The future of artificial hibernation medicine:protection of nerves and organs after spinal cord injury

Spinal cord injury is a serious disease of the central nervous system involving irreversible nerve injury and various organ system injuries.At present,no effective clinical treatment exists.As one of the artificial hibernation techniques,mild hypothermia has preliminarily confirmed its clinical effect on spinal cord injury.However,its technical defects and barriers,along with serious clinical side effects,restrict its clinical application for spinal cord injury.Artificial hibernation is a futureoriented disruptive technology for human life support.It involves endogenous hibernation inducers and hibernation-related central neuromodulation that activate particular neurons,reduce the central constant temperature setting point,disrupt the normal constant body temperature,make the body adapt"to the external cold environment,and reduce the physiological resistance to cold stimulation.Thus,studying the artificial hibernation mechanism may help develop new treatment strategies more suitable for clinical use than the cooling method of mild hypothermia technology.This review introduces artificial hibernation technologies,including mild hypothermia technology,hibernation inducers,and hibernation-related central neuromodulation technology.It summarizes the relevant research on hypothermia and hibernation for organ and nerve protection.These studies show that artificial hibernation technologies have therapeutic significance on nerve injury after spinal co rd injury through inflammatory inhibition,immunosuppression,oxidative defense,and possible central protection.It also promotes the repair and protection of res pirato ry and digestive,cardiovascular,locomoto r,urinary,and endocrine systems.This review provides new insights for the clinical treatment of nerve and multiple organ protection after spinal cord injury thanks to artificial hibernation.At present,artificial hibernation technology is not mature,and research fa ces various challenges.Neve rtheless,the effort is wo rthwhile for the future development of medicine.

Liver protection strategies in liver transplantation

BACKGROUND： Liver transplantation is the therapy of choice for patients with end-stage liver diseases. However, the gap between the low availability of organs and high demand is continuously increasing. Innovative strategies for organ protection are necessary to expand donor pool and to achieve better outcomes for liver transplantation. The present review analyzed and compared various strategies of liver protection.DATA SOURCES： Databases such as PubM ed, Embase and Ovid were searched for the literature related to donor liver protection strategies using following key words： ＂ischemia reperfusion injury＂, ＂graft preservation＂, ＂liver transplantation＂, ＂machine perfusion＂ and ＂conditioning＂. Of the 146 studies identified,only those with cutting edge strategies were analyzed.RESULTS： A variety of therapeutic approaches were proposed to alleviate graft ischemia/reperfusion injury, which included static cold storage, machine perfusion （hypothermic, normothermic and subnormothermic）, manual conditioning （pre,post and remote）, and pharmacological conditioning. Evidences from animal experiments and clinical trials suggested that all these strategies could potentially protect liver graft; however, their clinical applications are limited partially due to their own disadvantages.CONCLUSIONS： There are a plenty of methods suggested to decrease the degree of donor liver transplantation-related injury. However, none of these approaches is perfect in clinical practice. More translational researches （molecular and clinical studies） are needed to improve the techniques in liver graft protection.

On Protection of Worker Rights by Union Organizations through Handling of Letters & Visits

Chinese trade unions have always been keen on devel- oping and protecting worker rights. Today, they have the task of helping build up harmonious labor relations. By working to properly handle letters and visits, union orga- nizations aim at resolving problems workers are most concerned with, problems that are most practical and affect the immediate interests of work- ers. The job is of great significance to the country＇s endeavor to ensure decent labor and social stability.

Research Progress of Perioperative Application of GLP-1 and Its Protective Effects on Organs

Glucagon-like peptide-1(GLP-1)is a multifunctional hormone with broad pharmacological potential to control inflammation,protect cardiovascular,kidney,and liver functions.Moreover,GLP-1 can also cross the blood-brain barrier and bind with GLP-1R distributed in various parts of the brain,thereby reducing apoptosis caused by neuroinflammation and oxygen stress,and promoting learning,memory,cognitive function,neuroprotection,and nerve cell remodeling.However,the exact molecular pathway by which GLP-1 receptor agonists(GLP-1RAs)exerts protective effects on many organs is not fully understood,so it is a hot topic of research.In this article,the recent research on the multi-organ protection of GLP-1 is reviewed,with emphasis on the research progress in the field of nervous system and perioperative anesthesia.

A NEW POLYMER-BOUND 1,2-DIOL AS A PROTECTING AGENT FOR SYMMETRICAL DIALDEHYDE

A novel polymer-bound 1,2-diol, 3-polystyrylsulfonyl-1,2-propanediol (6) had been prepared by the reaction of sodium polystyrylsulfinate with allyl bromide, followed by oxidation and. hydrolysis or directly with 3-chloro-1,2-propanediol in the presence of a phase transfer catalyst, n-tetrabutylammonium iodide. The capacity of resin 6 for terephthaidehyde reached 1.43 mmol/g. The aldehydic groups attached to polymer 6 reacted with hydroxylamine hydrochloride or reduced by sodium borohydride giving p-formylbenzaldoxime (yield: 89%)and p-formyl-benzalcohol (yield: 734%), respectively. The high yields of these polymer-supported reactions showed that the polymer 6 possessed the effective isolation of its reactive sites.

How China’s Procuratorial Organs Protect Human Rights

EDITOR＇S NOTE： Following is a transcript of an interview by the Human Rights magazine with Jing Dali, chief procurator of the Hubei Provincial People＇s Procuratorate. Jing talked about how China＇s procuratorial work protects human rights in his province and what will be done to improve it.

An Organization to Protect the Weak

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Acupuncture Mechanisms: Anesthesia, Analgesia and Protection on Organ Functions

Acupuncture, as a healing art in traditional Chinese medicine, has been widely used to treat various diseases. In the history of acupuncture anesthesia, in the past decades, mechanisms of acupuncture analgesia has been widely investigated, and in recent years, acupuncture protection on organ functions has attracted great interest. This review summarized the research progress on mechanisms of acupuncture for analgesia and its protection against organ function injury in anesthesia, and its perspective of analgesia, immunomodulation, neuroendocrine regulation and multiple organ protection. The current evidence supports that acupuncture analgesia and its organ protection in anesthesia is associated with the integration of neuroendocrine-immune networks in the level of neurotransmitters, cytokines, hormones, neuronal ensembles,lymphocytes, and endocrine cells. Although the mechanisms of acupuncture analgesia and its organ protection are still not completely understood, basic as well as clinic researches on the mechanisms and applications of acupuncture and related techniques are being carried out.

Expert consensus on perioperative management of liver transplantation in adults with acute-on-chronic liver failure

Acute-on-chronic liver failure(ACLF)is a syndrome in which acute liver failure with extrahepatic organ failure occurs on chronic liver disease.Recently,liver transplantation is the only effective treatment for ACLF.There is still room for discussion on the optimal surgery timing for ACLF,perioperative infection prevention and control,and maintenance of nutrition and organ function.The Transplantation Immu-nology Committee of Branch of Organ Transplantation Physician of Chinese Medical Doctor Association and Enhanced Recovery of Liver Transplantation Group of Enhanced Recovery after Surgery Committee of Chinese Research Hospital Association invited relevant experts to discuss the perioperative management of ACLF liver transplantation in areas including surgery timing,organ protection,nutritional support,infection prevention and control,rehabilitation exercises,regulation of the internal environment,etc.An expert consensus was developed as reference for clinicians.

A novel intravenous general anesthetic—emulsified isoflurane:from bench to bedside

Application of volatile anesthetics greatly alters modern medicine.There are obvious advantages of volatile anesthetics such as strong anesthetic potency,rapid onset and elimination through respiration system.Isoflurane is one of the most widely used volatile anesthetics in clinic.Emulsified isoflurane,the emulsion of isoflurane,is a novel intravenous general anesthetic.With the development of emulsified isoflurane in the past fifteen years,its utility has spread from intravenous general anesthesia to various fields including regional anesthesia,organ protection,as well as anesthetic pharmacological study.In this review,we will summarize literatures of emulsified isoflurane about its history,clinical application and future potential utility in the above mentioned fields.

Does airway pressure release ventilation offer new hope for treating acute respiratory distress syndrome?

Mechanical ventilation(MV)is an essential life support method for patients with acute respiratory distress syn-drome(ARDS),which is one of the most common critical illnesses with high mortality in the intensive care unit(ICU).A lung-protective ventilation strategy based on low tidal volume(LTV)has been recommended since a few years;however,as this did not result in a significant decrease of ARDS-related mortality,a more optimal venti-lation mode was required.Airway pressure release ventilation(APRV)is an old method defined as a continuous positive airway pressure(CPAP)with a brief intermittent release phase based on the open lung concept;it also perfectly fits the ARDS treatment principle.Despite this,APRV has not been widely used in the past,rather only as a rescue measure for ARDS patients who are difficult to oxygenate.Over recent years,with an increased under-standing of the pathophysiology of ARDS,APRV has been reproposed to improve patient prognosis.Nevertheless,this mode is still not routinely used in ARDS patients given its vague definition and complexity.Consequently,in this paper,we summarize the studies that used APRV in ARDS,including adults,children,and animals,to illustrate the settings of parameters,effectiveness in the population,safety(especially in children),incidence,and mechanism of ventilator-induced lung injury(VILI)and effects on extrapulmonary organs.Finally,we found that APRV is likely associated with improvement in ARDS outcomes,and does not increase injury to the lungs and other organs,thereby indicating that personalized APRV settings may be the new hope for ARDS treatment.