Protective effects of combined treatment with ciprofol and mild therapeutic hypothermia during cerebral ischemia-reperfusion injury

Despite improvement in cardiopulmonary resuscitation(CPR)performance,cardiac arrest(CA)is still associated with poor prognosis.The high mortality rate is due to multi-organ dysfunction caused by cerebral ischemia and reperfusion injury(I/R).The guidelines for CPR suggest the use of therapeutic hypothermia(TH)as an effective treatment to decrease mortality and the only approach confirmed to reduce I/R injury.During TH,sedative agents(propofol)and analgesia agents(fentanyl)are commonly used to prevent shiver and pain.However,propofol has been associated with a number of serious adverse effects such as metabolic acidosis,cardiac asystole,myocardial failure,and death.In addition,mild TH alters the pharmacokinetics of agents(propofol and fentanyl)and reduces their systemic clearance.For CA patients undergoing TH,propofol can be overdosed,leading to delayed awakening,prolonged mechanical ventilation,and other subsequent complications.Ciprofol(HSK3486)is a novel anesthetic agent that is convenient and easy to administer intravenously outside the operating room.Ciprofol is rapidly metabolized and accumulates at low concentrations after continuous infusion in a stable circulatory system compared to propofol.Therefore,we hypothesized that treatment with HSK3486 and mild TH after CA could protect the brain and other organs.

Lung injury after cardiopulmonary bypass:Alternative treatment prospects

Although the lung injury caused by cardiopulmonary bypass(CPB)has been extensively investigated,the incidence and mortality of lung injury after CPB remain a prominent clinical problem.The poor outcome has been attributed to multifactorial etiology,including the systemic inflammatory response and ischemia reperfusion(I/R)injury during CPB.Lung injury after CPB is a complex pathophysiological process and has many clinical manifestations of mild to severe disease.Which is associated with prognosis.To alleviate this lung injury,interventions that address the pathogenesis are particularly important.This review summarizes the pathogenesis,mechanism and treatment options of lung injury after CPB,such as lung protection with intralipid.

NF-κB: A novel therapeutic pathway for gastroesophageal reflux disease?

Although gastroesophageal reflux disease(GERD),a common chronic disease in clinical practice,has been widely studied,its potential adverse impact on patients is still a significant clinical concern.It is necessary to understand the pathogenesis of the disease and choose appropriate treatment according to its mechanism.The pathogenesis of GERD is diverse and complex.As the traditional treatment methods are expensive and ineffective in alleviating symptoms in some patients,new treatment options need to be explored.Our previous study suggested that the activation of nuclear factor-kappa beta(NF-κB)in esophageal mucosa may be related to the injury of epithelial barrier function caused by reflux.Based on the literature and our previous study results,it is speculated that inhibition of NF-κB activation may block the insult of GERD on the esophageal mucosal barrier.NF-κB may play an important role in the development of GERD.This article reviews the pathogenesis of GERD and the relationship between NF-κB and GERD,in order to provide new strategies for the treatment of GERD.

Lactation mastitis: Promising alternative indicators for early diagnosis

Although lactation mastitis(LM)has been extensively researched,the incidence rate of LM remains a salient clinical problem.To reduce this incidence rate and achieve a better prognosis,early and specific quantitative indicators are particularly important.It has been found that milk electrolyte concentrations(chloride,potassium,and sodium)and electrical conductivity(EC)significantly change in the early stages of LM in an animal model.Several studies have evaluated EC for the detection of subclinical mastitis in cows.EC,chloride,and sodium content of milk were more accurate for predicting infection status than were other variables.In the early stages of LM,lactic sodium,chloride,and EC increase,but potassium decreases.However,these indicators have not been reported in the diagnosis of LM in humans.This review summarizes the pathogenesis and the mechanism of LM in terms of milk electrolyte concentration and EC,and aim to provide new ideas for the detection of sub-clinical mastitis in humans.

Sinucrassins A-K, Casbane-type Diterpenoids from the South China Sea Soft Coral Sinularia crassa

A detailed chemical study on the Hainan soft coral Sinularia crass has resulted in the isolation and characterization of eleven cas-bane-type diterpenoids,named sinucrassins A-K(1-11),along with six known related ones(12-17).Their structures were elucidated by extensive spectroscopic analyses and comparison with the reported data.The absolute configurations of new compounds were determi ned by the X-ray diffracti on analysis and computer-assisted structural elucidati on in eluding 13C NMR data calculati on and time-dependent density functional theory/electronic circular dichroism calculation.