DH Group Research Articles

The study of the serum level of IL-4, TGF-β, IFN-γ, and IL-6 in overweight patients with and without diabetes mellitus and hypertension.

Obesity increases the risk of diabetes mellitus (DM) and hypertension. We aimed to analyze the serum levels of cytokines that have relevance to the pathologies including, interleukin-4 (IL-4), transforming growth factor-β (TGF-β), interferon-γ (IFN-γ), and IL-6 cytokines of overweight men with DM and/or hypertension. The study collected serum from 164 men. The sample population contained, 54 overweight men without DM or hypertension (control [CTL] group), 36 men with both DM and hypertension (DH group), 20 men with DM but no hypertension (D group), and 54 had hypertension without DM (H). The main results showed that the concentration of IFN-γ in the DH group was significantly higher than the D, H, and CTL groups, IL-6 in DH and D groups was significantly lower than the CTL group. The serum level ofTGF-β and IL-4 cytokines did not show any significant differences across the four groups. Serum levels of IL-6 were also significantly lower in untreated patients in D group than controls and in DH when compared with H groups. In conclusion, it appears that the proinflammatory and anti-inflammatory cytokines either play a significant role in the pathogenesis of hypertension and DM or serve as markers for these pathologies. Accordingly, increased serum levels of IFN-γ may participate in the pathogenesis of hypertension in the diabetic patients and decreased IL-6 is associated with type 2 DM.

Effects of four weeks intermittent hypoxia intervention on glucose homeostasis, insulin sensitivity, GLUT4 translocation, insulin receptor phosphorylation, and Akt activity in skeletal muscle of obese mice with type 2 diabetes.

AimsThe aims of this study were to determine the effects of four weeks of intermittent exposure to a moderate hypoxia environment (15% oxygen), and compare with the effects of exercise in normoxia or hypoxia, on glucose homeostasis, insulin sensitivity, GLUT4 translocation, insulin receptor phosphorylation, Akt-dependent GSK3 phosphorylation and Akt activity in skeletal muscle of obese mice with type 2 diabetes.MethodsC57BL/6J mice that developed type 2 diabetes with a high-fat-diet (55% fat) (fasting blood glucose, FBG = 13.9 ± 0.69 (SD) mmol/L) were randomly allocated into diabetic control (DC), rest in hypoxia (DH), exercise in normoxia (DE), and exercise in hypoxia (DHE) groups (n = 7, each), together with a normal-diet (4% fat) control group (NC, FBG = 9.1 ± 1.11 (SD) mmol/L). The exercise groups ran on a treadmill at intensities of 75–90% VO2max. The interventions were applied one hour per day, six days per week for four weeks. Venous blood samples were analysed for FBG, insulin (FBI) and insulin sensitivity (QUICKI) pre and post the intervention period. The quadriceps muscle samples were collected 72 hours post the last intervention session for analysis of GLUT4 translocation, insulin receptor phosphorylation, Akt expression and phosphorylated GSK3 fusion protein by western blot. Akt activity was determined by the ratio of the phosphorylated GSK3 fusion protein to the total Akt protein.ResultsThe FBG of the DH, DE and DHE groups returned to normal level (FBG = 9.4 ± 1.50, 8.86 ± 0.94 and 9.0 ± 1.13 (SD) mmol/L for DH, DE and DHE respectively, P < 0.05), with improved insulin sensitivity compared to DC (P < 0.05), after the four weeks treatment, while the NC and DC showed no significant changes, as analysed by general linear model with repeated measures. All three interventions resulted in a significant increase of GLUT4 translocation to cell membrane compared to the DC group (P < 0.05). The DE and DH showed a similar level of insulin receptor phosphorylation compared with NC that was significantly lower than the DC (P < 0.05) post intervention. The DH and DHE groups showed a significantly higher Akt activity compared to the DE, DC and NC (P < 0.05) post intervention, as analysed by one-way ANOVA.ConclusionsThis study produced new evidence that intermittent exposure to mild hypoxia (0.15 FiO2) for four weeks resulted in normalisation of FBG, improvement in whole body insulin sensitivity, and a significant increase of GLUT4 translocation in the skeletal muscle, that were similar to the effects of exercise intervention during the same time period, in mice with diet-induced type 2 diabetes. However, exercise in hypoxia for four weeks did not have additive effects on these responses. The outcomes of the research may contribute to the development of effective, alternative and complementary interventions for management of hyperglycaemia and type 2 diabetes, particularly for individuals with limitations in participation of physical activity.

Effect of pharmacological doses of niacin on testicular structure and function in normal and diabetic rats.

Male diabetic patients may experience adverse changes in testicular functions or structure. Niacin has antidyslipidemic properties in diabetic patients. We aimed to clarify the effect of pharmacological doses of niacin on testicular structure and function of normal and diabetic rats. Sixty adult male rats were treated as follows. Healthy control (HC); diabetic control (DC); NL and NH groups: normal rats that received niacin at 800 and 4,000mg/kg of diet; DL and DH groups: diabetic rats that received niacin at 800 and 4,000mg/kg diet for 50days. In normal rats, obvious increase in serum testosterone especially in NL group associated with improved antioxidant status of testicular tissue was observed. In diabetic rats, niacin resulted in higher testicular weight/body weight and improved some histological parameters without affecting blood glucose, testosterone and sperm count. Testicular MDA content decreased. In conclusion, niacin especially at 800mg/kg diet improves serum testosterone levels and antioxidant status of testes in normal rats. In diabetic rats, despite positive changes in histological features and antioxidant status of testes reproductive outcome including sperm count or testosterone levels were not improved. This study set the scene for further investigations on the effect of niacin on male reproductive system.

Renoprotective Effect of Danhong Injection on Streptozotocin-Induced Diabetic Rats through a Peroxisome Proliferator-Activated Receptor γ Mediated Pathway.

The aim of the study was to investigate the protective effect of Danhong injection (DHI) on diabetic kidney disease and explore the potential mechanisms. Diabetic kidney disease was induced by unilateral nephrectomy, high-fat diet, and streptozotocin. After DHI administration, the renal function deterioration, 24-hour total urine protein excretion, and elevated serum lipid levels were reversed to some extent, and the renal pathological damage was also ameliorated. The KEGG pathway enrichment analysis demonstrated that the PPARγ signal pathway was significantly upregulated in DH group. And the increased expressions of PPARγ and UCP-1 were confirmed by immunohistochemistry, whereas the p38MAPK was significantly decreased. These data show that DHI could delay the progress of DKD, and the effect might be achieved in part by activating the PPARγ signaling pathway.

Inpatient Choledocholithiasis Requiring ERCP and Cholecystectomy: Outcomes of a Combined Single Inpatient Procedure Versus Separate-Session Procedures

ObjectivesSeparate-session endoscopic retrograde cholangiography (ERCP) and laparoscopic cholecystectomy (LC) is the usual method for management of inpatient choledocholithiasis. Our goal was to compare single operative-session LC and ERCP to a multi-session approach for both the same hospitalization and within 30 days after; there is limited data comparing the three groups. MethodsA retrospective review on inpatients with choledocholithiasis that underwent ERCP and LC was performed. Single operative-session ERCP + LC (SOS group) and separate hospitalization ERCP + LC (DH group) were compared against the control cohort: separate-session ERCP + LC performed during the same hospitalization (SH group). ResultsAmong the 214 cases, 37 (17%) had LC + ERCP performed under a single operative session (SOS), 130 (60.7%) cases had LC + ERCP performed in separate operative sessions during the same hospitalization (SH), and 47 (22%) cases had LC + ERCP performed in different hospitalizations, within 30 days (DH). There was no statistically significant difference in efficacy or adverse events. The SOS group had a statistically significant mean shorter length of hospital stay as compared to the SH and DH groups (5.46 vs 7.15 vs 9.38; p = 0.05 and 0.02). There was a statistically significant reduction in the total cost of care in the SOS group versus the SH group ($59,221 vs $75, 808; p = 0.007). ConclusionThe SOS approach is safe, efficacious, and cost-efficient when compared to separate operative sessions. This approach can be considered in situations where it is preferable for the patient to undergo a single session of anesthesia, without compromising technical success and safety.

Association of vitamin D receptor gene polymorphisms with diabetic dyslipidemia in the elderly male population in North China.

BackgroundThe prevalence of dyslipidemia is rising alarmingly in elderly Han Chinese male patients with type 2 diabetes mellitus (T2DM). The genetic factors that contribute to the development of diabetic dyslipidemia remain incompletely identified. This study was conducted to assess the association between vitamin D receptor (VDR) polymorphisms and development of dyslipidemia in the Han elderly male population with T2DM in North China.MethodsA total of 242 T2DM patients with dyslipidemia (DH group, n=108) or without dyslipidemia (DO group, n=134) and 100 controls were genotyped for ApaI, TaqI and FokI single nucleotide polymorphisms (SNPs) of the VDR gene using polymerase chain reaction-restriction fragment length polymorphism and sequencing. The frequency and distribution of the SNPs were compared between cases and controls.ResultsThe distribution of genotypes of VDR-FokI was significantly different between the control and DM group (P=0.033), as well as between the control and DH subgroup (P=0.011) but not DO subgroup (P=0.111). The frequency of C allele and CC genotype of FokI was significantly higher in the DH patients than in the controls (P=0.015 and P=0.003, respectively). Logistic regression analysis in a dominant model homozygous for the C allele of the FokI SNP showed that CC genotype was associated with DH patients (OR =1.797, 95% CI: 1.077–2.999, P=0.025). Significant associations of the ApaI and TaqI SNPs with either DO or DH subjects were not observed.ConclusionThese findings suggest that CC genotype of VDR-FokI is a risk factor for T2DM patients with dyslipidemia in elderly males in North China.

Randomized controlled trial of moderate hypothermia versus deep hypothermia anesthesia on brain injury during Stanford A aortic dissection surgery

This study aimed to compare the effects of moderate versus deep hypothermia anesthesia for Stanford A aortic dissection surgery on brain injury. A total of 82 patients who would undergo Stanford A aortic dissection surgery were randomized into two groups: moderate hypothermia group (MH, n=40, nasopharyngeal temperature 25°C, and rectal temperature 28°C) and deep hypothermia group (DH, n=42, nasopharyngeal temperature 20°C, and rectal temperature 25°C). Different vascular replacement techniques including aortic root replacement, Bentall, and Wheat were used. The intraoperative and postoperative indicators of these patients were recorded. There were no differences in intraoperative and postoperative measures between MH and DH groups. The concentrations of neuron-specific enolase and S-100β increased with operation time, and were significantly lower in MH group than those in the DH group (P<0.05). The occurrence rates of complications including chenosis, postoperative agitation, and neurological complications in MH group were significantly lower than in DH group. The recovery time, postoperative tube, and ICU intubation stay were significantly shorter in MH group than those in DH group (P<0.05). There were no significant differences revealed in hospital stay and death rate. MH exhibited better cerebral protective effects, less complications, and shorter tube time than DH in surgery for Stanford A aortic dissection.

Multidisciplinary approach to manage antenatally suspected placenta percreta: updated algorithm and patient outcomes

BackgroundDue to the significant morbidity and mortality associated with placenta percreta, alternative management options are needed. Beginning in 2005, our institution implemented a multidisciplinary strategy to patients with suspected placenta percreta. The purpose of this study is to present our current strategy, maternal morbidity and outcomes of patients treated by our approach.MethodsFrom 2005 to 2014, a retrospective cohort study of patients with suspected placenta percreta at an academic tertiary care institution was performed. Treatment modalities included immediate hysterectomy at the time of cesarean section (CHYS), planned delayed hysterectomy (interval hysterectomy 6 weeks after delivery) (DH), and fertility sparing (uterine conservation) (FS). Prognostic factors of maternal morbidity were identified from medical records. Complications directly related to interventional procedures and DH was recorded. Descriptive statistics were utilized.ResultsOf the 21 patients with suspected placenta percreta, 7 underwent CHYS, 13 underwent DH, and 1 had FS with uterine preservation. Of the 20 cases that underwent hysterectomy, final pathology showed 11 increta, 7 percreta, and 2 inconclusive. 19/20 cases underwent interventional radiology (IR) procedures. Selective embolization was utilized in 14 cases (2/7 CHYS; 12/13 DH). The median time from cesarean section (CS) to DH was 41 [26–68] days. There were no cases of emergent hysterectomy, delayed hemorrhage, or sepsis in the DH group. Both estimated blood loss and number of packed red blood cell transfusions were significantly higher in the CHYS group. 3/21 cases required massive transfusion (2 CHYS, 1 FS) with median total blood product transfusion of 13 units [12–15]. The four IR-related complications occurred in the DH group. Incidence of postoperative complications was similar between both groups. Median hospital length of stay (LOS) after CHYS was 4 days [3–8] compared to DH cohort: 7 days [3–33] after CS and 4 days [1 –10] after DH. The DH cohort had a higher rate of hospital readmission of 54% (7/13) compared to 14% (1/7) CHYS, most commonly due to pain. There were no maternal deaths.ConclusionThis multidisciplinary strategy may appear feasible; however, further investigation is warranted to evaluate the effectiveness of alternative approaches to cesarean hysterectomy in cases of morbidly adherent placenta.

Mass Production of Doubled Haploids in Japanese Flounder, Paralichthys olivaceus

AbstractDoubled haploid (DH) individuals have many applications in fish genetic and genomic research, as well as in fish breeding programs. Mass production of DHs is difficult because of an extremely low induction rate. Here, we report the mass production of mitotic gynogenetic DHs in Japanese flounder, Paralichthys olivaceus, an economically important marine‐culture fish species. Four groups of mitotic gynogenetic DHs were induced from four females of different genetic backgrounds. The heterozygous clonal female group had the highest hatching rate, lowest abnormality rate, and highest homozygosity rate. Early growth comparisons showed that the body weight and total length of the heterozygous clonal female group were the largest among the three DH groups (P &lt; 0.05). At 6 mo postinduction, an estimated 10,766 DHs survived, and a notable percentage of male DHs (3.34–23.33%) were detected. This successful mass production of DHs lays the foundation for extensive use of DHs in Japanese flounder breeding and research.

Knee Recurvatum in Children With Spastic Diplegic Cerebral Palsy.

The purpose of this study is to determine which factors drive patients with diplegic cerebral palsy to walk without knee recurvatum despite hyperextension of the knee on physical examination. A retrospective review was conducted of all data collected in the Gait Analysis Laboratory between 1999 and 2014. Patients with spastic diplegic cerebral palsy and at least 5 degrees of knee extension on clinical examination were identified for the study. After IRB approval, a total of 60 children ranging in age from 4 to 17 were included in the study. There were 27 female patients. Gross Motor Function Classification System level was distributed in the population as follows: 34 patients at Gross Motor Function Classification System level I, 18 at level II, and 8 at level III. Patients were excluded from this study if they had extrapyramidal involvement, history of selective dorsal rhizotomy or lower extremity surgery. Patient who received botulinum toxin A injections within 1 year of the study were excluded as well. Patients were divided into 2 groups: children that walked with knee hyperextension (KH) and children that walked without knee hyperextension (KF, "knee flexion"). There were 15 subjects in the KH group and 45 subjects in the KF group. Motion Laboratory evaluation included a comprehensive examination, kinematics, and kinetic analysis with a VICOM system. All data were analyzed with unpaired t test to detect differences between the 2 groups. All statistical analysis was done only for the right legs (unless the right leg did not meet the exclusion then the left leg was analyzed) to meet the statistical requirement for independence. The Pearson correlation was applied to correlate the maximum knee extension in stance with maximum ankle dorsiflexion in stance. The static measurement of dorsiflexion with knee flexed showed statistically significant difference (P=0.004) with KH group having 2.3±11.6 degrees and KF group having 13.1±12.2 degrees. There was also a statistically significant difference in the static measurement of dorsiflexion with knee extended (P=0.0014) with KH group having -3.3±9.0 degrees and KF group having 5.8±9.1 degrees. Maximum dorsiflexion in stance phase also showed significant difference (P=0.0022) with the KH group having 0.1±14.0 degrees and KF group having 11.5±11.2 degrees. Maximum dorsiflexion in stance phase also showed significant difference (P<0.001) with the DH group having 0.1 (SD) 14.0 degrees and KF group having 11.5 (SD) 11.2 degrees. There were no significant differences in popliteal angle measurements or any strength measurement. Our study shows that the plantar flexion knee extension couple is the major contributing factor to cause patients with passive knee hyperextension to walk in a recurvatum pattern. This would have implications of further treatment of the knee hyperextension in stance. Level III-case-control study.

Effects of transdermal flunixin meglumine on pain biomarkers at dehorning in calves.

The objective of this study was to evaluate the analgesic properties of transdermal flunixin meglumine when given at the time of dehorning on pain biomarkers. Twenty-four weaned male Holstein calves, 6 to 8 wk of age were enrolled into the study. The calves were randomly assigned to 1 of 3 treatment groups: 1) transdermal flunixin and dehorn (DH-FLU); 2) transdermal flunixin and sham dehorn (SHAM-FLU); and 3) placebo and dehorn (DH-PLBO). Transdermal flunixin at a label dose of 3.33 mg/kg (or placebo at an equivalent volume) was administered as a pour-on along the top-line of the calves in each treatment group concurrently with electrocautery dehorning or sham dehorning. Biomarker parameters collected and analyzed included: infrared thermography (IRT), mechanical nociception threshold (MNT), plasma cortisol, and substance P (SP). There were no differences in maximal temperatures detected for the IRT measurements of the medial canthus of the eye for the DH groups. Mean control point MNT measurements at 48 h were 3.14 kgF, 3.46 kgF, and 1.43 kgF for the DH-FLU, Sham-FLU, and DH-PLBO groups, respectively (P = 0.0001). No other differences of MNT were detected between the dehorned groups for the other test sites and time points. Plasma cortisol reached peak concentration at 20 min postdehorning for the DH-FLU and DH-PLBO groups and 10 min for SHAM-FLU group. Peak plasma cortisol concentrations were 32.0 ng/mL, 12.7 ng/mL, and 28.8 ng/mL for the DH-FLU, SHAM-FLU, and DH-PLBO groups, respectively. Cortisol concentrations were lower for the DH-FLU group at 90 min postdehorning compared to the SHAM-FLU and DH-PLBO groups ( = 0.04). Area under the effect curve (AUEC) were similar for all groups ( = 0.93). No statistical differences in SP concentrations between groups were detected for any of the time points. In conclusion, transdermal flunixin meglumine given at the time of dehorning did not provide substantial analgesia based on the pain biomarkers investigated. Further investigation into its role as part of a multimodal analgesic plan is warranted.

N-3 Long-chain polyunsaturated fatty acids improve the sperm, egg, and offspring quality of Siberian sturgeon (Acipenser baerii)

Two diets with the same docosahexaenoic acid:eicosapentaenoic acid ratio (1.8:1), but with different n-3 long-chain polyunsaturated fatty acid (n-3 LC-PUFA) contents [29.5g/kg (DH) and 17.9g/kg (DL)], were designed and fed to two groups of 46 female and 30 male Siberian sturgeon (Acipenser baerii) broodstock for 11months. Sperm and egg quality and reproductive performance indices were recorded during cross-breeding. Larval offspring resulting from cross-matings were divided into the following four groups for a 30-d feeding trial: D1 (DH♀×DH♂), D2 (DH♀×DL♂), D3 (DL♀×DH♂), and D4 (DL♀×DL♂). The results showed that egg size of the DH group was significantly larger than that of the DL group. With respect to sperm quality, there were no significant differences in wobble, amplitude of lateral head displacement, beat/cross frequency, and mean angular displacement between the two dietary groups; however, a high n-3 LC-PUFA diet increased sperm curvilinear, straight-line, and average path velocities in the DH group. The DH group had significantly lower levels of serum triglyceride, low-density lipoprotein cholesterol, and malonaldehyde, but higher superoxide dismutase level, and total antioxidant capacity compared with the DL group. At 7 and 32days post hatching, the survival of larvae in groups D1 and D2 was significantly higher than that in groups D3 and D4. The specific growth rate of larvae in group D4 was the lowest among the four groups. The results suggest that n-3 LC-PUFA can improve the reproductive performance of male and female broodstock of Siberian sturgeon and the quality of their offspring, but that n-3 LC-PUFA enrichment of the diet is more critical for female broodstock than for males.

ISSLS PRIZE IN CLINICAL SCIENCE 2017: Is infection the possible initiator of disc disease? An insight from proteomic analysis.

Proteomic and 16S rDNA analysis of disc tissues obtained in vivo. To address the controversy of infection as an aetiology for disc disorders through protein profiling. There is raging controversy over the presence of bacteria in human lumbar discs in vivo, and if they represent contamination or infection. Proteomics can provide valuable insight by identifying proteins signifying bacterial presence and, also host defence response proteins (HDRPs), which will confirm infection. 22 discs (15-disc herniations (DH), 5-degenerate (DD), 2-normal in MRI (NM) were harvested intraoperatively and immediately snap frozen. Samples were pooled into three groups and proteins extracted were analysed with liquid chromatography-tandem mass spectrometry (LC-MS/MS). Post identification, data analysis was performed using Uniprotdb, Pantherdb, Proteome discoverer and STRING network. Authentication for bacterial presence was performed by PCR amplification of 16S rDNA. LC-MS/MS analysis using Orbitrap showed 1103 proteins in DH group, compared to 394 in NM and 564 in DD. 73 bacterial specific proteins were identified (56 specific for Propionibacterium acnes; 17 for Staphylococcus epidermidis). In addition, 67 infection-specific HDRPs, unique or upregulated, such as Defensin, Lysozyme, Dermcidin, Cathepsin-G, Prolactin-Induced Protein, and Phospholipase-A2, were identified confirming presence of infection. Species-specific primers for P. acnes exhibited amplicons at 946bp (16S rDNA) and 515bp (Lipase) confirming presence of P. acnes in both NM discs, 11 of 15 DH discs, and all five DD discs. Bioinformatic search for protein-protein interactions (STRING) documented 169 proteins with close interactions (protein clustering co-efficient 0.7) between host response and degenerative proteins implying that infection may initiate degradation through Ubiquitin C. Our study demonstrates bacterial specific proteins and host defence proteins to infection which strengthen the hypothesis of infection as a possible initiator of disc disease. These results can lead to a paradigm shift in our understanding and management of disc disorders.

Angelica sinensis Suppresses Body Weight Gain and Alters Expression of the FTO Gene in High-Fat-Diet Induced Obese Mice.

The root of Angelica sinensis (RAS) is a traditional Chinese medicine used for preventing and treating various diseases. In this study, we assessed RAS supplementation effects on body weight and the FTO gene expression and methylation status in a high-fat-diet (HFD) induced obese mouse model. Female obese mice were divided into groups according to RAS dosage in diet as follows: normal diet, HFD diet (HC), HFD with low-dosage RAS (DL), HFD with medium-dosage RAS (DM), and HFD with high-dosage RAS (DH). After RAS supplementation for 4 weeks, body weight suppression and FTO expression in DH mice were significantly higher than in HC mice, whereas no significant change in FTO expression was detected between DM and DL mice or in their offspring. Bisulfite sequencing PCR (BSP) revealed that the CpG island in the FTO promoter was hypermethylated up to 95.44% in the HC group, 91.67% in the DH group, and 90.00% in the normal diet group. Histological examination showed that adipocytes in the DH group were smaller than those in the HC group, indicating a potential role of RAS in obesity. This study indicated that RAS could ameliorate obesity induced by HFD and that the molecular mechanism might be associated with the expression of the FTO gene.

Abstract 12002: Delayed Inhalation of Hydrogen Improves Myocardial dysfunction in a Porcine Model of Cardiac Arrest and Cardiopulmonary Resuscitation

Introduction: Immediate inhalation of hydrogen (H 2 ) has been demonstrated to improve post-resuscitation (PR) myocardial dysfunction. In this study, we investigated the effects of delayed treatments with H 2 on myocardial dysfunction in a porcine model of cardiac arrest (CA). Hypothesis: Delayed inhalation of H 2 improves myocardial dysfunction after resuscitation in a CA porcine model. Methods: Twenty male pigs weighing 39±2 kg were utilized. Ventricular fibrillation was electrically induced and untreated for 10 mins. All the animals were successfully resuscitated manually and then randomized into two groups: delayed inhalation of H 2 (DH group) or continuous inhalation of room air (C group). Animals in DH group were ventilated with 2% H 2 /21% oxygen from PR 2h till PR 4h. Left ventricle pressure (LVP) was recorded continuously and cardiac output (CO) was measured by the thermo-dilution technique at baseline (BL) and then hourly after resuscitation for 6 hours. Serum levels of troponin T (Tn T) and N-terminal probrain natriuretic peptide (NTpro-BNP) were measured by ELISA at BL, PR 180 min and PR 360 min. Results: Deteriorations in maximum rate of LVP increase (dp/dtmax), maximum rate of LVP decline (-dp/dtmax) and CO were observed in all the animals after PR 4 h (Figure 1). However, better dp/dtmax, -dp/dtmax and CO were achieved in the DH group after PR 5h when compared with the C group. Although levels of both Tn T and NTpro-BNP in serum increased after resuscitation, they were significantly lower in animals of DH group in comparison with C group (Figure 2). Conclusion: Delayed treatment of H 2 attenuates myocardial injury and improves myocardial dysfunction after resuscitation.

Abstract 11983: Delayed Inhalation of Hydrogen Mitigates Neurological Dysfunction in a Porcine Model of Cardiac Arrest and Cardiopulmonary Resuscitation

Introduction: Immediate inhalation of hydrogen (H 2 ) has been demonstrated to improve post-resuscitation (PR) neurological dysfunction. However, early applying inhaled H 2 is not practical especially in out of hospital cardiac arrest because of the safety issue. In the present study, we investigated the effects of delayed treatments with H 2 on post resuscitation neurological function in a porcine model of prolonged cardiac arrest (CA). Hypothesis: Delayed inhalation of H 2 mitigates neurological dysfunction after resuscitation in a CA porcine model. Methods: Eighteen male domestic pigs weighing 39±2 kg were utilized. Ventricular fibrillation (VF) was induced electrically and CPR was initiated after 10 mins of untreated VF. All the animals were resuscitated successfully and randomized into two groups immediately following resuscitation: delayed inhalation of H 2 (DH group, N=9) or inhalation of room air (C group, N=9). Animals in the DH group were ventilated with 2% H 2 /21% oxygen from 2h post resuscitation (PR) to PR 4h. Serum levels of S100B and neuron-specific enolase (NSE) were measured by ELISA at baseline and PR 360 min. The neurological deficit score (NDS) and survival were evaluated daily for a total of 72 hours. Results: Better survival duration and NDS at 24h, 48h and 72h were observed in the DH group animals compared with those of the C group (Table). The serum levels of S100B and NSE were significantly lower in the DH group when compared with the C group (Figure). Conclusion: Delayed treatment of H 2 mitigates neurological injury and improves neurological dysfunction after resuscitation.

Abstract 11607: Effects of Delayed Treatment With Inhaled Hydrogen on Oxidative Stress and Inflammatory Cytokines After Resuscitation in a Porcine Model of Cardiac Arrest

Introduction: Immediate treatment with inhaled hydrogen (H 2 ) has been demonstrated to attenuate oxidative stress conditions and inflammatory cytokines in serum after resuscitation from cardiac arrest. However, early applying inhaled H 2 is not practical especially in out of hospital cardiac arrest because of the safety issue. In the present study, we investigated the effects of delayed treatment with H 2 on oxidative stress and inflammatory cytokines in a porcine model of cardiac arrest (CA). Hypothesis: Delayed inhalation of H 2 reduces proinflammatory cytokines but without effect on oxidative stress after resuscitation in a CA porcine model. Methods: Twenty male domestic pigs weighing 39±2 kg were studied. Ventricular fibrillation (VF) was induced electrically and CPR was initiated after 10 min of untreated VF. Animals were randomized into two groups immediately after successfully resuscitation: delayed inhalation of H 2 (DH group) or continuous inhalation of room air (C group). DH group animals were ventilated with 2% H 2 /21% oxygen from post-resuscitation 120 min (PR120) until PR240 min. Serum levels of oxidative product (8-iso-PGF 2α ) and proinflammatory cytokines (tumor necrosis factor-α [TNF-α], interleukin-6 [IL-6], and high-mobility group box protein 1 [HMGB1]) were measured by ELISA at baseline (BL), PR30, PR180 and PR360. Results: Serum levels of 8-iso-PGF 2α in all the animals were significantly increased at PR30 then decreased to the levels of BL after PR180. The levels of TNF-α, IL-6 and HMGB1 in serum of all animals were elevated after PR180. Although no significant differences in the levels of 8-iso-PGF 2α were observed between both groups, the levels of TNF-α, IL-6 and HMGB1 were significantly lower in DH group animals when compared with those in C group (Figure). Conclusions: Delayed treatment with H2 attenuates proinflammatory cytokines but without effect on oxidative stress conditions after resuscitation.

PS 01-21] RENAL DENERVATION PROTECTS RENAL FUNCTION BY SUPPRESSING NAD(P)H OXIDASE ACTIVITY IN DAHL SALT-SENSITIVE RATS

Objective: Sympathetic activity is increased in CKD patients and plays an important and distinct role in renal disease-associated hypertension. Indeed, sympathetic activation is of crucial importance for both the raised blood pressure and the high morbidity and mortality of end-stage renal disease. So we investigated whether renal denervation protects renal function through an anti-oxidative effect. Design and Method: Dahl salt sensitive rats in two groups had the right kidney removed (uninephrectomy; Nx) and those in the other two groups had sham surgery (DL group or DH group). Two weeks later, half of the Nx group underwent left renal denervation (Nx-RDNx group; n = 10) and the other half had sham surgery (Nx-Sham; n = 10). The DL group received a 0.3% salt diet and the DH, Nx-RDNx, and Nx-Sham groups received an 8% salt diet after renal denervation or sham operation. After a further 6 weeks, kidney function and the renal tissue were assessed. Results: Blood pressure, heart rate, body weight, kidney weight and urinary sodium excretion did not differ between Nx-RDNx and Nx-Sham group. Creatinine clearance and urinary albumin excretion were significantly lower in the Nx-RDNx group than in the Nx-Sham group. Desmin staining was lower in Nx-RDNx compared with Nx-Sham. Fluorescent staining for reactive oxygen species in isolated glomeruli was significantly weaker in the Nx-RDNx group. A lucigenin assay of NAD(P)H oxidase activity in isolated glomeruli indicated that renal denervation may have caused the reduction in reactive oxygen species through suppression of the activity of NAD(P)H oxidase. Plasma renin activity was significant increased in the Nx-Sham group compared with DH, and renal denervation suppressed this activity. Conclusions: Renal sympathetic denervation helps protect against glomerular sclerosis, possibly by suppressing NAD(P)H oxidase activity, thereby decreasing glomerular reactive oxygen species.

Medication-Overuse Headache: Differences between Daily and Near-Daily Headache Patients.

Medication-overuse headache (MOH) is a challenging neurological disease, which brings frustration for sufferers and treating physicians. The patient’s lack of adherence and limited treatment evidence are frequent. The aim of this study was to compare the outcome and treatment strategies between consecutive MOH patients with daily and near-daily headache from a tertiary center. Methods: Every consecutive patient seen between January and December 2014 with the diagnosis of MOH was included. Psychiatric comorbidities, inability to inform baseline headache frequency, current or previous two-month use of preventive medications, and refusal to sign informed consent were exclusion criteria. The patients were evaluated in thorough initial consultations and divided in two groups based on their baseline headache frequency. The diagnosis and treatment strategies were clearly explained. The filling out of a detailed headache diary was requested from all patients. Endpoints compared headache frequency and adherence after two, four, and eight months between the two study groups. Results: One-hundred sixty-eight patients (31 male, 137 female) met the inclusion criteria. Nineteen patients (11.3%) were excluded. All patients had migraine or chronic migraine as primary headaches. Eighty had daily (DH), and 69 near-daily headache (NDH), at baseline consultation. Mean baseline frequency was 24.8 headache days/month (18.9 days/month for the near-daily group), average headache history was 20.6 years and mean time with >15 headache days/month was 4.8 years. Outpatient withdrawal, starting prevention, and enforcing the correct use of rescue therapy was carried out with all patients. After two months, 88% of the DH and 71% of the NDH groups adhered to treatment (p = 0.0002). The HF decreased to 12 and 9 headache days/month, respectively in DH and NDH groups (p > 0.05, non-significant) (Intention-to-treat (ITT) 14 DH; 12 NDH; p > 0.05). After four and eight months, 86.3% and 83.7% of the DH patients, and 59.4% and 55% of the NDH patients were still under treatment (p = 0.0003 and p = 0.0001). The HF decreased, respectively, to nine and nine headache days/month in the DH patients compared to 6 and 7 headache days/month in the NDH group (p > 0.05) (ITT, 12; 12; DH; 10; 11; NDH; p > 0.05). Conclusions: Although open studies provide limited conclusions, withdrawing overused medications and starting prevention may have helped the favorable outcomes. However, daily headache patients had a significantly higher adherence and lower relapse rates than near-daily headache patients, despite a considerable reduced headache frequency in both groups. Additionally, real-world patient studies are scarce and the comparison between these two subsets of patients may be useful to guide clinicians in approaching their patients. Controlled studies are necessary to confirm these observations.

Hibiscus cannabinus: efeitos nos parâmetros nutricionais e bioquímicos de ratos dislipidêmicos

The plant Hibiscus cannabinus (Hc) is used in folk medicine for inflammatory treatments. There are few studies that characterize the anti-hyperlipidemic potential of this plant, mainly flowers. The aim of this study was to evaluate the effect of dry extract of Hc flowers in nutritional and biochemical parameters of dyslipidemic mice. 21 male rats and adults were divided into three groups: Group C - standard diet; Group D - fat diet; DH Group - plus fat diet dry extract of Hc flowers. The study lasted seven weeks. In two weeks the animals in Groups D and DH received high fat diet for induction of dyslipidemia, then the DH group received treatment with Hc (500mg / kg weight) for five weeks. Group C received standard diet (AIN-93M) during the study. The animals were kept in a controlled environment, being collected body weight, food intake, water intake, urinary and fecal excretion. At the end of the study the blood was used for biochemical determinations and weight of organs for comparison between groups. The DH Group, the 7th week of the study, showed lower food consumption compared to Group C and increased fecal excretion in the 2nd and 4th weeks, compared to Groups C and D. The variables body weight, water intake and urinary excretion were not influenced the Hc extract of flowers. The dyslipidemic diet increased liver weight in Groups D and DH. The Hc was not effective in maintaining the normal parameters of the variables studied, with the exception of food and fecal excretion consumption.