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Huang J, Chen XY. Elderly Man With Right Lower Leg Numbness. Ann Emerg Med 2021; 78:e25-e26. [PMID: 34420569 DOI: 10.1016/j.annemergmed.2021.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Jun Huang
- Department of Cardiovascular Ultrasound, the Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, China
| | - Xiao-Yu Chen
- Department of Vascular and Cardio-Thoracic Surgery, the Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, China
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Xie P, Ren ZK, Lv J, Hu YM, Guan ZZ, Yu WF. Berberine Ameliorates Oxygen-glucose Deprivation/Reperfusion-induced Apoptosis by Inhibiting Endoplasmic Reticulum Stress and Autophagy in PC12 Cells. Curr Med Sci 2021; 40:1047-1056. [PMID: 33428132 DOI: 10.1007/s11596-020-2286-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 11/30/2020] [Indexed: 02/06/2023]
Abstract
This study aimed to elucidate the molecular mechanisms by which berberine protects against cerebral ischemia/reperfusion (I/R) injury. The oxygen-glucose deprivation/reperfusion (OGD/R) PC12 model was established. Cell counting kit-8 (CCK-8) was used to detect the toxicity of berberine and the viability of PC12 cells. Hoechst 33258 staining and flow cytometry were used to observe the nuclear morphology, and changes of apoptosis and reactive oxygen species (ROS), respectively. Western blotting and immunofluorescence assay were employed to detect autophagy-related proteins [microtubule-associated protein 1A/1B-light chain 3 (LC3), P62/SQSTM-1, Beclin-1] and endoplasmic reticulum (ER) stress-related markers [glucose-regulated protein 78 (GRP78), C/EBP homologous protein (CHOP), Bcl-2-associated X (Bax) and cleaved caspase-3]. The GFP-RFP-LC3 adenovirus was used to assay the change of autophagic flux. Our results showed that berberine could increase the viability of PC12 cells, decrease the concentrations of ROS after OGD/R treatment, and suppress OGD/R-induced ER stress and autophagy. Moreover, the results revealed the involvement of the mammalian target of rapamycin (mTOR) pathway in the induction of autophagy, and berberine could activate the phosphorylation of mTOR and thus mitigate autophagy. In conclusion, our study suggested that berberine may protect against OGD/R-induced apoptosis by regulating ER stress and autophagy, and it holds promises in the treatment of cerebral I/R injury.
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Affiliation(s)
- Peng Xie
- Department of Biochemistry and Molecular Biology, School of Basic Medical Science, Guizhou Medical University, Guiyang, 550025, China.,Key Laboratory of Endemic and Ethnic Diseases, Ministry of Education, Guiyang, 550004, China
| | - Zhen-Kui Ren
- Department of Biochemistry and Molecular Biology, School of Basic Medical Science, Guizhou Medical University, Guiyang, 550025, China.,Key Laboratory of Endemic and Ethnic Diseases, Ministry of Education, Guiyang, 550004, China.,Department of Laboratory Medicine, the Second People's Hospital of Guizhou Province, Guiyang, 550002, China
| | - Ju Lv
- Department of Biochemistry and Molecular Biology, School of Basic Medical Science, Guizhou Medical University, Guiyang, 550025, China.,Key Laboratory of Endemic and Ethnic Diseases, Ministry of Education, Guiyang, 550004, China
| | - Yu-Mei Hu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Science, Guizhou Medical University, Guiyang, 550025, China.,Key Laboratory of Endemic and Ethnic Diseases, Ministry of Education, Guiyang, 550004, China
| | - Zhi-Zhong Guan
- Key Laboratory of Endemic and Ethnic Diseases, Ministry of Education, Guiyang, 550004, China.,Department of Pathology, Affiliated Hospital of Guizhou Medical University, Guiyang, 550004, China
| | - Wen-Feng Yu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Science, Guizhou Medical University, Guiyang, 550025, China. .,Key Laboratory of Endemic and Ethnic Diseases, Ministry of Education, Guiyang, 550004, China.
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Determinants of amputation and mortality following thromboembolectomy in native acute lower limb arterial occlusions, the influence of early intervention: A retrospective cohort study. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.750145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bath J, Kim RJ, Dombrovskiy VY, Vogel TR. Contemporary trends and outcomes of thrombolytic therapy for acute lower extremity ischemia. Vascular 2018; 27:71-77. [DOI: 10.1177/1708538118797782] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective Acute limb ischemia is a common vascular emergency requiring immediate intervention. Thrombolysis has been widely utilized for acute limb ischemia; the purpose of this study is to analyze contemporary trends, outcomes and complications of thrombolysis for acute limb ischemia. Methods Patients were identified from the Nationwide Inpatient Sample (2003–2013) using ICD-9. Patients undergoing emergency thrombolysis for acute limb ischemia were evaluated. Three groups were analyzed: thrombolysis alone, thrombolysis and endovascular procedure (T+ENDO), and failed thrombolysis requiring open surgery (T+OPEN). Results A total of 162,240 patients with acute limb ischemia were estimated: 33,615 patients (20.7%) underwent thrombolysis as the initial treatment. Mean age was 66.2 ± 34.9 years with 54% male. The utilization of thrombolysis increased significantly during the study period (16.8–24.2%, p < 0.0001). The most common group was thrombolysis and endovascular procedure (40.7%), followed by thrombolysis alone (34.1%), and T+OPEN (25.2%). Thrombolysis and endovascular procedure increased significantly over time (31.6–47.8%, p < 0.0001) whereas thrombolysis alone and T+OPEN significantly decreased (39.6–28.6% and 28.7–23.6%, respectively, p < 0.0001). Overall mortality was 4.9%; thrombolysis and endovascular procedure compared to thrombolysis alone and T-OPEN had a lower mortality rate (3.2% vs. 6.1% and 5.9%, p < 0001). The overall stroke rate was 1.9%; thrombolysis alone had the highest stroke rate (3.0%, p < 0.0001) with thrombolysis and endovascular procedure the lowest (1.2%) and T+OPEN 1.7%. The highest amputation rate was T+OPEN (11.6%, p < 0.001) compared to thrombolysis and endovascular procedure (5.1%) and thrombolysis alone (5.3%). T+OPEN had the highest incidence of cardiac (5.5%), respiratory (7.3%) and renal complications (12.5%), pneumonia (4.0%), and fasciotomy (16.8%) (all p < 0.0001). Conclusion Thrombolysis remains an effective treatment for acute limb ischemia with increased utilization over time. There was a significant increase in thrombolysis and endovascular procedure leading to improved outcomes. Thrombolysis alone carried the highest mortality and stroke rate, with T+OPEN associated with the highest amputation and complications. Although thrombolysis is effective, 25% of patients required an open procedure suggesting that patient selection for thrombolysis first instead of open surgery continues to be a clinical challenge.
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Affiliation(s)
- Jonathan Bath
- Division of Vascular Surgery, University of Missouri, School of Medicine, Columbia, USA
| | - Ryan J Kim
- Division of Vascular Surgery, University of Missouri, School of Medicine, Columbia, USA
| | - Viktor Y Dombrovskiy
- Department of Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, USA
| | - Todd R Vogel
- Division of Vascular Surgery, University of Missouri, School of Medicine, Columbia, USA
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