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Effects of plant-derived analgesic compounds sinomenine and salvinorin A in infant rats

Journal of Integrative medicine 2020年第2期18卷 174-180页

作者： Conrad J.Mascarenhas Renyu Liu Gordon A.Barr Department of anesthesiology and critical care Children’s Hospital of PhiladelphiaPhiladelphiaPA 19104USA Department of anesthesiology and critical care Perelman School of Medicine at the University of PennsylvaniaPhiladelphiaPA 19104USA Department of Psychology University of PennsylvaniaPhiladelphiaPA 19104USA

Objective: Premature and ill neonates undergo painful but medically necessary procedures while hospitalized. Although opiate drugs are administered as analgesics, problems associated with their side effects,tolerance, and potential dependence necessitate research into alternative pain-relieving *** we test two plant-derived compounds in infant rats: sinomenine, which targets the Mas-related G-protein-coupled receptor member X2 opioid receptor;and salvinorin A, which is a j opioid receptor agonist. In adult animals both sinomenine and salvinorin A are analgesic, but neither has been tested in ***: We used the formalin and thermal plantar tests in rats 7 and 21 days of age(PN7 and PN21) for behavioral signs of pain. In addition, brain sections were stained using Fos immunohistochemistry to examine patterns of brain activation in the midbrain periaqueductal gray and the paraventricular nucleus of the ***: Sinomenine was analgesic in both the formalin and thermal tests on animals 21 days of age. At PN7 only the highest dose elevated response latencies in the thermal test and there were no effects of sinomenine in the formalin test. Analysis of Fos expression in the sinomenine-treated animals showed no drug effect, in contrast to the behavioral results. Salvinorin A was analgesic in the formalin test only at the highest dose at 21 days of age but not in the thermal test at either ***: The increased modest effectiveness of sinomenine in older animals and the minimum salvinorin A drug effect suggest that the compounds act on sites that develop during the preweaning period(sinomenine) or after weaning(salvinorin A).

关键词： Thermal pain Formalin test Fos Ontogeny Sinomenine Salvinorin A

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Eosinophils in asthma

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Chinese Medical Journal 2004年第5期117卷 792-794页

作者：施焕中 Department of Pulmonary and critical care medicine

The contribution of eosinophils to host-defense and inflammatory responses has undergone periodic reevalu-ations. Thirty years ago, eosinophil was considered as a principal effector cell in host-defense against parasi... 详细信息

关键词： IL SCH Eosinophils in asthma

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Sodium Leak Channel in Glutamatergic Neurons of the Lateral Parabrachial Nucleus Helps to Maintain Respiratory Frequency Under Sevoflurane Anesthesia

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Neuroscience Bulletin 2024年第8期40卷 1127-1140页

作者： Lin Wu Donghang Zhang Yujie Wu Jin Liu Jingyao Jiang Cheng Zhou Department of anesthesiology West China HospitalSichuan UniversityChengdu 610041China laboratory of Anesthesia and critical care medicine National-Local Joint Engineering Research Centre of Translational Medicine of AnesthesiologyWest China HospitalSichuan UniversityChengdu 610041China

The lateral parabrachial nucleus(PBL)is implicated in the regulation of respiratory *** leak channel(NALCN)mutations disrupt the respiratory rhythm and influence anesthetic sensitivity in both rodents and ***,we investigated whether the NALCN in PBL glutamatergic neurons maintains respiratory function under general *** results showed that chemogenetic activation of PBL glutamatergic neurons increased the respiratory frequency(RF)in mice;whereas chemogenetic inhibition suppressed *** knockdown in PBL glutamatergic neurons but not GABAergic neurons significantly reduced RF under physiological conditions and caused more respiratory suppression under sevoflurane *** knockdown in PBL glutamatergic neurons did not further exacerbate the respiratory suppression induced by propofol or *** sevoflurane anesthesia,painful stimuli rapidly increased the RF,which was not affected by NALCN knockdown in PBL glutamatergic *** study suggested that the NALCN is a key ion channel in PBL glutamatergic neurons that maintains respiratory frequency under volatile anesthetic sevoflurane but not intravenous anesthetic propofol.

关键词： Glutamatergic neurons Lateral parabrachial nucleus NALCN Respiration General anesthesia

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Transient elastography(FibroScan)in critical care:Applications and limitations

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World Journal of Meta-Analysis 2023年第7期11卷 340-350页

作者： Sahil Kataria Deven Juneja Omender Singh Department of critical care medicine Holy Family HospitalNew Delhi 110025India Department of critical care medicine Max Super Speciality HospitalNew Delhi 110017India

FibroScan®is a non-invasive device that assesses the‘hardness’(or stiffness)of the liver via the technique of transient *** fibrous tissue is harder than normal liver,the degree of hepatic fibrosis can be inferred from the liver *** technique is increasingly being employed to diagnose liver fibrosis,even in critically ill *** is now being used not only for diagnosis and staging of liver cirrhosis,but also for outcome ***,the presence of several confounding factors,especially in critically ill patients,may make interpretation of these results *** this review we aim to describe the indications and pitfalls of employing FibroScan in patients admitted to intensive care units.

关键词： FibroScan Intensive care unit Liver dysfunction Liver stiffness Transient elastography

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Supraglottic jet oxygenation and ventilation(SJOV) for resuscitation of injured soldiers and people in war field

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Military Medical Research 2022年第6期9卷 757-758页

作者： Hua-Feng Wei Department of anesthesiology and critical care Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPA 19104USA

Dear Editor,Soldiers or people in battlefield settings are frequently injured with acute trauma, resulting in respiratory depression, hypoxia and associated morbidity and mortality. Traumatic brain injury(TBI) is with as much as 80%–90% of mild to moderate in combat casualties and contributed significantly to morbidity and mortality in battlefield settings. Correction of hypoxia at as capable as possible is expected to reduce or minimize the morbidity/mortality due to acute brain injury. An easy, quick and safe setup to promote oxygenation/ventilation of injured military personnel or peoples by non-medical personnel in battlefield settings immediately after acute injury before transfer to hospital is expected to reduce the morbidity/mortality due to injury mediated respiratory depression.

关键词： Battlefield War Trauma Acute injury Respiratory depression Hypoxia Oxygenation Resuscitation Supraglottic jet oxygenation and ventilation(SJOV)

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critical care management and intensive care unit outcomes following cytoreductive surgery with hyperthermic intraperitoneal chemotherapy

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World Journal of critical care medicine 2017年第2期6卷 116-123页

作者： Sumit Kapoor Adel Bassily-Marcus Rafael Alba Yunen Parissa Tabrizian Sabrine Semoin Joseph Blankush Daniel Labow John Oropello Anthony Manasia Roopa Kohli-Seth Department of Pulmonary Critical Care and SleepBaylor College of Medicine Department of Surgery Critical Care DivisionIcahn School of Medicine at Mount Sinai Department of Pulmonary and critical care Medical College of GeorgiaAugusta University Department of Surgery Icahn School of Medicine at Mount Sinai General Surgery Resident Vanderbilt University Medical Center

AIM To study the early postoperative intensive care unit(ICU) management and complications in the first 2 wk of patients undergoing cytoreductive surgery(CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC).METHODS Our study is a retrospective, observational study per-formed at Icahn School of medicine at Mount Sinai, quaternary care hospital in New York City. All adult patients who underwent CRS and HIPEC between January 1, 2007 and December 31, 2012 and admitted to ICU postoperatively were studied. Fifty-one patients came to the ICU postoperatively out of 170 who underwent CRS and HIPEC therapy during the study period. Data analysis was performed using descriptive *** Of the 170 patients who underwent CRS and HIPEC therapy, 51(30%) came to the ICU postoperatively. Mean ICU length of stay was 4 d(range 1-60 d) and mean APACHE Ⅱ score was 15(range 7-23). Thirtyone/fifty-one(62%) patients developed postoperative complications. Aggressive intraoperative and postoperative fluid resuscitation is required in most patients. Hypovolemia was seen in all patients and median amount of fluids required in the first 48 h was 6 L(range 1-14 L). Thirteen patients(25%) developed postoperative hypotension with seven requiring vasopressor support. The major cause of sepsis was intraabdominal, with 8(15%) developing anastomotic leaks and 5(10%) developing intraabdominal abscess. The median survival was 14 mo with 30 d mortality of 4%(2/51) and 90 d mortality of 16%(8/51). One year survival was 56.4%(28/51). Preoperative medical co morbidities, extent of surgical debulking, intraoperative blood losses, amount of intra op blood products required and total operative time are the factors to be considered while deciding ICU vs non ICU *** Overall, ICU outcomes of this study population are excellent. Triage of these patients should consider preoperative and intraoperative factors. Intensivists should be vigilant to aggressive postop fluid resuscitation,

关键词： Hyperthermic Abdominal sepsis Cytoreduction Carcinomatosis Respiratory failure Vasopressors

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Perioperative intensive insulin therapy using artificial endocrine pancreas in patients undergoing pancreatectomy

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World Journal of Gastroenterology 2009年第33期15卷 4111-4115页

作者： Hiromichi Maeda Takehiro Okabayashi Tomoaki Yatabe Koichi Yamashita Kazuhiro Hanazaki Department of Surgery Kochi Medical SchoolKochi University Department of anesthesiology and critical care medicine Kochi Medical SchoolKochi University

Perioperative glycemic control is important for reducing postoperative infectious complications. However, clinical trials have shown that efforts to maintain normoglycemia in intensive care unit patients result in deviation of glucose levels from the optimal range, and frequent attacks of hypoglycemia. Tight glycemic control is even more challenging in those undergoing pancreatic resection. Removal of lesions and surrounding normal pancreatic tissue often cause hormone deficiencies that lead to the destruction of glucose homeostasis, which is termed pancreatogenic diabetes. Pancreatogenic diabetes is characterized by the occurrence of hyperglycemia and iatrogenic severe hypoglycemia, which adversely effects patient recovery. Postoperatively, a variety of factors including surgical stress, inflammatory cytokines, sympathomimetic drug therapy, and aggressive nutritional support can also affect glycemic control. This review discusses the endocrine aspects of pancreatic resection and highlights postoperative glycemic control using a closed-loop system or artificial pancreas. In previous experiments, we have demonstrated the reliability of the artificial pancreas in dogs with total pancreatectomy, and its postoperative clinical use has been shown to be effectiveand safe, without the occurrence of hypoglycemic episodes, even in patients after total pancreatectomy. Considering the increasing requirement for tight perioperative glycemic control and the recognized risk of hypoglycemia, we propose the use of an artificial endocrine pancreas that is able to monitor continuously blood glucose concentrations with proven accuracy, and administer automatically substances to return blood glucose concentration to the optimal narrow range.

关键词： Blood glucose Diabetes mellitus Hyperglycemia Pancreas Artificial Pancreatectomy

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Healthcare providers’perspectives on factors influencing their critical care decision-making during the COVID-19 pandemic:An international pilot survey

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World Journal of critical care medicine 2025年第1期14卷 100-110页

作者： Sonali Vadi Neha Sanwalka Pramod Thaker Department of critical care medicine Kokilaben Dhirubhai Ambani Hospital and Medical Research InstituteMumbai 400053MahārāshtraIndia Department of Statistics HCJMRIJehangir HospitalPune 411001MahārāshtraIndia Medical Ethics Fellowship Harvard Medical SchoolBostonMA 02138United States

BACKGROUND Understanding a patient's clinical status and setting priorities for their care are two aspects of the constantly changing process of clinical *** analytical technique that can be helpful in uncertain situations is clinical *** must deal with contradictory information,lack of time to make decisions,and long-term factors when emergencies *** To examine the ethical issues healthcare professionals faced during the coronavirus disease 2019(COVID-19)pandemic and the factors affecting clinical *** This pilot study,which means it was a preliminary investigation to gather information and test the feasibility of a larger investigation was conducted over 6 months and we invited responses from clinicians worldwide who managed patients with *** survey focused on topics related to their professional roles and personal *** examined five core areas influencing critical care decision-making:Patients'personal factors,family-related factors,informed consent,communication and media,and hospital administrative policies on clinical *** collected data were analyzed using theχ2 test for categorical *** A total of 102 clinicians from 23 specialties and 17 countries responded to the *** was a significant factor in treatment planning(n=88)and ventilator access(n=78).Sex had no bearing on how decisions were *** doctors reported maintaining patient confidentiality regarding privacy and informed *** 50%of clinicians reported a moderate influence of clinical work,with many citing it as one of the most important factors affecting their health and *** from developing countries had a significantly higher score for considering a patient's financial status when creating a treatment plan than their counterparts from developed *** personal experiences,some respondents noted that treatment plans and preferences change

关键词： Survey Clinical decision-making COVID-19 pandemic

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The Experts Consensus for Patient Management of Neurosurgical critical care Unit in China （2015）

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Chinese Medical Journal 2015年第9期128卷 1252-1267页

作者： Zhao, Ji-Zong Zhou, Ding-Biao Zhou, Liang-Fu Wang, Ren-Zhi Zhang, Jian-Ning Wang, Shuo Li, Xin-Gang Hua-Feng Liu, Jian Jiang, Jiyao Zhang, Sai Zhang, Jun-Ting Zhang, Jian-Min Hou, Lijun Hong, Tao Yuan, Xian-Rui Gao, Guo-Dong Kang, De-Zhi You, Chao Bao, Shengde Qi, Song-Tao Zhao, Shi-Guang Zhao, Yuan-Li Hu, Jin Cui, Li-ying Peng, Bin Liu, Da-Wei Guo, Shu-Bin Lin, Yuan-Xiang Sun, Shi-Zhong Gao, Liang Jiang, Rong-Cai Shi, Guang-Zhi Chai, Wen-Zhao Wang, Ning Zhao, Yuan-Li Wei, Jun-Ji China Neurosurgical critical care Specialist Counc

INTRODUCTION Great changes have taken place in modern neurosurgery in the past *** models of management for complex neurosurgical patients have been developed in China as the specialty evolving,thus arise many *** demand calls for an expert consensus on neurosurgical inpatients management,especially for the subspecialty of neurosciences critical care （NCC）.

关键词： Experts Consensus Multidisciplinary Neurosurgical critical care Patient Management Standardization

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Impaired Hypothalamic Regulation of Sympathetic Outflow in Primary Hypertension

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Neuroscience Bulletin 2019年第1期35卷 124-132页

作者： Jing-Jing Zhou Hui-Jie Ma Jian-Ying Shao Hui-Lin Pan De-Pei Li Division of anesthesiology and critical care The University of Texas MD Anderson Cancer Center Department of Physiology Hebei Medical University Department of medicine Center for Precision MedicineUniversity of Missouri

The hypothalamic paraventricular nucleus(PVN) is a crucial region involved in maintaining homeostasis through the regulation of cardiovascular, neuroendocrine, and other functions. The PVN provides a dominant source of excitatory drive to the sympathetic outflow through innervation of the brainstem and spinal cord in hypertension. We discuss current findings on the role of the PVN in the regulation of sympathetic output in both normotensive and hypertensive conditions. The PVN seems to play a major role in generating the elevated sympathetic vasomotor activity that is characteristic of multiple forms of hypertension, including primary hypertension in humans. Recent studies in the spontaneously hypertensive rat model have revealed an imbalance of inhibitory and excitatory synaptic inputs to PVN presympathetic neurons as indicated by impaired inhibitory and enhanced excitatory synaptic inputs in *** imbalance of inhibitory and excitatory synaptic inputs in the PVN forms the basis for elevated sympathetic outflow in hypertension. In this review, we discuss the disruption of balance between glutamatergic and GABAergic inputs and the associated cellular and molecular alterations as mechanisms underlying the hyperactivity of PVN pre-sympathetic neurons in hypertension.

关键词： Hypothalamus Paraventricular nucleus Synaptic plasticity Essential hypertension Sympathetic nervous system

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