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Background: The purpose of this randomized controlled trial was to determine if enhanced recovery after surgery (ERAS) would improve outcomes for three-stage minimally invasive esophagectomy (MIE). Methods: Patients with esophageal cancer undergoing MIE between March 2016 and August 2018 were consecutively enrolled, and were randomly divided into 2 groups: ERAS+group that received a guideline-based ERAS protocol, and ERAS- group that received standard care. The primary endpoint was morbidity after MIE. The secondary endpoints were the length of stay (LOS) and time to ambulation after the surgery. The perioperative results including the Surgical Apgar Score (SAS) and Visualized Analgesia Score (VAS) were also collected and compared. Results: A total of 60 patients in the ERAS+ group and 58 patients in the ERAS- group were included. Postoperatively, lower morbidity and pulmonary complication rate were recorded in the ERAS+ group (33.3% vs. 51.7%; p= 0.04, 16.7% vs. 32.8%; p= 0.04), while the incidence of anastomotic leakage remained comparable (11.7% vs. 15.5%; p= 0.54). There was an earlier ambulation (3 [2–3] days vs. 3 [3–4] days, p= 0.001), but comparable LOS (10 [9–11.25] days vs. 10 [9–13] days; p= 0.165) recorded in ERAS+ group. The ERAS protocol led to close scores in both SAS (7.80 ± 1.03 vs. 8.07 ± 0.89, p= 0.21) and VAS (1.74 ± 0.85 vs. 1.78 ± 1.06, p= 0.84). Conclusions: Implementation of an ERAS protocol for patients undergoing MIE resulted in earlier ambulation and lower pulmonary complications, without a change in anastomotic leakage or length of hospital stay. Further studies on minimizing leakage should be addressed in ERAS for MIE.

ABSTRACTAcute lung injury (ALI) is a critical clinical condition with a high mortality rate, characterized with excessive uncontrolled inflammation and apoptosis. Recently, microRNAs (miRNAs) have been found to play crucial roles in the amelioration of various inflammation-induced diseases, including ALI. However, it remains unknown the biological function and regulatory mechanisms of miRNAs in the regulation of inflammation and apoptosis in ALI. The aim of this study is to identify and evaluate the potential role of miRNAs in ALI and reveal the underlying molecular mechanisms of their effects. Here, we analyzed microRNA expression profiles in lung tissues from LPS-challenged mice using miRNA microarray. Because microRNA-27a (miR-27a) was one of the miRNAs being most significantly downregulated, which has an important role in regulation of inflammation, we investigated its function. Overexpression of miR-27a by agomir-27a improved lung injury, as evidenced by the reduced histopathological changes, lung wet/dry (W/D) ratio, lung microvascular permeability and apoptosis in the lung tissues, as well as ameliorative survival of ALI mice. This was accompanied by the alleviating of inflammation, such as the reduced total BALF cell and neutrophil counts, decreased levels of tumor necrosis factor alpha (TNF-α), interleukin-1 (IL-6) interleukin-1β (IL-1β) and myeloperoxidase (MPO) activity in BAL fluid. Toll-like receptor 4 (TLR4), an important regulator of the nuclear factor kappa-B (NF-κB) signaling pathway, was identified as a novel target of miR-27a in RAW264.7 cells. Furthermore, our results showed that LPS stimulation increased the expression of MyD88 and NF-κB p65 (p-p65), but inhibited the expression of inhibitor of nuclear factor-κB-α (IκB-α), suggesting the activation of NF-κB signaling pathway. Further investigations revealed that agomir-miR-27a reversed the promoting effect of LPS on NF-κB signaling pathway. The results here suggested that miR-27a alleviates LPS-induced ALI in mice via reducing inflammation and apoptosis through blocking TLR4/MyD88/NF-κB activation.

Background: Tetrandrine has good pharmacological effects, especially in the treatment of pulmonary hypertension. It has the potential to be valuable for clinical applications, however the poor solubility and the high variability of oral bioavailability greatly limited its development. Our research group prepared a new type of tetrandrine microspheres by using chitosan. However, it was lack of pharmacodynamic evaluation and difficult to evaluate if the application of this dosage form can really meet the target to improve curative effect. Methods: In this study, we established animal model of rats with hypoxic pulmonary hypertension, and evaluated acute therapeutic effect by prepared tetrandrine microspheres. Results: In vivo pharmacodynamic showed that tetrandrine lung targeting microspheres had stronger and longer effect to reduce pulmonary arterial pressure (mPAP) than aqueous solvent. After apply tetrandrine lung targeting microspheres on hypoxia rats, no matter the level of dose, mSBP all had no obvious change. Conclusion: Thus it indicated that tetrandrine lung targeting microspheres were mainly effective inside lung, with certain selectivity.

To investigate the protective effects of propofol in brain ischemiareperfusion injury and the role of heme oxygenase-1 (HO-1) in this process.

Winter wheat (Triticum aestivum) cultivars Dongnongdongmai 1 with strong cold/freezing tolerance and Jimai 22 with weak cold/freezing tolerance were used for investigating the difference of microstructure and ultrastructure between leaves of two cultivars under low temperature stress (5°C and −15°C) using optical and electron microscope. The results showed that there was no obvious difference between leaves of Dongnongdongmai 1 and Jimai 22 in microstructure. However, the difference between those leaves was distinct in ultrastructure. The grana lamella and stroma lamella were stacked regularly and arranged parallelly along the long axis of chloroplasts in cv. Dongnongdongmai 1, while the arrangement directions of thylakoids in Jimai 22's leaves were so irregular as to form various angles with the long axis of chloroplasts. At −15°C, the mitochondrias were swelled to be round and the structure of cristaes became blurry in both cultivars' leaves, while some cristaes of Jimai 22 disappeared. These results would provide theoretical evidence for selecting cold/freezing tolerant winter wheat germplasm resources.

Although the regulation of Pi homeostasis by miR399 has been studied in various plant species, its underlying molecular mechanism in response to freezing stress is still poorly understood. In this work, we found that the expression of tae-miR399 and its target gene TaUBC24in the tillering nodes of the strong cold-resistant winter wheat cultivar Dongnongdongmai1 (Dn1) was not only significantly altered after severe winters but also responsive to short-term freezing stress. TaUBC24 physically interacted with TaICE1. Enhanced freezing tolerance was observed for tae-miR399-overexpressing Arabidopsis lines. Under freezing stress, overexpression of tae-miR399 ultimately decreased the expression of AtUBC24, inhibiting the degradation of AtICE1, which increased the expression of genes involved in the CBF signaling pathway and starch metabolism and promoted the activities of antioxidant enzymes. These results will improve our understanding of the molecular mechanism through which the miR399-UBC24module plays a cardinal role in regulating plant freezing stress tolerance through mediation of downstream pathways.

ABSTRACTAbscisic acid (ABA) is an important plant hormone that plays significant roles in cold tolerance regulation. However, whether ABAimproves cold tolerance by increasing the activities of antioxidant enzymes in wheat remains unknown. In this study,the activities of antioxidant enzymes of the winter wheat variety ‘dongnongdongmai 1ʹ(‘dn1ʹ)afterthe application of exogenous ABA under low temperature (0°C, −10°C, −20°C, and −25°C) were investigated. Results showed that cold stress significantly increased H2O2and relative conductivity, whileABA significantly reduced this effect. ABA enhanced cold tolerance in both leaves and rhizomes at −10°C and −20 °Cby increasing CAT, SOD, POD, APX, GR, DHAR, and MDHAR. However, this tolerance was weakenedat −25°C with decreasing ASA, GSH, APX, DHAR, and MDHARthan at-10°C and −20°C.POD, GR, and DHARlevels peaked at −10°C, while CAT, SOD, GSH, APX, and MDHAR content in rhizomes peaked at −20°C. The rate of returning green was significantly increased after ABA treatment than in controls (93.5% vs 83.6 %). In ‘dn1ʹ, rhizomes had a higher cold tolerance than leaves. Thereby, exogenous ABA could enhance cold tolerance byincreasing the activities of antioxidant enzymes.