BACKGROUND: Ischemic preconditioning (IPC) is a strategy to reduce ischemia-reperfusion (I/R) injury. The protective effect of remote ischemic preconditioning (RIPC) on liver I/R injury is not clear. This study aimed ...BACKGROUND: Ischemic preconditioning (IPC) is a strategy to reduce ischemia-reperfusion (I/R) injury. The protective effect of remote ischemic preconditioning (RIPC) on liver I/R injury is not clear. This study aimed to investigate the roles of RIPC in liver I/R in fatty liver rats and the involvement of endothelial nitric oxide synthase-nitric oxide (eNOS-NO) pathway and microRNA expressions in this process. METHODS: A total of 32 fatty rats were randomly divided into the sham group, I/R group, RIPC group and RIPC+I/R group. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and nitric oxide (NO) were measured. Hematoxylin-eosin staining was used to observe histological changes of liver tissues, TUNEL to detect hepatocyte apoptosis, and immunohistochemistry assay to detect heat shock protein 70 (HSP70) expression. Western blotting was used to detect liver inducible NOS (iNOS) and eNOS protein levels and realtime quantitative polymerase chain reaction to detect miR-34a, miR-122 and miR-27b expressions. RESULTS: Compared with the sham and RIPC groups, serum ALT, AST and iNOS in liver tissue were significantly higher in other two groups, while serum NO and eNOS in liver tissue were lower, and varying degrees of edema, degeneration and inflammatory cell infiltration were found. Cell apoptosis number was slightly lower in the RIPC+I/R group than that in I/R group. Compared with the sham group, HSP70 expressions were significantly increased in other three groups (all P<0.05). Compared with the sham and RIPC groups, elevated miR-34a expressions were found in I/R and RIPC+I/R groups (P<0.05). MiR-122 and miR-27b were found significantly decreased in I/R and RIPC+I/R groups compared with the sham and RIPC groups (all P<0.05). CONCLUSION: RIPC can reduce fatty liver I/R injury by affecting the eNOS-NO pathway and liver microRNA expressions.展开更多
Three cycles of remote ischemic pre-conditioning induced by temporarily occluding the bilateral femoral arteries （10 minutes） prior to 10 minutes of reperfusion were given once a day for 3 days before the animal rec...Three cycles of remote ischemic pre-conditioning induced by temporarily occluding the bilateral femoral arteries （10 minutes） prior to 10 minutes of reperfusion were given once a day for 3 days before the animal received middle artery occlusion and reperfusion surgery. The results showed that brain infarct volume was significantly reduced after remote ischemic pre-conditioning. Scores in the forelimb placing test and the postural reflex test were significantly lower in rats having undergone remote ischemic pre-conditioning compared with those who did not receive remote ischemic pre-conditioning. Thus, neurological function was better in rats having undergone remote ischemic pre-conditioning compared with those who did not receive remote ischemic pre-conditioning. These results indicate that remote ischemic pre-conditioning in rat hindlimb exerts protective effects in ischemia-reperfusion injury.展开更多
Common gastrointestinal diseases such as radiation enteritis(RE),acute pancreatitis,inflammatory bowel diseases(IBD)and drug-induced hepatotoxicity share pathophysiological mechanisms at the molecular level,mostly inv...Common gastrointestinal diseases such as radiation enteritis(RE),acute pancreatitis,inflammatory bowel diseases(IBD)and drug-induced hepatotoxicity share pathophysiological mechanisms at the molecular level,mostly involving the activation of many pathways of the immune response,ultimately leading to tissue injury.Increased oxidative stress,inflammatory cytokine release,inflammatory cell infiltration and activation and the up-regulation of inflammatory transcription factors participate in the pathophysiology of these complex entities.Treatment varies in each specific disease,but at least in the cases of RE and IBD immunosuppressors are effective.However,full therapeutic responses are not always achieved.The pathophysiology of ischemiareperfusion(IR)injury shares many of these mechanisms.Brief and repetitive periods of ischemia in an organ or limb have been shown to protect against subsequent major IR injury in distant organs,a phenomenon called remote ischemic preconditioning(RIP).This procedure has been shown to protect the gut,pancreas and liver by modulating many of the same inflammatory mechanisms.Since RIP is safe and tolerable,and has shown to be effective in some recent clinical trials,I suggest that RIP could be used as a physiologicallyrelevant adjunct treatment for non-ischemic gastrointestinal inflammatory conditions.展开更多
BACKGROUND Studies suggested that remote ischemic preconditioning(RIPC)may effectively lessen the harmful effects of ischemia reperfusion injury during organ transplantation surgery.AIM To investigate the protective e...BACKGROUND Studies suggested that remote ischemic preconditioning(RIPC)may effectively lessen the harmful effects of ischemia reperfusion injury during organ transplantation surgery.AIM To investigate the protective effects of RIPC on living liver donors and recipients following pediatric liver transplantation.METHODS From January 2016 to January 2019 at Renji Hospital Affiliated with Shanghai Jiao Tong University School of Medicine,208 donors were recruited and randomly assigned to four groups:S-RIPC group(no intervention;n=55),D-RIPC group(donors received RIPC;n=51),R-RIPC group(recipients received RIPC,n=51)and DR-RIPC group(both donors and recipients received RIPC;n=51).We primarily evaluated postoperative liver function among donors and recipients and incidences of early allograft dysfunction,primary nonfunction and postoperative complications among recipients.RESULTS RIPC did not significantly improve alanine transaminase and aspartate aminotransferase levels among donors and recipients or decrease the incidences of early allograft dysfunction,primary nonfunction,and postoperative complications among recipients.Limited protective effects were observed,including a lower creatinine level in the D-RIPC group than in the S-RIPC group on postoperative day 0(P<0.05).However,no significant improvements were found in donors who received RIPC.Furthermore,RIPC had no effects on the overall survival of recipients.CONCLUSION The protective effects of RIPC were limited for recipients who received living liver transplantation,and no significant improvement of the prognosis was observed in recipients.展开更多
AIM： To investigate the influence of remote ischemic preconditioning （RIPC） on anastomotic integrity. METHODS： Sixty male Wistar rats were randomized to six groups. The control group （n = 10） had an end- to-end ...AIM： To investigate the influence of remote ischemic preconditioning （RIPC） on anastomotic integrity. METHODS： Sixty male Wistar rats were randomized to six groups. The control group （n = 10） had an end- to-end ileal anastomosis without RIPC. The preconditioned groups （n = 34） varied in time of ischemia and time of reperfusion. One group received the amino acid L-arginine before constructing the anastomosis （n = 9）. On postoperative day 4, the rats were re-laparotomized, and bursting pressure, hydroxyproline concentration, intra-abdominal adhesions, and a histological score concerning the mucosat ischemic injury were collected. The data are given as median （range）.RESULTS： On postoperative day 4, median bursting pressure was 124 mmHg （60-146 mmHg） in the control group. The experimental groups did not show a statistically significant difference （P 〉 0.05）. Regarding the hydroxyproline concentration, we did not find any significant variation in the experimental groups. We detected significantly less mucosal injury in the RIPC groups. Furthermore, we assessed more extensive intra-abdominal adhesions in the preconditioned groups than in the control group. CONCLUSION： RIPC directly before performing small bowel anastomosis does not affect anastomotic stability in the early period, as seen in ischemic preconditioning.展开更多
AIM To study whether remote ischemic preconditioning(RIPC) has an impact on clinical outcomes, such as post-operative atrial fibrillation(POAF).METHODS This was a prospective, single-center, single-blinded,randomized ...AIM To study whether remote ischemic preconditioning(RIPC) has an impact on clinical outcomes, such as post-operative atrial fibrillation(POAF).METHODS This was a prospective, single-center, single-blinded,randomized controlled study. One hundred and two patients were randomized to receive RIPC(3 cycles of 5 min ischemia and 5 min reperfusion in the upper arm after induction of anesthesia) or no RIPC(control). Primary outcome was POAF lasting for five minutes or longer during the first seven days after surgery. Secondary outcomes included length of hospital stay, incidence of inpatient mortality, myocardial infarction, and stroke. RESULTS POAF occurred at a rate of 54% in the RIPC group and 41.2% in the control group(P = 0.23). No statistically significant differences were noted in secondary outcomes between the two groups. CONCLUSION This is the first study in the United States to suggest that RIPC does not reduce POAF in patients with elective or urgent cardiac surgery. There were no differences in adverse effects in either group. Further studies are required to assess the relationship between RIPC and POAF.展开更多
Background and objectives:Coronary stenosis is responsible for angina attacks in coronary heart disease(CHD).A prospective pilot study was conducted to investigate the effects of combining remote ischemic precondition...Background and objectives:Coronary stenosis is responsible for angina attacks in coronary heart disease(CHD).A prospective pilot study was conducted to investigate the effects of combining remote ischemic preconditioning(RIPC)with Radix salviae decoction(RSD).Methods:A total of 60 patients diagnosed with CHD were enrolled and divided into the control group and the RIPC-RSD treatment group.The primary outcome was the frequency of angina attacks,while the secondary outcomes included Canadian Cardiovascular Society levels,emergency medications,and prognosis indicators.Results:A total of 57 patients were included in the final analysis.Demographic characteristics and vessel stenosis comparisons showed similar results(p>0.05).There was no significant difference in the frequency of angina attacks before(χ^(2)=2.170,p=0.404)or after(χ^(2)=1.509,p=0.662)treatment.Similarly,there was no significant difference in CCS levels of angina attacks between the two groups before(χ^(2)=1.504,p=0.681)or after(χ^(2)=1.392,p=0.707)treatment.Although there was no significant difference in the use of emergency medications for angina attacks before(χ^(2)=1.321,p=0.517)or after(χ^(2)=2.457,p=0.356)treatment,a significant decrease in the frequency of emergency medications was observed(Z=−2.188,p=0.029).However,the RIPC-RSD treatment did not have a significant impact on the prognosis(cardiac death,χ^(2)=1.831,p=0.176;target vessel revascularization,χ^(2)=1.111,p=0.292;rehospitalization,χ^(2)=0.495,p=0.482)of coronary stenosis in CHD patients.Conclusions:Due to the limitations of a relatively small sample size,this prospective pilot study did not observe a significant effect of RIPC-RSD on angina attacks and prognosis in CHD patients,but it implied potential efficacy in reducing the frequency of emergency medications.展开更多
Corrigendum on:Liu Q,Pan G,Liu P,Zhang A,Wang K,Yang R,et al.Effects of Remote Ischemic Preconditioning Combined with Radix salviae Decoction on Coronary Stenosis and Prognosis:A Prospective Pilot Study.Future Integra...Corrigendum on:Liu Q,Pan G,Liu P,Zhang A,Wang K,Yang R,et al.Effects of Remote Ischemic Preconditioning Combined with Radix salviae Decoction on Coronary Stenosis and Prognosis:A Prospective Pilot Study.Future Integrative Medicine.2023;2(4):181-188.doi:10.14218/FIM.2023.00034.Missing clinical trial registration information:In the original publication,the required statement of prospective trial registration was omitted.The study was not registered in a public trials registry prior to patient enrollment.This was an oversight that does not align with standard publication ethics and the journal's policy.展开更多
Regarding the Registration Status of the Below Article Liu Q,Pan G,Liu P,Zhang A,Wang K,Yang R,et al.Effects of Remote Ischemic Preconditioning Combined with Radix salviae Decoction on Coronary Stenosis and Prognosis:...Regarding the Registration Status of the Below Article Liu Q,Pan G,Liu P,Zhang A,Wang K,Yang R,et al.Effects of Remote Ischemic Preconditioning Combined with Radix salviae Decoction on Coronary Stenosis and Prognosis:A Prospective Pilot Study.Future Integrative Medicine.2023;2(4):181-188.doi:10.14218/FIM.2023.00034.The journal has been informed by the authors that the clinical trial reported was not prospectively registered.The authors have since retrospectively registered the study(ITMCTR2025002387)and submitted the Corrigendum Notice.展开更多
基金supported by a grant from 2013 Applied Basic Research of Changzhou Bureau of Science and Technology(CJ20130044)
文摘BACKGROUND: Ischemic preconditioning (IPC) is a strategy to reduce ischemia-reperfusion (I/R) injury. The protective effect of remote ischemic preconditioning (RIPC) on liver I/R injury is not clear. This study aimed to investigate the roles of RIPC in liver I/R in fatty liver rats and the involvement of endothelial nitric oxide synthase-nitric oxide (eNOS-NO) pathway and microRNA expressions in this process. METHODS: A total of 32 fatty rats were randomly divided into the sham group, I/R group, RIPC group and RIPC+I/R group. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and nitric oxide (NO) were measured. Hematoxylin-eosin staining was used to observe histological changes of liver tissues, TUNEL to detect hepatocyte apoptosis, and immunohistochemistry assay to detect heat shock protein 70 (HSP70) expression. Western blotting was used to detect liver inducible NOS (iNOS) and eNOS protein levels and realtime quantitative polymerase chain reaction to detect miR-34a, miR-122 and miR-27b expressions. RESULTS: Compared with the sham and RIPC groups, serum ALT, AST and iNOS in liver tissue were significantly higher in other two groups, while serum NO and eNOS in liver tissue were lower, and varying degrees of edema, degeneration and inflammatory cell infiltration were found. Cell apoptosis number was slightly lower in the RIPC+I/R group than that in I/R group. Compared with the sham group, HSP70 expressions were significantly increased in other three groups (all P<0.05). Compared with the sham and RIPC groups, elevated miR-34a expressions were found in I/R and RIPC+I/R groups (P<0.05). MiR-122 and miR-27b were found significantly decreased in I/R and RIPC+I/R groups compared with the sham and RIPC groups (all P<0.05). CONCLUSION: RIPC can reduce fatty liver I/R injury by affecting the eNOS-NO pathway and liver microRNA expressions.
基金supported by the National Natural Science Foundation of China (The mechanism of the remote ischemia postconditioning and its time therapeutic window), No.30870854(The cerebral protection of remote ischemia postconditioning and its mechanism), No. 30770743(The effect and its mechanism of EPO intravascular injection on the thrombolysis time window of tPA on cerebral infarction in rats),No. 81071058
文摘Three cycles of remote ischemic pre-conditioning induced by temporarily occluding the bilateral femoral arteries （10 minutes） prior to 10 minutes of reperfusion were given once a day for 3 days before the animal received middle artery occlusion and reperfusion surgery. The results showed that brain infarct volume was significantly reduced after remote ischemic pre-conditioning. Scores in the forelimb placing test and the postural reflex test were significantly lower in rats having undergone remote ischemic pre-conditioning compared with those who did not receive remote ischemic pre-conditioning. Thus, neurological function was better in rats having undergone remote ischemic pre-conditioning compared with those who did not receive remote ischemic pre-conditioning. These results indicate that remote ischemic pre-conditioning in rat hindlimb exerts protective effects in ischemia-reperfusion injury.
文摘Common gastrointestinal diseases such as radiation enteritis(RE),acute pancreatitis,inflammatory bowel diseases(IBD)and drug-induced hepatotoxicity share pathophysiological mechanisms at the molecular level,mostly involving the activation of many pathways of the immune response,ultimately leading to tissue injury.Increased oxidative stress,inflammatory cytokine release,inflammatory cell infiltration and activation and the up-regulation of inflammatory transcription factors participate in the pathophysiology of these complex entities.Treatment varies in each specific disease,but at least in the cases of RE and IBD immunosuppressors are effective.However,full therapeutic responses are not always achieved.The pathophysiology of ischemiareperfusion(IR)injury shares many of these mechanisms.Brief and repetitive periods of ischemia in an organ or limb have been shown to protect against subsequent major IR injury in distant organs,a phenomenon called remote ischemic preconditioning(RIP).This procedure has been shown to protect the gut,pancreas and liver by modulating many of the same inflammatory mechanisms.Since RIP is safe and tolerable,and has shown to be effective in some recent clinical trials,I suggest that RIP could be used as a physiologicallyrelevant adjunct treatment for non-ischemic gastrointestinal inflammatory conditions.
基金Supported by Renji Hospital Clinical Innovation Foundation,No.PYIII-17-002Outstanding Academic Leaders’Program of Health and Family Planning Commission of Shanghai,No.2017BR042+1 种基金Investigative Doctor Program(2017)of Shanghai Jiao Tong University School of MedicineJoint Project of Health and Family Planning Commission of Pudong District,No.PW2015D-3.
文摘BACKGROUND Studies suggested that remote ischemic preconditioning(RIPC)may effectively lessen the harmful effects of ischemia reperfusion injury during organ transplantation surgery.AIM To investigate the protective effects of RIPC on living liver donors and recipients following pediatric liver transplantation.METHODS From January 2016 to January 2019 at Renji Hospital Affiliated with Shanghai Jiao Tong University School of Medicine,208 donors were recruited and randomly assigned to four groups:S-RIPC group(no intervention;n=55),D-RIPC group(donors received RIPC;n=51),R-RIPC group(recipients received RIPC,n=51)and DR-RIPC group(both donors and recipients received RIPC;n=51).We primarily evaluated postoperative liver function among donors and recipients and incidences of early allograft dysfunction,primary nonfunction and postoperative complications among recipients.RESULTS RIPC did not significantly improve alanine transaminase and aspartate aminotransferase levels among donors and recipients or decrease the incidences of early allograft dysfunction,primary nonfunction,and postoperative complications among recipients.Limited protective effects were observed,including a lower creatinine level in the D-RIPC group than in the S-RIPC group on postoperative day 0(P<0.05).However,no significant improvements were found in donors who received RIPC.Furthermore,RIPC had no effects on the overall survival of recipients.CONCLUSION The protective effects of RIPC were limited for recipients who received living liver transplantation,and no significant improvement of the prognosis was observed in recipients.
基金Supported by Science Fund of the Department for General and Visceral Surgery at the University of Freiburg
文摘AIM： To investigate the influence of remote ischemic preconditioning （RIPC） on anastomotic integrity. METHODS： Sixty male Wistar rats were randomized to six groups. The control group （n = 10） had an end- to-end ileal anastomosis without RIPC. The preconditioned groups （n = 34） varied in time of ischemia and time of reperfusion. One group received the amino acid L-arginine before constructing the anastomosis （n = 9）. On postoperative day 4, the rats were re-laparotomized, and bursting pressure, hydroxyproline concentration, intra-abdominal adhesions, and a histological score concerning the mucosat ischemic injury were collected. The data are given as median （range）.RESULTS： On postoperative day 4, median bursting pressure was 124 mmHg （60-146 mmHg） in the control group. The experimental groups did not show a statistically significant difference （P 〉 0.05）. Regarding the hydroxyproline concentration, we did not find any significant variation in the experimental groups. We detected significantly less mucosal injury in the RIPC groups. Furthermore, we assessed more extensive intra-abdominal adhesions in the preconditioned groups than in the control group. CONCLUSION： RIPC directly before performing small bowel anastomosis does not affect anastomotic stability in the early period, as seen in ischemic preconditioning.
文摘AIM To study whether remote ischemic preconditioning(RIPC) has an impact on clinical outcomes, such as post-operative atrial fibrillation(POAF).METHODS This was a prospective, single-center, single-blinded,randomized controlled study. One hundred and two patients were randomized to receive RIPC(3 cycles of 5 min ischemia and 5 min reperfusion in the upper arm after induction of anesthesia) or no RIPC(control). Primary outcome was POAF lasting for five minutes or longer during the first seven days after surgery. Secondary outcomes included length of hospital stay, incidence of inpatient mortality, myocardial infarction, and stroke. RESULTS POAF occurred at a rate of 54% in the RIPC group and 41.2% in the control group(P = 0.23). No statistically significant differences were noted in secondary outcomes between the two groups. CONCLUSION This is the first study in the United States to suggest that RIPC does not reduce POAF in patients with elective or urgent cardiac surgery. There were no differences in adverse effects in either group. Further studies are required to assess the relationship between RIPC and POAF.
基金supported by Zhuhai Medical Science and Technology Research Fund Project(No.ZH24013310210002PWC,to QL)National Natural Science Foundation of China(No.82274279,to QL)+1 种基金Special Funding for Chinese Medicine Science and Technology Research of Guangdong Provincial Hospital of Chinese Medicine(No.YN2020QN10,to QL)Guangdong Provincial Bureau of Chinese medicine Fund Project(No.20221360,to QL).
文摘Background and objectives:Coronary stenosis is responsible for angina attacks in coronary heart disease(CHD).A prospective pilot study was conducted to investigate the effects of combining remote ischemic preconditioning(RIPC)with Radix salviae decoction(RSD).Methods:A total of 60 patients diagnosed with CHD were enrolled and divided into the control group and the RIPC-RSD treatment group.The primary outcome was the frequency of angina attacks,while the secondary outcomes included Canadian Cardiovascular Society levels,emergency medications,and prognosis indicators.Results:A total of 57 patients were included in the final analysis.Demographic characteristics and vessel stenosis comparisons showed similar results(p>0.05).There was no significant difference in the frequency of angina attacks before(χ^(2)=2.170,p=0.404)or after(χ^(2)=1.509,p=0.662)treatment.Similarly,there was no significant difference in CCS levels of angina attacks between the two groups before(χ^(2)=1.504,p=0.681)or after(χ^(2)=1.392,p=0.707)treatment.Although there was no significant difference in the use of emergency medications for angina attacks before(χ^(2)=1.321,p=0.517)or after(χ^(2)=2.457,p=0.356)treatment,a significant decrease in the frequency of emergency medications was observed(Z=−2.188,p=0.029).However,the RIPC-RSD treatment did not have a significant impact on the prognosis(cardiac death,χ^(2)=1.831,p=0.176;target vessel revascularization,χ^(2)=1.111,p=0.292;rehospitalization,χ^(2)=0.495,p=0.482)of coronary stenosis in CHD patients.Conclusions:Due to the limitations of a relatively small sample size,this prospective pilot study did not observe a significant effect of RIPC-RSD on angina attacks and prognosis in CHD patients,but it implied potential efficacy in reducing the frequency of emergency medications.
文摘Corrigendum on:Liu Q,Pan G,Liu P,Zhang A,Wang K,Yang R,et al.Effects of Remote Ischemic Preconditioning Combined with Radix salviae Decoction on Coronary Stenosis and Prognosis:A Prospective Pilot Study.Future Integrative Medicine.2023;2(4):181-188.doi:10.14218/FIM.2023.00034.Missing clinical trial registration information:In the original publication,the required statement of prospective trial registration was omitted.The study was not registered in a public trials registry prior to patient enrollment.This was an oversight that does not align with standard publication ethics and the journal's policy.
文摘Regarding the Registration Status of the Below Article Liu Q,Pan G,Liu P,Zhang A,Wang K,Yang R,et al.Effects of Remote Ischemic Preconditioning Combined with Radix salviae Decoction on Coronary Stenosis and Prognosis:A Prospective Pilot Study.Future Integrative Medicine.2023;2(4):181-188.doi:10.14218/FIM.2023.00034.The journal has been informed by the authors that the clinical trial reported was not prospectively registered.The authors have since retrospectively registered the study(ITMCTR2025002387)and submitted the Corrigendum Notice.
