The Effectiveness and Safety of Intrapartum or Postpartum Catheterization in the Prevention of Postpartum Urinary Retention: A Scoping Review.

INTRODUCTION AND HYPOTHESIS: Catheterization is a common treatment for postpartum urinary retention (PUR); however, its application before diagnosis of PUR remains unclear. The aim was to give an overview of the existing literature on the effectiveness and safety of intrapartum or postpartum catheterization in the prevention of PUR. METHODS: This scoping review followed a methodological framework. PubMed, the Cochrane Library, Embase, Web of Science, the China National Knowledge Infrastructure, WanFang, the China Science and Technology Journal Database, and the China Biomedical Literature Database were searched from the inception of each database to 21 May 2023. RESULTS: The search revealed 16 studies examining three different catheterization methodologies, including 12 intrapartum studies. Ten studies concluded that intrapartum or postpartum catheterization prevented PUR, two of which were only for overt or covert PUR. In 4 out of 13 experimental studies, no significant difference was found: one for intrapartum catheterization versus routine nursing, the other for intrapartum or postpartum intermittent versus indwelling catheterization. However, one found that postpartum disposable catheterization after ineffective targeted care reduced the incidence of PUR compared with indwelling catheterization. One out of the 3 case-control studies concluded that prenatal catheterization ≥2 times was a risk factor for PUR. CONCLUSIONS: Based on the findings in this scoping review, catheterization prior to the diagnosis of PUR appears to play a role in preventing PUR and is safe. Preliminary evidence is accumulating on the effectiveness of three types of catheterization methods in preventing PUR, but more comprehensive studies are needed to establish these findings.

Nonlinear Optical Properties of Cs2AgIn1-xBixCl6 Single Crystals.

Lead-free double perovskites offer enhanced stability and lower toxicity compared to their lead-based counterparts. Dual B-site cations can introduce elemental and structural diversity into double perovskite materials, enabling fine-tuning of the optical properties. However, the study of the nonlinear optical (NLO) properties of lead-free double perovskites is still nascent, hindering their relevant potential applications. Based on this, this work synthesizes a series of Cs2AgIn1-xBixCl6 (x = 0, 0.1, 0.25, 0.75, 1) single crystals, with the aim to explore the impact of composition on their NLO properties. Interestingly, Cs2AgInCl6 shows surface defect-induced second harmonic generation. With increasing Bi3+ concentration, the multiphoton absorption coefficients of Cs2AgIn1-xBixCl6 single crystals increase as a result of increasing state density. This work is helpful to understand well the NLO properties of lead-free double perovskites, laying a foundation for the development of related applications.

Factors associated with urinary retention after vaginal delivery under intraspinal anesthesia: a path analysis model.

INTRODUCTION AND HYPOTHESIS: Women who have intraspinal anesthesia for delivery are more likely to experience postpartum urinary retention (PUR), which, if not recognized and treated promptly, can result in long-term urinary dysfunction. Many factors influencing PUR have been proposed, but no study has been conducted to investigate the relationship between them. This study is aimed at determining the influencing factors of PUR and to explore the relationship between them. METHODS: A prospective, cross-sectional survey using self-made questionnaires was conducted among 372 puerperae in a Grade A hospital in Guangzhou, China, from April to September 2022. SPSS25.0 and AMOS24.0 were used for data analysis, and a path analysis model was established to determine the relationship between the influencing factors. RESULTS: The incidence of PUR was 49.85%. Residence, the level of postpartum pain, and the change of postnatal urination position had a direct effect on PUR. Episiotomy and analgesic duration have both direct and indirect effects on PUR. Forceps delivery, perineal edema and oxytocin had an indirect effect on PUR. Variables could influence the occurrence of PUR by mediating the analgesic duration, episiotomy, postpartum pain level, and postnatal urination position changes. CONCLUSIONS: This study provides an empirical model to illustrate the relationship between PUR and related factors in women who delivered under intraspinal anesthesia. In future management, more attention should be paid to women who live in cities, have higher levels of postpartum pain, longer analgesic duration, higher grade of perineal edema, and received episiotomy, forceps delivery, and oxytocin during labor.

Noninvasive external therapy of traditional Chinese medicine for preventing postpartum urinary retention in women with vaginal delivery: A network meta-analysis.

BACKGROUND: To compare the effect of different noninvasive external therapies of traditional Chinese medicine (TCM) on the prevention of postpartum urinary retention (PUR) using a network meta-analysis (NMA). METHODS: A search of the China National Knowledge Infrastructure, WanFangDate, VIP, China Biomedical Literature Database, PubMed, The Cochrane Library, Embase, and Web of Science databases were reviewed for related randomized controlled trials dated between database inception and December 31, 2022, on the prevention of PUR by noninvasive TCM. Two researchers independently screened the literature, extracted the data, and assessed the risk of bias in the included studies; then, a NMA was performed using Revman5.3 software, State13.1 software, and frequency methodology. RESULTS: In total, 16 studies involving 3637 cases of parturients and 9 types of noninvasive TCM external treatments were incorporated into the NMA. The NMA results show that based on routine nursing, in terms of reducing the incidence of urinary retention, acupoint compressing combined with auricular acupressure is ranked first, followed by acupoint hot compress, acupoint massage combined with auricular acupressure, Yin-Yang therapy, acupoint massage, auricular acupressure, acupoint compressing, and routine nursing. In terms of urination time, acupoint compressing combined with auricular acupressure ranked first, followed by acupoint massage combined with auricular acupressure, acupoint electrical stimulation, acupoint compressing, TCM heating therapy, acupoint massage, auricular acupressure, and routine nursing. In terms of reducing residual urine volume after the first urination, acupoint compressing combined with auricular acupressure was ranked first, followed by auricular acupressure, acupoint compressing, acupoint massage, TCM heating therapy, and routine nursing. CONCLUSION: Current evidence shows that acupoint compressing combined with auricular acupressure may be the best noninvasive TCM treatment for preventing PUR based on routine nursing; however, further high-quality clinical randomized controlled trials are needed for validation and support.

High Platelet Count is a Potential Prognostic Factor of the Early Recurrence of Hepatocellular Carcinoma in the Presence of Circulating Tumor Cells.

Purpose: Recent studies indicated the vital role of platelet in enhancing the survival of circulating tumor cells (CTCs) in the blood, thereby stimulating the metastasis of tumors. CTCs have been considered an indicator of early tumor recurrence. Therefore, this study evaluated the prognostic potential of platelet count in predicting the early recurrence of hepatocellular carcinoma (HCC) in the presence of CTCs. Patients and Methods: 127 patients, whose preoperative CTCs were detected, were enrolled in this study. Univariate analysis was performed to identify the significant association of factors with the early recurrence of HCC, followed by multivariate analysis to determine the independent prognostic indicators. The prediction potential was evaluated using receiver operating characteristic (ROC) curves. Results: A total of 81 (63.7%) patients showed early HCC recurrence. The platelet count ≥225×109/L (hazard ratio, HR: 1.679, P = 0.041), CTCs >5/5 mL (HR: 2.467, P = 0.001), and presence of microvascular invasion (MVI) (HR: 2.580, P = 0.002) were independent factors correlated with the early recurrence of HCC in multivariate analysis. The prognostic potential of the combined CTCs-platelet count (0.738) was better than that of CTCs (0.703) and platelet (0.604) alone. The subgroup analysis, excluding 23 patients with pathological cirrhosis and splenomegaly, showed that the platelet count ≥225×109/L and CTCs >5/5 mL were also independent factors of early HCC recurrence. The prediction potential of the combined CTCs-platelet count was 0.753, which was better than that of the whole cohort. Kaplan-Meier survival curve analysis indicated that the HCC patients with high platelet or CTCs had the worse recurrence-free survival (RFS). Conclusion: The high platelet count was an independent factor of early HCC recurrence in the presence of CTCs. The combination of preoperative CTCs and platelet count could effectively predict the early recurrence of HCC. The subgroup analysis also showed similar results.

Effect of dexmedetomidine on the Montreal Cognitive Assessment in older patients undergoing pulmonary surgery.

OBJECTIVE: We investigated the effect of dexmedetomidine anesthesia on postoperative cognitive function after pulmonary surgery. METHODS: A blinded, prospective, randomized, placebo-controlled study was performed on 60 patients (age range 65-74 years) undergoing lobectomy by video-assisted thoracoscopic surgery (29 in the dexmedetomidine group; 31 in the placebo group). Dexmedetomidine group patients received dexmedetomidine, and placebo group patients received an equal volume of physiological saline 20 minutes before anesthesia induction. Cognitive function was evaluated using the Montreal Cognitive Assessment 1 day before surgery and on postoperative day (POD)1, POD3, and POD7. The regional cerebral oxygen saturation (rSO2) was monitored continuously by near-infrared spectroscopy before anesthesia. RESULTS: The Montreal Cognitive Assessment score was significantly different between the two groups on POD1 (dexmedetomidine 26.4 ± 0.73 vs. placebo 25.5 ± 0.96) and POD3 (dexmedetomidine 27.1 ± 0.79 vs. placebo 26.6 ± 0.80). Specifically, attention and orientation scores were increased in the dexmedetomidine group on POD1 and POD3. The rSO2 was not significantly different between the dexmedetomidine and placebo groups. CONCLUSION: Dexmedetomidine given before induction of anesthesia could reduce the risk of postoperative cognitive dysfunction and might not decrease rSO2. Hence, dexmedetomidine could be employed in pulmonary surgical procedures, especially for older patients with a high risk of cognitive dysfunction.

Strong two-photon absorption induced by energy funneling in chiral quasi-2D perovskites.

Quasi-2D Ruddlesden-Popper-type perovskites (RPPs) exhibit excellent nonlinear optical properties due to their multiple quantum well structures with large exciton binding energy. Herein, we introduce chiral organic molecules into RPPs and investigate their optical properties. It is found that the chiral RPPs possess effective circular dichroism in the ultraviolet to visible wavelengths. Two-photon absorption (TPA)-induced efficient energy funneling from small- to large-n domains is observed in the chiral RPP films, which induces strong TPA with a coefficient up to 4.98 cm MW-1. This work will broaden the application of quasi-2D RPPs in chirality-related nonlinear photonic devices.

Expression of Rv2031c-Rv2626c fusion protein in Mycobacterium smegmatis enhances bacillary survival and modulates innate immunity in macrophages.

Dormancy-associated antigens encoded by the dormancy survival regulon (DosR) genes are required for survival of Mycobacterium tuberculosis (Mtb) in macrophages. However, mechanisms underlying survival of Mtb in macrophages remains to be elucidated. A recombinant Mycobacterium smegmatis strain (rMs) expressing a fusion protein of two dormancy­associated antigens Rv2031c and Rv2626c from Mtb was constructed in the present study. In an in vitro culture, growth rate of rMs was lower compared with Ms. A total of 24 h following infection of murine macrophages with rMs or Ms, percentage of viable cells decreased and the number of bacteria in viable cells increased compared with Ms, demonstrating that virulence and intracellular survival of rMs were enhanced. Compared with macrophages infected with Ms, necrosis of macrophages infected with rMs was increased, while apoptosis was inhibited. Macrophages infected with rMs secreted more interferon­Î³ and interleukin­6, but fewer nitric oxide and tumor necrosis factor­α, compared with macrophages infected with Ms. The present study demonstrated that the fusion protein composed of dormancy­associated antigens Rv2031c and Rv2626c in Ms serves a physiological function of a dormancy­associated antigen and modulates innate immunity of host macrophages, therefore favoring intracellular bacillary survival.

Ideal Cardiovascular Health Metrics and Coronary Artery Calcification in Northern Chinese Population: A Cross-sectional Study.

OBJECTIVE: Coronary artery calcification (CAC) is a well-established risk predictor of coronary heart disease events and is recognized as an indicator of subclinical atherosclerosis. METHODS: A cross-sectional study consisting of 2999 participants aged ⋝40 years from the Jidong community of Tangshan City, an industrial and modern city of China, was conducted between 2013 and 2014 to examine the association between the ideal cardiovascular health (CVH) metrics and CAC. The ideal CVH metrics were determined based on the definition of the American Heart Association (AHA). The participants were then grouped into 4 categories according to the quartiles of their CVH metric scores as follows: first quartile (0-2), second quartile (3), third quartile (4), and fourth quartile (5-7). CAC was assessed by using high-pitch dual-source CT, and patients were identified based on thresholds of 0, 10, 100, or 400 Agatston units, as per common practice. RESULTS: The prevalence of subclinical atherosclerosis was 15.92%, 13.85%, 6.76%, and 1.93%, determined by using the CAC scores at thresholds of 0, 10, 100, and 400 Agatston units, respectively. Compared with the group in the first quartile, the other three CVH groups had a lower odds ratio of CAC >0 after adjusting for age, sex, income level, education level, and alcohol use in the logistic regression analysis. The odds ratios in these groups were 0.86 [95% confidence interval (CI), 0.63-1.17; P<0.05], 0.75 (95% CI, 0.55-1.02; P<0.05), and 0.49 (95% CI, 0.35-0.69; P<0.05), respectively. These associations of CAC with the CVH metrics were consistent when different CAC cutoff scores were used (0, 10, 100, or 400). CONCLUSION: The participants with more-ideal cardiovascular metrics had a lower prevalence of subclinical atherosclerosis determined according to CAC score. Maintaining an ideal cardiovascular health may be valuable in the prevention of atherosclerosis in the general population.

[Research progress on peptidoglycan recognition proteins of medical shells and molluscs].

Peptidoglycan recognition proteins (PGRPs) are highly conserved pattern recognition receptors in evolution, and they can recognize peptidoglycan (PGN) and bacteria that contain PGN in their cell wall component in early immune process of host, then provide signal transduction and activate a series of immune proteins. PGRPs are extensively present in insects, molluscs, echinoderms and vertebrates. Research progress and frontiers on PGRPs gene, type, structure, express localization, function, and evolution in medical molluscs and other snails were briefly reviewed in this article.

Anatomic properties of coronary arteries are correlated to the corrected thrombolysis in myocardial infarction frame count in the coronary slow flow phenomenon.

BACKGROUND: Coronary slow flow phenomenon (CSFP) is an important, angiographic clinical entity, but its etiology remains unclear. The purpose of this study was to explore the potential role of local coronary anatomic properties in the genesis of CSFP. METHODS: One hundred and thirty-one consecutive patients with CSFP and 131 patients with angiographically normal coronary flow were prospectively enrolled after documenting coronary flow by corrected thrombolysis in myocardial infarction frame count (CTFC). Local anatomic parameters including the tortuosity index (TI), the ostial-to-middle diameter ratio, the ostial-to-middle cross-sectional area ratio, and the number of distal branches (NDB) of arteries at end-systole were compared between patients with CSFP and controls. RESULTS: For each major coronary artery, CSFP patients had higher TI and NBD compared with controls (all P<0.05). The diameter ratio and cross-sectional area ratio of the three major coronary arteries were higher in the CSFP group (P=0.004 and 0.020, respectively). The TI (r=0.476, P<0.001) and NDB (r=0.186, P=0.004) were significantly correlated with CTFC. However, the higher TI (ß=0.424, P<0.001) was the only independent correlate to CTFC. Multivariate logistic analysis revealed that TI (adjusted odds ratio 1.17, 95% confidence interval 1.11-1.23, P<0.001) and NDB (adjusted odds ratio 2.20, 95% confidence interval 1.50-3.21, P<0.001) were independent predictors of CSFP. CONCLUSION: The presence of CSFP was associated with higher tortuosity and more distal branches in coronary arteries, indicating that the anatomic properties of coronary arteries could also play a role in the pathogenesis of CSFP.

[Status quo and factors influencing smoking cessation in cigarette smoking patients with coronary artery disease].

OBJECTIVE: To investigate the status quo of smoking cessation and analyze factors influencing smoking cessation in cigarette smoking patients with coronary artery disease (CAD). METHOD: A total of 350 smoking patients with CAD was surveyed by questionnaire, logistic regression analysis was performed to analyze factors influencing smoking cessation. RESULTS: Incidence of smoking cessation was 57.1% (200/350) in this cohort. Patients were divided into two groups, the elderly (> 65 years old, n = 111) and the young group (≤ 65 years old, n = 239). The smoking cessation rate in the elderly group is significantly higher than in the young group (71.2% vs. 50.6%, P < 0.001). Aged patients and patients with high cultural level are easier to give up smoking. Logistic analysis showed that age ≤ 65 years old (OR = 2.336, P = 0.004), low cultural level (OR = 1.310, P = 0.028), PCI (OR = 0.261, P < 0.001), coronary artery bypass graft (OR = 0.107, P = 0.004), total family income > 4000 RMB/month (OR = 1.828, P = 0.003) are risk factors for failed smoking cessation. There are 76 patients smoking again in current smokers, most due to lack of self-control (76.3%). Compared to the elderly group, there is a higher proportion of smoking again due to the need of daily communication and work in the young group. CONCLUSIONS: We still need to raise the awareness of smoking cessation for smoking patients with CAD. Following factors should be focused for tobacco control in CAD patients: younger age, lower cultural level, not treated with PCI or CABG, patients with smoking family members, higher body mass index and higher total family income.

Can transthoracic Doppler echocardiography be used to detect coronary slow flow phenomenon?

BACKGROUND: Coronary slow flow phenomenon (CSFP) is an important, angiographic clinical entity but is lacking non-invasive detecting techniques. This study aimed to elucidate the value of transthoracic Doppler echocardiography (TTDE) in the diagnosis and monitoring of coronary slow flow in left anterior descending (LAD) coronary artery. METHODS: We consecutively enrolled 27 patients with CSFP in LAD detected by coronary arteriography from August 2009 to April 2010. Thirty-eight patients with angiographically normal coronary flow served as control. Corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC) was used to document coronary flow velocities. All subjects underwent TTDE within 24 hours after coronary angiography. LAD flow was detected and the coronary diastolic peak velocities (DPV) and diastolic mean velocities (DMV) were calculated. RESULTS: Sixty of 65 (92.3%) subjects successfully underwent TTDE. Baseline clinical characteristics were similar between the two groups. Coronary DPV and DMV of LAD were significantly lower in the CSFP group than in the control group ((0.228 ± 0.029) m/s vs. (0.302 ± 0.065) m/s, P = 0.000; (0.176 ± 0.028) m/s vs. (0.226 ± 0.052) m/s, P = 0.000, respectively). There was a high inverse correlation between CTFC and coronary DPV and DMV (r = -0.727, P = 0.000; r = -0.671, P = 0.000, respectively). Receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) was less than one half for coronary DPV (AUC = 0.104) and DMV (AUC = 0.204), respectively. CONCLUSIONS: In patients with CSFP, there is a high inverse correlation between CTFC and coronary diastolic flow velocities in the LAD coronary artery, as measured by TTDE. The value of TTDE in the monitoring and evaluation of coronary flow in patients with CSFP deserves further investigation.

[Effects of perindopril and spirolactone on plasma aldosterone and left atrial remodeling in a canine model of atrial fibrillation].

OBJECTIVE: To investigate the effects of perindopril and spirolactone on plasma aldosterone (Ald) and left atrial remodeling and function in a canine model of atrial fibrillation (AF). METHODS: Adult dogs were randomly assigned to receive normal diet (group A), perindopril (group B, 1 mgxkg(-1)xd(-1)) and spironolactone (group C, 10 mgxkg(-1)xd(-1), n = 6 each) and rapid paced (500 beats/min) for 8 weeks. Plasma Ald levels as well as atrial dimension and function at baseline and at 4 and 8 weeks after pacing were measured by RIA and echocardiography, respectively. Incidence of maintained AF and AF duration were recorded when pacing was stopped after 8 weeks of pacing. Left and right atrial tissues were collected for measurements of tissue Ald levels and fibrosis. RESULTS: Plasma Ald was similar among groups at baseline (P > 0.05) and significantly increased post 4 and 8 weeks pacing in group A (P < 0.05) while remained unchanged post pacing in group B and C (P > 0.05) compared to respective baseline level. Atrial Ald was significantly lower in group B and C compared that in group A post 8 weeks pacing (P < 0.05). Left atrial dimension, end-systolic and end-diastolic volume were significantly increased while left atrial ejection fraction (LAEF) was significantly reduced post pacing in group A (all P < 0.05 vs. baseline) and thses changes were significantly attenuated in group B and C (P < 0.05 vs. group A). Incidence of maintained AF and AF duration post pacing as well as interstitial collagen volume fraction were significantly lower in group B and C compared those in group A (P < 0.05). CONCLUSION: Increased Ald might be an important pathogenesis for AF formation and progression, spironolactone and perindopril could attenuate atrial remodeling and improve atrial function by reducing plasma and tissue Ald levels in this model.