-
The Use of Esketamine in Clinical Anesthesia Practice
Issue:
Volume 12, Issue 4, July 2023
Pages:
61-64
Received:
3 June 2023
Accepted:
28 June 2023
Published:
6 July 2023
Abstract: Esketamine, a new noncompetitive antagonist of the N-Methyl-D-Aspartate (NMDA) receptor, has been approved by Food and Drug Administration of the United States of America and recently permitted to apply in Chinese medical institutions. By binding to NMDA receptor, esketamine exerts analgesic, sedative and antidepressant effects with no suppression of respiratory and circulatory system, which is similar to ketamine. However, as the right hand enantiomer of ketamine, esketamine shows higher efficiency, which means that a lower dose can exert comparable effects of ketamine. Meanwhile, the security of esketamine is higher due to less severe adverse events observed in preliminary clinical trials. With more advantages and less disadvantages, anesthesiologists have attached much attention to esketamine. Previous studies have explored the applications of esketamine in clinical practice, such as pediatric anesthesia, painless endoscopy, intubation or non-intubation surgery. These studies focused on the dosage, effectiveness, merits and demerits under different circumstances. In this review, we retrospected recent clinical trials, summarized the efficiency and safety of esketamine by classification of applying scenarios. Either anesthetic or subanesthetic dosage, bolus or continuous infusion made a significance in perioperative management. We also promoted some promising applications of esketamine in anesthesia. However, these novel ideas need more high-quality trials to reconfirm. Anyway, esketamine is a superior choice for anesthesiologists.
Abstract: Esketamine, a new noncompetitive antagonist of the N-Methyl-D-Aspartate (NMDA) receptor, has been approved by Food and Drug Administration of the United States of America and recently permitted to apply in Chinese medical institutions. By binding to NMDA receptor, esketamine exerts analgesic, sedative and antidepressant effects with no suppression ...
Show More
-
Bone Marrow Mesenchymal Stem Cells Alleviated Bleomycin-Induced Pulmonary Fibrosis in Mice
Chunmei Zhang,
Chenguang Li,
Zhongyan Zhao
Issue:
Volume 12, Issue 4, July 2023
Pages:
65-71
Received:
5 June 2023
Accepted:
28 June 2023
Published:
11 July 2023
Abstract: Objective: The purpose of this study was to investigate the effect of bone marrow mesenchymal stem cells (BMSCs) on bleomycin-induced pulmonary fibrosis in mice. Methods: Pulmonary fibrosis model in mice was established by bleomycin (BLM) induction. This study was divided into 7 groups, bone marrow mesenchymal stem cells (BMSCs) as the treatment measure in 4 groups, the saline and pirfenidone as other 2 groups. The body weight of mice after BLM modeling was measured. The content of hydroxyproline (HYP) and collagen 1 (COL1) in lung tissue were determined by kits. Pathological changes of lung tissue were observed by hematoxylin-eosin (HE) staining. The levels of cytokines in serum and lung tissue of mice were detected by Enzyme-Linked Immunosorbent Assay (ELISA) kits. Immunohistochemistry was used to detect the expression of collagen-1 and α-SMA protein in lung tissue of mice. The levels of TGF-β/smad-3 and NLRP3/NF-κB signal pathway in lung was detected by western blotting. Results: BMSCs significantly decreased the content of HYP and COL1 in lung tissue of mice. BMSCs significantly decreased cytokines in serum and lung tissue. Immunohistochemistry results shown BMSCs significantly decreased the levels of collagen-1 and α-SMA in lung tissue. In addition, BMSCs significantly inhibited TGF-β/smad-3 and NLRP3/NF-κB signal pathway in lung tissue. Conclusions: BMSCs effectively inhibited bleomycin-induced pulmonary fibrosis in mice, and its mechanism may be related to inhibiting the activation of TGF-β/smad-3 and NLRP3/NF-κB signal pathway.
Abstract: Objective: The purpose of this study was to investigate the effect of bone marrow mesenchymal stem cells (BMSCs) on bleomycin-induced pulmonary fibrosis in mice. Methods: Pulmonary fibrosis model in mice was established by bleomycin (BLM) induction. This study was divided into 7 groups, bone marrow mesenchymal stem cells (BMSCs) as the treatment me...
Show More
-
CADASIL Presenting with Parkinsonism, Intracerebral Hemorrhage, and Atypical White Matter Lesions: A Case Report
Fan Xinman,
Xu Yezi,
Zhu Huili,
Guo Li,
Deng Zhe,
Xu Xiaohong
Issue:
Volume 12, Issue 4, July 2023
Pages:
72-76
Received:
25 June 2023
Accepted:
11 July 2023
Published:
21 July 2023
Abstract: Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a hereditary cerebrovascular disorder characterized by common clinical manifestations such as frequent migraine episodes, recurrent transient ischemic attacks or strokes, gradual cognitive decline, and emotional disturbances. The typical Magnetic Resonance Imaging (MRI) characteristics for CADASIL include symmetrical white matter hyperintensities (WMHs) in the anterior temporal poles, external capsules, frontal cortex, and surrounding the lateral ventricle, along with multiple lacunar infarcts and cerebral microbleedings (CMBs), and occasionally with intracerebral hemorrhage (ICH). The presence of WMHs in the anterior temporal poles demonstrates high sensitivity and specificity in diagnosing CADASIL. In this report, we present a case featuring clinical manifestations of progressive cognitive impairment, apathy, and parkinsonism, accompanied by ICH. However, the reported case lacked the typical WMHs in the anterior temporal poles, which is generally observed in CADASIL patients. Ultimately, a missense mutation c.1630C>T (p.R544C) in the Notch3 gene was identified through next-generation sequencing, confirming a CADASIL diagnosis. This case implies that the p.R544C mutation may pose a significant risk factor for ICH, and individuals carrying this mutation are more susceptible to developing parkinsonism. Therefore, CADASIL should be considered as a potential diagnosis for patients exhibiting clinical symptoms of recurrent strokes, progressive cognitive dysfunction, mood disturbances, and parkinsonism, even if their imaging findings display atypical white matter lesions (WMLs).
Abstract: Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a hereditary cerebrovascular disorder characterized by common clinical manifestations such as frequent migraine episodes, recurrent transient ischemic attacks or strokes, gradual cognitive decline, and emotional disturbances. The typical Magnetic...
Show More
-
Comparison of the Brock Model and LU-RADS in Differentiating Benign and Malignant Subsolid Pulmonary Nodules
Haolei Liu,
Weiyun Cao,
Haifen Liu,
Jun Tan,
Xiang Zeng,
Shikui Wu
Issue:
Volume 12, Issue 4, July 2023
Pages:
77-81
Received:
2 July 2023
Accepted:
20 July 2023
Published:
26 July 2023
Abstract: Background The Lung Imaging Reporting and Data System (LU-RADS) and the Brock model are commonly utilized tools in clinical practice for evaluating pulmonary nodules. However, both LU-RADS and the Brock model have yet to be validated and compared specifically in subsolid pulmonary nodules (SSN). Therefor, the objective of this study was to compare the perfomance of the Brock model and LU-RADS in differentiating between malignant and benign SSN. Methods The study retrospectively analyzed the clinical data of patients diagnosed with SSN who underwent surgical resection and received pathological confirmation between January 2018 and December 2022. Based on the pathological results, the patients were categorized into two groups: benign SSN and malignant SSN. The clinical data of these groups were subjected to statistical analysis. The probability of malignancy in SSN was determined using the Brock model. Additionally, the LU-RADS category of SSN was independently determined by two radiologists. Receiver operating characteristic (ROC) curves were constructed for both the Brock model and LU-RADS, and the area under the curve (AUC) was calculated. Results A total of 133 patients with SSN were included in the study. The malignant SSN group, specifically LU-RADS category 4A and 4B, exhibited a higher prevalence compared to the benign SSN group (56 vs 4, P<0.05). Furthermore, the probability of malignancy in the malignant SSN group was significantly greater than that in the benign SSN group (0.21 vs 0.06, P<0.05). The Brock model demonstrated a strong correlation with LU-RADS (r=0.75, P<0.01) and exhibited comparable diagnostic performance in identifying lung cancer in patients with SSN (Brock vs LU-RADS, AUC: 0.83 vs 0.78, P=0.16). Subgroup analysis revealed that the Brock model displayed superior diagnostic accuracy in identifying malignancy in mixed ground glass nodules (Brock vs LU-RADS, AUC: 0.92 vs 0.85, P=0.03). However, both models demonstrated similar lower performance in detecting malignancy in pure ground glass nodules (Brock vs LU-RADS, AUC: 0.59 vs 0.55, P=0.66). Conclusion The Brock model demonstrated superior efficacy in distinguishing between malignant and benign mixed ground glass nodules, as compared to the LU-RADS. However, both the Brock model and LU-RADS exhibited limited efficacy in distinguishing between malignant and benign pure ground glass nodules.
Abstract: Background The Lung Imaging Reporting and Data System (LU-RADS) and the Brock model are commonly utilized tools in clinical practice for evaluating pulmonary nodules. However, both LU-RADS and the Brock model have yet to be validated and compared specifically in subsolid pulmonary nodules (SSN). Therefor, the objective of this study was to compare ...
Show More
-
Research Progress of Microglia in the Intervention Effect of Alzheimer's Disease
Tianying Fang,
Caiping Han,
Qingli Song,
Yaning Hao,
Wei Yuan,
Meng Yu,
Lin Zhang
Issue:
Volume 12, Issue 4, July 2023
Pages:
82-87
Received:
28 June 2023
Accepted:
24 July 2023
Published:
22 August 2023
Abstract: Alzheimer's disease (AD) is a degenerative disease of the central nervous system characterized by an insidious onset and progressive worsening of cognitive function. The main pathological features of AD are β-amyloid (Aβ) plaques, neuroprogenitor fibril tangles (NFT) formed by hyperphosphorylated Tau proteins, and other pathological features. In addition, there is growing evidence that AD is strongly associated with microglia activation, due to the fact that most of the risk genes for AD are highly expressed by microglia in the brain. The category of microglia is mainly depending on the milieu in which they become activated and the factors they are stimulated. In the development of AD, microglia can be activated to the M1 type to exert neuroinflammatory effects by producing various pro-inflammatory cytokines such as TNF-α, IL-1β, and IL-6 to induce neurotoxicity, and to the M2 type to exert anti-inflammation effects through enhancing the expression of neurotrophin, IL-4, and IL-6, and accelerate the clearance of Aβ plaques, which is believed to be promising molecules in AD therapy. This paper summarizes the mechanisms of microglia in AD and reviews the activation of microglia, the triggering receptor expressed on myeloid cells 2 (TREM2), disease-associated microglia (DAM), and gut microbiota to identify new therapeutic targets for AD, which currently lacks effective interventions.
Abstract: Alzheimer's disease (AD) is a degenerative disease of the central nervous system characterized by an insidious onset and progressive worsening of cognitive function. The main pathological features of AD are β-amyloid (Aβ) plaques, neuroprogenitor fibril tangles (NFT) formed by hyperphosphorylated Tau proteins, and other pathological features. In ad...
Show More
-
Bilateral Congenital Eyelid Eversion: Management of a Case Using the Conservative Approach at the CADESSO of the University Hospital Center, Donka, Conakry, Guinea
Baldé Abdoul Karim,
Bah Thierno Madjou,
Diop Mamadou Samba,
Zoumanigui Christophe,
Camara Sidikiba,
Kolié Diariou,
Ly Mariame,
Cissoko Amadou
Issue:
Volume 12, Issue 4, July 2023
Pages:
88-90
Received:
3 July 2023
Accepted:
18 July 2023
Published:
31 August 2023
Abstract: Introduction: Congenital eversion of the eyelid is a rare palpebral pathology, the first-line treatment for which is the conservative method consisting of the use of artificial tears, antibiotics and bilateral inversion of the eyelids. Observation: We present a clinical observation of a female neonate ten hours old, referred from a peripheral health centre for management of a bilateral upper eyelid malformation. Ophthalmological examination: revealed bilateral, symmetrical eversion of the upper eyelids in which the diagnosis of congenital bilateral eversion of the eyelids was accepted after ruling out congenital ectropion and upper eyelid haemangioma. Conclusion: Conservative treatment was used, which gave a good result within 10 days.
Abstract: Introduction: Congenital eversion of the eyelid is a rare palpebral pathology, the first-line treatment for which is the conservative method consisting of the use of artificial tears, antibiotics and bilateral inversion of the eyelids. Observation: We present a clinical observation of a female neonate ten hours old, referred from a peripheral healt...
Show More
