Mild hypothermia is an effective therapeutic strategy to improve poor neurological outcomes in patients following cardiac arrest (CA). However, the underlying mechanism remains unclear. The aim of the study was to evaluate the effect of mild hypothermia on intracellular autophagy and mitophagy in hippocampal neurons in a rat model of CA. CA was induced in Sprague-Dawley (SD) rats by asphyxia for 5 min. After successful resuscitation, the surviving rats were randomly divided into two groups, the normothermia (NT) group and the hypothermia (HT) group. Mild hypothermia (32 °C) was induced following CA for 4 h, and animals were rewarmed at a rate of 0.5 °C/h. Neurologic deficit scores (NDS) were used to determine the status of neurological function. Cytoplasmic and mitochondrial protein from the hippocampus was extracted, and the expression of LC3B-II/I and Parkin were measured as markers of intracellular autophagy and mitophagy, respectively. Of the 60 rats that underwent CA, 44 were successfully resuscitated (73 %), and 33 survived until the end of the experiment (55 %). Mild hypothermia maintained eumorphism of nuclear and mitochondrial structures and significantly improved NDS (p < 0.05). Expression of LC3B-II/I and Parkin in hippocampal nerve cells were significantly increased (p < 0.05) in the NT group relative to the control. Meanwhile, mild hypothermia reduced the level of LC3B-II/I and Parkin (p < 0.05) relative to the NT group. Mild hypothermia protected mitochondria and improved neurological function following CA and resuscitation after ischemia/reperfusion (I/R) injury, likely by reducing excessive autophagy and mitophagy in neurons.

BACKGROUND: Cardiac arrest (CA) is a common and serious event in emergency medicine. Despite recent improvements in resuscitation techniques, the survival rate of patients with CA is unchanged. The present study was undertaken to observe the effect of mild hypothermia (MH) on the reactive oxygen species (ROS) and the effect of neurological function and related mechanisms. METHODS:Sixty-five healthy male Sprague Dawley (SD) adult rats were randomly (random number) divided into 2 groups: blank control group (n=5) and CPR group (n=60). CA was induced by asphyxia. The surviving rats were randomly (random number) divided into two groups: normothermia CPR group (NT) and hypothermia CPR group (HT). Normothermia of 37 °C was maintained in the NT group after return of spontaneous circulation (ROSC), hypothermal intervention of 32 °C was carried out in the HT group for 4 hours immediately after ROSC. Both the NT and HT groups were then randomly divided into 2 subgroups 12 hours and 24 hours after ROSC (NT-12, NT-24, HT-12, HT-24 subgroups). During observation, the neurological defi cit scores (NDSs) was recorded, then the bilateral hippocampi were obtained from rats' head, and monoplast suspension of fresh hippocampus tissue was made immediately to determine the level of intracellular ROS by flow cytometry. Transmission electron microscope was used to observe the ultramicro changes of cellular nucleus and mitochondria. Reverse transcription-polymerase chain reaction (RT-PCR) was used to determine the expression of caspase-3 mRNA, and western-blotting (WB) was used to determine the level of LC3 in frozen hippocampus tissue. Measured data were analyzed with paired sample t test and One-Way ANOVA.RESULTS: Of 60 rats with CA, 44 (73%) were successfully resuscitated and 33 (55%) survived until the end of the experiment. The NDSs of rats in the NT and HT groups were more signifi cantly reduced than those in the BC group (F=8.107, P<0.05), whereas the NDSs of rats in the HT-12 and HT-24 subgroups were significantly increased in comparison with those NDSs of rats in the NT-12 and NT-24 subgroups, respectively (t=9.692, P<0.001; t=14.374, P<0.001). The ROS in hippocampus nerve cells in the NT and HT groups signifi cantly increased compared to the BC group (F=16.824, P<0.05), whereas the ROS in the HT-12 and HT-24 subgroups significantly reduced compared with that ROS in the respectively (t=9.836, P<0.001; t=7.499, P<0.001). The expression of caspase-3 mRNA in hippocampus nerve cells in the NT and HT groups were signifi cantly increased compared to the BC group (F=24.527, P<0.05), whereas the expression of caspase-3 mRNA in rats of the HT-12 and HT-24 subgroups was signifi cantly reduced compared to the respectively (t=6.935, P<0.001; t=4.317, P<0.001). The expression of LC3B-II/I in hippocampus nerve cells of rats in the NT and HT groups signifi cantly www.wjem.org 299 World J Emerg Med, Vol 5, No 4, 2014 increased compared to the BC group (F=6.584, P<0.05), whereas the expression of LC3B-II/I in rats of the HT-12 and HT-24 ...

Rosiglitazone (RGZ) is a thiazolidinedione ligand of peroxisome proliferator-activated receptor-γ. Our previous studies have confirmed that RGZ possesses antitumoral properties. Bone marrow angiogenesis exhibits an important role in multiple myeloma (MM), and angiogenesis often correlates with the prognosis and disease burden of MM. However, to the best of our knowledge, inhibition of angiopoiesis by RGZ in MM has not yet been reported. The present study aimed to investigate whether RGZ prevents angiogenesis and the possible underlying mechanism of this effect in MM. RPMI‑8226 cells, primary myeloma cells from patients with MM or mononuclear cells from healthy patients were treated with different concentrations of RGZ, and various biological responses were detected using MTT, reverse transcription-polymerase chain reaction and western blot assays. The expression levels of hypoxia-inducible transcription factor‑1α (HIF1α) and insulin-like growth factor‑1 (IGF1) were significantly increased in the RPMI-8226 cells and the primary myeloma cells from the patients with MM compared with those in the mononuclear cells from the healthy patients. The results also showed that RGZ was able to inhibit proliferation and reduce viability of RPMI-8226 cells in a concentration-and time-dependent manner. RGZ was able to concentration‑dependently inhibit the expression of HIF1α and IGF1 mRNA in RPMI-8226 and primary myeloma cells from patients with MM. RGZ also inhibited the expression of pAKT and downregulated the expression levels of phosphorylated extracellular signal-regulated kinase (ERK) in RPMI-8226 cells. The results suggested that RGZ inhibits the angiopoiesis of tumors by interfering with the phosphatidylinositol 3-kinase/AKT and ERK signaling pathways.

It was to adopt magnetic resonance imaging (MRI) combined with computed tomography (CT) to diagnose multiple myeloma (MM) and evaluate the therapeutic effect of the doxorubicin nano-drug delivery system on MM, providing a more effective method for the treatment of MM. For this aim, eighty-eight patients with MM admitted to our Hospital from June 2019 to July 2020.7 were selected as study subjects and divided into a control group (treated with doxorubicin) and an observation group (treated with doxorubicin-loaded nanoparticles) according to the random number table, 44 cases for each group. MRI and CT were used to examine the two groups of patients to assess the clinical efficacy and side effects of the two treatments and to compare the myeloma cell survival rate and apoptosis rate. Results showed that the diameter of nanoparticles was about 50 nm, the particle size was uniform, the distribution was dense, and the stability was good; the lesion was well-circumscribed on CT scan, and a soft tissue mass could be detected on MRI. The number of patients with effective treatment in the observation group was significantly higher than that in the control group (42 cases vs 34 cases) (P< 0.05); the number of patients with small plate reduction, increased myocardial enzymes, alopecia, liver failure, gastrointestinal reactions, peripheral neuritis, and other adverse reactions in the observation group was significantly lower than that in the control group (total number of patients 48 vs 101) (P< 0.05); the survival rate of myeloma cells in the observation group was obviously inferior to that in the control group (61.3 % vs 88.31 %) (P< 0.05). Conclusion: MRI combined with CT examination can be better used for the diagnosis of the disease, and the study shows that doxorubicin nano-drug delivery preparation is safer and more effective in the treatment of MM disease, which is worthy of clinical promotion.