Induction Stage Research Articles

КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯ ИЗМЕНЕНИЙ МИКРОБИОМА ПОЛОСТИ НОСА У ДЕТЕЙ СО ЗЛОКАЧЕСТВЕННЫМИ ОПУХОЛЯМИ ПАРАМЕНИНГЕАЛЬНОЙ ЛОКАЛИЗАЦИИ ВО ВРЕМЯ ХИМИОЛУЧЕВОЙ ТЕРАПИИ

Malignant tumors of parameningeal localization are various morphological neoplasms located in the nasal cavity, nasopharynx, paranasal sinuses and middle ear. As a result of tumor growth, conditions are created for the development of chronic inflammation. Studies of the microbiome of the upper respiratory tract in children with malignant tumors were practically not conducted. Objective of the research: to identify changes in the microbiome of the nasal cavity in children with malignant tumors of parameningeal localization during chemoradiotherapy. Materials and methods: the study included 29 patients with parameningeal tumors, 2–17 years old. Among the included in the study there were 18 boys (62%) and 11 girls (37%). Morphologically, the following were verified: embryonic rhabdomyosarcoma (ERMS) – 17 (58%), alveolar rhabdomyosarcoma (arms) – 3 (10%), other sarcomas – 4 (13%), nasopharyngeal cancer – 5 (17%). All patients received induction chemotherapy. Simultaneous radiotherapy (LT) and chemotherapy (CT) – in 24 (82%) cases. After completing the chemoradiotherapy stage, consolidation therapy continued in 20 (70%) patients. Results: before the start of LT (after the induction stage of chemotherapy), a variety of microflora was observed in the nasal secretions, gram-positive and gram-negative bacteria were isolated in an equal ratio. The absence of growth of microorganisms was determined in 4 (13%) cases before the start of LT. Methicillin-resistant Staphylococcus epidermidis and Staphylococcus haemolyticus were more frequently detected after LT. Colonization of the nasal cavity of Candida albicans occurred before the start of LT in 4 (13%) and persisted after irradiation in 5 (17%) patients. In the delayed period, there was an increase in the percentage of patients who ridiculed gram-negative microorganisms – Pseudomonas aeruginosa in 4 (13%) cases. After 12 months, 3 (10%) patients showed a return of nosocomial flora (S. epidermidis MRSE and S. haemolyticus MRS), a decrease in colonization of P. aeruginosa and the preservation of C. albicans. Conclusion: at different stages of chemoradiotherapy, the nasal mucosa is colonized by various microorganisms that differ in their properties and pathogenicity. The continuation of this study will clarify the clinical significance of certain types of opportunistic microorganisms in the pathogenesis of inflammatory diseases of the upper respiratory tract in children with malignant tumors.

Comparative Analysis of Acid-base Status Parameters in Newborn with Congenital Surgical Malformations During Perioperative Care Based on Types of Anesthesia

Introduction: Congenital malformations (CM) are most common in newborns and infants in the first year of life and require surgical correction in the first hours, days, months of life. Surgical interventions in severely ill babies with malformations can lead to catabolic stress, circulatory and respiratory disorders, metabolism shifts, water-electrolyte, protein, and acid-base status disorders.
 This study aimed to compare acid-base status in newborns and infants with congenital surgical pathology under different types of combined anesthesia. 
 Materials and methods: This retrospective study included 150 newborns and infants with CM who required surgery. The patients were divided into three groups based on types of provided anesthesia: inhalation by Sevoran (sevoflurane) and regional anesthesia (group I); inhalation of Sevoran and intravenous anesthesia by Fentanyl (group II); and intravenous combination of Fentanyl and 20% Sodium Oxybutyrate (group III). The analysis included: acid-base status, peripheral oximetry, and the need for an oxygen mixture inhaled by the patient.
 Results In group I, there was a significant reduction in partial tension of CO2 and increased pH from the pre-surgical status, at the time of induction of anesthesia, during the most painful, traumatic stage, and after surgery compared to group II and III. Peripheral O2 saturation was not critically reduced at all stages of observation except in babies of group I compared to group III at the stage of induction of anesthesia (97.79 ± 2.45 vs. 98.79 ± 1.63, p = 0.0194) and at the most painful period of surgery (96.29 ± 3.47 vs. 98.10 ± 2.47, p = 0.0368). In group I, newborns and infants required higher oxygen concentrations in the inhalation mixture. There was a significant difference in FiO2 between groups I and III during the most painful stage of surgery (0.47 ± 0.29 and 0.33 ± 0.2, p = 0.0071), and immediately after surgery (0.34 ± 0, 19 and 0.26 ± 0.13, p = 0.0246).
 Conclusion: Among the newborns and infants with CM requiring surgical intervention and combined anesthesia, the most substantial acid-base status changes were observed in the group where anesthesia was provided by Sevoran (sevoflurane) and regional anesthesia (Group I).

MazF toxin causes alterations in Staphylococcus aureus transcriptome, translatome and proteome that underlie bacterial dormancy.

Antibiotic resistance is a serious problem which may be caused by bacterial dormancy. It has been suggested that bacterial toxin–antitoxin systems induce dormancy. We analyzed the genome-wide role of Staphylococcus aureus endoribonuclease toxin MazF using RNA-Seq, Ribo-Seq and quantitative proteomics. We characterized changes in transcriptome, translatome and proteome caused by MazF, and proposed that MazF decreases translation directly by cleaving mRNAs, and indirectly, by decreasing translation factors and by promoting ribosome hibernation. Important pathways affected during the early stage of MazF induction were identified: MazF increases cell wall thickness and decreases cell division; MazF activates SsrA-system which rescues stalled ribosomes, appearing as a result of MazF mRNA cleavage. These pathways may be promising targets for new antibacterial drugs that prevent bacteria dormancy. Finally, we described the overall impact of MazF on S. aureus cell physiology, and propose one of the mechanisms by which MazF might regulate cellular changes leading to dormancy.

619 Timing of induction of labor has no association with labor or delivery complications

To assess labor, delivery, maternal and neonatal complications associated with timing of induction of labor. This was a secondary analysis of 2 randomized trials involving 6 cervical ripening methods. The inclusion criteria were patients with obstetric or medical indication for IOL, singleton gestation and unfavorable cervix. The 6 cervical ripening methods included: Foley + 4 mg compound PGE (gel) vs Foley + 10 μg misoprostol (oral) vs 100 μg misoprostol (oral) vs 10 mg dinoprostone (pessary) vs Athad + Prepidil 0.5 mg (gel) vs 25 μg then 50 μg misoprostol (intra-vaginal). For this analysis, 905 patients were included and divided into 4 groups according to time period of labor induction: Early Day (ED)- 06:00 to 12:00; Late Day (LD)- 12:00 to 18:00; Early Night (EN)- 18:00 to midnight; Late Night (LN)- midnight to 06:00. The demographic, obstetric, labor and delivery characteristics and neonatal outcomes were compared. Demographic were significant for mean maternal age, BMI categories, mean gestational age and gestational age categories (LN had largest percent < 37 weeks), There were non-significant between the 4 groups for percent of nulliparous, ethnicity, maternal weight, BMI. There were significant differences for indications of induction with more preterm and hypertensive disorders at LN; however the percent of bishop score < 6 was similar. The most common indication for induction is hypertensive disorders follow by oligohydramnios and post-term. The duration of medical induction, 1st and 2nd stage of labor were similar. The mode of delivery and cesarean indications were similar. The rate of meconium, chorioamnionitis and uterine tachysystole were similar. Neonatal outcomes were similar for gender, birth-weight, umbilical cord pH, Apgar < 7 and NICU admission. IOL at LN had younger mom and more at < 37 weeks with hypertensive disorders. There were no difference in duration in medical induction, 1st and 2nd stage of labor, and mode of delivery across the 4 IOL periods. There were differences in labor or neonatal complications associated with timing of IOL.

Impact of mild hypothermia therapy on hemodynamics during the induction stage in neonates with moderate to severe hypoxic-ischemic encephalopathy

Objective To study the changes in hemodynamics during the induction stage of systemic mild hypothermia therapy in neonates with moderate to severe hypoxic-ischemic encephalopathy (HIE). Methods A total of 21 neonates with HIE who underwent systemic mild hypothermia therapy in the Department of Neonatology, Dongguan Children's Hospital Affiliated to Guangdong Medical University, from July 2017 to April 2020 were enrolled. The rectal temperature of the neonates was lowered to 34℃ after 1-2 hours of induction and maintained at this level for 72 hours using a hypothermia blanket. The impedance method was used for noninvasive hemodynamic monitoring, and the changes in heart rate (HR), mean arterial pressure (MAP), stroke volume (SV), cardiac output (CO), cardiac index (CI), and total peripheral resistance (TPR) from the start of hypothermia induction to the achievement of target rectal temperature (34℃). Blood lactic acid (LAC) and resistance index (RI) of the middle cerebral artery were recorded simultaneously. Results The 21 neonates with HIE had a mean gestational age of (39.6±1.1) weeks, a mean birth weight of (3 439±517) g, and a mean 5-minute Apgar score of 6.8±2.0. From the start of hypothermia induction to the achievement of target rectal temperature (34℃), there were significant reductions in HR, CO, and CI (P 0.05). There was a significant increase in TPR (P 0.05). Conclusions The systemic mild hypothermia therapy may have a significant impact on hemodynamics in neonates with moderate to severe HIE, and continuous hemodynamic monitoring is required during the treatment.

Expression of putative chitinase of Rhipicephalus sanguineus sensu lato in Rosetta (DE3) pLysS cells

Recombinant protein expression from bacteria is less time consuming and more economical in comparison to other expression systems. However, bacterial expression systems fail to express certain proteins due to their inability to code for certain amino acids. Rosetta (DE3) pLysS cells possess the ability to express even such rare codons and are also capable of post translational modification to some extent. Expression of protein is also affected by factors like stage of induction with cell density, aerobic conditions and the toxic effect of metabolite produced post induction. In the current study, the ideal expression conditions needed to obtain optimum yield of a putative chitinase from Rhipicephalus sanguineus sensu lato using recombinant Rosetta (DE3)pLysS cells was evaluated. The expressed proteins were visualised in SDS-PAGE and confirmed by western blotting. Double selection of colonies expressing the recombinant protein was carried in the study. The study showed that induction at an OD600 range of 0.6-0.8 and aerobic conditions with the induction volume being one-fifth the flask volume favoured the expression of recombinant protein. Post-induction incubation periods of 1- 16hr did not influence protein production among the induced cultures.

Square root law model for the delivery and intestinal absorption of drugs: a case of hydrophilic captopril

The in vivo release and absorption of drugs are dependent on the interplay between many factors related to compound, formulation, and physiological properties. The mathematical models of oral drug absorption attempt to strike a balance between a complete description that takes into consideration as many independent factors as possible, and simple models that operate with fewer parameters, based mainly on critical factors. The latter models are by far more robust and easier to apply to predict the extent and sometimes even the rate of absorption. The present paper attempted to develop a simple model to describe the time course of absorption of the hydrophilic drug captopril (CPT) at the early phases of absorption, with implications mainly in the induction and early stages of achieving its therapeutic effect. As a phenomenological model, the instantaneous release of CPT was considered in the gastrointestinal fluid, leading to a constant drug concentration for a prolonged time, followed by a ‘long path diffusion’ inside the intestinal wall and a very low concentration at the interface intestinal wall-blood. These conditions regarding CPT concentration were translated into initial and boundary mathematical conditions for the diffusion equation in the intestinal wall. The solution of the diffusion equation led in the end to a square root law describing the dependence between the fraction of the drug absorbed and time. The model was successfully applied to data obtained in five bioequivalence studies: three comparing plasma levels achieved after the administration of a single dose of CPT 50 mg, one evaluating CPT pharmacokinetics after a 100 mg dose, and a fifth comparing CPT pharmacokinetics of two fixed-dose combinations of CPT 50 mg and hydrochlorothiazide 25 mg.

EFFECTIVENESS OF FLAVORED ORAL CRYOTHERAPY ON THE PREVENTION AND MANAGEMENT OF STOMATITIS INDUCED BY CHEMOTHERAPY

Background: Stomatitis is probably the most prevalent, debilitating complication ofcancer treatments particularly chemotherapy. Aim: This study aimed to examineeffectiveness of flavored oral cryotherapy on the prevention and management of stomatitisinduced by chemotherapy. Method :A quasi experimental design was conducted on apurposive sample of 46 children from both gender with cancer and undergoingchemotherapy who attended the pediatric outpatient clinics and in-patient pediatriconcology department in Oncology Center at Mansoura University and their age from 6-18years, newly diagnosed with cancer and in induction stage of chemotherautic protocol, hada healthy oral mucosa and treated with methotrexate, Adriamycin or 5-Fluorouracil.Tools: A structural interview questionnaire sheet about characteristics, clinical data andoral health status of children and oral assessment guide tool (OAG). Result: More thanhalf of children in flavored cryotherapy had healthy oral cavity while nearly two third ofthem had sever stomatitis at 14th day. Conclusion: Using flavored oral cryotherapy lead tohealthier oral mucosa and lower stomatitis score compared to using only mouthwash(chlorhexidine). Recommendations: Provide in-services, up to date, regular trainingprograms to improve nurses' knowledge and practices regarding the use of flavoredcryotherapy and mouthwashes as routine care for children treated with chemotherapy

INHIBITION OF REDD1 EXPRESSION FOR THE REDUCTION OF GLUCOCORTICOID-INDUCED SIDE EFFECTS

Glucocorticoids (GC ) have been an integral component of the treatment of leukemias and lymphomas for several decades. Specific cytotoxic effect of GC on transformed lymphoblasts mediates their use at the stage of the remission induction as well as consolidation of treatment. However, the main problem of the long-term GC use is the development of atrophic and metabolic side effects as well as GC resistance. The biological effects of GC are realized via activation of the glucocorticoid receptor (GR) by two mechanisms: transrepression (TR) associated with the therapeutic effects of GC , and transactivation (TA ), which mediates the development of metabolic and atrophic complications. It was demonstrated that an increase in the expression of the GC - dependent gene REDD1 associated with GC -induced skin, muscle and bone atrophy of the skin, muscle and bone tissue was realized via the induction of transactivation. Therefore, identification of potential inhibitors of REDD1 expression and study of their biological effects in combination with GC in models of leukemia and lymphoma is of particular interest. In our recent study we have selected a number of drugs from the class of PI 3K/Akt/mTO R modulators using bioinformatic screening. These drugs effectively inhibited REDD1 expression, modulated GR activity and shifted it towards transrepression, and prevented the development of GC -induced side effects in mice. Here we aimed to study the effects of potential inhibitors of REDD1 expression from different pharmacological groups, the compounds Emetine and CGP -60474, on leukemia and lymphoma cells in combination with GC . We demonstrated antitumor effect of the compounds in vitro, a decrease in the expression of TA -associated genes and an increase in TR induction. Further studies of the antitumor effects of REDD1 expression inhibitors (Emetine and CGP -60474 is a promising area of research.

Induction and pore-formed stages in Al2Au’s dealloying process in HCl solutions

Two stages, induction stage and pore-formed stage, were distinguished in Al2Au’s dealloying process in HCl solutions by OCP, SEM and XPS characterization. In induction stage, the Au state with binding energy 85.4 eV (labelled as Al2Au (I)) was transformed into the state 84.7 eV (Al2Au (II)); in pore-formed stage, nanoporous structure started to be formed, Al2Au (II) and residual Al2Au (I) were transformed into the state 83.7 eV (pure Au). Multi-resolution analysis on OCP noise revealed that the induction stage and pore-formed stage undergo different corrosion modes: the former is local corrosion and the latter is global corrosion.

Клінічний аналіз вітальних показників у новонароджених і немовлят із хірургічною патологією при різних видах анестезіологічного супроводу

Congenital defects are more common in newborns and children of the first year of life and require surgical correction in the first hours, days of life. Surgical interventions against the background of serious diseases and malformations can lead to catabolic stress, circulatory and respiratory disorders, metabolism, water-electrolyte, protein and acid-base states, which are reflected in the indicators of vital functions. Purpose — to conduct a clinical analysis of indicators of vital functions in newborns and infants with congenital surgical pathology with various types of combined anesthesia. Materials and methods. A retrospective study included 150 newborns and infants with congenital malformations of the surgical profile, depending on the anesthesia (inhalation + regional anesthesia — group І (50 newborns); inhalation + intravenous anesthesia — group ІІ (50 newborns); total intravenous — group III (50 newborns)). The parameters of peripheral and cerebral oximetry, blood pressure, heart rate and respiration were analyzed. Results. The minimum indicator of cerebral oximetry was noted in the left brain hemisphere of children of the ІІ group — 50.57±16.66, which may be an unfavorable prognostic factor in further recovery and influence on the cognitive functions of the child's brain. Peripheral saturation did not critically decrease at all stages of observation. With the exception of the resulting decrease in the indicator in children of group I compared with group III at the stage of induction into anesthesia (97.79±2.45 versus 98.79±1.63, at p=0.0194, respectively) and at the most painful moment of surgical intervention (96.29±3.47 versus 98.10±2.47, with p=0.0368). In children who received combined intravenous anesthesia with two drugs, there was an increase in mean arterial pressure from the beginning of surgical treatment to the child's recovery after surgery (49.49±10.71; 56.18±8.05, respectively, at p&lt;0.01). Conclusions. Among the surveyed groups, the most vulnerable to pathological changes in vital function indicators were children for whom anesthetic support was provided by inhalation anesthesia with sevoran with regional anesthesia. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the author. Key words: newborns, infants, congenital malformations, combined anesthesia, vital indicators.

Аналіз факторів ризику при різних видах анестезіологічного супроводу новонароджених і немовлят із хірургічною патологією

High-quality anesthetic support during surgical correction of congenital malformations of internal organs and the postoperative period in newborns and infants is complicated by concomitant diseases, significantly affects the processes of metabolism, gas exchange, homeostasis, cerebral, peripheral hemodynamics, etc. before, during and after the surgical intervention. Purpose — to identify the leading risk factors associated with death in various types of anesthetic support for newborns and infants during surgical correction of congenital malformations. Materials and methods. The retrospective study included newborns with congenital malformations of the surgical profile, as well as infants who received and continued stepwise surgical treatment for congenital malformations, depending on the chosen combined anesthetic accompaniment (inhalation + regional anesthesia and inhalation + intravenous anesthesia). The study was carried out in the following stages: 1) to conduct surgical treatment and anesthetic support, 2) introduction of the child into anesthesia, 3) the traumatic stage of the operation, 4) within 1 hour after the operation, 5) 24 hours after the operation. Risk factors were determined by simple logistic regression with the calculation of the odds ratio, 95% confidence interval (95% CI). Results. Among the functional indicators of the vital functions of the body of children with congenital disorders before, during, immediately and 24 hours after surgery against the background of combined anesthesia, with a simple logistic regression analysis, the chance of a fatal case increases with deviations from the norm of peripheral saturation — at all stages of surgical support (7.8–15.0 times); cerebral oxygenation of the child — at the moments of induction into anesthesia and in the postoperative period (10.8 at the stage 2, 72.0 times at the stage 4); increased diastolic blood pressure at the stage of induction of the child into anesthesia (1.6 times). Conclusions. To prevent the chances of death under various types of anesthesia for children with congenital malformations during surgical treatment, it is advisable to more closely monitor blood pressure, cerebral, peripheral oximetry and promptly correct the impaired condition of the child. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: newborns, infants, congenital malformations, anesthesia, risk factors.

Analysis of vital indicators for different types of anesthesia in newborns and infants with surgical pathology

Annotation. In newborns and infants, surgical interventions against the background of severe concomitant and background perinatal pathologies and malformations lead to catabolic stress, circulatory and respiratory disorders, which are reflected in the indicators of vital functions. Given the high risk of severe complications of organ function in the perioperative and postoperative periods, it is advisable to continuously monitor key clinical parameters. Aim of the study – to establish the absolute values of indicators of vital functions in newborns and infants with congenital surgical pathology with various types of combined anesthesia and compare them with clinical data. A retrospective study included 150 newborns and infants with congenital malformations of the surgical profile, depending on the anesthesia (inhalation + regional anesthesia; inhalation + intravenous anesthesia and total intravenous). The parameters of peripheral oximetry, blood pressure, heart rate and respiration were analyzed. It was found that peripheral saturation did not critically decrease at all stages of observation. With the exception of the resulting decrease in the indicator in children of group I compared with group III at the stage of induction into anesthesia (97.79±2.45 versus 98.79±1.63, at p=0.0194, respectively) and at the most painful moment of surgical intervention (96.29±3.47 versus 98.10±2.47, with p=0.0368). In children who received combined intravenous anesthesia with two drugs, there was an increase in mean arterial pressure from the beginning of surgical treatment to the child's recovery after surgery (49.49±10.71, 56.18±8.05, respectively, at p˂0.01). Thus, among the surveyed groups, the most vulnerable were children for whom anesthesia was provided by Sevoflurane inhalation with regional anesthesia. The performed correlation analysis established the effect of anesthesia on the general hemodynamics in children during all stages of observation.

Comparison of anesthesia effects between closed-loop and open-loop target controlled infusion of propofol using the bispectral index in abdominal surgery.

Bispectral index (BIS) can reflect the depth of propofol sedation. This study aims to compare the anesthetic satisfaction, anesthetic dose, and hemodynamic changes between closed-loop target controlled infusion (CLTCI) and open-loop target controlled infusion (OLTCI) during abdominal surgery. From December 2016 to December 2018, 70 patients undergoing abdominal surgery under general anesthesia were selected in Beijing Hospital, including 51 males and 19 females, at the age from 49 to 65 years old. They were classified as grade I-II by the American Society of anesthesiologists (ASA) and were randomly divided into the CLTCI group and the OLTCI group (n=35). The CLTCI group received propofol CLTCI, and the target BIS value was set between 45 to 55; in the OLTCI group, the plasma target concentration was adjusted to maintain the BIS value between 40 to 60. Both groups were given remifentanil by target controlled infusion, and the plasma target concentration was 6.0 ng/mL. The percentages of adequate anesthesia time, deep anesthesia time, and light anesthesia time were calculated. The total induction dose of propofol, continuous infusion dose of propofol, predicted target propofol concentration of effect chamber, and continuous infusion dose of remifentanil were calculated. The times of automatic adjustment of propofol concentration in closed-loop system and manual adjustment of propofol concentration in the OLTCI group were recorded. Hemodynamic indexes were recorded, and the percentage of target mean arterial pressure (MAP) maintenance time and target heart rate (HR) maintenance time were calculated. Anesthesia time, operation time, recovery time, and extubation time were compared between the 2 groups. In the induction stage, the percentage of adequate anesthesia time in the CLTCI group was higher than that in the OLTCI group, and the percentage of deep anesthesia time in the CLTCI group was significantly lower than that in the OLTCI group (both P<0.05). In the maintenance stage, the percentage of light anesthesia time in the CLTCI group was significantly lower than that in the OLTCI group (P<0.05). The times of propofol adjustment in the CLTCI group was significantly more than that in the OLTCI group (P<0.001). The total induction dose of propofol in the CLTCI group was less than that in the OLTCI group (P<0.05), but there were no significant differences in the continuous infusion dose of propofol, predicted target concentration of propofol, continuous infusion dose of remifentanil between the 2 groups (all P>0.05). There were no significant differences in the percentages of target MAP maintenance time and target HR maintenance time between the 2 groups (both P>0.05). There was no intraoperative awareness in both groups, and there were no significant differences in operation time and anesthesia time between the 2 groups (both P>0.05). Compared with propofol OLTCI, anesthesia with propofol CLTCI under BIS guidance can maintain a more appropriate depth of anesthesia sedation and more stable hemodynamics.

OPTIMIZED SCHEME OF DIAZEPAM USAGE DURING CORONARY ARTERY STENTING

During invasive procedures in the X-ray operating room, sedation and analgesia have been used throughout its history. For sedation and anxiolytic effects, benzodiazepines, namely diazepam, were one of the drugs of choice. However, when using this drug, undesirable side effects have been identified, such as drowsiness, fatigue, amnesia, headache, tremors, cognitive impairments, and others.Objective. To establish the optimal scheme of analgosedation using diazepam for coronary artery stenting.Materials and research methods. The study included 60 patients with coronary artery disease who underwent a planned stenting of the coronary arteries. Analgosedation (AS) during stenting of the coronary arteries was performed routinely, and the patients were evenly divided into two study groups. The comparison group consisted of patients who underwent analgosedation based on diazepam and fentanyl. Patients in this group of AC were administered 10 mg of diazepam and 100 μg of fentanyl for induction, and repeated administration of drugs at the same dosage to maintain anesthesia during surgery. The study group consisted of patients with balanced usage of diazepam, namely, at the induction stage, we slowly intravenously injected 5 mg of diazepam solution and fentanyl solution at a dose of 1.5 mg / kg and 1.5 mg / kg / h to maintain the level analgesia. Intraoperatively, to maintain the level of sedation III on the RAMSEY scale (surface sedation), we used propofol solution.Conclusions. During the main stage, when sampling blood gases, we noted a difference in the level of oxygen, which was 6% higher in the study group (p = 0.044) and carbon dioxide, which was 11% higher (p = 0.018). This indicates the best rates of gas exchange in the balanced anesthesia group. During AS, based on the balanced usage of a combination of fentanyl and propofol solution, was better analgesic profile and fewer episodes of excessive sedation.

Choice of anesthetic support components for children during MRI procedures

Introduction. An MRI-scan in early childhood requires anesthesia to create complete immobility of the patient due to the high incidence of artifacts with an MRI duration of 40 to 60 minutes. The purpose of the work is to select the components of anesthetic support in children from one month to three years old with MRI.&#x0D; Materials and methods. The object of the study was 33 patients aged one month to three years with congenital and acquired brain pathology. Anesthetic management intravenous general anesthesia without mechanical ventilation. Anesthesia in 11 (33.3%) patients of group 1 midazolam 0.5% 0.3 mg/kg, in 12 (36.4%) patients of group 2 midazolam 0.5% at a dose of 0.3 mg/kg + ketamine 5% 1.5 mg/kg, and in 10 (30.3%) patients of group 3 midazolam 0.5% at a dose of 0.3 mg/kg + propofol 2 mg/kg.&#x0D; Results. Group 1 patients achieved a sedation level on the RASS scale of 2.2 0.1 points with preservation of sound and tactile sensitivity, spontaneous involuntary movements limbs in 72.7% of cases. Group 2 patients had a lack of motor activity, consciousness - an assessment on the RASS scale 4.6 0.4 points, BIS 59.4 1%, increased in blood pressure by 7.3%, and normal without depression of respiratory function. Group 3 patients required careful titration of each subsequent dose, constant monitoring of breathing and hemodynamics, and, if necessary, maintaining adequate ventilation during the induction stage.&#x0D; Conclusion. The most rational components for anesthesia support in young children during MRI scanning are midazolam solutions at a dose of 0.3 mg/kg and ketamine at 1.5/kg.

Anaesthetic efficacy of eugenol in doctor fish ( Garra rufa ): Behavioural and cardiovascular responses

The effects of eugenol anaesthesia on the behavioural and cardiovascular responses of doctor fish (Garra rufa) (2.0 ± 0.2 g mean weight) were studied. Two experiments were performed. In experiment 1, G. rufa was exposed to eugenol baths at different concentrations (0, 12.5, 25, 50, 75, 100 and 150 μl/L) to record induction and recovery times and fish behavioural responses. Experiment 2 was performed to evaluate the effects of different eugenol concentrations (50, 100 and 150 μl/L) on the electrocardiographic parameters of anaesthetized fish. Induction and recovery times were recorded for each fish separately, and 10 fish were used per eugenol concentration. During the induction stage, video recordings were taken to evaluate fish behaviour. Thereafter, electrocardiographic (ECG) records were taken with the help of electrodes attached to the anaesthetized fish. A strong relationship between eugenol concentrations and induced anaesthesia was verified (R2 = 0.8583), but this relationship decreased slightly during recovery time (R2 = 0.6481). Distance movement, movement duration, swimming speed (velocity) and mobility significantly decreased with an increase in eugenol concentration. ECG results indicated that G. rufa had higher heart rates when anaesthetized with a high concentration of eugenol than with a low concentration (150 μl/L, 94.4 ± 7.3 beats/min; 50 μl/L, 69.0 ± 3.7 beats/min). The QT interval was significantly higher for G. rufa anaesthetized with 100 and 150 μl/L eugenol concentrations. In conclusion, 25 and 50 μl/L eugenol concentrations can be used for general aquaculture procedures in G. rufa, and 75 μl/L is suitable for rapid blood sampling.

Role of growth arrest-specific protein 6 in migration and osteogenic differentiation of human periodontal ligament cells

Objective To investigate the role of growth arrest-specific protein 6 (Gas6) in the process of the migration and osteogenic differentiation of human periodontal ligament cells (hPDLCs). Methods After different concentrations of recombinant human Gas6 (rhGas6) were added to hPDLCs, cell prolife-ration experiment (CCK-8) was taken to observe the effect of rhGas6 on hPDLCs cell proliferation. Scratch test and cell migration test (Transwell) were taken to analyze the migratory ability of hPDLCs in different concentrations of rhGas6 groups. After osteogenic induction, real-time quantitative polymerase chain reaction (real-time PCR) was taken to detect the expression of the Runt-related transcription factor 2 (Runx2) and alkaline phosphatase (ALP). ALP staining was used to detect the amount of mineralized nodules. Results After adding different concentrations of rhGas6, there were no statistically significant differences in hPDLCs cell proliferation among the experimental groups and the control group at 24, 48 and 72 hours (P>0.05). After 24 h of scratch, the healing area in the 800 μg/L of the rhGas6 group was greater than that in the control group, but without statistically significant difference (31.06%±13.70% vs. 21.79%±9.51%, P>0.05). In the migration test, after 24 h, the number of hPDLCs cells which penetrated through the membrane in the 800 μg/L rhGas6 group was significantly higher than that in the control group (P 0.05). After 7 days of osteogenic induction, the mineralized nodules formed in the Gas6 knockdown group were significantly less than those in control group (0.25±0.04 vs. 1.00±0.11, P 0.05). Conclusion After downregulation of Gas6 gene, mineralized nodule formation was reduced and ALP gene expressions were decreased in the early stage of osteogenic induction (7 days). After addition of rhGas6, Runx2 and ALP gene expressions were increased and the number of cell migration was increased, suggesting that Gas6 might play a promoting role in the migration and osteogenic differentiation of human periodontal ligament cells.

Different Regulation of Glut1 Expression and Glucose Uptake during the Induction and Chronic Stages of TGFβ1-Induced EMT in Breast Cancer Cells.

Transforming growth factor beta 1 (TGF-β1) is associated with epithelial-mesenchymal transition (EMT), lymph metastasis, and poor prognosis in breast cancer. Paradoxically, TGF-β1 is also a potent inhibitor of cell proliferation. TGF-β1-induced EMT involves activation of several pathways including AKT, which also regulates glucose uptake. Recent data show that prolonged TGF-β1 exposure leads to a more stable EMT phenotype in breast cancer cells. However, whether this is linked to changes in glucose metabolism is not clear. Here, we used a model of TGF-β1-induced EMT in mammary epithelial cells to study the regulation of Glut1 and EMT markers during the induction compared to a prolonged phase of EMT by western blot, immunofluorescence and qPCR analysis. We also measured cell proliferation and uptake of the glucose analogue 2-NDBG. We found that EMT induction was associated with decreased Glut1 expression and glucose uptake. These effects were linked to reduced cell proliferation rather than EMT. Knockdown of Glut1 resulted in growth inhibition and less induction of vimentin during TGF-β1-induced EMT. Intriguingly, Glut1 levels, glucose uptake and cell proliferation were restored during prolonged EMT. The results link Glut1 repression to the anti-proliferative response of TGF-β1 and indicate that re-expression of Glut1 during chronic TGF-β1 exposure allows breast cancer cells to develop stable EMT and proliferate, in parallel.

Increased number of activated microglia in rat spinal cord during early stage of diabetic induction.

Diabetic neuropathy is a common chronic complication in diabetes mellitus. Such neuropathy associates with chronic inflammation and immune system activation. Microglia, a type of neuroglia, are involved in the immune system and are found in grey and white matter of the central nervous system, such as the brain and spinal cord. The spinal cord connects the peripheral nervous system and the higher brain centre. Hyperglycaemia during diabetes mellitus has been found to activate and increase number of microglia in the dorsal grey horn or column of the lumbar segments in spinal cord, which release several cytokines in the development of hypersensitivity in diabetic neuropathic pain. Therefore, in this study, anatomical alterations of rat spinal microglia in all areas (dorsal, intermediate and ventral columns of grey matter and dorsal, lateral and ventral funiculi of white matter) in cervical enlargement, thoracic level and lumbosacral enlargement were observed in early stage of diabetic conditions by using light and transmission electron microscopies. The numbers of microglia in all parts of grey and white matter of all spinal levels significantly increased in the diabetic group. The structures and ultrastructures of microglia in grey and white matter at cervical enlargement, thoracic level and lumbosacral enlargement similarly changed in diabetes. In diabetic rats, microglia became hypertrophied with a pale nucleus. Moreover, short fragments of rough endoplasmic reticulum, elevated numbers of lysosomes and numerous actin filaments in the cytoplasm were examined. Microglial phagocytosis of myelin and axonal debris were also observed. In this investigation, the morphology of spinal microglia during short-term diabetes became activated during hyperglycaemia. It is suggested that these changes may be involved in the development of diabetic neuropathic pain in the spinal cord.