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Pulmonary arterial hypertension (PAH) is an obstructive vasculopathy that, if not promptly treated, culminates in right heart failure. Therefore, pre-clinical studies are needed to support and optimize therapeutic approaches of PAH. Here, we explore a prospective function of sevoflurane in experimental PAH through regulating TRAF6. Monocrotaline (MCT)-induced PAH rats were subjected to sevoflurane inhalation and intratracheal instillation of lentivirus overexpressing TRAF6. Platelet-derived growth factor (PDGF)-treated pulmonary artery smooth muscle cells (PASMCs) were exposed to sevoflurane and genetically manipulated for TRAF6 overexpression. It was found that MCT and PDGF challenge upregulated the levels of TRAF6 in rat lung tissues and PASMCs, but sevoflurane treatment led to reduced TRAF6 expression. Sevoflurane inhalation in MCT-induced rats resulted in alleviative pulmonary vascular remodeling, mitigated right ventricular dysfunction and hypertrophy, improved mitochondrial function and dynamics, and inactivation of NF-κB pathway. In vitro studies confirmed that exposure to sevoflurane repressed PDGF-induced proliferation, migration, and phenotype switching of PASMCs, and suppressed mitochondrial dysfunction and NF-κB activation in PDGF-stimulated PASMCs. The beneficial impact of sevoflurane on pathological changes of lung and cell phenotype of PASMCs were reversed by overexpression of TRAF6. In summary, our study suggested the protective properties of sevoflurane in targeting PAH by downregulating TRAF6 expression, providing a novel avenue for the management of PAH.
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Colorectal cancer (CRC) is a common digestive system tumor with high morbidity and mortality worldwide. At present, the use of computer-assisted colonoscopy technology to detect polyps is relatively mature, but it still faces some challenges, such as missed or false detection of polyps. Therefore, how to improve the detection rate of polyps more accurately is the key to colonoscopy. To solve this problem, this paper proposes an improved YOLOv5-based cancer polyp detection method for colorectal cancer. The method is designed with a new structure called P-C3 incorporated into the backbone and neck network of the model to enhance the expression of features. In addition, a contextual feature augmentation module was introduced to the bottom of the backbone network to increase the receptive field for multi-scale feature information and to focus on polyp features by coordinate attention mechanism. The experimental results show that compared with some traditional target detection algorithms, the model proposed in this paper has significant advantages for the detection accuracy of polyp, especially in the recall rate, which largely solves the problem of missed detection of polyps. This study will contribute to improve the polyp/adenoma detection rate of endoscopists in the process of colonoscopy, and also has important significance for the development of clinical work.
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Algoritmos , Pólipos del Colon , Colonoscopía , Neoplasias Colorrectales , Humanos , Colonoscopía/métodos , Pólipos del Colon/diagnóstico , Pólipos del Colon/diagnóstico por imagen , Pólipos del Colon/patología , Neoplasias Colorrectales/diagnóstico , Redes Neurales de la Computación , Semántica , Interpretación de Imagen Asistida por Computador/métodosRESUMEN
BACKGROUND: Intracranial arterial narrowing is a significant factor leading to brief episodes of reduced blood flow to the brain, known as transient ischemic attacks, or full-blown strokes. While atherosclerosis is commonly associated with intracranial arterial narrowing, it is frequently of a non-atherosclerotic nature in younger patients. CASE SUMMARY: Here, we present the case of a young stroke patient with narrowing of the middle cerebral artery (MCA), characterized as non-atherosclerotic lesions, who experienced an ischemic stroke despite receiving standard drug therapy. The patient underwent digital subtraction angiography (DSA) to assess the entire network of blood vessels in the brain, revealing significant narrowing (approximately 80%) in the M1 segment of the right MCA. Subsequently, the patient underwent Drug-Coated Balloon Angioplasty to treat the stenosis in the right MCA's M1 segment. Follow-up DSA confirmed the resolution of stenosis in this segment. Although the remaining branches showed satisfactory blood flow, the vessel wall exhibited irregularities. A review of DSA conducted six months later showed no evident stenosis in the right MCA, with a smooth vessel wall. CONCLUSION: The use of drug-coated balloon angioplasty demonstrated favorable outcomes in repairing and reshaping the blood vessel wall in young patients. Therefore, it may be considered a promising treatment option for similar cases.
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Glioma is a central nervous system (CNS) malignant tumor with high heterogeneity and mortality, which severely threatens the health of patients. The overall survival of glioma patients is relatively short and it is critical to identify new molecular targets for developing effective treatment strategies. UBE2K is a ubiquitin conjugating enzyme with oncogenic function in several malignant tumors. However, whether UBE2K participates in gliomas remains unknown. Herein, in glioma cells, UBE2K was found highly expressed in U87 and U251 cells. Subsequently, U87 and U251 cells were transfected with si-UBE2K to silence UBE2K, with the si-NC transfection as the negative control. In both U87 and U251 cells, the cell viability was sharply reduced by transfecting si-UBE2K for 48 and 72 h. Markedly decreased colony number, reduced number of migrated cells and invaded cells, and declined relative wound healing rate were observed in si-UBE2K transfected U87 and U251 cells. Moreover, the Bcl-2 level was markedly reduced, while the Bax and cleaved-caspase-3 levels were sharply increased in U87 and U251 cells after the si-UBE2K transfection. Furthermore, the p62 level was signally declined, while the Beclin-1 and LC-3 II/I levels were greatly increased in U87 and U251 cells by the si-UBE2K transfection. Furthermore, the facilitating effect of si-UBE2K on the apoptosis and autophagy in U87 and U251 cells was abolished by the coculture of 3-MA, an inhibitor of autophagy. Collectively, UBE2K facilitated the in vitro growth of glioma cells, possibly by inhibiting the autophagy-related apoptosis, which might be a promising target for treating glioma.
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Apoptosis , Autofagia , Glioma , Enzimas Ubiquitina-Conjugadoras , Humanos , Enzimas Ubiquitina-Conjugadoras/metabolismo , Enzimas Ubiquitina-Conjugadoras/genética , Glioma/patología , Glioma/metabolismo , Glioma/genética , Línea Celular Tumoral , Silenciador del Gen , Proliferación Celular , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/metabolismoRESUMEN
Disulfidptosis, a regulated form of cell death, has been recently reported in cancers characterized by high SLC7A11 expression, including invasive breast carcinoma, lung adenocarcinoma, and hepatocellular carcinoma. However, its role in colon adenocarcinoma (COAD) has been infrequently discussed. In this study, we developed and validated a prognostic model based on 20 disulfidptosis-related genes (DRGs) using LASSO and Cox regression analyses. The robustness and practicality of this model were assessed via a nomogram. Subsequent correlation and enrichment analysis revealed a relationship between the risk score, several critical cancer-related biological processes, immune cell infiltration, and the expression of oncogenes and cell senescence-related genes. POU4F1, a significant component of our model, might function as an oncogene due to its upregulation in COAD tumors and its positive correlation with oncogene expression. In vitro assays demonstrated that POU4F1 knockdown noticeably decreased cell proliferation and migration but increased cell senescence in COAD cells. We further investigated the regulatory role of the DRG in disulfidptosis by culturing cells in a glucose-deprived medium. In summary, our research revealed and confirmed a DRG-based risk prediction model for COAD patients and verified the role of POU4F1 in promoting cell proliferation, migration, and disulfidptosis.
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Adenocarcinoma , Biomarcadores de Tumor , Neoplasias Colorrectales , Regulación Neoplásica de la Expresión Génica , Humanos , Neoplasias Colorrectales/genética , Neoplasias Colorrectales/mortalidad , Neoplasias Colorrectales/diagnóstico , Pronóstico , Adenocarcinoma/genética , Adenocarcinoma/mortalidad , Biomarcadores de Tumor/genética , Femenino , Línea Celular Tumoral , Masculino , Proliferación Celular/genética , Perfilación de la Expresión Génica , Transcriptoma , Nomogramas , Factor 3 de Transcripción de Unión a Octámeros/genética , Movimiento Celular/genéticaRESUMEN
Sleep staging plays an important role in the diagnosis and treatment of clinical sleep disorders. The sleep staging standard defines every 30â¯seconds as a sleep period, which may mean that there exist similar brain activity patterns during the same sleep period. Thus, in this work, we propose a novel time-related synchronization analysis framework named time-related multimodal sleep scoring model (TRMSC) to explore the potential time-related patterns of sleeping. In the proposed TRMSC, the time-related synchronization analysis is first conducted on the single channel electrophysiological signal, i.e., Electroencephalogram (EEG) and Electrooculogram (EOG), to explore the time-related patterns, and the spectral activation features are also extracted by spectrum analysis to obtain the multimodal features. With the extracted multimodal features, the feature fusion and selection strategy is utilized to obtain the optimal feature set and achieve robust sleep staging. To verify the effectiveness of the proposed TRMSC, sleep staging experiments were conducted on the Sleep-EDF dataset, and the experimental results indicate that the proposed TRMSC has achieved better performance than other existing strategies, which proves that the time-related synchronization features can make up for the shortcomings of traditional spectrum-based strategies and achieve a higher classification accuracy. The proposed TRMSC model may be helpful for portable sleep analyzers and provide a new analytical method for clinical sleeping research.
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Encéfalo , Electroencefalografía , Fases del Sueño , Humanos , Electroencefalografía/métodos , Fases del Sueño/fisiología , Encéfalo/fisiología , Electrooculografía/métodos , Masculino , Adulto , Femenino , Polisomnografía/métodosRESUMEN
Hazardous chemical vehicles are specialized vehicles used for transporting flammable gases, medical waste, and liquid chemicals, among other dangerous chemical substances. During their transportation, there are risks of fire, explosion, and leakage of hazardous materials, posing serious threats to human safety and the environment. To mitigate these possible hazards and decrease their probability, this study proposes a lightweight object detection method for hazardous chemical vehicles based on the YOLOv7-tiny model.The method first introduces a lightweight feature extraction structure, E-GhostV2 network, into the trunk and neck of the model to achieve effective feature extraction while reducing the burden of the model. Additionally, the PConv is used in the model's backbone to effectively reduce redundant computations and memory access, thereby enhancing efficiency and feature extraction capabilities. Furthermore, to address the problem of performance degradation caused by overemphasizing high-quality samples, the model adopts the WIoU loss function, which balances the training effect of high-quality and low-quality samples, enhancing the model's robustness and generalization performance. Experimental results demonstrate that the improved model achieves satisfactory detection accuracy while reducing the number of model parameters, providing robust support for theoretical research and practical applications in the field of hazardous chemical vehicle object detection.
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Algoritmos , Sustancias Peligrosas , Sustancias Peligrosas/análisis , HumanosRESUMEN
RATIONALE: Severe stenosis of the internal carotid artery tandem affects the blood supply to the brain and threatens human life, which can be solved by interventional procedures. PATIENT CONCERNS: A 64-year-old male patient presented with a sudden onset of dizziness, palpitation, numbness, and weakness of the limbs. Imaging studies suggested multiple tandem severe stenoses from the left internal carotid artery contrast C2 to C4. DIAGNOSIS: Severe stenosis of the left internal carotid tandem. INTERVENTIONS: Multiple drug-eluting stent splicing and implantation were performed. OUTCOMES: The left internal carotid artery stenosis was released, intracranial vascular filling was significantly improved, and the patient recovered well. LESSONS: Interventional implantation of multiple drug-eluting stents relieves tandem severe stenosis of the internal carotid artery, with a wide range of applicability, high safety profile, and rapid postoperative recovery compared with endothelial debridement procedures.
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Estenosis Carotídea , Stents Liberadores de Fármacos , Masculino , Humanos , Persona de Mediana Edad , Arteria Carótida Interna/cirugía , Constricción Patológica , Stents , Estenosis Carotídea/cirugíaRESUMEN
Colorectal polyp is an important early manifestation of colorectal cancer, which is significant for the prevention of colorectal cancer. Despite timely detection and manual intervention of colorectal polyps can reduce their chances of becoming cancerous, most existing methods ignore the uncertainties and location problems of polyps, causing a degradation in detection performance. To address these problems, in this paper, we propose a novel colorectal image analysis method for polyp diagnosis via PAM-Net. Specifically, a parallel attention module is designed to enhance the analysis of colorectal polyp images for improving the certainties of polyps. In addition, our method introduces the GWD loss to enhance the accuracy of polyp diagnosis from the perspective of polyp location. Extensive experimental results demonstrate the effectiveness of the proposed method compared with the SOTA baselines. This study enhances the performance of polyp detection accuracy and contributes to polyp detection in clinical medicine.
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RATIONALE: Intracranial artery stenosis is an important cause of ischemic stroke, and MCA is one of the most common vessels causing intracranial artery stenosis. At present, there are 3 main treatments for MCA stenosis: medical drug therapy, surgery, and endovascular interventional therapy. PATIENT CONCERNS: We report a patient with severe middle cerebral artery stenosis, including his imaging and clinical manifestations. DIAGNOSIS: Severe stenosis of middle cerebral artery. INTERVENTIONS: Banxia Baizhu Tianma decoction combined with Taohong Siwu decoction combined with western medicine. OUTCOMES: The stenosis of M1 segment of middle cerebral artery was significantly improved, the stenosis rate was reduced from 70% to 30%, and the clinical symptoms of the patients basically disappeared. LESSONS: Banxia Baizhu Tianma decoction combined with Taohong Siwu plus subtraction combined with western medicine is effective in the treatment of middle cerebral artery stenosis.
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Medicamentos Herbarios Chinos , Arteria Cerebral Media , Enfermedades Vasculares , Humanos , Arteria Cerebral Media/diagnóstico por imagen , Constricción Patológica/tratamiento farmacológicoRESUMEN
The circular economy is essential as it encourages the reuse and recycling of resources while reducing waste, which ultimately helps to reduce environmental pollution and boosts economic efficiency. The current review highlights the management of agricultural and livestock residues and their conversion into valuable resources to combat environmental degradation and improve social well-being. The current trends in converting agricultural residues into useful resources emphasize the social benefits of waste management and conversion. It also emphasizes how waste conversion can reduce environmental degradation and enhance food security. Using agricultural residues can increase soil health and agricultural output while reducing pollution, greenhouse gas emissions, and resource depletion. Promoting sustainable waste-to-resource conversion processes requires a combination of strategies that address technical, economic, social, and environmental aspects. These multiple strategies are highlighted along with prospects and considerations.
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Cambio Climático , Administración de Residuos , Agricultura , Suelo , Seguridad AlimentariaRESUMEN
In this paper, the first-principle calculations of the lateral heterojunction model synthesized by hBN-Graphene were carried out, and it was found that the bandgap of graphene varied with the change in the proportion of hBN, and the bandgap was best regulated with a bandgap of 1.177 eV when the proportion of hBN was 66.67 %. At this time, the adsorption structures of HCN, CO, NH3, and Cl2 were established and energy band calculations were performed on the hBN and Graphene portions of the hBN-Graphene lateral heterojunctions, respectively, and it was found that the adsorption of Cl2 resulted in a significant change in the band gap, which showed a very high electrical sensitivity. To further investigate the adsorption mechanism of Cl2 on the surface of hBN-Graphene lateral heterojunction, the energy band structure, PDOS, charge transfer, adsorption energy, and recovery time of each stabilized adsorption site of Cl2 on the surface of hBN-Graphene lateral heterojunction were calculated. The results show that the adsorption of Cl2 on the surface of hBN-Graphene lateral heterojunction is a stable chemisorption, and the band gap of C-Top1 increases to 1.274 eV, and the band gaps of C-Top3, N-Top1, and N-Top2 decrease to 0.684 eV, 0.376 eV, and 0.398 eV, respectively, and the changes of band gaps are significant and easy to be electrically detection. The recovery time of Cl2 on the surface of hBN-Graphene lateral heterojunction was 7.36 s-2.59 s in visible light and in the temperature interval of 273 K-283 K. The recovery time of Cl2 on the surface of hBN-Graphene lateral heterojunction was 7.36 s-2.59 s in visible light and in the temperature interval of 273 K-283 K. These findings have implications for the research and application of graphene-based Cl2 gas sensors.
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Electrones , Grafito , Adsorción , ADN-Topoisomerasas de Tipo II , ElectricidadRESUMEN
BACKGROUND: In China, lung cancer remains the cancer with the highest incidence and mortality rate. Among early-stage lung adenocarcinomas (LUAD), the micropapillary (MPP) component is prevalent and typically exhibits high aggressiveness, significantly correlating with early metastasis, lymphatic infiltration, and reduced five-year survival rates. Therefore, the study is to explore the similarities and differences between MPP and non-micropapillary (non-MPP) components in malignant pulmonary nodules characterized by GGOs in early-stage LUAD, identify unique mutational features of the MPP component and analyze the relationship between the ZNF469 gene, a member of the zinc-finger protein family, and the prognosis of early-stage LUAD, as well as its correlation with immune infiltration. METHODS: A total of 31 malignant pulmonary nodules of LUAD were collected and dissected into paired MPP and non-MPP components using microdissection. Whole-exome sequencing (WES) was performed on the components of early-stage malignant pulmonary nodules. Mutational signatures analysis was conducted using R packages such as maftools, Nonnegative Matrix Factorization (NMF), and Sigminer to unveil the genomic mutational characteristics unique to MPP components in invasive LUAD compared to other tumor tissues. Furthermore, we explored the expression of the ZNF469 gene in LUAD using The Cancer Genome Atlas (TCGA) database to investigate its potential association with the prognosis. We also investigated gene interaction networks and signaling pathways related to ZNF469 in LUAD using the GeneMANIA database and conducted Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Lastly, we analyzed the correlation between ZNF469 gene expression and levels of immune cell infiltration in LUAD using the TIMER and TISIDB databases. RESULTS: MPP components exhibited a higher number of genomic variations, particularly the 13th COSMIC (Catalogue of Somatic Mutations in Cancer) mutational signature characterized by the activity of the cytidine deaminase APOBEC family, which was unique to MPP components compared to non-MPP components in tumor tissues. This suggests the potential involvement of APOBEC in the progression of MPP components in early-stage LUAD. Additionally, MPP samples with high similarity to APOBEC signature displayed a higher tumor mutational burden (TMB), indicating that these patients may be more likely to benefit from immunotherapy. The expression of ZNF469 was significantly upregulated in LUAD compared to normal tissue, and was associated with poor prognosis in LUAD patients (P<0.05). Gene interaction network analysis and GO/KEGG enrichment analysis revealed that COL6A1, COL1A1, COL1A2, TGFB2, MMP2, COL8A2 and C2CD4C interacted with ZNF469 and were mainly involved in encoding collagen proteins and participating in the constitution of extracellular matrix. ZNF469 expression was positively correlated with immune cell infiltration in LUAD (P<0.05). CONCLUSIONS: The study has unveiled distinctive mutational signatures in the MPP components of early-stage invasive LUAD in the Asian population. Furthermore, we have identified that the elevated expression of mutated ZNF469 impacts the prognosis and immune infiltration in LUAD, suggesting its potential as a diagnostic and prognostic biomarker in LUAD.
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Adenocarcinoma del Pulmón , Neoplasias Pulmonares , Humanos , Neoplasias Pulmonares/genética , Adenocarcinoma del Pulmón/genética , China , Pronóstico , Factores de TranscripciónRESUMEN
The electrocatalytic oxygen evolution reaction (OER) plays a crucial role in renewable clean energy conversion technologies and has developed into an important direction in the field of advanced energy, becoming the focus of basic research and industrial development. Herein, we report the synthesis and application of flower-like nickel-coated Fe3O4@SiO2 magnetic nanoparticles decorated on a graphene electrocatalyst for the OER that exhibit high efficiency and robust durability. The catalysts were optimized using a rotating ring-disk electrode to test their oxygen evolution properties in 1.0 M KOH solution. Importantly, owing to the high specific surface area and conductivity of C3N4 and graphene, the as-synthesized Fe3O4@SiO2@NiO/graphene/C3N4 exhibits a small Tafel slope of 40.46 mV dec-1, low overpotential of 288 mV at 10 mA cm-2, and robust OER durability within a prolonged test period of 100 h. The cytotoxicity of Fe3O4@SiO2, Fe3O4@SiO2@NiO, and Fe3O4@SiO2@NiO/graphene/C3N4 was evaluated in HeLa and MC3T3-E1 cells, demonstrating that they are efficient and biocompatible catalysts for the OER. Owing to its excellent electrocatalytic efficiency and eco-friendliness, Fe3O4@SiO2@NiO/graphene/C3N4 has considerable potential as a new multifunctional composite for large-scale applications in catalysis, biology, medicine, and high-efficiency hydrogen production.
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BACKGROUND: Inflammatory myofibroblastic tumor (IMT) is a distinctive tumor composed of spindle cells accompanied by mixed inflammatory cells, and immunohistochemical positivity for ALK (anaplastic lymphoma kinase protein) can be detected in half of IMTs. The diagnosis of ALK-negative IMT could be a challenge. Recently, the fusions of some kinase genes, such as RET, NTRK1, ROS1, etc., are revealed in ALK-negative IMT. CASE PRESENTATION: A 19-year-old woman presented with swelling of the left upper arm. Magnetic resonance imaging (MRI) scan revealed a tumor in the left postbrachium extended to the left axillary, serratus anterior muscle, and latissimus dorsi muscle. Histopathologically, the irregular-circumscribed tumor was composed of dense spindle-shaped cells with eosinophilic abundant cytoplasm and hyalinized mesenchyme in an inflammatory background. Immunohistochemically (IHC), tumor cells were positive for SMA, MDM2, and p16; the cells were negative for desmin, MyoD1, Myogenin, pan-cytokeratin, S100, SOX10, HMB45, Malen-A, CD34, CD31, CD99, and ALK. By RNA-based NGS, a novel fusion between TPD52L2 3' end of exon 1-4 and ROS1 5' end of exon 36-43 was revealed. ROS1 IHC staining was negative. The final diagnosis of IMT with TPD52L2-ROS1 fusion was made. Subsequently, the patient experienced a good clinical response to Crizotinib, and clinical follow-up showed stable disease after 9 months. CONCLUSION: This report expands the spectrum of ROS1 gene rearrangements in the IMT and highlights the importance of molecular analysis of IMT for getting a diagnostic clue and determining potential therapeutic strategies.
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Proteínas Tirosina Quinasas , Proteínas Proto-Oncogénicas , Femenino , Humanos , Adulto Joven , Anticuerpos Monoclonales , Exones , Fusión Génica , Proteínas Tirosina Quinasas/genética , Proteínas Proto-Oncogénicas/genéticaRESUMEN
Crosstalk is the primary source of noise in quantum computing equipment. The parallel execution of multiple instructions in quantum computation causes crosstalk, which causes coupling between signal lines and mutual inductance and capacitance between signal lines, destroying the quantum state and causing the program to fail to execute correctly. Overcoming crosstalk is a critical prerequisite for quantum error correction and large-scale fault-tolerant quantum computing. This paper provides an approach for suppressing crosstalk in quantum computers based on multiple instruction exchange rules and duration. Firstly, for the majority of the quantum gates that can be executed on quantum computing devices, a multiple instruction exchange rule is proposed. The multiple instruction exchange rule reorders quantum gates in quantum circuits and separates double quantum gates with high crosstalk on quantum circuits. Then, time stakes are inserted based on the duration of different quantum gates, and quantum gates with high crosstalk are carefully separated in the process of quantum circuit execution by quantum computing equipment to reduce the influence of crosstalk on circuit fidelity. Several benchmark experiments verify the proposed method's effectiveness. In comparison to previous techniques, the proposed method improves fidelity by 15.97% on average.
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Surface-enhanced Raman scattering (SERS) signals are fundamental for spectroscopy applications. However, existing substrates cannot perform a dynamically enhanced modulation of SERS signals. Herein, we developed a magnetically photonic chain-loading system (MPCLS) substrate by loading magnetically photonic nanochains of Fe3O4@SiO2 magnetic nanoparticles (MNPs) with Au nanoparticles (NPs). We achieved a dynamically enhanced modulation by applying an external stepwise magnetic field to the randomly dispersed magnetic photonic nanochains that gradually align in the analyte solution. The closely aligned nanochains create a higher number of hot spots by new neighboring Au NPs. Each chain represents a single SERS enhancement unit with both a surface plasmon resonance (SPR) effect and photonic property. The magnetic responsivity of MPCLS enables a rapid signal enhancement and tuning of the SERS enhancement factor.
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Background: Percutaneous nephrolithotripsy (PCNL) is the main method for urinary calculi. An anesthesia method with little effect on the blood circulation and which does not affect the postoperative activity of a patient is lacking. Objective: To compare the effects of paravertebral nerve block (PNB) and epidural block (EPB) on quadriceps femoris muscle (QFM) strength in patients after PCNL. Methods: 163 patients were separated into two groups: EPB (81) and PNB (82). Primary outcome parameters were QFM strength and range of motion (RoM) of the knee 1â h, 2â h, 3â h, and 24â h after anesthesia induction (AI). Secondary outcome parameters were: time from AI beginning to first ambulation; time of sensory-plane recovery; amount of additional analgesics given during and after surgery; prevalence of nausea and vomiting; duration of hospital stay (DoHS); mean arterial pressure (MAP), heart rate (HR), and oxygen saturation (SpO2) before, 0.5â h, and 1â h after AI; visual analog scale (VAS) score 0.5â h, 1â h, 2â h, 3â h and 24â h after AI. Results: There was no significant difference in QFM strength or knee RoM before or 24â h after AI between the two groups (P > 0.05). The time from AI to first ambulation was shorter (P < 0.05) and the sensory plane took longer to recover (P < 0.05) in the PNB group than in the EPB group. The amount of additional analgesics during surgery was more in the PNB group than in the EPB group (P < 0.05), but there was no significant difference after surgery (P > 0.05). VAS scores were higher in the PNB group than in the EPB group 0.5 after AI (P < 0.05). MAP 1â h after AI was higher in the PNB group than in the EPB group (P < 0.05). There was no significant difference in the prevalence of postoperative nausea and vomiting, DoHS, HR, or SpO2 at 0.5â h and 1â h after AI between the two groups (P > 0.05). Conclusions: For patients undergoing PCNL, PNB can meet the need for surgical analgesia while having little effect on QFM strength. Trial registration: http://www.chictr.org.cn/, identifier ChiCTR2200060606.
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Pulmonary vascular remodeling caused by the excessive proliferation of pulmonary arterial smooth muscle cells (PASMCs) is the hallmark feature of pulmonary arterial hypertension (PAH). Eukaryotic initiation factor 3 subunit A (EIF3A) exhibited proliferative activity in multiple cell types. The present study investigated the role of EIF3A in the progression of PAH. A monocrotaline (MCT)-induced PAH rat model was constructed, and adeno-associated virus type 1 (AAV1) carrying EIF3A shRNA was intratracheally delivered to PAH rats to block EIF3A expression. PASMCs were isolated from rats and treated with PDGF-BB to simulate PASMC proliferation, and shRNA for EIF3 was conducted to investigate the mechanism behind the role of EIF3A in PASMC function in vitro. EIF3A expression was upregulated in pulmonary arteries, and EIF3A inhibition effectively improved pulmonary hypertension and right ventricular hypertrophy and suppressed MCT-induced vascular remodeling in vivo. In addition, we found that genetic knockdown of EIF3A reduced PDGF-triggered proliferation and arrested cell cycle, accompanied by downregulated proliferation-related protein expression in PASMCs. Mechanistically, the histone deacetylase 1 (HDAC1)-mediated PTEN/PI3K/AKT pathway was recognized as a primary mechanism in PAH progression. Silencing EIF3A decreased HDAC1 expression, and further inhibited the excessive proliferation of PASMCs by increasing the phosphatase and tension homolog (PTEN) expression and suppressing the AKT phosphorylation. Notably, HDAC1 expression reversed the effect of silencing EIF3A on PAH and PTEN/PI3K/AKT pathway. Collectively, silencing EIF3A improved PAH by decreasing PASMC proliferation through the HDAC1-mediated PTEN/PI3K/AKT pathway. These findings suggest that targeting EIF3A may represent a potential approach for the treatment of PAH.