Efficacy and safety of radiofrequency ablation versus surgical sympathectomy in palmar hyperhidrosis.

Radiofrequency ablation (RFA) comparative efficacy of treatments using video-assisted thoracoscopic sympathectomy (VATS) in the long term remains uncertain in patients with palmar hyperhidrosis (PHH). This study aimed to compare the efficacy and safety of RFA and VATS in patients with PHH. We recruited patients aged ≥ 14 years with diagnosed PHH from 14 centres in China. The treatment options of RFA or VATS were assigned to two cohort in patients with PHH. The primary outcome was the efficacy at 1-year. A total of 807 patients were enrolled. After propensity score matching, the rate of complete remission was lower in RFA group than VATS group (95% CI 0.21-0.57; p < 0.001). However, the rates of palmar dryness (95% CI 0.38-0.92; p = 0.020), postoperative pain (95% CI 0.13-0.33; p < 0.001), and surgery-related complications (95% CI 0.19-0.85; p = 0.020) were lower in RFA group than in VATS group, but skin temperature rise was more common in RFA group (95% CI 1.84-3.58; p < 0.001). RFA had a lower success rate than VATS for the complete remission of PHH. However, the symptom burden and cost are lower in patients undergoing RFA compared to those undergoing VATS.Trial Registration: ChiCTR2000039576, URL: http://www.chictr.org.cn/index.aspx .

Case report: Paralysis after epidural analgesia due to a hemorrhage of pure epidural venous hemangioma.

Purpose: To report a case of sudden paralysis after epidural analgesia to raise awareness of the condition and the importance of early identification and appropriate treatment of extradural venous angiomas. Clinical features: A 28-year-old man with myofascial pain syndrome experienced paraplegia after receiving an epidural block for pain relief, which was later discovered to be caused by hemorrhage from extradural venous angiomas. Decompression surgery was performed immediately and successfully. A follow-up examination was performed 5 months after surgery. The patient reported improvement in urinary retention. The muscle strength in both his lower extremities had recovered to 4 out of 5 but still exhibited considerable residual spasticity. Conclusions: Before administering epidural analgesia to relieve undetermined pain, it is prudent to carefully weigh potential benefits against potential risks to patient health to minimize the likelihood of complications.

IP3R1 regulates Ca2+ transport and pyroptosis through the NLRP3/Caspase-1 pathway in myocardial ischemia/reperfusion injury.

Intracellular ion channel inositol 1,4,5-triphosphate receptor (IP3R1) releases Ca2+ from endoplasmic reticulum. The disturbance of IP3R1 is related to several neurodegenerative diseases. This study investigated the mechanism of IP3R1 in myocardial ischemia/reperfusion (MI/R). After MI/R modeling, IP3R1 expression was silenced in myocardium of MI/R rats to explore its role in the concentration of myocardial enzymes, infarct area, Ca2+ level, NLRP3/Caspase-1, and pyroptosis markers and inflammatory factors. The adult rat cardiomyocytes were isolated and cultured to establish hypoxia/reperfusion (H/R) cell model. The expression of IP3R1 was downregulated or ERP44 was overexpressed in H/R-induced cells. Nifedipine D6 was added to H/R-induced cells to block Ca2+ channel or Nigericin was added to activate NLRP3. IP3R1 was highly expressed in myocardium of MI/R rats, and silencing IP3R1 alleviated MI/R injury, reduced Ca2+ overload, inflammation and pyroptosis in MI/R rats, and H/R-induced cells. The binding of ERP44 to IP3R1 inhibited Ca2+ overload, alleviated cardiomyocyte inflammation, and pyroptosis. The increase of intracellular Ca2+ level caused H/R-induced cardiomyocyte pyroptosis through the NLRP3/Caspase-1 pathway. Activation of NLRP3 pathway reversed the protection of IP3R1 inhibition/ERP44 overexpression/Nifedipine D6 on H/R-induced cells. Overall, ERP44 binding to IP3R1 inhibits Ca2+ overload, thus alleviating pyroptosis and MI/R injury.

[Preparation and Characterization of Chitosan-Poloxamer-based Antibacterial Hydrogel Containing Silver Nanoparticles].

In order to solve the problem of high cytotoxicity in vitro of nano-silver antibacterial gel,and the problem of large nano-silver particle size and size distribution,this study prepared nano-silver antibacterial gel with better biocompatibility and good antibacterial effect by using physical cross-linking method and using poloxamer as dispersant when prepared nano-silver.In this study,nano-silver was prepared by photo-initiator method and by adding poloxamer as a dispersant,and then UV-visible absorption spectrum test and scanning electron microscopy(SEM)test were carried out using prepared nano-silver mixture and particles after drying respectively.The gel was prepared through adjusting its pH value by using sodium bicarbonate,and then pH value test,SEM test for cross-section of gel,swelling ratio test,viscosity test,inhibition zone test and in vitro cytotoxicity test were carried out.The test results showed that the maximum absorption wavelength of prepared nano-silver,using poloxamer as dispersant and ultra-pure water as solvent,was 414 nm,and the average nano-silver size was about 60 nm.The prepared nano-silver using poloxamer as dispersant had smaller particle diameter and narrower particle size distribution than those using PVP as dispersant.Similarly,the prepared nano-silver using ultra-pure water as solvent also had smaller particle diameter and narrower particle size distribution than those using distilled water as solvent.The pH value of the prepared gel was between 5.8~6.1.The dried gel section had many holes.The water absorption of gel was fine and the viscosity of gel was fit to coat on the gauze.In addition,the prepared gel with nano-silver had greater ability to inhibit Escherichia coli and Staphyloccocus aureus at the concentrations of 24,18 and 12µg/mL.And the biocompatibility of the prepared gel with nano-silver was good when the concentration below 24µg/mL.Based on the above features,the nano-silver antibacterial gel could be used in the treatment of burn or other wounds.

Primary Pulmonary Paraganglioma: A Case Report and Review of Literature.

Primary pulmonary paraganglioma is a rare disease. We report a case of a 37-year old female patient with space-occupying lesions in the right lower pulmonary lobe during a routine examination without any symptoms. The patient underwent video-assisted thoracoscopic surgery (VATS) resection of the right middle lobe and dissection of hilar and mediastinal lymph nodes under general anesthesia. She recovered without recrudescence. Preoperative diagnosis is difficult. Accurate diagnosis requires pathological examination, and immunohistochemical test is particularly important. Complete resection is the first treatment option for solitary primary pulmonary paraganglioma; however, VATS is a better technique. Given the high local control rates and few complications of radiotherapy, it is considered as a standard treatment.

Compressed sampling strategies for tomography.

We investigate new sampling strategies for projection tomography, enabling one to employ fewer measurements than expected from classical sampling theory without significant loss of information. Inspired by compressed sensing, our approach is based on the understanding that many real objects are compressible in some known representation, implying that the number of degrees of freedom defining an object is often much smaller than the number of pixels/voxels. We propose a new approach based on quasi-random detector subsampling, whereas previous approaches only addressed subsampling with respect to source location (view angle). The performance of different sampling strategies is considered using object-independent figures of merit, and also based on reconstructions for specific objects, with synthetic and real data. The proposed approach can be implemented using a structured illumination of the interrogated object or the detector array by placing a coded aperture/mask at the source or detector side, respectively. Advantages of the proposed approach include (i) for structured illumination of the detector array, it leads to fewer detector pixels and allows one to integrate detectors for scattered radiation in the unused space; (ii) for structured illumination of the object, it leads to a reduced radiation dose for patients in medical scans; (iii) in the latter case, the blocking of rays reduces scattered radiation while keeping the same energy in the transmitted rays, resulting in a higher signal-to-noise ratio than that achieved by lowering exposure times or the energy of the source; (iv) compared to view-angle subsampling, it allows one to use fewer measurements for the same image quality, or leads to better image quality for the same number of measurements. The proposed approach can also be combined with view-angle subsampling.