Echocardiographic features and outcomes of fetuses with isolated restrictive foramen ovale or redundant foramen ovale flap using atrial septum excursion index.

PURPOSE: This study was designed to investigate the application value of the atrial septum excursion index (ASEI) in fetuses with isolated restrictive foramen ovale (RFO) or redundant foramen ovale flap (RFOF) and the outcomes of these fetuses. METHODS: This was a retrospective study. Healthy pregnant women who were examined by antenatal fetal echocardiography from January 1, 2019 to December 31, 2021, at Sir Run Run Shaw Hospital were enrolled. One hundred seventy-seven (177) fetuses were categorized into three groups by diagnosis: (1) RFOF (n = 33), (2) RFO (n = 21), and (3) normal (n = 123). Fetal echocardiographic features and postnatal outcomes were collected. RESULTS: The median ASEIs were 0.50 (range, 0.41-0.65) in the control group, 0.76 (range, 0.67-0.88) in the RFOF group and 0.31 (range, 0.14-0.35) in the RFO group, and the differences were significant (p < 0.001). The ratios of right atrium/left atrium, right ventricle/left ventricle, and pulmonary artery diameter to aorta diameter (PA/AO) and the pulmonary annulus Z-scores were greater in fetuses with RFOF and RFO than in the controls (p < 0.05). Twenty-seven of 33 fetuses (87.9%) with RFOF and 19 of 21 fetuses (90.5%) with RFO had good outcomes after birth. CONCLUSION: The ASEI may be a new tool for quantitatively assessing the mobility of foramen ovale flaps in fetuses with isolated RFOF or RFO.

Clinicopathological significance and immunotherapeutic outcome of claudin 18.2 expression in advanced gastric cancer: A retrospective study.

Objective: Immunotherapeutic outcomes and clinical characteristics of claudin 18 isoform 2 positive (CLDN18.2-positive) gastric cancer (GC) vary in different clinical studies, making it difficult to optimize anti-CLDN18.2 therapy. We conducted a retrospective analysis to explore the association of CLDN18.2 expression with clinicopathological characteristics and immunotherapeutic outcomes in GC. Methods: A total of 536 advanced GC patients from 2019 to 2021 in the CT041-CG4006 and CT041-ST-01 clinical trials were included in the analysis. CLDN18.2 expression on ≥40% of tumor cells (2+, 40%) and CLDN18.2 expression on ≥70% of tumor cells (2+, 70%) were considered the two levels of positively expressed GC. The clinicopathological characteristics and immunotherapy outcomes of GC patients were analyzed according to CLDN18.2 expression status. Results: CLDN18.2 was expressed in 57.6% (cut-off: 2+, 40%) and 48.9% (cut-off: 2+, 70%) of patients. Programmed death-ligand 1 (PD-L1) and CLDN18.2 were co-expressed in 19.8% [combined positive score (CPS)≥1, CLDN18.2 (cut-off: 2+, 40%)] and 17.2% [CPS≥5, CLDN18.2 (cut-off: 2+, 70%)] of patients. CLDN18.2 expression positively correlated with younger age, female sex, non-gastroesophageal junction (non-GEJ), and diffuse phenotype (P<0.001). HER2 and PD-L1 expression were significantly lower in CLDN18.2-positive GC (both P<0.05). Uterine adnexa metastasis (P<0.001) was more frequent and liver metastasis (P<0.001) was less common in CLDN18.2-positive GC. Overall survival and immunotherapy-related progression-free survival (irPFS) were inferior in the CLDN18.2-positive group. Conclusions: CLDN18.2-positive GC is associated with poor prognosis and worse immunotherapeutic outcomes. The combination of anti-CLDN18.2 therapy, anti-PD-L1/PD-1 therapy, and chemotherapy for GC requires further investigation.

Quantitative Analysis of Morphology and Function in the Fetal Heart with Severe Tricuspid Regurgitation by Speckle Tracking Imaging.

Morphology and function in a fetal heart with severe tricuspid regurgitation remains challenging. The aim of this study was to assess cardiac morphology and function in fetuses with severe tricuspid regurgitation by fetal heart quantification (HQ) and to assess the practical value of fetal HQ. Clinical information was analyzed for 63 pregnant women who underwent fetal cardiac ultrasonography. The women were divided into those who had a fetus with severe tricuspid regurgitation (n = 20) and those with a normal fetus (n = 40). The global sphericity index (GSI), fractional area change (FAC), and global longitudinal strain (GLS) of both ventricles and the sphericity index (SI) and fractional shortening (FS) of 24 segments were quantified by fetal HQ using speckle tracking imaging. Fetuses with severe tricuspid regurgitation had a significantly lower GSI (1.14 ± 0.10 vs. 1.26 ± 0.08, p < 0.001) and a higher GSI Z-score (-0.98 ± 1.01 vs. 0.25 ± 0.87, p < 0.001) as well as a significantly lower right ventricular FAC (36.50 ± 7.34% vs. 45.19 ± 3.39%, p < 0.001), FAC Z-score (-1.02 ± 1.41 vs. 0.49 ± 0.74, p < 0.001), and GLS (-21.01 ± 5.66% vs. 45.19 ± 3.49%, p < 0.001). The SI and SI Z-score were significantly lower in segments 1-18 of the right ventricle in fetuses with severe tricuspid regurgitation (p < 0.05); furthermore, FS of segments 1-12 and 19-24 and the FS Z-score of segments 18-24 were significantly lower in fetuses with severe tricuspid regurgitation (p < 0.05). Fetal HQ is useful for evaluation of cardiac morphology and function in fetuses with severe tricuspid regurgitation and can provide important reference information for both clinical diagnosis and treatment.

Correlation between Dynamics of Polaronic Photocarriers and Photoelectrochemical Performance in Mo-Doped Bismuth Vanadate.

Bismuth vanadate (BiVO4) has received intense research interest due to its outstanding performance for solar water splitting, and doping it with molybdenum (Mo) ions can effectively boost photoelectrochemical performance. In this material, highly localized polarons play a key role in the photoconversion process. Herein, we uncovered the influence of Mo dopants on the dynamics of polaronic transient species using transient absorption spectroscopy. We find that the preexisting electron small polarons stemming from the thermal ionization of dopants provide additional centers to capture itinerant holes, which significantly decrease the hole lifetime. However, the introduction of dopants increases the lifetime of self-trapped excitons that arise from the binding of electron polarons and holes. The dependence of the photoelectrochemical performance of BiVO4 photoelectrodes on doping levels can be well explained by combining the dopant effects on the lifetimes of delocalized and self-trapped transient species. Our findings provide guidance for rational optimization of dopant concentration to maximize the PEC efficiency.

Rapidly determining the 3D structure of proteins by surface-enhanced Raman spectroscopy.

Despite great advances in protein structure analysis, label-free and ultrasensitive methods to obtain the natural and dynamic three-dimensional (3D) structures are still urgently needed. Surface-enhanced Raman spectroscopy (SERS) can be a good candidate, whereas the complexity originated from the interactions between the protein and the gradient surface electric field makes it extremely challenging to determine the protein structure. Here, we propose a deciphering strategy for accurate determination of 3D protein structure from experimental SERS spectra in seconds by simply summing SERS spectra of isolated amino acids in electric fields of different strength with their orientations in protein. The 3D protein structure can be reconstructed by comparing the experimental spectra obtained in a well-defined gap-mode SERS configuration with the simulated spectra. The gradient electric field endows SERS with a unique advantage to section biomolecules with atomic precision, which makes SERS a competent tool for monitoring biomolecular events under physiological conditions.

Does inflammatory bowel disease promote kidney diseases: a mendelian randomization study with populations of European ancestry.

BACKGROUND: This study aimed to investigate a causal relationship between IBD and multiple kidney diseases using two-sample Mendelian randomization (MR) analyses. METHODS: We selected a group of single nucleotide polymorphisms (SNPs) specific to IBD as instrumental variables from a published genome-wide association study (GWAS) with 86,640 individuals of European ancestry. Summary statistics for multiple kidney diseases were obtained from the publicly available GWAS. Genetic data from one GWAS involving 210 extensive T-cell traits was used to estimate the mediating effect on specific kidney disease. Inverse-variance weighted method were used to evaluate the MR estimates for primary analysis. RESULTS: Genetic predisposition to IBD was associated with higher risk of IgA nephropathy (IgAN) (OR, 1.78; 95% CI, 1.45-2.19), but not membranous nephropathy, diabetic nephropathy, glomerulonephritis, nephrotic syndrome, chronic kidney disease, and urolithiasis. CD4 expression on CD4 + T cell had a significant genetic association with the risk of IgAN (OR, 2.72; 95% CI, 1.10-6.72). Additionally, consistent results were also observed when IBD was subclassified as ulcerative colitis (OR, 1.38; 95% CI, 1.10-1.71) and Crohn's disease (OR, 1.37; 95% CI, 1.12-1.68). MR-PRESSO and the MR-Egger intercept did not identify pleiotropic SNPs. CONCLUSIONS: This study provides genetic evidence supporting a positive casual association between IBD, including its subclassification as ulcerative colitis and Crohn's disease, and the risk of IgAN. However, no casual association was found between IBD and other types of kidney diseases. Further exploration of IBD interventions as potential preventive measures for IgAN is warranted.

Volume-Corrected Free Energy as a New Criterion for Structural Elucidation in Chemical-Tagging-Based Metabolomics.

Chemical tagging via possible derivatization reagents alters metabolites' retention times, leading to different retention behavior during liquid chromatography-mass spectrometry (LC-MS) analysis. Incorporation of the retention time dimension can dramatically reduce false-positive structural elucidation in chemical-tagging-based metabolomics. However, few studies predict the retention times of chemically labeled metabolites, especially requiring a simple, easy-to-access, accurate, and universal predictor or descriptor. This pilot study demonstrates the application of volume-corrected free energy (VFE) calculation and region mapping as a new criterion to describe the retention time for structure elucidation in chemical-tagging-based metabolomics. The universality of VFE calculation is first evaluated with four different types of submetabolomes including hydroxyl-group-, carbonyl-group-, carboxylic-group-, and amino-group-containing compounds and oxylipins with similar chemical structures and complex isomers on reverse-phase LC. Results indicate a good correlation (r > 0.85) between VFE values and their corresponding retention times using different technicians, instruments, and chromatographic columns, describing retention behavior in reverse-phase LC. Finally, the VFE region mapping is described for identifying 1-pentadecanol from aged camellia seed oil using three proposed steps, including public database searching, VFE region mapping for its 12 isomers, and chemical standard matching. The possibility of VFE calculation of nonderivatized compounds in retention time prediction is also investigated, demonstrating its effectiveness on retention times with different influence factors.

Causal links between socioeconomic status, leisure sedentary behaviours and gastro-oesophageal reflux disease: a multivariable two-sample Mendelian randomisation study.

INTRODUCTION: We implemented a two-sample multivariable Mendelian randomisation (MR) analyses to estimate the causal effect of socioeconomic status and leisure sedentary behaviours on gastro-oesophageal reflux disease (GERD). METHODS: Independent single-nucleotide polymorphisms associated with socioeconomic status and leisure sedentary behaviours at the genome-wide significance level from the Medical Research Council Integrative Epidemiology Unit (MRC-IEU) UK Biobank were selected as instrumental variables. Summary-level data for GERD were obtained from a recent publicly available genome-wide association involving 78 707 GERD cases and 288 734 controls of European descent. Univariable and multivariable two-sample MR analyses, using inverse variance weighted method for primary analyses, were performed to jointly evaluate the effect of socioeconomic status and leisure sedentary behaviours on GERD risk. RESULTS: Three socioeconomic status, including educational attainment (OR 0.46; 95% CI 0.30 to 0.69; p<0.001), average total household income before tax (OR 0.65; 95% CI 0.47 to 0.90; p=0.009) and Townsend Deprivation Index at recruitment (OR 1.60; 95% CI 1.06 to 2.41; p=0.026), were independently and predominately responsible for the genetic causal effect on GERD. In addition, one leisure sedentary behaviour, such as time spent watching television, was independently and predominately responsible for genetic causal effect on GERD (OR 3.74; 95% CI 2.89 to 4.84; p<0.001). No causal effects of social activities and driving on GERD were observed. CONCLUSIONS: Genetically predicted Townsend Deprivation Index at recruitment and leisure watching television were causally associated with increased risk of GERD, and age at completion of full-time education and average total household income before tax were causally associated with decreased risk of GERD.

Proteome and Ubiquitylome Analyses of Maize Endoplasmic Reticulum under Heat Stress.

High temperatures severely affect plant growth and pose a threat to global crop production. Heat causes the accumulation of misfolded proteins in the endoplasmic reticulum(ER), as well as triggering the heat-shock response (HSR) in the cytosol and the unfolded protein response (UPR) in the ER. Excessive misfolded proteins undergo further degradation through ER-associated degradation (ERAD). Although much research on the plant heat stress response has been conducted, the regulation of ER-localized proteins has not been well-studied thus far. We isolated the microsome fraction from heat-treated and untreated maize seedlings and performed proteome and ubiquitylome analyses. Of the 8306 total proteins detected in the proteomics analysis, 1675 proteins were significantly up-regulated and 708 proteins were significantly down-regulated. Global ubiquitination analysis revealed 1780 proteins with at least one ubiquitination site. Motif analysis revealed that alanine and glycine are the preferred amino acids upstream and downstream of ubiquitinated lysine sites. ERAD components were found to be hyper-ubiquitinated after heat treatment, implying the feedback regulation of ERAD activity through protein degradation.

Alkylamine-Confined Thickness-Tunable Synthesis of Co(OH)2-CoO Nanosheets toward Oxygen Evolution Catalysis.

Thickness regulation of transition metal hydroxides/oxides nanosheets with superior catalytic properties represents a promising strategy to enhance catalytic performance, but it remains an enormous challenge to achieve precise control, especially when it comes to the ultrathin limit (several atomic layers). In this work, a facile strategy of alkylamine-confined growth is proposed for the synthesis of thickness-tunable metal hydroxide/oxide nanosheets. Specifically, ultrathin cobalt hydroxide and cobaltous oxide hybrid (Co(OH)2-CoO) nanosheets (Co-O NSs) with a thickness in the range of 2-6 nm (5-13 atomic layers) are synthesized by using alkylamines with different carbon chain lengths as the ligand to modulate vertical coordination ability. Co-O NSs with a thickness of 2 nm (Co-O NSs-2 nm) exhibit excellent oxygen evolution reaction (OER) performance with an overpotential of 278 mV at 10 mA/cm2. The maximized number of active sites including oxygen vacancies, optimal adsorption strength, and the highest electrical conductivity are considered as the potential factors contributing to the excellent OER performance of Co-O NSs-2 nm. This work holds great significance for the precise thickness-tunable synthesis of transition metal layered hydroxide nanosheets with modulated and improved catalytic performance.

Triterpene Derivatives from Garcinia oligantha and Their Anti-Cancer Activity.

Phytochemical investigations of leaves and twigs from Garcinia oligantha Merr. resulted in the isolation of five undescribed triterpene derivatives (1-5) and six known analogs (6-11). Their structures were determined based on extensive spectroscopic data and high-resolution mass spectra analyses. Compounds 1-11 were tested for their in vitro cytotoxicity against three human cancer cell lines (HeLa, HepG-2, and MCF-7). Compounds 1, 2, 8, and 11 exhibited broad and significant cytotoxicity against the tested cell lines with IC50 values ranging from 5.04 to 21.55 µM. Compounds 5 and 9 showed cytotoxicity against HeLa and MCF-7 with IC50 values ranging from 13.22 to 19.62 µM. The preliminary structure-activity relationship for the 11 isolated compounds is also discussed.

RuO2-Incorporated Co3O4 Nanoneedles Grown on Carbon Cloth as Binder-Free Integrated Cathodes for Tuning Favorable Li2O2 Formation.

Developing ideal Li-O2 batteries (LOBs) requires the discharge product to have a large quantity, have large contact area with the cathode, and not passivate the porous surface after discharge, which put forward high requirement for the design of cathodes. Herein, combining the rational structural design and high activity catalyst selection, minor amounts of RuO2-incorporated Co3O4 nanoneedles grown on carbon cloth are successfully synthesized as binder-free integrated cathodes for LOBs. With this unique design, plenty of electron-ion-oxygen tri-phase reaction interface is created, the side reaction from carbon is isolated, and oxygen reduction reaction/oxygen evolution reaction (OER) kinetics are significantly facilitated. Upon discharge, film-like Li2O2 is observed growing on the needle surface first and eventually ball-like Li2O2 particles form at each tip of the needle. The cathode surface remains porous after discharge, which is beneficial to the OER and is rare in the previous reports. The battery exhibits a high specific discharge capacity (7.64 mAh cm-2) and a long lifespan (500 h at 0.1 mA cm-2). Even with a high current of 0.3 mA cm-2, the battery achieves a cycling life of 200 h. In addition, punch-type LOBs are fabricated and successfully operated, suggesting that the cathode material can be utilized in ultralight, flexible electronic devices.

Assessment of fetal left atrial volume and function using a novel left atrial volume tracking method.

BACKGROUND: Several fetal cardiovascular structural defects may alter the hemodynamics of the cardiac chambers resulting in changes in chamber sizes. Quantitative measurements of the sizes of cardiac chambers can augment the diagnostic power of fetal echocardiography. AIMS: Using a new left atrial volume tracking (LAVT) method, time-left atrial volume curves (TLAVCs) can be automatically obtained. The goal of this study was to examine whether this method can be used to evaluate left atrial volume (LAV) and provide reference values for LAV and indices of left atrial function in normal human fetuses. METHODS: Two hundred and four normal human fetuses were enrolled. Using LAVT, the maximal left atrial volume (LAVmax) and minimal left atrial volume (LAVmin) were measured from TLAVCs. Left atrial ejection fraction (EF) was calculated. The maximal left atrial area (LAAmax) and minimal left atrial area (LAAmin) were measured using manual method tracing. RESULTS: Between 21 and 40 weeks, mean LAVmax increased from 0.27 ml to 4.15 ml, and mean LAVmin increased from 0.13 ml to 2.26 ml, respectively, while the EF remained stable at around 0.43. From 21 to 40 weeks, mean LAAmax increased from 0.61 cm2 to 2.64 cm2, and mean LAAmin increased from 0.34 cm2 to 1.53 cm2. CONCLUSIONS: This study establishes reference values for fetal LAV during the second half of gestation. The LAVT method appears to be feasible in estimating fetal LAV and shows potential for assessing left atrial function.

Correlation coefficient-directed label-free characterization of native proteins by surface-enhanced Raman spectroscopy.

Investigation of proteins in their native state is the core of proteomics towards better understanding of their structures and functions. Surface-enhanced Raman spectroscopy (SERS) has shown its unique advantages in protein characterization with fingerprint information and high sensitivity, which makes it a promising tool for proteomics. It is still challenging to obtain SERS spectra of proteins in the native state and evaluate the native degree. Here, we constructed 3D physiological hotspots for a label-free dynamic SERS characterization of a native protein with iodide-modified 140 nm Au nanoparticles. We further introduced the correlation coefficient to quantitatively evaluate the variation of the native degree, whose quantitative nature allows us to explicitly investigate the Hofmeister effect on the protein structure. We realized the classification of a protein of SARS-CoV-2 variants in 15 min, which has not been achieved before. This study offers an effective tool for tracking the dynamic structure of proteins and biomedical research.

Effects of Ultrasound-Guided Stellate Ganglion Block on Postoperative Quality of Recovery in Patients Undergoing Breast Cancer Surgery: A Randomized Controlled Clinical Trial.

Surgery has been the primary treatment for breast cancer. However, instant postoperative complications, such as sleep disorder and pain, dramatically impair early postoperative quality of recovery, resulting in more extended hospital stays and higher costs. Recent clinical trials indicated that stellate ganglion block (SGB) could prolong sleep time and improve sleep quality in breast cancer survivors. Moreover, during the perioperative period, SGB enhanced the recovery of gastrointestinal functions in patients with laparoscopic colorectal cancer surgery and thoracolumbar spinal surgery. Furthermore, perioperative SGB decreased intraoperative requirements for anesthetics and analgesics in patients with complex regional pain syndrome. However, information is scarce regarding the effects of SGB on postoperative quality recovery in patients with breast cancer surgery. Therefore, we investigated the effects of SGB on the postoperative quality of recovery of patients undergoing breast cancer surgery. Sixty patients who underwent an elective unilateral modified radical mastectomy were randomized into two 30-patient groups that received either an ultrasound-guided right-sided SGB with 6 ml 0.25% ropivacaine (SGB group) or no block (control group). The primary outcome was the quality of postoperative recovery 24 hours after surgery, assessed with a Chinese version of the 40-item Quality of Recovery (QoR-40) questionnaire. Secondary outcomes were intraoperative requirements of propofol and opioids, rest pain at two, four, eight, and 24 hours after surgery, patient satisfaction score, and the incidence of postoperative abdominal distension. At 24 hours after surgery, global QoR-40 scores were higher in the SGB group than in the control group. Besides, in the SGB group, patients needed less propofol, had a lower incidence of postoperative abdominal bloating, and had higher satisfaction scores. Ultrasound-guided SGB could improve the quality of postoperative recovery in patients undergoing breast cancer surgery by less intraoperatively need for propofol and better postoperative recovery of sleep and gastrointestinal function.

Selective and sensitive detection of tartrazine in beverages by sulfur quantum dots with high fluorescence quantum yield.

In this work, sulfur quantum dots (TPA-SQDs) protected by terephthalic acid as a stabilizer were synthesized using a one-pot method. When excited at 310 nm, the synthesized TPA-SQDs solution emitted strong blue fluorescence at 428 nm, and the absolute quantum yield was as high as 85.99%. The proposed SQDs can be used as a fluorescent probe to specifically quench tartrazine (TZ), showing a good linear relationship (R2 = 0.996) at TZ concentrations of 0.1-20 µM, with a detection limit of 39 nM. By analysing the fluorescence lifetime, UV-Vis absorption spectrum and zeta potential of the assay system, it can be speculated that the fluorescence quenching mechanism of TZ on TPA-SQDs is the inner filter effect (IFE). The proposed method was applied to the detection of TZ in vitamin water and orange juice, and the results were consistent with the determination results by high-performance liquid chromatography. The recoveries and relative standard deviations were 93.2-102.6% and 1.34-2.88%, respectively, which provided an alternative method for the determination of TZ in beverages or other food samples.

Evaluation and Correlation Analysis of Mental and Psychological Factors and Premature Ejaculation in Patients with Benign Prostatic Hyperplasia in Mobile Medical System.

Chronic prostatitis is a very common and very difficult disease. Based on the mobile medical system, this paper carried out a correlation analysis on the psychological factors and the evaluation of premature ejaculation in patients with benign prostatic hyperplasia. The article first analyzes the application in the field of mobile medical and then introduces the prostate image segmentation method based on the geometric active contour model. The emergence of automatic organ tissue segmentation technology is timely; it can help clinicians save a lot of manual segmentation time and has better reversibility and objectivity, and the theory of curve evolution is analyzed. Finally, this paper introduces the experimental research object and purpose, makes a statistical analysis of the symptoms of benign prostatic hyperplasia, and compares the incidence of psychological symptoms in patients with prostatitis under different factors. The experimental results of this paper show that 90% of prostatitis patients have mild psychological problems, and 10% have moderate psychological problems. Among them, the main reason for the psychological disorder of patients is depression, for which we should strengthen the care for patients.

Claudin18.2-specific CAR T cells in gastrointestinal cancers: phase 1 trial interim results.

Despite success in hematologic malignancies, the treatment landscape of chimeric antigen receptor (CAR) T cell therapy for solid tumors remains limited. Claudin18.2 (CLDN18.2)-redirected CAR T cells showed promising efficacy against gastric cancer (GC) in a preclinical study. Here we report the interim analysis results of an ongoing, open-label, single-arm, phase 1 clinical trial of CLDN18.2-targeted CAR T cells (CT041) in patients with previously treated, CLDN18.2-positive digestive system cancers ( NCT03874897 ). The primary objective was safety after CT041 infusion; secondary objectives included CT041 efficacy, pharmacokinetics and immunogenicity. We treated 37 patients with one of three CT041 doses: 2.5 × 108, 3.75 × 108 or 5.0 × 108 cells. All patients experienced a grade 3 or higher hematologic toxicity. Grade 1 or 2 cytokine release syndrome (CRS) occurred in 94.6% of patients. No grade 3 or higher CRS or neurotoxicities, treatment-related deaths or dose-limiting toxicities were reported. The overall response rate (ORR) and disease control rate (DCR) reached 48.6% and 73.0%, respectively. The 6-month duration of response rate was 44.8%. In patients with GC, the ORR and DCR reached 57.1% and 75.0%, respectively, and the 6-month overall survival rate was 81.2%. These initial results suggest that CT041 has promising efficacy with an acceptable safety profile in patients with heavily pretreated, CLDN18.2-positive digestive system cancers, particularly in those with GC.

Pharyngolaryngeal Morbidity With the Laryngeal Mask Airway SupremeTM at Different Fiberoptic Bronchoscopy Grades: An Observational Study.

OBJECTIVE: To assess whether the different fiberoptic bronchoscopy (FOB) grades of laryngeal mask airway (LMA) Supreme™ affects pharyngolaryngeal morbidity (PLM, including sore throat, dysphonia, pharyngoxerosis, and dysphagia) after general anesthesia. METHODS: A total of 235 adult patients scheduled for elective laser lithotripsy undergoing general anesthesia with the placement of LMA Supreme™ were enrolled. The position of LMA Supreme™ was assessed by FOB and categorized into five grades. Meanwhile, patients were divided into four groups (grades A-D); none was assessed as grade E. We collected blinded data on PLM at 2 (H+2), 6 (H+6), and 24 hours (H+24) postoperatively. The incidence and severity of PLM as the primary outcome and incidence of PLM at three time points as a secondary outcome were compared. RESULTS: The incidence of PLM was higher at 2 and 6 hours than at 24 hours; however, no significant difference was found between the incidence of PLM in the FOB groups. Furthermore, the severity of sore throat and dysphonia between groups were obviously differed at H+6 and H+24, but similar at H+2. The severity of postoperative pharyngoxerosis and dysphagia were similar between groups at three time points. CONCLUSIONS: A positive association was found between the severity of postoperative sore throat and dysphonia and FOB grade after LMA Supreme™ placement. PLM secondary to placement of the LMA Supreme™ was short lasting.