ObjectiveTo systematically review the influence of dexmedetomidine on early postoperative cognitive dysfunction (POCD) and serum inflammatory factors in elderly patients.MethodsWe searched PubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases from inception to April 2017, to collect randomized controlled trials (RCTs) about dexmedetomidine for early POCD in elderly patients. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed by RevMan 5.3 software.ResultsA total of 23 RCTs, including 2 026 patients were enrolled. The results of meta-analysis showed that, the incidence of POCD in the dexmedetomidine group was lower than that in the control group (the first day: RR=0.40, 95%CI 0.30 to 0.53, P<0.000 01; the third day: RR=0.33, 95%CI 0.23 to 0.48,P<0.000 01; the seventh day: RR=0.42, 95%CI 0.22 to 0.78,P=0.006). Meanwhile, compared with the control group, the dexmedetomidine group significantly decreased the serum levels of TNF-α (immediately after operation: MD=–5.43, 95%CI –7.44 to –3.42, P<0.000 01; 1 h after operation: MD=–4.64, 95%CI –6.92 to –2.36,P<0.000 1; 24 h after operation: MD=–3.27, 95%CI –4.92 to –1.63,P<0.000 1) and IL-6 (immediately after operation: MD=–30.69, 95%CI –41.39 to –20.00,P<0.000 01; 1h after operation: MD=–20.84, 95%CI –28.87 to –12.80,P<0.000 01; 24 h after operation: MD=–13.42, 95%CI –19.90 to –6.94,P<0.000 1).ConclusionCurrent evidence indicates that dexmedetomidine could relief early POCD in elderly patients, in which the reduction of serum inflammatory factors alleviate inflammation response may play a vital role. Due to the limited quality and quantity of included studies, more high quality RCTs are required to verify the above conclusion.
Objective To explore the role of macrophage-stimulating protein ( MSP) and receptor tyrosine kinase RON in the airway inflammation of chronic obstructive pulmonary disease( COPD) , and investigate its possible mechanism. Methods The rat COPDmodel was established by exposing the rats to cigarette smoke daily for three months. Rat alveolar macrophages ( AMs) were isolated in vivo and cultured,and then challenged with different concentrations of MSP for 24 hours. The concentrations of MSP in broncho-alveolar lavage fluid ( BALF) and serum, and the levels of IL-1β, TNF-α, IL-8, and IL-10 in the supernatants were measured by ELISA. The expression of RONmRNA in lung tissue was assessed by reverse transcription-polymerase chain reaction. The levels of RON protein in the lung tissue and AMs cultured in vitro were observed by immunohistochemistry. The activity of superoxide dismutase ( SOD) and malondialdehyde ( MDA) content in the culture solution were measured with chromatometry method. Results Compared with the control group, the concentrations of MSP in serum and BALF of the COPD rats were significantly higher ( P lt;0. 01) . The levels of RONmRNA and RON protein in the COPD rats were also upregulated significantly ( P lt; 0. 01) . MSP evoked the AMs isolated from the normal and COPD rats to generate more content of MDA and caused a reduction in activity of SOD. In addition, MSP stimulated TNF-α, IL-8, IL-1βand IL-10 release fromAMs of the normal and COPD rats dose-dependently. The levels of TNF-α, IL-8, and IL-1βwere higher, while the level of IL-10 and the SOD activity were lower in AMs of the COPD group than those of the control group in the same dose of MSP ( P lt;0. 01) . The more significant increase in the levels of TNF-α, IL-8, IL-1β, and the more notable decrease in the activity of SOD was found in the COPD group compared with the control group. But the degree of increasing MDA and IL-10 in the AMs of the COPD group was lower than that in the control group. Linear correlation analysis showed that the MSP concentration and the RON protein level in the COPD rats were positively associated with the total cellcounts and AM counts in BALF, and were related to the indexes for pulmonary emphysema. Conclusions There is a close correlation between the MSP and receptor tyrosine kinase RON with the airway inflammation of COPD. The mechanism might be that MSP promote the macrophages release inflammatory factors and increase the production of oxygen free radicals.
ObjectiveTo evaluate the clinical effects of segmentectomy versus lobectomy under single utility port video-assisted thoracic surgery on inflammatory factors and immune cells in peripheral blood of non-small cell lung cancer patients, and to analyze the effect of changes of postoperative inflammatory factors and immune cells on the prognosis of the patients.MethodsThe clinical data of 256 patients who underwent segmentectomy or lobectomy under single utility port video-assisted thoracic surgery for non-small cell lung cancer in the First Affiliated Hospital of Hebei North University from January 2016 to October 2020 were retrospectively collected. According to the operation method, they were divided into a segmentectomy group (126 patients with 79 males and 47 females at an age of 63.4±6.2 years) and a lobectomy group (130 patients with 91 males and 39 females at an age of 62.9±5.6 years). The change of inflammatory factors (C reactive protein, interleukin-6, interleukin-8, tumor necrosis factor-α) and immune cells (CD4+T cells, CD8+T cells and natural killer cells) were recorded and analyzed before operation (T0) and 1 day (T1), 3 days (T2), 7 days (T3), 1 month (T4) after the operation between the two groups. According to postoperative recurrence situations, they were divided into a recurrence group and a non-recurrence group, multivariate logistic regression analysis was used to analyze the relationship between the change of postoperative inflammatory factors, immune cells, and the prognosis of patients with non-small cell lung cancer.Results(1) There was no statistical difference in sex ratio, underlying diseases, body mass index, levels of preoperative inflammatory factors or immune cells between the two groups (all P>0.05). (2) The changes of postoperative inflammatory factors in the segmentectomy group were significantly less than those in the lobectomy group at T1-T3 (all P<0.05), and the changes of postoperative immune cells in the segmentectomy group were significantly less than those in the lobectomy group at T1-T4 (all P<0.05). (3) The changes of postoperative inflammatory factors and immune cells on postoperative day 3 in the recurrence group were significantly more than those in the non-recurrence group (all P<0.05). (4) Multivariate logistic regression analysis showed that the changes of postoperative inflammatory factors and immune cells on postoperative day 3 may be the risk factors for postoperative recurrence and metastasis in patients with non-small cell lung cancer (all P<0.05).ConclusionSingle utility port video-assisted thoracic surgery segmentectomy for the treatment of non-small cell lung cancer can reduce the inflammatory response and protect body's immune function, and the change of postoperative inflammatory factors and immune cells in postoperative day 3 may be the risk factors for postoperative recurrence and metastasis in patients with non-small cell lung cancer.
ObjectiveTo investigate the changes of interleukin-8 (IL-8), tumor necrosis factor-α(TNF-α) and phospholipase A2 (PLA2) in serum, bronchoalveolar lavage fluid (BALF) and lung tissue of COPD rats and the effects of tiotropium.To identify the anti-inflammatory function of tiotropium. MethodsRat COPD model was established by passive smoking as well as intratracheal instillation of lipopolysaccharide(LPS).Thirty male SD rats were randomly divided into a control group, a COPD group and a tiotropium bromide treatment group (n=10 in each group).The pathologic changes of the lung tissue and airway were observed by HE staining.The total and differential cell counts in BALF were observed.The levels of IL-8, TNF-α, PLA2 in serum, BALF and lung tissue were measured by enzyme-linked immunosorbent assay. ResultsHE staining revealed that the rat COPD model was successfully established.The COPD group appeared obvious emphysema, while the treatment group appeared mild emphysema.The total inflammatory cells, the proportion of neutrophils and lymphocyte, and the levels of IL-8, TNF-α, PLA2 in serum, BALF and lung tissue in the COPD group were obviously higher than those in the control group (P < 0.01).The total inflammatory cells, the proportion of neutrophils and lymphocyte, and the levels of IL-8, TNF-α, PLA2 in serum, BALF and lung tissue in the treatment group were significantly lower than those in the COPD group but higher than those in the control group (P < 0.01). ConclusionsTiotropium bromide can reduce the levels of IL-8, TNF-α, PLA2 in serum, BALF and lung tissue of COPD rats by reducing the leakage of inflammatory cells, and alleviate the airway inflammation and the degree of emphysema.
ObjectiveTo observe the relationship between the serum level changes of high-sensitivity C-reactive protein (hsCRP), interleukin (IL)-18, intercellular adhesion molecule-1(ICAM1), matrix metalloproteinase (MMP)-9 and lipoprotein-associated phospholipase A2(Lp-PLA2), and the multiple factors of acute cerebral infarction (ACI). MethodsWe chose 76 patients with ACI treated between July 2012 and June 2014 as our study subjects.On the second day (acute phase) and the 15th day (recovery phase) after onset, we checked the patients for their serum levels of hsCRP, IL-18, ICAM1, MMP-9 and Lp-PLA2.Then, multiple linear regression analysis was performed to observe the correlation of the serum level change degree of inflammatory factors with hypertension, diabetes, coronary heart disease, smoking history, carotid atherosclerotic plaque, lipid levels, infarct size and National Institute of Health Stroke Scale (NIHSS) score. ResultsThe changes of all the inflammatory factors in the acute phase and the recovery phase of cerebral infarction were not significantly related to smoking history, hypertension, coronary heart disease, low-density lipoprotein and NIHSS scores (P > 0.05).The changes of hsCRP and ICAM1 had significant correlation with cerebral infarct size, diabetes mellitus and carotid atherosclerotic plaque (P < 0.05), and the change level of Lp-PLA2 was related to diabetes mellitus, and carotid atherosclerotic plaque (P < 0.05).MMP-9 serum level change had correlation with only cerebral infarct size (P < 0.05). ConclusionsSerum level changes of inflammatory factors are related to various factors of cerebral infarction.The main factors that affecting the serum level changes are cerebral infarction area, diabetes mellitus and carotid atherosclerosis.
This study aims to investigate the protective effect of resveratrol against liver injury in hindlimb unloading rats. Thirty 2-month-old male SD rats were randomly divided into normal group (Control), hindlimb unloading model group (Model), and hindlimb unloading+resveratrol administration group (Model+Res). The Model + Res group was injected intraperitoneally with 30 mg/kg of resveratrol, and the Control and Model groups were injected intraperitoneally with an equal volume of 0.9% NaCl. Liver tissues were collected after 28 days and analyzed for oxidative stress, inflammatory factors, energy metabolism indices, Na+-K+-ATPase and Ca2+-Mg2+-ATPase activity, and morphological changes were observed by hematoxylin-eosin staining. The protein expression levels of Bax, Bcl-2, p-PI3K, PI3K, p-AKT, and AKT were detected by Western blotting. Compared with the Control group, hepatocytes in the Model group showed swelling, abnormal morphology, nuclear consolidation, and cell membrane disruption. Oxidative stress, inflammatory factor levels, hepatic glycogen accumulation, and energy metabolism were increased in the liver tissues of the Model group, while resveratrol treatment significantly reversed these changes. The results of Western blotting showed that resveratrol significantly reduced the expression of Bax and increased the expression levels of Bcl-2, and the proteins of p-PI3K/PI3K and p-AKT/AKT expression levels. It is suggested that 28 days of hindlimb unloading treatment could lead to liver tissue injury in rats, which is manifested as oxidative stress, inflammatory response, energy metabolism disorder and increased apoptosis level, and resveratrol has a certain mitigating effect on this.
ObjectiveTo summarize the clinical usage of modified ultrafiltration in pediatric cardiopulmonary bypass. MethodsWe selected 40 infants with congenital heart defects as our study subjects between January 2010 and February 2012. They were randomly divided into two groups. One group used modified ultrafiltration, while the other did not, during the operation with cardiopulmonary bypass. The different perioperative changes of pulmonary pressure and the tumor necrosis factor (TNF) and interleukin-8 (IL-8) concentration in plasma were observed in both the two groups. ResultsNo complication relative to modified ultrafiltration was found. After the operations began, TNF and IL-8 concentration in the two groups rose fast; at the end of operations and 2 hours after operation, the pulmonary pressure and TNF and IL-8 concentration in the two groups decreased, and the decrease in the modified ultrafiltration group was faster. ConclusionThe use of modified ultrafiltration during operations with cardiopulmonary bypass can reduce residual water within the body in a short period and decrease the concentration of inflammatory factors, which is helpful for postoperative recovery of the cardiac and lung functions.
Obstructive sleep apnea hypopnea syndrome (OSAHS) is a disease in which apnea and hypopnea occur during sleep, and the main symptoms are sleep snoring. OSAHS is not only closely related to the occurrence of various eye diseases, but also the severity of OSAHS can affect the progression of related eye diseases. At present, continuous positive airway pressure (CPAP) is an effective means to treat OSAHS, and the progression of related eye diseases has been improved correspondingly after CPAP treatment. In the future, it is necessary to further study the pathogenesis of OSAHS and enrich the research evidence of the association between OSAHS and eye diseases, so as to provide more comprehensive theoretical evidence for the prevention and treatment of OSAHS-related eye diseases.
ObjectiveTo explore the effects of simvastatin on the expression of matrix metalloproteinase (MMP) and inflammatory factors in rats with smoke-induced chronic obstructive pulmonary disease (COPD). Methods40 male Wistar rats were randomly divided into four groups, including a normal group (group A), a simvastatin group (group B), a COPD model group (group C) and a simvastatin intervention group (group D). The COPD model of the group C and D were induced through exposing to the cigarette smoke repeatedly. At the same time, the rats of group B and D were given by gavage 5 mg/(kg·d) with simvastatin, and the other two groups were given with the same volume saline for 16 weeks. Pulmonary function tests and pathological examination of the lung tissue were performed after the induction of COPD model. Enzyme-linked immunosorbent assay (ELISA) method was used to measure the content of MMP-2, MMP-9, IL-6, IL-8, TNF-α in lung tissue homogenate. ResultsThe airway resistance of group C and group D was significantly higher than the group A and group B (P<0.01), and the airway resistance of group D was significantly lower than group C (P<0.01). The degree of bronchial inflammation and emphysema of group C was more apparent than group D in the pathological section, and there were no bronchial inflammation and emphysema in group A and group B. The ELISA results showed that the contents of MMP-2, MMP-9, IL-6, IL-8, TNF-α in group C were all significantly higher than those in group D. ConclusionSimvastatin has inhibitory effect on pulmonary inflammation of COPD, and can reduce the expression of matrix metalloproteinase and inflammatory factors in the lung.
ObjectiveThis study applied Mendelian randomization to explore the potential causal relationship between inflammatory factors and diabetic nephropathy. MethodsSummary-level data from genome-wide association studies of inflammatory factors and diabetic nephropathy were used, and inverse variance weighted analysis was used as the primary analytical method, complemented by results from weighted median, MR-Egger regression, simple model, and median model approaches. Sensitivity analysis was used to test the reliability of the MR analysis results. ResultsIn the inverse variance weighted method, stem cell factor (OR=1.28, 95%CI 1.04 to 1.58, P=0.020) and interferon-γ (OR=1.36, 95%CI 1.10 to 1.70, P=0.005) were positively correlated with diabetic nephropathy, and diabetic nephropathy was positively correlated with interferon-inducible protein 10 (OR=0.90, 95%CI 0.83 to 0.98, P=0.012) were negatively correlated with diabetic nephropathy. Sensitivity analysis showed that MR analysis was reliable. ConclusionStem cell factors and interferon-γ are associated with an increased risk of developing diabetic nephropathy, and diabetic nephropathy decreases the expression of interferon-inducible protein 10 in vivo. Our results demonstrate a potential causal relationship between inflammatory factors and the development of diabetic nephropathy. This finding is of clinical significance for the pre-diagnosis and treatment of diabetic nephropathy.