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BACKGROUND/PURPOSE(S): The gut microbiota and its metabolites play crucial roles in pathogenesis of arthritis, highlighting gut microbiota as a promising avenue for modulating autoimmunity. However, the characterization of the gut virome in arthritis patients, including osteoarthritis (OA) and gouty arthritis (GA), requires further investigation. METHODS: We employed virus-like particle (VLP)-based metagenomic sequencing to analyze gut viral community in 20 OA patients, 26 GA patients, and 31 healthy controls, encompassing a total of 77 fecal samples. RESULTS: Our analysis generated 6819 vOTUs, with a considerable proportion of viral genomes differing from existing catalogs. The gut virome in OA and GA patients differed significantly from healthy controls, showing variations in diversity and viral family abundances. We identified 157 OA-associated and 94 GA-associated vOTUs, achieving high accuracy in patient-control discrimination with random forest models. OA-associated viruses were predicted to infect pro-inflammatory bacteria or bacteria associated with immunoglobulin A production, while GA-associated viruses were linked to Bacteroidaceae or Lachnospiraceae phages. Furthermore, several viral functional orthologs displayed significant differences in frequency between OA-enriched and GA-enriched vOTUs, suggesting potential functional roles of these viruses. Additionally, we trained classification models based on gut viral signatures to effectively discriminate OA or GA patients from healthy controls, yielding AUC values up to 0.97, indicating the clinical utility of the gut virome in diagnosing OA or GA. CONCLUSION: Our study highlights distinctive alterations in viral diversity and taxonomy within gut virome of OA and GA patients, offering insights into arthritis etiology and potential treatment and prevention strategies.
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Artrite Gotosa , Microbioma Gastrointestinal , Osteoartrite , Viroma , Humanos , Artrite Gotosa/virologia , Artrite Gotosa/microbiologia , Masculino , Osteoartrite/virologia , Osteoartrite/microbiologia , Feminino , Pessoa de Meia-Idade , Estudos de Casos e Controles , Idoso , Metagenômica , Fezes/virologia , Fezes/microbiologiaRESUMO
OBJECTIVES: Few studies on ischemic complications and flow changes after a flow diverter covering the anterior cerebral artery. The purpose of the study was to explore the ischemic complications and anatomical alterations associated with the flow diverter after it covers the anterior cerebral artery. MATERIALS AND METHODS: In this single-center study, patients treated with FD covering the anterior cerebral artery at the First Affiliated Hospital of Zhengzhou University were retrospectively collected. The primary endpoint was ischemic complications related to the anterior cerebral artery. Secondary endpoints were anatomical changes in the anterior cerebral artery postoperatively and at follow-up. RESULTS: A total of 59 patients were included in this study. Four (6.8%) patients presented with ischemic stroke symptoms. Immediately after the procedure, complete occlusion of A1 and decreased blood flow was observed in 13 (22.0%) and 21 patients (35.6%), respectively. At follow-up, A1 artery was occluded in 34 patients (57.6%) and decreased blood flow was observed in 10 patients (16.9%). Symptoms of neurological deficits related to the anterior cerebral artery were not observed in all patients at follow-up. CONCLUSION: Coverage of A1 is safe, with a low incidence of ischemic stroke, when using an FD to treat aneurysms. Risk of reduced perfusion of the anterior cerebral artery postoperatively even if the anterior communicating artery is open. In cases with A1 occlusion, the blood flow in the distal the anterior cerebral artery can be adequately compensated by opening the anterior communicating artery and good vascular anastomoses.
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Artéria Cerebral Anterior , Humanos , Masculino , Feminino , Artéria Cerebral Anterior/cirurgia , Artéria Cerebral Anterior/diagnóstico por imagem , Pessoa de Meia-Idade , Estudos Retrospectivos , Idoso , Adulto , Aneurisma Intracraniano/cirurgia , Resultado do Tratamento , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Seguimentos , Circulação Cerebrovascular/fisiologiaRESUMO
Hydroxychloroquine (HCQ) is used as a traditional disease-modifying antirheumatic drugs (DMARDs), for the treatment of autoimmune diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). However, it can cause serious adverse reactions, including hyperpigmentation of the skin and bull's-eye macular lesions. Here, we present a case of HCQ-induced hyperpigmentation of the skin and bull's-eye macular lesions in a patient who received HCQ for RA. A 65-year-old female patient developed blurred vision and hyperpigmentation of multiple areas of skin over the body for one month after 3 years of HCQ treatment for RA. Based on clinical presentation, ophthalmological examination and dermatopathological biopsy, a diagnosis of drug-induced cutaneous hyperpigmentation and bullous maculopathy of the right eye was made. After discontinuation of HCQ and treatment with iguratimod tablets, the hyperpigmentation of the patient 's skin was gradually reduced, and the symptoms of blurred vision were not significantly improved. We also reviewed the available literature on HCQ-induced cutaneous hyperpigmentation and bull's-eye macular lesions and described the clinical features of HCQ-induced cutaneous hyperpigmentation and bull's-eye macular lesions. In conclusion, clinicians should be aware of early cutaneous symptoms and HCQ-associated ophthalmotoxicity in patients with rheumatic diseases on HCQ sulphate and should actively monitor patients, have them undergo regular ophthalmological examinations and give appropriate treatment to prevent exacerbation of symptoms.
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Antirreumáticos , Artrite Reumatoide , Hidroxicloroquina , Hiperpigmentação , Humanos , Hidroxicloroquina/efeitos adversos , Hidroxicloroquina/uso terapêutico , Idoso , Feminino , Antirreumáticos/efeitos adversos , Antirreumáticos/uso terapêutico , Hiperpigmentação/induzido quimicamente , Hiperpigmentação/diagnóstico , Artrite Reumatoide/tratamento farmacológico , Pele/patologia , Pele/efeitos dos fármacosRESUMO
The synergistic effects on the 0.18 µm PPD CISs induced by neutron displacement damage and gamma ionization damage are investigated. The typical characterizations of the CISs induced by the neutron displacement damage and gamma ionization damage are presented separately. The CISs are irradiated by reactor neutron beams up to 1 × 1011 n/cm2 (1 MeV neutron equivalent fluence) and 60Co γ-rays up to the total ionizing dose level of 200 krad(Si) with different sequential order. The experimental results show that the mean dark signal increase in the CISs induced by reactor neutron radiation has not been influenced by previous 60Co γ-ray radiation. However, the mean dark signal increase in the CISs induced by 60Co γ-ray radiation has been remarkably influenced by previous reactor neutron radiation. The synergistic effects on the PPD CISs are discussed by combining the experimental results and the TCAD simulation results of radiation damage.
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OBJECTIVES: To evaluate the efficacy and safety of adalimumab (ADA) combined with Tripterygium wilfordii Hook F (TwHF) in the treatment of methotrexate (MTX)-inadequate response patients with rheumatoid arthritis (RA). METHODS: In this multicenter, open-label, randomized controlled clinical trial, 64 RA patients with inadequate response to MTX were 1:1 randomly assigned into treatment or control groups. The treatment group was treated with ADA in combination with TwHF, and the control group was treated with ADA in combination with MTX for 24 weeks. The primary endpoint was the percentage of patients having low disease activity (2.6 ≤ DAS28-ESR < 3.2) and remission rates (DAS28-ESR < 2.6) at week 24. RESULTS: In total, 53 of the 64 patients (82.8%) completed this 24-week clinical trial. By intent-to-treat (ITT) analysis, a comparable outcome was observed between the two groups. The percentage of patients achieving low disease activity in the treatment group and control group were 43.8% and 46.9% (95% CI, 21.28 to 27.48, p = .802). Percentage of patients achieving low disease activity rates were respectively 28.1% and 31.3% in the treatment group and control group (95% CI, 19.18 to 25.58, p = .784). In per-protocol (PP) analysis, the results were consistent with the ITT model. The incidence of adverse events was comparable between the two groups. CONCLUSIONS: There were no significant differences in efficacy and safety between ADA combined with TwHF versus ADA combined with MTX in the treatment of RA. TwHF might be an alternative treatment for RA patients who are intolerant to MTX.
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Antirreumáticos , Artrite Reumatoide , Humanos , Adalimumab/efeitos adversos , Antirreumáticos/efeitos adversos , Tripterygium , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/induzido quimicamente , Metotrexato/efeitos adversos , Quimioterapia Combinada , Resultado do TratamentoRESUMO
RATIONALE: Acute generalized exanthematous pustulosis (AGEP) is a serious adverse skin reaction characterized by the rapid appearance of densely distributed, small, sterile pustules with erythema. However, its pathogenesis is not fully understood. Hydroxychloroquine is widely used for the treatment of autoimmune diseases. Some patients presenting with AGEP have IL36RN and CARD14 gene mutations. Our report describes a patient with rheumatoid arthritis and AGEP associated with hydroxychloroquine and a newly discovered CARD14 gene mutation. PATIENT CONCERNS: A 28-year-old woman with rheumatoid arthritis, treated with leflunomide therapy without marked relief of joint pain, developed multiple rashes with pruritis covering the body 5 days after switching to hydroxychloroquine treatment. DIAGNOSES: Based on the patient's history, symptoms, and histopathological findings, AGEP was diagnosed. INTERVENTIONS: Whole-exome sequencing and Sanger validation revealed no mutations in the IL36RN gene; however, a CARD14 gene mutation was present. The patient was treated using ketotifen fumarate tablets, dexamethasone sodium phosphate, calcium gluconate injection, methylprednisolone injection, vitamins C and B12, hydrocortisone butyrate cream, Reed acne cream, potassium chloride tablets, and pantoprazole enteric-coated capsules. OUTCOMES: The rash improved after 15 days. LESSONS SUBSECTIONS: There has been little basic research on AGEP-related genetics, and the CARD14 mutation may underlie several pustular rashes, including AGEP and generalized pustular psoriasis. Follow-up studies and further accumulation of patient data are required.
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Pustulose Exantematosa Aguda Generalizada , Artrite Reumatoide , Exantema , Feminino , Humanos , Adulto , Hidroxicloroquina/efeitos adversos , Pustulose Exantematosa Aguda Generalizada/etiologia , Pele/patologia , Artrite Reumatoide/complicações , Exantema/induzido quimicamente , Mutação , Guanilato Ciclase/genética , Proteínas de Membrana/genética , Proteínas Adaptadoras de Sinalização CARD/genética , Interleucinas/genéticaRESUMO
This study aimed to evaluate the cost-effectiveness of Chaiyin Granules compared with Oseltamivir Phosphate Capsules in the treatment of influenza(exogenous wind-heat syndrome). Based on a randomized, double-blind, positive drug parallel control clinical trial, this study evaluated the pharmacoeconomics of Chaiyin Granules with cost-effectiveness analysis method. A total of 116 patients with influenza from eight hospitals(grade â ¡ level A above) in 6 cities were selected in this study, including 78 cases in the experimental group with Chaiyin Granules and Oseltamivir Phosphate Capsules placebo, and 38 cases in the control group with Oseltamivir Phosphate Capsules and Chaiyin Granules placebo. The total cost of this study included direct medical cost, direct non-medical cost, and indirect cost. The remission time of clinical symptoms, cure time/cure rate, antipyretic onset time/complete antipyretic time, viral nucleic acid negative rate, and traditional Chinese medicine(TCM) syndrome curative effect were selected as the effect indicators for cost-effectiveness analysis. Four-quadrant diagram was used to estimate the incremental cost-effectiveness ratio. The results showed that Chaiyin Granules were not inferior to Oseltamivir Phosphate Capsules in the remission time of clinical symptoms of influenza(3.1 d vs 2.9 d, P=0.360, non-inferiority margin was 0.5 d). Compared with Oseltamivir Phosphate Capsules, Chaiyin Granules would delay the remission time of clinic symptoms of influenza for 1 d, but could save 213.9 yuan. 1 d delay in cure time could save 149.3 yuan; 1% reduction in the cure rate could save 8.2 yuan; 1 d delay in antipyretic onset time could save 295.4 yuan; 1 d delay in complete antipyretic time could save 114.3 yuan; 1% reduction in the 5-day cure rate of TCM syndrome could save 19.2 yuan. Different from other indicators, there was no statistically significant difference between two groups in the effect of negative conversion rate of viral nucleic acid, but the cost was lower and the effect was superior, and the pharmacoeconomics was not different from that of Oseltamivir Phosphate Capsules in the field of influenza treatment.
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Antipiréticos , Influenza Humana , Ácidos Nucleicos , Humanos , Antipiréticos/uso terapêutico , Antivirais/uso terapêutico , Análise de Custo-Efetividade , Influenza Humana/tratamento farmacológico , Ácidos Nucleicos/uso terapêutico , Oseltamivir/uso terapêutico , Fosfatos/uso terapêutico , Resultado do Tratamento , Método Duplo-CegoRESUMO
A novel wastewater treatment plant process was constructed to overcome the challenge of simultaneous nitrate removal and phosphorus (P) recovery. The results revealed that the P and nitrate removal efficiency rose from 39.0 % and 48.4 % to 92.8 % and 93.6 % after 136 days of operation, and the total P content in the biofilm (TPbiofilm) rose from 15.8 mg/g SS to 57.8 mg/g SS. Moreover, the increase of TPbiofilm changed the metabolic mode of denitrifying polyphosphate accumulating organisms (DPAOs), increasing the P concentration of the enriched stream to 172.5 mg/L. Furthermore, the acid/alkaline fermentation led to the rupture of the cell membrane, which released poly-phosphate and ortho-phosphate of cell/EPS in DPAOs and released metalphosphorus (CaP and MgP). In addition, high-throughput sequencing analysis demonstrated that the relative abundance of DPAOs involved in P storage increased, wherein the abundance of Acinetobacter and Saprospiraceae rose from 8.0 % and 4.1 % to 16.1 % and 14.0 %. What's more, the highest P recovery efficiency (98.3 ± 1.1 %) could be obtained at optimal conditions for struvite precipitation (pH = 7.56 and P: N: Mg = 1.87:3.66:1) through the response surface method (RSM) simulation, and the precipitates test analysis indicated that P recovery from biofilm sludge was potentially operable. This research was of great essentiality for exploring the recovery of P from biofilm sludge.
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Fósforo , Esgotos , Fósforo/metabolismo , Nitratos/metabolismo , Desnitrificação , Anaerobiose , Reatores Biológicos , Polifosfatos , Biofilmes , Eliminação de Resíduos Líquidos/métodos , NitrogênioRESUMO
A novel process was proposed for simultaneous denitrification and phosphorus (P) recovery. The increased nitrate concentration facilitated the activity of denitrifying P removal (DPR) in P enrichment, which stimulated P uptake and storage, making P more readily accessible for release into the recirculated stream. The total P content in the biofilm (TPbiofilm) rose to 54.6 ± 3.5 mg/g SS as the nitrate concentration increased from 15.0 to 25.0 mg/L, while the P concentration of the enriched stream reached 172.5 ± 3.5 mg/L. Moreover, the abundance of denitrifying polyphosphate accumulating organisms (DPAOs) increased from 5.6% to 28.0%, and the increased nitrate concentration facilitated the process of carbon, nitrogen, and P metabolism due to the rise in the genes involved in critical functions of metabolism. Acid/alkaline fermentation analysis indicated that the EPS release was the primary P-release pathway. Additionally, pure struvite crystals were obtained from the enriched stream and fermentation supernatant.
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Esgotos , Águas Residuárias , Fósforo/metabolismo , Nitratos , Desnitrificação , Reatores Biológicos , Compostos Orgânicos , Nitrogênio , Eliminação de Resíduos LíquidosRESUMO
The development of drug-resistance in the opportunistic pathogen Escherichia coli has become a global public health concern. Due to the share of similar flora between pets and their owners, the detection of pet-origin antibiotic-resistant E. coli is necessary. This study aimed to detect the prevalence of feline-origin ESBL E. coli in China and to explore the resistance elimination effect of garlic oil to cefquinome on ESBL E. coli. Cat fecal samples were collected from animal hospitals. The E. coli isolates were separated and purified by indicator media and polymerase chain reaction (PCR). ESBL genes were detected by PCR and Sanger sequencing. The MICs were determined. The synergistic effect of garlic oil and cefquinome against ESBL E. coli was investigated by checkerboard assays, time-kill and growth curves, drug-resistance curves, PI and NPN staining, and a scanning electronic microscope. A total of 80 E. coli strains were isolated from 101 fecal samples. The rate of ESBL E. coli was 52.5% (42/80). The prevailing ESBL genotypes in China were CTX-M-1, CTX-M-14, and TEM-116. In ESBL E. coli, garlic oil increased the susceptibility to cefquinome with FICIs from 0.2 to 0.7 and enhanced the killing effect of cefquinome with membrane destruction. Resistance to cefquinome decreased with treatment of garlic oil after 15 generations. Our study indicates that ESBL E. coli has been detected in cats kept as pets. The sensitivity of ESBL E. coli to cefquinome was enhanced by garlic oil, indicating that garlic oil may be a potential antibiotic enhancer.
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Infecções por Escherichia coli , Escherichia coli , Gatos , Animais , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/veterinária , Infecções por Escherichia coli/epidemiologia , Farmacorresistência Bacteriana/genética , Antibacterianos/farmacologia , beta-Lactamases/genéticaRESUMO
The heavy metal zinc (Zn) is known to be transmitted in the food chain; however, the effect of Zn stress on beans and herbivorous insects is largely unclear. This study aimed to investigate the resistance of broad bean plants to Zn stress and the consequent changes in their physiological and biochemical metabolism by simulating heavy metal pollution in soil. Simultaneously, the effects of aphid progeny treated with different Zn concentrations on the expression of carbohydrate and related genes were analyzed. The results showed that Zn had no effect on the germination rate of broad beans, but other effects mainly manifested as follows. (1) Chlorophyll content decreased. (2) The total soluble sugar and Zn content in stems and leaves increased with increasing Zn content. (3) The proline content first increased and then decreased with increasing Zn content. (4) The height of the seedlings indicates that low concentrations promote growth and high concentrations inhibit growth. In addition, only the first-generation fecundity decreased significantly when aphids fed on heavy metal broad beans. Continuous high Zn levels increase the trehalose content of aphid F1 and F2, while F3 decreases. These results can not only provide a theoretical basis for exploring the impact of soil heavy metal pollution on ecosystems but also preliminarily evaluate the possibility of broad beans as a means of pollution remediation.
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Afídeos , Metais Pesados , Poluentes do Solo , Vicia faba , Animais , Zinco/metabolismo , Afídeos/fisiologia , Ecossistema , Metais Pesados/toxicidade , Reprodução , Solo/química , Poluentes do Solo/toxicidadeRESUMO
Introduction: Acute generalized exanthematous pustulosis (AGEP) is a rare condition characterized by superficial pustules following drug ingestion or infection. Currently, there is no clear link between rheumatism and AGEP. It has been described that hydroxychloroquine (HCQ) is a rare cause of acute generalized epidermal necrolysis (AGEP). Presently, there are limited studies on HCQ-induced AGEP. We aimed to explore the clinical features and associated gene expression of AGEP induced after HCQ treatment exposure in rheumatology patients. Methods: We assessed patients with HCQ-induced AGEP diagnosed at the Second Affiliated Hospital of Guizhou University of Chinese Medicine between January 1, 2017, and May 1, 2022. We also reviewed similar cases reported in specific databases. Results: The study included five females (mean age, 40.2 years), and the mean time from initiation of HCQ treatment to symptom onset was 12.2 d. All patients received steroids and allergy medications after HCQ discontinuation, and the rash completely resolved within an average of 25.2 d. We performed whole exome sequencing and Sanger validation in our patient sample. CARD14 gene mutations were detected in three patients. Additionally, seven mutation sites were detected. Discussion: HCQ-induced AGEP may have a longer latency period and regression time than AGEP induced by other drugs. Our patients all experienced CARD14 gene mutations. AGEP often resolves with topical therapy and drug discontinuation, although some cases require systemic steroid therapy. In the future, patients with rheumatism should pay attention to the effectiveness of HCQ during treatment and be aware of the associated skin toxicity.
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Background: The development of antimicrobial resistance in the opportunistic pathogen Escherichia coli has become a global public health concern. Due to daily close contact, dogs kept as pets share the same E. coli with their owners. Therefore, the detection of antimicrobial resistance in canine E. coli is important, as the results could provide guidance for the future use of antibiotics. This study aimed to detect the prevalence of antibiotic-resistance of canine origin E. coli in Shaanxi province and to explore the inhibition effect of magnolol combined with cefquinome on MDR E. coli, so as to provide evidence for the use of antibiotics. Methods: Canine fecal samples were collected from animal hospitals. The E. coli isolates were separated and purified using various indicator media and polymerase chain reaction (PCR). Drug-resistance genes [aacC2, ant(3')-I, aph(3')-II, aac(6')-Ib-cr, aac(3')-IIe, bla KPC , bla IMP-4 , bla OXA , bla CMY , bla TEM-1 , bla SHV , bla CTX-M-1 , bla CTX-M-9 , Qnra, Qnrb, Qnrs, TetA, TetB, TetM, Ermb] were also detected by PCR. The minimum inhibitory concentration (MIC) was determined for 10 antibiotics using the broth-microdilution method. Synergistic activity of magnolol and cefquinome against multidrug-resistant (MDR) E. coli strains was investigated using checkerboard assays, time-kill curves, and drug-resistance curves. Results: A total of 101 E. coli strains were isolated from 158 fecal samples collected from animal hospitals. MIC determinations showed that 75.25% (76/101) of the E. coli strains were MDR. A total of 22 drug-resistance genes were detected among the 101 strains. The bla TEM-1gene exhibited the highest detection rate (89.77%). The TetA and Sul gene also exhibited high detection rate (66.34 and 53.47%, respectively). Carbapenem-resistant E. coli strains were found in Shangluo and Yan'an. Additionally, in MDR E. coli initially resistant to cefquinome, magnolol increased the susceptibility to cefquinome, with an FICI (Fractional Inhibitory Concentration Index) between 0.125 and 0.5, indicating stable synergy. Furthermore, magnolol enhanced the killing effect of cefquinome against MDR E. coli. Resistance of MDR E. coli to cefquinome decreased markedly after treatment with magnolol for 15 generations. Conclusion: Our study indicates that antibiotic-resistance E. coli has been found in domestic dogs. After treatment with magnolol extracted from the Chinese herb Houpo (Magnolia officinalis), the sensitivity of MDR E. coli to cefquinome was enhanced, indicating that magnolol reverses the resistance of MDR E. coli. The results of this study thus provide reference for the control of E. coli resistance.
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Wildfires are a global crisis, but current fire models fail to capture vegetation response to changing climate. With drought and elevated temperature increasing the importance of vegetation dynamics to fire behavior, and the advent of next generation models capable of capturing increasingly complex physical processes, we provide a renewed focus on representation of woody vegetation in fire models. Currently, the most advanced representations of fire behavior and biophysical fire effects are found in distinct classes of fine-scale models and do not capture variation in live fuel (i.e. living plant) properties. We demonstrate that plant water and carbon dynamics, which influence combustion and heat transfer into the plant and often dictate plant survival, provide the mechanistic linkage between fire behavior and effects. Our conceptual framework linking remotely sensed estimates of plant water and carbon to fine-scale models of fire behavior and effects could be a critical first step toward improving the fidelity of the coarse scale models that are now relied upon for global fire forecasting. This process-based approach will be essential to capturing the influence of physiological responses to drought and warming on live fuel conditions, strengthening the science needed to guide fire managers in an uncertain future.
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Incêndios , Incêndios Florestais , Plantas , Fenômenos Fisiológicos Vegetais , Água , Carbono , EcossistemaRESUMO
Upper airway collapsibility after anaesthesia induction may be associated with unpredictable difficult airway. However, most works on airway anatomy are tended to morphological description before anaesthesia. This study aimed to evaluate the changes of upper airway after anaesthesia induction and using pre-anesthetic ultrasound measurements to predict Difficult Laryngoscopy (DL). We included 104 eligible subjects with complete data, who were performed tracheal intubations under general anaesthesia in the study. The upper airway changes before and after anaesthesia induction were determined by seven neck ultrasound measurements, included as follow: (1) Distance from skin to under surface of Tongue (DT), (2) Thickness of the thickest part of Tongue body (TT), (3) Hyoid Mental Distance (HMD), (4) Depth of Hyoid (DH), (5) Width of Hyoid (WH), (6) Distance from Skin to Epiglottis (DSE), (7) Depth of the anterior combination of the Vocal Cords (DVC). DL was evaluated with Cormack-Lehane (CL). Data regarding HMD [from 45.3 (42.4-48.5) to 41.1 (38.5-44.9) mm], DH [from 8.7 (6.6-10.9) to 7.0 (5.3-9.1) mm], DSE [from 20.1 (16.6-22.5) to 19.5 (16.5-21.6) mm] and the DVC [from 7.1 (5.7-8.3) to 6.8 (5.7-7.9) mm] were decreased (P < 0.05), while the DT [from 15.9 (13.1-18.4) to 17.4 (14.5-19.8) mm] was increased (P > 0.05) after anaesthesia induction. Additionally, when cut-off value of DSE was 21.25 mm before anaesthesia, it may be better predicted to DL [sensitivity 80.0% (95% CI: 60.7-91.6%) and specificity 83.8% (95% CI: 73.0-91.0%)]. The upper airway after induction showed the propensity of collapsibility by ultrasound measurements. Compared with other indicators, the DSE assessed by ultrasound might be considered to a valuable predictor of DL.Trial registration: The study was registered in ClinicalTrials.gov on 23th Jan 2019, ChiCTR1900021123.
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Laringoscopia , Laringe , Humanos , Intubação Intratraqueal , Laringe/diagnóstico por imagem , Anestesia Geral , EpigloteRESUMO
BACKGROUND: The optimal analgesia for video-assisted thoracoscopic surgery (VATS) is still unknown. OBJECTIVES: Our aim was to conduct a network meta-analysis and systematic review to compare the efficacy of different analgesic strategies in VATS. STUDY DESIGN: Bayesian network meta-analysis. METHODS: We searched PubMed, Embase, Medline, Springer, Google Scholar, and Web of Science to evaluate all relevant randomized controlled trials that investigated the analgesic effects of different regional analgesia methods for VATS published through July 2021. After a comprehensive search of electronic databases, the following methods were identified: epidural analgesia (EA), local anesthetics (LA), superficial serratus anterior plane block (SSAPB), deep serratus anterior plane block (DSAPB), erector spinae plane block (ESPB), paravertebral block (PVB), and intercostal nerve block (ICNB). Primary outcomes were the visual analog scale score at rest, at 2 hours, 6 hours and 24 hours postoperatively. The secondary outcomes were postoperative analgesic consumption, incidence of nausea and emesis, and pruritus. RESULT: Overall, 35 trials met our inclusion criteria. EA and PVB were relatively more advantageous in terms of analgesic effect at 2 hours and 6 hours postoperatively; the EA group was superior to the DSAPB, ESPB, and ICNB groups at 24 hours postoperatively. EA was found to be superior to other analgesia techniques for 24 hour postoperative analgesic consumption., PVB showed advantages in reducing postoperative nausea, emesis, and pruritus. LIMITATIONS: Different concentrations and volumes of local anesthetics might affect the analgesic effects of the various analgesia techniques. CONCLUSION: EA and PVB have certain advantages in analgesia, but the incidence of postoperative pruritus after EA is higher. At the same time, considering the risk of coagulation and puncture complications, PVB may be a better choice.
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Analgesia Epidural , Cirurgia Torácica Vídeoassistida , Humanos , Cirurgia Torácica Vídeoassistida/métodos , Dor Pós-Operatória/tratamento farmacológico , Anestésicos Locais , Metanálise em Rede , Teorema de Bayes , Náusea e Vômito Pós-Operatórios , Analgésicos , PruridoRESUMO
BACKGROUND: Carotenoid cleavage oxygenases (CCOs) include the carotenoid cleavage dioxygenase (CCD) and 9-cis-epoxycarotenoid (NCED), which can catalize carotenoid to form various apocarotenoids and their derivatives, has been found that play important role in the plant world. But little information of CCO gene family has been reported in litchi (Litchi chinensis Sonn.) till date. RESULTS: In this study, a total of 15 LcCCO genes in litchi were identified based on genome wide lever. Phylogeny analysis showed that LcCCO genes could be classified into six subfamilies (CCD1, CCD4, CCD7, CCD8, CCD-like, and NCED), which gene structure, domain and motifs exhibited similar distribution patterns in the same subfamilies. MiRNA target site prediction found that there were 32 miRNA target sites in 13 (86.7%) LcCCO genes. Cis-elements analysis showed that the largest groups of elements were light response related, following was plant hormones, stress and plant development related. Expression pattern analysis revealed that LcCCD4, LcNCED1, and LcNCED2 might be involving with peel coloration, LcCCDlike-b might be an important factor deciding fruit flavor, LcNCED2 and LcNCED3 might be related to flower control, LcNCED1 and LcNCED2 might function in fruitlet abscission, LcCCD4a1, LcCCD4a2, LcCCD1, LcCCD4, LcNCED1, and LcNCED2 might participate in postharvest storage of litchi. CONCLUSION: Herein, Genome-wide analysis of the LcCCO genes was conducted in litchi to investigate their structure features and potential functions. These valuable and expectable information of LcCCO genes supplying in this study will offer further more possibility to promote quality improvement and breeding of litchi and further function investigation of this gene family in plant.
Assuntos
Dioxigenases , Litchi , MicroRNAs , Carotenoides/metabolismo , Dioxigenases/genética , Frutas/genética , Frutas/metabolismo , Litchi/genética , Litchi/metabolismo , MicroRNAs/genética , Oxigenases/genética , Melhoramento Vegetal , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Plantas/genéticaRESUMO
ABSTRACT: It is recommended to use visual laryngoscope for tracheal intubation in a Corona Virus Disease 2019 patient to keep the operator farther from the patient. How the position of the operator affects the distance in this setting is not ascertained. This manikin study compares the distances between the operator and the model and the intubation conditions when the operator is in sitting position and standing position, respectively.Thirty one anesthesiologists with minimum 3-years' work experiences participated in the study. The participant's posture was photographed when he performed tracheal intubation using UE visual laryngoscope in standing and sitting position, respectively. The shortest distance between the model's upper central incisor and operator's face screen (UF), the horizontal distance between the model's upper central incisor and the operator's face screen, the angle between the UF line and the vertical line of the model's upper central incisor were measured. The success rate of intubation, the duration of intubation procedure, the first-attempt success rate, the Cormack-Lehane grade, and operator comfort score were also recorded.When the operator performed the procedure in sitting position, the horizontal distance between the model's upper central incisor and the operator's face screen distance was significantly longer (9.5 [0.0-17.2] vs 24.3 [10.3-33.0], Pâ≤â.001) and the angle between the UF line and the vertical line of the model's upper central incisor angle was significantly larger (45.2 [16.3-75.5] vs 17.7 [0.0-38.9], Pâ≤â.001). There was no significant difference in UF distance when the operator changed the position. Cormack-Lehane grade was significantly improved when it was assessed using visual laryngoscope. Cormack-Lehane grade was not significantly different when the operator assessed it in sitting and standing position, respectively. No significant differences were found in the success rate, duration for intubation, first-attempt success rate, and operator comfort score.The operator is kept farther from the patient when he performs intubation procedure in sitting position. Meanwhile, it does not make the procedure more difficult or uncomfortable for the operator, though all the participants prefer to standing position.
Assuntos
COVID-19 , Intubação Intratraqueal , Laringoscópios , Postura Sentada , Posição Ortostática , Humanos , Laringoscopia , Masculino , Manequins , Posicionamento do PacienteRESUMO
Jinwujiangu capsule (JWJGC) is a traditional Chinese medicine formula used to treat rheumatoid arthritis (RA). However, whether its mechanism is associated with pyroptosis remains unclear. In this study, the ability of JWJGC to inhibit the growth of fibroblast-like synoviocytes of RA (RA-FLS) through pyroptosis was evaluated. The cells isolated from patients with RA were identified by hematoxylin and eosin (H&E) staining, immunohistochemistry, and flow cytometry. After RA-FLS were treated with different concentrations of JWJGC-containing serum, the cell proliferation inhibition rate, expression of caspase-1/3/4/5, NOD-like receptor protein 3 (NLRP3), gasdermin-D (GSDMD), and apoptosis-associated speck-like protein containing a CARD (ASC), concentrations of interleukin-1ß (IL-1ß) and interleukin-18 (IL-18), the activity of lactic dehydrogenase (LDH), and pyroptosis were evaluated. The results showed that JWJGC increased the proliferative inhibition rate, decreased the expression of caspase-1/3/4/5, GSDMD, NLRP3, and ASC, suppressed the expression of IL-1ß and IL-18, induced the activity of LDH, and downregulated the number of double-positive FITC anti-caspase-1 and PI. Generally, our findings suggest that JWJGC can regulate NLRP3/CAPSES/GSDMD in treating RA-FLS through pyroptosis.