Objective: Thoracic aortic dissection (TAD) is a fatal disease that leads to aortic rupture and sudden death. However, little is known about the effect and molecular mechanism of S-nitrosylation (SNO) modifications in TAD formation. Approach and Results: SNO levels were higher in aortic tissues from TAD patients than in those from healthy controls, and PLS3 (plastin-3) SNO was identified by liquid chromatography-tandem mass spectrometry analysis. Furthermore, tail vein administration of endothelial-specific adeno-associated viruses of mutant PLS3-C566A (denitrosylated form) suppressed the development of TAD in mice, but the wild-type PLS3 (S-nitrosylated form) virus did not. Mechanistically, Ang II (angiotensin II)–induced PLS3 SNO enhanced the association of PLS3 with both plectin and cofilin via an iNOS (inducible nitric oxide synthase)-dependent pathway in endothelial cells. The formation of PLS3/plectin/cofilin complex promoted cell migration and tube formation but weakened adherens junction formation in Ang II–treated endothelial cells. Interestingly, denitrosylated form of PLS3 partially mitigated Ang II–induced PLS3/plectin/cofilin complex formation and cell junction disruption. Additionally, the inhibition of iNOS attenuated PLS3 SNO and the association of PLS3 with plectin and cofilin, thereby modulating endothelial barrier function. Conclusions: Our data indicate that protein SNO modification in endothelial cells modulates the progression of aortic aneurysm and dissection. The iNOS-mediated SNO of PLS3 at the Cys566 site promoted its interaction with cofilin and plectin, thus contributing to endothelial barrier disruption and pathological angiogenesis in TAD.
The positive detection of SARS-CoV-2 is the “gold standard” for diagnosing COVID-19. However, due to the low detection capacity of SARS-CoV-2 and the high false negative rate at the beginning of the epidemic, and the medical staff did not know much about the condition and treatment of COVID-19 patients. Therefore, our hospital paid more attention to the results of other laboratory indicators in the early stage of the epidemic of COVID-19. The aim of this study was to explore clinical characteristics and laboratory results of COVID-19 patients in Wuhan, China and provide evidence for the prevention and treatment of COVID-19. Retrospective study of 562 COVID-19 patients hospitalized in Wuhan Red Cross Hospital from January 28 to March 12, 2020 was performed. The patients were divided into 2 groups according to the severity of illness: Mild group ( n = 436) and Severe group ( n = 126). The general clinical characteristics of the patients were collected, including age, gender, past medical history, clinical symptoms, etc. All patients underwent blood routine test, biochemical indicators, blood gas analysis and other related laboratory examinations. The clinical data and laboratory results of the two groups were compared. Compared with the patients in the Mild group, the patients in Severe group were older and the proportion of patients suffering from underlying disease (61.11%) was higher ( p < 0.05). In Severe group, WBC, NEUT, NLR, PCT, CRP, IL-6, ESR, CK, CK-MB, Mb, cTnI, D-D, Fib, and PaCO2 of patients had higher values, while the levels of LYMPH, HBG, PLT, PO2, and SaO2 were significantly reduced, and the differences were statistically significant ( p < 0.05). Between Severe group and Mild group, there was no significant difference in other indexes such as ALT, Urea, and Cr ( p > 0.05) or in the positive rate of influenza A, B virus, or other respiratory pathogens by pairwise comparison ( p > 0.05). Viral infection and inflammation were more serious in elderly patients or patients with underlying diseases. They were more likely to progress to severely ill patients. Clinical manifestations and laboratory examinations were important basis for clinical classification and treatment. Therefore, Timely and accurate attention to these indicators is beneficial to prevent the deterioration of the disease.
In order to explore the effects of dexmedetomidine (DEX) on functional magnetic resonance imaging (fMRI) and emergence agitation of patients who underwent general anesthesia surgery with sevoflurane under comfortable nursing intervention, 66 patients who received upper abdominal surgery were selected as research objects. According to nursing and anesthesia methods, the patients were randomly divided into control group (routine nursing and anesthesia), group A (routine nursing and DEX-assisted anesthesia), and group B (comfortable nursing and DEX-assisted anesthesia). The differences in the brain fMRI characteristics, hemodynamic indexes, anesthesia recovery indexes, and nursing satisfaction in the perioperative period were evaluated. The results showed that the regional homogeneity values were different in different brain regions, but there was no difference in the Z value of functional connectivity P > 0.05 . Compared with the control group, heart rate, mean arterial pressure, awakening time, extubation time, the Riker sedation-agitation scale (SAS) score, and anesthetic dosage were signally decreased in group A and group B, while the Ramsay scores, the postanesthesia care unit (PACU) stay, and anesthesia maintenance time in the two groups was obviously increased P < 0.05 . Compared with group A, the extubation time, the SAS score, PACU stay, and hospital stay were all remarkably reduced in group B, while the nursing satisfaction score was greatly increased P < 0.05 . To sum up, DEX was helpful to safely and effectively reduce the occurrence of emergence agitation in patients under general anesthesia surgery with sevoflurane. Besides, comfortable nursing intervention could further reduce the incidence of emergence agitation in patients with general anesthesia, shorten the length of hospital stay, and improve nursing satisfaction.
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