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Bone cancer pain (BCP) seriously affects patient’s quality of life, which remains a difficult clinical problem, lacking effective drugs for treating it. The inflammation in the spinal cord involves the pathogenesis of BCP. The inhibition of spinal phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway or spinal P2X7 receptor (P2X7R) has previously been shown to alleviate BCP. Naringenin (NAR) has analgesic role and anti-inflammatory property. The present study investigated the protection of NAR against BCP and explored whether the inhibition of spinal inflammation and the blockade of spinal P2X7R/PI3K/AKT signaling involved in this protection. NAR significantly alleviated mechanical allodynia (the increase of paw withdrawal threshold in Von Frey test) and thermal hyperalgesia (the increase of paw withdrawal latency in Hargreaves test) in BCP rats. Additionally, NAR inhibited inflammatory cytokines (the reduced levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) were measured using Elisa assay) and down-regulated P2X7R/PI3K/AKT signaling (the decreased P2X7R expression, the reduced ratios of phosphorylated (p)-PI3K/PI3K and p-AKT/AKT, which were detected Western blot) in the spinal cord of BCP rats. NAR alleviated BCP through inhibiting inflammatory cytokines and down-regulating P2X7R/PI3K/AKT signaling in the spinal cord of rats. These findings revealed that NAR, as an effective agent against BCP, may provide an effective approach in the management of bone cancer patients.

To investigate the mechanism of electroacupuncture (EA) in improving the long-term survival rate of mice after myocardial infarction by promoting angiogenesis and inhibiting ventricular remodeling.A total of 102 male C57BL/6 mice were randomly divided into sham operation, model and EA groups (After modeling, the survival rate, EF, and the thickness of the left cardiac ventricle were significantly decreased (EA of PC6 and PC4 can significantly improve the cardiac function and long-term survival rate in mice with myocardial infarction, which may be related to its functions in up-regulating the expression of HIF-1α and VEGF to promote angiogenesis and in inhibiting ventricular remodeling.

Objective Sepsis is a major challenge in intensive care unit (ICU) worldwide and the septic survivors are left with long-term cognitive deficits. This work aims to explore the effects of electroacupuncture (EA) on long-term cognitive function and its underlying mechanism in sepsis-survivor mice. Methods Sepsis was induced by cecal ligation and puncture in C57BL/6 male mice. Seven days post-surgery, sepsis-survivor mice were treated with EA or nonacupoint EA for 17 days twice daily. Then, cognitive function was evaluated by Morris water maze task. The hippocampus tissue were collected from the mice at 30 days post-surgery. The level of nitric oxide and the expression of endothelial nitric oxide (eNOS), phospho-eNOS (p-eNOS), and amyloid β–peptide (Aβ) were measured. Results Compared with the sham-operated control, sepsis-survivors had significant cognitive deficits evidenced by the increased time of escape latency and reduced crossing number in Morris water maze task, as well as lower NO and p-eNOS level and higher Aβ level. EA treatment at GV20 and ST36 acupoints but not at a nonacupoint improved the cognitive function, increased the NO and p-eNOS level, and decreased Aβ generation; while eNOS inhibitor (L-NAME) undermined the efficacy of EA treatment. Conclusion In conclusion, repeated EA treatment could ameliorate the long-term cognitive impairment via manipulating the expression of p-eNOS and related Aβ in sepsis-survivor mice.

IntroductionPostoperative ileus (POI), a common complication after surgery, severely affects postoperative recovery. It is unclear whether pretreatment with transcutaneous electrical acupoint stimulation (TEAS) can improve recovery from POI. This trial will evaluate the effects of pretreatment with TEAS on POI.Methods and analysisThis will be a prospective, randomised controlled trial. American Society of Anesthesiologists (ASA) physical status classification I–III level patients, aged 18–75 years and scheduled for laparoscopic colon surgery, will be included in the study. It is planned that 146 subjects will be randomised to the TEAS and sham TEAS (STEAS) groups. The groups will undergo two sessions of TEAS/STEAS daily for 3 days before surgery, with a final TEAS/STEAS treatment 30 min before anaesthesia. The primary endpoint of the study will be time to first defaecation. Secondary endpoints will include time to first flatus, time to tolerance of oral diet, GI-2 (composite outcome of time to first defaecation and time to tolerance of oral diet), time to independent walking, length of hospital stay, postoperative pain Visual Analogue Scale score on the first 3 days after surgery, analgesic requirements, complications and plasma concentrations of interferon-β (IFN-β), IFN-γ, interleukin-6 (IL-6) and IL-1β. Multiple linear regression will be used to identify independent predictors of outcome measures.Ethics and disseminationThis study has been approved by the Chinese Registered Clinical Trial Ethics Review Committee (No. ChiECRCT-20170084). The results of the trial will be published in an international peer-reviewed journal.Trial registration numberThis study has been registered with the Chinese Clinical Trial Registry (No. ChiCTR-INR-17013184).Trial statusThe study was in the recruitment phase at the time of manuscript submission.

Background: Though Cardiac surgery under cardiopulmonary bypass (CPB) under epidural anesthesia in conscious patients is associated with increased risk of epidural hematoma. We developed a monitored anesthesia care (MAC) platform for cardiac surgery under CPB. In the current prospective study, we investigated the safety and effectiveness of the MAC platform versus intubated general anesthesia (IGA) in patients receiving elective open-heart surgery. Methods: The study included adult patients who were scheduled to undergo open-heart surgery under CPB at our hospital between April 2012 and February 2017. MAC consisted of local anesthesia at the site of sternotomy, sedation with dexmedetomidine, analgesia with remifentanil/sufentanil, and electroacupuncture. MAC versus IGA was chosen by the patients. Findings: Eleven patients received MAC and 13 patients received IGA. The two groups were comparable in the demographic, baseline and operative variables. No conversion occurred from MAC to IGA. No major complications occurred during the surgery in both groups. No confirmed awareness events after surgery were reported in both groups. There was no statistical difference in the incidence of postoperative complications between the two groups (P >0.05). The intraoperative consumption of sufentanil and remifentanil was significantly lower in the MAC group than the IGA group (P < 0.001). The time to drinking was significantly shorter in the MAC group (2.14±0.90 h) than the IGA group (22.31±3.33 h) (P

Background Cardiac surgery involving cardiopulmonary bypass (CPB) is known to be associated with a transient postoperative immunosuppression. When severe and persistent, this immune dysfunction predisposes patients to infectious complications, which contributes to a prolonged stay in the intensive care unit (ICU), and even mortality. Effective prevention and treatment methods are still lacking. Recent studies revealed that acupuncture-related techniques, such as electroacupuncture and transcutaneous electrical acupoint stimulation (TEAS), are able to produce effective cardioprotection and immunomodulation in adult and pediatric patients undergoing cardiac surgery with CPB, which leads to enhanced recovery. However, whether perioperative application of TEAS, a non-invasive technique, is able to improve immunosuppression of the patients with post-cardiosurgical conditions is unknown. Thus, as a preliminary study, the main objective is to evaluate the effects of TEAS on the postoperative expression of monocytic human leukocyte antigen (-D related) (mHLA-DR), a standardized “global” biomarker of injury or sepsis-associated immunosuppression, in patients receiving on-pump coronary artery bypass grafting (CABG). Methods This study is a single-center clinical trial. The 88 patients scheduled to receive CABG under CPB will be randomized into two groups: the group receiving TEAS, and the group receiving transcutaneous acupoint pseudo-electric stimulation (Sham TEAS). Expression of mHLA-DR serves as a primary endpoint, and other laboratory parameters (e.g., interleukin [IL]-6, IL-10) and clinical outcomes (e.g., postoperative infectious complications, ICU stay time, and mortality) as the secondary endpoints. In addition, immune indicators, such as high mobility group box 1 protein and regulatory T cells will also be measured. Discussion The current study is a preliminary monocentric clinical trial with a non-clinical primary endpoint, expression of mHLA-DR, aiming at determining whether perioperative application of TEAS has a potential to reverse CABG-associated immunosuppression. Although the immediate clinical impact of this study is limited, its results would inform further large-sample clinical trials using relevant patient-centered clinical outcomes as primary endpoints. Trial registration ClinicalTrials.gov, NCT02933996. Registered on 13 October 2016.

Background: The coronary artery bypass grafting (CABG) is a surgery to relieve angina and reduce mortality of coronary heart disease. However, the patient is more prone to have immunosuppression after the surgery, causing secondary infection, and it is closely correlated to the occurrence and progress of tumor after surgery. More and more studies revealed that needle puncture was able to effectively regulate the function of immune system. However, its perioperative application is unclear. Therefore, this clinical study is aimed to evaluate whether the effect of Transcutaneous Electrical Acupoint Stimulation (TEAS) on improvement of immunosuppression of patients after receiving CABG. Methods: This clinical study was a single-center clinical trial. The 88 patients scheduled to receive CABG under extracorporeal circulation were randomized into 2 groups: the group of TEAS combined with general anesthesia (TEAS+GA), and the group of transcutaneous acupoint pseudo - electric stimulation combined with general anesthesia (Sham TEAS+GA). Human leukocyte antigen of monocyte (mHLA-DR) was the main endpoint to evaluate on the improvement of immunosuppression of patient after surgery. In addition, the monitoring indicators, such as interleukin-6 (IL-6), reactive protein C (CRP), high mobility group protein 1 (HMGB1), regulatory T cell (Treg) and secondary infection, etc., were recorded, and further statistical analysis was conducted. Discussion: This study performs TEAS intervention on patients scheduled to receive CABG under extracorporeal circulation in perioperative period, to improve their postoperative immunosuppression, reduce postoperative complications, reduce secondary infection rate, shorten hospital stay and improve the patient’s outcome. This study also aims to provide clinical evidence for application of this technique. However, TEAS related parameters in this study (stimulus intensity and waveform, intervention timing and duration, etc.) should be further optimized. Trial registration: This study was approved by Ethics Committee of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine with the number 2016-455-06-01. The results of the trial will be published in an internationally peer-reviewed journal. This study was registered at ClinicalTrials with the Identifier NCT02933996 on 13 October 2016, https://www.clinicaltrials.gov/ct2/show/NCT02933996 Keywords: CABG; TEAS; immunosuppression; mHLA-DR

The study examined the global metabolic and some biochemical changes in rats with cholestasis induced by bile duct ligation (BDL). Serum samples were collected in male Wistar rats with BDL (n = 8) and sham surgery (n = 8) at day 3 after surgery for metabolomics analysis using a combination of reversed phase chromatography and hydrophilic interaction chromatography (HILIC) and quadrupole-time-of-flight mass spectrometry (Q-TOF MS). The serum levels of malondialdehyde (MDA), total antioxidative capacity (T-AOC), glutathione (GSH) and glutathione disulfide (GSSG), the activities of superoxide dismutase (SOD) and glutathion peroxidase (GSH-Px) were measured to estimate the oxidative stress state. Key changes after BDL included increased levels of l-phenylalanine, l-glutamate, l-tyrosine, kynurenine, l-lactic acid, LysoPC(c) (14:0), glycine and succinic acid and decreased levels of l-valine, PC(b) (19:0/0:0), taurine, palmitic acid, l-isoleucine and citric acid metabolism products. And treatment with BDL significantly decreased the levels of GSH, T-AOC as well as SOD, GSH-Px activities, and upregulated MDA levels. The changes could be mapped to metabolism of amino acids and lipids, Krebs cycle and glycolysis, as well as increased oxidative stress and decreased antioxidant capability. Our study indicated that BDL induces major changes in the metabolism of all 3 major energy substances, as well as oxidative stress.

Xiao-Ming Wu,1 Jun-Feng Wang,1 Jian-Song Ji,2 Ming-Gao Chen,1 Jian-Gang Song1 1Department of Radiology, Jinhua People’s Hospital, Jinhua, 2Department of Radiology, Lishui Municipal Center Hospital, Lishui, People’s RepublicofChina Abstract: Although the efficacy of transcatheter arterial chemoembolization (TACE) has been recommended as first-line therapy for nonsurgical patients with hepatocellular carcinoma (HCC), it is difficult to accurately predict the efficacy of TACE. Therefore, this study evaluated the efficacy of TACE for HCC using magnetic resonance (MR) diffusion-weighted imaging (DWI). A total of 84 HCC patients who received initial TACE were selected and assigned to the stable group (n=39) and the progressive group (n=45). Before TACE treatment, a contrast-enhanced MR scan and DWI (b=300, 600, and 800 s/mm2) were performed on all patients. The modified response evaluation criteria in solid tumors were used for evaluation of tumor response. Receiver operating characteristic curve was employed to predict the value of apparent diffusion coefficient (ADC) for TACE efficacy. The ADC values of HCC patients in the progressive group were higher than those in the stable group at different b-values (b=300, 600, and 800 s/mm2) before TACE treatment. The area under the curve of ADC values with b-values of 300, 600, and 800 s/mm2 were 0.693, 0.724, and 0.746; the threshold values were 1.94×10-3 mm2/s, 1.28×10-3 mm2/s, and 1.20×10-3 mm2/s; the sensitivity values were 55.6%, 77.8%, and 73.3%; and the specificity values were 82.1%, 61.5%, and 71.8%, respectively. Our findings indicate that the ADC values of MR-DWI may accurately predict the efficacy of TACE in the treatment of HCC patients. Keywords: magnetic resonance imaging, diffusion-weighted imaging, hepatocellular carcinoma, transcatheter arterial chemoembolization, apparent diffusion coefficient

Background The present study aimed to compare the safety and efficacy for novices to conduct intubation with the Bonfils intubation fiberscope (BIF) using the transillumination-assisted or midline approach technique in patients with normal airways. Methods In this prospective randomized control study, 10 trainees were assigned to the transillumination-assisted technique group (T group) or the midline approach technique group (R group). Each trainee was required to conduct intubation in 50 patients. The primary outcome was intubation time. The secondary outcomes were success rate (%), number of attempts, and complications. Results Among the cases of successful intubation, the intubation time was not significantly different between the two groups (P > 0.05). The overall success rate of intubation was not significantly different between the two groups (P > 0.05). The intubation success rates at the first, second, and third attempts as well as the average intubation times were similar between the two groups (P > 0.05), but in patients receiving successful intubation at the second attempt, the intubation time was longer in the T group (P = 0.0006). The incidences of dry throat, sore throat, and hoarseness were higher in the T group (all P < 0.05). Conclusions For patients with a normal airway, the transillumination-assisted technique was unlikely to increase the success rate of intubation with the BIF compared with the midline approach technique, but led to more complications. Trial registration ChiCTR-INR-16009967, retrospectively registered on November 22, 2016 Electronic supplementary material The online version of this article (doi:10.1186/s12871-017-0322-6) contains supplementary material, which is available to authorized users.

This paper presents a study on the different applying methods of (NH4)2HPO4 fire retardant influence on physical and mechanical properties of bamboo scrimber. The results showed: the properties of bamboo scrimber would change with applying methods changing of fire retardant; the method of applying fire retardants before gluing would increase the part of physical and mechanical properties of bamboo scrimber, but it would increase the manufacturing cost of bamboo scrimber; the method of applying fire retardants after gluing would reduce the part of physical and mechanical properties of bamboo scrimber.

This paper presents a study on the different fire retardant treatment technologies influence on the physical and mechanical properties of bamboo particleboard. The results showed: the properties of bamboo particleboard would change with changing of fire retardant treatment technology; among them the treated technology of fire retardant spraying after resin blending had larger changed; compared with non-fire retardant bamboo particleboard, the density and moisture content (MC) and 2h thickness swell (2h TS) of fire retardant bamboo particleboard had a little improved, and their internal bond (IB) and modulus of rupture (MOR) and modulus of elasticity (MOE) had slightly reduced.

Background Recent advances have indicated a complex interplay between the autonomic nervous system and the innate immune system. Targeting neural networks for the treatment of sepsis is being developed as a therapeutic strategy. Because electroacupuncture at select acupoints can modulate activities of the autonomic nervous system, we tested the hypothesis that electroacupuncture at specific acupoints could modulate systemic inflammatory responses and improve survival via its impact on the autonomic nervous system in a rat model of sepsis. Methods Sprague-Dawley male rats received electroacupuncture for 45 min before and at 1, 2, or 4 h after a lethal dose of intraperitoneal lipopolysaccharide injection (6 mg/kg). Outcomes included survival and systemic cytokine responses. Also, the possible roles of neural circuitry, including the hypothalamic-pituitary-adrenal axis and the autonomic nervous system, were evaluated. Results Electroacupuncture pretreatment at the Hegu acupoints significantly attenuate systemic inflammatory responses and improve survival rate from 20% to 80% in rats with lethal endotoxemia. Such a site-specific effect requires the activation of muscarinic receptors in the central nervous system, but not increasing central sympathetic tone. In the periphery synergistic, rather than independent, action of the sympathetic and parasympathetic systems is also necessary. Conclusions Electroacupuncture pretreatment has a dramatic survival-enhancing effect in rats with lethal endotoxemia, which involves the activation of efferent neural circuits of the autonomic nervous system (e.g., cholinergic antiinflammatory pathway). This approach could be developed as a prophylactic treatment for sepsis or perioperative conditions related to excessive inflammation.

Background Obstructive jaundice is associated with enhanced susceptibility to hypotensive shock, renal failure, and toxic effects of endotoxin, which results in high perioperative morbidity and mortality. Since the normal arterial baroreflex function is necessary for hemodynamic homeostasis and improving survival in sepsis, this study aimed to determine whether baroreflex sensitivity was impaired in jaundiced patients. Methods Thirty-five patients with obstructive jaundice scheduled for surgery were included, and 30 nonjaundiced patients served as controls. A modified Oxford pharmacologic technique was used for evaluating baroreflex sensitivity immediately before the surgery. Potential factors that may affect baroreflex sensitivity in jaundice, such as liver biochemistry, plasma concentrations of methionine-enkephalin, atrial natriuretic peptide and nitrate, were also measured. Results Patients with obstructive jaundice had decreased sensitivity in both the sympathetic and vagal components of the baroreflex, as compared with the controls (P < 0.01). There was a significant inverse correlation between plasma atrial natriuretic peptide concentration and decreased sympathetic baroreflex sensitivity in the jaundiced group (r = -0.44, P = 0.008). Conclusions Baroreflex sensitivity is impaired in patients with obstructive jaundice, which may contribute to their enhanced susceptibility to the well-known perioperative complications. The underlying mechanisms for such a change may be associated with an increased level of plasma atrial natriuretic peptide.

Excessive release of high mobility group box-1 (HMGB1) protein from ischemic cardiomyocytes activates inflammatory cascades and enhances myocardial injury after reperfusion. Here we report evidence that electroacupuncture of mice at Neiguan acupoints can inhibit the up-regulation of cardiac HMGB1 following myocardial ischemia and attenuate the associated inflammatory responses and myocardial injury during reperfusion. These benefits of electroacupuncture were partially reversed by administering recombinant HMGB1 to the mice and further potentiated by administering anti-HMGB1 antibody. Electroacupuncture-induced inhibition of HMGB1 release was markedly reduced by unilateral vagotomy or administration of nicotinic receptor antagonist, but not by chemical sympathectomy. The cholinesterase inhibitor neostigmine mimicked the effects of electroacupuncture on HMGB1 release and myocardial ischemia reperfusion injury. Culture experiments with isolated neonatal cardiomyocytes showed that acetylcholine, but not noradrenaline, inhibited hypoxia-induced release of HMGB1 via a α7nAchR-dependent pathway. These results suggest that electroacupuncture acts via the vagal nerve and its nicotinic receptor-mediated signaling to inhibit HMGB1 release from ischemic cardiomyocytes. This helps attenuate pro-inflammatory responses and myocardial injury during reperfusion.

We propose in this paper an approach to describe the dynamical moment of inertia of superdeformed nuclear states in the spirit of variable moments of inertia. Both the general changing feature and the turnover of dynamical moments of inertia with rotational frequency are well described in our approach. It indicates that the competition between the angular momentum driving effect and the restraining effect plays a crucial role in determining the dynamical moments of inertia of superdeformed nuclear states.

We show in this paper that the superdeformed nuclear states can be described with a four parameter formula in the spirit of the perturbated SU(3) limit of the sdg IBM. The E2 transition {gamma}-ray energies, the dynamical moments of inertia of the lowest superdeformed (SD) bands in even-even Hg, Pb, Gd, and Dy isotopes, and the energy differences {Delta}E{sub {gamma}}{minus}{Delta}E{sub {gamma}}{sup ref} of the SD band 1 of {sup 194}Hg are calculated. The calculated results agree with experimental data well. This indicates that the SD states are governed by a rotational interaction plus a perturbation with SO{sub sdg}(5) symmetry. The perturbation causing the {Delta}I=4 bifurcation to emerge in the {Delta}I=2 superdeformed rotational band may then possess SO{sub sdg}(5) symmetry. {copyright} {ital 1997} {ital The American Physical Society}

An approach considering both pairing and anti-pairing correlations in superdeformed (SD) states is proposed. Calculated results show that not only the general changing feature but also the turnover of dynamical moment of inertia with rotational frequency of the first SD band of 192Hg, 194Hg, and 152Dy are well described in the approach. It indicates that there exist competition, even change-over between the anti-pairing and pairing effects in the SD states in A ~ 190 and 150 ranges.

The physical implication of the changing feature of nuclear energy level statistics versus the structure parameter χ is discussed in this letter. It indicates that the changing characteristic is an evidence that the continuous dynamical transformation, which cannot be represented by the generators of the corresponding dynamical group, is a necessary condition for chaotic motion taking place in the process of evolution.

Synchronous fluorescence spectroscopy and 3-dimensional excitation emission matrices spectra (3DEEM) were used to study the composition variation of dissolved organic matter (DOM) in landfill leachate in the adsorption process with 717 resin. The synchronous fluorescence spectra showed fluorescence intensities of longer wavelength went down greatly while those of shorter wavelength went up in the first 10 min, then there were little changes. 3DEEM results indicated that there were two fulvic-like fluorescence peaks, whose intensities decreased dramatically, the peak intensities ratio (I(UV)/I(Vis)) also decreased, and the blue shifts of emission wavelengths took place obviously with the time rising. It was indicated that the adsorption rate of DOM by 717 resin was fast, and the main adsorbed DOM had higher molecular weight and higher degree of complexity, which was potential to facilitate subsequent bio-treatment.

AIM: To investigate the role of hepatic peroxisome proliferator-activated receptor-γ (PPAR-γ) in increased susceptibility to endotoxin-induced toxicity in rats with bile duct ligation during endotoxemia. METHODS: Male Sprague-Dawley rats were subjected to bile duct ligation (BDL). Sham-operated animals served as controls. DNA binding were determined by polymerase chain reaction, Western blotting analysis, and electrophoretic mobility shift assay, respectively. BDL and sham-operated rats received a non-lethal dose of intraperitoneal lipopolysaccharide (LPS) injection (3 mg/kg, i.p.). Additionally, the potential beneficial effects of the PPAR-γ agonist rosiglitazone were determined in BDL and sham-operated rats treated with a non-lethal dose of LPS. Survival was assessed in BDL rats treated with a non-lethal dose of LPS and in sham-operated rats treated at a lethal dose of LPS (6 mg/kg, i.p.). RESULTS: PPAR-γ activity in rats undergoing BDL was significantly lower than in the sham-controls. Hepatic PPAR-γ gene expression was downregulated at both the mRNA and protein levels. In a parallel group, serum levels of pro-inflammatory cytokines were nearly undetectable in the sham-operated rats. When challenged with a non-lethal dose of LPS (3 mg/kg), the BDL rats had approximately a 2.4-fold increase in serum IL-6, a 2.7 fold increase in serum TNF-α, 2.2-fold increase in serum IL-1 and 4.2-fold increase in serum ALT. The survival rate was significantly lower as compared with that in sham-operated group. Additionally, rosiglitazone significantly reduced the concentration of TNF-α, IL-1β, IL-6 and ALT in sham-operated rats, but not in BDL rats, in response to LPS (3 mg/kg). Also, the survival was improved by rosiglitazone in sham-operated rats challenged with a lethal dose of LPS, but not in BDL rats, even with a non-lethal dose of LPS (3 mg/kg). CONCLUSION: Obstructive jaundice downregulates hepatic PPAR-γ expression, which in turn may contribute to hypersensitivity towards endotoxin.