The exploration of perioperative hypotension subtypes: a prospective, single cohort, observational pilot study.

Background: Hypotension is a risk factor for postoperative complications, but evidence from randomized trials does not support that a higher blood pressure target always leads to optimized outcomes. The heterogeneity of underlying hemodynamics during hypotension may contribute to these contradictory results. Exploring the subtypes of hypotension can enable optimal management of intraoperative hypotension. Methods: This is a prospective, observational pilot study. Patients who were ≥ 45 years old and scheduled to undergo moderate-to-high-risk noncardiac surgery were enrolled in this study. The primary objective of this pilot study was to investigate the frequency and distribution of perioperative hypotension and its subtypes (hypotension with or without cardiac output reduction). The exposure of hypotension and its subtypes in patients with and without myocardial or acute kidney injury were also explored. Results: Sixty patients were included in the analysis. 83% (50/60) of the patients experienced perioperative hypotension. The median duration of hypotension for each patient was 8.0 [interquartile range, 3.1-23.3] minutes. Reduced cardiac output was present during 77% of the hypotension duration. Patients suffering from postoperative myocardial or acute kidney injury displayed longer duration and more extensive exposure in all hypotension subtypes. However, the percentage of different hypotension subtypes did not differ in patients with or without postoperative myocardial or acute kidney injury. Conclusion: Perioperative hypotension was frequently accompanied by cardiac output reduction in moderate-to-high-risk noncardiac surgical patients. However, due to the pilot nature of this study, the relationship between hypotension subtypes and postoperative myocardial or acute kidney injury still needs further exploration. Clinical trial registration: https://www.chictr.org.cn/showprojEN.html?proj=134260, CTR2200055929.

Cellulolytic Bacillus cereus produces a variety of short-chain fatty acids and has potential as a probiotic.

Cellulolytic bacteria ferment dietary fiber into short-chain fatty acids, which play an important role in improving fiber utilization and maintaining intestinal health. Safe and effective cellulolytic bacteria are highly promising probiotic candidates. In this study, we isolated three strains of Bacillus cereus, which exhibited cellulolytic properties, from Kele pig feces. To assess the genetic basis of cellulose degradation by the isolates, whole-genome sequencing was used to detect functional genes associated with cellulose metabolism. Subsequently, we identified that the B. cereus CL2 strain was safe in mice by monitoring body weight changes, performing histopathologic evaluations, and determining routine blood indices. We next evaluated the biological characteristics of the CL2 strain in terms of its growth, tolerance, and antibiotic susceptibility, with a focus on its ability to produce short-chain fatty acids. Finally, the intestinal flora structure of the experimental animals was analyzed to assess the intestinal environment compatibility of the CL2 strain. In this study, we isolated a cellulolytic B. cereus CL2, which has multiple cellulolytic functional genes and favorable biological characteristics, from the feces of Kele pigs. Moreover, CL2 could produce a variety of short-chain fatty acids and does not significantly affect the diversity of the intestinal flora. In summary, the cellulolytic bacterium B. cereus CL2 is a promising strain for use as a commercial probiotic or in feed supplement. IMPORTANCE: Short-chain fatty acids are crucial constituents of the intestinal tract, playing an important and beneficial role in preserving the functional integrity of the intestinal barrier and modulating both immune responses and the structure of the intestinal flora. In the intestine, short-chain fatty acids are mainly produced by bacterial fermentation of cellulose. Therefore, we believe that safe and efficient cellulolytic bacteria have the potential to be novel probiotics. In this study, we systematically evaluated the safety and biological characteristics of the cellulolytic bacterium B. cereus CL2 and provide evidence for its use as a probiotic.

Why Treg should be the focus of cancer immunotherapy: The latest thought.

Regulatory T cells are a subgroup of T cells with immunomodulatory functions. Different from most cytotoxic T cells and helper T cells, they play a supporting role in the immune system. What's more, regulatory T cells often play an immunosuppressive role, which mainly plays a role in maintaining the stability of the immune system and regulating the immune response in the body. However, recent studies have shown that not only playing a role in autoimmune diseases, organ transplantation, and other aspects, regulatory T cells can also play a role in the immune escape of tumors in the body, through various mechanisms to help tumor cells escape from the demic immune system, weakening the anti-cancer effect in the body. For a better understanding of the role that regulatory T cells can play in cancer, and to be able to use regulatory T cells for tumor immunotherapy more quickly. This review focuses on the research progress of various mechanisms of regulatory T cells in the tumor environment, the related research of tumor cells acting on regulatory T cells, and the existing various therapeutic methods acting on regulatory T cells.

Associations of imbalance of intestinal flora with severity of disease, inflammatory factors, adiponectin, and vascular endothelial function of hypertension patients.

To explore the relationship between the severity of hypertension and the imbalanced intestinal flora, inflammatory factors, adiponectin (ADPN) and vascular endothelial function in primary hypertension patients. According to the grading criteria for hypertension, in total of 60 patients with primary hypertension in our hospital from April to July, 2020 were divided into Grade 1 group (n = 20), Grade 2 group (n = 20), and Grade 3 group (n = 20). The feces of the research subjects were collected to extract the deoxyribonucleic acid (DNA) and detect its composition of intestinal flora. Subsequently, the peripheral blood was collected to determine the changes in inflammatory factors interleukin-2 (IL-2), IL-4, tumor necrosis factor-α (TNF-α) and IL-1ß, serum immunoglobulin G (IgG) and IgM, ADPN and vascular endothelial function-related endothelin-1 (ET-1), nitric oxide (NO), vascular endothelial growth factor (VEGF), and intercellular adhesion molecule-1 (ICAM-1). There were no significant differences in the gender, age, and body mass index (BMI), the proportion of smokers, diet habit, probiotics and antihypertensive medication use, and number of diabetic cases among groups (p > 0.05). We found an inverse association between blood pressure measures and microbial diversity, in particular microbial richness (p < 0.05). Among the four major kinds of intestinal flora, the composition of firmicutes (p < 0.05) and bacteroidetes (p < 0.05) showed obvious differences among the three groups, and they had consistent trends with the changes in the abundance of firmicutes and bacteroidetes. Intestinal flora imbalance is closely related to the severity of hypertension, inflammatory factors, ADPN, and vascular endothelial function.

Value of shear wave elastography in the diagnosis and evaluation of cervical cancer.

The aim of the present study was to explore the value of shear wave elastography (SWE) in the differential diagnosis of cervical disease and to evaluate the infiltration of cervical cancer. A total of 40 inpatients with cervical cancer, 40 inpatients with cervical benign lesion and 40 healthy volunteers encountered between October 2014 and January 2017 were enrolled. All patients and volunteers underwent conventional ultrasound (US) and SWE examinations. The malignancy and the size (including long, tranverse and anteroposterior diameter) of the lesion were assessed on US. The elastic score, strain ratio, shear wave speed (SWS) and the size of lesions were determined on SWE. Infiltration of the uterus and vaginal vault were also evaluated on US and SWE. The SWS values of cervical cancers, cervical benign lesions and normal cervixes groups were compared. The results suggested that the optimal cut-off elasticity score for predicting cervical cancers was 3 points. The strain ratio between the cervical cancers and the cervical benign lesions exhibited a significant difference (P<0.01). The mean value of SWS for cervical cancers was significantly higher than that of cervical benign lesions and normal cervix (P<0.05). Regarding the lesion size and volume, SWE and pathological measurements were larger than those determined by US (P<0.05 for each). The lesion volume on SWE and pathological measurements exhibited no significant difference (P>0.05). Compared to the pathological diagnosis of focal infiltration of uterus and vaginal vault, the diagnostic accuracy of SWE was higher than that of US. In conclusion, SWE may be used to differentiate between cervical benign lesions and cervical cancers. The elastic score, strain ratio and SWS of cervical cancers were higher than those of cervical benign lesions. Furthermore, SWE is able to evaluate the infiltration of cervical cancer.

An alternative type of fullerene products from the reaction of [60]fullerene with alkoxides and subsequent derivatization.

Reaction of [60]fullerene with freshly prepared RCH(2)CH(2)ONa/RCH(2)CH(2)OH (R = H, Me, Et, Ph) in anhydrous toluene in the presence of air unexpectedly afforded fullerene products with a C(60)-fused tetrahydrofuran ring skeleton and an acetal moiety, which could be further transformed into C(60)-fused dihydrofurans, tolyl-substituted C(60)-fused tetrahydrofuran, and methanofullerenes bearing a formyl group by boron trifluoride etherate. Possible reaction mechanisms are proposed to explain the formation of different fullerene products.

Manganese(III) acetate-mediated free radical reactions of [60]fullerene with beta-dicarbonyl compounds.

[60]Fullerene reacted with various beta-dicarbonyl compounds in the presence of Mn(OAc)3*2H2O to generate dihydrofuran-fused [60]fullerene derivatives or 1,4-bisadducts. Dihydrofuran-fused [60]fullerene derivatives 2 could be formed by treatment of alpha-unsubstituted beta-diketones 1a-e or beta-ketoesters 1f and 1g with [60]fullerene in refluxing chlorobenzene in the presence of Mn(III). Solvent-participated unsymmetrical 1,4-bisadducts 3 were obtained through the reaction of [60]fullerene with dimethyl malonate 1h or alpha-substituted beta-dicarbonyl compounds 1i-1n in toluene. A possible reaction mechanism for the formation of different fullerene derivatives is proposed.