Objective To determine the difference between sevoflurane- and anoxic preconditioning in protecting newborn rat heart muscle cells from anoxia-reoxygenation injury. Methods The second generation of primary cultured cardiac myocytes from 2-3d newborn SD rats were randomly divided into 4 groups: control group (C), anoxia/reoxygenation group (A/R) in which cultured cardiac myocytes were exposed to 2h anoxia followed by 48h reoxygenation; anoxic preconditioning group (IP) in which before A/ R the cardiac myocytes were pretreated with 20 min anoxia; sevoflurane preconditioning group (S) in which cardiac myocytes were pretreated with 20 min 2.5% sevoflurane (1.5 MAC) before A/R. Ultrastructure of heart muscles cells was observed 1 h after reoxygenation, Cell survival was determined by MTT rapid colorimetric assay and apoptosis was measured by flow cytometry at 0, 1, 12, 24, 36 and 48 h after reoxygenation. Results (1) In S and IP group there was no significant change in ultrastructure and no apoptosis cell was found, whereas in A/R group the change in ultrastructure was significant , and apoptosis cells were found. (2) The cell survival in group S and group IP was significantly lower than that in group C but significantly higher than that in group A/R. (P 0.05) . The survival of cardiac myocytes increased with prolongation of reoxygenation time in group S and group IP. (3) The apoptosis percentage of cells in group S and group IP was significantly higher than that in group C and lower than that in group A/R(F

Objective To observe the effect of Chinese herbal compound Tangbikang on the level of plasma β-EP of diabetic peripheral neuropathy rats, and to discuss its mechanism of neuroprotection and abirritation. Methods STZ and feeding high fat forage induced diabetic rats were randomly divided into diabetic model group, Mecobalamin group, Tangbikang high dose group, Tangbikang medium dose group, Tangbikang low dose group, with 10 normal rats as control. The control group and model group were daily gavaged with distilled water, Tangbikang groups were given Tangbikang with different dose. Mecobalamin was used as the control medicine. Body weight and FBG was detected every 4 weeks, rats’ unilateral sciatic nerve were taken out at the 16th week. Pathological variation of sciatic nerve was presented by HE staining, and radioimmunoassay method was used to detect the levels of plasma β-EP of diabetic peripheral neuropathy of rats. Results The weight and FBG had obviously changed in the 16th week. Compared with the model group, pathological injury of diabetic peripheral neuropathy rats in the Tangbikang groups were significantly improved. The level ofβ-EP of model group was significantly decreased (P<0.01) compared with normal group. Tangbikang medium and high dose group significantly increased the level of plasma β-EP (P<0.01). Conclusion Chinese herbal compound Tangbikang could reduce the fasting blood glucose, protect nervous system and promote the level of plasmaβ-EP of diabetic peripheral neuropathy rats.

Objective To explore one mechanism of therapeutic action of electroacupuncture on Alzheimer’s disease (AD), that is, improving the way to eliminate cerebral microvascular Ab by investigating the effect of electroacupuncture on hippocampal microvascular Ab deposition and learning and memory abilities in APP/PSI double transgenic mice. Method Twenty-four 7-month-old male APP/PSI double transgenic mice were randomized into model and electroacupuncture groups, 12 mice each. Same sex transgene-negative littermate mice (12 mice) constituted a blank control group. The electroacupuncture group received electric acupuncture at points Baihui (GV20) and Yongquan (KI1), 15 min once every other day, for a total of six weeks. After treatment, mouse learning and memory abilities were tested using the Morris water maze. The expressions of Ab 1-40 and Ab 1-42 in the hippocampal microvascular wall and senile plaque were determined by immunohistochemical method. Hippocampal microvascular Ab-positive expression was semi-quantitatively analyzed using the Imagine Pro Plus software. Result The Morris water maze test showed that escape latency lengthened (P<0.05), and the number of crossing platform and swimming time in the platform quadrant decreased (P<0.05) in the model group compared with the blank control group. Escape latency shortened (P<0.05), and the number of crossing platform and swimming time in the platform quadrant increased (P<0.05) in the electroacupuncture group compared with the model group. The immunohistochemical results showed that hippocampal microvascular Ab 1-42 and Ab 1-40 integral optical densities were higher in the model group than in the blank control group (P<0.05) and senile plaques appeared in the hippocampus. Hippocampal microvascular Ab 1-42 and Ab 1-40 integral optical densities were lower in the in the electroacupuncture group than in the model group (P<0.05). Conclusion Electroacupuncture reduces mouse learning and memory impairments and hippocampal microvascular Ab deposition. Its mechanism may be that electroacupuncture improves the way of eliminating cerebral microvascular Ab to decrease cerebral Ab deposition.

BACKGROUND: The neurotoxicity and cardiotoxicity of bupivacaine have been reported frequently. However, the studies on bupivacaine-induced muscle toxicity are few.
OBJECTIVE: To establish and evaluate local intramuscular injection of bupivacaine on the changes in histomorphology and ultrastructure of rat multifidus muscle at various time points.
METHODS: A total of 54 male Sprague-Dawley rats weighing 280-320 g were randomly divided into black group (n=18), model group (n=18) and model control group (n=18). Each group was then equal y subdivided into three subgroups according to time points (4, 7 and 14 days) (n=6). Both sides of multifidus muscle of the rats (L4 and L5) were injected with 0.5% bupivacaine. The morphological and ultrastructural changes of multifidus muscle were observed and analyzed with light microscope and transmission electron microscope at 4, 7 and 14 days after model establishment.
RESULTS AND CONCLUSION: (1) A single intramuscular injection of 0.5% bupivacaine induced muscular damage. (2) Hematoxylin-eosin staining results showed fiber necrosis, inflammatory cel infiltration, and a smal amount of macrophages in local skeletal muscle. (3) Under the transmission electron microscope, the structure of myofibrils was destroyed or disintegrated; kinds of bands and lines were indistinct, disrupted or disappeared; the structure of mitochondria was abnormal, the mitochondrial cristae were reduced or disappeared. In the 7- and 14-day groups, multifidus muscle proliferated and repaired. (4) Ultrastructural change scores in skeletal muscle were significantly higher in the model group than in the blank and model control groups (P < 0.05). Above scores were significantly greater in the 4-day group than in the 7- and 14-day groups (P < 0.05), and higher in the 7-day group than in the 14-day group (P < 0.05). (5) Results suggest that a single intramuscular injection of 0.5% bupivacaine can result in pathological changes of skeletal muscle from morphology and ultrastructure. This method can establish a suitable model of skeletal muscle injury.

Objective To observe over-time changes in rat blood flow in the skins of related meridian points during physiological status, the pathological state of ischemic myocardial injury and low or high frequency electroacupuncture intervention and explore the post effect of different frequency electroacupuncture on related meridian points after treating ischemic myocardial injury. Method Fifty male Wister rats were randomized into five groups: blank control, sham operation, model, low frequency electroacupuncture (meridian point A) and high frequency electroacupuncture (meridian point B), 10 rats each. Blood flow in the skins of bilateral points Neiguan (PC6), Ximen (PC4) and Tianquan (PC2), and non-meridian and non-acupoint control points was measured by laser speckle contrast imaging in every group immediately and at 30 and 60 min after the end of three treatments. Statistical analysis was made. Result Blood flow in the skins of bilateral points Neiguan, Ximen and Tianquan was significantly lower in the blank control group than in the model group (P<0.01,P<0.05). Blood flow in the skin of every acupoint increased in varing degrees after low or high frequency electroacupuncture treatment. Blood flow in bilateral points Neiguan, Ximen and Tianquan regions in meridian point group A was closer to that in the blank control group immediately after treatment. Blood flow in three left-side and three right-side acupoint regions in meridian point group B was closer to that in the blank control group at 30 and 60 min, respectively, after treatment. Conclusion The immediate effect of low frequency electroacupuncture on blood flow in acupoint regions is better than high frequency electroacupuncture during intervention in ischemic myocardial injury. The post effect of high frequency electroacupuncture on blood flow in acupoint regions is better than low frequency electroacupuncture during intervention in ischemic myocardial injury.

Periodontitis is a chronic periodontal disease with a high incidence, and chronic obstructive pulmonary disease (COPD) is considered to be a chronic airway inflammatory disease. In recent years, many studies have observed that there is a potential relationship between periodontitis and COPD. The periodontal condition of patients with COPD is relatively poor, and the composition of their oral microbiome is different from that of healthy people. The inflammation “spillage”and hypoxia may induce the occurrence and development of periodontal disease. At the same time, the risk of COPD in periodontitis patients may be related to the inhalation of periodontal pathogens and inflammatory factors. Regular periodontal sequence therapy can reduce the risk of acute exacerbation of the disease to a certain extent. Since periodontitis and COPD are both chronic progressive diseases characterized by chronic inflammation and accompanied by proteolytic destruction of connective tissue, they may share a common pathophysiological process and may be intrinsically linked. This article reviews the latest research progress on the relationship between chronic periodontitis and COPD, and possible interaction mechanism, in order to provide insight for further study on the interaction between the two conditions.

Objective:To analyze the characteristics of upper airway three-dimensional CT images in children with laryngoscope exposure.Methods:50 cases of Pierre Robin sequence who suffered mandibular distraction osteogenesis were included. Preoperation, Cone beam CT scan was performed to get upper airway anatomy information. Images were imported into medical engineering software Mimics for 3D reconstruction. The related anatomical parameters such as the cross-sectional area of the epiglottis tip, oral volume, palatopharynx volume, and glossopharyngeal volume were measured. The exposure of glottis was observed by direct laryngoscope after anaesthesia. According to Cormack-Lehane classification, 2 groups were divided into groups (group A, 30 cases), non exposure group (group B, 20 cases), and the difference of image data between the two groups was compared.Results:Comparing CT measurement index values of the two groups, it was found that there were no statistically significant differences in D4, D8, D10, D11, angle 3, angle 6 and oral volume between the two groups ( P≥0.05), while there were statistically significant differences in other indicators between the two groups ( P<0.05). The area of the airway at the tip of epiglottis and the volume of palatopharyngeal cavity are of great significance to the differential diagnosis of laryngoscopic exposure in children with Pierre Robin sequence, and the decision tree model was established accordingly. Conclusions:The decision tree model based on the area of the airway at the tip of epiglottis and the volume of the palatopharyngeal cavity can predict the difficulty of laryngoscopic exposure in children with Pierre Robin sequence.

Objective:To analyze the characteristics of upper airway three-dimensional CT images in children with laryngoscope exposure.Methods:50 cases of Pierre Robin sequence who suffered mandibular distraction osteogenesis were included. Preoperation, Cone beam CT scan was performed to get upper airway anatomy information. Images were imported into medical engineering software Mimics for 3D reconstruction. The related anatomical parameters such as the cross-sectional area of the epiglottis tip, oral volume, palatopharynx volume, and glossopharyngeal volume were measured. The exposure of glottis was observed by direct laryngoscope after anaesthesia. According to Cormack-Lehane classification, 2 groups were divided into groups (group A, 30 cases), non exposure group (group B, 20 cases), and the difference of image data between the two groups was compared.Results:Comparing CT measurement index values of the two groups, it was found that there were no statistically significant differences in D4, D8, D10, D11, angle 3, angle 6 and oral volume between the two groups ( P≥0.05), while there were statistically significant differences in other indicators between the two groups ( P<0.05). The area of the airway at the tip of epiglottis and the volume of palatopharyngeal cavity are of great significance to the differential diagnosis of laryngoscopic exposure in children with Pierre Robin sequence, and the decision tree model was established accordingly. Conclusions:The decision tree model based on the area of the airway at the tip of epiglottis and the volume of the palatopharyngeal cavity can predict the difficulty of laryngoscopic exposure in children with Pierre Robin sequence.

Objective To analyze the anatomical characteristics of the upper airway in Pierre Robin sequence pediatric patients with difficult laryngoscopy using the computed tomography-based three-dimensional reconstruction.Methods Fifty pediatric patients of both sexes with Pierre Robin sequence,aged 10-101 days,weighing 2.0-6.3 kg,of American Society of Anesthesiologists physical status Ⅲ,scheduled for elective mandibular distraction osteogenesis under general anesthesia,were enrolled in this study.Cone beam CT scan was performed to obtain upper airway anatomy information during the natural sleep before operation.Images were imported into medical engineering software MIMICS 17.0 to reconstruct the three-dimensional images of the oral and maxillofacial bones and airways.The related anatomical parameters were measured,including the distance between the alveolar ridge of the upper central incisor and root of the epiglottis (D1),distance between the root of the epiglottis and midpoint of glottis (D2),distance between the bilateral lower edge of the mandible and midpoint of glottis (D3),distance between the alveolar ridge of the lower central incisor and the lower edge of the mandible (D4),length of the mandibular ramus (D5),length of the mandible body (D6),and length of the total mandible (D7),angle between lines D1 and D2 (angle 1),the angle between line D2 and the alveolar ridge of the upper central incisor to the midpoint of glottis (angle 2),the angle between lines D3 and D4 (angle 3),the angle of the point of the upper central incisor alveolar ridge to the trailing edge of the hard palate and then to the root of epiglottis (angle 4),the angle of bilateral mandible (angle 5),the angle of the point of gnathion to the two gonions (angle 6),the airway cross-sectional area at the tip of epiglottis,volume of oral cavity,volume of velopharyngeal cavity,and volume of glossopharyngeal cavity.Fiberoptic bronchoscope-guided endotracheal intubation was performed under topical anesthesia with lidocaine.Propofol,sufentanil and cis-atracurium were intravenously injected to induce anesthesia after successful intubation,and then the pediatric patients were sent to the operating room.Anesthesia was maintained by inhalation of sevoflurane.The exposure of glottis was observed with a laryngoscope.Pediatric patients were divided into difficult laryngoscopy group (group A) and non-difficult laryngoscopy group (group B) according to whether they presented with difficult laryngoscopy (Cormack-Lehane classification Ⅲ or Ⅳ).Results Compared with group B,the airway cross-sectional area at the tip of epiglottis and in the volume of velopharyngeal cavity were decreased (P＜0.05),and no significant change was found in D1,D2,D3,D4,D5,D6,D7,angle 1,angle 2,angle 3,angle 4,angle 5,angle 6,volume of oral cavity or volume of glossopharyngeal cavity in group A (P＞0.05).Conclusion The three-dimensional CT images of the upper airway show characteristic changes in Pierre Robin sequence pediatric patients with difficult laryngoscopy,and the main manifestations are the decrease in the airway section area and in the volume of the palatopharyngeal cavity at the tip of the epiglottis.

Objective:To identify the risk factors for weaning failure after mandibular distraction osteogenesis in the infants with Pierre Robin sequence.Methods:A retrospective cohort study was conducted to collect clinical records of infants with Pierre Robin sequence underwent mandibular distraction osteogenesis at Guangzhou Women and Children′s Medical Center from November 2016 to May 2019.The inclusion criteria consisted of the following: age <1 yr and no serious cardiopulmonary disease or serious airway malformation.The medical charts were reviewed for sex, age, weight, premature delivery, low birth weight, preoperative intubation, preoperative pulmonary infection, ventilator-associated pneumonia, as well as mechanical ventilation time and distraction length at first weaning.The infants were divided into 2 groups according to the outcome of ventilator weaning at first attempt: successful group and failure group.The risk factors of which P values were less than 0.05 would enter the logistic regression analysis to stratify weaning failure-related risk factors. Results:A total of 140 infants were included in this study, of which 9 cases developed failure of weaning at first attempt after operation, with the incidence of 6.4%.The results of logistic regression analysis showed that the distraction length and incidence of ventilator-associated pneumonia were independent risk factors for weaning failure after operation ( P<0.05). Conclusion:The length of distraction and ventilator-associated pneumonia are independent risk factors for weaning failure after mandibular distraction osteogenesis in the infants with Pierre Robin sequence.