术前超声引导下腰方肌阻滞联合全身麻醉对肾移植患者术后血清应激反应和疼痛相关指标的影响

摘要 目的：探讨术前超声引导下腰方肌阻滞（QLB）联合全身麻醉对肾移植患者术后血清应激反应和疼痛相关指标的影响。方法：选择我院2019年9月~2021年8月期间收治的行肾移植手术的患者82例作为观察对象。根据随机数字表法分为A组和B组,分别为41例。A组给予全身麻醉,B组给予术前超声引导下QLB联合全身麻醉,对比两组静息视觉疼痛模拟（VAS）评分、自控静脉镇痛中的舒芬太尼使用量、有效按压次数,对比两组术后血清应激反应和疼痛相关指标变化,对比两组不良反应发生情况。结果：B组术后6 h、12 h、24 h、48 h静息VAS评分低于A组（P<0.05）。B组自控静脉镇痛中的舒芬太尼使用量少于A组,有效按压次数少于A组（P<0.05）。B组拔管后、术后24 h血糖（Glu）、皮质醇（Cor）低于A组（P<0.05）。两组术后24 h P物质（SP）、前列腺素E₂（PGE₂）及5-羟色胺（5-HT）均升高,但B组低于A组（P<0.05）。两组的不良反应发生率对比无差异（P<0.05）。结论：术前超声引导下QLB联合全身麻醉用于肾移植手术患者,可有效减轻疼痛和应激反应,减少自控静脉镇痛中的舒芬太尼使用量、有效按压次数,且不增加不良反应发生率。     

超声引导下髂筋膜神经阻滞联合全麻对老年股骨近端骨折患者术后血清疼痛介质PGE2、SP和认知功能及睡眠质量的影响

摘要 目的：观察超声引导下髂筋膜神经阻滞联合全麻对老年股骨近端骨折患者术后血清疼痛介质前列腺素E₂（PGE₂）、P物质（SP）和认知功能及睡眠质量的影响。方法：选取2018年8月~2021年9月期间我院收治的择期行手术治疗的老年股骨近端骨折患者80例,根据随机数字表法分为对照组（40例,常规全麻方案）和观察组（40例,超声引导下髂筋膜神经阻滞联合全麻方案）,对比两组麻醉效果、血流动力学、疼痛情况、认知功能和睡眠质量,观察不同模式麻醉下的安全性。结果：观察组的苏醒及拔管时间均短于对照组,丙泊酚使用量少于对照组（P<0.05）。两组置入喉罩时（T1）~术毕时（T3）心率（HR）先升高后下降,平均动脉压（MAP）先下降后升高（P<0.05）;观察组T1~T3时点HR低于对照组,MAP高于对照组（P<0.05）。两组术后24 h血清PGE₂、SP水平和视觉疼痛模拟量表（VAS）评分均升高,但观察组低于对照组（P<0.05）。两组术后1 d、2 d、3 d 蒙特利尔认知评估量表（MoCA）评分较术前先下降后升高（P<0.05）;观察组术后2 d、3 d MoCA评分高于对照组（P<0.05）。两组术后1 d、2 d、3 d匹兹堡睡眠质量评估量表（PSQI）评分较术前先升高后下降（P<0.05）;观察组术后1 d、2 d、3 d PSQI评分低于对照组（P<0.05）。两组不良反应发生率对比无差异（P>0.05）。结论：老年股骨近端骨折患者术中选用超声引导下髂筋膜神经阻滞联合全麻,镇痛效果显著,可稳定机体血流动力学,减少对认知功能和睡眠质量的影响,且安全性良好。     

ED50 G Na Block Predictions for Phenyl Substituted and Unsubstituted n-Alkanols

To study the role the phenyl group plays in producing local anesthetic block, a sequence of n-alkanols and phenyl-substituted alkanols (Φ-alkanols) were characterized in their ability to block Na channels. The sequence of n-alkanols studied possess 3–5 carbons (propanol-pentanol). The action of phenol and 3-Φ-alkanols (benzyl alcohol, phenethyl alcohol, 3-phenyl-1-propanol) were also studied. Na currents (I _Na ) were recorded from single frog skeletal muscle fibers using the Vaseline-gap voltage clamp technique. I _Na s were recorded prior to, during, and following the removal of the solutes in Ringer's solution. All alkanols and phenol acted to block I _Na in a dose-dependent manner. Effective doses to produce half block (ED₅₀) of I _Na or Na conductance (G _Na ) were obtained from dose-response relations for all solutes used. The block of G _Na depended on voltage, and could be separated into voltage-dependent and -independent components. Each solute acted to shift G _Na -V relations in a depolarized direction and reduce the maximum G _Na and slope of the relation. All solutes acted to speed up I _Na kinetics and cause hyperpolarizing shifts in steady-state inactivation. The magnitude of the kinetic changes increased with dose. Size was an important variable in determining the magnitude of the changes in I _Na ; however, size alone was not sufficient to predict the changes in I _Na . ED₅₀s for G _Na and AP block could be predicted as a function of intrinsic molar volume, hydrogen bond acceptor basicity (β) and donor acidity (α), and polarity (P) of the solutes. The equivalency of ED₅₀ predictions for AP and G _Na block can be explained by the fact that AP block arises from channel block and solute-induced changes in I _Na kinetics. Φ-alkanols were more effective at blocking and inactivating Na channels than their unsubstituted counterparts. Phenyl-substituted alkanols are more likely to interact with the channel than their unsubstituted counterparts. Received: 11 August 2000/Revised: 21 December 2000     

Stereospecific synthesis of "para-hydroxymexiletine" and sodium channel blocking activity evaluation

Both enantiomers of "para-hydroxymexiletine" (PHM), one of the main metabolites of mexiletine, were synthesized and fully characterized. Properties of (R)- and (S)-PHM, in terms of blocking potency and stereoselectivity on frog skeletal muscle Na(+) channels, were evaluated. The presence of a hydroxy group on the aryloxy moiety in the 4-position, as in PHM, reduced potency with respect to mexiletine in reducing I(Na max). However, PHM showed clear use-dependent behavior similar to that of mexiletine and, in contrast with what is observed with the parent compound, maintained its stereoselectivity during the use-dependent block. Chirality 16:72-78, 2004.     

Elongated mouse chromosomes suitable for enhanced molecular cytogenetics

Characterization of genetic disorders in humans and animal models requires identification of chromosomal aberrations. However, identifying fine deletions or insertion in metaphase chromosomes has been always a challenge due to limitations of resolution. In this study we developed a rapid method for chromosome elongation using two different intercalating agents: ethidium bromide and 5-bromo-2′-deoxyuridine (BrdU), together with a short-term mitotic block using colcemid. About 70% of the chromosomes from cells that underwent this elongation procedure reached three times longer than those prepared from control cells. FISH experiments using elongated chromosomes revealed a duplicated region of chromosome 11 that was not visible in cells prepared with conventional methods.     

In silico protein design by combinatorial assembly of protein building blocks

Utilizing concepts of protein building blocks, we propose a de novo computational algorithm that is similar to combinatorial shuffling experiments. Our goal is to engineer new naturally occurring folds with low homology to existing proteins. A selected protein is first partitioned into its building blocks based on their compactness, degree of isolation from the rest of the structure, and hydrophobicity. Next, the protein building blocks are substituted by fragments taken from other proteins with overall low sequence identity, but with a similar hydrophobic/hydrophilic pattern and a high structural similarity. These criteria ensure that the designed protein has a similar fold, low sequence identity, and a good hydrophobic core compared with its native counterpart. Here, we have selected two proteins for engineering, protein G B1 domain and ubiquitin. The two engineered proteins share approximately 20% and approximately 25% amino acid sequence identities with their native counterparts, respectively. The stabilities of the engineered proteins are tested by explicit water molecular dynamics simulations. The algorithm implements a strategy of designing a protein using relatively stable fragments, with a high population time. Here, we have selected the fragments by searching for local minima along the polypeptide chain using the protein building block model. Such an approach provides a new method for engineering new proteins with similar folds and low homology.     

Delay of ZGA initiation occurred in 2-cell blocked mouse embryos

One-cell mouse embryos from KM strain and B6C3F1 strain were cultured in M16 medium, in which2-cell block generally occurs. Embryos of KM strain exhibited 2-cell block, whereas B6C3F1 embryos,which are regarded as a nonblocking strain, proceeded to the 4-cell stage in our culture condition. It is oftenassumed that the block of early development is due to the failure of zygotic gene activation (ZGA) in culturedembryos. In this study we examined protein synthesis patterns by two-dimensional gel electrophoresis of[35^S] methionine radiolabeled 2-cell embryos. Embryos from the blocking strain and the nonblocking strainwere compared in their development both in vitro and in vivo. The detection of TRC expression, a markerof ZGA, at 42 h post hCG in KM embryos developed in vitro suggested that ZGA was also initiated even inthe 2-cell arrested embryos. Nevertheless, a significant delay of ZGA was observed in KM strain as comparedwith normally developed B6C3F1 embryos. At the very beginning of major ZGA as early as 36 h post hCG,TRC has already been expressed in B6C3F1 embryos developed in vitro and KM embryos developed in vivo.But for 2-cell blocked KM embryos, TRC was still not detectable even at 38 h post hCG. These evidences suggest that 2-cell-blocked embryos do initiate ZGA, and that 2-cell block phenomenon is due not to the disability in initiating ZGA, but to a delay of ZGA.     

Mutation-induced blocker permeability and multiion block of the CFTR chloride channel pore

Chloride permeation through the cystic fibrosis transmembrane conductance regulator (CFTR) Cl- channel is blocked by a broad range of anions that bind tightly within the pore. Here we show that the divalent anion Pt(NO2)42- acts as an impermeant voltage-dependent blocker of the CFTR pore when added to the intracellular face of excised membrane patches. Block was of modest affinity (apparent Kd 556 microM), kinetically fast, and weakened by extracellular Cl- ions. A mutation in the pore region that alters anion selectivity, F337A, but not another mutation at the same site that has no effect on selectivity (F337Y), had a complex effect on channel block by intracellular Pt(NO2)42- ions. Relative to wild-type, block of F337A-CFTR was weakened at depolarized voltages but strengthened at hyperpolarized voltages. Current in the presence of Pt(NO2)42- increased at very negative voltages in F337A but not wild-type or F337Y, apparently due to relief of block by permeation of Pt(NO2)42- ions to the extracellular solution. This "punchthrough" was prevented by extracellular Cl- ions, reminiscent of a "lock-in" effect. Relief of block in F337A by Pt(NO2)42- permeation was only observed for blocker concentrations above 300 microM; as a result, block at very negative voltages showed an anomalous concentration dependence, with an increase in blocker concentration causing a significant weakening of block and an increase in Cl- current. We interpret this effect as reflecting concentration-dependent permeability of Pt(NO2)42- in F337A, an apparent manifestation of an anomalous mole fraction effect. We suggest that the F337A mutation allows intracellular Pt(NO2)42- to enter deeply into the CFTR pore where it interacts with multiple binding sites, and that simultaneous binding of multiple Pt(NO2)42- ions within the pore promotes their permeation to the extracellular solution.     

Mg2+-dependent gating and strong inward rectification of the cation channel TRPV6

TRPV6 (CaT1/ECaC2), a highly Ca(2+)-selective member of the TRP superfamily of cation channels, becomes permeable to monovalent cations in the absence of extracellular divalent cations. The monovalent currents display characteristic voltage-dependent gating and almost absolute inward rectification. Here, we show that these two features are dependent on the voltage-dependent block/unblock of the channel by intracellular Mg(2+). Mg(2+) blocks the channel by binding to a site within the transmembrane electrical field where it interacts with permeant cations. The block is relieved at positive potentials, indicating that under these conditions Mg(2+) is able to permeate the selectivity filter of the channel. Although sizeable outward monovalent currents were recorded in the absence of intracellular Mg(2+), outward conductance is still approximately 10 times lower than inward conductance under symmetric, divalent-free ionic conditions. This Mg(2+)-independent rectification was preserved in inside-out patches and not altered by high intracellular concentrations of spermine, indicating that TRPV6 displays intrinsic rectification. Neutralization of a single aspartate residue within the putative pore loop abolished the Mg(2+) sensitivity of the channel, yielding voltage-independent, moderately inwardly rectifying monovalent currents in the presence of intracellular Mg(2+). The effects of intracellular Mg(2+) on TRPV6 are partially reminiscent of the gating mechanism of inwardly rectifying K(+) channels and may represent a novel regulatory mechanism for TRPV6 function in vivo.     

Exocytosis of a 60 kDa protein (calreticulin) from activated hamster oocytes

The sp50 protein localized at the acrosomal region of guinea pig sperm was suggested to participate in acrosome exocytosis, the acrosome reaction (AR). On the other hand, the cortical reaction (CR), also an exocytotic event, occurs during egg activation. The aim of the present work was to identify sp50 and also to define if sp50 is present in hamster eggs, as well as its location before and after CR. Sp50 was identified as calreticulin (CRT), based on: (a) its NH(2)-terminal amino acid (25 aa) sequence, (b) a cross-recognition of pure sp50 and pure CRT with anti-CRT (from Santa Cruz, anti-CRTsc), and anti-sp50 (anti-sp50/CRT) antibodies, respectively, and (c) that both antibodies revealed a 50 kDa protein in a Brij sperm extract. On the other hand, CRT presence in eggs was positively determined by Western blotting (Wb) using anti-sp50/CRT antibody which recognized a 60 kDa protein in the egg extract, and by indirect immunofluorescence (IIF), CRT was located in the cortical granules (CG). It was defined by a granular pattern and co-localization with mannose, a specific carbohydrate of the CG. Additionally, a decrease in CRT concentration occurred in eggs after their activation and, in parallel, the protein was revealed in the egg's incubation medium. In activated eggs with zona pellucida (ZP), CRT remains as a halo in the perivitelline space and around the polar body. From these results we suggest that: (1) CRT is present in the CG of non-activated hamster eggs, (2) CRT is exocytosed during the CR, in response to egg activation, and (3) CRT might participate in the block to polyspermy, together with other CG components.