Intravenous Infusion of Lidocaine Can Accelerate Postoperative Early Recovery in Patients Undergoing Surgery for Obstructive Sleep Apnea.

Obstructive sleep apnea (OSA) is defined by intermittent and recurrent episodes of partial or complete obstruction of the upper airway during sleep. Intermittent and recurrent hypoxia/reoxygenation is the main pathophysiological mechanism of OSA. Its consequences include systemic inflammation, activation of the sympathetic nervous system, and release of oxygen free radicals. Infusion of intravenous (IV) lidocaine has anti-inflammatory, antihyperalgesic, and analgesic properties, supporting its use as an anesthetic adjuvant. Lidocaine can reduce nociception and/or cardiovascular responses to surgical stress, as well as postoperative pain and/or analgesic requirements. Because of the high prevalence of OSA in obese patients, the use of opioids to manage postoperative pain in that population is often accompanied by the development of adverse respiratory events, such as hypoventilation and hypoxemia. IV infusion of lidocaine has been shown to enhance the quality of early recovery after laparoscopic bariatric and upper airway surgery. However, limited evidence exists regarding its use in patients undergoing surgery for OSA. In addition, whether IV infusion of lidocaine can improve postoperative early recovery in patients undergoing surgery for OSA remains unknown. Therefore, we hypothesized that IV infusion of lidocaine can improve postoperative early recovery in patients undergoing surgery for OSA. Perioperative infusion also may be a promising analgesic adjunct to enhanced recovery after surgery (ERAS) protocols.

Overexpression of Hsc70 promotes proliferation, migration, and invasion of human glioma cells.

Migration and invasion are often recognized as the main reasons for the high recurrence and death rates of glioma and limit the efficacy of surgery and other antitumor therapies. In this study, we found over activation of heat shock cognate protein 70 (Hsc70) in human glioma specimens, which was closely related to glioma grade. We investigated whether Hsc70 induced the migration and invasion of glioma cells. Wound healing and transwell migration assay were used to determine the migration and invasion ability of human glioma U251 and U87 cells, in which the expression of Hsc70 was knocked down by small interfering RNA. Western blot analysis was performed to determine the expression of FAK-Src signaling in malignant glioma cells. The results showed that Hsc70 deficiency significantly retarded migration and invasion and reduced the phosphorylation of FAK, Src, and Pyk2 in U251 and U87 cells. Overall, our results indicate that the migration and invasion capacity of human brain glioma cells is at least partly induced by Hsc70-dependent activation of FAK-Src signaling.

Comparison between auto-trilevel and bilevel positive airway pressure ventilation for treatment of patients with concurrent obesity hypoventilation syndrome and obstructive sleep apnea syndrome.

PURPOSE: Our study aims to compare the difference in clinical efficacy between auto-trilevel positive airway pressure (auto-trilevel PAP) ventilator and conventional fixed bilevel positive airway pressure (BiPAP) ventilator for obesity hypoventilation syndrome (OHS) patients with coexisting moderate or severe obstructive sleep apnea hypopnea syndrome (OSAHS). METHODS: Twenty-three OHS patients with moderate or severe OSAHS enrolled between January 2015 and September 2017 underwent ventilation by three different modes of positive airway pressure (PAP) for 8 h per night. A single variable mode was applied at the first night followed by two nights when no PAP therapy was carried out as a washout period between each mode. The inspiratory positive airway pressure (IPAP) decided by PaCO2 was consistently used for modes 1, 2, and 3. In mode 1, the expiratory positive airway pressure (EPAP) issued by BiPAP was decided by the minimal PAP levels for cessation of snoring. However, in mode 2, the EPAP was fixed at 3 cmH2O higher than this value. With the use of auto-trilevel PAP in mode 3, the EPAP was set to initially match that of mode 1 but the end of EPAP (EEPAP) was automatically regulated to be elevated according to upper airway patency condition. We also compared the following parameters including apnea hypopnea index (AHI), minimal SpO2 (miniSpO2), arousal index, and sleep efficiency during sleep; PaCO2 in the morning and Epword sleepiness score (ESS) at daytime were measured prior to and during PAP treatment as well as between three selected PAP modes. RESULTS: Compared with the parameters before ventilation therapies, all three variable modes of ventilation were associated with a higher nocturnal miniSpO2 and sleep efficiency (all P < 0.01). Among the three variable modes, mode 3 resulted in not only the lowest arousal index and daytime ESS but also the highest sleep efficiency. Compared to mode 1, mode 2 demonstrated a significantly reduced AHI and an elevated miniSpO2 and morning PaCO2 (all P < 0.05), while mode 3 was associated with a decreased AHI, an increased miniSpO2 (all P < 0.05), and no statistical change of PaCO2 following the end of PAP treatment (P > 0.05). Comparison between mode 2 and mode 3 revealed that mode 3 had a significantly lower PaCO2 (P < 0.05), but displayed no remarkable changes of AHI and miniSpO2 (all P > 0.05). CONCLUSION: Compared to fixed BiPAP ventilation, auto-trilevel PAP ventilation could more effectively correct hypercapnia, achieve lower index of nocturnal apnea and hypopnea, more improved sleep quality, and lower daytime sleepiness score. Auto-trilevel PAP ventilation is therefore more efficacious than conventional BiPAP ventilation in non-invasive ventilation therapy for OHS patients with concurrent moderate or severe OSAHS.

Risk factors of coronary artery stenosis in patients with obstructive sleep apnoea: a prospective study.

OBJECTIVE: To investigate the prevalence of coronary artery disease and characteristics of coronary artery in patients with obstructive sleep apnoea. METHODS: The prospective study was conducted at the Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, China, from January, 2012, to June, 2015, and comprised consecutive patients with diagnosed obstructive sleep apnoea. High-resolution 320-slice coronary computed tomography was performed in all the patients. Data was evaluated for the presence of coronary lumen narrowing. Demographic, clinical, laboratory, and echocardiographic characteristics were carefully recorded. Logistic regression was used for multivariate analysis of independent risk factors. SPSS 16 was used for data analysis. RESULTS: Of the 277 patients, 186(67.14%) were males. The overallmean age was 55.1±14.3 years. Coronary artery disease was found in 41(14.8%) patients. Prospective Cardiovascular Münster score, uric acid, triglyceride, C-reactive protein, apnoea hypopnoea index, Epworth sleepiness scale values were significantly higher in patients with the disease (p<0.05 each). Higher Prospective Cardiovascular Münster score, C-reactive protein, apnoea hyponoea index levels had a significant ability to reflect the occurrence of coronary artery disease (p<0.05 each). CONCLUSIONS: Coronary heart disease occurrence in obstructive sleep apnoea patients was found to be strongly related to Prospective Cardiovascular Münster score, apnoea hyponoea index and Creactive protein level.

Design and performance of a terahertz absorber based on patterned graphene.

Modern terahertz (THz) technology offers the advantage of enhanced target detection ability with high spatial and temporal resolutions in the THz band, which makes it a formidable threat to stealth targets. Consequently, THz absorbers have outstanding potential as an electromagnetic countermeasure. In this Letter, we design, fabricate, and characterize a THz absorber based on patterned graphene. We present the transfer, photolithography, and etching processes involved in graphene patterning, as well as the experimental measurements of the fabricated absorber. Our simulations show that with an increase in the Fermi energy, the performance of the designed absorber gradually improves and, finally, decreases slightly. Further, the absorption bandwidth first broadens and then narrows slightly. The effective bandwidth with absorption ≥90% ranges from 1.54 to 2.23 THz, with the relative bandwidth (RBW) reaching about 36.6%. Although the measured RBW (from ∼12% to ∼14% and then to ∼8%) slightly deviates from the simulated one, the position of the resonant frequency is well matched between theory and experiment. Moreover, we illuminate the absorption mechanism using the theory of destructive interference. This Letter can significantly contribute to the design, manufacture, and application of patterned graphene-based THz absorbers.

miR-200b-3p in plasma is a potential diagnostic biomarker in oral squamous cell carcinoma.

CONTEXT: Circulating MicroRNAs (miRNAs) are emerging as novel biomarkers for tumour. OBJECTIVE: Evaluate the diagnostic potential of plasma miR-200b-3p in oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: miR-200b-3p was detected by qRT-PCR in paired pre-operative and post-operative plasmas from 80 OSCC patients and 80 healthy controls. RESULTS: Plasma miR-200b-3p was significantly upregulated in OSCC, and it was higher in WHO II/III grade than WHO I grade. The AUC of miR-200b-3p for OSCC was 0.9173. miR-200b-3p was significantly downregulated after surgery. High miR-200b-3p expression was associated with poor prognosis. DISCUSSION AND CONCLUSION: Plasma miR-200b-3p could be a potential diagnostic biomarker for OSCC.

Auto-trilevel versus bilevel positive airway pressure ventilation for hypercapnic overlap syndrome patients.

PURPOSE: Although bilevel positive airway pressure (Bilevel PAP) therapy is usually used for overlap syndrome (OS), there is still a portion of OS patients in whom Bilevel PAP therapy could not simultaneously eliminate residual apnea events and hypercapnia. The current study was expected to explore whether auto-trilevel positive airway pressure (auto-trilevel PAP) therapy with auto-adjusting end expiratory positive airway pressure (EEPAP) can serve as a better alternative for these patients. METHODS: From January of 2014 to June of 2016, 32 hypercapnic OS patients with stable chronic obstructive pulmonary diseases (COPD) and moderate-to-severe obstructive sleep apnea syndrome (OSAS) were recruited. Three variable modes of positive airway pressure (PAP) from the ventilator (Prisma25ST, Weinmann Inc., Germany) were applicated for 8 h per night. We performed the design of each mode at each night with an interval of two nights with no PAP treatment as a washout period among different modes. In Bilevel-1 mode (Bilevel-1), the expiratory positive airway pressure (EPAP) delivered from Bilevel PAP was always set as the lowest PAP for abolishment of snoring. For each patient, the inspiratory positive airway pressure (IPAP) was constantly set the same as the minimal pressure for keeping end-tidal CO2 (ETCO2) ≤45 mmHg for all three modes. However, the EPAP issued by Bilevel PAP in Bilevel-2 mode (Bilevel-2) was kept 3 cmH2O higher than that in Bilevel-1. In auto-trilevel mode (auto-trilevel) with auto-trilevel PAP, the initial part of EPAP was fixed at the same PAP as that in Bilevel-1 while the EEPAP was automatically regulated to rise at a range of ≤4 cmH2O based on nasal airflow wave changes. Comparisons were made for parameters before and during or following treatment as well as among different PAP therapy modes. The following parameters were compared such as nocturnal apnea hypopnea index (AHI), minimal SpO2 (minSpO2), arousal index, sleep structure and efficiency, morning PaCO2, and daytime Epworth Sleepiness Scale (ESS). RESULTS: Compared with the parameters before PAP therapies, during each mode of PAP treatment, significant reduction was detected in nocturnal AHI, arousal index, morning PaCO2, and daytime ESS while significant elevation was revealed in nocturnal minSpO2 and sleep efficiency (all P < 0.01). Comparison among three PAP modes indicated that under the same IPAP, the auto-trilevel PAP mode could result in the lowest arousal index, daytime ESS, and the highest sleep efficiency. Compared with Bilevel-1, it was detected that (a) AHI was lower but minSpO2 was higher in both Bilevel-2 and auto-trilevel (all P < 0.05) and (b) morning PaCO2 showed no statistical difference from that in auto-trilevel but displayed higher in Bilevel-2 (P < 0.05). Compared with Bilevel-2, in auto-trilevel, both AHI and minSpO2 showed no obvious changes (all P > 0.05) except with a lower morning PaCO2 (P < 0.05). CONCLUSION: Auto-trilevel PAP therapy was superior over conventional Bilevel PAP therapy for hypercapnic OS patients with their OSAS moderate to severe, since auto-trilevel PAP was more efficacious in synchronous elimination of residual obstructive apnea events and CO2 retention as well as in obtaining a better sleep quality and milder daytime drowsiness.

Effect Evaluation of Modified Uvulopalatopharyngoplasty With Low-Temperature Plasma and Selective Nasal Cavity Vasodilatation With Tongue Volume Reduction in Patients With Obstructive Sleep Apnea Hypopnea Syndrome.

OBJECTIVE: To compare the clinical effects of modified uvulopalatopharyngoplasty (UPPP) with low-temperature plasma with selective nasal cavity vasodilatation with tongue volume reduction for obstructive sleep apnea/hypopnea syndrome (OSAHS). METHODS: A retrospective analysis based on 156 patients with serious OSAHS was used for the evaluation. These patients were divided into 2 groups according to surgery methods according to 1:1.s. The patients in observation group accepted modified UPPP with low-temperature plasma and selective nasal cavity vasodilatation with tongue root volume reduction on the basis of fully preparation for surgery, while the patients in the control group accepted normal treatment. The clinic effects, operative complications, postoperative relapse, and other indexes were compared. RESULT: After 6 months of follow-up visit, the general effective rates of the observation group and control groups were 80.77% and 61.54%, the difference was statistically significant (P < 0.05). Besides, the rate complication occurrence in the observation group was also lower than that in the control group. CONCLUSION: The effect of modified UPPP with low-temperature plasma and selective nasal cavity vasodilatation with tongue volume reduction is satisfactory for patients with moderate and severe OSAHS after enough preparation.

Utility of uric acid as a risk marker of extubation success in chronic obstructive pulmonary disease.

BACKGROUND: The objective of this observational study was to determine whether there is an association between extubation success and uric acid in chronic obstructive pulmonary disease patients with mechanical ventilation admitted to the intensive care units, and identify the risk markers for extubation success in COPD patients with mechanical ventilation. METHODS: Consecutive COPD patients with intubation were screened at baseline. The study included patients on mechanical ventilation (MV) for over 12 hours and who, in the process of weaning, were subjected to low-level pressure support. Exclusion criteria were age under 18 years, ventilation via tracheotomy, and patients failing to cooperate for different reasons. The final study population consisted of 106 patients. Demographic, clinical, laboratory, and mechanical ventilation parameters were carefully recorded. Logistic regression was used for the multivariate analysis of independent risk factors. RESULTS: Uric acid on admission, duration of mechanical ventilation, pressure support ventilation, and APACHE II score on admission were significantly higher in COPD patients with extubation failure than in those with extubation success (p < 0.05), but lower tidal volume before weaning was observed in COPD patients with extubation failure. Among these patients, multiple logistic analyses indicated the independent risk factors for extubation success in the COPD subjects included serum uric acid level, APACHE II score on admission, and duration of mechanical ventilation. The diagnosis analysis showed that higher uric acid level and APACHE II score on admission and longer duration of mechanical ventilation had a significant ability to reflect extubation success in the COPD patients with respiratory failure. CONCLUSIONS: The novel finding of this study is that the extubation failure in COPD patients with respiratory failure is strongly related to serum uric acid level, APACHE II score on admission, and duration of mechanical ventilation. These results might be helpful for selecting the best time to remove the tracheal intubation and improving extubation success rate in COPD patients with respiratory failure.

Identification of diagnostic signature, molecular subtypes, and potential drugs in allergic rhinitis based on an inflammatory response gene set.

Background: Rhinitis is a complex condition characterized by various subtypes, including allergic rhinitis (AR), which involves inflammatory reactions. The objective of this research was to identify crucial genes associated with inflammatory response that are relevant for the treatment and diagnosis of AR. Methods: We acquired the AR-related expression datasets (GSE75011 and GSE50223) from the Gene Expression Omnibus (GEO) database. In GSE75011, we compared the gene expression profiles between the HC and AR groups and identified differentially expressed genes (DEGs). By intersecting these DEGs with inflammatory response-related genes (IRGGs), resulting in the identification of differentially expressed inflammatory response-related genes (DIRRGs). Afterwards, we utilized the protein-protein interaction (PPI) network, machine learning algorithms, namely least absolute shrinkage and selection operator (LASSO) regression and random forest, to identify the signature markers. We employed a nomogram to evaluate the diagnostic effectiveness of the method, which has been confirmed through validation using GSE50223. qRT-PCR was used to confirm the expression of diagnostic genes in clinical samples. In addition, a consensus clustering method was employed to categorize patients with AR. Subsequently, extensive investigation was conducted to explore the discrepancies in gene expression, enriched functions and pathways, as well as potential therapeutic drugs among these distinct subtypes. Results: A total of 22 DIRRGs were acquired, which participated in pathways including chemokine and TNF signaling pathway. Additionally, machine learning algorithms identified NFKBIA, HIF1A, MYC, and CCRL2 as signature genes associated with AR's inflammatory response, indicating their potential as AR biomarkers. The nomogram based on feature genes could offer clinical benefits to AR patients. We discovered two molecular subtypes, C1 and C2, and observed that the C2 subtype exhibited activation of immune- and inflammation-related pathways. Conclusions: NFKBIA, HIF1A, MYC, and CCRL2 are the key genes involved in the inflammatory response and have the strongest association with the advancement of disease in AR. The proposed molecular subgroups could provide fresh insights for personalized treatment of AR.

Insight into the fate of nitrogen during char thermal conversion and the influence mechanism of potassium: A theoretical research.

Nitrogen oxides (NOₓ) are primary pollutants produced during biomass combustion. During the devolatilization stage, char nitrogen (char(N)) is formed. In the subsequent char combustion stage, char(N) can decompose directly into NOx precursors or engage in heterogeneous reactions with O2 or NO to form NO and N2. Nonetheless, a comprehensive understanding of the reaction mechanisms and competitiveness of char(N) migration, especially the influence of the alkali metal potassium (K) present in biomass, remains incomplete. Building on the Zigzag char(N) models, the present study delves into the migration reactions of char(N), assessing their competitive dynamics through the integration of density functional theory, electronic structure analysis, and conventional transition state theory. Furthermore, it examines the impact of K on char(N) conversion. The competitiveness of the heterogeneous reactions follows the sequence: heterogeneous reduction of NO to N2 > heterogeneous oxidation of char(N) to NO > decomposition of char(N) to NOx precursors. Moreover, the formation of HCN is more favorable than NH3 production. The successive conversion from char(N) to NO and then to N2 is the predominant migration route for char(N), with NO generation as the pivotal step. The less preferred char(N) migration route involves decomposition to NH3/HCN, followed by oxidation to NOx within the main combustion zone, which cannot be mitigated by char. K can accelerate NO generation and sustain the primacy of the heterogeneous NO reduction, consequently enhancing the oxidation-reduction process of char(N). As a result, K plays a constructive role in managing NOx emissions during the thermal conversion of char.

Soil and vegetation characteristics during the formation of typical Ligularia virgaurea degraded grassland.

To understand the formation process of typical poisonous plant degraded grassland, we studied the cha-racteristics of vegetation and soil during the gradual expansion of Ligularia virgaurea into the native grassland of Qinghai-Tibet Plateau. The results showed that population density, plant height, coverage, and biomass of L. virgaurea increased during the formation of L. virgaurea degraded grassland. In comparison with native grassland, the degraded grassland had higher total aboveground biomass (113.9%), soil total nitrogen concentration (61.0%), NH4+-N (77.9%), organic carbon concentration (45.3%), available phosphorus concentration (78.8%) as well as soil microbial biomass carbon (42.1%) and nitrogen (47.4%), but lower NO3--N (40.1%) and species richness (28.5%) and aboveground biomass (45.7%) of other species beyond L. virgaurea. The extremely strong abilities of interspecific inhibition and morphological plasticity of L. virgaurea, as well as efficient nutrient accumulation and utilization were the keys to its successful expansion, which facilitated the formation of typical L. virgaurea degraded grassland.

LINC00704 contributes to the proliferation and accelerates the cell cycle of nasopharyngeal carcinoma cells via regulating ETS1/CDK6 axis.

This study is aimed at exploring the biological functions and related mechanism of long noncoding RNA 704 (LINC00704) in the proliferation and cell cycle progression of nasopharyngeal carcinoma (NPC) cells. The expression of LINC00704 in NPC tissues and cells was quantified by quantitative real-time polymerase chain reaction (qRT-PCR). After LINC00704 was overexpressed or knocked down in NPC cell lines, cell counting kit-8 (CCK-8) assay, 5-bromo-2'-deoxyuridine assay, flow cytometry assay, and Transwell assay were adopted to detect the proliferation, cell cycle progression, migration, and invasion of NPC cells. The interaction between LINC00704 and ETS proto-oncogene 1 (ETS1) was verified by bioinformatics analysis, RNA pull-down assay, and RNA immunoprecipitation assay. Dual-luciferase reporter gene assay and chromatin immunoprecipitation followed by qPCR analysis were used to verify the binding status between ETS1 and the promoter region of cyclin-dependent kinase 6 (CDK6). The regulatory effects of LINC00704 and ETS1 on CDK6 expression were detected by Western blot. LINC00704 expression was elevated in NPC tissues and cells, which was significantly correlated with the advanced TNM stage and poor differentiation. LINC00704 overexpression promoted the multiplication, migration, and invasion of NPC cells and blocked the cell cycle progression while knocking down LINC00704 worked oppositely. LINC00704 could bind to ETS1, thus promoting CDK6 transcription. Knocking down LINC00704 inhibited the CDK6 expression in NPC cells. LINC00704 promotes CDK6 transcription by recruiting ETS1 to the promoter region of CDK6, thus promoting the malignant progression of NPC.

Effect of Thermal Treatment on the Internal Structure, Physicochemical Properties and Storage Stability of Whole Grain Highland Barley Flour.

In this study, to improve the processing performance of whole grain highland barley flour (whole grain HB flour), they were prepared by sand-roasting, far-infrared baking, steam explosion, and extrusion, and the effects of on functional properties and storage characteristics were measured. The results indicated that sand-roasting, far-infrared baking, and steam explosion all caused cracks and honeycomb structures in the outer layer and endosperm of the highland barley. The XRD analysis results indicated that highland barley starch treated by far-infrared baking exhibited typical A-type crystal structure, while sand-roasting, steam explosion, and extrusion presented the typical V-type. The results of DSC analysis revealed that the onset temperature (To), peak temperature (Tp), gelatinization enthalpy (ΔH), peak viscosity (PV), trough viscosity (TV), and final viscosity (FV) decreased significantly, while the swelling power, water-holding capacity and oil-holding capacity increased significantly. During the storage period, the moisture content and lipase activity of the whole grain HB flour after thermal treatment remained at a low level; the fatty acid value, peroxide value, and malondialdehyde value increased; finally, the cooked whole grain HB flour was unstable during storage. The functional properties of whole grain HB flour can be improved by steam explosion, and will then have better storage stability.

Evaluation of Nutritional Components, Phenolic Composition, and Antioxidant Capacity of Highland Barley with Different Grain Colors on the Qinghai Tibet Plateau.

The nutritional composition, polyphenol and anthocyanin composition, and antioxidant capacity of 52 colored highland barley were evaluated. The results showed that the protein content of highland barley in the black group was the highest, the total starch and fat contents in the blue group were the highest, the amylose content in the purple group was quite high, the fiber content in the yellow group was quite high, and the ß-glucan content of the dark highland barley (purple, blue and black) was quite high. The polyphenol content and its antioxidant capacity in the black group were the highest, while the anthocyanin content and its antioxidant capacity in the purple highland barley were the highest. Ten types of monomeric phenolic substances were the main contributors to DPPH, ABTS, and FRAP antioxidant capacity. All varieties could be divided into four categories according to nutrition or function. The grain color could not be used as an absolute index to evaluate the quality of highland barley, and the important influence of variety on the quality of highland barley also needed to be considered. In actual production, suitable raw materials must be selected according to the processing purpose and variety characteristics of highland barley.

Revision endoscopic frontal sinus surgery for refractory chronic rhinosinusitis via modified agger nasi approach.

OBJECTIVE: To examine the clinical effects of revision endoscopic frontal sinus surgery (RESS) through modified agger nasi (MAN)-middle turbinate resection on refractory chronic rhinosinusitis (CRS). METHODS: We reviewed 156 patients who were treated for refractory CRS from February 2012 to August 2014. These patients had been diagnosed with refractory CRS by computed tomography and endoscopy and had received several surgical and medical treatments in the past, but their condition had not been cured. They were divided into the observation group (RESS through MAN-middle turbinate resection, n = 78) and the control group (endoscopic sinus surgery, n = 78). Complete or partial control of the patient's symptoms and signs suggested that the treatment was effective, and no improvement in the symptoms and signs indicated that the treatment was ineffective. RESULTS: The 6-month treatment efficacy rate was significantly higher in the observation group (91.03%) than in the control group (71.79%). The observation group had a significantly lower complication rate (7.69%) and recurrence rate (3.85%) than the control group (17.95% and 12.82%, respectively). CONCLUSION: RESS through MAN-middle turbinate resection together with adequate perioperative preparation has a significant effect on the outcome of refractory CRS and is worthy of clinical promotion.

Effect of Intravenous Lidocaine Infusion on Postoperative Early Recovery Quality in Upper Airway Surgery.

OBJECTIVES/HYPOTHESIS: Systemic infusions of lidocaine have been widely used as perioperative analgesic adjuvants. The aim of this randomized, double-blinded, controlled trial was to investigate the effect of perioperative lidocaine infusion on postoperative early recovery quality in upper airway surgery. STUDY DESIGN: Prospective, randomized, double-blinded, placebo-controlled trial. METHODS: A total of 99 patients were randomly assigned to the lidocaine group (group L) or the control group (group C). The patients received 2 mg/kg lidocaine completed within 10 minutes before the induction of anesthesia followed by continuous infusions of 2 mg/kg/hr lidocaine (group L) or the same volume of 0.9% normal saline (group C) intravenously during anesthesia. The Quality of Recovery-40 (QoR-40) survey was administered on the preoperative day (Pre) and postoperative days 1 (POD1) and 2 (POD2). The primary endpoint was QoR-40 score on POD1 and POD2. RESULTS: Compared with Pre, global QoR-40 scores on POD1 and POD2 were significantly lower (P < .05). Compared with group C, global QoR-40 scores were significantly higher in group L on POD1 and POD2 (P < .05). Among the five dimensions of QoR-40, the scores for physical comfort, emotional state, and pain were superior in group L compared to group C (P < .05). Compared with group C, the consumption of remifentanil and diclofenac as well as the incidence of postoperative nausea and vomiting (PONV) and postoperative 48-hour numeric rating scale (NRS) scores in group L were significantly lower (P < .05). CONCLUSIONS: Systemic lidocaine infusion can improve QoR-40 scores in patients with upper airway surgery, reduce the dosage of intraoperative opioids, decrease the incidence of PONV and NRS scores 2 days after surgery, thus improving postoperative early recovery quality. LEVEL OF EVIDENCE: 1b Laryngoscope, 131:E63-E69, 2021.

Impaired calcium signaling in astrocytes modulates autism spectrum disorder-like behaviors in mice.

Autism spectrum disorder (ASD) is a common neurodevelopmental disorder. The mechanisms underlying ASD are unclear. Astrocyte alterations are noted in ASD patients and animal models. However, whether astrocyte dysfunction is causal or consequential to ASD-like phenotypes in mice is unresolved. Type 2 inositol 1,4,5-trisphosphate 6 receptors (IP3R2)-mediated Ca2+ release from intracellular Ca2+ stores results in the activation of astrocytes. Mutations of the IP3R2 gene are associated with ASD. Here, we show that both IP3R2-null mutant mice and astrocyte-specific IP3R2 conditional knockout mice display ASD-like behaviors, such as atypical social interaction and repetitive behavior. Furthermore, we show that astrocyte-derived ATP modulates ASD-like behavior through the P2X2 receptors in the prefrontal cortex and possibly through GABAergic synaptic transmission. These findings identify astrocyte-derived ATP as a potential molecular player in the pathophysiology of ASD.

Influence of multiple apolipoprotein A-I and B genetic variations on insulin resistance and metabolic syndrome in obstructive sleep apnea.

BACKGROUND: The relationships between apolipoprotein A-I (APOA-I), apolipoprotein B (APOB) with insulin resistance, metabolic syndrome (MetS) are unclear in OSA. We aimed to evaluate whether the multiple single nucleotide polymorphism (SNP) variants of APOA-I and APOB exert a collaborative effect on insulin resistance and MetS in OSA. METHODS: Initially, 12 APOA-I SNPs and 30 APOB SNPs in 5259 subjects were examined. After strict screening, four APOA-I SNPs and five APOB SNPs in 4007 participants were included. For each participant, the genetic risk score (GRS) was calculated based on the cumulative effect of multiple genetic variants of APOA-I and APOB. Logistic regression analyses were used to evaluate the relationships between APOA-I/APOB genetic polymorphisms, insulin resistance, and MetS in OSA. RESULTS: Serum APOB levels increased the risk of insulin resistance and MetS adjusting for age, gender and BMI [odds ratio (OR = 3.168, P < 0.001; OR = 6.098, P < 0.001, respectively]. APOA-I GRS decreased the risk of insulin resistance and MetS after adjustments (OR = 0.917, P = 0.001; OR = 0.870, P < 0.001, respectively). APOB GRS had no association with insulin resistance (OR = 1.364, P = 0.610), and had weak association with MetS after adjustments (OR = 1.072, P = 0.042). In addition, individuals in the top quintile of the APOA-I genetic score distribution had a lower risk of insulin resistance and MetS after adjustments (OR = 0.761, P = 0.007; OR = 0.637, P < 0.001, respectively). CONCLUSIONS: In patients with OSA, cumulative effects of APOA-I genetic variations decreased the risk of insulin resistance and MetS, whereas multiple APOB genetic variations had no associations with insulin resistance and weak association with MetS.

Oxygen doped graphitic carbon nitride nanosheets for the degradation of organic pollutants by activating hydrogen peroxide in the presence of bicarbonate in the dark.

The development of novel wastewater treatment processes that use heterogeneous catalysts to activate hydrogen peroxide (H2O2) with bicarbonate (HCO3 -) has been a subject of great interest in recent years; however, significant challenges remain, despite research into numerous metal-based catalysts. The work presented herein employed oxygen-doped graphitic carbon nitride (O/g-C3N4) as a non-metal catalyst for activating H2O2 in the presence of HCO3 -, and this method represented the first system capable of removing organic pollutants in the dark, to our knowledge. The catalysts were characterized using several microscopic imaging, spectroscopic, electrochemical, and crystallographic techniques, as well as N2-physorption procedures. Analysis of the results revealed that the O/g-C3N4 catalyst possessed a high specific surface area and many defect sites. Various operational parameters, including the relative amounts of HCO3 -, H2O2, and O/g-C3N4, were systemically investigated. A clear performance enhancement was observed in the degradation of organic contaminants when subjected to the HCO3 --H2O2-O/g-C3N4 system, and this result was ascribed to the synchronous adsorption and chemical oxidation processes. The novel system presented herein represented a new water treatment technology that was effective for removing organic contaminants.