AIM:To investigate the effects of chronic alcohol consumption on retinal microcirculation by comparing different alcohol-consuming groups using optical coherence tomography(OCT)and OCT angiography(OCTA).METHODS:This o...AIM:To investigate the effects of chronic alcohol consumption on retinal microcirculation by comparing different alcohol-consuming groups using optical coherence tomography(OCT)and OCT angiography(OCTA).METHODS:This observational clinical study utilized a cross-sectional and prospective design,focusing on chronic alcohol consumers alongside a non-consuming control group.OCT/OCTA imaging parameters including central retinal subfield thickness(CST),subfoveal choroidal thickness(SCT),foveal avascular zone(FAZ)and vessel density(VD)in the superficial and deep capillary plexuses in both the macular and optic disc(OD)regions were recorded.Data were analyzed using SPSS 15.0;descriptive statistics were reported,group comparisons were performed with Chisquare,Kruskal–Wallis,and Bonferroni-corrected Mann–Whitney U tests,and relationships were assessed using Spearman correlation,with statistical significance set at P<0.05.RESULTS:A total of 160 eyes of 160 participants(110 females and 50 males with mean age 38.7±9.9y)who don’t smoke were divided into five groups:never,occasional,monthly,weekly and daily drinkers.The mean CST was 216.6±14.2μm and the mean SCT was 358.9±84.5μm.There was no statistically significantly difference in CST and SCT among the groups(P=0.890,0.799).Foveal superficial capillary plexuses(SCPs)VD was higher in monthly drinkers compared to occasional drinkers(P=0.015).Foveal VD in deep capillary plexus was also higher in monthly drinkers than in never and occasional drinkers(P=0.004,0.006).Nasal SCPs VD at the OD was higher in monthly drinkers compared to never drinkers(P=0.005).There was no significant difference FAZ area among the groups(P=0.071).CONCLUSION:Both superficial and deep microvascular structures in the inferior quadrants of macula are positively correlated with frequency of alcohol use.Also in our study results is that the monthly drinker group has uniquely higher VDs in both macula and OD.This leads us to consider moderate alcohol consumption may also have protective effects on retinal microcirculation.展开更多
Objective:To investigate the effects of“Three Methods and Three Acupoints”(TMTP)Tuina therapy on spinal microcirculation in sciatic nerve injury(SNI).Methods:Thirty-six SpragueeDawley rats were randomly assigned to ...Objective:To investigate the effects of“Three Methods and Three Acupoints”(TMTP)Tuina therapy on spinal microcirculation in sciatic nerve injury(SNI).Methods:Thirty-six SpragueeDawley rats were randomly assigned to four groups:normal,sham operation,model,and TMTP Tuina.Successful model induction was confirmed by observable hind limb lameness.After 20 sessions,hind limb grip strength and motor nerve conduction velocity(MNCV)were measured at baseline and following the 10th and 20th intervention.CD31 and a-SMA in the ventral horn of SNI model rats were detected using immunofluorescence.Motor neurons in the ventral horn were detected by Nissl staining.PTEN levels in the ventral horn were measured by ELISA,and PI3K,Akt,BDNF,VEGF,and HIF-1a expression was determined by RT-PCR.Spinal cord microcirculation was evaluated by western blotting analysis of the levels of Akt,p-Akt,BDNF,and VEGF.Results:Hind limb grip strength and MNCV significantly improved in the TMTP Tuina group compared to the model group(both P<.001).Morphology of ventral horn motor neurons in the TMTP Tuina group improved compared to the model group,with increased expressions of a-SMA(P=.002)and CD31(P=.006).Western blot analysis indicated increased expression of VEGF(P=.005),p-Akt(P<.001),and BDNF(P=.008)in the ventral horn following Tuina treatment.RT-PCR analysis revealed increased expression of PI3K,Akt,BDNF,VEGF and HIF-1a(all P<.05).In contrast,expression of PTEN decreased compared to the model group(P<.001).Conclusion:TMTP Tuina therapy may restore motor function in rats,enhance ventral horn motor neuron morphology,and promote angiogenesis and vascular smooth muscle proliferation.The mechanism may involve the activation of the PI3K/Akt signaling pathway.展开更多
The management of acute coronary syndrome(ACS)in older patients remains challenging because standard anticoagulants often fail to yield optimal outcomes.Bivalirudin,a direct inhibitor of thrombin,serves as an alternat...The management of acute coronary syndrome(ACS)in older patients remains challenging because standard anticoagulants often fail to yield optimal outcomes.Bivalirudin,a direct inhibitor of thrombin,serves as an alternative to traditional therapies.This drug is particularly effective in enhancing myocardial microcircu-lation and reducing adverse events after clinical interventions.The present article explores the findings of a recent study that highlighted the clinical benefits of bivalirudin by investigating its effects on myocardial microcirculation and adverse cardiac events after percutaneous coronary intervention in older patients with ACS.Compared with unfractionated heparin,bivalirudin markedly reduced the emergency response time and improved cardiac function indicators.It further mitigated the risks of cardiovascular events and recurrent myocardial infarctions.These findings suggest that bivalirudin can enhance myocardial perfusion and reduce bleeding complications,thus serving as a safe,effective anticoagulation agent for older patients with ACS.Nonetheless,further large-scale,high-quality trials are needed to establish optimal usage guidelines and assess long-term outcomes.Integrating bivalirudin into ACS treatment protocols for older patients may help optimize patient care,balancing efficacy and safety.Continual research and consensus building are necessary for the widespread clinical application of bivalirudin and the improvement of ACS outcomes in older patients.展开更多
Drug development and precision therapy are core technologies in the biopharmaceutical field.In the traditional paradigm,new drug development relies on validation through animal testing and clinical trials-a process th...Drug development and precision therapy are core technologies in the biopharmaceutical field.In the traditional paradigm,new drug development relies on validation through animal testing and clinical trials-a process that requires a decade of testing and costs over two billion dollars[1].Although animal testing has long served as the standard approach for evaluating drug efficacy and toxicity,its predictive accuracy for human responses remains limited due to translational barriers arising from interspecies physiological differences[2].Despite passing animal testing,only about 12%of drug candidates proceed to preclinical trials,and fewer than 11.7%gain final approval[3].展开更多
BACKGROUND The integrity and functionality of the hepatic microcirculation are essential for maintaining liver health,which is influenced by sex and genetic background.Understanding these variations is crucial for add...BACKGROUND The integrity and functionality of the hepatic microcirculation are essential for maintaining liver health,which is influenced by sex and genetic background.Understanding these variations is crucial for addressing disparities in liver disease outcomes.AIM To investigate the sexual dimorphism and genetic heterogeneity of liver microcirculatory function in mice.METHODS We assessed hepatic microhemodynamics in BALB/c,C57BL/6J,and KM mouse strains using laser Doppler flowmetry and wavelet analysis.We analyzed the serum levels of alanine transaminase,glutamic acid aminotransferase,total bile acid,total protein,alkaline phosphatase,and glucose.Histological and immunohistochemical staining were employed to quantify microvascular density and the expression levels of cluster of differentiation(CD)31,and estrogen receptorα,andβ.Statistical analyses,including the Mantel test and Pearson correlation,were conducted to determine the relationships among hepatic function,microcirculation,and marcocirculation between different sexes and across genetic backgrounds.RESULTS We identified sex-based disparities in hepatic microhemodynamics across all strains,with males exhibiting higher microvascular perfusion and erythrocyte concentration,but lower blood velocity.Strain-specific differences were evident,particularly in the endothelial oscillatory characteristics of the erythrocyte concentration.No sexdependent differences in estrogen receptor expression were observed,while significant variations in CD31 expression and microvascular density were observed.The correlations highlighted relationships between hepatic microhemodynamics and liver function indicators.CONCLUSION Our findings indicate the influence of genetic and sex differences on hepatic microcirculation and liver function,highlighting the necessity of incorporating both genetic background and sex into hepatic physiology studies and potential liver disease management strategies.展开更多
Vascular cognitive impairment and dementia is a debilitating neurological disorder caused by chronic cerebral hypoperfusion,for which no effective causative treatments are currently available.Intermittent hypoxia has ...Vascular cognitive impairment and dementia is a debilitating neurological disorder caused by chronic cerebral hypoperfusion,for which no effective causative treatments are currently available.Intermittent hypoxia has been shown to enhance cerebral blood flow in mice,but its efficacy in a model of vascular cognitive impairment and dementia remains unclear.In this study,we established a mouse model of vascular cognitive impairment and dementia by bilateral carotid artery stenosis.Intermittent hypoxia was induced before and after this stenosis.We found that intermittent hypoxia increased cerebral blood flow,oxygen saturation,and microcirculation in the prefrontal cortex and hippocampus in the model mice,without causing neurovascular damage.Additionally,intermittent hypoxia significantly improved cognitive function in the mouse model of vascular cognitive impairment and dementia,with perconditioning showing greater efficacy than preconditioning.Improvements in cerebral microcirculation and blood flow were positively correlated with cognitive recovery.Even in a mouse model of vascular cognitive impairment and dementia with comorbidities induced by a high-fat,high-fructose diet,intermittent hypoxic perconditioning demonstrated protective effects on cognitive function.Proteomic analysis indicated that mitochondrial protection is a key mechanism,particularly through upregulating NDUFB8 expression and increasing the activity of mitochondrial complex I.These findings suggest that intermittent hypoxia is a potential non-invasive strategy for the prevention and treatment of vascular cognitive impairment and dementia.展开更多
Objective To explore the mechanism of moxibustion for people in sub-health status. Methods Thirty-nine young and middle-aged sub-health volunteers were enrolled, including 13 males and 26 females. Mild moxibustion was...Objective To explore the mechanism of moxibustion for people in sub-health status. Methods Thirty-nine young and middle-aged sub-health volunteers were enrolled, including 13 males and 26 females. Mild moxibustion was adopted, and Shenque （神阙 CV 8）, Guanyuan （关元 CV 4）, Zusanli （足三里 ST 36, bilateral）, Pish0 （脾俞 BL 20, bilateral） and Shenshu （肾俞 BL 23, bilateral） were selected. The moxibustion was performed once every other day, 20 min at each time, and moxibustion for ten times was needed. The changes in morphology, flow velocity and pefiloop of nailfold microcirculation were detected by adopting microcirculation detector before moxibustion, after moxibustion for three times, six times, ten times, and on the 15th day after moxibustion, respectively. Results After moxibustion, the abnormal blood capillary morphology of microcirculation gradually turned into normal pattern along with the increase of the number of times of moxibustion, according to the comparison of the number of capillary loop, the diameter of input limb, the diameter of output limb/the diameter of input limb, flow pattern integral, pefiloop integral and total integral with those before moxibustion, the differences were all statistically significant （all P〈0.01）. Conclusion Moxibustion changs the microcirculation of nailfold of body, improves the blood flow pattern, makes the pefiloop status clear, accelerats the blood flow and increases the microcirculation perfusion amount, thus regulating the sub- health status of human body.展开更多
BACKGROUND:Intestinal microcirculation dysfunction is an important factor that causes poor prognosis in sepsis patients and is an important pathophysiological basis for the occurrence and development of sepsis.DATA RE...BACKGROUND:Intestinal microcirculation dysfunction is an important factor that causes poor prognosis in sepsis patients and is an important pathophysiological basis for the occurrence and development of sepsis.DATA RESOURCES:PubMed,Web of Science,and China National Knowledge Infrastructure(CNKI)were searched from inception to August 1,2021.The search was limited to the English language only.Two reviewers independently identified studies related to intestinal microcirculation dysfunction in sepsis.Exclusion criteria were duplicate articles according to multiple search criteria.RESULTS:Fifty articles were included,and most of them were animal studies.These studies reported pathogenesis,including endothelial dysfunction,leukocyte recruitment and adhesion,microthrombus formation,microcirculation hypoperfusion,and redistribution of intestinal wall blood flow.The monitoring methods of intestinal microcirculation were also diverse,including handheld microscopes,intravital microscopy(IVM),laser Doppler blood flow instruments,laser speckle contrast imaging,tissue refl ectance spectrophotometry,biochemical markers of intestinal ischemia,and histopathological examination.In view of the related pathogenesis of intestinal microcirculation disorder in sepsis,existing studies also have diff erent opinions on its treatment.CONCLUSIONS:Limited by monitoring,there are few clinical studies on intestinal microcirculation dysfunction in sepsis.Related research mainly focuses on basic research,but some progress has also been made.Therefore,this review may provide a reference for future research on intestinal microcirculation dysfunction in sepsis.展开更多
AIM： To investigate the effect of epidural anaesthesia （EA） on pancreatic microcirculation during acute pancreatitis （AP）. METHODS： AP was induced by injection of sodium taurocholate into the pancreatic duct of ...AIM： To investigate the effect of epidural anaesthesia （EA） on pancreatic microcirculation during acute pancreatitis （AP）. METHODS： AP was induced by injection of sodium taurocholate into the pancreatic duct of Sprague-Dawley rats. To realize EA, a catheter was introduced into the epidural space between T7 and T9 and bupivacaine was injected. Microcirculatory flow was measured by laser Doppler flowmetry. Arterial blood gas analyses were performed. At the end of the experiment （≤ 5 h）, pancreas was removed for histology. The animals were divided into three groups： Group 1 （n =9）, AP without EA, Group 2 （n = 4）, EA without AP; and Group 3 （n = 6）, AP treated by EA. RESULTS： In Group 1, pancreatic microcirculatory flow prior to AP was 1414, 39 perfusion units （PU）. After AP, microcirculatory flow obviously decreased to 9 4-6 PU （P〈0.05）. Metabolic acidosis developed with base excess （BE） of - 14 4, 3 mmol/L. Histology revealed extensive edema and tissue necrosis. In Group 2, EA did not significantly modify microcirculatory flow. BE remained unchanged and histological analysis showed normal pancreatic tissue. In Group 3, AP initially caused a significant decrease in microcirculatory flow from 155 ± 25 to 11± 7 PU （P〈0.05）. After initiation of EA, microcirculatory flow obviously increased again to 81±31 PU （P〈0.05）. BE was -6±4 retool/L, which was significantly different compared to Group 1 （P〈0.05）. Furthermore, histology revealed less extensive edema and necrosis in pancreatic tissue in Group 3 than that in Group 1. CONCLUSION： AP caused dramatic microcirculatory changes within the pancreas, with development of metabolic acidosis and tissue necrosis. EA allowed partial restoration of microcirculatory flow and prevented development of tissue necrosis and systemic complications. Therefore, EA should be considered as therapeutic option to prevent evolution from edematous to necrotic AP.展开更多
文摘AIM:To investigate the effects of chronic alcohol consumption on retinal microcirculation by comparing different alcohol-consuming groups using optical coherence tomography(OCT)and OCT angiography(OCTA).METHODS:This observational clinical study utilized a cross-sectional and prospective design,focusing on chronic alcohol consumers alongside a non-consuming control group.OCT/OCTA imaging parameters including central retinal subfield thickness(CST),subfoveal choroidal thickness(SCT),foveal avascular zone(FAZ)and vessel density(VD)in the superficial and deep capillary plexuses in both the macular and optic disc(OD)regions were recorded.Data were analyzed using SPSS 15.0;descriptive statistics were reported,group comparisons were performed with Chisquare,Kruskal–Wallis,and Bonferroni-corrected Mann–Whitney U tests,and relationships were assessed using Spearman correlation,with statistical significance set at P<0.05.RESULTS:A total of 160 eyes of 160 participants(110 females and 50 males with mean age 38.7±9.9y)who don’t smoke were divided into five groups:never,occasional,monthly,weekly and daily drinkers.The mean CST was 216.6±14.2μm and the mean SCT was 358.9±84.5μm.There was no statistically significantly difference in CST and SCT among the groups(P=0.890,0.799).Foveal superficial capillary plexuses(SCPs)VD was higher in monthly drinkers compared to occasional drinkers(P=0.015).Foveal VD in deep capillary plexus was also higher in monthly drinkers than in never and occasional drinkers(P=0.004,0.006).Nasal SCPs VD at the OD was higher in monthly drinkers compared to never drinkers(P=0.005).There was no significant difference FAZ area among the groups(P=0.071).CONCLUSION:Both superficial and deep microvascular structures in the inferior quadrants of macula are positively correlated with frequency of alcohol use.Also in our study results is that the monthly drinker group has uniquely higher VDs in both macula and OD.This leads us to consider moderate alcohol consumption may also have protective effects on retinal microcirculation.
基金supported by the National Natural Science Foundation of China(82274675&82074573)the Beijing Natural Science Foundation(7232278).
文摘Objective:To investigate the effects of“Three Methods and Three Acupoints”(TMTP)Tuina therapy on spinal microcirculation in sciatic nerve injury(SNI).Methods:Thirty-six SpragueeDawley rats were randomly assigned to four groups:normal,sham operation,model,and TMTP Tuina.Successful model induction was confirmed by observable hind limb lameness.After 20 sessions,hind limb grip strength and motor nerve conduction velocity(MNCV)were measured at baseline and following the 10th and 20th intervention.CD31 and a-SMA in the ventral horn of SNI model rats were detected using immunofluorescence.Motor neurons in the ventral horn were detected by Nissl staining.PTEN levels in the ventral horn were measured by ELISA,and PI3K,Akt,BDNF,VEGF,and HIF-1a expression was determined by RT-PCR.Spinal cord microcirculation was evaluated by western blotting analysis of the levels of Akt,p-Akt,BDNF,and VEGF.Results:Hind limb grip strength and MNCV significantly improved in the TMTP Tuina group compared to the model group(both P<.001).Morphology of ventral horn motor neurons in the TMTP Tuina group improved compared to the model group,with increased expressions of a-SMA(P=.002)and CD31(P=.006).Western blot analysis indicated increased expression of VEGF(P=.005),p-Akt(P<.001),and BDNF(P=.008)in the ventral horn following Tuina treatment.RT-PCR analysis revealed increased expression of PI3K,Akt,BDNF,VEGF and HIF-1a(all P<.05).In contrast,expression of PTEN decreased compared to the model group(P<.001).Conclusion:TMTP Tuina therapy may restore motor function in rats,enhance ventral horn motor neuron morphology,and promote angiogenesis and vascular smooth muscle proliferation.The mechanism may involve the activation of the PI3K/Akt signaling pathway.
文摘The management of acute coronary syndrome(ACS)in older patients remains challenging because standard anticoagulants often fail to yield optimal outcomes.Bivalirudin,a direct inhibitor of thrombin,serves as an alternative to traditional therapies.This drug is particularly effective in enhancing myocardial microcircu-lation and reducing adverse events after clinical interventions.The present article explores the findings of a recent study that highlighted the clinical benefits of bivalirudin by investigating its effects on myocardial microcirculation and adverse cardiac events after percutaneous coronary intervention in older patients with ACS.Compared with unfractionated heparin,bivalirudin markedly reduced the emergency response time and improved cardiac function indicators.It further mitigated the risks of cardiovascular events and recurrent myocardial infarctions.These findings suggest that bivalirudin can enhance myocardial perfusion and reduce bleeding complications,thus serving as a safe,effective anticoagulation agent for older patients with ACS.Nonetheless,further large-scale,high-quality trials are needed to establish optimal usage guidelines and assess long-term outcomes.Integrating bivalirudin into ACS treatment protocols for older patients may help optimize patient care,balancing efficacy and safety.Continual research and consensus building are necessary for the widespread clinical application of bivalirudin and the improvement of ACS outcomes in older patients.
基金supported by the Program of the National Natural Science Foundation of China(Grant Nos.:52435006,and 52275291)the Program for Innovation Team of Shaanxi Province The work was supported by the Program of the National Natural Science Foundation of China(Grant Nos.:52435006,and 52275291)the Program for Innovation Team of Shaanxi Province。
文摘Drug development and precision therapy are core technologies in the biopharmaceutical field.In the traditional paradigm,new drug development relies on validation through animal testing and clinical trials-a process that requires a decade of testing and costs over two billion dollars[1].Although animal testing has long served as the standard approach for evaluating drug efficacy and toxicity,its predictive accuracy for human responses remains limited due to translational barriers arising from interspecies physiological differences[2].Despite passing animal testing,only about 12%of drug candidates proceed to preclinical trials,and fewer than 11.7%gain final approval[3].
基金Supported by the Beijing Municipal Natural Science Foundation,No.7212068the National Natural Science Foundation of China,No.81900747.
文摘BACKGROUND The integrity and functionality of the hepatic microcirculation are essential for maintaining liver health,which is influenced by sex and genetic background.Understanding these variations is crucial for addressing disparities in liver disease outcomes.AIM To investigate the sexual dimorphism and genetic heterogeneity of liver microcirculatory function in mice.METHODS We assessed hepatic microhemodynamics in BALB/c,C57BL/6J,and KM mouse strains using laser Doppler flowmetry and wavelet analysis.We analyzed the serum levels of alanine transaminase,glutamic acid aminotransferase,total bile acid,total protein,alkaline phosphatase,and glucose.Histological and immunohistochemical staining were employed to quantify microvascular density and the expression levels of cluster of differentiation(CD)31,and estrogen receptorα,andβ.Statistical analyses,including the Mantel test and Pearson correlation,were conducted to determine the relationships among hepatic function,microcirculation,and marcocirculation between different sexes and across genetic backgrounds.RESULTS We identified sex-based disparities in hepatic microhemodynamics across all strains,with males exhibiting higher microvascular perfusion and erythrocyte concentration,but lower blood velocity.Strain-specific differences were evident,particularly in the endothelial oscillatory characteristics of the erythrocyte concentration.No sexdependent differences in estrogen receptor expression were observed,while significant variations in CD31 expression and microvascular density were observed.The correlations highlighted relationships between hepatic microhemodynamics and liver function indicators.CONCLUSION Our findings indicate the influence of genetic and sex differences on hepatic microcirculation and liver function,highlighting the necessity of incorporating both genetic background and sex into hepatic physiology studies and potential liver disease management strategies.
基金supported by the Beijing Nova Program,Nos.20230484436,Z211100002121038the Chinese Institutes for Medical Research,No.CX23YQ01+1 种基金the NationalNatural Science Foundation of China,Nos.32100925,82027802Beijing-Tianjin-Hebei Basic Research Cooperation Project,No.22JCZXJC00190(all to XJand JL).
文摘Vascular cognitive impairment and dementia is a debilitating neurological disorder caused by chronic cerebral hypoperfusion,for which no effective causative treatments are currently available.Intermittent hypoxia has been shown to enhance cerebral blood flow in mice,but its efficacy in a model of vascular cognitive impairment and dementia remains unclear.In this study,we established a mouse model of vascular cognitive impairment and dementia by bilateral carotid artery stenosis.Intermittent hypoxia was induced before and after this stenosis.We found that intermittent hypoxia increased cerebral blood flow,oxygen saturation,and microcirculation in the prefrontal cortex and hippocampus in the model mice,without causing neurovascular damage.Additionally,intermittent hypoxia significantly improved cognitive function in the mouse model of vascular cognitive impairment and dementia,with perconditioning showing greater efficacy than preconditioning.Improvements in cerebral microcirculation and blood flow were positively correlated with cognitive recovery.Even in a mouse model of vascular cognitive impairment and dementia with comorbidities induced by a high-fat,high-fructose diet,intermittent hypoxic perconditioning demonstrated protective effects on cognitive function.Proteomic analysis indicated that mitochondrial protection is a key mechanism,particularly through upregulating NDUFB8 expression and increasing the activity of mitochondrial complex I.These findings suggest that intermittent hypoxia is a potential non-invasive strategy for the prevention and treatment of vascular cognitive impairment and dementia.
基金Supported by General program of National Natural Science Foundation of China:81373742,81674062Special program of social development and medical health of science and technology projects in Taiyuan:12016925
文摘Objective To explore the mechanism of moxibustion for people in sub-health status. Methods Thirty-nine young and middle-aged sub-health volunteers were enrolled, including 13 males and 26 females. Mild moxibustion was adopted, and Shenque （神阙 CV 8）, Guanyuan （关元 CV 4）, Zusanli （足三里 ST 36, bilateral）, Pish0 （脾俞 BL 20, bilateral） and Shenshu （肾俞 BL 23, bilateral） were selected. The moxibustion was performed once every other day, 20 min at each time, and moxibustion for ten times was needed. The changes in morphology, flow velocity and pefiloop of nailfold microcirculation were detected by adopting microcirculation detector before moxibustion, after moxibustion for three times, six times, ten times, and on the 15th day after moxibustion, respectively. Results After moxibustion, the abnormal blood capillary morphology of microcirculation gradually turned into normal pattern along with the increase of the number of times of moxibustion, according to the comparison of the number of capillary loop, the diameter of input limb, the diameter of output limb/the diameter of input limb, flow pattern integral, pefiloop integral and total integral with those before moxibustion, the differences were all statistically significant （all P〈0.01）. Conclusion Moxibustion changs the microcirculation of nailfold of body, improves the blood flow pattern, makes the pefiloop status clear, accelerats the blood flow and increases the microcirculation perfusion amount, thus regulating the sub- health status of human body.
文摘BACKGROUND:Intestinal microcirculation dysfunction is an important factor that causes poor prognosis in sepsis patients and is an important pathophysiological basis for the occurrence and development of sepsis.DATA RESOURCES:PubMed,Web of Science,and China National Knowledge Infrastructure(CNKI)were searched from inception to August 1,2021.The search was limited to the English language only.Two reviewers independently identified studies related to intestinal microcirculation dysfunction in sepsis.Exclusion criteria were duplicate articles according to multiple search criteria.RESULTS:Fifty articles were included,and most of them were animal studies.These studies reported pathogenesis,including endothelial dysfunction,leukocyte recruitment and adhesion,microthrombus formation,microcirculation hypoperfusion,and redistribution of intestinal wall blood flow.The monitoring methods of intestinal microcirculation were also diverse,including handheld microscopes,intravital microscopy(IVM),laser Doppler blood flow instruments,laser speckle contrast imaging,tissue refl ectance spectrophotometry,biochemical markers of intestinal ischemia,and histopathological examination.In view of the related pathogenesis of intestinal microcirculation disorder in sepsis,existing studies also have diff erent opinions on its treatment.CONCLUSIONS:Limited by monitoring,there are few clinical studies on intestinal microcirculation dysfunction in sepsis.Related research mainly focuses on basic research,but some progress has also been made.Therefore,this review may provide a reference for future research on intestinal microcirculation dysfunction in sepsis.
文摘AIM： To investigate the effect of epidural anaesthesia （EA） on pancreatic microcirculation during acute pancreatitis （AP）. METHODS： AP was induced by injection of sodium taurocholate into the pancreatic duct of Sprague-Dawley rats. To realize EA, a catheter was introduced into the epidural space between T7 and T9 and bupivacaine was injected. Microcirculatory flow was measured by laser Doppler flowmetry. Arterial blood gas analyses were performed. At the end of the experiment （≤ 5 h）, pancreas was removed for histology. The animals were divided into three groups： Group 1 （n =9）, AP without EA, Group 2 （n = 4）, EA without AP; and Group 3 （n = 6）, AP treated by EA. RESULTS： In Group 1, pancreatic microcirculatory flow prior to AP was 1414, 39 perfusion units （PU）. After AP, microcirculatory flow obviously decreased to 9 4-6 PU （P〈0.05）. Metabolic acidosis developed with base excess （BE） of - 14 4, 3 mmol/L. Histology revealed extensive edema and tissue necrosis. In Group 2, EA did not significantly modify microcirculatory flow. BE remained unchanged and histological analysis showed normal pancreatic tissue. In Group 3, AP initially caused a significant decrease in microcirculatory flow from 155 ± 25 to 11± 7 PU （P〈0.05）. After initiation of EA, microcirculatory flow obviously increased again to 81±31 PU （P〈0.05）. BE was -6±4 retool/L, which was significantly different compared to Group 1 （P〈0.05）. Furthermore, histology revealed less extensive edema and necrosis in pancreatic tissue in Group 3 than that in Group 1. CONCLUSION： AP caused dramatic microcirculatory changes within the pancreas, with development of metabolic acidosis and tissue necrosis. EA allowed partial restoration of microcirculatory flow and prevented development of tissue necrosis and systemic complications. Therefore, EA should be considered as therapeutic option to prevent evolution from edematous to necrotic AP.
