Pearl River Vision | Good Essay of the Month: Domestic Anesthesiology Abstract 2024.06 (II)

Translator's note:

The translation team of the Department of Anesthesiology, Zhujiang Hospital, Southern Medical University, screened out the recent high-quality SCI literature and research results published by domestic anesthesiology through keyword search and search engines such as PubMed and Web of Science every month.

This issue of Pearl River Vision-Monthly Good Essay excerpts some articles published from May 2024 to June 2024, from the Department of Anesthesiology of Zhujiang Hospital of Southern Medical University, the Department of Anesthesiology of Xiangya Hospital of Central South University, the Department of Anesthesiology of Shengjing Hospital of China Medical University, the Department of Anesthesiology of Guizhou Provincial People's Hospital, the Department of Anesthesiology of Nanjing Drum Tower Hospital, the Department of Anesthesiology of Tianjin Medical University General Hospital, the Department of Anesthesiology of Nanfang Hospital of Southern Medical University, and the Department of Anesthesiology of the Second Affiliated Hospital of Wenzhou Medical University. The content covers TET1-lipid nanoparticle-encapsulated morphine specific targeting peripheral nerve pain relief, the effect of remimazolam on delirium in children undergoing laparoscopic surgery, and novel treatment strategies for postoperative neurocognitive impairment (#为第一作者, *is the corresponding author).

Monthly Good Article (2024.05.02-06.01).

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17. Dan Yang#, Bin-Bin Nie#, Jin-Gang He, Zong-Qiang Lv, Feng-Feng Mo, Si-Yi Ouyang, Jie Wang*, Juxiang Chen*, Tao Tao*. Exploring cerebral structural and functional abnormalities in a mouse model of post-traumatic headache induced by mild traumatic brain injury. Zoological Research, 2024, 45(3): 648−662. PMID: 38766747

【Title】

To investigate the brain structure and functional abnormalities of a mouse model of posttraumatic headache caused by mild traumatic brain injury

【Corresponding Author】

Jie Wang, Key Laboratory of Magnetic Resonance Biosystems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan National Research Center for Magnetic Resonance, Wuhan National Laboratory of Optoelectronics, Wuhan Institute of Physics and Mathematics, Institute of Precision Measurement Science and Technology Innovation, Chinese Academy of Sciences; Institute of Neuroscience and Brain Diseases, Xiangyang Central Hospital, Hubei University of Arts and Sciences; Songjiang Research Institute, Songjiang Hospital, Shanghai Jiao Tong University School of Medicine

Juxiang Chen, Department of Neurosurgery, Changhai Hospital, Naval Medical University

Tao Tao, Department of Anesthesiology, Zhanjiang Central People's Hospital; Department of Anesthesiology, Zhujiang Hospital, Southern Medical University

【First Author】

Dan Yang, Department of Anesthesiology, Zhanjiang Central People's Hospital

Nie Binbin, Key Laboratory of Nuclear Radiation and Nuclear Energy Technology, Institute of High Energy Physics, Chinese Academy of Sciences

【Abstract】

Post-traumatic headache (PTH) due to mild traumatic brain injury (mTBI) is an urgent public health problem and remains the leading cause of disability worldwide. Post-traumatic headaches are often accompanied by neurological disorders, however, to a large extent, the exact underlying mechanism remains unknown. Identification of potential biomarkers can facilitate the diagnosis of mTBI-induced post-traumatic headache and the development of effective treatments. In this study, a mouse model of mTBI-induced post-traumatic headache was established, and a series of techniques were used to study the effects of mTBI on brain structure and function in a short recovery period. The results showed that mTBI-induced post-traumatic headache exhibited balance deficits in the early post-injury period. Metabolic dynamics studies have shown that changes in neurotransmitters in the early stages of post-traumatic headache are most prominent in the cerebellum, temporal cortex, and hippocampus. In addition, changes in functional activity and connectivity are further detected in the brain in the early stages of post-traumatic headache, particularly in the cerebellum and temporal cortex. These results suggest that the cerebellum and temporal cortex play a central role in the study of the mechanism of post-traumatic headache. In addition, the results also suggest that GABA and glutamate may serve as potential diagnostic or prognostic biomarkers for post-traumatic headache. Future studies should explore the specific neural circuits involved in the regulation of post-traumatic headache in the cerebellum and temporal cortex, which could serve as targets for non-invasive stimulation therapy techniques in future clinical treatments.

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18. Liqun Yang*, Ling Zhu*, Bo Qi*, Yin Zhang, Chenlu Ni, Yijue Zhang, Xiao Shi, Qiang Xia, Joe Masters, Daqing Ma & Weifeng Yu. Dexmedetomidine use during orthotopic liver transplantation surgery on early allograft dysfunction: A randomized controlled trial. Int J Surg, 2024 May 20. PMID: 38768468

【Title】

A Randomized Controlled Trial of the Use of Dexmedetomidine in Orthotopic Liver Transplantation for the Treatment of Early Allogeneic Liver Transplant Dysfunction

【Corresponding Author】

Weifeng Yu, Department of Anesthesiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Key Laboratory of Anesthesiology, Ministry of Education

Daqing Ma is a member of the Department of Anaesthesiology, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Chelsea and Westminster Hospital Medical School, Imperial College London

【First Author】

Liqun Yang, Ling Zhu, Bo Qi, Department of Anesthesiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Key Laboratory of Anesthesiology, Ministry of Education

【Abstract】

Background: Previous studies have shown a protective effect of dexmedetomidine in kidney transplantation. In contrast, it is unclear whether intraoperative dexmedetomidine reduces the incidence of early allogeneic transplant dysfunction after liver transplantation.

Objective: To observe the effect of intraoperative dexmedetomidine on early graft dysfunction after orthotopic liver transplantation (OLT). Study design: This is a single-center, double-blind, placebo-controlled, randomized clinical trial. From January 14, 2019 to May 22, 2022, a total of 330 adult orthotopic liver transplant patients were registered. Intraoperative treatment with dexmedetomidine or normal saline was given. A 1-year follow-up period was recorded.

Methods: The patients were randomly divided into two groups, and were given dexmedetomidine and normal saline intraoperatively, respectively. The dexmedetomide group was given a loading dose (1 μg/kg/10 min) after anesthesia induction, followed by a continuous infusion (0.5 μg/kg/h) until the end of surgery. The normal saline group was given 0.9% normal saline with an isovolemic loading volume after anesthesia induction, and then the isovolemic infusion was continued until the end of the operation. The primary outcome is early allograft dysfunction. Secondary outcomes included primary graft insufficiency, acute kidney injury, and acute lung injury/acute respiratory distress syndrome.

Results: Of the 330 patients included in the intention-to-treat analysis, 165 were in the dexmedetomidine group (mean age 49 [10] years; 117 were males [70.9%]) and 165 were in the saline group (mean SD age 49[9] years; 118 [74%] males). There was no significant difference in early transplanted kidney dysfunction in 39 cases (24.4%) and 31 cases (19.4%) in the dexmedetomidine group and normal saline group (P=0.28). Secondary outcomes, including primary graft insufficiency and acute kidney injury, were similar between the two groups.

Conclusion: Intraoperative dexmedetomidine cannot reduce the incidence of early functional impairment after allogeneic liver transplantation.

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19.Kai Chen#, Xiaojin Wei, Wenjuan Zhang, Ruixuan Wang, Yaping Wang*, Lin Yang*. Bone morphogenetic protein 4 derived from the cerebrospinal fluid in patients with postherpetic neuralgia induces allodynia via the crosstalk between microglia and astrocyte. Brain Behav Immun. 2024 May 10. PMID:38735405

【Title】

Bone morphogenetic protein 4 (BMP4) in the cerebrospinal fluid of postherpetic neuralgia patients participates in and influences the occurrence of neuropathic pain through microglia-astrocyte interactions

【Corresponding Author】

Yaping Wang, Lin Yang, Department of Pain, Department of Anesthesiology, Second Xiangya Hospital, Central South University

【First Author】

Kai Chen, Department of Pain, Xiangyaji Hospital, South Central University

【Abstract】

Introduction: Cerebrospinal fluid (CSF) has the ability to trigger glial cell activation and inflammation during postherpetic neuralgia (PHN), but the specific mechanism is unknown. Our recent study found that bone morphogenetic protein 4 (BMP4) acts as an independent regulator of glial cells during neuropathic pain (NP). Therefore, this study aimed to detect the expression of CSF-BMP4 and its role in glial regulation during PHN.

Methods: Cerebrospinal fluid (CSF) samples were collected from PHN patients and non-pain individuals (control group), and the levels of BMP4 and antagonist Noggin were measured. In addition, two cerebrospinal fluid types were administered intrathecalally in normal rats to evaluate their effects on pain behavior, glial cell activity, and inflammation. In addition, PHN-CSF or exogenous BMP4 were treated with Noggin and the STAT3 antagonist statstatic to activate isolated astrocytes to explore downstream signaling. Finally, microglial depletion was performed prior to PHN-CSF intervention to elucidate microglia-astrocyte crosstalk during PHN-CSF-induced neuralgia.

Results: The level of BMP4 in PHN-CSF was significantly higher than that in the control group (p < 0.001), and was positively correlated with pain duration (p < 0.05, r = 0.502). Compared with the control group, CSF produced a moderate decrease in the threshold for foot contraction (PWT) and microglial activation, and PHN-CSF further aggravated ectopic pain and triggered microglia and astrocyte activation (p < 0.05). In addition, PHN-CSF, but not Control-CSF, may induce microglial proliferation and pro-inflammatory transformation through phosphorylated SMAD159 and STAT3 signaling, enhance iron storage, and activate astrocytes, all of which were alleviated by the application of Noggin (p < 0.05). Second, both Noggin and static potently attenuate BMP4-induced upregulation of GFAP and IL-6 in astrocytes, as well as phosphorylation of SMAD159 and STAT3 (p < 0.05). Finally, microglial depletion decreases PHN-CSF-induced astrocyte hyperplasia, inflammation, and endogenous BMP4 expression (p < 0.05).

Conclusions: Our study highlights the role of CSF-BMP4 elevation in glial cell activation and ectopic pain sensation during PHN, providing a potential therapeutic avenue for future exploration.

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20. Shasha Jiang# , Zhengyiqi Li# , Si-Jian Huang# , Wangyuan Zou* , Jian-Gang Luo*. IRF7 overexpression alleviates CFA-induced inflammatory pain by inhibiting nuclear factor-κB activation and pro-inflammatory cytokines expression in rats. Brain Behav Immun. 2024 May 21. PMID: 38777286

【Title】

IRF7 overexpression attenuates CFA-induced inflammatory pain in rats by inhibiting the activation of nuclear factor-κB and pro-inflammatory cytokine expression

【Corresponding Author】

Zou Wangyuan, Department of Anesthesiology, Xiangya Hospital, Central South University

Luo Jiangang, Department of Anesthesiology, Xiangya Hospital, Central South University

【First Author】

Shasha Jiang, Zhengyiqi Li, Department of Anesthesiology, Xiangya Hospital, Central South University, National Clinical Research Center for Geriatric Diseases, Xiangya Hospital, Central South University

Si-Jian Huang 中南大学湘雅二医院