Identification of key differentially expressed immune related genes in patients with persistent atrial fibrillation: an integrated bioinformation analysis.

OBJECTIVE: We aimed to investigate key differentially expressed immune related genes in persistent atrial fibrillation. METHODS: Gene expression profiles were downloaded from Gene Expression Omnibus (GEO) using "GEO query" package. "limma" package and "sva" package were used to conduct normalization and eliminate batch effects, respectively. We screened out differentially expressed genes (DEGs) based on "limma" package with the standard of |log fold change (FC)| ≥ 1.5 and false discovery rate (FDR) < 0.05. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses of DEGs were performed by "clusterProfler" package. We further applied LASSO to select key DEGs, and intersected key DEGs with immune related genes from ImmPort database. The ROC curve of each DEIRG was constructed to evaluate its diagnostic efficiency for AF. RESULTS: A total of 103 DEGs we were screened out, of them, 48 genes were down-regulated and 55 genes were up-regulated. Result of functional enrichment analysis show that, most of DEGs were related to immune response, inflammation, and oxidative stress. Ultimately, CYBB, RORB, S100A12, and CHGB were determined as key DEIRGs, each of which displayed a favor efficiency for diagnosing persistent AF. CONCLUSION: CYBB, RORB, S100A12, and CHGB were identified as key DEIRGs in persistent AF, and future studies are needed to further explore the underlying roles of CYBB, RORB, S100A12, and CHGB in persistent AF.

Efficacy of liposomal bupivacaine for pain control in shoulder surgery: a systematic review and meta-analysis.

BACKGROUND: Total shoulder arthroplasty and rotator cuff repair surgery result in considerable postoperative pain. Optimal postoperative pain management based on a multidisciplinary approach is necessary to promote early postoperative rehabilitation. The purpose of this study was to compare liposomal bupivacaine (LB) with traditional, non-LB agents after total arthroplasty or rotator cuff repair surgery. METHODS: Two independent authors searched the PubMed Central, Google Scholar, and Cochrane Library websites for suitable articles. We included randomized controlled trials comparing outcomes after the administration of LB and non-LB agents for rotator cuff repair or total shoulder arthroplasty. The outcome measures for our meta-analysis were visual analog scale (VAS) pain scores at 24 and 48 hours after surgery, opioid consumption 24 and 48 hours after surgery, hospital stay duration, and complications within 48 hours after surgery. We used the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) tool to assess the degree of evidence for the outcomes, and we used the Cochrane risk-of-bias assessment tool to assess the risk of bias. RESULTS: The current meta-analysis comprised 11 randomized controlled studies with 846 subjects. Seven studies used local infiltration to administer LB, and 3 used a block. Our pooled analysis results showed no significant difference in VAS pain scores at 24 hours after surgery (standardized mean difference [SMD], -0.27; 95% confidence interval [CI], -0.55 to 0.01; prediction interval, -1.25 to 0.70), VAS pain scores at 48 hours after surgery (SMD, -0.18; 95% CI, -0.46 to 0.09; prediction interval, -1.10 to 0.73), opioid consumption at 24 hours after surgery (SMD, 0.04; 95% CI, -0.27 to 0.34; prediction interval, -1.01 to 1.09), and opioid consumption at 48 hours after surgery (SMD, 0.10; 95% CI, -0.44 to 0.64; prediction interval, -1.76 to 1.96) between the LB and non-LB groups. The LB and non-LB groups had similar hospital stay durations (SMD, -0.38; 95% CI, -1.51 to 0.74; prediction interval, -14.7 to 13.9) and adverse events (risk ratio, 0.89; 95% CI, 0.42 to 1.36) following the shoulder procedures. The level of evidence was low according to the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) analysis. CONCLUSION: Our meta-analysis provides evidence indicating that LB is similar to non-LB agents in terms of overall pain relief and opioid requirements. The duration of hospital stay and complication rates were also similar in the 2 groups. Future well-designed and adequately powered randomized controlled studies are needed to confirm our results and to be able to recommend LB for various types of shoulder operations.

Paravascular abnormalities observed by spectral domain optical coherence tomography are risk factors for retinoschisis in eyes with high myopia.

PURPOSE: To investigate the retinal features and distribution of paravascular abnormalities (PVAs) and their relationship with retinoschisis in eyes with high myopia. METHODS: One hundred and fifty-two eyes of 88 patients with high myopia [refractive error greater than -6 dioptres (D) or axial length (AL) ≥26.5 mm] who had undergone comprehensive ophthalmic examinations were evaluated in this cross-sectional study. Multiple optical coherence tomography (OCT) scans were performed to study the microstructural alterations adjacent to the retinal vascular arcades and the entire macular area. The presence and distribution patterns of various PVAs, retinoschisis and the association between these parameters were analysed. RESULTS: Of the 152 highly myopic eyes, PVAs were detected by OCT in 126 eyes (82.9%), including paravascular microfolds in all 126 eyes, paravascular cysts in 109 eyes (71.7%) and paravascular lamellar holes in 44 eyes (28.9%). All three types of PVAs were observed more frequently along the temporal vascular arcades than along the nasal vascular arcades (p < 0.005). Seventy-eight eyes (51.3%) were identified with retinoschisis at retinal vascular arcades, most frequently in the inner plexiform layer (IPL) and along temporal arcades. Eyes with all three types of PVAs (microfolds, cysts and lamellar holes) had the highest incidence of retinoschisis at vascular arcades (p < 0.001). Multivariate analysis indicated that age, the AL, presence of paravascular microfolds and cysts, and simultaneously existence of all three types of PVAs were associated with an increased risk for retinoschisis at vascular arcades. Macular retinoschisis was detected in 25 eyes (19.8%) and presented with splitting of the outer retina in all cases. All seven eyes with entire macular area retinoschisis (S4 grade) were accompanied by retinoschisis at vascular arcades within multiple layers, including outer retinoschisis, IPL schisis and inner limiting membrane (ILM) detachment. CONCLUSION: Our findings indicated that all three types of PVAs and different types of retinoschisis were most frequently observed along the temporal vascular arcades. Eyes with paravascular microfolds and cysts, and those with all three paravascular lesions may in risk of developing retinoschisis at vascular arcades.