Comparison of different concentrations of ropivacaine in epidural anesthesia for percutaneous transforaminal endoscopic discectomy: a randomized controlled trial.

BACKGROUND: This study investigated the optimal concentration of ropivacaine epidural anesthesia for clinical use in percutaneous transforaminal endoscopic discectomy (PTED) by comparing the effects of different concentrations. METHODS: Seventy patients scheduled for their first PTED procedure were enrolled in this randomized controlled trial. Patients were randomized to receive ropivacaine at varying concentrations (0.3% or 0.4%). Primary outcome measures included the numeric rating scale (NRS) and hip extension level (HEL). Secondary outcome measures included intraoperative fentanyl dosage and postoperative complications. RESULTS: One patient withdrew due to severe postoperative complications. The remaining 69 patients were allocated to the 0.3% (n = 34) and 0.4% (n = 35) groups, respectively. Baseline characteristics showed no significant differences between the two groups (P > 0.05). The NRS score was significantly lower in the 0.4% group than in the 0.3% group (P < 0.01), whereas the HEL score was significantly higher (P < 0.001). The average fentanyl dose in the 0.4% group was significantly lower than that in the 0.3% group (P < 0.01). Postoperative complications occurred in five and two patients in the 0.3% and 0.4% groups, respectively. CONCLUSION: Although 0.4% ropivacaine (20 mL) impacts muscle strength, it does not impede PTED surgery. Given its effective analgesic properties and few postoperative complications, 0.4% ropivacaine can be considered a preferred dose for PTED. TRIAL REGISTRATION: This study was registered with the Chinese Clinical Trials Registry (Registration number: ChiCTR2200060364; Registration Date: 29/5/2022) and on chictr.org.cn ( https://www.chictr.org.cn/showproj.html?proj=171002 ).

Characteristics of the top 100 cited electroencephalography articles on aging: a bibliometric analysis.

Electroencephalography (EEG) is a widely used tool in neuroscience. To explore the features of the top 100 cited articles related to EEG and aging over the past decade, we conducted a bibliometric analysis using Web of Science Core Collection (WoSCC) data as of January 21, 2024. The selected top 100 cited papers were analyzed using VOSviewer and Excel. We examined the distribution of publication years, authors, institutions, countries/regions, and journals. Hotspots were identified through keyword analysis. The analyzed articles were published between 2014 and 2021, with the majority being published before 2020 (n=91). Citation counts in WoSCC ranged from 24 to 250, with a median of 40 and a mean of 53. A total of 818 authors from 283 institutions in 35 countries/territories contributed to these top papers. The United States of America (USA) (n=37), Germany (n=14), and Canada (n=11) ranked in the top three in terms of total publications or citations. The predominant journals were in the fields of Neuroscience (n=58), Geriatrics & Gerontology (n=22), Clinical Neurology (n=13), and Anesthesiology (n=9), which published most of the high-quality articles. Key themes included EEG, aging, Alzheimer's disease, mild cognitive impairment, functional connectivity, and alpha oscillations. Emerging topics included sleep, machine learning, delirium, postoperative cognitive function, virtual reality, monitoring, resting state, coherence, and transcranial direct current stimulation. In conclusion, this study provides a comprehensive overview of the trends in scientific literature on EEG in aging over the past decade. Authors and institutions from North America, Europe, and East Asia led in contributions. Journals focusing on neuroscience, geriatrics, and anesthesiology published the majority of articles. Degenerative neurological diseases and cognitive impairment were prominent topics, suggesting future studies should explore EEG's diagnostic utility for these disorders.

Involvement of miR-665 in protection effect of dexmedetomidine against Oxidative Stress Injury in myocardial cells via CB2 and CK1.

BACKGROUND: Dexmedetomidine (Dex) can confer cardioprotective effects against ischemia/reperfusion (I/R) injury. While there are no studies addressing cardioprotection of Dex via regulation of microRNAs. The purpose of this study was to examine the roles and mechanisms of microRNA in cardioprotection of dexmedetomidine. METHODS: Rat heart Langendorff preparation was established. We assayed expression profiling of miRNAs in perfused rat hearts and predicted Target genes using MiRanda, MiRDB, and TargetScan. Oxide stress (H2O2) was employed to simulate I/R injury. miR-665 mimic, inhibitor, and siRNA of AK1 and Cnr2 were transfected to H9C2. The real-time quantitative polymerase chain reaction was used to quantify miR-665 and Ak1 and Cnr2 mRNA. The apoptosis of the cells was examined. The expression levels of cleaved caspase-3, Bcl-2, Bax, AK1, and Cnr2 were detected by Western blot. The combination between miR-665 and the 3'-untranslated region of AK1 and Cnr2 was validated by a luciferase reporter assay. RESULTS: Dex precondition down-regulated miR-665 expression in hearts compared to I/R group. Dex reduced miR-665 expression and apoptosis increased by oxide stress. However, up-regulation of miR-665 exacerbated the changes caused by oxide stress and inhibited the effects of Dex. Down-regulation of miR-665 also reduced apoptosis, but inhibition of AK1 and Cnr2 aggravated apoptosis. The luciferase reporter assay indicated that miR-665 could down-regulate expression levels of AK1 and Cnr2. CONCLUSIONS: Dex precondition confers hearts protective effect against I/R injury by down-regulating expression of miR-665 and up-regulating expression of AK1 and Cnr2.