Cenobamate is one of the latest antiseizure medications (ASMs) developed for the treatment of focal onset seizures in adult patients. Cenobamate is characterized by a peculiar pharmacology. The mechanisms responsible for its anti-seizure activity include enhancement of the inactivated state of voltage-gated sodium channels with blockade of the persistent sodium current and positive allosteric modulation of GABAa receptors at a non-benzodiazepine binding site. Studies showed that cenobamate appears to be an effective treatment for focal epilepsy, showing reductions in seizure frequency, increased responder rates, and high rates of seizure freedom, and is well tolerated and safe. This article reviews the mechanism, pharmacokinetic characteristics, clinical efficacy, and safety of cenobamate as a novel anti-seizure drug
ObjectiveTo study the mechanism, diagnosis and treatment of spontaneous rupture of hepatocellular carcinoma (HCC) for the purpose of screening out the effective methods of diagnosis and treatment. MethodsArticles have been reviewed to find out the difference among many kinds of diagnosis and treatment. ResultsThe mechanism of spontaneous rupture was not clear. Possible factors included tumor necrosis, coagulopathy, cirrhosis and portal hypertension. Diagnosis of spontaneous rupture of HCC can be made by abdominal paracentesis, ultrasonography and CT. Judging from the reported results the first choice of emergency treatment for hemostasis was transcatheter arterial embolization (TAE). The rational treatment of patients with ruptured HCC was TAE followed by hepatectomy if the lesion was resectable. ConclusionThe prognosis of patients with ruptured HCC could be improved if the correct diagnosis and treatment can be adopted.
Objective To investigate the basic mechanism of venous flow in reverseflow island flap. Methods Recent relevant literature on the mechanism of venous reverse flow in reverseflow island flap wereextensively reviewed. Results The mechanism of venous reverse flow was a multifactorial phenomenon. “Communicating and collateral by pass route” and “incompetent valve route” were two theories. Conclusion The two routes of venous reverse flow in reverse-flow island flap coexistand complement each other.
Abstract： As the most common blunt thoracic injury, lung contusion may develop into acute lung injury, adult respiratory distress syndrome or ventilation associated pneumonia, which can cause a high mortality. However, the pathogenesis and pathophysiology of lung contusion is not well understood yet. Stress is laid by many researchers on inflammatory response in the pathogenesis of lung contusion. We review the potential role of inflammatory response in the pathogenesis and pathophysiological changes of lung contusion. Emphasis is put on studies of inflammatory cells, mediators, receptors, surfactant dysfunction, and the potential role of epithelial cell or neutrophil apoptosis. The animal models are essential to the study of lung contusion and the studies examining secondary injuries exacerbating lung contusion are also noted.
Objective To assess the tolerance of preoperative carbohydrate-rich beverage, to determine its effect on postoperative insulin resistance and analyze its potential mechanism. Methods Thirty-two patients undergoing elective colorectal cancer resection were recruited to this randomized controlled study and assigned to two groups at random. Patient in control group was fasted before operation, while patient in study group was given oral water. Homeostasis model assessment (HOMA) indexes, activity of PTK, and mRNA and (or) protein expressions of PKB, PI3K and GluT4 were measured before and (or) immediately after surgery. Furthermore preoperative well-beings of patients were studied. Results Among well-beings, feeling of thirst, hunger and anxiety tended to be better in patients receiving carbohydrate-rich beverages compared with fasted ones (P＜0.05). Whole body insulin sensitivity decreased by 33% in the study group while 38% in the control group (P=0.007 2), and the activity of PTK, expressions of PI3K and PKB in study group were higher than those in control group (P＜0.05， P＜0.01), but no significantly difference was observed about GluT4 in both groups (Pgt;0.05）. Conclusion Preoperative consumption of carbohydrate-containing fluids is safe and effective. Provision of carbohydrate energy source prior to surgery may attenuate immediate postoperative insulin resistance. A carbohydrate-rich drink enhances insulin action at the time of onset of anaesthesia or surgery by activating three kinases named PTK, PI3K, PKB which are key enzymes in pathway of insulin signal transduction. It is likely to explain the effects on postoperative insulin resistance.
Pain is one of the common complications of most diseases. Due to the unknown mechanism of pain, its treatment has been controversial. Repeated peripheral magnetic stimulation for pain has the advantages of non-invasiveness, painlessness, and well-targeted. However, the parameters of repeated peripheral magnetic stimulation for pain are not uniform due to various factors such as frequency, location of action, and coil type. In this paper, the parameters and efficacy of repeated peripheral magnetic stimulation for various kinds of pain such as acute and chronic low back pain, myofascial pain, migraine, peripheral neuralgia and post-traumatic pain are described, in order to providea theoretical basis for future research. In addition, the mechanism of repeated peripheral magnetic stimulation for pain has not been known, and this article will briefly summarize and explain on this.
Objective To explore the mechanism of mesenchymal stem cells （MSCs） transplantation for chronic hindlimb ischemia in Lewis rats by using cell tracer technique. Methods MSCs were isolated and cultured by using density gradient centrifugation and adherence method respectively， then labeled by 5-bromo-2-deoxyuridine （BrdU）. Eight chronic hindlimb ischemia models of Lewis rats were prepared by using suture-occluded method and then divided randomly to MSCs transplantation group and control group， each group enrolled 4 rats， accepting MSCs transplantation and saline respectively. Then on 7 days and 14 days after transplantation， clinical observation， determination of blood flow， and angiography were performed on rats of the 2 groups. At the same time points after previous tests， rats of the 2 groups were sacrificed to get quadriceps tissues and gastrocnemius tissues to perform HE staining and BrdU immunohis-tochemistry. Results The 8 rats were all survived on 14 days after transplantation， with no tumor happened and necroses in the transplanted area. On 14 days after transplantation， the blood flow ratio of operated side to un-operated side in the hindlimb （1.773 vs. 1.279） of rats in MSCs transplantation group and control group increased， and the angiography results showed that there were no much increase in ratio of collateral vessels number （0.908 vs. 0.835）. There were no significant change in the quadriceps tissues and gastrocnemius tissues by HE staining. The BrdU positive kernels located in the inter-stitial substance cells and vascular endothelia cells， and divided differently in different parts of hindlimb at different time points， that the ratio of positive cells in gastrocnemius tissue was higher than those of quadriceps tissue on 7 days after transplantation， but lower on 14 days. Conclusions MSCs transplantation can increases the blood perfusion of hindlimb in the early stage of chronic hindlimb ischemia model， and the possible mechanism may be the paracrine effect of MSCs but not the number increase of collateral vessels.
ObjectiveTo explore and hypothesize the potential mechanisms of cancer stem cell(CSC) in peritoneal metastasis of gastric cancer. MethodsThe databases of PubMed and CNKI were searched, and relevant literatures were reviewed to draw out systematic hypotheses. ResultsMetastatic cancer stem cell(MCSC) was the subpopulation of CSC with the capacity of metastasis, had still not been well investigated. MCSC transfer was the tendency of migration and planting to specific target tissue by multi-steps of "homing" process. Peritoneal metastasis of gastric cancer was a simplified "homing" process, and we thinked that the key steps were adhesion, migration, and niche establishment of MCSC in peritoneum. That capturing human MCSC of peritoneal metastases in gastric cancer and identifying its stemness feature to determine high tumorigenicity and high invasive ability of it were the important research fields. ConclusionMCSC might play certain role in multiple processes in peritoneal metastasis of gastric cancer, but currently it's lack of relevant researches.
【Abstract】ObjectiveTo study the mechanism of spontaneous rupture of hepatocellular carcinoma (HCC). MethodsArticles have been reviewed to find out the theory of spontaneous rupture of HCC. ResultsResearchful results suggested that the injury of small arteries was usually followed in patients of spontaneous rupture of HCC. In this review, the immune complex, which composed of hepatitis B virus e antigen, complement C1q and immunoglobulins, was found deposited in the elastic membrane of arteries. Likely as a result of immune complex deposition, vascular injury occurs mainly in the small arteries where the deposition of immune complex was present. The small arteries in which immune complex deposited are readily injuried and cause hemorrhage and rupture of HCC during vascular load increase. ConclusionWe would conclude that immune complex deposition in vessel wall led to the small arteries injury may be the factor involved in the pathogenesis of spontaneous ruptured HCC.
Objective To summarize the recent progress in research on the mechanism of denerved skeletal muscle atrophy. Methods The recently-publ ished l iteratures at home and abroad on denerved skeletal muscle atrophy were reviewedand summarized. Results The mechanism of denerved skeletal muscle atrophy was very complex. At present, the studyof the mechanism was based on the changes in histology, cytology and molecules. Fiber thinning and disorderly arrangement of denerved skeletal muscles were observed and apoptotic bodies were detected. Apoptosis-promoting genes expressed upregulatedly and apoptosis-restraining genes expressed down-regulatedly. Muscle satell ite cells increased after denervation, but then they decreased and disappeared because they could not differentiate to mature muscle fibers. The structural change of cytomiscrosome and down-regulation of metabol ism-related enzymes induced cell metabol ism disorder. Conclusion The histological change of skeletal muscle fibers, the change of the number of muscle satell ite cells and differentiation, the structural change of cytomiscrosome and the change of apoptosis-related and metabol ism-related gene expressions contribute to denerved skeletal muscle atrophy.