Intelligent Three-Dimensional Reconstruction Algorithm-Based Ultrasound-Guided Nerve Block in Intraoperative Anesthesia and Postoperative Analgesia of Orthopedic Surgery.

This research was aimed at analyzing the role of ultrasound-guided nerve block based on intelligent three-dimensional (3D) reconstruction algorithm in intraoperative anesthesia and postoperative analgesia of orthopedic surgery. 68 elderly patients were undergoing orthopedic surgery on the lower extremities, and they were randomly rolled into two groups with 34 patients in each group. The patients in control group received sciatic nerve block anesthesia (SNBA), and the patients in the experimental group received ultrasound-guided SNBA (UG-SNBA) under 3D reconstruction algorithm to analyze and compare the anesthesia effect and the postoperative analgesia effect. The results showed that compared with other algorithms, the evaluation index of ultrasound images processed by the 3D reconstruction algorithm was better. In terms of anesthesia effect, there was no significant difference in systolic blood pressure, diastolic blood pressure, and heart rate between the two groups before surgery (P > 0.05). Intraoperative and postoperative indicators of the experimental group were significantly better than those of the control group; the drug dosage (61 mg) was less than that of the control group (78 mg). In addition, the onset time of anesthesia, the time of pain blockade, and the postoperative awake time (5 minutes, 8 minutes, and 8 minutes, respectively) were shorter than those in the control group (13 minutes, 15 minutes, and 15 minutes, respectively). The visual analogue scale (VAS) scores of the experimental group were better than those of the control group on the day after surgery, one day after surgery, two days after surgery, and three days after surgery, with significant differences (P < 0.05). In summary, 3D reconstruction algorithm-based ultrasound image effect was clearer, the effect of UG-SNBA was more stable, and the postoperative analgesic effect was better. This work provided a higher reference for the selection of safe and effective anesthesia options in orthopedic surgery.

Internet of Things-Based Ultrasound-Guided Erector Spinae Plane Block Combined with Edaravone Anesthesia in Thoracoscopic Lobectomy.

This paper aimed to study the application value of Internet of Things (IoT) edge computing algorithm-based ultrasound-guided erector spinae plane block combined with edaravone anesthesia in thoracoscopic lobectomy. A total of 110 patients undergoing thoracoscopic resection were selected as subjects. The patients were anesthetized with erector spinae plane block combined with edaravone before surgery and underwent chest ultrasound scan. IoT edge computing algorithm was constructed and applied to ultrasound images of patients to enhance and denoise the images. It was found that, in different mixed noise mixtures (Gaussian noise 10% + speckle noise 90%; Gaussian noise 30% + speckle noise 70%), the edge computing algorithm can still maintain the edge information of the output image, showing better performance on edge information detection and denoising compared with the Prewitt and Canny operator. In addition, visual analog scale (VAS) scores decreased with postoperative time after edaravone anesthesia induction and erector spinae plane block lobectomy and reached the lowest level after five days. In short, erector spinae plane block combined with edaravone showed good sedative and analgesic effects on patients undergoing thoracoscopic lobectomy. Ultrasound images processed by IoT edge computing algorithm showed high accuracy in the identification of lung lesions, which was worth applying to clinical diagnosis.

Hepatocyte-specific deficiency of Nrf2 exacerbates carbon tetrachloride-induced liver fibrosis via aggravated hepatocyte injury and subsequent inflammatory and fibrogenic responses.

BACKGROUND: Liver fibrosis, in which hepatocyte damage and inflammatory response play critical roles, is a physiological response to chronic or iterative liver injury and can progress to cirrhosis over time. Nuclear factor E2-related factor 2 (Nrf2) is a master transcription factor that regulates oxidative and xenobiotic stress responses as well as inflammation. METHOD: To ascertain the cell-specific roles of Nrf2 in hepatocytes and myeloid lineage cells in the progression of liver fibrosis, mice lacking Nrf2 specifically in hepatocytes [Nrf2(L)-KO] and myeloid lineage cells [Nrf2(M)-KO] were generated to evaluate carbon tetrachloride (CCl4)-induced liver injury, subsequent inflammation and fibrosis. In addition, mouse primary hepatocytes were used to investigate the underlying mechanisms. RESULTS: Nrf2-mediated antioxidant response in the liver is responsive to acute CCl4 exposure in mice. With repeated CCl4 administration, Nrf2(L)-KO, but not Nrf2(M)-KO, mice showed more severe liver fibrosis than Nrf2-LoxP control mice. In addition, in response to acute CCl4 exposure, Nrf2(L)-KO mice displayed aggravated liver injury, elevated lipid peroxidation and inflammatory response compared to control mice. In mouse primary hepatocytes, deficiency of Nrf2 resulted in more severe CCl4-induced lipid oxidation and inflammatory response. CONCLUSION: Deficiency of Nrf2 in hepatocytes sensitizes the cells to CCl4-induced oxidative damage and inflammatory response, which are initiator and enhancer of subsequent hepatic inflammation and fibrosis. Thus, Nrf2 is a critical determinant of liver injury and fibrosis in response to CCl4, suggesting that Nrf2 might be a valuable target for the intervention.

Clinicopathological characteristics of xeroderma pigmentosum associated with keratoacanthoma in an infant.

A rare case of xeroderma pigmentosum coexisted with keratoacanthoma in an 18-month-old boy was reported. The boy was admitted with unequal size, irregularly shaped brown spots, patches and depigmentation spots on his face. A well-circumscribed hemispherical mass measuring 3 cm×3 cm with smooth surface and brown patches was observed beneath his left lower eyelid. Light microscopic examination of the skin lesions revealed epidermal hyperkeratosis, chronic inflammatory infiltration of the superficial dermal layer, and increases in melanocytes and melanin in the basal layer. The mass beneath the left lower eyelid was cup-shaped, consisting of proliferating squamous cells with a central keratin plug. The squamous epithelium was acanthotic with hypergranulosis. The adjacent epidermis formed exophytic projections resulting in a silhouette likened to lips. The patient was treated with a combination of antioxidant drugs, keeping the child from light and surgical excision of the mass. No recurrence has been observed.

Inhibition of PI3Kδ improves systemic lupus in mice.

Systemic lupus erythematosus (SLE) is an autoimmune disease accompanying excessive inflammatory responses. Phosphoinositide 3-kinase p110δ (PI3Kδ) is reported to associate with autoimmune conditions. We here aimed to determine whether selective inhibition of PI3Kδ is effective in a lupus model of BXSB mice, using the selective PI3Kδ inhibitor IC87114, which was intraperitoneally administrated to BXSB mice aged from 14 to 22 weeks. We showed that IC87114 improved renal function by decreasing the levels of proteinuria and serum creatinine, ameliorating the pathologic changes of kidneys and IgG and C3 deposition. Serum anti-autoantibody to nuclear antigen, anti-dsDNA, IL-1ß, and IL-17 were markedly reduced by IC87114 therapy. Hepatic damage was also inhibited by administration of IC87114. Expression of phosphorylated AKT (p-AKT) and monocyte chemoattractant protein-1 was inhibited and mouse survival improved. In sum, PI3Kδ activation may be a critical factor for escalating autoimmune renal and hepatic damage, and its inhibition may alleviate the autoimmune damage. Our study reveals that the selective blockade of PI3Kδ is effective for mouse SLE.

Increased permeability of blood-brain barrier is mediated by serine protease during Cryptococcus meningitis.

OBJECTIVES: To determine the role of serine protease in the disruption of the blood-brain barrier (BBB) during Cryptococcus neoformans meningitis. METHODS: Reverse transcription-polymerase chain reaction and immunohistochemistry were used to determine the production of serine protease by different strains of C. neoformans. BBB permeability in immunosuppressed rats inoculated with C. neoformans or C. neoformans plus aprotinin was examined via Evans blue staining. In vitro BBB permeability (transwell passage of horseradish peroxidase) was determined in human brain microvascular endothelial cells (BMECs) cultured with serine protease or serine protease plus aprotinin. Electron microscopy of rat brain tissue was used to visualise C. neoformans infection. RESULTS: Serine protease mRNA and protein were detected in all C. neoformans serotypes. C. neoformans infection increased BBB permeability in vivo, but this effect was ameliorated by aprotinin. Treatment of BMECs with serine protease increased permeability in vitro. This effect was reversed by aprotinin. CONCLUSION: Serine protease secreted by C. neoformans leads to BBB disruption during Cryptococcus meningitis. Serine protease may be a novel treatment target for Cryptococcus meningitis.