Integrated bioinformatics analysis for identifying key genes and pathways in female and male patients with dilated cardiomyopathy.

Dilated cardiomyopathy (DCM) is a common cause of heart failure, and males are more likely to suffer from DCM than females. This research aimed at exploring possible DCM-associated genes and their latent regulatory effects in female and male patients. WGCNA analysis found that in the yellow module, 341 and 367 key DEGs were identified in females and males, respectively. A total of 22 hub genes in females and 17 hub genes in males were identified from the PPI networks of the key DEGs based on Metascape database. And twelve and eight potential TFs of the key DEGs were also identified in females and males, respectively. Eight miRNAs of 15 key DEGs were screened in both females and males, which may be differentially expressed in females and males. Dual-luciferase reporter assay demonstrated that miR-21-5P could directly target the key gene MATN2. Furthermore, Sex differences in KEGG pathways were identified. Both KOBAS and GSEA analysis identified 19 significantly enriched pathways related to immune response in both females and males, and the TGF-ß signaling pathway was exclusively identified in males. Network pharmacology analysis revealed that seven key DEGs were potential targets for the treatment of DCM, of which the OLR1 gene was only identified in males, the expression levels of the seven genes were verified by RT-PCR. The above results could offer a novel understanding of sex differences in key genes and pathways in DCM progression.

The efficacy and safety of nerve combing for trigeminal neuralgia without neurovascular compression.

OBJECTIVE: The purpose of our study was to review and evaluate the efficacy and safety of nerve combing without neurovascular decompression for trigeminal neuralgia. METHODS: A retrospective review of 298 patients with trigeminal neuralgia between August 2007 and August 2016 was conducted. The patients were divided into two groups: the A group was treated by nerve combing (34 patients) and the B group received microvascular decompression (264 patients). Surgical outcomes and postoperative complications were compared between the two groups. RESULTS: Pain was completely relieved in 88.2% of group A patients and 92.8% of group B after surgery. The median duration of follow-up was 60 months (range 10-115 months) in group A and 62 months (range 12-118 months) in group B. 72.7% and 86.4% of cases were completely relieved in groups A and B, respectively. There were no statistically significant differences in the surgical outcomes between the two groups. Almost all patients experienced some degree of numbness or hypesthesia (76.5%). The rate of facial numbness in group A was significantly higher than that in group B. CONCLUSION: This study demonstrated that nerve combing without neurovascular decompression is a safe and effective treatment for trigeminal neuralgia. However, a majority of patients treated with nerve combing experienced some degree of facial numbness.

The Outcome of Sling Retraction Technique in Microvascular Decompression for Hemifacial Spasm.

OBJECTIVE: This study explored the technical characteristics and effectiveness of sling retraction technique in microvascular decompression for hemifacial spasm. METHODS: Between January 2008 and May 2016, 158 patients affected by hemifacial spasm underwent microvascular decompression. Among them, the traditional technique was performed in 86 patients (A Group) and the sling retraction technique was used in 72 patients (B Group). The authors conducted a retrospective study and compared the surgical outcome of the 2 groups. The authors measured cure rate at 3 months and 5 years after microvascular decompression. RESULTS: In the traditional technique group, the cure rate of microvascular decompression was 94.2% and 83.3%. While in the sling retraction technique group, the cure rate of microvascular decompression was 95.8% and 94.4%. Facial nerve palsy, hearing loss, meningitis, and ataxia were frequent complications in both 2 groups. CONCLUSIONS: The sling technique using biomedical glue is an effective and safe option for patients of hemifacial spasm. During the long-term follow-up, the sling retraction technique of microvascular decompression was more effective than the traditional technique, while there were no significant differences in the incidences of complications.

Microvascular decompression for hemifacial spasm associated with the vertebral artery.

The aim of this study was to discuss the baseline characteristics of hemifacial spasm (HFS) associated with the vertebral artery (VA) and evaluate microvascular decompression (MVD) as a surgical treatment of the associated HFS. From February 2010 to February 2015, 118 consecutive patients with HFS underwent MVD. Of these, 29 cases of HFS were associated with VA, this series was compared with the remaining non-VA-associated HFS. Of the 29 cases of VA-associated HFS, the VA was directly compressing the root exit zone (REZ) in eight cases. In the other 21 cases, the VA contacted REZ indirectly via its branches. The symptoms were completely relieved in 26 cases (89.7%) and partially relieved in another two cases (6.9%). Between the VA-associated group and non-VA-associated group, no statistically significant difference existed in the surgical results. VA-associated HFS is not a rare condition. For all cases of VA-associated HFS, indirect compression due to VA was more common. MVD for VA-associated HFS still can achieve good results.

Ultrasound guidance improves the success rate of axillary plexus block: a meta-analysis / Orientação por ultrassom melhora a taxa de sucesso do bloqueio do plexo axilar: uma metanálise

ABSTRACT OBJECTIVE: To evaluate the value of real-time ultrasound (US) guidance for axillary brachial plexus block (AXB) through the success rate and the onset time. METHODS: The meta-analysis was carried out in the Anesthesiology Department of the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China. A literature search of Medline, EMBASE, Cochrane database from the years 2004 to 2014 was performed. The literature searches were carried out using medical subject headings and free-text word: "axilla", "axillary", "brachial plexus", "ultrasonography", "ultrasound", "ultrasonics". Two different reviewers carried out the search and evaluated studies independently. RESULTS: Seven randomized controlled trials, one cohort study and three retrospective studies were included. A total of 2042 patients were identified. 1157 patients underwent AXB using US guidance (US group) and the controlled group included 885 patients (246 patients using traditional approach (TRAD) and 639 patients using nerve stimulation (NS)). Our analysis showed that the success rate was higher in the US group compared to the controlled group (90.64% vs. 82.21%, p < 0.00001). The average time to perform the block and the onset of sensory time were shorter in the US group than the controlled group. CONCLUSION: The present study demonstrated that the real-time ultrasound guidance for axillary brachial plexus block improves the success rate and reduce the mean time to onset of anesthesia and the time of block performance.

RESUMO OBJETIVO: Avaliar o valor da orientação por ultrassonografia (US) em tempo real para bloqueio do plexo braquial por via axilar (BPBA) pela taxa de sucesso e tempo de latência. MÉTODOS: Uma metanálise foi feita no Departamento de Anestesiologia do Segundo Hospital Afiliado da Universidade de Soochow, Suzhou, província de Jiangsu, China. Fizemos uma pesquisa bibliográfica nas bases de dados Medline, Embasa e Cochrane de 2004 a 2014. A pesquisa foi feita com títulos de assuntos médicos e palavras de texto livre: axilla, axillary, brachial plexus, ultrasonography, ultrasound, ultrasonics. Dois revisores fizeram a pesquisa e avaliaram os estudos de forma independente. RESULTADOS: Sete estudos clínicos randômicos, um estudo de coorte e três estudos retrospectivos foram incluídos. Foram identificados 2.042 pacientes, dos quais 1.157 foram submetidos ao BPBA guiado por ultrassom (grupo US); o grupo controle incluiu 885 pacientes, dos quais 246 foram submetidos à abordagem tradicional (TRAD) e 639 à estimulação do nervo (EN). Nossa análise mostrou que a taxa de sucesso foi maior no grupo US em comparação com o grupo controle (90,64% vs. 82,21%, p< 0,00001). As médias do tempo necessário para fazer o bloqueio e do tempo de latência foram mais curtas no grupo US do que no grupo controle. CONCLUSÃO: O presente estudo demonstrou que a orientação por ultrassom em tempo real para o bloqueio do plexo braquial por via axilar melhora a taxa de sucesso e reduz a média do tempo de início da anestesia e do tempo de execução do bloqueio.

Ultrasound guidance improves the success rate of axillary plexus block: a meta-analysis.

OBJECTIVE: To evaluate the value of real-time ultrasound (US) guidance for axillary brachial plexus block (AXB) through the success rate and the onset time. METHODS: The meta-analysis was carried out in the Anesthesiology Department of the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China. A literature search of Medline, EMBASE, Cochrane database from the years 2004 to 2014 was performed. The literature searches were carried out using medical subject headings and free-text word: "axilla", "axillary", "brachial plexus", "ultrasonography", "ultrasound", "ultrasonics". Two different reviewers carried out the search and evaluated studies independently. RESULTS: Seven randomized controlled trials, one cohort study and three retrospective studies were included. A total of 2042 patients were identified. 1157 patients underwent AXB using US guidance (US group) and the controlled group included 885 patients (246 patients using traditional approach (TRAD) and 639 patients using nerve stimulation (NS)). Our analysis showed that the success rate was higher in the US group compared to the controlled group (90.64% vs. 82.21%, p<0.00001). The average time to perform the block and the onset of sensory time were shorter in the US group than the controlled group. CONCLUSION: The present study demonstrated that the real-time ultrasound guidance for axillary brachial plexus block improves the success rate and reduce the mean time to onset of anesthesia and the time of block performance.

[Ultrasound guidance improves the success rate of axillary plexus block: a meta-analysis]. / Orientação por ultrassom melhora a taxa de sucesso do bloqueio do plexo axilar: uma metanálise.

OBJECTIVE: To evaluate the value of real-time ultrasound (US) guidance for axillary brachial plexus block (AXB) through the success rate and the onset time. METHODS: The meta-analysis was carried out in the Anesthesiology Department of the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China. A literature search of Medline, Embase, Cochrane database from the years 2004 to 2014 was performed. The literature searches were carried out using medical subject headings and free-text word: "axilla", "axillary", "brachial plexus", "ultrasonography", "ultrasound", "ultrasonics". Two different reviewers carried out the search and evaluated studies independently. RESULTS: Seven randomized controlled trials, one cohort study and three retrospective studies were included. A total of 2042 patients were identified. 1157 patients underwent AXB using US guidance (US group) and the controlled group included 885 patients (246 patients using traditional approach (TRAD) and 639 patients using nerve stimulation (NS)). Our analysis showed that the success rate was higher in the US group compared to the controlled group (90.64% vs. 82.21%, p<0.00001). The average time to perform the block and the onset of sensory time were shorter in the US group than the controlled group. CONCLUSION: The present study demonstrated that the real-time ultrasound guidance for axillary brachial plexus block improves the success rate and reduce the mean time to onset of anesthesia and the time of block performance.

Second microvascular decompression for trigeminal neuralgia in recurrent cases after microvascular decompression.

OBJECTIVES: The objectives of this work are to report the outcomes of our finding during microvascular decompression (MVD) for patients with recurrent trigeminal neuralgia (TN) and to introduce the sling retraction technique. METHODS: The authors performed a retrospective review of redo MVD for consecutive cases with recurrent TN after previous operation. Sling retraction techniques were used during the reoperation. RESULTS: Fifteen patients underwent redo MVD. During the second operation, arachnoid adhesion of the Teflon felt was confirmed at the trigeminal nerve in 10 cases, and neurovascular conflict was found in 4 cases. Symptoms were completely relieved in 14 patients (93.3%) and partially relieved in 1 patient (6.7%). The mean follow-up period was 38 months (range, 21-60 months), and no patient experienced recurrence. CONCLUSIONS: Arachnoid adhesion of the Teflon felt and vascular compression to the nerve were main causes of recurrence. The sling retraction technique is still an effective and useful treatment for recurrent TN after MVD.

The efficacy and safety of microvascular decompression for idiopathic trigeminal neuralgia in patients older than 65 years.

OBJECTIVE: The aim of this study was to review the efficacy and safety of microvascular decompression (MVD) for idiopathic trigeminal neuralgia (ITN) in elderly patients older than 65 years. METHODS: From June 2006 to June 2011, a total of 59 elderly patients with ITN underwent MVD. We performed a retrospective study of the medical records and compared the outcome data with those from 164 patients younger than 64 years during the same period. RESULTS: The mean age of the elderly and younger patient groups was 72 and 55 years. The pain was completely relieved in 93.2% and partially relieved in another 5.1% of the elderly patient group after surgery. The mean follow-up period was 42 months (range, 16-75 mo). A total of 8.9% of the patients in the elderly patient group experienced recurrence. Headaches, nausea, and vomiting were more frequent complications. There were no mortalities and severe morbidities after surgery. Between the elderly and younger patient groups, no statistically significant differences existed in the outcomes. CONCLUSIONS: Microvascular decompression is a safe and effective procedure for elderly patients with ITN. It is recommended that any patients with ITN should have the opportunity to choose MVD, unless their condition cannot tolerate general anesthesia.

Synthesis and structure characterization of new 1,2,4-oxadiazolo[4,5-d]-1,5-benzothiazepines derivatives containing 2-phenyl-1,2,3-triazole through 1,3-dipolar cycloaddition reaction.

Reaction of 1,5-benzothiazepines, containing 2-phenyl-1,2,3-triazole 2a-d, with aryl nitrile oxides in CH2 Cl2 at room temperature leads to a series of novel 1,2,4-oxadiazolo[4,5-d]-1,5-benzothiazepine derivatives 3a-l in good yields. The products were characterized by IR, 1H NMR, MS, elemental analyses, X-ray and their spectrum characters were discussed.