The Hormone Replacement Therapy in Cerebrovascular Diseases: Is the Receptor Remodeled?

Events in cerebral vessel have long been considered as a leading cause of disability in postmenopausal women with the physiological changes in expression and secretion of sex hormones. Hormone replacement therapy (HRT) emerged as a supplementary therapeutic strategy for them with the potential risk of cerebrovascular accidents. Epidemiological and genetic data showed that an interrelationship exists between hormone replacement and cerebrovascular disorders. Many animal experiments and clinical observations produced different results: these varied from positive to negative. Furthermore, recent studies could not identify the particular hormone, estrogen or progesterone that is more beneficial than the other. Here we summarize the two hormones’ effects on cerebrovascular diseases; associated epidemiological and genetic evidences; and the real status of the benefits and risks of HRT as well. We further hypothesize that whatever effects of HRT on brain vessel, hormone receptor expression, density, sensitivity and function may undergo alteration to varying extents, i.e. receptor plasticity gives rise to the receptor remodeling in postmenopausal older women, this may terminally produce the unwelcome effects

Homeostatic Synaptic Plasticity: Balanced by COX2-PGE2 System to a New Setpoint

The setpoint of neural activity plays a critical role in maintaining the complex neural circuits into stable activities. Homeostatic synaptic plasticity is a major component of the setpoint theory that dynamically adjusts synaptic strengths. Cyclooxy-genase 2 (COX 2) is rapidly upregulated in inflammatory episodes after nervous injury and its product prostaglandin E2 (PGE2) exerts contrast functions in the nervous system by working on the homeostatic plasticity. New data revealed that COX2-PGE2 system takes an essential part in balancing excitation and inhibition of the synaptic activities at a new setpoint that finally is maintained by the homeostatic synaptic plasticity

Accuracy of Palpation for Cricothyroidotomy

Cricothyroidotomy is a practical procedure that is critical for patients in the context of emergency. Accurately identify the cricothyroid membrane takes a crucial part in determining the success of cricothyroidotomy. However, it is not that easy for clinicians when facing patients with different conditions that limit the palpation accuracy. Obesity is a risk factor for the failure of cricothyroidotomy. Special care is needed for obese patients. We herein build a mathematic model to explain why it is hard for obese patients to be palpated, and we also give recommendations based on the model on how to increase the rate of the palpation accuracy

Is Postoperative Pain a Mediator of Cancerous Mortality?

Postoperative pain is considered as a risk factor for the mortality of cancerous patients. Are there convincing evidence demonstrating the causality between them? It is hard to draw a conclusion from the currently available data. Pain itself is an immune suppressor and functions as a tumor-promoting mediator, but it is strongly associated with the pain intensity. The mild-to-moderate pain is a favorable factor to the recovery for patients from surgeries. Everything possesses dual facets: yin and yang balance system. What we need to do is how to take advantage of the favorable from both sides rather than debate which is superior to the other. Yes, even overbalance there, the key necessary for it is to taking measures to keep them on balance

Postpartum Perineal Pain in the Absence of Obstetric Anal Sphincter Injuries: A Prospective Observational Study

OBJECTIVE The purpose of this study was to identify the prevalence of perineal pain at early postnatal period and to assess the association between maternal, obstetric or neonatal variables and perineal pain. METHODS Three hundred and six women were followed up for perineal pain with present pain intensity (PPI) and visual rating scale (VRS) components of the validated short-form McGill pain scale. Multivariate logistic regression was performed to identify which characteristics of the patients and neonates were independent determinants of perineal pain. RESULTS The incidence of perineal pain at days 1 and 7 postpartum was 88.2% and 24.9%, respectively. PPI was mild 63.1% (day 1) and 23.9% (day 7), moderate 24.2% and 1.1%, and severe 1% and 0%. VRS score was 2 (1-3) at day 1 and 0 (0-1) at day 7 postpartum, respectively. Perineal pain was more common in primiparous women with higher BMI, more maternal weight gain, received epidural analgesia, and use of episiotomy. In a multivariate logistic regression model, only episiotomy predicted the pain at day 1 postpartum (RR=2.05, 95% CI 0.95-4.42) suggesting that women with mediolateral episiotomy experienced more intense pain than women with median episiotomy. CONCLUSIONS In the absence of obstetric anal sphincter injuries, although perineal pain during the early postnatal period is prevalent, the intensity is slight. Moreover, the use of episiotomy is associated with more perineal pain than other perineal trauma

Granulocyte Therapy for Cancer

GRANULOCYTE THERAPY FOR CANCER is the first book ever published dealing with the origin and development of the Granulocyte Therapy for Cancer. Dr. Zheng Cui has been regarded as “the father of cancer resistance super-mice”, made great contribution to the progress of Cancer Immunology and Immunotherapy. This book, based on his ten years’ research, intends to present a comprehensive overview from the serendipity discovery of the cancer complete resistant/ spontaneous regression (CR/SR) mice to the relevant cancer target killing mechanism mediated by leukocytes, as well as how the innovative therapeutic approach, Leukocyte Infusion Therapy (LIFT) applicable to human cancer

Is It Feasible of Prophylactic Alpha-5 GABA(A) Receptor Blockade for Preventing POCD?

GAMMA-AMINOBUTYRIC ACID (GABA) is the chief inhibitory neurotransmitter in the mammalian central nervous system (CNS). It plays a role in regulating neuronal excitability throughout the nervous system. Also GABA activation is considered as the basis of general anesthesia including intravenous and inhalational anesthetics. Meanwhile, cumulating evidence indicated that GABA is the underlying mechanism of post-operative cognitive dysfunction (POCD). Based on these findings, researchers are beginning to focus on GABA as the target to treat POCD, but they ignored the role of GABA in the performance of general anesthesia, especially when the blockade of GABA was given prior to surgery. It is undoubtedly risking our patients in intra-operative awareness. Our exploratory data also verified our hypothesis in which the GABA inhibition would reduce the efficacy of inhalational anesthetics

Mobile Phone Short Messages for Health Professionals

Information communication technology has made great progress in past decades, whereas how much could the health professionals benefit from these techniques? Some reports concerned that mobile phone short messages can help health caregivers more focused on their work through reminding them what need do next, and positive results were presented showing that such “beep message” improves patients overall outcomes and satisfaction. Regarding this usage, several drawbacks need mentioned before it was recommended as routine reminder. Detraction from normal work, over-weighed dependence on this kind of remind, and uniform and non-individualized messages all will make the healthcare system lose flexibility and true efficacy

Albumin versus Saline in Mortality in Critically Ill Children

High mortality in critically ill patients is a challenge for the intensive care medicine. While different reasons were figured out and corresponding therapeutic protocols were recommended, the actual mortality is still high and it is hard to conquer it and make a big improvement of the overall outcomes. Albumin, the most abundant protein in human blood plasma, plays an essential role in maintaining oncotic pressure, in participating in as an important protein transporter, and in possessing many physiological functions. In the context of critical care medicine, administration of albumin was found benefit patients in increasing their survival rate. However, a more recent study reported that bolus injection of albumin in critically ill pediatric patients increased the mortality. Of this report, we analyzed carefully and commented their methodology in performing the study. Some issues were not that clear, and it is difficult to determine the real effect of albumin administration on the mortality in children. It is a challenge to answer one question precisely and in overall, and we herein raise our concerns on this topic to discuss them with other researchers