Changes in cognitive function due to combined propofol and remifentanil treatment are associated with phosphorylation of Tau in the hippocampus, abnormal total water and calcium contents of the brain, and elevated serum S100β levels

OBJECTIVE

Propofol and remifentanil are commonly used combined for anaesthesia and can cause cognitive dysfunction. We hypothesized that combined treatment with these drugs would exert its effect via increased phosphorylation of Tau protein in the brain hippocampus. To address this, we assessed cognitive function and extent phosphorylation of Tau in experimental animals treated with either drug or their combination. In addition, we documented other biochemical abnormalities, such as brain total calcium and water contents, and serum levels of S100β protein.

MATERIALS AND METHODS

60 Sprague-Dawley (SD) rats were divided into 5 groups: control, model, propofol-treated, remifentanil-treated, and combined treatment groups (12 animals per group). The Morris water maze test assessed latent periods as a measure of cognitive function in experimental animals. Tau phosphorylation was quantified by immunohistochemistry and expressed as a number of cells with positive Tau expression and as average staining area. Brain water content was assessed by measuring wet and dry brain weights, and calcium content was evaluated by the flame atomic absorption spectroscopy method. Serum S100β levels were assessed by ELISA.

RESULTS

Treatment with propofol and remifentanil markedly increased the latent period in the Morris water maze test, increased number the extent of Tau phosphorylation in the hippocampus, adversely modulated total water and calcium content in the brain, and elevated serum S100β levels. Under all conditions, combined treatment caused more pronounced effects on the studied outcomes.

CONCLUSIONS

Propofol combined with remifentanil induces a cognitive decline which is associated with Tau phosphorylation and modulation of local and systemic biochemical parameters.

[Early history of medicine and health career in Harbin]

Harbin, located in the northeast of China, was still an agricultural region dominated by traditional natural economy in the late 19th century. Harbin became the"Eurasia land bridge"and the transportation junction of the northeast railway network, along with the building of Mid-east railway in 1898, which sped up the development of the city. With the influx of foreign workers and capital, in the 1930s, Harbin has become a city with 19 countries' consulates and nearly 100, 000 people from more than 20 foreign countries. In this international multicultural city, the rapid introduction and spread of western medicine showed the great effect for the development of medicine and health career, ranking the top in China.

Building Virtual Watersheds: A Global Opportunity to Strengthen Resource Management and Conservation

Modern land-use planning and conservation strategies at landscape to country scales worldwide require complete and accurate digital representations of river networks, encompassing all channels including the smallest headwaters. The digital river networks, integrated with widely available digital elevation models, also need to have analytical capabilities to support resource management and conservation, including attributing river segments with key stream and watershed data, characterizing topography to identify landforms, discretizing land uses at scales necessary to identify human-environment interactions, and connecting channels downstream and upstream, and to terrestrial environments. We investigate the completeness and analytical capabilities of national to regional scale digital river networks that are available in five countries: Canada, China, Russia, Spain, and United States using actual resource management and conservation projects involving 12 university, agency, and NGO organizations. In addition, we review one pan-European and one global digital river network. Based on our analysis, we conclude that the majority of the regional, national, and global scale digital river networks in our sample lack in network completeness, analytical capabilities or both. To address this limitation, we outline a general framework to build as complete as possible digital river networks and to integrate them with available digital elevation models to create robust analytical capabilities (e.g., virtual watersheds). We believe this presents a global opportunity for in-country agencies, or international players, to support creation of virtual watersheds to increase environmental problem solving, broaden access to the watershed sciences, and strengthen resource management and conservation in countries worldwide.

[Effects of Tetrandrine Prenatal Intervention on Alveolar Epithelial Cells Type I Differentiation in Rat Model of Nitrofen-induced Congenital Diaphragmatic Hernia]

OBJECTIVE

To investigate the effects of Tetrandrine (TET) prenatal intervention on the differentiation of alveolar epithelial cells type I (AEC I) in rat model of Nitrofen-induced congenital diaphragmatic hernia (CDH).

METHODS

Timed-pregnant Sprague-Dawley rats were divided into three groups, namely control, CDH and TET group on day 9.5 of gestation. The rats in TET group and CDH group were given 125 mg of Nitrofen by gavage one time, while the rats in control group were given the same dose of seed fat. After that, the rats in TET group was given 30 mg/kg of TET by gavage once a day for three days from day 18.5 of gestation, while the rats in CDH and control group were given the same dose of normal saline. On day 21.5 of gestation, all fetuses were delivered by cesarean, the lungs of fetuses were histologically evaluated by microscope and electron microscope. The expressions of type I cell-specific protein (RT140) and thyroid transcription factor 1 (TTF1) in alveolar fluid content were analyzed by RT-PCR and immunohistochemistry staining. To detect the number of AEC I and AEC II of each group by transmission electron microscopy and calculate the percentage of AEC I and AEC II (I/II%).

RESULTS

The microscope and electron microscope study found the lungs of fetuses in CDH group showed marked hypoplasia, in contrast to the improvement of hypoplasia in TET fetuses. The pulmonary alveolar area had significant difference statistically (P < 0.01) in each group, which present as control > TET > CDH. I/II% had significant difference statistically (P < 0.01) in each group, which present as control > TET > CDH. The expression level of TTF1 was up-regulated in both CDH and TET groups, and it was higher in CDH group (P < 0.01). The expression level of RT140 were down-regulated in CDH and TET groups, which was lower in CDH group (P < 0.01).

CONCLUSION

The development of AEC I was interfered in CDH rat model, TET prenatal treatment could improve the lung development of CDH.

Post-translational modification of cortical GluA receptors in rodents following spinal cord lesion

Previous studies investigating the pathophysiology of neuropathic pain caused by injury to the spinal cord suggest that pain may result, at least in part, from maladaptive plasticity in the somatosensory cortex and associated pain networks. However, little is known about the molecular and cellular mechanisms leading to maladaptive plasticity in the cortex and how they contribute to the development of neuropathic pain. AMPA-type glutamate receptors (GluARs) mediate fast excitatory synaptic transmission in the mammalian brain and play an important role in pain processing. Here we used an electrolytic lesion model of spinal cord injury in animals to study the expression and phosphorylation of GluA1 and 2 in the primary somatosensory cortex (S1). Experiments in rats and mice revealed that maladaptive plasticity and hypersensitivity after spinal cord lesion (SCL) are associated with a reduction in the fraction of GluA1 subunits that are phosphorylated at serine 831 (S831) in the hindlimb representation of S1 (S1HL). Manipulations that reduce the fraction of phosphorylated S831 in S1HL of non-lesioned animals, including low-frequency electrical stimulation and viral-mediated gene transfer of mutant S831, were associated with the development of hypersensitivity. Taken together, these findings suggest that phosphorylation of GluA1 at S831 plays an important role in the development of hypersensitivity after SCL.

Molecular identification of the traditional herbal medicines, Arisaematis Rhizoma and Pinelliae Tuber, and common adulterants via universal DNA barcode sequences

Methods to identify Pinelliae Tuber and Arisaematis Rhizoma are required because of frequent reciprocal substitution between these two herbal medicines and the existence of several closely related plant materials. As a result of the morphological similarity of dried tubers, correct discrimination of authentic herbal medicines is difficult by conventional methods. Therefore, we analyzed DNA barcode sequences to identify each herbal medicine and the common adulterants at a species level. To verify the identity of these herbal medicines, we collected five authentic species (Pinellia ternata for Pinelliae Tuber, and Arisaema amurense, A. amurense var. serratum, A. erubescens, and A. heterophyllum for Arisaematis Rhizoma) and six common adulterant plant species. Maturase K (matK) and ribulose-1,5-bisphosphate carboxylase/oxygenase large subunit (rbcL) genes were then amplified using universal primers. In comparative analyses of two DNA barcode sequences, we obtained 45 species-specific nucleotides sufficient to identify each species (except A. erubescens with matK) and 28 marker nucleotides for each species (except P. pedatisecta with rbcL). Sequence differences at corresponding positions of the two combined DNA barcodes provided genetic marker nucleotides that could be used to identify specimens of the correct species among the analyzed medicinal plants. Furthermore, we generated a phylogenetic tree showing nine distinct groups depending on the species. These results can be used to authenticate Pinelliae Tuber and Arisaematis Rhizoma from their adulterants and to identify each species. Thus, comparative analyses of plant DNA barcode sequences identified useful genetic markers for the authentication of Pinelliae Tuber and Arisaematis Rhizoma from several adulterant herbal materials.

Population genetic structure and migration patterns of Liriomyza sativae in China: moderate subdivision and no Bridgehead effect revealed by microsatellites

While Liriomyza sativae (Diptera: Agromyzidae), an important invasive pest of ornamentals and vegetables has been found in China for the past two decades, few studies have focused on its genetics or route of invasive. In this study, we collected 288 L. sativae individuals across 12 provinces to explore its population genetic structure and migration patterns in China using seven microsatellites. We found relatively low levels of genetic diversity but moderate population genetic structure (0.05 < F ST < 0.15) in L. sativae from China. All populations deviated significantly from the Hardy-Weinberg equilibrium due to heterozygote deficiency. Molecular variance analysis revealed that more than 89% of variation was among samples within populations. A UPGMA dendrogram revealed that SH and GXNN populations formed one cluster separate from the other populations, which is in accordance with STRUCTURE and GENELAND analyses. A Mantel test indicated that genetic distance was not correlated to geographic distance (r = -0.0814, P = 0.7610), coupled with high levels of gene flow (M = 40.1-817.7), suggesting a possible anthropogenic influence on the spread of L. sativae in China and on the effect of hosts. The trend of asymmetrical gene flow was from southern to northern populations in general and did not exhibit a Bridgehead effect during the course of invasion, as can be seen by the low genetic diversity of southern populations.

Mesoporous NiCo2O4 nanospheres with a high specific surface area as electrode materials for high-performance supercapacitors

Ternary nickel cobaltite has attracted more and more attention as a promising electrode material for high performance supercapacitors (SCs) due to its high theoretical capacity, unique crystal structure and excellent electronic conductivity.

Epidemiological transition and distribution of stroke incidence in Tianjin, China, 1988-2010

OBJECTIVES

To examine the trends in epidemiological transition of stroke over the last two decades in Tianjin, and investigate the subtypes of stroke.

STUDY DESIGN

A population-based epidemiological study using data from the Stroke Incidence Surveillance System of the Tianjin Centres for Disease Control and Prevention from 1988 to 2010.

METHODS

Almost 500,000 cases were analysed to examine changes in the incidence of stroke between 1988 and 2010 by age, sex, subtype, year and urban/rural status.

RESULTS

The incidence of stroke amongst males increased from 136.8/100,000 in 1988 to 387.0/100,000 in 2010, and the incidence amongst females increased from 65.9/100,000 in 1988 to 249.7/100,000 in 2010. Over the study period, the proportion of haemorrhagic strokes decreased and the proportion of ischaemic strokes increased sharply in both men and woman; the differences were significant.

CONCLUSION

The distribution of stroke subtypes changed dramatically over the study period. Changes in trend and subtypes of stroke have raised new challenges and there is a need for adjustment for stroke prevention in Tianjin.

Clinical analysis of gastroenteropancreatic neuroendocrine tumor with liver metastasis, compared with primary hepatic neuroendocrine tumor

OBJECTIVE

The objective was to study the clinicopathologic features, grading, treatment protocols, and prognostic of gastroenteropancreatic neuroendocrine tumor (NET) with liver metastasis and primary hepatic NET.

MATERIALS AND METHODS

The clinical data of 34 patients with hepatic NET were retrospectively reviewed. According to the primary tumor location and 2010 World Health Organization classification, the cases were categorized to analyze the clinicopathologic features, treatment condition, and prognostic factors.

RESULTS

There was a marked male predominance either in gastroenteropancreatic NET liver metastasis group or primary group. Primary hepatic NET is mostly single nodule located in the right lobe of liver, and the metastatic hepatic NET is mostly from pancreas with multiple nodules and metastasizes to both lobes of the liver, with a high degree of malignancy and poor prognosis. There are 17 cases (50%) of NET and 17 cases (50%) of neuroendocrine carcinoma (NEC) in all the 34 patients of this study. The mitotic figure and Ki-67 proliferation index are both higher in NEC group than in NET group, which indicated highly malignancy of the NEC. The 5-year disease-free survival (DFS) rates for primary group and metastatic group were 30% and 40%, respectively (P > 0.05), while the 5-year survival rates were 35% and 66%, respectively (P > 0.05). Different tumor grade was found closely associated with 5-year DFS (P < 0.05) and overall survival (OS) (P < 0.05) in both groups. Furthermore, we found 5-year DFS of patients with primary site of the tumor located in the gastrointestinal tract was much lower than that located in pancreas (P < 0.05), while the 5-year OS showed no significant differences between two groups (P > 0.05).

CONCLUSIONS

Surgery is an effective method for the treatment of hepatic NET; tumor grading is an important determinant factor of prognosis.

Fetus in Fetu in the Scrotal Sac: Case Report and Literature Review

Fetus in fetu (FIF) is a rare congenital anomaly. The most common site at which FIF occurs is the retroperitoneum. The mechanisms underlying the development of FIF have not been fully elucidated. The monozygotic twin theory postulates that FIF results from the unequal division of the totipotent cells of the blastocyst. However, the monozygotic twin theory does not explain all cases of FIF.Herein, we describe the clinical characteristics of a 20-day-old infant with scrotal sac swelling. Ultrasonography and computed tomography revealed the presence of a mass consistent with a FIF rather than a teratoma. Surgical removal and a subsequent pathological evaluation demonstrated that the anencephalic fetus exhibited limb buds adjacent to a palpable vertebral column, supporting the diagnosis of FIF. The infant had an uneventful recovery and was discharged on the fifth postoperative day. In the present report, the pathogenesis, presentation, diagnosis, and management of FIF, as well as new concepts emerging in this area of research, are discussed.Although the majority of cases of FIF may be diagnosed preoperatively, FIF should be distinguished from teratoma because the latter has substantial malignant potential. The recommended treatment for FIF is complete resection. To confirm the diagnosis of FIF, pathological examination, karyotyping, serologic marker assessment, and DNA restriction site mapping should be performed after removing the mass. Although FIF is thought to be a benign disorder, follow-up is necessary as a precaution against malignant recurrence, which has been described once.

Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2D6 and CYP2C19 Genotypes and Dosing of Selective Serotonin Reuptake Inhibitors

Selective serotonin reuptake inhibitors (SSRIs) are primary treatment options for major depressive and anxiety disorders. CYP2D6 and CYP2C19 polymorphisms can influence the metabolism of SSRIs, thereby affecting drug efficacy and safety. We summarize evidence from the published literature supporting these associations and provide dosing recommendations for fluvoxamine, paroxetine, citalopram, escitalopram, and sertraline based on CYP2D6 and/or CYP2C19 genotype (updates at www.pharmgkb.org).

Estradiol modulates visceral hyperalgesia by increasing thoracolumbar spinal GluN2B subunit activity in female rats

BACKGROUND

We previously reported estrogen modulates spinal N-methyl-d-aspartate (NMDA) receptor processing of colorectal pain through changes in spinal GluN1 subunit phosphorylation/expression. The purpose of this study was to investigate whether spinal GluN2B containing NMDA receptors are involved in estrogen modulation of visceral pain processing.

METHODS

Behavioral, molecular, and immunocytochemical techniques were used to determine spinal GluN2B expression/phosphorylation and function 48 h following subcutaneous injection of estradiol (E2) or vehicle (safflower oil, Saff oil) in ovariectomized rats in the absence or presence of colonic inflammation induced by mustard oil.

KEY RESULTS

E2 increased the magnitude of the visceromotor response (VMR) to colorectal distention compared to Saff oil in non-inflamed rats. Intrathecal injection of the GluN2B subunit antagonist, Ro 25-6981, had no effect on the VMR in non-inflamed E2 or Saff oil rats. Colonic inflammation induced visceral hyperalgesia in E2, but not Saff oil rats. Visceral hyperalgesia in E2 rats was blocked by intrathecal GluN2B subunit selective antagonists. In inflamed rats, E2 increased GluN2B protein and gene expression in the thoracolumbar (TL), but not lumbosacral (LS), dorsal spinal cord. Immunocytochemical labeling showed a significant increase in GluN2B subunit in the superficial dorsal horn of E2 rats compared to Saff oil rats.

CONCLUSIONS & INFERENCES

These data support the hypothesis that estrogen increases spinal processing of colonic inflammation-induced visceral hyperalgesia by increasing NMDA receptor activity. Specifically, an increase in the activity of GluN2B containing NMDA receptors in the TL spinal cord by estrogen underlies visceral hypersensitivity in the presence of colonic inflammation.

Idiopathic neonatal pneumoperitoneum with favorable outcome: A case report and review

Neonatal pneumoperitoneum is a surgical emergency indicative of gastrointestinal perforation that requires immediate treatment to prevent death. There have been non-surgical conditions secondary to neonatal pneumoperitoneum (e.g., mechanical ventilation, pulmonary diseases and pneumatosis cystoides intestinalis) that neonates were able to overcome without the need for abdominal exploration. Idiopathic pneumoperitoneum, although similar to perforation of the alimentary tract and the previously mentioned non-surgical conditions, is a more rare and benign condition that does not yet have a definite cause. Hence, inexperienced surgeons may have a difficult time providing the right treatment for idiopathic pneumoperitoneum. We report a case of a neonate with a massive pneumoperitoneum who obtained a favorable outcome without surgical intervention. Nonetheless, the cause of pneumoperitoneum remains unclear. We hypothesize that the right sized perforation (range: 2 mm to 4 mm in diameter) at the anterior wall of the stomach is needed for pneumoperitoneum to occur. As the baby cries (aerophagia), the air in the stomach accumulates until it can enter the intraperitoneal cavity through the leak compressed by gastric peristalsis, hence forming a large pneumoperitoneum. Small amounts of gastric juice are able to penetrate the gastric wall; therefore, no signs or symptoms of peritonitis occur. The gastric leak self-seals, preventing further passage of the air, allowing the intraperitoneal free gas to dissipate gradually. This case demonstrated that laparotomy can be avoided in neonates with idiopathic pneumoperitoneum if a timely diagnosis is established.

Effects of intravenous analgesia with combined dezocine and butorphanol on postoperative cognitive function in elderly patients

The aim of this study was to observe the analgesic effects of the combination of dezocine and butorphanol on postoperative cognitive function in elderly patients. Forty elderly patients undergoing upper abdominal surgeries or thoracotomies with general anesthesia were randomly divided into the dezocine and butorphanol group or the butorphanol group (20 patients per group). A visual analog scale was used to evaluate analgesia and the degree of malignant vomiting. The Ramsay scoring method was used to evaluate sedation. The Mini-Mental State Examination (MMSE) was used to evaluate cognitive function. Forty-eight hours after the operation, the pain score of the dezocine and butorphanol group (means ± SD, 1.75 ± 0.44) was lower than that of the butorphanol group (2.25 ± 0.79; P < 0.05), and the nausea and vomiting score of the dezocine and butorphanol group (0) was lower than that of the butorphanol group (0.70 ± 1.30; P < 0.05). Six hours after the operation, the sedative score of the butorphanol group (3.75 ± 0.79) was higher than that of the dezocine and butorphanol group (2.15 ± 0.75; P < 0.05). Compared to 1 day before the operation, the MMSE scores of both groups decreased 6 h after the operation, and the MMSE score of the butorphanol group (15.00 ± 2.00) was lower than that of the dezocine and butorphanol group (20.95 ± 1.54; P < 0.05). Dezocine and butorphanol analgesia had transient effects on postoperative cognitive function in elderly patients, and the effect of the combination was superior than butorphanol only.

The International SSRI Pharmacogenomics Consortium (ISPC): a genome-wide association study of antidepressant treatment response

Response to treatment with selective serotonin reuptake inhibitors (SSRIs) varies considerably between patients. The International SSRI Pharmacogenomics Consortium (ISPC) was formed with the primary goal of identifying genetic variation that may contribute to response to SSRI treatment of major depressive disorder. A genome-wide association study of 4-week treatment outcomes, measured using the 17-item Hamilton Rating Scale for Depression (HRSD-17), was performed using data from 865 subjects from seven sites. The primary outcomes were percent change in HRSD-17 score and response, defined as at least 50% reduction in HRSD-17. Data from two prior studies, the Pharmacogenomics Research Network Antidepressant Medication Pharmacogenomics Study (PGRN-AMPS) and the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, were used for replication, and a meta-analysis of the three studies was performed (N=2394). Although many top association signals in the ISPC analysis map to interesting candidate genes, none were significant at the genome-wide level and the associations were not replicated using PGRN-AMPS and STAR*D data. The top association result in the meta-analysis of response represents SNPs 5′ upstream of the neuregulin-1 gene, NRG1 (P = 1.20E - 06). NRG1 is involved in many aspects of brain development, including neuronal maturation and variations in this gene have been shown to be associated with increased risk for mental disorders, particularly schizophrenia. Replication and functional studies of these findings are warranted.