AMPK-SIRT1-PGC1α Signal Pathway Influences the Cognitive Function of Aged Rats in Sevoflurane-Induced Anesthesia.

To understand the effect of AMP-activated protein kinase (AMPK)-SIRT1 (silent information regulator 1)-PPARγ coactivator-1α (PGC1α) signaling pathway on the cognitive function of sevoflurane-anesthetized aged rats. Aged rats were divided into Normal group, Sevo group (Sevoflurane anesthesia), Sevo + AICAR (the AMPK activator) group, Sevo + EX527 group (the AMPK inhibitor), and Sevo + AICAR + EX527 group. The cognitive function of rats was determined by the Morris water maze. Hippocampal neuronal apoptosis was evaluated by TUNEL and Fluoro-Jade C (FJC) staining, and the expression of cleaved caspase-3 was detected by immunohistochemistry. ROS, SOD, and MDA levels and the fluorescence intensity of GFAP in the hippocampus were assayed. The mitochondrial membrane potential (MMP), mitochondrial mass, ATP level, and the expression of AMPK-SIRT1-PGC1α were determined by the corresponding methods. Rats in the Sevo group manifested significant extension in the escape latency, with fewer platform crossings; and meanwhile, the apoptotic rate, the number of FJC-positive cells, and the fluorescence intensity of GFAP of neurons were elevated, with up-regulation of cleaved caspase-3. Moreover, the level of MDA and ROS was increased evidently, with significant down-regulation of SOD activity, ATP, mitochondrial mass and MMP levels, and AMPK, SIRT1 and PGC-1α protein expressions. However, sevoflurane-induced changes above were improved after the administration of AICAR, and EX527 could reverse AICAR-induced improvements in Sevo-anesthetized aged rats. Activating AMPK-SIRT1-PGC1α pathway can improve the cognitive function and mitigate the neuronal injury in Sevo-anesthetized aged rats by antagonizing the oxidative stress and maintaining the mitochondrial function.

A Prospective Study to Compare Analgesia from Femoral Obturator Nerve Block with Fascia Iliaca Compartment Block for Acute Preoperative Pain in Elderly Patients with Hip Fracture.

BACKGROUND This study aimed to compare femoral obturator nerve block (FONB) with fascia iliaca compartment block (FICB) in the management of acute preoperative pain in elderly patients with hip fracture. MATERIAL AND METHODS Patients ≥65 years (n=154) diagnosed with hip fracture who had surgery within 48 hours of hospital admission included two groups who received ultrasound-guided nerve block, the FONB group (n=77), and the FICB group (n=77). The visual analog scale (VAS) score for pain, requirement for analgesic drugs, nursing care requirements after hospitalization, post-operative complications, and rehabilitation were compared between the FONB and FICB patient groups. RESULTS The VAS scores after both nerve block procedures were significantly reduced compared with those before both nerve block procedures (P<0.05), but there were no differences on the second day after nerve block. The VAS scores at rest and on exercise in the FONB group were significantly lower than those in the FICB group at 30 min and one day after nerve block (P<0.05). The requirement for postoperative analgesic drugs in the FONB group was significantly lower than that in the FICB group (P=0.048). The incidence of nausea and vertigo in the FICB group were significantly higher than in the FONB group (P=0.031 and P=0.034, respectively). Patients in the FONB group experienced significantly improved quality of postoperative function (P=0.029). CONCLUSIONS Both FONB and FICB provided pain control for elderly patients with hip fracture. However, compared with FICB, FONB resulted in significantly improved analgesia with a reduced requirement for analgesic drugs.

NF-κB1 promoter-94ins/delATTG polymorphisms correlate with the acute exacerbation of chronic obstructive pulmonary disease.

BACKGROUND: To clarify the correlation between the NF-κB1 gene initiation sequence -94ins/delATTG polymorphisms and the acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: Blood samples of 260 AECOPD patients were collected from September 2013 to September 2015 in the department of respiratory medicine, the Third Affiliated Hospital of Southern Medical University. Blood samples of 260 healthy subjects were collected as a control group. DNA was extracted using genomic DNA extraction kits and analyzed on a DNA quantitative analyzer. Data analysis was performed using Rotor-Gene (60001.7) to determine genotypes. SPSS20.0 was used to compare -94ins/delATTG polymorphisms between patients and healthy subjects. The relationship between the promoter sequence -94ins/delATTG of NF-κB1 genotypes and AECOPD were further analyzed. RESULTS: We detected ins/ins, insertion or deletion (ins/del) and del/del genotypes from both the AECOPD and healthy control groups. The distribution of the three genotypes were consistent with the Hardy-Weinberg equilibrium law. The composition ratios of ins/ins, ins/del, del/del genotype distributions differed between AECOPD and control groups (P<0.05). The differences in ins/ins, ins/del and del/del genotype distributions between the two groups also significantly differed (P<0.05). The distribution of allele frequencies was comparable between the groups (P>0.05). The distribution ratio showed no relevance to the smoking index and clinical phenotypes of AECOPD patients, whether carrying ins/ins + ins/del genotypes or del/del genes (P>0.05). Compared to AECOPD patients with del/del genotypes, AECOPD patients with ins/ins + ins/del genotypes had a lower body mass index (BMI), a higher COPD assessment test (CAT) score, a larger number of acute episodes and longer hospital stays (P<0.05). CONCLUSIONS: The detection of the -94ins/delATTG polymorphism in patients with AECOPD can predict disease prognosis. The BMI of patients with AECOPD was significantly lower in patients carrying the -94insATTG gene. Gene detection is therefore important in patients carrying ins/ins or ins/del genotypes following admission.

Median effective volume of ropivacaine 0.5% for ultrasound-guided adductor canal block.

Objective This study aimed to identify the median effective volume of ropivacaine 0.5% for ultrasound-guided adductor canal block (ACB). Methods Thirty-two patients received ultrasound-guided ACB for knee arthroscopic meniscectomy. The criterion for successful ACB was the loss of pinprick sensation in the saphenous area (medial knee, leg, and foot). The volume of ropivacaine 0.5% in each case was determined using the up-down method and used for calculating the median effective dose. Results The mean age, weight, and height of patients were 28.6 ± 7.1 years, 68.2 ± 10.6 kg, and 172.5 ± 6.4 cm, respectively. Among patients who received 18- and 15-mL doses, ACB was successful in all four cases. Among patients who received a 12-mL dose, ACB was effective in eight and ineffective in two cases. Among patients who received a 10-mL dose, ACB was successful in six and unsuccessful in seven cases. In patients who received an 8-mL dose, ACB was ineffective in all five cases. The median effective volume of ropivacaine 0.5% was 10.4 mL (95% confidence interval, 9.1-11.4 mL). In all effective cases, the median quadriceps strength was grade 5. Conclusions The median effective volume of ropivacaine 0.5% is 10.4 mL for ultrasound-guided ACB.

[Effects of sevoflurane on brain neuroapoptosis and ability of long-term learning and memory in newborn rats].

OBJECTIVE: To investigate the changes of neuroapoptosis in brain and learning ability after neonatal mice are exposed to inhaled sevoflurane. METHODS: Twenty-one postnatal day (P) 7 Wistar rats were randomly divided into 7 groups for the preliminary experiment. Arterial blood samples were obtained immediately at the end of anesthesia, then blood analysis was performed. According to the results of the blood analysis, the groups that had no carbon dioxide accumulation were chosen for the following experiment. Ninety postnatal day (P) 7 Wistar rats were randomly divided into 5 groups: group A [sham anesthesia], group B [1% (volume fraction) sevoflurane for 2 h], group C (1% sevoflurane for 4 h), group D [2% (volume fraction) sevoflurane for 2 h] and group E (2% sevoflurane for 4 h). The animals from each group were perfused transcardially with 0.1 mol/L phosphate buffer containing 4% (volume fraction) paraformaldehyde 6 h after the end of anesthesia, and then the brains were exposed for immunohisochemistry, and caspase-3 positive cells were detected. Behavioral studies which included Morris water maze and passive voidance test were performed separately when the rats were 5-week-old, 8-week-old and 14-week-old. RESULTS: The blood gas data in the mice during the anesthesia showed that the pH, arterial carbon dioxide tension, arterial oxygen tension, and arterial oxygen saturation did not differ significantly from those of the sham controls. The amount of the caspase-3 positive cells in the rat brains of group B, group D and group E was greater than that in group A. When facing the spatial reference memory task or space exploration task, the rats from the different groups made it uniformly. The rats exposed to sham anesthesia had longer latency and less mistake times than those to sevoflurane in passive voidance test when they were 5-week-old, while all the rats had no significant difference in 8 weeks. CONCLUSION: Exposure to the concentration of 2% sevoflurane causes brain cell apoptosis of newborn rats. The memory ability to pessimal stimulation is decreased as the anesthesia mice were 5-week-old, such changes recede along with the growth of the rats. Exposure to the concentration of 2% sevoflurane does not affect the spatial reference memory of newborn rats during their growth.

CT presentations of colorectal cancer with chronic schistosomiasis: A comparative study with pathological findings.

OBJECTIVE: To clarify pathological basis of computed tomography (CT) presentations of colorectal cancer (CRC) with schistosomiasis for the purpose of improving the accuracy of CT diagnosis and differential diagnosis of the condition. MATERIALS AND METHODS: 130 patients (87 male and 43 female; age range 49-86 years, mean 71.1) were selected whose diagnoses were pathologically confirmed as CRC with schistosomiasis. All the patients underwent abdominal plain CT and contrast enhanced scanning. The location, morphology, size, calcification features and enhancement modalities (patterns) were evaluated and compared with the pathological findings by two radiologists in a blind way. RESULTS: CT showed that in 130 patients, the tumors occurred in the large intestine, among which 109 (83.9%) were solitary and 21 (16.1%) were multifocal. The intestinal wall was irregularly thickened in 123 patients, with soft tissue masses in 7 patients. Linear, spotty and small patchy calcifications were seen in 104 (80.0%) patients, with unclear margins in 96 patients. The tumors were markedly unevenly enhanced in 92 patients. Pathological examination revealed adenocarcinoma in 114 patients and in 104 patients, calcified Shistosoma japonicum (S. japonicum) ova inside the tumors, 15 patients were mucinous adenocarcinoma, and one patient was that of adenosquamous carcinoma. CONCLUSION: Irregular thickening of the intestinal wall, soft tissue masses, multiple S. japonicum ova calcifications inside the tumor with obscured margins and multiple intestinal masses in some patients are important CT features of CRC with schistosomiasis.

Cervical necrotizing fasciitis and a descending mediastinal abscess caused by acute epiglottitis with diabetes mellitus: a life-threatening complication.

Cervical necrotizing fasciitis and a descending mediastinal abscess of the neck following acute epiglottitis, life-threatening complications, is reported in a 43-year-old man with DM. The bacterial culture showed Peptostreptococcus anaerobius. The patient recovered after surgical debridement and broad-spectrum antibiotics therapy.

37-year-old woman with multiple intracranial masses.

Extramedullary hematopoiesis (EMH), defined as the presence of hematopoiesis outside bone marrow and peripheral blood, occurs asa compensatory phenomenon in several hematologic disorders and bone marrow dysfunction. EMH predominantly affects reticuloendothelial system including the spleen, liver and lymph nodes. Here,we report a rare case of multiple intracranial meningeal EMH. A37-year-old woman was anemic with gradually worsening vision for 8 months. Multiple extra-axial masses were found on imaging and the patient underwent the biopsy for the left frontotemporal lesion.Final diagnosis was multiple intracranial meningeal EMH. Treatment of fractionated external beam radiotherapy resulted in marked symptomatic improvement. This case indicates that although the diagnosis of meningeal EMH is difficult, there is a need to consider EMHin the differential diagnosis of anemic patients with tumor-like mass lesions in extramedullary sites.

[Effects of mesenchymal stem cell transplantation on growth of liver cancer: experiment with rats].

OBJECTIVE: To evaluate the effects of mesenchymal stem cell (MSC) transplantation on the growth of liver cancer. METHODS: MSCs were isolated from the bone marrows of SD rats. Walker-256 cancer cells were isolated from the cancerous ascites of rat and cultured. Forty-five SD rats were randomly divided into 3 equal groups: mixed transplantation group undergoing laparotomy and transplantation of cancer cells mixed with MSCs into the liver, MSC IV transplantation group undergoing injection of MSCs into the caudal vein, and control group undergoing only MSC transplantation into the liver. MR imaging was performed s at days 3, 6, 9 and 12 after modeling to measure the maximum cross section area of the tumor. At day 12 the rats were killed after MR imaging with their livers taken out to undergo HE staining and pathological examination. Immunohistochemistry was used to detect the expression of vascular endothelial cell growth factors (VEGF), nm23 gene, a tumor metastasis inhibiting gene, and proliferating cell nuclear antigen (PCNA), a nuclear polypeptide necessary in the DNA synthesis. RESULTS: No significant evidence of tumor formation was detected by MRI at days 3 and 6 after modeling in all rats and tumor nodules were observed since day 9. The maximum cross section areas of tumor of the mixed transplantation group and MSC IV transplantation group were significantly larger than that of the control group at days 9 and 12 (F = 4.21, P < 0.05; F = 8.52, P < 0.01). Immunohistochemistry showed that VEGF expression levels of the two study groups were both significantly higher than that of the control group (F = 9.58, P < 0.01), while the nm23 gene expression levels of the 2 study groups were both significantly lower than that of the control group (F = 4.61, P < 0.05). The PCNA expression level of the mixed transplantation group was significantly higher than that of the control group (d'((1, 0.05)) = 0.34, d'((1, 0.01)) = 0.63, P < 0.05), however, there was no significant difference in the PCNA expression level between the MSCs IV transplantation group and the control group (d'((1, 0.05)) = 0.32, d'((1, 0.01)) = 0.48, P > 0.05). There was no significant difference in the tumor apoptotic index between the 2 study groups and the control group (F = 1.25, P > 0.05). CONCLUSION: MSC transplantation increases the expression of VEGF and PCNA, while decreases the expression of nm23 gene in cancer cells, thus favoring the tumor growth.