Objective To investigate combination anesthesia with low-dose ketamine and mid-dose pentobarbital for open heart surgery in ju-venile pigs.Methods Thirty experimental juvenile pigs received ket-amine(3 mg·kg~(-1))and pentobarbital(20 mg·kg~(-1))intramuscularly for induction and intubation,then were given ketamine(5 mg·kg~(-1)·h~(-1)),pentobarbital(6-8 mg·kg~(-1)·h~(-1)),midazolam(0.1-0.2mg kg~(-1)·h~(-1))and pipecuronium(0.1 mg·kg~(-1)·h~(-1))intravenously for maintenance.The infusion of pentobarbital was withdrawn after car-diopulmonary bypass started.During the experimental treatment,vital signs were monitored;artery gas analysis and hemodynamie parameters were recorded.Results Twenty-eight juvenile pigs got stable hemody-namic parameters in the perioperative period.The time of anesthetic in-duction and maintenance is(9±2)and(179±15)min,respectively.The respiratory and cardiac arrest rates were 6.7% in induction and 3.3% in maintenance.respectively.Two cases got respiratory and cardi-ac arrest.on in induction and the OtIler after extubation.In addition,class I anesthetic effectiveness was achieved 73.3% in induction and 80.0% in maintenance,respectively.Conclusion This study demon-strated that lOW-dose ketamine combined with mid-dose pentobarbihal has little inhibition on respiration and circulation.The combination can achieve both hypnosis and analgesia effects with good surgical anesthetic effectiveness in juvenile pigs with open heart surgery.

OBJECTIVEp53-induced apoptosis is crucial in the development of hypoxic-ischemia (HI) brain damage and neurodegenerative disorders. Some experimental research has shown that a synthetic inhibitor of p53 can protect neurons against apoptosis. This study aimed to explore the expression of p53 in neonatal mice following HI brain damage and the effect of p53 inhibitor (pifithrin-alpha, PFT-alpha) on brain damage.

METHODSHI was induced in 9-day-old mice pups by ligation of left carotid artery and 10% oxygen exposure for 55 minutes. The pups were sacrificed and the brains were taken out at 3, 8, 24, and 72 hrs post-HI. The brains were sectioned and stained with antibody against p53 and microtubule-associated protein 2 (MAP-2). PFT-alpha was injected intraperitoneally: in experiment 1, immediately after HI with different dosages (1, 2 and 8 mg/kg); in experiment 2, 2 mg/kg at different HI times (1 hr before HI, and immediately and 1 hr after HI). Control animals without HI received injections of 0.5% dimethyl sulfoxide. Brain damage was evaluated by gross morphology scoring at 72 hrs after HI.

RESULTSThe number of p53 positive cells in the cortex, hippocampus and striatum of the ipsilateral hemisphere increased significantly and peaked at 3-8 hrs post-HI when compared with those of contralateral hemisphere as well as normal controls. The positive cells distributed mainly in the MAP-2 negative area. Both different dosages and different injection time PFT-alpha treatment did not reduce the extent of brain damage.

CONCLUSIONSThe immunoactivity of p53 increased significantly as early as 3 hrs post-HI. The distribution area of p53 expression was consistent with that of brain damage. The p53 inhibitor PFT-alpha has no protective effects against HI brain damage in neonatal mice.

Animals ; Animals, Newborn ; Benzothiazoles ; Brain ; drug effects ; pathology ; Dose-Response Relationship, Drug ; Female ; Hypoxia-Ischemia, Brain ; metabolism ; Immunohistochemistry ; Male ; Mice ; Mice, Inbred C57BL ; Thiazoles ; pharmacology ; Toluene ; analogs & derivatives ; pharmacology ; Tumor Suppressor Protein p53 ; analysis ; antagonists & inhibitors

Biomarkers, Tumor ; DNA Helicases ; Humans ; Neoplasms ; Nuclear Proteins/genetics* ; Transcription Factors

Objective: To investigate the clinicopathological features, immunophenotype and differential diagnoses of SMARCA4-deificient undifferentiated carcinoma (SMARCA4-DUC) of the gastrointestinal tract. Methods: The clinicopathological data and immunohistochemical profiles of nine cases of SMARCA4-DUC of the gastrointestinal tract diagnosed in Fudan University Shanghai Cancer Center, from 2018 to 2021, were analyzed retrospectively. The relevant literature was reviewed. Results: There were seven males and two females with age at presentation ranging from 39 to 74 years (mean 58 years, median 64 years). The tumor occurred in the stomach (6 cases), right hemicolon (2 cases) and duodenum (1 case). The main symptoms included dysphagia, abdominal pain, diarrhea and melena. Five cases were resected, and the tumor sizes ranged from 5.0 to 8.7 cm (mean 6.7 cm). Microscopically, the tumor was composed of sheets of undifferentiated round to epithelioid cells with large vesicular nuclei harboring prominent nucleoli and displaying brisk mitotic activity. Foci of dyscohesive rhabdoid cells were also noted. The tumor cells were generally uniform; however, prominent pleomorphism and spindle cell component was present in one case each. Five cases contained areas of coagulative necrosis, and one case showed myxoid change of the stroma. By immunohistochemistry, eight cases showed complete loss of BRG1 (SMARCA4) and BRM (SMARCA2) expression. Whereas the expression of these two markers was lost in the epithelioid component of one case, it remained in the spindle cell component (mosaic pattern). Apart from one case with partial expression of pan-cytokeratin, all other eight cases showed either limited (<5%, n=5) or totally negative (n=3) staining of pan-cytokeratin. In addition, four cases also expressed CD34, SOX2 and SALL4. Six patients had follow-up data: four died of disease within 1 year. Conclusions: SMARCA4-DUC of the gastrointestinal tract represents a highly aggressive malignancy with poor outcome. Due to lack of cell-specific differentiation, it is not uncommonly misdiagnosed as a wide variety of poorly-differentiated or undifferentiated tumors. Increased recognition of this rare but distinctive entity not only facilitates the diagnosis and differential diagnosis, but also provides important therapeutic and prognostic information for the clinicians.
Biomarkers, Tumor/genetics* ; Carcinoma/pathology* ; China ; DNA Helicases ; Female ; Gastrointestinal Tract/pathology* ; Humans ; Keratins ; Male ; Nuclear Proteins ; Retrospective Studies ; Transcription Factors