Digital surface scanning in flap perfusion

Monitoring vascular perfusion of transferred tissue is essential in reconstructive surgery to recognize early flap failure. The aim of this study was to evaluate the ability of a digital surface scanner to detect vascular perfusion disorders through the monitoring of skin colour changes. A total of 160 surface scans of the forearm skin were performed with a TRIOS 3D scanner. Vascular compromise was simulated at different time-points by intermittent occlusion of the blood supply to the forearm skin (first the arterial blood supply and then the venous blood supply). Skin colour changes were examined according to the hue, saturation, and value colour scale. Colour differences were analysed with a paired t-test. Significant differences were observed between the colour of the normal skin and that of the vascular compromised skin (P < 0.01). The surface scanner could distinguish between arterial occlusion and venous congestion (P < 0.01). A digital surface scan is an objective, non-invasive tool to detect early vascular perfusion disorders of the skin.     

Position paper on stress cardiac MRI in chronic coronary syndrome: Endorsed by the Société Française de Radiologie (SFR) the Société Française d’Imagerie CardioVasculaire (SFICV) and the Société Française de Cardiologie (SFC)

This position paper was intended to update the former consensus between the French Societies of Radiology and Cardiology about the use of stress cardiac magnetic resonance imaging (MRI) in chronic coronary syndrome published in 2009. The Delphi method was used to build the present consensus. This expert panel consensus includes recommendations for indications, procedure with patient preparation, stress inducing drugs, acquisition protocol, interpretation and risk stratification by stress MRI.     

Cardioprotective effects of sinomenine in myocardial ischemia/reperfusion injury in a rat model

BackgroundIschemia reperfusion (I/R) play an imperative role in the expansion of cardiovascular disease. Sinomenine (SM) has been exhibited to possess antioxidant, anticancer, anti-inflammatory, antiviral and anticarcinogenic properties. The aim of the study was scrutinized the cardioprotective effect of SM against I/R injury in rat.MethodsRat were randomly divided into normal control (NC), I/R control and I/R + SM (5, 10 and 20 mg/kg), respectively. Ventricular arrhythmias, body weight and heart weight were estimated. Antioxidant, inflammatory cytokines, inflammatory mediators and plasmin system indicator were accessed.ResultsPre-treated SM group rats exhibited the reduction in the duration and incidence of ventricular fibrillation, ventricular ectopic beat (VEB) and ventricular tachycardia along with suppression of arrhythmia score during the ischemia (30 and 120 min). SM treated rats significantly (P < 0.001) altered the level of antioxidant parameters. SM treatment significantly (P < 0.001) repressed the level of creatine kinase MB (CK-MB), creatine kinase (CK) and troponin I (Tnl). SM treated rats significantly (P < 0.001) repressed the tissue factor (TF), thromboxane B2 (TXB2), plasminogen activator inhibitor 1 (PAI-1) and plasma fibrinogen (Fbg) and inflammatory cytokines and inflammatory mediators.ConclusionOur result clearly indicated that SM plays anti-arrhythmia effect in I/R injury in the rats via alteration of oxidative stress and inflammatory reaction.     

蒙药安神补心六味丸预防给药对心肌缺血大鼠的保护作用及氧化应激水平的影响＊

目的 研究蒙药安神补心六味丸对大鼠心肌缺血损伤的保护作用和氧化应激机制。方法 将60只大鼠随机分为空白组、模型组、阳性对照组（丹参滴丸）及蒙药安神补心六味丸低、中、高剂量组，使用腹腔注射异丙肾上腺素方法制备大鼠急性心肌缺血模型，记录并观察大鼠心电图活动变化，然后进行腹主动脉取血，分离血清，测定乳酸脱氢酶（Lactic dehydrogenase，LDH）、肌酸激酶（Creatine kinase，CK）、磷酸肌酸激酶（Creatine kinase isoenzyme，CK-MB）、谷草转氨酶（Aspartate aminotransferase，AST）、超氧化物歧化酶（Superoxide dismutase，SOD）、丙二醛（Malondialdehyde，MDA）和谷胱甘肽过氧化物酶（Glutathione peroxidase，GSH-PX）含量变化。取心肌组织固定，对大鼠心肌组织进行HE染色，通过对心肌酶学和和心肌组织形态学两个方面来考察蒙药安神补心六味丸对大鼠心肌缺血模型的保护作用。结果 与空白组比较，模型组大鼠血清中LDH活性极显著升高（P<0.01），CK、CK-MB、AST、MDA活性均显著升高（P<0.05），SOD活性显著降低（P<0.05），GSH-PX活性高度显著降低（P<0.001），且差异均具有统计学意义；与模型组比较，蒙药安神补心六味丸组高剂量组大鼠血清中LDH、CK、CK-MB、MDA活性显著降低（P<0.05），SOD活性显著升高（P<0.05），GSH-PX活性极显著升高（P<0.01），且差异均具有统计学意义。从HE染色分析，蒙药安神补心六味丸能够改善因缺血而造成的心肌组织损伤。结论 蒙药安神补心六味丸能有效改善心肌组织病理状态，减轻大鼠心肌缺血损伤，以达到保护心肌作用，机制可能与氧化应激机制相关。     

Results of retrograde open mesenteric stenting for acute thrombotic mesenteric ischemia

Objective

Acute mesenteric ischemia (AMI) is an emergent event with a high mortality rate; survivors have high rates of intestinal failure. Restoration of blood flow using endovascular or surgical revascularization is associated with better outcome in terms of survival rate and intestinal resection. Retrograde open mesenteric stenting (ROMS), which is a hybrid technique, combines two benefits: prompt blood flow restoration with an endovascular approach and inspection and resection of the small bowel. The aim of the study was to assess the results of ROMS in thrombotic AMI in a retrospective multicenter study.

Excess salt intake promotes M1 microglia polarization via a p38/MAPK/AR-dependent pathway after cerebral ischemia in mice

A high salt diet (HSD) is among the most important risk factors for many diseases. One mechanism by which HSD aggravates cerebral ischemic injury is independent of blood pressure changes. The direct role of HSD in inflammation after cerebral ischemia is unclear. In this research, after twenty-one days of being fed a high salt diet, permanent focal ischemia was induced in mice via operation. At 12 h and 1, 3 and 5 days postischemia, the effects of HSD on the lesion volume, microglia polarization, aldose reductase (AR) expression, and inflammatory processes were analyzed. We report that in mice, surplus dietary salt promotes inflammation and increases the activation of classical lipopolysaccharide (LPS)-induced microglia/macrophages (M1). This effect depends on the expression of the AR protein in activated microglia after permanent middle cerebral artery ligation (pMCAL) in HSD mice. The administration of either the AR inhibitor Epalrestat or a p38-neutralizing antibody blocked the polarization of microglia and alleviated stroke injury.In conclusion, HSD promotes polarization in pro-inflammatory M1 microglia by upregulating the expression of the AR protein via p38/MAPK, thereby exacerbating the development of ischemia stroke.     

Internal Carotid Artery Dissection Presenting With Dysgeusia,Horner Syndrome,and Hypesthesia of the Fifth Cranial Nerve: A Case Report

BackgroundCarotid artery dissection (CAD) is a significant cause of ischemic stroke. Early recognition and treatment of CAD is important to prevent accompanying cerebral ischemia. This case report presents an atypical clinical presentation of CAD and emphasizes the diagnostic challenge for emergency physicians.Case ReportA 54-year-old woman presented to the emergency department with a bilateral headache of 4 days’ duration, hypesthesia of the left fifth cranial nerve, dysgeusia, and partial Horner syndrome on the left side. Magnetic resonance angiography showed a left-sided CAD without any signs of cerebral ischemic events. Antiplatelet therapy with clopidogrel was started, and the patient did not show any deterioration in the weeks thereafter.Why Should an Emergency Physician be Aware of This?CAD can present with different combinations of cranial nerve palsies and should be in the differential diagnosis of dysgeusia and hypesthesia of the trigeminal nerve. Early recognition of CAD can be challenging in patients with rare cranial nerve involvement, but early treatment is crucial to prevent cerebral ischemic events.     

国产沉香化学成分及药理作用研究进展

根据国内外有关国产沉香化学成分及药理作用的文献报道,国产沉香的主要化学成分为倍半萜类和色酮类成分,除此之外,还包括芳香族类、脂肪酸类、三萜类等成分。国产沉香具有多种生物活性,其药理作用包括催眠镇静、缓解肠道平滑肌痉挛、止咳平喘、抗心肌缺血、降血糖等。根据当前研究情况,今后应对国产沉香中2-(2-苯乙基)色酮类多聚体成分进行系统研究,探索沉香化学成分与药理药效的关系,以清楚地了解各成分在各种药理作用中的具体作用机制。参考文献46篇。