An algorithm of bupivacaine dose based on height is applied to reduce maternal hypotension in caesarean section under spinal anesthesia. This study is designed to further verify whether the algorithm ...of bupivacaine dose based on height is suitable.
The parturients were grouped according to height. The comparison of anesthesia characteristic among subgroups was carried out. The univariate and multivariate binary logistic regressions were executed to reanalyze the interference factor for the anesthesia characteristic.
When the dose of bupivacaine was adjusted by using the height based dosing algorithm, except for weight (P < 0.05), other general data did not present statistical changes with height (P > 0.05); the incidences of complications, characteristics of sensory or motor block, quality of anesthesia and neonatal outcome were of no statistical difference among parturients with different heights (P > 0.05); the height, weight and body mass index were not related with maternal hypotension (P > 0.05). When the dose of bupivacaine is constant, except for weight and body mass index (P > 0.05), the height was the independent risk factor for maternal hypotension (P < 0.05).
Except for weight and body mass index, the height has an influence on the bupivacaine dose. It is reasonable that the bupivacaine dose is adjusted by using this dosing algorithm based on height.
This study was registered at http://clinicaltrials.gov (13/04/2018, NCT03497364).
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Urethane has little effect on nervous system and is often used in neuroscience studies. However, the effect of urethane in neurons is not thoroughly clear. In this study, we investigated changes in ...neuron responses to tones in inferior colliculus during urethane anesthesia. As urethane was metabolized, the best and characteristic frequencies did not obviously change, but the minimal threshold (MT) remained relatively stable or was elevated. The frequency tuning bandwidth at 60 dB SPL (BW
60dBSPL
) remained unchanged or decreased, and the average evoked spike of effective frequencies at 60 dB SPL (ES
60dBSPL
) gradually decreased. Although the average evoked spike of effective frequencies at a tone intensity of 20 dB SPL above MT (ES
20dBSPLaboveMT
) decreased, the frequency tuning bandwidth at a tone intensity of 20 dB SPL above MT (BW
20dBSPLaboveMT
) did not change. In addition, the changes in MT, ES
60dBSPL
, BW
60dBSPL
, and ES
20dBSPLaboveMT
increased with the MT in pre-anesthesia awake state (MT
pre−anesthesiaawake
). In some neurons, the MT was lower, BW
60dBSPL
was broader, and ES
60dBSPL
and ES
20dBSPLaboveMT
were higher in urethane anesthesia state than in pre-anesthesia awake state. During anesthesia, the inhibitory effect of urethane reduced the ES
20dBSPLaboveMT
, but did not change the MT, characteristic frequency, or BW
20dBSPLaboveMT
. In the recording session with the strongest neuron response, the first spike latency did not decrease, and the spontaneous spike did not increase. Therefore, we conclude that urethane can reduce/not change the MT, increase the evoked spike, or broaden/not change the frequency tuning range, and eventually improve the response of auditory neurons to tone with or without “pushing down” the tonal receptive field in thresholding model. The improved effect increases with the MT
pre−anesthesiaawake
of neurons. The changes induced by the inhibitory and improved effects of urethane abide by similar regularities, but the change directions are contrary. The improvement mechanism may be likely due to the increase in the ratio of excitatory/inhibitory postsynaptic inputs to neurons.
In vivo loose patch and breakthrough whole-cell recordings are useful tools for investigating the intrinsic and synaptic properties of neurons. However, the correlation among pipette resistance, seal ...condition and recording time is not thoroughly clear. Presently, we investigated the recording time of different pipette resistances and seal conditions in loose patch and breakthrough whole-cell recordings. The recording time did not change with pipette resistance for loose patch recording (Rp-loose) and first increased and then decreased as seal resistance for loose patch recording (Rs-loose) increased. For a high probability of a recording time ≥ 30 min, the low and high cutoff values of Rs-loose were 21.5 and 36 MΩ, respectively. For neurons with Rs-loose values of 21.5-36 MΩ, the action potential amplitudes changed slightly 30 min after the seal. The recording time increased as seal resistance for whole-cell recording (Rs-tight) increased and the zero-current membrane potential for breakthrough whole-cell recording (MPzero-current) decreased. For a high probability of a recording time ≥ 30 min, the cutoff values of Rs-tight and MPzero-current were 2.35 GΩ and -53.5 mV, respectively. The area under the curve of the MPzero-current ROC curve was larger than that of the Rs-tight ROC curve. For neurons with MPzero-current values ≤ -53.5 mV, the inhibitory or excitatory postsynaptic current amplitudes did not show significant changes 30 min after the seal. In neurons with Rs-tight values ≥ 2.35 GΩ, the recording time gradually increased and then decreased as the pipette resistance for whole-cell recording (Rp-tight) increased. For the high probability of a recording time ≥ 30 min, the low and high cutoff values of Rp-tight were 6.15 and 6.45 MΩ, respectively. Together, we concluded that the optimal Rs-loose range is 21.5 - 36 MΩ, the optimal Rp-tight range is 6.15 - 6.45 MΩ, and the optimal Rs-tight and MPzero-current values are ≥ 2.35 GΩ and ≤ -53.5 mV, respectively. Compared with Rs-tight, the MPzero-current value can more accurately discriminate recording times ≥ 30 min and < 30 min.
Background
There is a high incidence of maternal hypotension in spinal anesthesia for cesarean section. The aim of the study is to investigate whether there is a height-based dosing algorithm of ...bupivacaine that provides adequate anesthesia with less maternal hypotension.
Methods
There were 2 groups of 280 parturients who did not receive prophylactic fluid preloading: Test and Conventional group. In Test group, a height based dosing algorithm was used to confirm the dose of bupivacaine in parturients without prophylactic vasopressors. In the Conventional group, a constant dose of bupivacaine was used. The complications and quality of anesthesia were evaluated.
Results
In the Conventional group, the shorter participants had higher incidence of hypotension, faster sensory block time, and more participants with complete motor block (
p
= 0.030, 2.957 × 10
−14
, and 0.012). In the Test group, the incidence of hypotension, sensory block time, and number of participants with complete motor block did not change with height (
p
= 0.199, 0.617, and 0.209). The height-based dosing algorithm of bupivacaine decreased the incidence of hypotension (
p
= 0.004), induced lower sensory block level and less degree of motor block (
p
= 3.513 × 10
−7
and 5.711 × 10
−11
). The quality of analgesia, quality of muscle relaxation, and degree of intraoperative comfort were similar in both groups (
p
= 0.065, 0.498, and 0.483).
Conclusions
The height influences the dose of bupivacaine in spinal anesthesia; without prophylactic fluid pre-loading and vasopressors, the height-based dosing algorithm of bupivacaine is suitable, and meets the cesarean section' requirement with less maternal hypotension.
Clinical Trial Registration
www.ClinicalTrials.gov
, identifier: NCT03497364.
Berberine exhibits anticancer efficacy against a variety of malignancies, including breast cancer (BRCA). However, the underlying mechanism is ambiguous. This study sought to explore the targets and ...the probable mechanism of berberine regulating autophagy in BRCA through network pharmacology, bioinformatics, and molecular docking. The targets of berberine and autophagy-modulated genes were derived from online databases, and the Cancer Genome Atlas database was used to identify the differentially expressed genes of BRCA. Then, through intersections, the autophagy-modulated genes regulated by berberine (AMGRBs) in BRCA were obtained. Next, we established a protein–protein interaction network using the Search Tool for the Retrieval of Interacting Genes database. Afterward, gene ontology and Kyoto encyclopedia of genes and genomes enrichment analyses were employed to explore the targets’ biological functions. Additionally, molecular docking was conducted to verify the binding ability of berberine to the targets. Finally, to determine the prognostic value of AMGRBs in BRCA, we performed overall survival analyses. We identified 29 AMGRBs in BRCA, including CASP3, MTOR, AKT1, GSK3B, PIK3CA, and others. Gene ontology enrichment analysis showed that the AMGRBs in BRCA were associated with autophagy regulation, negative regulation of catabolic process, macroautophagy, and other biological processes. Kyoto encyclopedia of genes and genomes enrichment analyses indicated that AMGRBs in BRCA were involved in epidermal growth factor receptor tyrosine kinase inhibitor resistance, PI3K/Akt signaling pathway, JAK-STAT signaling pathway, and others. Molecular docking results proved that berberine had strong binding affinities with AMGRBs in BRCA. Survival analyses indicated that ATM, HTR2B, LRRK2, PIK3CA, CDK5, and IFNG were associated with the prognosis of BRCA. This study identified the targets and pathways of berberine for regulating autophagy in BRCA, which contributed to a better understanding of berberine’s function in BRCA and serve as a foundation and reference for further study and therapeutic application of berberine.
The purpose of this study was to investigate the prognostic significance of tumor-infiltrating immune cells and microenvironment-relevant genes in nasopharyngeal carcinoma (NPC) and their ...correlations.
The “xCell” algorithm was used to calculate the enrichment scores for 33 immune cells in the samples of GSE12452, GSE40290, GSE53819, GSE68799, and GSE102349. The difference of immune cells between NPC group and non-cancerous group and the prognostic value of the immune cells were analyzed. Besides, based on the Microenvironment scores, the differentially expressed genes (DEGs) between the high- and low-score groups were screened to identify the microenvironment-relevant hub genes. Furthermore, the DEGs were used to establish a risk score model for predicting progression-free survival (PFS) via LASSO penalized Cox regression.
The scores of B-cells and Memory B-cells of NPC were significantly lower than those of non-cancerous tissues, and they were positively associated with PFS. Moreover, 10 hub genes (PTPRC, CD19, CD79B, BTK, CD79A, SELL, MS4A1, CD38, CD52, and CD22) were identified and positively correlated with B-cells, Memory B-cells, and Microenvironment scores in GSE12452, GSE68799, and GSE102349. High expression levels of CD22, CD38, CD79B, MS4A1, SELL, and PTPRC were associated with longer PFS. Besides, a risk score model composed of DARC, IL33, IGHG1, and SLC6A8 was established with a good performance for PFS prediction.
These results enhance our understanding of the composition and prognostic significance of tumor-infiltrating immune cells in NPC lesions, and provide potential targets for prognostication and immunotherapy for NPC patients.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
OBJECTIVETo investigate the application value of ropivacaine combined with sufentanil for epidural labor analgesia in painless labor. METHODSA total of 157 cases of pregnant female received painless ...labor in our hospital from January 2019 to December 2020 were randomly divided into observation group (n=81 cases) and control group (n=76 cases). The subjects in the observation group received 0.1% ropivacaine combined with sufentanil (0.25 μg/ml) 10 ml and added into the painless delivery pump, and the control group received 0.1% ropivacaine 10 ml into the painless delivery pump. The analgesic effect, lactation function, delivery outcomes and the labor course of the two groups were compared. RESULTSIn the active stage of labor, the time of first labor process was shorter compared with the control group, those in the observation group were more active than the control group (P<0.05). The lactation initiation time of the observation group was shorter than that of the control group, and the effective rate of lactation was higher than that of the control group (P<0.05). The Visual analogue scale (VAS) score at 5 min, 30 min, 60 min, and 90 min after analgesia were improved in the observation group, the analgesic effect of ropivacaine combined with sufentanil for epidural labor analgesia was prior to ropivacaine alone. There were significant differences in the rates of conversion to cesarean section and usage rate of forceps between the two groups (P<0.05), while there had no significant differences in lateral episiotomy rate and Apgar scores at 1 and 5 min after birth between the two groups (P>0.05). CONCLUSIONRopivacaine combined with sufentanil for epidural labor analgesia in painless labor can effectively relieve labor pain, improve lactation function, active the first stage of labor, shorten the time of labor, reduce the incidence of cesarean section and ensure the safety of mother and infant.
•General anesthetic acts on auditory brainstem.•General anesthetic does not alter L80 and ΔL but increases L50 and ΔI.•L80 and ΔL can evaluate the function of auditory brainstem and its inferior ...structures under general anesthesia.•L50 and ΔI exponentially reflect the blood concentration of a general anesthetic.
Confirming the effect of general anesthetic on brainstem auditory evoked potential (BAEP) is important to interpret BAEP data, elucidate the neuroanatomical sites of action of general anesthetic and monitor the effect of general anesthetic. However, the effect of general anesthetic on BAEP is not thoroughly understood, which may be due to unreasonable acoustic stimulation scheme. This study aimed to redesign acoustic stimulation scheme and attempted to test our hypothesis that general anesthetic induces differential changes in BAEP latency in mouse. Auditory evoked potential in the central nucleus of inferior colliculus (AEP-ICC) was used to represent BAEP. Every 10 min after pentobarbital anesthesia, AEP-ICC was recorded by delivering tones with a rate of 1/s, and pentobarbital blood concentration (PBC) was measured, until the mice awoke. AEP-ICC latency to 80-dB SPL sounds (L80) and latency change in nerve fibers (ΔL) did not present regular changes, and AEP-ICC latency to 50-dB SPL sounds (L50) and latency change in synapses (ΔI) gradually decreased as pentobarbital was metabolized. L50 and ΔI changes were exponentially associated with decreased PBC, and L50 showed a linear relationship with ΔI. We conclude that, general anesthetic acts on auditory brainstem; general anesthetic does not alter L80 and ΔL but increases L50 and ΔI; L80 and ΔL can evaluate the function of auditory brainstem and its inferior structures under general anesthesia; L50 and ΔI exponentially reflect the blood concentration of a general anesthetic.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Increasing evidence indicated that aberrant expression of long noncoding RNAs (lncRNAs) are involved in tumorigenesis of nasopharyngeal carcinoma (NPC). The purpose of this study was to construct a ...lncRNA-mediated ceRNA network based on weighted correlation network analysis (WGCNA). First, modules with highly correlated genes were identified from GSE102349 via WGCNA, and the preservation of the modules was evaluated by GSE68799. Then, the differentially expressed lncRNAs and mRNAs identified from GSE12452 which belonged to the same WGCNA modules and the differentially expressed miRNAs identified from GSE32960 were used to construct a ceRNA network. The prognostic value of the network was evaluated by survival analysis. Furthermore, a risk score model for predicting progression-free survival (PFS) of NPC patients was established via LASSO-penalized Cox regression, and the differences in the expression of the lncRNAs between high- and low-risk groups were investigated. Finally, 14 stable modules were identified, and a ceRNA network composed of 11 lncRNAs, 15 miRNAs, and 40 mRNAs was established. The lncRNAs and mRNAs in the network belonged to the turquoise and salmon modules. Survival analysis indicated that ZNF667-AS1, LDHA, LMNB2, TPI1, UNG, and hsa-miR-142-3p were significantly correlated with the prognosis of NPC. Gene set enrichment analysis indicated that the upregulation of ZNF667-AS1 was associated with some immune-related pathways. Besides, a risk score model consisting of 12 genes was constructed and showed a good performance in predicting PFS for NPC patients. Among the 11 lncRNAs in the ceRNA network, SNHG16, SNHG17, and THAP9-AS1 were upregulated in the high-risk group of NPC, while ZNF667-AS1 was downregulated in the high-risk group of NPC. These results will promote our understanding of the crosstalk among lncRNAs, miRNAs, and mRNAs in the tumorigenesis and progression of NPC.
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DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
•Highly expressed Hsp90 participates cell proliferation in colorectal cancer.•Hsp90 inhibitor induces cell death through activation of TNFR superfamily.•Regulatory network of circRNA–miRNA–mRNA in ...Hsp90 inhibitor induced cell death.
Colorectal cancer (CRC) is a global disease with high incidence and mortality rate. Hsp90 inhibitors induce cell death in various cancers, including CRC. However, the underlying mechanisms need to be clarified further. In this study, Caco-2 cells were treated with 0.25 μM SNX-2112, an Hsp90 inhibitor, for 48 h; subsequently, whole-transcriptome sequencing was performed. At the mRNA level in SNX-2112-treated Caco-2 cells, 1588 genes were upregulated, and 433 genes were downregulated. Six genes were found to be associated with necroptosis and apoptosis, and these 6 upregulated genes were validated by RT-qPCR. Hundred and six miRNAs were upregulated, and 48 miRNAs were downregulated in SNX-2112-treated Caco-2 cells. Eleven downregulated miRNAs were found to interact with the 6 upregulated genes. Moreover, 676 circRNAs were upregulated, and 291 circRNAs were downregulated in SNX-2112-treated Caco-2 cells. Among them, 126 circRNAs were found to be the target of the 11 downregulated miRNAs. The circRNA-miRNA-mRNA regulatory network of Hsp90 inhibitor-induced cell death in colorectal cancer was constructed. This regulatory network extends the underlying mechanism of Hsp90 and improves our understanding of Hsp90 inhibitors as potential targeted therapeutic agents.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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