ObjectiveTo review the regulatory effect of microRNA (miRNA) in wound heal ing, which abnormal expression associates with diabetes. MethodsThe literature on miRNA associating with wound heal ing was reviewed and summarized. ResultsmiRNA plays a key role in wound heal ing, including regulating inflammation, angiogenesis, granulation tissue formation, and re-epithel ization. ConclusionAbnormal expression of miRNA may be related to delayed healing of the diabetic wound, but further research is needed to confirm it.
Objective To evaluate the effect of remote ischemic perconditioning on inflammation and oxidative stress in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB). Methods Sixty adult patients undergowent cardiac valve replacement under CPB. There were 29 males and 31 females with an age ranging from 40–60 years and weight from 45–70 kg. They were randomly divided into 2 groups (n=30 in each) by random number generator: a control group (group C, 14 males and 16 females) and a remote ischemic perconditioning group (group R, 15 males and 15 females). Anesthesia was induced with intravenous injection of midazolam, fentanyl, vecuronium. The patients were mechanically ventilated after endotracheal intubation. Anesthesia was maintained with intravenous injection of midazolam, fentanyl, vecuronium and inhalation of sevoflurane. Three cycles of 5-min ischemia and 5-min reperfusion were performed on the right lower extremity immediately after aortic occlusion by means of a tourniquet in group R. A tourniquet was only placed under the right lower extremity in group C. Before CPB and at 0, 1, 6 and 24 h after termination of CPB (T0-4), blood samples were obtained from the right internal jugular vein for determination of levels of serum IL-6, IL-10, SOD and MDA and the count of white blood cell and the percentage of monocytes. The bladder temperature was measured at T0-4 and SIRS score was evaluated on preoperative 1 d and postperative 1, 2 and 3 d. Tracheal extubation time and length of ICU stay were record. Results Compared with group C, the concentration of serum IL-6 at T1-3, the concentration of MDA at T1, the count of leukocyte T3, the bladder temperature at T4 and the SIRS scores on postperative 1 d were significantly decreased, while the concentration of serum IL-10 at T2-T3, the SOD activity at T1-T2, and the percentage of monocyte at T3-T4 were significantly increased in group R (P<0.05). Tracheal extubation time and length of ICU stay in group R were significantly shorter than those of group C (P<0.05). Conclusion Remote ischemic perconditioning can reduce inflammation and oxidative stress and improve post-operative recovery in patients undergoing cardiac valve replacement with CPB.
ObjectiveTo study the effects of the new small molecular oxygen free radical scavenger Tempol on the survival and vasculogenesis of the long random pattern skin flap (LRPSF) and its mechanism. MethodsEighty-four male Sprague Dawley rats were randomly divided into control and Tempol groups (42 rats in each group). LRPSF of 9 cm×3 cm in size were prepared on the backs of rats in two groups based on the Mcfarlane flap. Rats were administered with Tempol (100 mg/kg) in the Tempol group and with normal saline in the control group by intraperitoneal injection at 15 minutes before operation and at 1-7 day after operation. The rat and the skin flap survival conditions were observed after operation; the survival rate of skin flap was measured, and the vascular structure, vascular volume, and total length of blood vessels were analyzed with Micro-CT three-dimensional imaging after 7 days; HE staining was used to observe the structure of the skin flaps and inflammation, immumohistochemical staining to observe vascular endothelial growth factor (VEGF) expression; water-soluble tetrazolium-1 method was used to measure the content of superoxide dismutase (SOD) and malondialdehyde (MDA), and ELISA to detect the expressions of tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) after 1, 3, and 7 days. ResultsAll of rats survived after operation, without hemorrhage, edema, and infection. With the extension of time, necrosis occurred in the distal part of the skin flaps in 2 groups, but the necrosis degree of the Tempol group was lower than that of control group; meanwhile, the blood vessel distribution and continuity were better than those of control group. The skin flaps survival rate, vascular volume, and total length of blood vessels of Tempol group were significantly higher than those of control group after 7 days (P<0.05). The clearer skin flaps structure, lighter inflammation reaction and inflammation cell infiltration, and higher VEGF staining intensity were observed in the Tempol group than the control group after 7 days. There was no significant difference in SOD, MDA, and TNF-α, and IL-6 contents between the 2 groups at immediate after operation. SOD significantly increased, but MDA, TNF-α, and IL-6 contents significantly decreased in the Tempol group when compared with control group after 1, 3, and 7 days (P<0.05). ConclusionTempol can significantly promote the LRPSF survival rates, its mechanism is closely related to the promotion of vasculogenesis and reduction of oxidative stress and inflammation.
ObjectiveTo investigate the effect of saikosaponin a (SSa) on the levels of immune inflammation in rats with acute spinal cord injury and its possible mechanism.MethodsSeventy-two Sprague Dawley rats (weighing, 220-250 g) were randomly divided into sham operation group (group A), spinal cord injury group (group B), and SSa treatment group (group C) respectively, 24 rats in each group. The spinal cord injury model was induced by using the Allen’s method in groups B and C; the spinous process and vertebral plate at both sides were cut off by lamina excision to expose the spinal cord in group A. The rats were given intraperitoneal injection of 10 mg/kg SSa in group C and equal volume of normal saline in group B at immediate after injury. The spinal cord tissue was harvested from 18 rats of each group at 24 hours after operation to measure the levels of tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) by ELISA, to detect the expressions of nuclear factor κB (NF-κB) P65, NF-κB P-P65, and aquaporin 4 (AQP4) by Western blot and to observe the morphology of spinal cord by HE staining. The motor function of the lower limbs was evaluated by BBB score and tiltboard experiment in 6 rats at 1, 3, 7, 14, 21, and 28 days after injury.ResultsThe BBB score and tiltboard experiment maximum angle were significantly higher in group A than groups B and C at each time point (P<0.05) and in group C than group B at 14, 21, and 28 days after operation (P<0.05). ELISA test showed that the concentrations of TNF-α and IL-6 were significantly lower in group A than groups B and C, and in group C than group B (P<0.05). Western blot results showed that the protein expression levels of NF-κB P65, NF-κB P-P65, and AQP4 were significantly lower in group A than groups B and C, and in group C than group B (P<0.05). HE staining demonstrated normal neurons of the spinal cord and no obvious lesion in group A; neuronal cells were observed in the injured area of group B, with hemorrhage, neutrophil infiltration, and nerve cell edema in the injured area; the neuronal cells were visible in the spinal cord of group C, with microglia mild hyperplasia, and the pathological changes were improved when compared with group B.ConclusionSSa has neuroprotective effects on acute spinal cord injury in rats by inhibiting NF-κB signaling pathway and AQP4 protein expression and reducing inflammation response and edema.
Objective To investigate effects of fast track surgery (FTS) combined with laparoscopy on perioperative inflammatory mediators, immune indices, and clinical short-term recovery effect in patient with colorectal cancer. Methods A prospective randomized controlled trial was conducted. The patients underwent laparoscopic colorectal cancer surgery at the Department of Gastrointestinal Surgery, The Third People’s Hospital of Chengdu from July 2014 to March 2017 were included in this study. The patients were randomly divided into FTS group and traditional group by the random digital table. The FTS mode and the traditional method were adopted during the perioperative period in the FTS group and the traditional group respectively. The inflammatory mediators such asC reactive protein (CRP) and interleukin 6 (IL-6) and cellular immune indexes such as CD4, CD8 and CD4/CD8 on the preoperative 1 d, postoperative 1 d, 3 d and 7 d, as well as the index of clinical short-term rehabilitation were compared between these 2 groups. Results ① Eighty-four patients were included in this study, there were 43 patients in the FTS group and 41 patients in the traditional group. There were no significant differences in the baseline characteristics and the surgical-related indicators between the two groups (P>0.050). ② There were no significant difference in the levels of CRP and IL-6 between the two groups at different time points (P>0.050). The change trend of CRP and IL-6 levels in FTS group and traditional group before and after operation were the same, the CRP and IL-6 levels at the first day after operation were significantly higher than those on 1 d before operation (P<0.001), but on the 7th day after operation decreased significantly. ③ There were no significant difference of CD4, CD 8 and CD4/CD8 levels between the two groups at different time points (P>0.050). The CD4 decreased significantly in 2 groups at the first day after operation (P<0.050), it began to rise on the 3rd day after operation and was close to the preoperative level on the 7th day after operation, but the increase in the traditional group was smaller. The changes of CD8 level at different time points before and after operation were not significant in two groups (P>0.050). The changes of CD4/CD8 ratio at different time points before and after operation were not significant in two groups (P>0.050), only the first day after operation of FTS group was significantly lower than that in preoperative 1 d (P<0.001), and on the third day after operation, it increased significantly and was close to the level of 1 day before operation. ④ The time of the first postoperative anal exhaustion or defecation in the FTS group was significantly shorter than that in the traditional group (P<0.001). The overall incidence of postoperative complications and the incidence of hypoproteinemia in the FTS group were significantly lower than those in the traditional group (P<0.050). Conclusion Compared with traditional perioperative management in combination with laparoscopic surgery, FTS combined with laparoscopic surgery has no effects on postoperative inflammatory mediators and immune parameters in patient with colorectal cancer, and it could reduce complications, reduce traumatic stress, and accelerate postoperative recovery for patient with colorectal cancer.
Objective Polylactic acid (PLA) patch has proper steric configuration, sufficient mechanic strength, and flexibil ity, to investigate the blocking effect on the intra-discal inflammation after annulus puncture sticked by medical glue so as to seal the pinhole left after annulus puncture. Methods Twenty healthy New Zealand white rabbits (weighing 2.0-2.5 kg) were randomly divided into 4 groups (n=5): groups A, B, C, and D. In group A, the rabbits underwent exposure of intervertebral disc and transverse process at L2-7 as a control; in group B, the rabbits received annulus puncture at L2-7 with an 18-gauge needle; and in groups C and D, the pinholes were sealed respectively with a PLA patch sticked with medical gel and medical gel alone after annulus puncture at L2-7. General condition of rabbits was observed after operation. The intervertebral disc tissue was harvested 1 week after operation. The tissue structure was observed by HE and Masson staining. And the expressions of inflammatory factors l ike interleukin 1β (IL-1β), tumor necrosis factor α (TNF-α), and inducible nitric oxide synthase (iNOs) were detected with immunohistochemistry and ELISA. Results All the animals survived till the end of the experiment. In group A at 1 week, the nucleus pulposus tissue had normal structure. In group B at 1 week, leak of nucleus pulposus from the pinhole and sl ight adhesion to the adjacent tissue could be seen, and the nucleus pulposus tissue had significant degenerative change by histological observation. In groups C and D, clots of coagulated medical gel and extensive adhesion to the adjacent tissue could be seen; histological observation suggested that the nucleus pulposus tissue of group C had similar histology manifestation to that of group A; while group D had similar histology manifestation to group B with obviously-decreased cells and disorder of matrix. ELISA test showed remarkably elevated expression level of inflammatory factors including IL-1β, TNF-α, and iNOs in groups B and D when compared with groups A and C, showing significant differences (P lt; 0.05), and similar expression level were observed in groups A and C, groups B and D (P gt; 0.05). Conclusion The PLA patch sticked with medical gel is effective in blocking the intra-discal inflammation 1 week after annulus puncture.
ObjectiveTo investigate the protective effect of mangiferin on acute spinal cord injury (SCI) in rats and its mechanism. MethodsNinety Sprague Dawley rats were randomly divided into 5 groups, 18 rats in each group. SCI was induced by using the Allen's method (60 g/cm) at T9 level in the rats of groups B, C, D, and E; laminectomy was performed at T8-10 in group A. The rats were injected intraperitoneally with saline in groups A and B, and with mangiferin in groups C (10 mg/kg), D (25 mg/kg), and E (50 mg/kg) every day for 30 days. The survival condition of rats was observed after operation; at 24, 48, and 72 hours after operation, the motor function of the hind limb was evaluated by the Basso, Beattie, Bresnahan (BBB) scores. The spinal cord edema was assessed by measuring the water content in spinal cord tissues at 72 hours. Meanwhile, malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GSH) were detected by ELISA; nuclear factor κB (NF-κB), tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β), and IL-6 were measured via ELISA at the same time. Caspase-3 and Caspase-9 were also detected by ELISA after mangiferin treatment for 30 days. The expressions of Bax and Bcl-2 proteins were detected by Western blot. Pathological changes of the spinal cord was observed by HE staining. And Caspase-3 protein expression was detected by immunohistochemical staining. ResultsAll rats survived to the end of experiment. BBB scores of groups B, C, D, and E were significantly less than that of group A (P < 0.05), and it showed an increase trend from groups B to E (P < 0.05). The content of water of groups B, C, D, and E were significantly greater than that of group A (P < 0.05), and it showed a decrease trend from groups B to E (P < 0.05). ELISA showed that the activities of MDA, NF-κB, TNF-α, IL-1β, IL-6, Caspase-3, and Caspase-9 in groups B, C, D, and E were significantly greater than that in group A (P < 0.05), and they showed decrease trends from groups B to E (P < 0.05). Meanwhile, the activities of CAT, SOD, and GSH in groups B, C, D, and E were significantly less than that in group A (P < 0.05), and they showed increase trends from groups B to E (P < 0.05). Western blot showed that the relative expression of Bax protein in groups B, C, D, and E were significantly greater than that in group A (P < 0.05), and it showed a decrease trend from groups B to E (P < 0.05). Meanwhile, the relative expression of Bcl-2 protein in groups B, C, D, and E were significantly less than that in group A (P < 0.05), and it showed an increase trend from groups B to E (P < 0.05). Histological observation showed that the pathological changes in group B were accord with that in SCI, and the degree of necrosis in groups C, D, and E were significantly improved when compared with that in group B, and the effect was better in group E than group D, and group D than group C. Immunohistochemical staining showed that the absorbance (A) value of Caspase-3 in groups B, C, D, and E were significantly greater than that in group A (P < 0.05), and it showed a decrease trend from groups B to E (P < 0.05). ConclusionMangiferin has neuroprotective effects on acute SCI in rats by alleviating edema of spinal cord, inhibiting oxidative stress and inflammation response, and regulating the Bcl-2 and Bax pathway.
Objective To study the inflammation response and the biocompatibil ity of valved bovine jugular vein conduit (BJVC) and valved bovine jugular vein patch (VBJV-P) in treating complex congenital heart disease (CHD). Methods From December 2007 to March 2008, 16 patients with complex CHD were treated. Of 16 patients, 6 underwent conjunction right ventricular to pulmonary artery with BJVC and broaden right ventricular outflow tract (RVOT) with VBJV-P (BJVC group), and 10 underwent broaden RVOT with self pericardial patch (control group). In BJVC group, there were 3 males and 3 females, aging (5.6 ± 3.6) years, and including 1 case of type I truncus arteriosus, 1 case of type I truncus arteriosus with ventricular septal defect and patent foramen ovale, 1 case of congenital pulmonary atresia with ventricular septal defect and patent arterial duct, and 3 cases of Fallot’s tetrad. In control group, there were 5 males and 5 females, aging(4.3 ± 3.1) years, all being Fallot’s tetrad. The periphery vein blood of the two groups was collected during operation and after operation, and the levels of cytokine were detected with ELISA method. Meanwhile the cl inical data of the two groups were collected. Results There were no significant differences at levels of TNF-α and IL-6 between BJVC group and control group 1 week after operation (P gt; 0.05), and there was significant difference at level of IL-10 [(25.7 ± 5.0) pg/mL vs (19.5 ± 4.7) pg/ mL, P lt; 0.05]. There were no significant differences at levels of IL-6 and IL-10 within groups both in control group and in BJVC group (P gt; 0.05) between 1 week after operation and the anesthesia inducing period. And there was significant difference at level of TNF-α in BJVC group [(77.0 ± 1.6) pg/mL vs (82.9 ± 1.3) pg/mL, P lt; 0.05] and in control group [(78.6 ± 3.4) pg/mL vs (83.1 ± 1.9) pg/mL, P lt; 0.05] between 1 week after operation and the anesthesia inducing period. There were no statistically significant differences (P gt; 0.05) in leukocyte count and body temperature between BJVC group and control group. The X-ray films showed no abnormal ity in BJVC group and control group before operation and after operation. No hepatic and renal dysfunction occurred in control group; and 2 patients had hepatic dysfunction, which may be caused by antibiotics. Conclusion BJVC has a good biocompatibil ity in treating complexty CHD.