Ca2+ signaling in injured in situ endothelium of rat aorta

The inner wall of excised rat aorta was scraped by a microelectrode and Ca(2+) signals were investigated by fluorescence microscopy in endothelial cells (ECs) directly coupled with injured cells. The injury caused an immediate increase in the intracellular Ca(2+) concentration ([Ca(2+)](i)), followed by a long-lasting decay phase due to Ca(2+) influx from extracellular space. The immediate response was mainly due to activation of purinergic receptors, as shown by the effect of P(2X) and P(2Y) receptors agonists and antagonists, such as suramin, alpha,beta-MeATP, MRS-2179 and 2-MeSAMP. Inhibition of store-operated Ca(2+) influx did not affect either the peak response or the decay phase. Furthermore, the latter was: (i) insensitive to phospholipase C inhibition, (ii) sensitive to the gap junction blockers, palmitoleic acid, heptanol, octanol and oleamide, and (iii) sensitive to La(3+) and Ni(2+), but not to Gd(3+). Finally, ethidium bromide or Lucifer Yellow did not enter ECs facing the scraped area. These results suggest that endothelium scraping: (i) causes a short-lasting stimulation of healthy ECs by extracellular nucleotides released from damaged cells and (ii) uncouples the hemichannels of the ECs facing the injury site; these hemichannels do not fully close and allow a long-lasting Ca(2+) entry.     

Interaction between descending input and thoracic reflexes for joint coordination in cockroach: I. Descending influence on thoracic sensory reflexes

Tethered cockroaches turn from unilateral antennal contact using asymmetrical movements of mesothoracic (T2) legs (Mu and Ritzmann in J Comp Physiol A 191:1037–1054, 2005). During the turn, the leg on the inside of the turn (the inside T2 leg) has distinctly different motor patterns from those in straight walking. One possible neural mechanism for the transformation from walking to inside leg turning could be that the descending commands alter a few critical reflexes that start a cascade of physical changes in leg movement or posture, leading to further alterations. This hypothesis has two implications: first, the descending activities must be able to influence thoracic reflexes. Second, one should be able to initiate the turning motor pattern without descending signals by mimicking a point farther down in the reflex cascade. We addressed the first implication in this paper by experiments on chordotonal organ reflexes. The activity of depressor muscle (Ds) and slow extensor tibia muscle (SETi) was excited and inhibited by stretching and relaxing the femoral chordotonal organ. However, the Ds responses were altered after eliminating the descending activity, while the SETi responses remain similar. The inhibition to Ds activity by stretching the coxal chordotonal organ was also altered after eliminating the descending activity.     

Extracellular-Purine Metabolism in Blood Vessels (Part I). Extracellular-Purine Level in Blood of Patients with Abdominal Aortic Aneurysm

Adenosine and adenosine derivatives are the main regulators of purinoceptors (P1 and P2) mediated hemostasis and blood pressure. Since impaired hemostasis and high blood pressure lead to atherosclerosis and to the development of aneurysm, in this study we tested and compared the concentration of extracellular purines (e-purines) in the blood in of patients having abdominal aortic aneurysm with that from healthy volunteers. Whereas adenine nucleosides and nucleotides level in human blood plasma was analysed using reverse phase high performance liquid chromatography (HPLC), cholesterol concentration was estimated by an enzymatic assay. We did not find any correlation between e-purines concentration and the age of healthy volunteers. Furthermore, the sum level of e-purines (ATP, ADP, AMP, adenosine, and inosine) in the control group did not exceed 70 μM, while it was nearly two-fold higher in the blood of patients having abdominal aortic aneurysm, (123 μM). In a special case of people with Leriche Syndrome, a disease characterized by deep atherosclerotic changes, the e-purines level had further increased. Additionally, we also report typical atherosclerotic changes in the aorta using histological assays as well as total cholesterol rise. The significant rise in cholesterol concentration in the blood of the patients with abdominal aortas aneurysm, compared with the control groups, was not unique since 23% of the healthy people also exceeded the normal level of cholesterol. Therefore, our results strongly indicate that the estimation of e-purines concentration in the blood may serve as another indicator of atherosclerosis and warrant further consideration as a futuristic diagnostic tool.     

Comparison between a generalized Newtonian model and a network-type multiscale model for hemodynamic behavior in the aortic arch: Validation with 4D MRI data for a case study

Blood is a complex fluid in which the presence of the various constituents leads to significant changes in its rheological properties. Thus, an appropriate non-Newtonian model is advisable; and we choose a Modified version of the rheological model of Phan-Thien and Tanner (MPTT). The different parameters of this model, derived from the rheology of polymers, allow characterization of the non-Newtonian nature of blood, taking into account the behavior of red blood cells in plasma. Using the MPTT model that we implemented in the open access software OpenFOAM, numerical simulations have been performed on blood flow in the thoracic aorta for a healthy patient. We started from a patient-specific model which was constructed from medical images. Exiting flow boundary conditions have been developped, based on a 3-element Windkessel model to approximate physiological conditions. The parameters of the Windkessel model were calibrated with in vivo measurements of flow rate and pressure. The influence of the selected viscosity of red blood cells on the flow and wall shear stress (WSS) was investigated. Results obtained from this model were compared to those of the Newtonian model, and to those of a generalized Newtonian model, as well as to in vivo dynamic data from 4D MRI during a cardiac cycle. Upon evaluating the results, the MPTT model shows better agreement with the MRI data during the systolic and diastolic phases than the Newtonian or generalized Newtonian model, which confirms our interest in using a complex viscoelastic model.     

Optimization of three-dimensional modeling for geometric precision and efficiency for healthy and diseased aortas

The study purpose is to optimize modeling parameters, specifically segmentation spacing and centerline extraction, to efficiently construct accurate 3D aortic models. Models are constructed by centerline extraction and orthogonal 2D segmentations. We examine the effect of segmentation interval spacing (2, 1, 0.5, 0.25 cm) and orthogonal segmentation and centerline extraction iteration (one, two, three iterations) for constructing models of Healthy, Tortuous, Aneurysmal, and Dissected human thoracic aortas. Aortic arclength, curvature, and cross-sectional axis ratio were computed to compare variations in modeling parameters. Centerline arclength is precisely characterized for all aortas with a single iteration of centerline extraction (≤1% deviation), however, complex anatomies required 1 cm segmentation intervals whereas the Healthy aorta only required 2 cm intervals. Centerline curvature is more sensitive to modeling methods, requiring 1 cm intervals for ≤5% deviation in peak curvature for the three diseased anatomies, and two iterations of segmentation and centerline extraction for the Aneurysmal and Dissected aortas. Accurate lumen cross-sectional characterization required 1 or 0.5 cm segmentation intervals, and two or three segmentation and centerline iterations, with greater refinement needed for more complex geometries. Depending on the geometric characteristic and complexity of anatomy and pathology, different levels of segmentation interval refinement and iterations of segmentation and centerline extraction are required.     

ICU中心发生胸腔感染的影响因素分析及预防对策

目的:探讨重症监护病房(ICU)中心发生胸腔感染的情况及其影响因素,并提出相应的预防对策。方法:选择2015年2月至2017年2月我院ICU中心收治的98例患者进行研究,均为全麻下行开胸术后住ICU者。收集所有患者临床资料,分析胸腔感染的发生情况,通过比较发生/未发生胸腔感染患者的临床资料,探讨ICU中心发生胸腔感染的危险因素,并提出相应的预防对策。结果:在98例患者中,有15例发生胸腔感染,发生率为15.31%,以铜绿假单胞菌所占比例最高,为40.00%。单因素分析结果显示:性别、术前抗菌药物的使用、胸管类型和ICU中心胸腔感染无相关性(P0.05),而年龄、手术时间、术前肺功能、引流管留置时间、手术创口污染、原发病灶蔓延均和ICU中心胸腔感染密切相关(P0.05);多因素logistic回归分析结果显示:年龄≥60岁、手术时间≥2h、术前肺功能、引流管留置时间≥3d、手术创口污染、原发病灶蔓延均是造成ICU中心胸腔感染的独立危险因素(OR=3.485、3.714、3.571、5.731、6.172、6.081,P0.05)。结论:ICU中心发生胸腔感染会对患者病情恢复造成较大影响,在今后临床工作中,需重视围术期管理,积极采取合理的预防措施,降低胸腔感染的发生率。     

硬膜外复合全身麻醉对开胸手术患者血流动力学和应激反应的影响研究

目的:研究硬膜外复合全身麻醉对开胸手术患者血流动力学和应激反应的影响。方法:选取120例我院2015年1月到2016年1月收治的开胸手术患者,按照随机数字表法将患者分为研究组和对照组,对照组给予单纯全麻,研究组给予硬膜外复合全身麻醉,比较两组苏醒时间、苏醒期收缩压、舒张压、心率及烦躁情况,并比较两组术前、术后72 h血糖、皮质醇以及肾上腺素水平。结果:两组苏醒时间比较无统计学意义(P0.05),苏醒期研究组收缩压、舒张压及心率、烦躁发生率均较对照组降低(P0.05);两组术前血糖、皮质醇及肾上腺素比较无统计学差异(P0.05);术后72 h,两组血糖、皮质醇及肾上腺素均升高(P0.05);研究组血糖、皮质醇及肾上腺素均较对照组降低(P0.05)。结论:硬膜外复合全身麻醉应用于开胸手术能显著提高患者苏醒期苏醒质量,稳定血流动力学,改善其应激反应。     

Short-Term Responders of Non–Small Cell Lung Cancer Patients to EGFR Tyrosine Kinase Inhibitors Display High Prevalence of TP53 Mutations and Primary Resistance Mechanisms

Non–small cell lung cancer (NSCLC) with activating EGFR mutations in exon 19 and 21 typically responds to EGFR tyrosine kinase inhibitors (TKI); however, for some patients, responses last only a few months. The underlying mechanisms of such short responses have not been fully elucidated. Here, we sequenced the genomes of 16 short-term responders (SR) that had progression-free survival (PFS) of less than 6 months on the first-generation EGFR TKI and compared them to 12 long-term responders (LR) that had more than 24 months of PFS. All patients were diagnosed with advanced lung adenocarcinoma and harbored EGFR 19del or L858R mutations before treatment. Paired tumor samples collected before treatment and after relapse (or at the last follow-up) were subjected to targeted next-generation sequencing of 416 cancer-related genes. SR patients were significantly younger than LR patients (P < .001). Collectively, 88% of SR patients had TP53 variations compared to 13% of LR patients (P < .001). Additionally, 37.5% of SR patients carried EGFR amplifications compared to 8% of LR patients. Other potential primary resistance factors were also identified in the pretreatment samples of 12 SR patients (75%), including PTEN loss; BIM deletion polymorphism; and amplifications of EGFR, ERBB2, MET, HRAS, and AKT2. Comparatively, only three LR patients (25%) were detected with EGFR or AKT1 amplifications that could possibly exert resistance. The diverse preexisting resistance mechanisms in SR patients revealed the complexity of defining treatment strategies even for EGFR-sensitive mutations.     

胞内钙平衡在培养的牛主动脉内皮细胞低氧和复氧损伤中的作用

本文通过建立培养的牛主动脉内皮细胞体外低氧复氧模型,观察低氧和复氧时胞内钙浓度的改变与存活率的关系。结果显示,随低氧时间延长内皮细胞存活率下降,低氧后再复氧存活率进一步降低。低氧时无钙溶液孵育降低细胞的存活率,但复氧时无钙溶液孵育则增加细胞的存活率。低氧２ｈ胞内钙浓度从９９ｎｍｏｌ／Ｌ降对６９ｎｍｏｌ／Ｌ,无钙时胞内钙进一步降低,低氧４ｈ再复氧４０ｍｉｎ,胞内钙浓度恢复至正常。提示细胞内钙浓度平衡     

Pranidipine,a new 1, 4-dihydropyridine calcium channel blocker,enhances cyclic GMP-independent nitric oxide-induced relaxation of the rat aorta

Pranidipine, a new calcium channel modulator, prolonged endothelium-dependent relaxation induced by acetylcholine in a aortic ring preparation, contracted with prostaglandin F2. This action was not shared by amlodipine. The effect was not modified by indomethacin, suggesting that the action of pranidipine does not involve prostanoid metabolism. N^G-nitro-L-arginine completely prevented the action of Pranidipine. The drug affected neither nitric oxide (NO) synthase activity nor the level of cyclic GMP in the vessel. Pranidipine did not affect the sensitivity of the contractile proteins to calcium. Pranidipine also did not alter cyclic GMP-induced relaxation in a-toxinskinned vascular preparations. Pranidipine also prolonged glyceryl trinitrate-induced relaxation in the endothelium denuded rat aorta. Furthermore, pranidipine enhanced relaxation of the aorta induced by glyceryl trinitrate even in the presence of methylene blue, a guanylyl cyclase inhibitor. This action was not modified by iberiotoxin or by charybdotoxin, two inhibitors of the calciumactivated potassium channel. The results strongly suggest that pranidipine enhances cyclic GMPindependent NO-induced relaxation of smooth muscle by a mechanism other than through NOinduced hyperpolarization. These effects were in direct contrast to amlodipine, another new 1,4dihydropyridine calcium antagonist.