Postoperative pulmonary complications in older patients undergoing elective surgery with a supraglottic airway device or tracheal intubation.

The two most commonly used airway management techniques during general anaesthesia are supraglottic airway devices and tracheal tubes. In older patients undergoing elective non-cardiothoracic surgery under general anaesthesia with positive pressure ventilation, we hypothesised that a composite measure of in-hospital postoperative pulmonary complications would be less frequent when a supraglottic airway device was used compared with a tracheal tube. We studied patients aged ≥ 70 years in 17 clinical centres. Patients were allocated randomly to airway management with a supraglottic airway device or a tracheal tube. Between August 2016 and April 2020, 2900 patients were studied, of whom 2751 were included in the primary analysis (1387 with supraglottic airway device and 1364 with a tracheal tube). Pre-operatively, 2431 (88.4%) patients were estimated to have a postoperative pulmonary complication risk index of 1-2. Postoperative pulmonary complications, mostly coughing, occurred in 270 of 1387 patients (19.5%) allocated to a supraglottic airway device and 342 of 1364 patients (25.1%) assigned to a tracheal tube (absolute difference -5.6% (95%CI -8.7 to -2.5), risk ratio 0.78 (95%CI 0.67-0.89); p < 0.001). Among otherwise healthy older patients undergoing elective surgery under general anaesthesia with intra-operative positive pressure ventilation of their lungs, there were fewer postoperative pulmonary complications when the airway was managed with a supraglottic airway device compared with a tracheal tube.

High-field magnetization and electronic spin resonance study in the twisted honeycomb latticeα-Mn2V2O7.

We report the single-crystal growth of Mn2V2O7and the results of magnetic susceptibility, high-field magnetization up to 55 T and high-frequency electric spin resonance (ESR) measurements for its low-temperatureαphase. Two antiferromagnetic (AFM) ordering at 17.5 K and 3 K and obvious magnetic anisotropy are observed inα-Mn2V2O7upon cooling. In pulsed high magnetic fields, the compound reaches the saturation magnetic moment of ∼10.5µBfor each molecular formula at around 45 T after two undergoing AFM phase transitions atHc1≈ 16 T,Hc2≈ 34.5 T forH//[11-0] andHsf1= 2.5 T,Hsf2= 7 T forH//[001]. In these two directions, two and seven resonance modes are detected by ESR spectroscopy, respectively. Theω1andω2modes ofH//[11-0] can be well described by two-sublattice AFM resonance mode with two zero-field gaps at 94.51 GHz and 169.28 GHz, indicating a hard-axis feature. The seven modes forH//[001] are partially separated by the critical fields ofHsf1andHsf2, displaying the two signs of spin-flop transition. The fittings ofωc1andωc2modes yield zero-field gaps at 69.50 GHz and 84.73 GHz forH//[001], confirming the axis-type anisotropy. The saturated moment and gyromagnetic ratio indicate the Mn2+ion inα-Mn2V2O7is in a high spin state with orbital moment completely quenched. A quasi-one-dimensional magnetism with a zig-zag-chain spin configuration is suggested inα-Mn2V2O7, due to the special neighbor interactions caused by a distorted network structure with honeycomb layer.

High-field phase diagram of Ni3V2O8studied by specific heat and magnetocaloric effect measurements.

TheH-Tphase diagram of Ni3V2O8is very rich and remains puzzling in a high magnetic field range. Through the state-of-the-art specific heat measurement in pulsed high field to 35 T and magnetocaloric effect measurement up to 45 T, we successfully construct the high-field phase diagram of Ni3V2O8for fields applied along thebaxis. The phase boundaries are corrected for previous results by magnetization and magneto-optical measurements. The resulting phase diagram shows that the high temperature incommensurate (HTI) phase develops well to high fields and low temperatures. In addition to the early reported C', C, low temperature incommensurate (LTI) and HTI phases, we explore a new magnetic ordered phase called HF1 in fields of 10-30 T. A multicritical point is also observed at 6 K and 8 T. Furthermore, the specific heat data reveal enhancements of the anomalies at ∼4 K, probably associated with a strong spin-lattice coupling in this frustrated multiferroic material.

[Interpretation of 2019 edition of Wilderness Medical Society practice guidelines for prevention and treatment of frostbite].

The Wilderness Medical Society updated and published the Wilderness Medical Society practice guidelines for the prevention and treatment of frostbite in July 2019. The guidelines provide evidence-based recommendations for the prevention and treatment of frostbite, mainly including pathophysiology, classification, prevention, and treatment of frostbite. This paper focuses on the interpretation of the guidelines, aiming at making clinical medical staff understand the new progress of frostbite treatment and providing reference for clinical practice.

[Interpretation of the connotation of the colored drawing of Neijing Tu in the Museum of Chinese Medical History].

Neijing Tu(, Chart of Inner Landscape), collected by the Museum of Chinese Medical History, is a colored drawing which is used to guide Taoist internal alchemy training pattern. It belongs to the inheritance of the immortals in the Tao Yin(physical and breathing exercise) of traditional Chinese medicine in folk. It is the essence for nurturing vitality of the traditional Chinese medicine. Its core tenet is that one practices with both Shen(spirit) and Qi(pneuma) and makes both to fuse in perfect harmony way. The specific practice process includes four phases: refining Jing and converting it into Qi, refining Qi and converting it into Shen, extracting and then restoring Xu(void)from Shen, purifying Xu to fit Dao. This process contains the contents of the Secret Alchemy such as sub-Meridian Circle Vessel, overcoming the roadblock and entering Primary Meridian Circle Vessel, getting Yangshen (highest level spirit) and harmonizing the body and spirit. Its important value lies in being able to treat the disease which has not yet completely developed and the disease developed already.

Field-induced magnetic transitions and strong anisotropy in α-CoV2O6 single crystal.

The Ising-like antiferromagnet α-CoV2O6 has received considerable interests because of stabilized 1/3 magnetization plateau around 5 K under magnetic field applied along magnetic easy c-axis. In this work, this magnetization plateau was studied by varying temperature or rotating magnetic field. As temperature decreased, this stabilized plateau collapsed, and additional magnetic transitions were observed. As a result, a rich magnetic phase diagram was constructed and extended to temperature lower than previously reported. When magnetic field moved from the c to b (or a) axis, the magnetization plateau developed with field directions and vanished finally when the field was restricted in the ab plane. An impressive observation is that this 1/3-plateau can be stabilized and remain robust even when magnetic field deviated from the c axis, accompanied by the evolutions of the magnetic moments and the critical transition fields. We suppose that the origins of these temperature and angular dependences of the 1/3 magnetization plateau are related to strong spin-orbital coupling. Indeed, electron spin resonance (ESR) measurement gives large Landé factor of 8.9, evidencing that there exists strong spin-orbital coupling.

Effects of residual superdoses of phytase on growth performance, tibia mineralization, and relative organ weight in ducks fed phosphorus-deficient diets.

This study was conducted to determine the effects of residual superdoses of phytase on growth performance, tibia mineralization, and relative organ weight in ducks fed phosphorus-deficient diets. In Exp. 1, 4 kinds of commercial phytase were used to determine retention rate of phyatse with the phytase C being the highest via both high water-bath temperature (90%) and pelleting (50%), followed by phytase A, B, and D. In Exp. 2, a total of 560 male ducks were blocked based on body weight, and then allocated randomly to 7 treatments (5 replicates with 16 birds per replicate). Treatments included a maize-soybean meal-based diet with recommended calcium and 4.0 g non-phytate phosphorus (nPP)/kg starter diet or 3.8 g nPP/kg grower diet (positive control; PC), an nPP-deficient diet with 1.3 g nPP/kg starter diet or 1.1 g nPP/kg grower diet (negative control; NC), NC diets with increasing levels of residual phytase C (500, 1,000, 2,000, 3,000, and 4,000 units/kg feed) after pelleting. Birds fed NC diets had lower (P < 0.05) average daily gain (ADG) and average daily feed intake (ADFI) throughout the experiment compared with those fed PC diet. Supplementing NC diet with increasing residual superdoses of phytase improved (P < 0.05) ADG and ADFI quadratically in the entire experiment, while reduced feed-to-gain ratio (P < 0.05) quadratically during day 0 to 14. On day 14 and 35, birds fed NC diet had lower (P < 0.05) tibia length, weight, ash, calcium, phosphorus, and manganese contents than those fed PC diet. Increasing residual superdoses of phytase in NC diet increased (P < 0.05) tibia weight and ash, calcium, phosphorus contents quadratically on day 14 and 35. NC treatment increased (P < 0.05) the duodenum, jejunum, ileum, and cecum index compared with other treatments on day 14 and 35. Taken together, feeding increasing residual superdoses of phytase could counteract or exceed the negative effects of NC diet on growth performance, tibia mineralization, and relative organ weight in ducks.

Magnetism study on a triangular lattice antiferromagnet Cu2(OH)3Br.

Magnetism of Cu2(OH)3Br single crystals based on a triangular lattice is studied by means of magnetic susceptibility, pulsed-field magnetization, and specific heat measurements. There are two inequivalent Cu2+ sites in an asymmetric unit. Both Cu2+ sublattices undergo a long-range antiferromagnetic (AFM) order at [Formula: see text] K. Upon cooling, an anisotropy crossover from Heisenberg to XY behavior is observed below 7.5 K from the anisotropic magnetic susceptibility. The magnetic field applied within the XY plane induces a spin-flop transition of Cu2+ ions between 4.9 T and 5.3 T. With further increasing fields, the magnetic moment is gradually increased but is only about half of the saturation of a Cu2+ ion even in 30 T. The individual reorientation of the inequivalent Cu2+ spins under field is proposed to account for the magnetization behavior. The observed spin-flop transition is likely related to one Cu site, and the AFM coupling among the rest Cu spins is so strong that the 30 T field cannot overcome the anisotropy. The temperature dependence of the magnetic specific heat, which is well described by a sum of two gapped AFM contributions, is a further support for the proposed scenario.

[The molecular mechanisms underpinning auditory neuropathy].

Auditory neuropathy (AN) is a hearing disorder where cochlear inner hair cell and/or the auditory nerve function is disrupted while outer hair cell function is normal. It can affect people of all ages, from infancy to adulthood. People with auditory neuropathy may have normal hearing threshold, or hearing loss ranging from mild to severe; they always have poor speech-perception abilities. It is a heterogeneous disorder which can have either congenital or acquired causes. AN may result from specific loss of cochlear inner hair cells, disordered release of neurotransmitters by inner hair cell ribbon synapses, deafferentation accompanying loss of auditory nerve fibers, neural dys-synchrony or conduction block as a result of demyelination of nerve fibers and auditory nerve hypoplasia. Although the definition of AN includes the central part, its incidence is low, and the etiology and pathology are not clear. The present review aimed to provide an overview of the genetic conditions associated with AN and highlight the neural and synaptic mechanism of AN. Possible strategy for treatments of AN was also discussed.

Salvinorin A preserves cerebral pial artery autoregulation after forebrain ischemia via the PI3K/AKT/cGMP pathway.

This study aimed to investigate the protective effect of salvinorin A on the cerebral pial artery after forebrain ischemia and explore related mechanisms. Thirty Sprague-Dawley rats received forebrain ischemia for 10 min. The dilation responses of the cerebral pial artery to hypercapnia and hypotension were assessed in rats before and 1 h after ischemia. The ischemia reperfusion (IR) control group received DMSO (1 µL/kg) immediately after ischemia. Two different doses of salvinorin A (10 and 20 µg/kg) were administered following the onset of reperfusion. The 5th, 6th, and 7th groups received salvinorin A (20 µg/kg) and LY294002 (10 µM), L-NAME (10 µM), or norbinaltorphimine (norBIN, 1 µM) after ischemia. The levels of cGMP in the cerebrospinal fluid (CSF) were also measured. The phosphorylation of AKT (p-AKT) was measured in the cerebral cortex by western blot at 24 h post-ischemia. Cell necrosis and apoptosis were examined by hematoxylin-eosin staining (HE) and TUNEL staining, respectively. The motor function of the rats was evaluated at 1, 2, and 5 days post-ischemia. The dilation responses of the cerebral pial artery were significantly impaired after ischemia and were preserved by salvinorin A treatment. In addition, salvinorin A significantly increased the levels of cGMP and p-AKT, suppressed cell necrosis and apoptosis of the cerebral cortex and improved the motor function of the rats. These effects were abolished by LY294002, L-NAME, and norBIN. Salvinorin A preserved cerebral pial artery autoregulation in response to hypercapnia and hypotension via the PI3K/AKT/cGMP pathway.

[A preliminary discussion on the contents and value of Shi er mai (Twelve Channels) and Bie mai (Allo-channels), the medical bamboo slips unearthed from Han tomb in Laoguanshan of Chengdu].

The 52 medical bamboo slips entitled Si er ma (Twelve Channels) and Bie mai (Allo-channels) , unearthed from Han tomb in Laoguanshan, are the exclusive medical books concerning channels. Shi er mai is the first work bearing the term " heart dominating channel" , and the running pathways and manifestations of 12 channels. This book could be the major original sources of the 12-channel theories described in the Chapter of Jing mai (Channels) of Ling shu (Miraculous Pivot) . While Bie mai suggests the coexistence of the multi-channel systems at the time when the book was compiled and, together with the 12 "channel" , and 3 "branched collaterals" , these 2 books represent the original condition before the establishment of the mode of channel circulation in Ling shu, and is significant to explore the nature and origin of channel.

3D Modelling on Biodegradable Nanoparticle-Enhanced Cryoablation of Liver Tumor Based on Real Anatomical Model.

BACKGROUND: Nanoparticle-enhanced freezing is of great importance for developing a conformal targeted cryoablation for liver tumor with complex shape. However, the safety and biocompatibility of nanoparticles should also be of major concerns. OBJECTIVE: This study is to investigate the enhanced cryoablation mediated by the MgO nanoparticles which are nontoxic, biodegradable, and have few side-effects on the human body. MATERIALS AND METHODS: A three-dimensional numerical model has been developed based on a real geometrical anatomical structure to characterize such nanocryosurgical freezing of liver tumor. The evolutions of temperature field and ablation volume were investigated subject to different concentrations and scopes of the loaded nanoparticles, respectively. Additionally, the results of different probe numbers were also taken into consideration. RESULTS: It was found that the lesion growth was evidently affected by the configurations of both the nanoparticles and cryoprobes. Both ablation and frozen regions were enlarged with the increase of the loading ratio and scope of MgO nanoparticles. It was worth mentioning that thermal-physiological behavior of the adjacent large blood vessels also played an important role in affecting the target temperature field distribution. CONCLUSION: The present study established a feasible way for verisimilarly simulating the physiological manifestation of human liver in the process of nano-freezing modality, which would provide a valuable guidance for future clinical practice of conformal nano-cryoablation on liver tumor.

Consumption of nuts and legumes and risk of stroke: a meta-analysis of prospective cohort studies.

BACKGROUND AND AIM: The relationships between dietary nuts and legume intake and risk of stroke are inconsistent. We summarized the evidence by a meta-analysis of prospective cohort studies. METHODS AND RESULTS: We systematically searched the MEDLINE and EMBASE databases up to 31 January 2014. Random-effects models were used to calculate summary relative risks (SRRs) and 95% confidence intervals (CIs). Between-study heterogeneity was assessed using the Cochran's Q and I(2) statistics. Eight prospective studies with a total of 468,887 subjects and 10,493 stroke events were included in the meta-analysis. Overall, a diet containing greater amounts of legumes may be not associated with a lower risk of stroke (SRR = 0.95, 95% CI: 0.84-1.08; P(heterogeneity) = 0.091, I(2) = 43.2%); however, a diet containing greater amounts of nuts may be associated with a lower risk of stroke (SRR = 0.90, 95% CI: 0.81-0.99; P(heterogeneity) = 0.527, I(2) = 0). Gender significantly modified the effects of nut consumption on stroke risk, and high nut intake was associated with reduced risk of stroke in women (SRR = 0.85, 95% CI: 0.75-0.97) other than in men (SRR = 0.95, 95% CI: 0.82-1.11). CONCLUSION: The current meta-analysis provides some evidences for the hypothesis that high intake of dietary nut was inversely associated with stroke risk, whereas dietary legumes intake was not associated with stroke risk.

The Moncrief-Popovich catheter. A new peritoneal access technique for patients on peritoneal dialysis.

Existing catheter implantation techniques violate a fundamental premise of wound healing. The immediate presence of the catheter in the post operative surgical wound forms a passage for permanent colonization of the catheter tunnel and cuff(s). This is manifested by the almost universal presence of the biologic products of bacterial growth (biofilm) on the external and internal surfaces of these catheters. The Moncrief-Popovich catheter and implantation technique are designed to address this problem. The Moncrief-Popovich catheter is implanted in the standard fashion, except that the external segment of the catheter is buried subcutaneously at the time of implantation. After allowing 3-5 weeks for tissue in-growth in a sterile environment, a small incision is made in the skin through which the external segment of the catheter is exteriorized and attached to an adapter. A 2 year trial was conducted in 59 patients, comprising 530 patient-months of experience; the incidence of peritonitis was one episode for every 29.4 patient months. All but three of the patients used the standard spike exchange technique. In a recently initiated study using disconnect procedures in 63 of the 74 patients studied, the peritonitis rate was one episode for every 28.7 patient-months; patient-months have totalled 201.2 to date. There was a rate of one exit site infection every 12.57 patients-months. It was concluded that the Moncrief-Popovich catheter and implantation technique result in a substantial decrease in the incidence of peritonitis for patients using the standard spike exchange system.

[The antibiotic effect of Pseudomonas jinanensis sp. nov].

The Pseudomonas jinanensis has been isolated from soil and screened by antibioticgram assay and spermatogonial assay. It has certain antibiotic properties. The metabolite which has been produced is certainly effective against Staphylococcus aureus and some other positive germs. The preparation of Pseudomonas jinanensis vaccine, namely PJV. It's biological activity on the growth of tumor-bearing mice and the murine spermatogenesis cell. It is considered that enhancement of nonspecific immunologic function of the host might increase the efficacy of praziquantel on schistosomiasis in mice. PJV has certainly produced effectiveness against malignant pleural effusion (effective rate was 76.5%), cancer of lung (effective rate was 58.3%), many solid kinds of cancer (effective rate was 52.1%), and the total effective rate was 64.2%. It could increase the sensitivity of cancer cells to radiation. PJV could stimulate the animal (rabbit) to develop specific antibody. PJV might belong to the class of immunomodulating agents.

[A sarcoma-static new species of Pseudomonas, Pseudomonas jinanensis sp. nov].

A strain of Gram negative bacteria was isolated from the surface soil of Wuying Hill at Jinan, Shandong province with Gause's medium in 1973. It is a strain of antagonistic bacteria for hysterocervicoma, hepatoma and melanoma of mice screened from 2100 strains of bacteria. It is also antagonistic to Staphylococcus aureus, Bacillus subtilis and Micrococcus. It is a Gram negative bacterium with lophotrichous polar flagella. Straight rods in shape or with a little slightly curved rods, 0.5-0.6 X 1-2 microns, randomly arranged, poly-beta-hydroxybutyrate granules are accumulated in cells after 2-5 days cultivation. Water green soluble pigment and green fluorescent pigment are produced. Respiratory metabolism, chemoorganotroph, many carbon-containing organic compounds can be used as carbon sources, such as glucose, trehalose, ethanol, cellulobiose, fucose, arginine and betaine, but propionic acid or tartaric acid is not utilized. Inorganic nitrogen containing compounds can be used ae the sole source of nitrogen. No growth factor is necessary for growth. Gelatin is hydrolyzed. Starch and cellulose are not hydrolyzed. Nitrate is not reduced. Arginine dihydrolase is produced. Levan is produced from sucrose. Growth occurs from 7 degrees C to 37 degrees C and from pH 5.65-8.40. No growth occurs at 40 degrees C and at pH value below 4.86. It can not grow autotrophically with hydrogen. Its G + C contents in DNA is 58.1 mol%. DNA-DNA hybridization experiments reveals a relatedness value of 58.6% between this strain and Ps. fluorescens. The above evidence shows that this strain differs from all species known in Pseudomonas, such as Pseudomonas fluorescens group. Pseudomonas caryophylli, Pseudomonas cepacia, Pseudomonas marginata, Pseudomonas acidovorans, Pseudomonas testosteroni and Pseudomonas delafieldii.(ABSTRACT TRUNCATED AT 250 WORDS)

The epidemiology of lung cancer in Xuan Wei, China: current progress, issues, and research strategies.

In Xuan Wei, a rural Chinese county of about one million people, females' annual lung cancer mortality is China's highest, and males' is among China's highest. Xuan Wei's very high indoor air pollution levels (sometimes exceeding 20 mg/m3), residentially stable population, relatively uncomplicated lifestyle, and wide geographic variation in lung cancer mortality render it highly amenable to quantitative, interdisciplinary investigation of chemical carcinogens due to indoor air pollution. To date, epidemiologic findings reveal a closer association of lung cancer with the indoor burning of "smoky" coal (as opposed to "smokeless" coal or wood) than with tobacco use or occupation. Current aerometric, chemical, and toxicologic findings tend to confirm this association, though the specific carcinogenic constituents of Xuan Wei indoor air pollution have not yet been determined. Chinese and American investigators are conducting interdisciplinary field and laboratory investigations to quantify the lung cancer risk attendant on indoor air pollution relative to other factors, to measure and compare the characteristics of pollution from different Xuan Wei fuels, to determine the relative etiologic importance of pollution composition and concentration, and to develop quantitative relationships between air pollution dose and lung cancer risk.