ETHNOPHARMACOLOGICAL RELEVANCE:Pholidota chinensis Lindl. has been used as a traditional medicinal plant for heat-clearing and detoxifying purposes, as well as for inflammatory and gastrointestinal conditions. However, the bioactive constituents and pharmacological mechanisms underlying the potential effects of P. chinensis in gastrointestinal disorders and colorectal carcinogenesis remain unclear. AIM OF THE STUDY:This study aimed to identify anticancer constituents from the pseudobulbs of P. chinensis and to investigate the pharmacological mechanisms of P. chinensis-derived natural products against colorectal cancer (CRC). MATERIALS AND METHODS:Through bioactivity-directed fractionation, the chromatographic fingerprint of P. chinensis pseudobulbs was analyzed, and phenanthrene-type phytochemicals were isolated and identified. The anticancer potential and pharmacological mechanisms were evaluated using human CRC cells, in silico simulations, and a zebrafish xenograft model. RESULTS:The ethyl acetate (EtOAc) fraction of P. chinensis pseudobulbs exhibited stronger anticancer activity than those of the ethanol and water fractions. A rare dihydrophenanthrene derivative, 1-(4'-hydroxybenzyl)imbricatin (3), was identified from the EtOAc fraction as a potent ferroptosis inducer. Compound 3 showed selective cytotoxicity against human CRC cells while exhibiting lower cytotoxicity toward non-tumor intestinal cells. Compound 3 triggered hallmark features of ferroptosis, including intracellular Fe2+ accumulation, lipid peroxidation, and disruption of the GPx4-related antioxidant defense system. Cellular thermal shift assays and molecular docking further supported the interaction of compound 3 with the catalytic pocket of GPx4. Importantly, compound 3 significantly reduced tumor burden in a zebrafish CRC xenograft model. CONCLUSIONS:These findings highlight the EtOAc fraction of P. chinensis pseudobulbs as a valuable source of anticancer lead compounds and identify 1-(4'-hydroxybenzyl)imbricatin (3) as a promising dihydrophenanthrene scaffold for inducing GPx4-associated ferroptosis in CRC.

Mitochondrial dysfunction and energy imbalance caused by chemotherapy are key contributors to skeletal muscle atrophy, which severely impacts the quality of life in cancer patients. Paclitaxel, a commonly used chemotherapeutic agent, is known to promote muscle wasting and cellular senescence, largely by impairing mitochondrial function. In this study, we investigated the protective role of loganin, a naturally occurring iridoid glycoside, in preventing paclitaxel-induced damage to skeletal muscle cells. Using C2C12 cells, we assessed whether loganin could counteract the harmful effects of paclitaxel. Our results demonstrated that loganin significantly improved cell viability and protected mitochondrial function, as reflected by better preservation of mitochondrial DNA content, membrane potential, and ATP production, while further enhancing mitochondrial biogenesis through upregulation of PGC-1α, TFAM, and NRF1. In parallel, loganin activated metabolic regulators SIRT1 and AMPK, while restoring PDK4 expression, suggesting improved energy regulation. Additionally, glycogen levels and myotube morphology were maintained, alongside sustained myosin heavy chain expression. Loganin effectively reduced both cellular and mitochondrial reactive oxygen species and increased antioxidant defenses, including superoxide dismutase activity and glutathione levels. Notably, it also suppressed paclitaxel-induced senescence and inflammation, as shown by decreased p21 expression, reduced NFκB phosphorylation, and lower levels of Cdkn1a and Il6 as well as reduced SA-β-gal staining. Overall, our findings demonstrate that loganin offers comprehensive protection against paclitaxel-induced skeletal muscle injury by preserving mitochondrial function, supporting metabolic homeostasis, reducing oxidative stress, and limiting senescence. These results highlight the potential of loganin as a preventive adjunctive agent to mitigate chemotherapy-related muscle toxicity.

Background/Objectives: Anterior cervical spine surgery (ACSS) is an effective surgical procedure used to treat degenerative cervical spine disease. Enhanced recovery after surgery (ERAS) is a new and promising paradigm for ACSS. The purpose of this study is to investigate the role of neuromuscular monitoring with sugammadex in the ERAS protocol, which had not been confirmed in ACSS. Methods: In this retrospective study, the electronic medical records of patients aged 20 to 80 years who had undergone first-time ACSS performed in the period from 1 December 2018 to 31 December 2023 were reviewed. Patients were divided into ERAS and non-ERAS groups. Inverse probability of treatment weighting (IPTW) was used to balance differences between the groups. Statistical analyses were conducted using SPSS 20, including independent samples t-tests, chi-square tests, linear regression, and logistic regression. Results: A total of 394 patients were included in this study: 163 in the non-ERAS group and 231 in the ERAS group. In the ERAS group, significant reductions were observed in several key outcomes compared with the non-ERAS group: LOS was reduced by 0.62 days (p < 0.001), hospital costs were lowered by NTD 13,174.40 (p < 0.001), ventilator time was decreased by 149.40 min (p < 0.001), time to first oral intake was shortened by 4.71 h (p < 0.001), and time to first ambulation was reduced by 8.00 h (p < 0.001). No significant differences in complication rates were observed between the two groups. Conclusions: The ACSS-tailored ERAS pathway with NMM and sugammadex can reduce LOS, cost, and speed of patient recovery without increasing complications.

Multimodal analgesia (MMA) combines different analgesic methods, such as non-steroidal inflammatory drugs (NSAIDs), acetaminophen, and regional anesthesia techniques, to optimize pain control while minimizing opioid use. Dinalbuphine sebacate (DS), a long-acting prodrug of nalbuphine, was chosen due to its potential to enhance MMA strategies. The aim of this study is to evaluate the effectiveness of DS in MMA for video-assisted thoracoscopic surgery (VATS). Sixty participants were randomly and equally assigned to either the MMA regimen containing DS (DS group) or placebo (placebo group). After anesthesia induction, all participants received ultrasound-guided thoracic paravertebral block (TPVB), and DS or placebo was injected into the gluteus medius muscle on the operated side. Intravenous patient-controlled analgesia (IVPCA) with fentanyl was provided for breakthrough pain postoperatively. The primary outcome was postoperative fentanyl consumption over three days. Statistical tests included Student’s t-test, chi-square test, and Fisher’s exact test. Finally, 57 participants were assigned to either the DS group (n = 28) or the placebo group (n = 29). The mean fentanyl consumption over three days was significantly lower in the DS group (283 ± 70 µg) compared to the placebo group (708 ± 190 µg, P < 0.001). Pain interference with daily life was significantly lower in the DS group at one week (28.57

Parkinson’s disease (PD) is a common neurodegenerative disorder characterized by the gradual loss of dopaminergic neurons in the substantia nigra pars compacta (SNpc), resulting in reduced dopamine levels in the striatum and eventual onset of motor symptoms. Linalool (3,7-dimethyl-1,6-octadien-3-ol) is a monoterpene in aromatic plants exhibiting antioxidant, antidepressant, and anti-anxiety properties. The objective of this study is to evaluate the neuroprotective impacts of linalool on dopaminergic SH-SY5Y cells, primary mesencephalic and cortical neurons treated with 1-methyl-4-phenylpyridinium ion (MPP+), as well as in PD-like mice induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Cell viability, α-tubulin staining, western blotting, immunohistochemistry and behavioral experiments were performed. In MPP+-treated SH-SY5Y cells, linalool increased cell viability, reduced neurite retraction, enhanced antioxidant defense by downregulation of apoptosis signaling (B-cell lymphoma 2 (Bcl-2), cleaved caspase-3 and poly ADP-ribose polymerase (PARP)) and phagocyte NADPH oxidase (gp91phox), as well as upregulation of neurotrophic signaling (brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF)) and nuclear factor-erythroid 2 related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) pathway. In MPP+-treated primary mesencephalic neurons, linalool enhanced the expressions of tyrosine hydroxylase (TH), Sirtuin 1 (SirT1), and parkin. In MPP+-treated primary cortical neurons, linalool upregulated protein expression of SirT1, γ-Aminobutyric acid type A-α1 (GABAA-α1), and γ-Aminobutyric acid type B (GABAB). In PD-like mice, linalool attenuated the loss of dopamine neurons in SNpc. Linalool improved the motor and nonmotor behavioral deficits and muscle strength of PD-like mice. These findings suggest that linalool potentially protects dopaminergic neurons and improves the impairment symptoms of PD.

BACKGROUND:Methylglyoxal (MGO) is a potent precursor of glycative stress that leads to oxidative stress and muscle atrophy in diabetes. Spatheliachromen (FPATM-20), derived from Ficus pumila var. awkeotsang, exhibited potential antioxidant activity. PURPOSE:This study aimed to evaluate the potential impact and underlying mechanisms of FPATM-20 on MGO-induced myotube atrophy and mitochondrial dysfunction in mouse skeletal C2C12 myotubes. METHODS:Atrophic and antioxidant factors were evaluated using immunofluorescence, enzyme-linked immunosorbent assay, and western blotting. Mitochondrial function was assessed using the ATP assay and Seahorse Cell Mito Stress Test. The glycogen content was determined using periodic acid-Schiff staining. Molecular docking was performed to determine the interaction between FPATM-20 and Keap1. RESULTS:In myotubes treated with MGO, FPATM-20 activated the Nrf2 pathway, reduced ROS levels, enhanced antioxidant defense, and increased glycogen content. FPATM-20 improved myotube viability and size, upregulated myosin heavy chain (MyHC) expression, modulated ubiquitin-proteasome molecules (nuclear FoxO3a, atrogin-1, MuRF-1, and p62/SQSTM1), and inhibited apoptosis (Bax/Bcl-2 ratio and cleaved caspase 3). Moreover, FPATM-20 restored mitochondrial function, including mitochondrial membrane potential, mitochondrial oxygen consumption rate, and mitochondrial biogenesis pathway (nuclear PGC-1α/TFAM/FNDC5). The inhibition of Nrf2 with ML385 reversed the effects of FPATM-20 on MGO. Furthermore, molecular docking confirmed the binding of FPATM-20 to Keap1, a suppressor of Nrf2, showing the crucial role of Nrf2 in protective effects. CONCLUSIONS:FPATM-20 protects myotubes from MGO toxicity by activating the Nrf2 antioxidant defense, reducing protein degradation and apoptosis, and enhancing mitochondrial function. Thus, FPATM-20 may be a novel agent for preventing skeletal muscle atrophy.

Background and aim:Skeletal muscle is the largest organ of the human body. It affects body metabolism and cooperates with other organs to maintain various physiological functions. Gan-Mai-Da-Zao-Tang (, gān mài dà zǎo tāng, GMDZ) is a traditional Chinese medicine consisting of licorice, wheat, and jujube. GMDZ is commonly used to treat anxiety and depression. Increasing evidence shows a correlation exists between sarcopenia and depression. Muscle wasting, particularly in older individuals, increases the risk of depressive symptoms. The study aims to explore the effects of GMDZ water extract (WE) on age-induced muscle wasting and mitochondrial dysfunction in 25-week-old and 82-week-old mice. Experimental procedure:Exercise capacity was assessed through locomotor activity, rotarod performance, and grid-hanging tests. Grip strength was measured to assess muscle strength, while histological analysis and immunofluorescence staining were used to evaluate muscle mass and myofiber cross-sectional area. Protein expression, mRNA, and ATP levels were determined using western blots, real-time PCR, and ATP bioluminescence assays. Results and conclusion:GMDZ-WE significantly improved motor performance, grip strength, muscle mass, and myofiber cross-sectional area in aging mice. These enhancements were associated with increased MyHC expression and the IGF-1R/Akt protein synthesis pathway in skeletal muscle. In addition, GMDZ-WE decreased age-related protein degradation and inflammatory signaling, enhanced mitochondrial biogenesis signaling, increased GSH levels, SOD activity, and reduced lipid oxidation in the skeletal muscle of aging mice. In conclusion, GMDZ-WE reduces age-related skeletal muscle wasting, motor impairment, oxidative stress, inflammation, and mitochondrial dysfunction, demonstrating anti-aging potential on skeletal muscles.

Guilu Erxian Jiao (GEJ) is a commonly used nutritional supplement due to its rich content of amino acids. It is also a traditional herbal medicine for improving degenerative joint. This study aimed to investigate the effect and mechanism of GEJ water extract (GEJ-WE) on skeletal muscle in C2C12 myotubes and C57BL/6J mice. Analysis of GEJ-WE were performed by high-performance liquid chromatography fingerprinting with chemical standards. Protein expression, mRNA level, glycogen content, mitochondria activity and ATP level were evaluated by western blots, real-time PCR, PAS staining, MTT and ATP bioluminescence assay, respectively. Skeletal muscle strength was evaluated by grip strength. Skeletal muscle volume, mass and fiber types were evaluated by micro computed tomography, histological analysis and immunofluorescence staining, respectively. Motor function was evaluated by rotarod performance and locomotor activity. In C2C12 myotubes, GEJ-WE significantly enhanced myogenic differentiation and myotube growth, protein synthesis signaling IGF-1/IGF-1R/IRS-1/Akt, Glut4 translocation, glycogen content, mitochondrial biogenesis signaling PGC-1α/NRF1/TFAM, mitochondrial activity and ATP production. However, IGF-1R antagonist AG1024 and PI3K inhibitor wortmannin reduced GEJ-WE-induced protein expression of MyHC, p-Akt, p-mTOR and p-GSK-3β, Glut4 translocation and glycogen content. In C57BL/6J mice, GEJ-WE not only upregulated protein synthesis and mitochondrial biogenesis signaling, but it also increased muscle volume, relative muscle weight, cross-sectional area of myofibers, glycogen content and transition of fast-to-slow type fibers of skeletal muscles. Moreover, GEJ-WE enhanced grip strength and motor activity of mice. In conclusion, the upregulation of protein synthesis, myogenic differentiation, glucose homeostasis, mitochondrial biogenesis and slow-twitch fibers contributes to the mechanisms of GEJ-WE on the enhancement of skeletal muscle mass and motor function.

Background The mainstream facilitation of one-lung ventilation is using double-lumen endobronchial tubes. However, it is more difficult to be positioned properly and more likely to cause airway injuries. How to place double-lumen endobronchial tubes rapidly and correctly is important for thoracic anesthesiologists. Methods One hundred eight patients with an American Society of Anesthesiologists physical status of I to III were 20 years of age or over, and required one-lung ventilation for thoracic surgery. They were randomly assigned to the conventional technique group ( n = 36), the flexible fiberoptic bronchoscopy group ( n = 36), or the Trachway® flexible stylet group ( n = 36). The primary endpoint was the time needed for intubation. T1, the time from the tip of the blade passing between the patient’s lips to identification of the vocal cords; and T2, the time from identification of the vocal cords to the bronchial lumen was in the correct position. Results T1 had no significant difference between groups, but T2 was significantly shorter in the Trachway® flexible stylet group ( p < 0.0001) and longer in the conventional technique group ( p < 0.0001). Conclusions Using Trachway® flexible stylet for correct placement of double-lumen endobronchial tubes not only significantly shortened the intubation time, but also reduced incidence of carinal injuries. It is an alternative, and a choice with good safety. Trial registration ClinicalTrials.gov Identifier: NCT02364622, 18/02/2015, Retrospectively registered.

Hyperbaric oxygen therapy (HBOT) has been suggested as a potential adjunctive therapy for Parkinson’s disease (PD). PD is a neurodegenerative disease characterized by the progressive loss of dopaminergic neurons in the substantia nigra pars compacta (SNpc). The aim of this study was to investigate the protective mechanisms of HBOT on neurons and motor function in a 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) mouse model of PD and 1-methyl-4-phenylpyridinium (MPP+)-mediated neurotoxicity in SH-SY5Y cells on the potential protective capability. In vivo: male C57BL/6 mice were randomly divided into three groups: control, MPTP group and MPTP+HBOT group. The MPTP-treated mice were intraperitoneally received MPTP (20 mg/kg) four times at 2 h intervals within a day. The day after MPTP treatment, MPTP+HBOT mice were exposed to hyperbaric oxygen at 2.5 atmosphere absolute (ATA) with 100% oxygen for 1 h once daily for 7 consecutive days. In vitro: retinoic acid (RA)-differentiated SH-SY5Y cells were treated with MPP+ for 1 h followed by hyperbaric oxygen at 2.5 ATA with 100% oxygen for 1 h. The results showed that MPTP induced a significant loss in tyrosine hydroxylase (TH)-positive neurons in the SNpc of mice. HBOT treatment significantly increased the number of TH-positive neurons, with enhanced neurotrophic factor BDNF, decreased apoptotic signaling and attenuated inflammatory mediators in the midbrain of MPTP-treated mice. In addition, MPTP treatment decreased the locomotor activity and grip strength of mice, and these effects were shown to improve after HBOT treatment. Furthermore, MPTP decreased mitochondrial biogenesis signaling (SIRT-1, PGC-1α and TFAM), as well as mitochondrial marker VDAC expression, while HBOT treatment was shown to upregulate protein expression. In cell experiments, MPP+ reduced neurite length, while HBOT treatment attenuated neurite retraction. Conclusions: the effects of HBOT in MPTP-treated mice might come from promoting mitochondrial biogenesis, decreasing apoptotic signaling and attenuating inflammatory mediators in the midbrain, suggesting its potential benefits in PD treatment.

UCL-2077 (triphenylmethylaminomethyl)pyridine) was previously reported to suppress slow afterhyperpolarization in neurons. However, the information with respect to the effects of UCL-2077 on ionic currents is quite scarce. The addition of UCL-2077 decreased the amplitude of erg-mediated K+ current (IK(erg)) together with an increased deactivation rate of the current in pituitary GH3 cells. The IC50 and KD values of UCL-2077-induced inhibition of IK(erg) were 4.7 and 5.1 μM, respectively. UCL-2077 (10 μM) distinctly shifted the midpoint in the activation curve of IK(erg) to less hyperpolarizing potentials by 17 mV. Its presence decreased the degree of voltage hysteresis for IK(erg) elicitation by long-lasting triangular ramp pulse. It also diminished the probability of the opening of intermediate-conductance Ca2+-activated K+ channels. In cell-attached current recordings, UCL-2077 raised the frequency of action currents. When KCNH2 mRNA was knocked down, a UCL-2077-mediated increase in AC firing was attenuated. Collectively, the actions elaborated herein conceivably contribute to the perturbating effects of this compound on electrical behaviors of excitable cells.

Objectives: Recent studies revealed the neuroprotective effects of naringenin (NGEN), a common dietary bioflavonoid contained in citrus fruits. However, there are limited data on its protection against methylglyoxal (MG), the most potent precursor of advanced glycation end-products. The present study was to investigate the protection of NGEN on MG-induced neurotoxicity and the involvement of insulin-like growth factor 1 receptor (IGF-1R) signaling. Methods: NSC34 motor neuron-like cells was used. Cell viability was measured by MTT assay. Protein expressions were analyzed by western blots. Morphological changes of neurites were observed by an inverted microscope. Reactive oxygen species (ROS) production and apoptotic cell numbers were measured by flow cytometer. Glutathione (GSH) level and superoxide dismutase (SOD) activity were measured by ELISA. Results: >NGEN attenuated ROS production and increased GSH level, SOD activity and nuclear factor erythroid 2-related factor 2 (Nrf2) nuclear expression in MG-treated NSC34 cells. NGEN also increased neurite length and enhanced IGF-1R and p-Akt in MG-treated NSC34 cells. Furthermore, NGEN attenuated MG-induced apoptotic death accompanied with down-regulation of cleaved-poly (ADP-ribose) polymerase (PARP) and up-regulation of B-cell lymphoma-2 (Bcl-2). However, AG1024, an IGF-1R antagonist, attenuated the anti-oxidative and anti-apoptotic effects of NGEN in MG-treated cells. Discussion: The present results demonstrated that NGEN decreased neuronal apoptosis and improved antioxidant defense in MG-treated NSC34 cells. Moreover, IGF-1R-mediated antioxidant defense plays an important role in this protective mechanism. These findings suggest the potential benefits of NGEN on the prevention of MG-induced or diabetes/hyperglycemia-related neurotoxicity. In vivo studies are needed for further confirmation on NGEN-mediated neuroprotection.

Background: The Chinese herbal formula Liuwei dihuang (LWDH), composed of dihuang (Rehmannia glutinosa), shanyao (Dioscorea opposite), shanzhuyu (Cornus officinalis), zexie (Alisma orientalis), hoelen (Poria cocos) and mudanpi (Paeonia suffruticosa), is a widely used traditional Chinese medicine for neurosis, diabetes, and osteoporosis. Our previous study demonstrated that the water extract of LWDH (LWDH-WE) protects dopaminergic neurons against Parkinson's toxin and improves motor activity of mice with MPTP-induced Parkinson's disease. Methylglyoxal (MG) is a reactive dicarbonyl intermediate and a precursor of advanced glycation end products. In this study, we investigated the effects of LWDH-WE on MG-induced myotube atrophy in C2C12 cells.

Superhydrophobic membranes for effective MD desalination.

Ethylenediaminetetraacetic acid disodium (EDTA-2Na) has been demonstrated as an excellent draw solution in the forward osmosis (FO) process because of its high osmotic pressure together with low reverse salt flux but its application is hindered by difficulties in the recovery of draw solution. Hence, in this study, microporous hydrophobic membranes were used in direct contact membrane distillation (DCMD) to concentrate the diluted EDTA-2Na draw solution. The MD was found to require lower operating pressures than do all other widely applied pressure-driven membrane processes, particularly in RO. This study systematically investigated the effect of different polytetrafluoroethylene membranes under various cross flow velocities of 2.67-14.67 cm/s, feed temperatures of 35-60 degrees C, and distillate temperatures of 10-20 degrees C in DCMD process for regeneration of diluted EDTA-2Na. The results revealed that DCMD system could achieve a salinity rejection rate exceeding 99.99%; furthermore, the conductivity of the permeate distillate was consistently below 6.41 mu S/cm for all of the EDTA-2Na feed concentrations. More importantly, the water flux slightly decreased from 8.27 to 7.04 L/m(2) h when the concentration of the EDTA-2Na feed increased from 0.1 to 0.5 M, corresponding to increased osmolality from 300 to 1411 mOsm/kg, indicating that water flux in DCMD is not significantly influenced by the osmotic pressure gradient across the membrane. This study demonstrated that MD could be an effective method for EDTA-2Na recovery in FO-MD systems and could economically utilize the wasted heat from industrial sources. (C) 2017 Elsevier B.V. All rights reserved.

Editor—Central venous catheter (CVC) placement under ultrasound guidance is useful not only to assess the potential abnormality of vessels, but also to decrease complications such as nerve injury, infection, haemothorax, and thrombus formation. We describe ultrasound detection of a potentially lethal free-floating thrombus before internal jugular vein catheterisation. A 36-yr-old female without systemic disease was transferred to hospital after a fall to the ground. She presented with right pneumothorax, liver laceration, right internal iliac artery rupture, multiple lumbar vertebral fractures, right trochanteric fracture, haemorrhagic shock, and respiratory failure. While in the intensive care unit, multiple bone open reductions and internal fixations were performed on admission day 9 (AD9) and AD13. Catheters in the left subclavian vein and right internal jugular vein (RIJV) were removed on AD12 and AD15, respectively. Before T12–L3 spinal fusion on AD19, a free-floating thrombus (1.2×0.3×1.5 cm) was found in the RIJV during ultrasound assessment before CVC placement (Fig. 1). To avoid thrombus shedding, we changed the insertion site to the right subclavian vein after examining that vessel. Thrombus formation is associated with CVC placement over 2 days, and the incidence can increase to 75% after surgery with mechanical ventilation.1Chen P.T. Chang K.C. Hu K.L. Ting C.K. Chan K.H. Chang W.K. Catheter-related right internal jugular vein thrombosis after chest surgery.Br J Anaesth. 2017; 119: 192-199Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar Thrombus formation can result from fibrin deposited on the thrombogenic catheter surface within hours of insertion, with reduced blood flow leading to further cellular adhesion, and catheter-tip induced endothelial erosion.2Geerts W. Central venous catheter-related thrombosis.Hematol Am Soc Hematol Educ Program. 2014; 2014: 306-311Crossref PubMed Scopus (100) Google Scholar CVC-related infection and septicaemia increase the incidence of thrombus formation.3Raad I.I. Luna M. Khalil S.A. Costerton J.W. Lam C. Bodey G.P. The relationship between the thrombotic and infectious complications of central venous catheters.JAMA. 1994; 271: 1014-1016Crossref PubMed Scopus (440) Google Scholar The causes of CVC-related thrombus in this patient are multifactorial, and the thrombus persisted several days after RIJV catheter removal. Thrombus cannot be detected without ultrasound assessment and guidance. If CVC placement is performed in the RIJV by the landmark method, the risk of shedding or even acute embolism is increased. We did not anticoagulate with either heparin or low-molecular-weight heparin because of the need for frequent interruption for serial invasive operations, the risk of uncontrolled bleeding, and the small size of the clot that did not occlude the vessel.4Wall C. Moore J. Thachil J. Catheter-related thrombosis: a practical approach.J Intensive Care Soc. 2016; 17: 160-167Crossref PubMed Scopus (79) Google Scholar For CVC placement with ultrasound guidance compared with the landmark method, there are significant reductions in access time, number of attempts, and associated complications (including artery puncture, hematoma, pneumothorax, haemothorax, or nerve injury).5Fragou M. Gravvanis A. Dimitriou V. et al.Real-time ultrasound-guided subclavian vein cannulation versus the landmark method in critical care patients: a prospective randomized study.Crit Care Med. 2011; 39: 1607-1612Crossref PubMed Scopus (264) Google Scholar In addition, successful central venous catheterisation under ultrasound guidance reaches 100% within three vein punctures.6Tokumine J. Lefor A.T. Yonei A. Kagaya A. Iwasaki K. Fukuda Y. Three-step method for ultrasound-guided central vein catheterization.Br J Anaesth. 2013; 110: 368-373Abstract Full Text Full Text PDF PubMed Scopus (38) Google Scholar Here, we show that CVC placement guided by ultrasound can identify a latent venous abnormality and possibly avoid thrombus embolisation. We therefore recommend ultrasound assessment and guidance for CVC repositioning for safe CVC placement. None declared.

Background Exposure to carbon black nanoparticles (CBNPs), a well-known industrial production, promotes pulmonary toxicity through inflammation and oxidative stress. Recent studies show that some polyphenols exert their antioxidant properties through regulation of protein kinase C-α (PKC-α) and NADPH oxidase (Nox) signaling. Resveratrol, a dietary polyphenol in fruits, possesses various health beneficial effects including anti-inflammatory and antioxidative properties. In this study, we aimed to elucidate the involvement of PKC-α and Nox in CBNPs-induced inflammation and oxidative stress, and to investigate the protective effects of resveratrol on CBNP-induced inflammation and oxidative stress in human lung epithelial A549 cells. Methods The production of reactive oxygen species (ROS) and the change of mitochondrial membrane potential (ΔΨm) were measured by flow cytometry. Nitric oxide (NO) was measured using the Griess reagent, and prostaglandin E 2 (PGE 2 ) production was detected by ELISA, while protein expressions were measured by Western blotting analysis. Results In lung epithelial A549 cells, CBNPs significantly enhanced oxidative stress by upregulation of Nox2 and membrane expression of p67 phox accompanied with increase of ROS production. CBNPs also increased inflammatory factors, including iNOS, COX-2, NO and PGE 2 . However, resveratrol attenuated the above effects induced by CBNPs in A549 cells; additionally, CBNPs-induced activation of PKC-α was observed. We found that PKC-α inhibitor (Gö6976) could attenuate CBNPs-induced inflammation by down-regulation of ROS, NO and PGE 2 production in A549 cells, suggesting PKC-α might be involved in CBNPs-induced oxidative stress and inflammation. Our results also found resveratrol was able to inhibit protein expression of PKC-α induced by CBNPs. Moreover, ROS scavenger (NAC) and Nox inhibitor (DPI) attenuated CBNPs-induced expressions of iNOS and COX-2. DPI could also attenuate CBNPs-induced ROS, NO and PGE 2 production. Conclusions Resveratrol attenuated CBNPs-induced oxidative and inflammatory factors in lung epithelial A549 cells, at least in part via inhibiting PKC-α- and Nox-related signaling.

Sugammadex (SGX) is a modified γ-cyclodextrin used for reversal of steroidal neuromuscular blocking agents during general anesthesia. Despite its application in clinical use, whether SGX treatment exerts any effects on membrane ion currents in neurons remains largely unclear. In this study, effects of SGX treatment on ion currents, particularly on delayed-rectifier K+ current [I K(DR)], were extensively investigated in differentiated NSC-34 neuronal cells.

Background: Naringenin (NGEN) is a common dietary bioflavonoid contained in the citrus fruits. It possesses potent pharmacological activities including anti-inflammatory, anti-oxidative stress, anxiolytic, anti-nociceptive and anti-diabetic properties. Methylglyoxal (MG), the reactive precursor of advanced glycation end products, is implicated in the pathophysiological mechanisms those associated with diabetic complications and neurodegenerative disorders.

BACKGROUND:Surgery for esophageal cancer is invasive and challenging, and always to be followed with arduous post-operative care and recovery. This study, maybe one of the first in Asian populations, is to determine whether a reinvented protocol for perioperative management for esophageal cancer surgery which is being implemented in our department, will lead to a faster convalescence and also significantly decrease financial burdens garnered by patients during hospitalization.METHODS:Operated on by the same surgeon and team in the same hospital, consecutive patients who had received esophagectomy and reconstruction for esophageal squamous cell carcinoma were retrospectively reviewed. On the basis of two different treatment periods, patients were divided into two groups: A and B. Group A was patients who had received the new reinvented protocol between 2012 and 2016, while group B patients were those having received the previous protocol between 2008 and 2011. Their demographics, post-operative outcome, and hospital charges were collected and compared.RESULTS:There were 64 patients in group A, and 69 in group B. Ventilator days (P<0.001), ICU stay (P<0.001), and post-operative stay (P<0.001) were significantly shorter in group A patients. Complication rates were similar between the two groups. No hospital mortality was noted in either group. Hospital charges in group A were found to be perceptively lower, although not statistically significant (P value =0.078).CONCLUSIONS:The current protocol of perioperative care effectively ameliorated convalescence after esophagectomy and reconstruction for esophageal squamous cell carcinoma without increasing complication rate or mortality. It is also potentially more practical in future health care policies during this era of financial shortage.