation pain on the behavioral changes and spinal astrocytic activation in amputated rats / 中南大学学报(医学版)

OBJECTIVE@#To determine the effect of preamputation pain on the behavioral response and astrocytic activation in the spinal cord of amputated rats, and to assess the association between preamputation pain and chronic amputation-related pain.@*METHODS@#A total of 84 adult male SD rats were randomly distributed into an NA group (n=42) and a PA group (n=42). The NA group was intraplantarly injected with saline 100 μL, while the PA group was intraplantarly injected with complete Freund's adjuvant (CFA) 100 μL in both cases at 7 d before the amputation. Thermal withdrawal latency (TWL) was measured before the injection and at 1, 3, 5, and 7 d after the injection. All rats were amputated on the 7th day. The TWL, diet and water intake were measured on 1, 3, 5, 7, 10, 14, 17, 21, and 28 d after the amputation. Expression of glial fibrillary acidic protein (GFAP) in the L4-6 of spinal cord was measured by immunohistochemistry before the saline/ CFA injection, 7 d after the injection and 1, 3, 5, 7, 10 d after the amputation..@*RESULTS@#The TWL significantly decreased on 1, 3, 5, and 7 d after the intraplantar administration of CFA compared with the basic value in the PA group (P0.05). In addtions to the basic value, the TWL of the PA group was shorter than that of the NA group at the above-mentioned time-points (P<0.05). Compared with the preoperative level, the diet and water intake decreased significantly after the amputation in both groups, but recovered to the preoperative levels, by 3 d after the amputation in the NA group, and by 5 d after the amputation in the PA group. Compared with the TWL of the residual limb on the day of amputation, the TWL of the residual limb increased significantly 3 d after the amputation and remained elevated until 28 d after the amputation in the NA group (P<0.05), while there was no difference between each time point after the amputation and the day of the amputation in the PA group. Compared with the basic value, there was an obviously high expression of GFAP in the NA group beginning on the day of amputation and in the PA group 7 d after the CFA injection (P<0.05). After the amputation, the expression of GFAP was significantly higher in the PA group (P<0.05).@*CONCLUSION@#Preamputation pain delays the recovery and activates the spinal astrocytes which may turn the acute postoperative pain into a chronic one.

The application value of water flea Daphnia pulex for hypoxia model / 生物医学工程学杂志

Hypoxia-inducible factor (HIF) is an important transcription factor under hypoxic condition in many organisms, and plays a key role in the induction of hypoxia tolerance. It is necessary to establish a hypoxia model for HIF and to perform further hypoxia tolerance research. To investigate the value of Daphnia as a model organism in hypoxia precondition, we developed a preconditioning protocol with a model organism, Daphnia pulex. We found that two episodes of exposure to hypoxic solution resulted in enhanced hypoxia tolerance which is dependent on HIF. Comparative genomic analysis was also made to highlight the homology of HIF-related genes among Daphnia, fruitfly and human. We found that Daphnia is suitable for the study of human hypoxic injury as a model organism.

Appraisement of stellate ganglion block therapy for uncertainty statements syndrome with infrared thermography / 生物医学工程学杂志

We treated 20 patients suffering from uncertainty statements syndrome (USS) with stellate ganglion block (SGB) therapy. The medical infrared thermography was examined before and after the SGB therapy. Analysis on the changes of surface temperature as well as the outcome of the patients was carried out. Among the mentioned 20 patients, 15 (75%) got obvious effect, 4 (20%) fairly good effect and 1 (5%) a little improvement after the SGB therapy. The corresponding surface temperatures of these patients were 1.32 +/- 0.27 degrees C, 0.97 +/- 0.31 degrees C, and 0.76 +/- 0.33 degrees C, respectively. The more the surface temperature changed, the better the efficacy of the therapy was. The medical infrared thermography may objectively represent the therapeutic effect of SGB on the USS.

Mutations in epidermal growth factor receptor and K-ras in Chinese patients with colorectal cancer.

BACKGROUND: Mutations of EGFR and K-ras are biomarkers for predicting the efficacy of targeting agents in non-small-cell lung cancer (NSCLC) and colorectal cancer (CRC). Data on the gene mutation status of EGFR and K-ras in Chinese patients with CRC are limited. METHODS: EGFR mutations in exon 18-21 and K-ras mutations in exon 1 and 2 were detected in tumor samples from 101 Chinese patients with CRC by polymerase chain reaction and Sanger sequencing. [corrected] The relationship between patients' characteristics and survival time and gene mutation status were analyzed using the Statistical Package for the Social Sciences. RESULTS: Only two samples (2.0%) had EGFR mutations in exon 18 or 21, and 33 of 101 samples (32.7%) had K-ras mutations in codon 12, 13, 45, 69, or 80. Univariate analysis suggested that differentiation might be correlated with K-ras mutations (p = 0.05), which was confirmed by a logistic regression model (p = 0.04). The median overall survival (OS) and median survival after metastasis were 44.0 and 18.0 months, respectively, in the mutant K-ras group, and 53.3 and 19.0 months, respectively, in the wild K-ras group. K-ras mutation was not an independent prognostic factor for OS or survival after metastasis (p = 0.79 and 0.78, respectively). CONCLUSIONS: In Chinese patients with CRC, EGFR mutations were rare, and K-ras mutations were similar to those of Europeans. New mutations in codons 45, 69, and 80 were found in the Chinese population. Poor differentiation was an independent factor related to K-ras mutations.

Hemodynamic changes during laparoscopic cholecystectomy under different anesthesia / 中华麻醉学杂志

To observe the hemodynamics changes of patients undergoing laparoscopic cholecystectomy under epidural or general anesthesia. Method: 25 patients were divided into two groups: general(GA, n=11)and epidural (EA, n=14) anesthesia groups. Hemodynamic parameters (HR, MAP, CVP, PCWP, PAP, CO, CI, SVR, PVR) were measured with Swan-Ganz technique after the patients being placed to rT position,CO2 being insufflated into peritoneal cavity, and at the end of operation. Result: 1. In the EA group, CVP reduced significantly after rT position placed, SV, CO, MAP and HR reduced significanty after peritoneal insufflation,but still within normal range. 2. In the GA group, CVP, SV, CO were significant ly reduced after rT position placed; After peritoneal insufflation, all parametere were significantly increased except SV had no significant change. Conclusion:Epidural anesthesia can be safely applied to the ASA Ⅰ-Ⅱ grade patients undergoing laparoscopic cbolecystectomy.