Comparison of volume-controlled ventilation, pressure-controlled ventilation and pressure-controlled ventilation-volume guaranteed in infants and young children in the prone position: A prospective randomized study.

STUDY OBJECTIVE: To explore if the pressure-controlled ventilation (PCV) and pressure-controlled ventilation-volume guaranteed (PCV-VG) modes are superior to volume-controlled ventilation (VCV) in optimizing intraoperative respiratory mechanics in infants and young children in the prone position. DESIGN: A single-center prospective randomized study. SETTING: Children's Hospital, Zhejiang University School of Medicine. PATIENTS: Pediatric patients aged 1 month to 3 years undergoing elective spinal cord detethering surgery. INTERVENTIONS: Patients were randomly allocated to the VCV group, PCV group and PCV-VG group. The target tidal volume (VT) was 8 mL/kg and the respiratory rate (RR) was adjusted to maintain a constant end tidal CO2. MEASUREMENTS: The primary outcome was intraoperative peak airway pressure (Ppeak). Secondary outcomes included other respiratory and ventilation variables, gas exchange values, serum lung injury biomarkers concentration, hemodynamic parameters and postoperative respiratory complications. MAIN RESULTS: A total of 120 patients were included in the final analysis (40 in each group). The VCV group showed higher Ppeak at T2 (10 min after prone positioning) and T3 (30 min after prone positioning) than the PCV and PCV-VG groups (T2: P = 0.015 and P = 0.002, respectively; T3: P = 0.007 and P = 0.009, respectively). The prone-related decrease in dynamic compliance was prevented by PCV and PCV-VG ventilation modalities at T2 and T3 than by VCV (T2: P = 0.008 and P = 0.015, respectively; T3: P = 0.015 and P = 0.014, respectively). Additionally, there were no significant differences in other secondary outcomes among the three groups. CONCLUSION: In infants and young children undergoing spinal cord detethering surgery in the prone position, PCV-VG may be a better ventilation mode due to its ability to mitigate the increase in Ppeak and decrease in Cdyn while maintaining consistent VT.

Outcomes of antiretroviral treatment for 0-14-year-old children living with HIV in Ganzhou, China, 2006-2023.

BACKGROUND: Studies on antiretroviral therapy (ART) in children living with HIV (CLHIV) are limited due to the small population and low accession rate of ART. METHODS: All 0-14-year-old CLHIV admitted to the Ganzhou Center for Disease Control and Prevention from January 2006 to June 2023 were included retrospectively. The information of treatment regimens, disease progression, and laboratory tests of the patients under ART were used to explore the outcomes and impacts of long-term ART. The normality of all the data was tested by the Shapiro-Wilk test. RESULTS: From 2006 to 2023, 18 CLHIV were reported in Ganzhou. Among them, 11 received ART and were followed up for 60.0 ± 48.4 months. After receiving ART, the median viral load of them decreased from 89,600 copies/ml to 22 copies/ml (P = 0.007), the median CD4+ T cell count increased from 380.7 cells/µL to 661.9 cells/µL (P = 0.028), and the median CD8+ T cell count decreased from 1065.8 cells/µL to 983.3 cells/µL (P = 0.584). The laboratory test results regarding liver function, renal function, blood cell count, and glucolipid metabolism tended to be within normal reference ranges, and the mean height-for-age z-score and weight-for-age z-score increased. However, all the three CLHIV who received cotrimoxazole developed pneumocystis carinii pneumonia, upper respiratory infection, skin lesions, bacterial pneumonia and/or thrush; the mean body-mass-index-for-age z-score decreased from 0.52 to -0.63. CONCLUSION: For CLHIV, ART could effectively inhibit the replication of HIV and improve the immune function of patients. More studies that focus on ART in CLHIV are urgently needed.

Impact of intravenous administration of nalbuphine at different time points for postoperative analgesia and sedation in adenotonsillectomized children: a prospective, randomized controlled trial.

Objective: To compare the efficacy of intravenous administration of nalbuphine at different time points for postoperative analgesia and sedation in adenotonsillectomized children. Methods: Patients with obstructive sleep apnea syndrome scheduled for adenotonsillectomy were randomly divided into group A (patients received intravenous nalbuphine 0.2 mg/kg before anesthesia induction), group B (patients received intravenous nalbuphine 0.2 mg/kg 10 min before the end of surgery), and group C (patients did not receive nalbuphine injection). The time points for measuring outcomes were before anesthesia induction (T0), extubation (T1), and 0, 15, 30, or 45 min in the postanesthesia care unit (PACU) (T2-T5, respectively). Results: There were 40 patients in group A, 41 patients in group B and 39 patients in group C. Patients in group B had significantly lower FLACC (Face, Legs, Activity, Cry, Consolability) pain scores at T2-T5 than those in group C (all p<0.05). Patients in group B had higher Ramsay Sedation Score at T2-T4 than those in group C (all p<0.05). The proportion of patients who received remedial analgesia in the PACU in group A (17.5%, p=0.008) and group B (9.8%, p<0.001) was significantly lower than that in group C (46.2%). Conclusion: Intravenous administration of nalbuphine 10 min before the end of adenotonsillectomy in children could decrease pain intensity and increase sedation levels during the recovery period with the reduction of remedial analgesia in the PACU.Trial registration number ChiCTR2200060118.

Interactive effects of sleep and physical activity on depression among rural university students in China.

Background: Decreased sleep quality and physical activity among university students have become important concerns, while depressive symptoms are on the rise, especially in rural areas. Previous studies have confirmed the association between sleep quality and physical activity and depressive symptoms, but the effect of their interaction on depressive symptoms has been less studied. For this reason, the present study analyzed the interaction between sleep quality and physical activity on depressive symptoms to provide reference and assistance for mental health promotion and intervention for university students in rural areas of China. Methods: In this study, we investigated sleep quality, physical activity, and depressive symptoms in 11,423 university students in rural areas of China. The association of sleep quality and physical activity with depressive symptoms was analyzed by using univariate analysis and logistic regression analysis. And further analyzed the association between the interaction effect of sleep quality and physical activity and depressive symptoms. Results: The proportion of university students with depressive symptoms in rural China was 33.3%, with a higher proportion of girls students (36.7%) having depressive symptoms than boys students (28.8%). Logistic regression analysis of the interaction between sleep quality and physical activity and depressive symptoms in university students showed that university students with poor sleep quality and MVPA>60 min/d (OR = 4.40,95% CI: 3.75-5.05) had the highest risk of depressive symptoms (p < 0.001). University students with moderate sleep quality and MVPA of 30-60 min/d (OR = 1.18, 95% CI: 0.75-1.61) had the lowest risk of depressive symptoms (p < 0.001). Moreover, there was no gender difference in this result. Conclusion: The prevalence of depressive symptoms was higher among university students in rural areas of China. There was an interaction between sleep quality and MVPA on depressive symptoms, maintaining a good quality of sleep and an appropriate length of MVPA has a contributory effect on mental health, and the same trend was found for both boys and girls students. It is recommended that university students in rural areas of China should first maintain proper sleep quality while maintaining 30-60 min of MVPA per day, which may reduce the risk of depressive symptoms.

Association between sleep quality and psychological symptoms: A cross-sectional survey of Chinese university students performed during the COVID-19 pandemic.

Background: Since the start of the coronavirus 2019 pandemic, people have faced many challenges, including in relation to sleep quality and psychological health. This study aims to analyze the association between sleep quality and psychological symptoms among university students in China, and to provide reference data to facilitate the development of interventions to improve the physical and mental health of university students. Methods: A stratified cluster sampling method was used to investigate the sleep quality and psychological symptoms of 6,363 university students in China. The Chi-square test was used to analyze differences in sleep quality among groups. Logistic regression analysis was used to analyze the association between sleep quality and psychological symptoms. Results: The proportions of Chinese university students with good, medium, and poor sleep quality were 25.73, 10.99, and 63.28%, respectively. The overall rate of psychological symptoms was 16.5%. Logistic regression analysis showed that, in general, university students with poor sleep quality had a higher risk of psychological symptoms than those with good sleep quality (OR = 1.53, 95%CI: 1.28, 1.84, p < 0.01). Compared with university students with good sleep quality, those with poor sleep quality were more likely to experience emotional symptoms (OR = 1.62, 95%CI: 1.36, 1.94), behavioral symptoms (OR = 1.55, 95% CI: 1.3, 1.84), and difficulties with social adaptation (OR = 1.84, 95% CI: 1.51, 2.25) (all p < 0.01). Conclusion: There was an association between sleep quality and psychological symptoms among Chinese university students. University students with poor sleep quality have a higher risk of psychological symptoms. Measures should be taken to improve the sleep quality of university students and reduce the incidence of psychological symptoms. This study provides reference data for government and education departments that could inform public health policies.

Development of a rapid reverse genetics system for feline coronavirus based on TAR cloning in yeast.

Introduction: Reverse genetics has become an indispensable tool to gain insight into the pathogenesis of viruses and the development of vaccines. The yeast-based synthetic genomics platform has demonstrated the novel capabilities to genetically reconstruct different viruses. Methods: In this study, a transformation-associated recombination (TAR) system in yeast was used to rapidly rescue different strains of feline infectious peritonitis virus, which causes a deadly disease of cats for which there is no effective vaccine. Results and discussion: Using this system, the viruses could be rescued rapidly and stably without multiple cloning steps. Considering its speed and ease of manipulation in virus genome assembly, the reverse genetics system developed in this study will facilitate the research of the feline coronaviruses pathogenetic mechanism and the vaccine development.

Relationship between body mass index and physical fitness index in Chinese college students: Results from a cross-sectional survey.

BACKGROUND: To explore the cross-sectional relationship between the body mass index (BMI) and physical fitness index (PFI) of Chinese college students. METHODS: In total, 30 497 (male 16 197, 55.5%) Chinese college students aged 19-22 were tested for height, weight and five physical fitness indicators (50-m sprint, sit and reach, standing long jump, 1000/800-m run, pull-up/bent-leg sit-up). Stratified according to age and gender, according to BMI percentile, divided into BMI < 10th Percentile (A), 10th ≤ BMI < 25th Percentile (B), 25th ≤ BMI < 75th Percentile (C), 75th ≤ BMI < 90th Percentile (D), BMI ≥ 90th Percentile (E), a total of 5 groups, and the PFI composed of 5 indicators of physical fitness was calculated according to age and gender. The comparison of PFI between different BMI groups was carried out using the effect size, and the non-linear relationship between BMI-Z and PFI was analyzed. RESULTS: The relationship between BMI-Z and PFI of male and female college students in China showed an inverted "U"-shaped curve. With comparable BMI, PFI change was greater in males than in females. CONCLUSION: The relationship between BMI and PFI of Chinese college students is nonlinear. The physical fitness level of college students who are underweight or overweight and those with obesity is lower than that of normal-weight students.

The association between duration of muscle exercise and psychological symptoms is higher in boys than in girls: A cross-sectional study based on Chinese college students during COVID-19.

Objective: The COVID-19 pandemic has had many negative effects on the physical and mental health of college students. Although many studies have analyzed the association between muscular fitness and psychological symptoms in children and adolescents, research during the COVID-19 pandemic is limited. Our study focused on analyzing the association between duration of muscle exercise and psychological symptoms among Chinese college students during the COVID-19 pandemic. Method: A four-stage stratified whole-group sampling method was used to investigate basic demographic information, duration of muscle exercise and psychological symptoms in 5,559 college students aged 19-22 years in China. Chi-square test (categorical variables) and one-way ANOVA (continuous variables) were used to compare the psychological symptoms of college students with different durations of muscle exercise. Logistic regression analysis was used to analyze the association between duration of muscle exercise and psychological symptoms. Result: The detection rate of psychological symptoms among Chinese college students was 9.0%; the detection rate was 10.7% for boys and 7.6% for girls. The proportions of duration of muscle exercise at <30 min/d, 30-60 min/d, and >60 min/d were 75.0%, 20.4%, and 4.6%, respectively. After adjusting for relevant confounding variables, taking Chinese college students with duration of muscle exercise >60 min/d as the reference group, duration of muscle exercise <30 min/d was positively correlated with the occurrence of psychological symptoms (OR: 4.19, 95%CI: 1.82, 9.61) (P < 0.001). In emotional symptoms (OR: 4.56, 95%CI: 1.99, 10.44), behavioral symptoms (OR: 3.44, 95%CI: 1.79, 6.60), social adaptation difficulties (OR: 3.04, 95%CI: 1.62, 5.68) dimensions, there is also a positive correlation (P < 0.01). Conclusions: The negative association between duration of muscle exercise and psychological symptoms among Chinese college students also suggests that longer duration of muscle exercise among college students is associated with a lower prevalence of psychological symptoms. The association between duration of muscle exercise and psychological symptoms was higher in boys compared to girls.

Astragalus polysaccharides affects multidrug resistance gene 1 and P-glycoprotein 170 in adriamycin nephropathy rats via regulating microRNA-16/NF-κB axis. / 黄芪多糖调控微RNA-16/NF-κBè½´å¯¹é˜¿éœ‰ç´ è‚¾ç— å¤§é¼ å¤šè¯è€è¯åŸºå› 1和P-糖蛋白170的影响.

OBJECTIVES: Nephrotic syndrome is a common disease of the urinary system. The aim of this study is to explore the effect of astragalus polysaccharides (APS) on multidrug resistance gene 1 (MDR1) and P-glycoprotein 170 (P-gp170) in adriamycin nephropathy rats and the underlying mechanisms. METHODS: A total of 72 male Wistar rats were divided into a control group, a model group, an APS low-dose group, an APS high-dose group, an APS+micro RNA (miR)-16 antagomir group and an APS+miR-16 antagomir control group, with 12 rats in each group. Urine protein (UP) was detected by urine analyzer, and serum cholesterol (CHOL), albumin (ALB), blood urea nitrogen (BUN), and creatinine (SCr) were detected by automatic biochemical analyzer; serum interleukin-6 (IL-6), IL-1ß, tumor necrosis factor α (TNF-α) levels were detected by ELISA kit; the morphological changes of kidney tissues were observed by HE staining; the levels of miR-16 and MDR1 mRNA in kidney tissues were detected by real-time RT-PCR; the expression levels of NF-κB p65, p-NF-κB p65, and P-gp170 protein in kidney tissues were detected by Western blotting; and dual luciferase was used to verify the relationship between miR-16 and NF-κB. RESULTS: The renal tissue structure of rats in the control group was normal without inflammatory cell infiltration. The renal glomeruli of rats in the model group were mildly congested, capillary stenosis or occlusion, and inflammatory cell infiltration was obvious. The rats in the low-dose and high-dose APS groups had no obvious glomerular congestion, the proliferation of mesangial cells was significantly reduced, and the inflammatory cells were reduced. Compared with the high-dose APS group and the APS+miR-16 antagomir control group, there were more severe renal tissue structure damages in the APS + miR-16 antagomir group. Compared with the control group, the levels of UP, CHOL, BUN, SCr, IL-6, IL-1ß, TNF-α, and MDR1 mRNA, and the protein levels of p-NF-κB p65 and P-gp170 in the model group were significantly increased (all P<0.05); the levels of ALB and miR-16 were significantly decreased (both P<0.05). Compared with the model group, the levels of UP, CHOL, BUN, SCr, IL-6, IL-1ß, TNF-α, and MDR1 mRNA, and the protein levels of pNF-κB p65 and P-gp170 in the low-dose and high-dose APS groups were significant decreased (all P<0.05); and the levels of ALB and miR-16 were significantly increased (both P<0.05). Compared with APS+miR-16 antagomir control group, the UP, CHOL, BUN, SCr, IL-6, IL-1ß, and TNF-α levels, MDR1 mRNA, and the protein levels of p-NF-κB p65 and P-gp170 were significantly increased (all P<0.05). The levels of ALB and miR-16 were significantly decreased in the APS+miR-16 antagomir group compared with the APS+miR-16 antagomir control group (both P<0.05). CONCLUSIONS: APS can regulate the miR-16/NF-κB signaling pathway, thereby affecting the levels of MDR1 and P-gp170, and reducing the inflammation in the kidney tissues in the adriamycin nephropathy rats.

Microbial communities in swamps of four mangrove reserves driven by interactions between physicochemical properties and microbe in the North Beibu Gulf, China.

Mangroves are distributed in coastal and estuarine regions and are characterized as a sink for terrestrial pollution. It is believed that complex interactions between environmental factors and microbial communities exist in mangrove swamps. However, little is known about environment-microbe interactions. There is a need to clarify some important environmental factors shaping microbial communities and how environmental factors interact with microbial assemblages in mangrove swamps. In the present study, physicochemical and microbial characteristics in four mangrove reserves (named ZZW, Qin, Bei, and GQ) in the North Beibu Gulf were determined. The interactions between environmental factors and microbial assemblages were analyzed with statistical methods in addition to CCA and RDA. Higher concentrations of sulfate (SO42--S) and Fe but lower concentrations of total phosphorus (TP) and NO3--N were detected in ZZW and Qin. Nutrient elements (NO3--N, NH4+-N, organic matter (OM), SO42--S, Fe, and TP) were more important than heavy metals for determining the microbial assemblages, and NO3--N was the most important factor. NO3--N, SO42--S, TP, and Fe formed a significant co-occurrence network in conjunction with some bacterial taxa, most of which were Proteobacteria. Notably, comparatively elevated amounts of sulfate-reducing bacteria (Desulfatibacillum, Desulfomonile, and Desulfatiglans) and sulfur-oxidizing bacteria (Thioprofundum and Thiohalophilus) were found in ZZW and Qin. The co-occurrence network suggested that some bacteria involved in sulfate reduction and sulfur oxidation drive the transformation of P and N, resulting in the reduction of P and N in mangrove swamps. Through the additional utilization of multivariate regression tree (MRT) and co-occurrence network analysis, our research provides a new perspective for understanding the interactions between environmental factors and microbial communities in mangroves.

PBK/TOPK promotes chemoresistance to oxaliplatin in hepatocellular carcinoma cells by regulating PTEN.

Oxaliplatin (OXA) resistance limits the efficiency of treatment for hepatocellular carcinoma (HCC). Studies have shown that the PDZ-binding kinase (PBK) plays important roles in tumors. However, the role of PBK in HCC is still a problem. In this study, we explored whether PBK is involved in the chemoresistance to OXA in HCC. Expressions of PBK in six HCC cell lines and one human hepatocytes line were determined by real-time quantitative PCR and western blot analysis. SNU-182 and HepG2 cells were chosen to induce OXA resistance. PBK was silenced or overexpressed in OXA-resistant and sensitive cell lines. Then, cell proliferation, migration, and invasion were measured by cholecystokinin-8 assay and Transwell assay, respectively. The Cancer Genome Atlas dataset showed that PBK is highly expressed in HCC and signifies poor prognosis to patient with HCC. Results showed that expression of PBK in HCC cells was significantly higher than that in THLE2 cells, and it was further increased in OXA-resistant HCC cells. Silencing of PBK promoted the sensitivity of drug-resistant HCC cells to OXA. Overexpression of PBK relieved the apoptosis induced by OXA and promoted the migration and invasion of OXA-sensitive HCC cells. Thus, this study revealed that high PBK expression is correlated with OXA resistance in HCC cells, which may provide a promising therapeutic target for treating HCC.

Paeonol attenuates isoflurane anesthesia-induced hippocampal neurotoxicity via modulation of JNK/ERK/P38MAPK pathway and regulates histone acetylation in neonatal rat.

Objective: Volatile anesthetic such as isoflurane causes widespread neurodegeneration in the developing animal brains and also induces cognitive impairments. Paeonol is a plant-derived phenolic compound possessing numerous bioactive properties. The study investigates the neuroprotective effects of paeonol against isoflurane-induced neurodegeneration and cognitive disturbances in neonatal rats.Methods: Paeonol (50, 100, and 150 mg/kg body weight/day) was given orally to separate groups of neonatal rats from postnatal day 3 (P3) to P21 and were exposed to isoflurane (0.75%; 6 h) on P7.Results: Neuroapoptosis following isoflurane exposure was remarkably reduced by paeonol. Isoflurane-induced elevated cleaved caspase-3, Bad, and Bax expression, were down-regulated on paeonol administration. Paeonol significantly enhanced expression of antiapoptotic proteins (Bcl-2, Bcl-xL, xIAP, c-IAP-1, c-IAP-2, and survivin) and improved acetylation of HK39 and HK412. The expression of histone deacetylases (HDACs)-HDAC2 and HDAC-3 were down-regulated. Isoflurane-induced activation of JNK/p38MAPK signaling and suppressed ERK signaling and were effectively regulated by paeonol. General behavior and freezing responses of the rats were improved. Results of the Morris Water Maze tests revealed improved learning and memory retention on paeonol treatment.Conclusions: Paeonol effectively inhibited neuroapoptosis and improved isoflurane-induced cognitive dysfunctions via regulating histone acetylation and JNK/ERK1/2/p38MAPK signaling pathways.

Spiraling elliptic beam in nonlocal nonlinear media.

Analytically discussed is the dynamical properties of the spiraling elliptic beams in nonlocal nonlinear media. This class of spiraling elliptic beams carry the orbital angular momentum (OAM), and can rotate on the cross section perpendicular to the propagation direction during the propagations. The optical intensity, the beam width, and specially the angular velocity are both analytically and numerically discussed in details. We shown that both the deviations from the critical power and the deviations from the critical OAM can make the spiraling elliptic beams breathe. The decrease (increase) of the OAM or the increase (decrease) of the power can both make the spiraling elliptic breathers contract (diffract), however, there still exist differences between them. The rotating speed can be changed by the input optical power or the input OAM, which may have potential applications in the controlling of the optical beams.