Bicarbonate ringer's solution could improve the intraoperative acid-base equilibrium and reduce hepatocellular enzyme levels after deceased donor liver transplantation: a randomized controlled study.

BACKGROUND: Bicarbonate Ringer's (BR) solution is a direct liver and kidney metabolism-independent HCO3- buffering system. We hypothesized that BR solution would be more effective in improving acid-base equilibrium and more conducive to better liver function than Acetate Ringer's (AR) solution in conventional orthotopic liver transplantation (OLT) patients. METHODS: Sixty-nine adult patients underwent OLT. Patients in the bicarbonate and acetate groups received BR solution or AR solution as infused crystalloids and graft washing solution, respectively. The primary outcome was the effect on pH and base excess (BE) levels. The secondary outcome measures were the incidence and volume of intraoperative 5% sodium bicarbonate infusion and laboratory indicates of liver and kidney function. RESULTS: The pH and absolute BE values changed significantly during the anhepatic phase and immediately after transplanted liver reperfusion in the bicarbonate group compared with the acetate group (all P < 0.05). The incidence and volume of 5% sodium bicarbonate infusion were lower in the bicarbonate group than in the acetate group (all P < 0.05). The aspartate transaminase (AST) level at 7 postoperative days and the creatine level at 30 postoperative days were significantly higher in the acetate group than in the bicarbonate group (all P < 0.05). CONCLUSION: Compared with AR solution, BR solution was associated with improved intraoperative acid-base balance and potentially protected early postoperative liver graft function and reduced late-postoperative renal injury.

Endoplasmic Reticulum Stress Mediates Methamphetamine-Induced Blood-Brain Barrier Damage.

Methamphetamine (METH) abuse causes serious health problems worldwide, and long-term use of METH disrupts the blood-brain barrier (BBB). Herein, we explored the potential mechanism of endoplasmic reticulum (ER) stress in METH-induced BBB endothelial cell damage in vitro and the therapeutic potential of endoplasmic reticulum stress inhibitors for METH-induced BBB disruption in C57BL/6J mice. Exposure of immortalized BMVEC (bEnd.3) cells to METH significantly decreased cell viability, induced apoptosis, and diminished the tightness of cell monolayers. METH activated ER stress sensor proteins, including PERK, ATF6, and IRE1, and upregulated the pro-apoptotic protein CHOP. The ER stress inhibitors significantly blocked the upregulation of CHOP. Knockdown of CHOP protected bEnd.3 cells from METH-induced cytotoxicity. Furthermore, METH elevated the production of reactive oxygen species (ROS) and induced the dysfunction of mitochondrial characterized by a Bcl2/Bax ratio decrease, mitochondrial membrane potential collapse, and cytochrome c. ER stress release was partially reversed by ROS inhibition, and cytochrome c release was partially blocked by knockdown of CHOP. Finally, PBA significantly attenuated METH-induced sodium fluorescein (NaFluo) and Evans Blue leakage, as well as tight junction protein loss, in C57BL/6J mice. These data suggest that BBB endothelial cell damage was caused by METH-induced endoplasmic reticulum stress, which further induced mitochondrial dysfunction, and that PBA was an effective treatment for METH-induced BBB disruption.

NaHCO3-Buffered Lidocaine Gel for Outpatient Rigid Cystoscopy in Men.

PURPOSE: The purpose of this study was to explore the effect of NaHCO3-buffered lidocaine gel as a topical anesthetic agent for pain relief for rigid cystoscopy. DESIGN: Prospective randomized controlled trial. METHODS: ASA I-II male patients undergoing rigid cystoscopy randomly received 10 mL 2% Carbocaine lidocaine gel with 1 mL 0.9% saline (group 1) or 1 mL 5% NaHCO3 solution (group 2). After 3 minutes exposure, the cystoscope was inserted into the urethra. On receiving the gel, cystoscope insertion, and intravesical observation, pain score was recorded using the visual analog scale. FINDINGS: The gel pH with or without NaHCO3 was 7.20 and 6.41, respectively. The concentration of soluble lidocaine in the gel was stable for 24 hours or more. The visual analog scale score in group 2 was significantly lower (1.3 ± 0.9) than in group 1 (5.28 ± 1.99). No adverse effects were recorded. CONCLUSION: Alkalized lidocaine gel resulted in successful analgesia for rigid cystoscopy in men without adverse effects.

[Effect of ulinastatin on postoperative cognitive function in the elderly with fracture].

OBJECTIVE: To observe the vary of postoperation cognitive function and inflammatory mediators CRP in elderly patients with fracture after using ulinastatin. METHODS: Forty-eight patients over 65 years old patients with hip fracture were randomly divided into two groups: ulinastatin group (n = 21) and control group (n = 27). All patients underwent combined spinal-epidural anesthesia. The patients in ulinastatin group received intravenous injection of ulinastatin with a dose of 5 000 U/kg before skin incision and at the moment of the end of operation. Cognitive function was assessed by Mini-Mental State Examination (MMSE) at the day of the operation (T0), 1 (T1), 3 (T2) and 7 (T3) days after opreation. The incidence of POCD was calculated. Blood samples were taken at the day of the operation and 3 days after operation for determination of CRP. RESULTS: Compared with control group (23.8 ± 0.8, 24.3 ± 0.7), the MMSE scores were significantly increased at T1, T2in ulinastatin group (26.0 ± 0.7, 26.6 ± 0.6) (t1= 2.161, t2= 2.431, P < 0.05). There were no differences at T00, T3(t0 = 0.472, t3 = 1.585, P > 0.05). The respectively incidence of POCD of ulinastatin group and control group were 40.7% and 4.8%, and that of ulinastatin group was significantly lower than control group (χ² = 8.155, P < 0.01). Serum CRP concentration of ulinastatin group after operation was (64.46 ± 9.86) mg/L, significantly lower than control group (123.63 ± 7.17) mg/L (t = -4.974, P < 0.05). CONCLUSION: Ulinastatin can reduce the incidence of POCD in the elderly patients with fracture, which may be related to the anti-inflammatory effect of ulinastatin.

Carbon-coated Si nanoparticles dispersed in carbon nanotube networks as anode material for lithium-ion batteries.

Si has the highest theoretical capacity among all known anode materials, but it suffers from the dramatic volume change upon repeated lithiation and delithiation processes. To overcome the severe volume changes, Si nanoparticles were first coated with a polymer-driven carbon layer, and then dispersed in a CNT network. In this unique structure, the carbon layer can improve electric conductivity and buffer the severe volume change, whereas the tangled CNT network is expected to provide additional mechanical strength to maintain the integrity of electrodes, stabilize the electric conductive network for active Si, and eventually lead to better cycling performance. Electrochemical test result indicates the carbon-coated Si nanoparticles dispersed in CNT networks show capacity retention of 70% after 40 cycles, which is much better than the carbon-coated Si nanoparticles without CNTs.

[Study on propofol and fentanyl administrated via common carotid artery in rabbits].

OBJECTIVE: To compare the pharmacodynamic differences of common carotid artery administration with ear vein administration of propofol and fentanyl in rabbits. METHODS: Sixty New Zealand white rabbits were randomly divided into four groups(n = 15):PvFv, PvFa, PaFv and PaFa groups. Propofol 30 mg×kg(-1)×h(-1) and fentanyl 2 µg×kg(-1)×h(-1)were administrated via the ear vein or the common carotid artery. The outcomes were recorded, including the time of consciousness loss and recovery, to electrocerebral silence, dose of propofol and fentanyl, mean arterial pressure, heart rate, respiration rate and SpO2. RESULTS: (1) None of rabbits appeared breathing to be depressed seriously in group PaFa, while respiratory in the other groups were significantly depressed. (2) The dosage of propofol and fentanyl of group PaFa was significantly less than the other groups (P < 0.05). (3) The time of consciousness loss and recovery of group PaFa were shorter than the other three groups. CONCLUSION: Compared to drugs infusion via the ear vein, infusion of propol and fentanyl via the common carotid artery is more advantageous in some aspects, such as rapid anesthesia induction and recovery, smaller dose, and smaller impact on the hemodynamic and respiratory.

Carbon nanotube-loaded electrospun LiFePO4/carbon composite nanofibers as stable and binder-free cathodes for rechargeable lithium-ion batteries.

LiFePO(4)/CNT/C composite nanofibers were synthesized by using a combination of electrospinning and sol-gel techniques. Polyacrylonitrile (PAN) was used as the electrospinning media and carbon source. Functionalized CNTs were used to increase the conductivity of the composite. LiFePO(4) precursor materials, PAN and functionalized CNTs were dissolved or dispersed in N,N-dimethylformamide separately and they were mixed before electrospinning. LiFePO(4) precursor/CNT/PAN composite nanofibers were then heat-treated to obtain LiFePO(4)/CNT/C composite nanofibers. Fourier transform infrared spectroscopy measurements were done to demonstrate the functionalization of CNTs. The structure of LiFePO(4)/CNT/C composite nanofibers was determined by X-ray diffraction analysis. The surface morphology and microstructure of LiFePO(4)/CNT/C composite nanofibers were characterized using scanning electron microscopy and transmission electron microscopy. Electrochemical performance of LiFePO(4)/CNT/C composite nanofibers was evaluated in coin-type cells. Functionalized CNTs were found to be well-dispersed in the carbonaceous matrix and increased the electrochemical performance of the composite nanofibers. As a result, cells using LiFePO(4)/CNT/C composite nanofibers have good performance, in terms of large capacity, extended cycle life, and good rate capability.

[Effects of depressive disorder on monocytic expression of CD(40) and plasma IL-8 concentration in senile coronary heart disease patients].

OBJECTIVE: To observe the monocytic expression of CD(40) and plasma IL-8 concentration in senile CHD (coronary heart disease) patients with depressive disorder and examine the effects of immunological factors in depressive disorder and CHD. METHODS: A total of 100 senile CHD patients (> 60 yr old) were divided into 3 group: control group (A, n = 30), depression score ≤ 20 & anxiety score ≤ 6; therapy group (B, n = 35), depression score ≥ 30 & anxiety score ≤ 6, psychological evaluations with HAMD (Hamilton depression rating scale) from Day 1 pre-operation to Day 7 post-operation; non-therapy group (C, n = 35), depression score ≥ 30 & anxiety score ≤ 6. They underwent the same operation: lumbar decompression & fusion, stripping of great saphenous vein and repair of indirect hernia. At Day 1 pre-operation and Day 7 post-operation, 2 ml venous blood was drawn for the detection of monocytic expression of CD(40) and plasma concentration of IL-8 (interleukin-8). RESULTS: Depressive value of Group B at post-operation was lower than that at pre-operation and Group C ((25.1 ± 2.9) vs (33.2 ± 1.4) & (34.2 ± 0.8), P < 0.05); the pre-operative expression of CD(40) of Group A was lower than the other groups ((123 ± 18) vs (197 ± 23) & (204 ± 26), P < 0.05). And Group B at post-operation was lower than Group C ((147 ± 19) vs (212 ± 18), P < 0.05); the pre-operative concentration of IL-8 was lowest in Group A ((85 ± 16) ng/L vs (151 ± 18) ng/L & (164 ± 22) ng/L, P < 0.05). And Group B at post-operation was lower than Group C ((158 ± 19) ng/L vs (197 ± 24) ng/L, P < 0.05). There were significantly positive correlations between depression scores, the expression of CD(40) and the plasma concentration of IL-8. CONCLUSION: Depressive disorders elevate the monocytic expression of CD(40) and raise the plasma concentration of IL-8 in senile CHD patients. Some immunological factors may play a important role in depressive disorder and CHD.