Latest ArticlesTo observe the anesthetic effect of ciprofol in intracranial aneurysm embolization.
One hundred and twenty patients undergoing intracranial aneurysm embolization, ASA Ⅰor Ⅱ, were randomly divided into control group and experimental group （n=60, each group）. During anesthesia induction, patients were given with midazolam 0.04 mg·kg-1, sufentanil 0.25 μg·kg-1, ciprofol 0.4 mg·kg-1 （experimental group） or propofol 2.0 mg·kg-1 （control group）, and rocuronium 0.6 mg·kg-1. During anesthesia maintenance, all patients were maintained with remifentanil 1 μg·kg-1·h-1 and cisatracurium 0.1 mg·kg-1·h-1, combined with ciprofol 0.8 mg·kg-1·h-1 （experimental group） or propofol 5 mg·kg-1·h-1 （control group）. The bispectral index （BIS） was maintained between 40 and 60 by adjusting the pumping speed during the operation. The changes of vital signs and BIS were observed. The anesthesia induction time,awakening time, and Ramsay sedation score after extubation were recorded. And the occurrence of adverse reactions was also observed.
There was no significant difference in systolic blood pressure （SBP）, diastolic blood pressure （DBP）,and heart rate （HR） between the two groups before anesthesia, after anesthesia induction, after tracheal intubation, at the end of operation, and after tracheal extubation. The BIS at the end of operation in the experimental group was lower than that in the control group （P<0.05）. The fluctuation value of SBP, DBP, and HR during anesthesia induction in the control group was significantly greater than that in the experimental group （P<0.05）. The recovery time of the experimental group was slightly longer while the use of sedatives was less than that of the control group （P<0.05）. The incidences of post-induced hypotension, hypertension after intubation, and injection pain in the experimental group were lower than those in the control group （P<0.05）.
Ciprofol can be used in intracranial aneurysm embolization with outstanding sedative efficacy. The hemodynamics of patient is more stable, and the incidence of postoperative adverse reaction is low.
To observe the difference of clinical efficacy and safety between regular hemodialysis （HD）and peritoneal dialysis （PD） uremic patients treated with roxadustat for renal anemia.
From December 2019 to March 2023, 102 renal anemia patients treated with roxadustat for uremic dialysis were selected. The initial dose of roxadustat was chosen based on weight, with 100 mg orally for patients weighing 45 to 60 kg and 120 mg for those weighing ≥60 kg. The medication was administered three times a week for 12 consecutive weeks, with dosage adjustments according to hemoglobin （Hb） levels. According to the dialysis method, there were 50 cases in the PD group and 52 cases in the HD group. Within the groups, those with high sensitive C-reactive protein （hs-CRP） ≥6 mg·L-1 were classified as high hs-CRP subgroup, while those with <6 mg·L-1 were considered the normal hs-CRP subgroup.Changes in anemia-related indicators, iron metabolism, lipid metabolism, and adverse reactions before and after roxadustat treatment were observed in both groups.
After 12 weeks of treatment with roxadustat, the levels of Hb, red blood cell count （RBC）, hematocrit （HCT）, and serum iron （SI） in the both groups all increased compared with before the treatment （P<0.05）, while the levels of serum ferritin （SF）, total cholesterol （TC）,triglyceride （TG）, and low-density lipoprotein cholesterol （LDL-C） all decreased （P<0.05）. After treatment, the levels of Hb, RBC, HCT, SI, TC, and LDL-C in the PD group were significantly higher than those in the HD group（P<0.05）. There were no significant differences in transferrin saturation （TSAT）, total iron-binding capacity （TIBC）,and high-density lipoprotein cholesterol （HDL-C） levels within and between the groups before and after the treatment（P>0.05）. There were no significant differences in TG and SF levels and the occurrence of adverse reactions between the two groups （P>0.05）. After 12 weeks of treatment, the average Hb level of the high hs-CRP subgroup and normal hs-CRP subgroup of the two groups significantly increased compared with before treatment （P<0.05）, and there was no significant difference between the two subgroups （P>0.05）.
Roxadustat is effective in improving renal anemia in uremia patients with HD or PD, and the short-term safety is good. Compared with HD patients, anemia is more significantly improved in PD patients.
To study the protective effect of cerebroprotein hydrolysate and its related mechanism of regulating endoplasmic reticulum stress in ischemic stroke based on network pharmacology and animal experiments.
GeneCards and OMIM databases were used to screen the targets related to ischemic stroke and endoplasmic reticulum stress, and Wayne diagram was drawn to get the intersection genes. The protein-protein interaction network diagram was downloaded from String database and visualized by Cytoscape software, and the top 10 genes were screened by cytoHubba plug-in. Finally, Gene Ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） were enriched and analyzed. Mouse models of ischemic stroke were made by the suture-occluded method, and randomly divided into sham group, model group, cerebroprotein hydrolysate 0.2 g·kg-1 group and 0.5 g·kg-1 group, and edaravone 8 mg·kg-1 group,with 11 mice in each group. The drug was administered continuously for 5 days after operation. The volume of cerebral infarction was measured by TTC staining, the contents of interleukin （IL）-6, IL-1β, γ-interferon （IFN-γ） and brain-derived neurotrophic factor （BDNF） in cerebral ischemic penumbra and serum were measured by ELISA, and the expression of Caspase-3 and AKT protein in brain tissue was observed by immunohistochemistry.
According to the results of network pharmacology, 41 intersection genes of ischemic stroke and endoplasmic reticulum stress were screened, and the top 10 genes screened were IL-6, ALB, INS, TNF, AKT1, CASP3, MAPK3, TP53, SIRT1 and VEGFA, respectively. GO enrichment resulted in 515 related entries. KEGG pathway enrichment involved lipid and atherosclerosis pathway, human cytomegalovirus infection, Alzheimer’s disease, phosphatidylinositol -3- kinase/ protein kinase B （PI3K/AKT） signaling pathway and so on. Compared with the model group, the cerebral infarction volume was significantly reduced （P<0.01）; the contents of IL-6, IL-1β and IFN-γ in serum and penumbra were decreased significantly （P<0.05）, and the contents of BDNF in serum and penumbra were increased significantly （P<0.05）; the expression of Caspase-3 in brain tissue was decreased significantly （P<0.05）, and the expression of AKT was increased significantly （P<0.05） in the two groups of cerebroprotein hydrolysate.
Based on the analysis of network pharmacology, the endoplasmic reticulum stress mechanism of ischemic stroke may be related to inflammation and apoptosis. The neuroprotective mechanism of cerebroprotein hydrolysate may be related to activating BDNF/PI3K/AKT pathway and inhibiting inflammation and apoptosis.
To study the antibacterial mechanism of palmatine based on network pharmacology, molecular docking, and molecular dynamics.
The drug targets of palmatine were predicted through the Swiss Target Prediction website, and the potential antibacterial targets of palmatine were obtained by mapping them with the antibacterial targets retrieved from GeneCards and OMIM databases. Protein-protein interaction network was constructed using STRING database and Cytoscape software and key targets were screened. The DAVID database was used to carry out Gene Ontology（GO） functional analysis and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis of potential targets, and visual processing was performed to build the “Component-Target-Pathway” network of palmatine. The binding of palmatine to key targets was validated through molecular docking and molecular dynamics simulations. In vitro antibacterial experiments were conducted to verify the antibacterial activity of palmatine.
A total of 28 critical anti-bacterial targets of palmatine were screened and enriched to 199 GO entries and 105 related pathways. “Ingredients-Target-Pathway”network showed that MAPK8, RAC1, and STAT3 were key anti-bacterial targets.The molecular docking results indicated that palmatine had an excellent binding effect with key targets MAPK8 and RAC1. Molecular dynamics studies found that there were hydrogen bonds and hydrophobic interactions between palmatine and proteins, enabling stable binding of palmatine to target proteins. In vitro antibacterial experiments showed that palmatine had strong inhibitory activity against Staphylococcus aureus and Candida albicans, and it had synergistic effects when combined with positive drugs.
Palmatine may exert its antibacterial effects by inhibiting the gene expression of MAPK8 and RAC1 through endocrine resistance and signaling pathways such as PI3K-Akt and FoxO.
To analyze the general patterns and characteristics of osimertinib related interstitial lung disease（ILD）.
The case reports of osimertinib related ILD from CNKI, VIP, Wanfang and PubMed database between November 2015 to June 2023 were searched and analyzed.
A total of 25 case reports were enrolled,involving 28 cases with ILD, 14 male and 14 female cases, aged 32 to 86 years old. PD-1 inhibitors were used sequentially in 4 patients before administering osimertinib, 21 patients developed ILD in 3 months, 25 patients experienced symptom relief after discontinuation reduction medication, and 3 patients died.
ILD should be closely guarded in 3 months of the application of osimertinib, especially these patients who received the sequence treatment of PD-1 inhibitors.The key to improving the prognosis is to stop using osimertinib immediately after ILD.
Amyotrophic lateral sclerosis (ALS) is a rare neurodegenerative disease characterized by the degeneration of upper and lower motor neurons. Clinically, it manifests as progressive muscle weakness and atrophy, ultimately leading to death, imposing a significant burden on patients’ families and society. The pathogenesis of ALS remains unclear. Currently, several ALS treatment drugs have failed to significantly extend survival or alter the outcome. In recent years, cell therapy has been increasingly applied to refractory or incurable diseases. Various types of stem cell therapies have been developed for ALS treatment, undergoing preclinical research and clinical trials. This article provides an overview of the application of cell therapy in ALS, with a detailed examination of the research and development history of the representative cell therapy NurOwn in ALS. And the achievements and challenges of current ALS cell therapy, suggesting the optimization of cell type selection and efficacy evaluation metrics in future ALS cell therapy research were further discussed. This optimization aims to guide the development, approval, and market entry of ALS cell therapies, benefiting patients and their families.
Preeclampsia is a common hypertensive disorder of pregnancy, which seriously endangers the health of mothers and infants. The early application of low-dose aspirin can effectively prevent preeclampsia, and effectively reduce the probability of hemolysis, elevated liver function and low platelet count syndrome, placental abruption, and fetal distress. In recent years, with the deepening of research, more experimental evidences show that there is a correlation between gene polymorphisms and aspirin resistance. Because some patients have gene polymorphisms, the expected therapeutic effect cannot be achieved. This paper reviewed the research progress of precision medication of aspirin in high-risk pregnant women with preeclampsia, in order to guide the medication of aspirin in special groups such as pregnant women with preeclampsia and improve pregnancy outcomes.
Alzheimer’s disease (AD) is the most common form of irreversible dementia. In addition to assessing of patients’ memory abilities, positron emission tomography (PET), as a non-invasive diagnostic modality with high sensitivity and qualitative or quantitative imaging of the target sites, can qualitatively and quantitatively evaluate β-amyloid (Aβ), tau proteins, synaptic proteins, and other related biomarkers, which is of great significance in the diagnosis of AD. As PET imaging approved by FDA, [18F]-flutemetamol, a derivative of 18F labelled thioflavin-T, and [18F]-florbetaben, [18F]-florbetapir, which are phenylpyridine derivates, have high specificity in their affinity for Aβ plaque binding. Other radionuclides such as 68Ga and 64Cu labeled radiotracers also showed high affinity with Aβ plaques. Quinoline derivatives [18F]-THK5351, [18F]-PPQ8, benzimidazolopyrimidine and pyridine-indole derivatives [18F]-T807, and lansoprazole derivatives [11C]-NML as PET imaging agents, can quantify tau protein tangles. And the structural derivatives of levetiracetam [11C]-UCB-J and [18F]-SDM-8 can measure synaptic density, while the structural derivatives [18F]-FPEB of 3-fluoro-4-acetylidene-benzylnitrile can assist in the diagnosis of AD by binding with mGluR5. The fluorobenzoyl derivative [18F]-altanserin, with ketoserin as its structural parent, acts on 5-hydroxytryptamine to study the molecular changes of early AD.
CD34+ cells have microcirculatory regenerative potential and paracrine anti-inflammatory effects, but the number and function of CD34+ cells involved in vascular repair are decreased in patients with heart failure. Multiple trials have found that CD34+cell transplantation therapy in patients with chronic heart failure can improve myocardial performance, reduce neurohumoral activation, improve exercise capacity and quality of life, and even improve the survival rate in patients with heart failure. CD34+ cell transplantation may be a future treatment option for patients with chronic heart failure.
Intrahepatic cholangiocarcinoma (ICC) is a malignant tumor that occurs in the biliary system, with a hidden onset, poor overall prognosis and high mortality. Futibatinib is a fibroblast growth factor receptor (FGFR) 1-4 inhibitor, which was approved by the U.S. Food and Drug Administration in 2022 for the treatment of adult patients with previously treated, unresectable, locally advanced or metastatic ICC with FGFR2 gene fusions or other rearrangements. Phase Ⅰ and Ⅱ clinical trials have shown that futibatinib has good clinical effect on ICC, which can significantly improve the objective response rate and prolong the survival time of ICC patients. The common adverse events include hyperphosphatemia, diarrhea, constipation, and dry mouth, with a high incidence of adverse events.
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