Quantification of tissue concentrations of inflammatory cytokines in the peri-ulcer gastric tissues at day 7 after creation of gastric ulcer in controls, diabetic (DM) rats and diabetic rats treated by exendin-4 (DM+Ex4) using ELISA kits.

<p>Concentrations of interleukin (IL)-1β, IL-6, IL-10 and monocyte chemotactic protein (MCP)-1 were analyzed. Data were analyzed by the one-way ANOVA, and are presented as median (interquartile range). *P< 0.05 DM vs DM+Ex4 in IL-1β, and DM vs control in IL-10. n = 4–9 different animals in each group. Dashed lines indicate the mean concentrations of sham-operated animals.</p

Exendin-4, a glucagon-like peptide-1 analogue accelerates healing of chronic gastric ulcer in diabetic rats - Fig 4

<p><b>4A.</b> Measurement of myeloperoxidase activity in the peri-ulcer tissues of the three treatment groups at day 7 after creation of gastric ulcer. n = 5–6 different animals in each group. <b>4B.</b> Measurement of tissue levels of superoxide anions in the peri-ulcer tissues. n = 5–8 different animals in each group. <b>4C.</b> Measurement of concentrations of cyclic adenosine monophosphatase (cAMP) in the peri-ulcer tissues. n = 9–13 different animals in each group. Data were analyzed by the one-way ANOVA, and are presented as median (interquartile range). *P< 0.05 DM vs DM+Ex4, ^#P< 0.05 DM vs control+Ex4. Dashed lines indicate the mean concentrations of sham-operated animals.</p

Representative photographies of gastric ulcer in controls and diabetic rats.

<p>Ulcer areas were determined by measuring the margins of mucosa (ulcer border) and ulcer base at day 7 after creation of gastric ulcer. Both ulcer border and ulcer base areas were significantly enlarged in diabetic rats, and were potentitated by exendin-4 (Ex4) treatment. The ulcer areas were quantified using the ImageJ Software. Data were analyzed by the one-way ANOVA, and are presented as median (interquartile range). *P< 0.05 DM vs control, ^#P<0.05 DM vs DM+Ex4. n = 8–10 different animals in each group.</p

Physiological parameters and blood tests.

<p>Physiological parameters and blood tests.</p

Representative histological sections of gastric ulcers in the three treatment groups at day 7 after creation of gastric ulcer.

<p>The upper two panels are tissue stained with hematoxylin & eosin (HE) stain, the third panel is immunohistochemical staining for myeloperoxidase, and the forth panel is tissue stained with Masson’s trichrome stain. Solid-line boxes indicate the magnified view (400x) of HE stained tisses, in which more polymorphonuclear leukocyte infiltration. Dotted-line boxes highlight the immunostaining of myeloperoxidase (arrows) in the peri-ulcer gastric tissue. The Masson’ trichrome stain shows fragmented and disorganized collagen fibers in the peri-ulcer gastric tissue of diabetic rats. Histological sections were performed in 6 different animals in each group.</p

Incidence and risk factors for postoperative lingual neuropraxia following airway instrumentation: A retrospective matched case-control study

<div><p>Background</p><p>Lingual nerve injury or neuropraxia is a rare but potentially serious perioperative complication following airway instrumentation during general anesthesia. This study explored the the incidence and perioperative risk factors for lingual nerve injury in patients receiving laryngeal mask (LMA) or endotracheal (ETGA) general anesthesia in a single center experience.</p><p>Methods and results</p><p>All surgical patients in our hospital who received LMA or ETGA from 2009 to 2013 were included, and potential perioperative risk factors were compared. Matched controls were randomly selected (in 1:5 ratio) from the same database in non-case patients. A total of 36 patients in the records had reported experiencing tongue numbness after anesthesia in this study. Compared with the non-case surgical population (n = 54314), patients with tongue numbness were significantly younger (52.2±19.5 vs 42.0±14.5; P = 0.002) and reported lower ASA physical statuses (2.3±0.7 vs 1.6±0.6; P<0.001). Patient gender, anesthesia technique used, and airway device type (LMA or ETGA) did not differ significantly across the two groups. A significantly higher proportion of patients underwent operations of the head-and-neck region (38.9 vs 15.6%; P = 0.002) developed tongue numbness after anesthesia. Multivariate logistic regression analysis indicated that head-and-neck operations remained the most significant independent risk factor for postoperative lingual nerve injury (AOR 7.63; 95% CI 2.03–28.70).</p><p>Conclusion</p><p>The overall incidence rate of postoperative lingual neuropraxy was 0.066% in patients receiving general anesthesia with airway device in place. Young and generally healthy patients receiving head-and-neck operation are at higher risk in developing postoperative lingual neuropraxy. Attention should be particularly exercised to reduce the pressure of endotracheal tube or laryngeal mask on the tongue during head-and-neck operation to avert the occurrence of postoperative lingual neuropraxy.</p></div

Characteristics and descriptions of intraoperative awareness.

<p>Characteristics and descriptions of intraoperative awareness.</p

Inhalation of volatile anesthetics via a laryngeal mask is associated with lower incidence of intraoperative awareness in non-critically ill patients

<div><p>Background</p><p>Increased incidence of intraoperative awareness was reported in critically ill patients during major operations, particularly under total intravenous (TIVA) or endotracheal general anesthesia (ETGA). However, the incidence and effect of anesthesia techniques on awareness in generally healthy, non-critically ill patients during operations have yet to receive significant attention.</p><p>Methods and results</p><p>This retrospective matched case-control study was conducted between January 2009 to December 2014. Surgical patients (ASA physical status I-III) whom reported intraoperative awareness during this study period were interviewed and their medical records were reviewed. The potential risk factors for awareness were compared with the non-case matched controls, who were randomly selected from the database. A total of 61436 patients were included and 16 definite cases of intraoperative awareness were identified. Patients who received ETGA and TIVA had significantly higher incidence of developing awareness compared to those who were anesthetized using laryngeal masks (LMA) (P = 0.03). Compared with the matched controls (n = 80), longer anesthesia time was associated with increased incidence of awareness (odds ratio 2.04; 95% CI 1.30–3.20, per hour increase). Perioperative use of muscle relaxant was also associated with increased incidence of awareness, while significantly lower incidence of awareness was found in patients who were anesthetized with volatile anesthetics.</p><p>Conclusions</p><p>The overall incidence of awareness was 0.023% in the ASA≤ III surgical patients who received general anesthesia. Anesthesia with a laryngeal mask under spontaneous ventilation and supplemented with volatile anesthetics may be the preferred anesthesia technique in generally healthy patients in order to provide a lower risk of intraoperative awareness.</p></div

Conditional logistic regression analysis of the risk factors associated with postoperative lingual neuropraxy (cases vs non-cases population, n = 36 vs 54314).

<p>Conditional logistic regression analysis of the risk factors associated with postoperative lingual neuropraxy (cases vs non-cases population, n = 36 vs 54314).</p

Conditional logistic regression analysis of the risk factors associated with awareness.

<p>Conditional logistic regression analysis of the risk factors associated with awareness.</p