Abstract Pressure-assisted thermal sterilization (PATS) is a new technology to inactivate bacterial spores and ensure food safety. Little has been known about the effects of PATS combining with ε-PL on the spore’s nucleic acid, enzymes and other key substances. This study aimed to investigate the inactivation effect of PATS combining with ε-PL on the spores of B. subtilis. The spores were treated with pressure 600 MPa at 25 °C, 65 °C and 75 °C, and ε-PL at 0.1% and 0.3%. After treatment, the survival rate of B. subtilis spores, leakage of nucleic acid and protein, the change in the cell membrane ATPase activity, the leakage of dipicolinic acid, and the damage on protein and nucleic acid of the spores were determined. The results showed that PATS combining with ε-PL inactivated more spores, and significantly increased the release of protein and nucleic acid compared to the control. ATPase activity reached the lowest value after the treatment of 600 MPa/75 °C combining with 0.3% ε-PL. The release of dipicolinic acid from the spores was increased by 600 MPa/75 °C combining with 0.3% ε-PL as compared with 600 MPa/75 °C treatment alone. FTIR analysis showed that a combination of PATS with ε-PL changed the spectral features of B. subtilis functional groups of proteins and nucleic acids. The PATS treatments when combined with ε-PL were found to shift the symmetric and antisymmetric stretching vibrational absorption peaks of phosphodiester group in nucleic acid molecules (P=O). This change suggested that the combined treatment denatured nucleic acid. The combined treatment also changed the protein from an ordered state to a disordered state, and decreased protein stability. The results improved our understanding on the principle of spore inactivation by PATS combining with ε-PL.

RESUMO Introdução: A articulação do tornozelo é a articulação do corpo humano que mais suporta carga. A consciência da saúde das pessoas está aumentando de dia para dia, a probabilidade de lesões esportivas no tornozelo também está aumentando. Objetivo: Analisar o valor de aplicação do ultra-som de medicina esportiva para a reabilitação de lesão no tendão talofibular anterior. Métodos: Setenta e dois pacientes com lesão talofibular anterior em um determinado hospital foram divididos em grupos de controle e observação para observar o efeito da recuperação, o tempo de recuperação e o grau de lesão ligamentar durante o tratamento da reabilitação. Resultados: No grupo de observação, a taxa de recuperação completa foi de 91,67%, a recuperação incompleta (8,33%), o tempo de recuperação foi de (2,36±0,9) meses. A taxa de recuperação completa do grupo de controle é de (77,78%), a recuperação incompleta (22,2%), o tempo de recuperação (3,58±0,42) meses. Os pacientes do grupo experimental tiveram maior grau de lesão ligamentar III do que os do grupo controle durante cada período de reabilitação, a diferença foi estatisticamente significativa (P<0,05). Conclusões: A ultra-sonografia médica esportiva pode determinar o grau de ruptura do ligamento talofibular anterior após a lesão, fornecendo uma base para a formulação clínica do plano de tratamento. Nível de evidência II; Estudos Terapêuticos - Investigação de Resultados.

ABSTRACT Introduction: The ankle joint is the most load-bearing joint of the human body. The health consciousness of people is increasing day by day, the probability of ankle sports injuries is also increasing. Objective: Analyze the applying sports medicine ultrasound value to rehabilitate anterior talofibular tendon injury. Methods: Seventy- two patients with anterior talofibular injury in a particular hospital were divided into control and observation groups to observe the effect of recovery, recovery time, and degree of ligament injury during rehabilitation treatment. Results: In the observation group, the complete recovery rate was 91.67%, incomplete recovery (8.33%), recovery time was (2.36±0.9) months. The complete recovery rate of the control group is (77.78%), the incomplete recovery (22.2%), the recovery time (3.58±0.42) months. Patients in the experimental group had a higher grade of ligament injury III than those in the control group during each rehabilitation period; the difference was statistically significant (P<0.05). Conclusions: Sports medical ultrasound can determine the degree of anterior talofibular ligament rupture after injury, providing a basis for the clinical formulation of the treatment plan. Evidence Level II; Therapeutic Studies - Investigating the result.

RESUMEN Introducción: La articulación del tobillo es la que más carga soporta del cuerpo humano. La conciencia de la salud de las personas aumenta día a día, la probabilidad de lesiones deportivas en el tobillo también aumenta. Objetivo: Analizar el valor de la aplicación de ultrasonidos en medicina deportiva para la rehabilitación de la lesión del tendón talofibular anterior. Métodos: Setenta y dos pacientes con lesión talofibular anterior en un hospital particular fueron divididos en grupos de control y de observación para observar el efecto de la recuperación, el tiempo de recuperación y el grado de lesión del ligamento durante el tratamiento de rehabilitación. Resultados: En el grupo de observación, la tasa de recuperación completa fue del 91,67%, la recuperación incompleta (8,33%), el tiempo de recuperación fue de (2,36±0,9) meses. La tasa de recuperación completa del grupo de control fue (77,78%), la recuperación incompleta (22,2%), el tiempo de recuperación (3,58±0,42) meses. Los pacientes del grupo experimental tuvieron un mayor grado de lesión del ligamento III que el grupo de control durante cada periodo de rehabilitación, la diferencia fue estadísticamente significativa (P<0,05). Conclusiones: La ecografía médico-deportiva puede determinar el grado de rotura del ligamento talofibular anterior tras la lesión, proporcionando una base para la formulación clínica del plan de tratamiento. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.

Abstract Polygonum capitatum (Polygonaceae) exists in rural areas of Southwest China and some other Asian countries. Its aerial part or whole herbal plant has been used as a Miao ethnomedicine against urinary system diseases, infections, pyelonephritis, diarrhea, and so on. The progress in phytochemical research on P. capitatum over the past decades is summarized. Two hundred and three chemical constituents that have been isolated and identified from this plant are included in this article, the chemical structures of which include aliphatic hydrocarbons, aliphatic alcohols, aliphatic ketones, aromatic aldehydes, aliphatic acids, glycerides, triterpenic acids, sterols, anthraquinones, chromones and their glycosides, flavonoids and their glycosides, phenols, phenolic acids and their esters, lignanoids, flavonolignans, phenolic glycosides, alcoholic glycosides, amino acids, nucleobases, amides, alkaloids, alkyl glycosides, volatile oils, and polysaccharides.

Abstract This study aims to explore the molecular mechanism of neuronal axonal lesions caused by high glucose, and to investigate the protective effect of Lycium barbarum polysaccharide (LBP) on neuronal axon damage with in vitro models. A rat model of type II diabetic encephalopathy was established, and the rats were treated with LBP for 10 weeks. Morris water maze experiment was used to detect spatial learning and memory ability. Neuronal axon lesions were measured by in vivo neuron tracing experiment. Immunohistochemistry and Western-blot technology were employed to detect protein localization and expression. Combined with in vitro primary neuron culture, total internal reflection fluorescence microscopy was used to detect the effects of high glucose and LBP on neuronal axon transport. PI3K inhibitors LY294002 and an activator of insulin signaling pathway were used to investigate the possible molecular mechanism. In vivo and in vitro experiments showed that in the hippocampus tissue of STZ-induced type II diabetic encephalopathy model rats, neuronal axons were damaged, accompanied by hyperphosphorylation of Tau protein, which subsequently resulted in axonal transport damage and cognition dysfunction. LBP significantly reduced peripheral blood glucose and serum insulin levels in type II diabetic encephalopathy model rats, thereby alleviating peripheral insulin resistance. At the same time, LBP can significantly improve the learning and memory impairment and brain neuron axon pathology in model rats. LY294002 treatment can effectively block the PI3K/Akt signaling pathway. The phosphorylation level of Tau protein in the LY294002+ LBP treatment group is higher than that of the LBP intervention group, while the insulin treatment can effectively reverse the blocking effect of LY294002 on LBPs. LBP can reduce the phosphorylation level of Tau protein by up-regulating the PI3K/Akt/GSK3β signaling pathway, with a protective effect on neuronal axon damage, thereby improving the cognitive function performance of type II diabetic encephalopathy model rats.

Abstract Nowadays brown rice (BR) and germinated brown rice (GBR) have aroused great interest of consumers, due to the higher nutrition compared with polished rice. In this study, the nutritional and bioactive compositions of BR and GBR samples prepared by 6 early indica rice cultivars and 12 middle indica rice cultivars from three producing areas were investigated. The free amino acid (215.75 mg/100 g), γ-aminobutyric acid (18.04 mg/100 g) and ferulic acid (195.9 μg/ g) content in early indica rice cultivars after germinated were significantly higher (P < 0.05) than those of other cultivars. In addition, principal component analysis and orthogonal partial least squares discriminant analysis models were able to identify BR and GBR, quercetin and p-coumaric acid were the most differential metabolites of all tested rice samples after germinated. The results provided the potential of early indica rice on functional food processing.

Abstract Introduction The standard approach to thyroidectomy is a collar incision via the anterior neck, and the neck scar has always been a source of worry for patients. Acceptable wound cosmetology has become a focus for thyroid surgeons. Objective To verify the effectiveness and cosmetic results of thyroidectomy through a lateral supraclavicular incision. Methods 180 patients were randomly divided into two groups: a lateral supraclavicular approach and a conventional transcervical approach. The main outcomes included incision length, intraoperative blood loss, operative time, total drainage volume, hospitalization expense, early postoperative pain measured by visual analog scale, infection, and perceived cosmetic outcome. Results There were no statistical significances between the two groups in terms of age, gender, nodule size, intraoperative blood loss, operative time, total drainage volume, hospital expense and postoperative complications, whereas there were significant differences in terms of incision length (5.2 ± 1.04 cm vs. 6.9 ± 1.14 cm, p < 0.05). Conclusions The lateral supraclavicular incision is a safe and feasible approach for thyroidectomy. Compared with conventional approach, it provides a better cosmetic result.

Resumo Introdução A abordagem padrão para tireoidectomia é uma incisão em colar na face anterior do pescoço; a cicatriz no pescoço sempre foi uma fonte de preocupação para os pacientes; consequentemente, a cosmetologia aceitável da ferida tornou‐se um foco de atenção para os cirurgiões de cabeça e pescoço. Objetivos Verificar a eficácia e os resultados cosméticos da tireoidectomia por meio de incisão supraclavicular lateral. Método Foram divididos aleatoriamente 180 pacientes em dois grupos: um grupo supraclavicular lateral (Grupo LS) e outro transcervical convencional (Grupo TC). Os desfechos principais incluíram comprimento da incisão, perda de sangue intraoperatória, tempo cirúrgico, volume total de drenagem, despesas hospitalares, dor no pós‐operatório imediato medida através de escala visual analógica, infecção e resultado cosmético percebido. Resultados Não houve significância estatística entre os dois grupos em termos de idade, sexo, tamanho do nódulo, perda sanguínea intraoperatória, tempo cirúrgico, volume total de drenagem, custo hospitalar e complicações pós‐operatórias, mas houve diferença significante em termos de comprimento da incisão (5,2 ± 1,04 cm vs. 6,9 ± 1,14 cm, p < 0,05). Conclusão A incisão supraclavicular lateral é uma abordagem segura e viável para tireoidectomia. Em comparação com a abordagem convencional, oferece um melhor resultado cosmético.

Hepatocellular carcinoma is one of the most prevalent malignancies and a leading cause of cancer-related mortality worldwide. However, the therapies to prevent hepatocellular carcinoma are still limited and the emergence of drug resistance leads to the development of new anti-cancer drugs and combinational chemotherapy regimens. Our study was aimed to explore the anticancer effects of the essential oil extract (EEEO) from Euphorbia esula which has been widely used in traditional Chinese folk medicine and possessed potential cytotoxic effects in several human tumor cells. However, the mechanisms of EEEO-induced anti-proliferation and apoptosis have not been completely elucidated. In this study, EEEO was prepared by hydro-distillation and the main chemical component of EEEO was identified by GC-MS. HepG2 cells were treated with EEEO in vitro and then evaluated with respect to proliferation, apoptosis, and levels of reactive oxygen species (ROS) and apoptotic proteins. Our studies showed that EEEO decreased cell viability, elevated ROS levels, and induced apoptosis of HepG2 cells in a concentration- and time-dependent manner. Furthermore, Bcl-2 was down-regulated, while Bax was up-regulated in HepG2 after EEEO treatment. These results suggest that EEEO induced apoptosis of HepG2 cells and indicate that this apoptosis might be mediated by the mitochondrial pathway.

Abstract Background: Osteoarthritis (OA) is one of the most common rheumatic diseases of which clinical symptoms includes swelling, synovitis and inflammatory pain, affect patients' daily life. It was reported that non-coding RNAs play vital roles in OA. However, the regulation mechanism of ncRNA in OA pathogenesis has not been fully elucidated. Methods: The expression of SNHG7, miR-34a-5p and SYVN1 was detected using qRT-PCR in tissues, serum and cells. The protein expression of SYVN1, PCNA, cleavage-caspase 3, beclinl and LC3 were measured using western blot. The RNA immunoprecipitation (RIP), RNA pulldown, and luciferase reporter assays were used to verify the relationship between SNHG7, miR-34a-5p and SYVN1. The MTT and flow cytometry assay was performed to detected cell proliferation and cell apoptosis respectively. Results: In this study, SNHG7 and SYVN1 expression were down-regulated, but miR-34a-5p was up-regulated in OA tissues and IL-1P treated cells compared with normal tissues and chondrocyte. Functional investigation revealed that up-regulated SNHG7 or down-regulated miR-34a-5p could promote cell proliferation and inhibit cell apoptosis and autophagy in OA cells. More than that, RIP, pulldown and luciferase reporter assay was applied to determine that miR-34a-5p was a target miRNA of SNHG7 and SYVN1 was a target mRNA of miR-34-5p. Rescue experiments showed that overexpression of miR-34a reversed high expression of SNHG7-mediated suppression of apoptosis and autophagy as well as promotion of proliferation, while its knockdown inhibited cell apoptosis and autophagy and promoted cell proliferation which could be impaired by silencing SYVN1. In addition, SNHG7 regulated SYVN1 through sponging miR-34a-5p. Conclusion: SNHG7 sponged miR-34a-5p to affect cell proliferation, apoptosis and autophagy through targeting SYVN1 which provides a novel sight into the pathogenesis of OA.

Abstract: The abnormal increase in proliferation rate of human periodontal ligament stem cells (PDLSCs) is considered to be involved in the pathogenesis of periodontitis, a disease in which the IL-10-mediated anti-inflammatory pathway plays a critical role. This study aimed to investigate the involvement of microRNA-466l in periodontitis and to explore the possible interaction between IL-10 and microRNA-466l. PDLSCs were obtained from periodontitis-affected teeth and healthy control teeth. The expression of microRNA-466l and IL-10 mRNA was measured in PDLSCs using RT-qPCR. The proliferation ability of PDLSCs was analyzed using CCK-8 assays. Overexpression of microRNA-466l in a PDLSC cell line was established using two different types of PDLSCs, and the effect of microRNA-466l overexpression on IL-10 expression and cell proliferation were detected by western blot and CCK-8 assays, respectively. We found that expression levels of microRNA-466l and IL-10 mRNA were significantly lower (P < 0.05) in PDLSCs derived from periodontitis-affected teeth compared to those derived from healthy teeth. However, the cell proliferation ability was significantly higher in the PDLSCs derived from periodontitis-affected teeth. Meanwhile microRNA-466l overexpression decreased cell proliferation rates of both types of PDLSCs and upregulated IL-10 expression. Together, these data suggest that microRNA-466l can upregulate IL-10 and reduce the proliferation rate of PDLSCs.

BACKGROUND: Glycoproteins play a critical role in the cellular activities of eukaryotes. Sialic acid is typically the outermost monosaccharide of glycolipids and glycoproteins, and is necessary for normal development. RESULTS: A strategy based on avidin-biotin affinity was established to enrich sialylated glycoproteins from HeLa cervical carcinoma, SW1990 pancreatic adenocarcinoma, and A549 lung adenocarcinoma cells. Using HPLC-MS/MS, western blot, real-time PCR, and enzyme-linked immunosorbent assay, gp96 was identified in all three cell lines. No significant difference in the protein expression of gp96 was detected at the whole cell level, but the amount of bioti-nylated gp96 in SW1990 cells was 30-40 % lower than that in A549 and HeLa cells, and the amount of sialylated gp96 in SW1990 cells was 30 % lower than that in A549 and HeLa cells. Immunoblotting results showed that the expression of sialyltransferase proteins in the total cell lysates from HeLa and A549 cells were higher than that in SW1990 cells. CONCLUSIONS: We established a new method for investigating the expression and sialylation of glycoproteins using metabolic labeling, click chemistry, and avidin-biotin affinity. We successfully used this method to purify sialylated glycoproteins from cancer cell lines. Our results showed that the levels of gp96 sialylation varied across different cancer cell lines, and this may be because of differences in sialyltransferase expression.

OBJETIVO: validar de forma prospectiva um nomograma de bilirrubina transcutânea (BTc) para identificar hiperbilirrubinemia grave em neonatos a termo e pré-termo tardios saudáveis na China.MÉTODOS: foi realizado um estudo multicêntrico que incluiu 9174 neonatos a termo e pré-termo tardios saudáveis em oito unidades da China. Foram realizadas dosagens de BTc utilizando um bilirrubinômetro. Os valores de BTc foram traçados em um nomograma de BTc para identificara capacidade de predição de hiperbilirrubinemia significativa.RESULTADOS: 972 recém-nascidos (10,6%) desenvolveram hiperbilirrubinemia significativa. O percentil 40 de nosso nomograma pode identificar todos os recém-nascidos com risco de hiper-bilirrubinemia significativa, porém com baixo valor preditivo positivo (VPP) (18,9%). De 453 recém-nascidos acima do percentil 95, 275 recém-nascidos desenvolveram posteriormente hiperbilirrubinemia significativa, com VPP elevado (60,7%), porém com baixa sensibilidade (28,3%). O percentil de 75 foi altamente específico (81,9%) e moderadamente sensível (79,8%). A área sob a curva (ASC) de nosso nomograma de BTc foi de 0,875.CONCLUSÕES: este estudo validou o nomograma de BTc, que pode ser utilizado para prever hiperbilirrubinemia significativa em neonatos a termo e pré-termo tardios saudáveis na China. Contudo, combinar o nomograma de BTc e fatores de risco clínicos pode melhorar a precisãode predição da hiperbilirrubinemia grave, o que não foi avaliado neste estudo. São necessários estudos adicionais para confirmar essa combinação.

OBJECTIVE:to prospectively validate a previously constructed transcutaneous bilirubin (TcB) nomogram for identifying severe hyperbilirubinemia in healthy Chinese term and late-preterm infants.METHODS:this was a multicenter study that included 9,174 healthy term and late-preterm infants in eight hospitals of China. TcB measurements were performed using a JM-103 bilirubinometer. TcB values were plotted on a previously developed TcB nomogram, to identify the predictive ability for subsequent significant hyperbilirubinemia.RESULTS:in the present study, 972 neonates (10.6%) developed significant hyperbilirubinemia. The 40th percentile of the nomogram could identify all neonates who were at risk of significant hyperbilirubinemia, but with a low positive predictive value (PPV) (18.9%). Of the 453 neonates above the 95th percentile, 275 subsequently developed significant hyperbilirubinemia, with a high PPV (60.7%), but with low sensitivity (28.3%). The 75th percentile was highly specific (81.9%) and moderately sensitive (79.8%). The area under the curve (AUC) for the TcB nomogram was 0.875.CONCLUSIONS:this study validated the previously developed TcB nomogram, which could be used to predict subsequent significant hyperbilirubinemia in healthy Chinese term and late-preterm infants. However, combining TcB nomogram and clinical risk factors could improve the predictive accuracy for severe hyperbilirubinemia, which was not assessed in the study. Further studies are necessary to confirm this combination.

Background Optimization of nutrient feeding was developed to improve the growth of Bacillus subtilis in fed batch fermentation to increase the production of jiean-peptide (JAA). A central composite design (CCD) was used to obtain a model describing the relationship between glucose, total nitrogen, and the maximum cell dry weight in the culture broth with fed batch fermentation in a 5 L fermentor. Results The results were analyzed using response surface methodology (RSM), and the optimized values of glucose and total nitrogen concentration were 30.70 g/L and 1.68 g/L in the culture, respectively. The highest cell dry weight was improved to 77.50 g/L in fed batch fermentation, which is 280% higher than the batch fermentation concentration (20.37 g/L). This led to a 44% increase of JAA production in fed batch fermentation as compared to the production of batch fermentation. Conclusion The results of this work improve the present production of JAA and may be adopted for other objective products' production.

OBJETIVO: validar de forma prospectiva um nomograma de bilirrubina transcutânea (BTc) para identificar hiperbilirrubinemia grave em neonatos a termo e pré-termo tardios saudáveis na China.MÉTODOS: foi realizado um estudo multicêntrico que incluiu 9174 neonatos a termo e pré-termo tardios saudáveis em oito unidades da China. Foram realizadas dosagens de BTc utilizando um bilirrubinômetro. Os valores de BTc foram traçados em um nomograma de BTc para identificara capacidade de predição de hiperbilirrubinemia significativa.RESULTADOS: 972 recém-nascidos (10,6%) desenvolveram hiperbilirrubinemia significativa. O percentil 40 de nosso nomograma pode identificar todos os recém-nascidos com risco de hiper-bilirrubinemia significativa, porém com baixo valor preditivo positivo (VPP) (18,9%). De 453 recém-nascidos acima do percentil 95, 275 recém-nascidos desenvolveram posteriormente hiperbilirrubinemia significativa, com VPP elevado (60,7%), porém com baixa sensibilidade (28,3%). O percentil de 75 foi altamente específico (81,9%) e moderadamente sensível (79,8%). A área sob a curva (ASC) de nosso nomograma de BTc foi de 0,875.CONCLUSÕES: este estudo validou o nomograma de BTc, que pode ser utilizado para prever hiperbilirrubinemia significativa em neonatos a termo e pré-termo tardios saudáveis na China. Contudo, combinar o nomograma de BTc e fatores de risco clínicos pode melhorar a precisãode predição da hiperbilirrubinemia grave, o que não foi avaliado neste estudo. São necessários estudos adicionais para confirmar essa combinação.

OBJECTIVE:to prospectively validate a previously constructed transcutaneous bilirubin (TcB) nomogram for identifying severe hyperbilirubinemia in healthy Chinese term and late-preterm infants.METHODS:this was a multicenter study that included 9,174 healthy term and late-preterm infants in eight hospitals of China. TcB measurements were performed using a JM-103 bilirubinometer. TcB values were plotted on a previously developed TcB nomogram, to identify the predictive ability for subsequent significant hyperbilirubinemia.RESULTS:in the present study, 972 neonates (10.6%) developed significant hyperbilirubinemia. The 40th percentile of the nomogram could identify all neonates who were at risk of significant hyperbilirubinemia, but with a low positive predictive value (PPV) (18.9%). Of the 453 neonates above the 95th percentile, 275 subsequently developed significant hyperbilirubinemia, with a high PPV (60.7%), but with low sensitivity (28.3%). The 75th percentile was highly specific (81.9%) and moderately sensitive (79.8%). The area under the curve (AUC) for the TcB nomogram was 0.875.CONCLUSIONS:this study validated the previously developed TcB nomogram, which could be used to predict subsequent significant hyperbilirubinemia in healthy Chinese term and late-preterm infants. However, combining TcB nomogram and clinical risk factors could improve the predictive accuracy for severe hyperbilirubinemia, which was not assessed in the study. Further studies are necessary to confirm this combination.

Encapsulation and immobilization technology is important for the food processing and bioengineering industries. Chitosan is a natural polysaccharide prepared by the N - deacetylation of chitin. It has been widely used in food and bioengineering industries, including the encapsulation of active food ingredients, in enzyme immobilization, and as a carrier for controlled drug delivery, due to its significant biological and chemical properties such as biodegradability, biocompatibility, bioactivity, and polycationicity. In this work, chitosan nanoparticles and nanofibers used to encapsulate bioactive substances and immobilize enzymes were reviewed. Preparation of chitosan nanoparticles and nanofibers, including the work achieved in our group on chitosan nanoparticles for enzyme immobilization, were also introduced. Some problems encountered with nano - structured chitosan carriers for bioactive substance encapsulation and enzyme immobilization were discussed, together with the future prospects of such systems.

JUSTIFICATIVA E OBJETIVOS: Os anestésicos locais são amplamente utilizados na prevenção ou na reversão de dor aguda e no tratamento de dor crônica. A reação de cardiotoxicidade induzida pelos anestésicos locais é um evento acidental sem terapia farmacológica, exceto a infusão de intralípides relatados recentemente cujo mecanismo de ação ainda não é bem compreendido. CONTEÚDO: A cardiolipina, um fosfolipídio aniônico, desempenha papel relevante na determinação de reação respiratória mitocondrial, metabolismo de ácidos graxos e apoptose celular. A disfunção do metabolismo energético mitocondrial é sugerida em associação com a cardiotoxicidade dos anestésicos locais, a partir de um estudo in vitro de que ela talvez se deva a fortes ligações eletrostáticas entre os anestésicos locais e a cardiolipina na membrana mitocondrial. Não há, contudo, evidência experimental. Portanto, levantamos a hipótese de que as interações anestésico-cardiolipina sejam o principal determinante associado à reação de cardiotoxicidade, o que pode ser estabelecido com a adoção de métodos teóricos e biológicos estruturais. Esse modelo de interação nos daria uma pista sobre o mecanismo da cardiotoxicidade dos anestésicos locais, visando a futuras pesquisas na área de desenvolvimento de fármacos de prevenção a esse evento na prática clínica. CONCLUSÕES: A interação entre a cardiolipina mitocondrial e os anestésicos locais pode ser a principal fonte de sua cardiotoxicidade, em função de seus efeitos sobre o metabolismo energético e o estado eletrostático.

BACKGROUND AND OBJECTIVES: Local anesthetics are used broadly to prevent or reverse acute pain and treat symptoms of chronic pain. Local anesthetic-induced cardiotoxic reaction has been considered the accidental event without currently effective therapeutic drugs except for recently reported intralipid infusion whose possible mechanism of action is not well known. CONTENTS: Cardiolipin, an anionic phospholipid, plays a key role in determining mitochondrial respiratory reaction, fatty acid metabolism and cellular apoptosis. Mitochondrial energy metabolism dysfunction is suggested as associated with local anesthetic cardiotoxicity, from an in vitro study report that the local anesthetic cardiotoxicity may be due to the strong electrostatic interaction of local anesthetics and cardiolipin in the mitochondria membrane, although there is a lack for experimental evidence. Herein we hypothesized that local anesthetic-cardiolipin interactions were the major determinant of local anesthetic-associated cardiotoxic reaction, established by means of theoretic and structural biological methods. This interacting model would give an insight on the underlying mechanism of local anesthetic cardiotoxicity and provide clues for further in depth research on designing preventive drugs for such inadvertent accidence in routine clinical practice. CONCLUSIONS: The interaction between local anesthetic and mitochondrial cardiolipin may be the underlying mechanism for cardiotoxicity affecting its energy metabolism and electrostatic status.