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Leukocyte function-associated antigen-1 deficiency impairs responses to polymicrobial sepsis

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World Journal of Clinical Cases 2015年第9期3卷 793-806页

作者： Jia-Ren Liu Xiaohui Han Sulpicio G Soriano Koichi Yuki department of Anesthesiology Perioperative and Pain MedicineBoston Children’s Hospital department of anaesthesia Harvard Medical School

AIM: To determine the role of leukocyte functionassociated antigen-1(LFA-1) in polymicrobial sepsis model in ***: Cecal ligation and puncture model was used to study polymicrobial sepsis in wild type and LFA-1 knockout(KO)(= CD11 a KO) mice. Their survivals were examined. Neutrophil recruitment to the abdominal cavity, bacterial tissue load and bacterial killing by neutrophils, tissue cytokine profiles, and serum cytokines were examined. Apoptosis of tissues was assessed using cleaved-caspase 3 and TUNNEL staining. The recruitment of neutrophils to various tissues was assessed using myeloperoxidase staining or measuring myeloperoxidase activity. RESULTS: LFA-1 deficiency significantly decreased survival(P = 0.0024) with the reduction of neutrophil recruitment to the abdominal cavity and higher bacterial load in blood. It was also associated with increased apoptosis in spleen and more organ injuries probed by interleukin-6 m RNA level. However, the deficiency of LFA-1 did not prevent neutrophil recruitment to lung, liver, spleen or kidney, which suggested the existence of LFA-1 independent recruitment mechanism in these organs. CONCLUSION: LFA-1 deficiency did not attenuate neutrophil recruitment to various organs to adequately mitigate secondary tissue injury in sepsis. It was associated with decreased neutrophil recruitment to the abdominal cavity, higher bacterial load, leading to increased mortality in an abdominal, polymicrobial sepsis.

关键词： Leukocyte function-associated antigen-1 Tissue injury Neutrophil recruitment Polymicrobial sepsis Apoptosis

Perioperative fluid management in major hepatic resection: an integrative review

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Hepatobiliary & Pancreatic Diseases International 2017年第5期16卷 458-469页

作者： Osamu Yoshino Marcos Vinicius Perini Christopher Christophi Laurence Weinberg department of Surgery Austin Hospital and University of Melbourne Melbourne Victoria Australia anaesthesia Perioperative pain Medicine Unit University of Melbourne Melbourne Victoria Australia

BACKGROUND: Fluid intervention and vasoactive pharmacological support during hepatic resection depend on the preference of the attending clinician, institutional resources, and practice culture. Evidence-based recommendations to guide perioperative fluid management are currently limited. Therefore, we provide a contemporary clinical integrative overview of the fundamental principles underpinning fluid intervention and hemodynamic optimization for adult patients undergoing major hepatic resection. DATA SOURCES: A literature review was performed of MEDLINE, EMBASE and the Cochrane Central Registry of Controlled Trials using the terms 'surgery', 'anesthesia', 'starch', 'hydroxyethyl starch derivatives', 'albumin', 'gelatin', 'liver resection', 'hepatic resection', 'fluids', 'fluid therapy', 'crystalloid', 'colloid', 'saline', 'plasma-Lyte', 'plasmalyte', 'hartmann's', 'acetate', and 'lactate'. Search results for MEDLINE and EMBASE were additionally limited to studies on human populations that included adult age groups and publications in English. RESULTS: A total of 113 articles were included after appropriate inclusion criteria screening. Perioperative fluid management as it relates to various anesthetic and surgical techniques is ***: Clinicians should have a fundamental understanding of the surgical phases of the resection, hemodynamic goals, and anesthesia challenges in attempts to individualize therapy to the patient's underlying pathophysiological condition. Therefore, an ideal approach for perioperative fluid therapy is always individualized. Planning and designing large-scale clinical trials are imperative to define the optimal type and amount of fluid for patients undergoing major hepatic resection. Further clinical trials evaluating different intraoperative goal-directed strategies are also eagerly awaited.

关键词： hepatic resection liver resection fluid therapy anesthesia crystalloid colloid goal-directed therapy

Ventilation strategies in burn intensive care:A retrospective observational study

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Burns & Trauma 2014年第1期2卷 29-35页

作者： Stefano Palazzo Emma James-Veldsman Caroline Wall Michelle Hayes Marcela Vizcaychipi Magill department of anaesthesia Intensive Care Medicine and Pain ManagementChelsea and Westminster HospitalLondonUK

Consensus regarding optimal burns intensive care(BICU)patient management is *** study aimed to assess whether ventilation strategies,cardiovascular support and sedation in BICU patients have changed over time,and whether this affects outcome.A retrospective observational study comparing two 12-patient BICU cohorts(2005/06 and 2010/11)was *** and admission characteristics,ventilation parameters,sedation,fluid resuscitation,cardiovascular support and outcome(length of stay,mortality)data were collected from patient *** was analysed using T-tests,Fisher’s exact and Mann-Whitney U *** our study cohort groups were equivalent in demographic and admission *** were equal ventilator-free days in the two cohorts 10±12.7 vs.13.3±12.2 ventilator free days;(P=0.447).The 2005/06 cohort were mechanically ventilated more often than in 2010/11 cohort(568 ventilator days/1000 patient BICU days vs.206 ventilator days/1000 patient BICU days;P=0.001).The 2005/06 cohort were ventilated less commonly in tracheostomy group/endotracheal tube spontaneous(17.8%vs.26%;P=0.001)and volumecontrolled modes(34.4%vs.40.8%;P=0.001).Patients in 2010/11 cohort were more heavily sedated(P=0.001)with more long-acting sedative drug use(P=0.001)than the 2005/06 cohort,fluid administration was *** outcome did not *** injury patients were ventilated in volume-controlled(44.5%vs.28.1%;P=0.001)and pressure-controlled modes(18.2%vs.9.5%;P=0.001)more frequently than those *** did not *** study showed there has been shift away from mechanical ventilation,with increased use of tracheostomy/tracheal tube airway spontaneous *** injury patients require more ventilatory support though patient outcomes do not *** trials are required to establish which strategies confer benefit.

关键词： Burns intensive care ventilation inhalation injury

Time to raise awareness regarding complications of androgen deprivation therapy

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Asian Journal of Andrology 2012年第2期14卷 175-176页

作者： Shehzad Basaria department of Medicine Division of Endocrinology and Metabolism Boston University School of Medidne Boston MA 02118 USA

No treatment is devoid of adverse effects, and androgen deprivation therapy （ADT） in men with prostate cancer （PCa） bears no exception. PCa is the most common non-cutaneous malignancy in men worldwide. In 2011, ap... 详细信息

关键词： X-ray crystallography

Synthesis and Characterization of Polyurethane

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Journal of Wuhan University of Technology(Materials Science) 2010年第6期25卷 984-986页

作者：贺纯静倪家骧 department of pain Xuanwu HospitalCapital Medical University

Polyurethane was synthesized by the copolymerization with isocyanate and *** structure and properties of the copolymers were characterized by infrared spectrometer（IR）,differential scanning calorimetry（DSC） and thermogravimetry（TG）.The rabbit blood samples was dripped on the polyurethane,which was prepared by drying and die,and the contact angle was measured by contact angle measurement,then infiltration phenomenon was observed by electron *** results showed that the contact angle of blood samples and polyurethane was decreased with increasing time,and the platelets on the polyurethane would gradually increase and more *** the polyurethane coating had good hydrophilic property and anticoagulant activity.

关键词： polyurethane hydrophilicity anticoagulant

Hepatoprotective actions of melatonin:Possible mediation by melatonin receptors

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World Journal of Gastroenterology 2010年第48期16卷 6087-6097页

作者： Alexander M Mathes department of Anesthesiology Critical Care and Pain MedicineSaarland University Hospital

Melatonin,the hormone of darkness and messenger of the photoperiod,is also well known to exhibit strong direct and indirect antioxidant properties. Melatonin has previously been demonstrated to be a powerful organ protective substance in numerous models of injury; these beneficial effects have been attributed to the hormone's intense radical scavenging capacity. The present report reviews the hepatoprotective potential of the pineal hormone in various models of oxidative stress in vivo,and summarizes the extensive literature showing that melatonin may be a suitable experimental substance to reduce liver damage after sepsis,hemorrhagic shock,ischemia/reperfusion,and in numerous models of toxic liver injury. Melatonin's influence on hepatic antioxidant enzymes and other potentially relevant pathways,such as nitric oxide signaling,hepatic cytokine and heat shock protein expression,are evaluated. Based on recent literature demonstrating the functional relevance of melatonin receptor activation for hepatic organ protection,this article finally suggests that melatonin receptors could mediate the hepatoprotective actions of melatonin therapy.

关键词： Antioxidant enzymes Hemorrhagic shock Hepatoprotection Ischemia Liver Liver function Melatonin Melatonin receptor Ramelteon Reperfusion Sepsis Toxic liver injury

Adult neurogenesis from reprogrammed astrocytes

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Neural Regeneration Research 2020年第6期15卷 973-979页

作者： Brian B.Griffiths Anvee Bhutani Creed M.Stary department of Anesthesiology Pain & Perioperative Medicine Stanford University School of Medicine

The details of adult neurogenesis,including environmental triggers,region specificity,and species homology remain an area of intense *** or halting age-related cognitive dysfunction,or restoring neurons lost to disease or injury represent just a fraction of potential therapeutic *** neurons can derive from stem cells,pluripotent neural progenitor cells,or non-neuronal glial cells,such as *** must be epigenetically"reprogrammed"to become neurons,which can occur both naturally in vivo,and via artificial exogenous *** neural progenitor cells are localized to a few neurogenic zones in the adult brain,astrocytes populate almost every brain *** this review,we will summarize recent research into neurogenesis that arises from conversion of post-mitotic astrocytes,detail the genetic and epigenetic pathways that regulate this process,and discuss the possible clinical relevance in supplementing stem-cell neurogenic therapies.

关键词： astrocyte brain dedifferentiation development disease glia injury neurogenesis

Nerve coblation for treatment of trigeminal neuralgia: A case report

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World Journal of Clinical Cases 2019年第9期7卷 1060-1065页

作者： Xiao-Hui Yang Yan Li Li-Qiang Yang Bai-Shan Wu Jia-Xiang Ni department of pain Medicine Capital Medical University Xuanwu Hospital department of pain Medicine Aerospace Central Hospital National Clinical Research Center for Geriatric Disorders

BACKGROUND Trigeminal neuralgia(TN) is a severe type of neuropathic pain which is often inadequately managed using conventional therapies. In this report, we present the first case of TN treated with gasserian ganglion nerve coblation(NC).CASE SUMMARY A 58-year-old man presented with right facial pain, mostly localized in the right zygomatic zone, alveolar region, and jaws. Similar to acupuncture and shock pain, the pain lasted about five seconds after each attack before resolving unaided. A diagnosis of TN was made, after which treatment with acupuncture therapy and oral carbamazepine was given. However, the pain was not satisfactorily controlled. Subsequently, gasserian ganglion NC of the right trigeminal nerve guided by computed tomography(CT) was performed on the patient. Following this procedure, the right zygomatic, alveolar, submandibular,and cheek pain disappeared completely. The right zygomatic and alveolar areas experienced mild numbness(level II). At 1-, 2-, 3-, and 6-mo follow-ups after surgery, the patient was painless and the numbness score was level *** CT-guided gasserian ganglion(NC) is an effective treatment for TN and is associated with less or no postoperative numbness or hypoesthesia in comparison with current standard-of-care approaches.

关键词： Nerve coblation Trigeminal neuralgia Gasserian ganglion Computed tomography guided Case report

Ultrasound-Guided Greater Occipital Nerve Hydrodissection for Treatment of Cervicogenic Headache: A Case Report

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pain Studies and Treatment 2023年第1期11卷 1-8页

作者： Paul J. Ryan Dominic C. Harmon department of anaesthesia and pain Medicine University Hospital Limerick Dooradoyle Limerick Ireland

We describe an innovative technique of ultrasound-guided greater occipital nerve (GON) hydrodissection for treatment of cervicogenic headache and occipital neuralgia. A 35-year-old female presented to the pain clinic with severe chronic cervicogenic headache impacting her sleep, work and activities of daily living. Conservative management had failed to adequately resolve her pain. Ultrasound-guided suboccipital hydrodissection of the greater occipital nerve was performed with the patient in the prone position. After skin sterilization, the linear ultrasound transducer was oriented in a transverse orientation at the level of the C2-C3 vertebrae. The needle was advanced from medial to lateral “in-plane” under direct ultrasound visualization, until the needle was positioned at the C2 lamina. After confirming the needle tip position, 10 ml of hydrodissection fluid was injected with good visualization of distribution of the solution. The patient described immediate and significant improvement in her symptoms. She reported a sustained decrease in pain scores when followed up in the pain clinic at six and twelve weeks respectively. To the best of our knowledge this is the first application of ultrasound-guided hydrodissection of the GON for cervicogenic headache. It offers a novel, safe and effective technique to aid in the diagnosis and treatment of a common pain condition.

关键词： Cervicogenic Headache Neck pain Occipital Nerve Hydrodissection Ultrasound