The latest advance of sedation for critically ill adult patients in intensive care unit (ICU) was reviewed in order to provide certain clinical information for the ICU physicians about sedation. Guidelines, clinical research, Meta-analysis, and reviews in recent years were collected using electronic data base. Discussions included: ① the definition of light sedation, and its effects on clinical outcome, stress, sleep and delirium; ② light sedation strategies included: the target population, the target sedation strategy and daily sedation interruption, clinical assessment and monitoring of sedation, selection of sedative drugs, light sedation extenuation; ③ light sedation strategies and pain, agitation, delirium control bundles; ④ the problems and prospects of light sedation. Light sedation is the main principle of currently ICU sedation strategy in critically ill adult patients. Goal-directed light sedation should be considered as a routine therapy in most clinical situation, and its goal should be achieved as early as possible in the early stage of sedation. Routine use of benzodiazepines should be avoided, especially in patients with or at a risk of delirium. Prevention and treatment of agitation with a combination of non-pharmacologic or pharmacologic methods; ICU specification rules for pain, agitation and delirium prevention and treatment should be made. Light sedation is the main ICU sedation strategy in adult patients now, but must be individualized for each patient.

Objective The purpose of our study is to analyze the effects of different ways of anesthesia on the prognosis of these patients.Methods Our study was a retrospective study,enrolling elderly patients (≥65 years)undergoing pheochromocytoma resection surgery from Jan 2004 to Feb 201 5 in our hospital.We recorded perioperative data including demography,primary disease,com-bined disease,preoperative management,anesthesiology,surgery,and prognosis.Then we divided the patients into two groups,general anesthesia (group G)and general anesthesia combined with epi-dural anesthesia (group GE),to make further statistical analysis.Results There were 33 patients en-rolled,totally undergoing 35 cases of surgery accounting for 13.4% of pheochromocytoma resection surgery in the same period in our hospital.The maintenance of analgesia during surgery by using remifentanyl (18.2% vs 79.2%,P = 0.001 )and sufentanyl (45.5% vs 79.2%,P = 0.046 )were significantly lower in group of general anesthesia combined with epidural anesthesia.However hemo-dynamic parameters didn’t show statistical difference between groups.There were no patients dead during perioperative period.In group GE,the duration of mechanical ventilation (P =0.039),post-operative hospital stay (P =0.013)and total hospital stay (P =0.01 5)were much shorter than those in group G.Multivariable Cox model analysis showed that general anesthesia combined with epidural anesthesia was an independent protective factor for shorter postoperative hospital stay (RR=0.245, 95% CI 0.106-0.564,P =0.001),and combination of vasopressors during operation were the inde-pendent predictors of longer postoperative hospital stay (RR= 4.184,95% CI 1.146-1 5.281,P =0.030).Conclusion During pheochromocytoma resection surgery in elderly patients,general anesthe-sia combined with epidural anesthesia had lower rate of using intravenous analgesic drugs,shorter du-ration of mechanical ventilation,postoperative hospital stay and total hospital stay.

Objective Ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS)and network pharmacology technology combined with pharmacodynamic experiments were used to analyze the quality markers(Q-markers)in Saorilao Qingfei Zhike Capsules.Methods Using UPLC-Q-TOF-MS technology,the chemical components in different polar extracts of Saorilao Qingfei Zhike Capsules was analyzed.Potential pharmacological components were screened by using antitussive and expectorant models.The"components-targets-diseases"network was constructed and potential Q-markers were screened by network pharmacology technology.Then we conducted pharmacodynamic validation to confirm the Q-markers,which have antitussive and expectorant effects in Saorilao Qingfei Zhike Capsules.Results A total of 120 compounds were obtained from the Saorilao Qingfei Zhike Capsules through qualitative analysis.Among the extracts of different polarity,44 compounds were derived from petroleum ether extract,85 compounds were derived from ethyl acetate extract,79 compounds were derived from n-butanol extract,and 71 compounds were derived from water extract.The results of pharmacological experiments showed that among extracts of different polarity,petroleum ether extract had the best antitussive effect,while n-butanol extract had the best expectorant effect.Three core components for eliminating phlegm and relieving cough were screened through network pharmacology techniques:farcalinol,farcalinediol,and rubimaillin.Pharmacodynamic studies verified that all core components mentioned above have certain antitussive and expectorant effects.Conclusion Based on the above research,farcalinol,farcalindiol,and rubimaillin can be used as Q-markers for the antitussive and expectorant effects of Saorilao Qingfei Zhike Capsules.This paper provides reference for the quality standard of Saorilao Qingfei Zhike Capsules.

BACKGROUND:The temporal and spatial expression of fibroblast growth factor receptors 1 and 2 remains a controversial issue during kidney development,so the relationship between them and kidney development remains unclear. OBJECTIVE:To observe the dynamic expression of fibroblast growth factor receptors 1 and 2 during kidney development of mice,and to investigate the relationship between them and kidney development. METHODS:The kidneys of fetal mice[embryotic days(E)12,14,16,and 18]and neonatal mice[neonatal days(N)1,3,7,14,24,and 40]were selected to examine the temporal and spatial expression of fibroblast growth factor receptors 1 and 2 by immunohistochemistry method in kidney tissues,and quantitative analysis was performed using western blot assay. RESULTS AND CONCLUSION:(1)Immunohistochemistry showed that fibroblast growth factor receptor 1 was mainly localized in metanephric tissue surrounding the tip of the ureteral bud at E12.Subsequently,fibroblast growth factor receptor 1 was expressed in immature renal corpuscles at various stages,some distal convoluted tubules and capillary loops.The positive site was mainly concentrated in the generative region.Fibroblast growth factor receptor 2 was initially expressed in both ureteral buds and metanephric tissue.Fibroblast growth factor receptor 2 was localized in immature renal corpuscles,distal tubules,collecting ducts and thin segments of medullary loops with kidney development.However,the expression of renal corpuscles was weak.(2)Stereology and western blot assay showed that the expression of fibroblast growth factor receptor 1 was high before birth and gradually decreased after birth,while the expression was very low after N7 day.The expression level of fibroblast growth factor receptor 2 increased gradually with the kidney development and tended to be stable after N7 day.(3)The results exhibit that fibroblast growth factor receptors 1 and 2 are expressed spatially and temporally during kidney development.It is speculated that fibroblast growth factor receptors 1 and 2 may influence nephron development and maturation,and fibroblast growth factor receptor 2 is critical during the formation of ureteral buds and morphology.

Recent studies have discovered a selective autophagy-lipophagy, which can selectively identify and degrade lipids and plays an important role in regulating cellular lipid metabolism and maintaining intracellular lipid homeostasis. The process of lipophagy can be directly or indirectly regulated by genes, enzymes, transcriptional regulators and other factors. This review examines the role of lipophagy in reducing liver lipid content, regulating pancreatic lipid metabolism, and regulating adipose tissue differentiation, and summarizes the findings of the molecules (Rab GTPase, enzymes, ion channels, transcription factors, small molecular substances) involved in the regulation of lipophagy, which points to new directions for the treatment of diseases caused by lipid accumulation.
Adipose Tissue ; Autophagy ; Homeostasis ; Lipid Metabolism ; Liver