[The correlation between burst suppression on electroencephalogram during laparoscopic surgery and emergence delirium in elderly patients].

Objective: To investigate the relationship between intraoperative electroencephalogram burst suppression (BS) and emergence delirium (ED) in elderly patients undergoing elective laparoscopic surgery under total intravenous anesthesia (TIVA). Methods: From October 2017 to September 2019, a total of 358 elderly patients who underwent elective laparoscopic surgery under TIVA at Xiangya Hospital, Central South University, were included. Patients were divided into two groups based on the confusion assessment method for the intensive care unit (CAM-ICU) assessment conducted before leaving the post-anesthesia care unit (PACU): the ED group [n=63, 46 males, 17 females, average age of (70.8±0.6) years] and the non-ED group [n=295, 220 males, 75 females, average age of (69.7±0.2) years]. Preoperative general information, intraoperative conditions, and intraoperative electroencephalogram BS status were collected. A multivariate logistic regression model was employed to identify risk factors associated with ED. Results: In the ED group, the duration of surgery, intraoperative blood loss, the burst suppression ratio (BSR)>10% lasting for more than 1 minute were (224.4±9.6) min, (240.8±33.9) ml, 36.5% (23/63), respectively, which were higher than those of the non-ED group [(204.7±3.6) min, (150.5±9.2) ml, 21.7% (64/295), all P<0.05]. Multivariate logistic regression analysis revealed that a longer duration of education was a protective factor for ED (OR=0.904, 95%CI: 0.833-0.982,P=0.016), whereas increased intraoperative blood loss (OR=1.002, 95%CI: 1.000-1.003, P=0.013) and BSR>10% lasting for more than 1 minute (OR=2.131, 95%CI: 1.004-4.524,P=0.049) were identified as risk factors for ED. Conclusion: In elderly patients undergoing laparoscopic surgery under TIVA, intraoperative electroencephalogram BS may be a risk factor for ED.

[Analysis of differences and influencing factors of liver injury associated with different strains of 2019-nCoV infection].

Objective: To analyze whether there are differences and related influencing factors in liver injury associated with different strains of 2019-nCoV/SARS-CoV-2 infection. Methods: Data of epidemiology, clinical symptoms, laboratory tests, and treatment outcomes of patients with COVID-19 infection confirmed with Alpha and Delta virus strain in Zhejiang Province were retrospectively collected. Statistical analysis was performed using independent samples t-test or Mann-Whitney U test, χ2 test or Fisher's exact test, and logistic regression analysis. Results: A total of 788 and 381 cases with Alpha and Delta virus strain were included. Vaccination ratio was 0% in Alpha and 85.30% in Delta group (P<0.001), The proportion of patients with fever (80.71% vs. 40.94%, P<0.001) was significantly higher in Alpha than Delta strain group. The proportion of critical ill patients was significantly higher in Delta group (9.90% vs. 1.57%, respectively, P<0.001). The virus negative conversion time was significantly longer in Delta than Alpha group (22 d vs. 11 d, P<0.001), but the incidence of liver injury was significantly higher in Alpha than Delta group (20.05% vs. 13.91%, P=0.011). Univariate analysis showed that Alpha virus strain infection, male sex, body mass index, chronic liver disease, fever, diarrhea, shortness of breath, severe/critical illness, elevated creatine kinase (CK), elevated international normalized ratio (INR) and an elevated neutrophil/lymphocyte ratio was significantly associated with an increased risk of liver injury occurrence, and in patients with pharyngeal pain the risk of liver injury occurrence was significantly reduced. Multivariate analysis showed that shortness of breath [OR, 2.667 (CI: 1.389-5.122); P=0.003], increased CK [OR, 2.544 (CI: 1.414-4.576); P=0.002] and increased INR [OR, 1.721] (CI: 1.074-2.758); P=0.024] was significantly associated with an increased risk of liver injury occurrence, and in patients with pharyngeal pain the risk of liver injury occurrence was significantly reduced [OR, 0.424 (CI: 0.254-0.709); P=0.001]. Conclusion: Although the virulence of the Delta is stronger than Alpha strain, most patients infected with Delta strain vaccinated against COVID-19 in Zhejiang province had milder clinical symptoms and a lower incidence and degree of liver injury. Notably, the infection risk even remains after vaccination; however, symptoms and the incidence of severe and critical illness can be significantly reduced.

[Relationship between liver controlled attenuation parameters and body fat mass and its distribution].

Objective: To explore the relationship between liver controlled attenuation parameters (CAP) and body fat mass and its distribution. Methods: From May to December 2018, 978 adult patients visited at the fatty liver center of the Third People's Hospital of Changzhou were treated. The patient's liver controlled attenuation parameters were measured by transient elastography and the body fat mass and its distribution were measured by bioelectrical impedance technology. Pearson's correlation coefficient was adopted to describe the correlation between liver CAP value and body mass index (BMI), body fat mass index (BFMI), trunk fat mass index (TFMI), limbs fat mass index (LFMI) and visceral fat area (VFA). Receiver operating characteristic curve (ROC) and area under the curve (AUC) were used to evaluate BMI, BFMI, TFMI, LFMI and VFA to differentiate the cut-off points and efficacy of CAP for diagnosing grading of fatty liver changes in S0-1 and S2-3. Results: In 653 cases of male, S0 ~ S3 accounted for 4.90%, 3.37%, 22.36% and 69.37%, respectively, and in 325 cases of females, S0 ~ S3 accounted for 7.38%, 6.46%, 13.23% and 72.92%, respectively. Female patients had more visceral, trunk and limbs fat than male (P < 0.01). Body mass, body fat mass, body fat percentage, BMI, BFMI, TFMI, LFMI, and VFA were increased in male and female patients with increasing liver fat grade (P < 0.01). CAP values ​​of male and female patients were positively correlated with BMI, BFMI, TFMI, LFMI and VFA. Percentage of body fat mass increased with increasing liver fat grade (male: F = 13.42, P < 0.001; female: F = 3.22, P = 0.023); while limb fat mass percentage did not increase with liver fat grade (Male: F = 1.13, P = 0.34; female: F = 1.05, P = 0.37). Hepatic steatosis grading (S0 ~ 1 or S2 ~ 3) diagnosed with CAP were distinguished through BMI, BFMI, TFMI, LFMI and VFA. AUC was 0.80 ~ 0.82 in males (P < 0.01), and 0.75 ~ 0.78 in females (P < 0.01). Conclusion: The liver CAP value is positively correlated with the body's limbs, trunk and visceral fat, and has a strong correlation with trunk and visceral fat. BMI, BFMI, TFMI, LFMI and VFA up to some extent can identify the CAP diagnosis of grading of fatty liver changes in S0-1 and S2-3.

Gunshot-caused Facial Injury Combined with Lower Cervical Spine Injury: A Case Report.

A 32-year old male patient was wounded by a pistol. As shown in computed tomography (CT) scanning images, there was comminuted fracture of the left mandible and the bullet was found in the left side behind the sixth cervical vertebra. After the patient was hospitalized, the debridement was done in the emergency room and the operation of open reduction and internal fixation for comminuted fracture of left mandible was performed successfully. Eighteen days later, the patient was taken to surgery for anterior cervical decompression and fusion with autogenous iliac bone grafting for the sixth cervical vertebra. Postoperative follow-up of the patient over two years indicated that the left biceps muscle strength was recovered to level 4. Gunshot wound to the face associated with injury of the low cervical spine has the possibility of survival. It is safe to treat facial wounds early in the patient's treatment course, even if the bullet remains in the cervical vertebral body and there is neurological function damage.

MiR-582-5p inhibits the growth and invasion of osteosarcoma cell by targeting NOVA1.

OBJECTIVE: To investigate the role of microRNA-582-5p (miR-582-5p) on osteosarcoma (OS) cell behaviors and provide potential therapeutic targets for OS. MATERIALS AND METHODS: Expression levels of miR-582-5p in OS cell lines and normal cell lines were measured by quantitative real-time PCR. Cell proliferation, migration and invasion capacities were assessed by cell counting kit-8 assay, wound-healing assay, and transwell invasion assay, respectively. Downstream target of miR-582-5p was confirmed by Luciferase activity reporter assay and Western blotting assay. RESULTS: MiR-582-5p expression was downregulated in OS cell lines compared with normal cell lines. Overexpression of miR-582-5p inhibits OS cell proliferation, migration, and invasion capacities. Neuro-oncological ventral antigen 1 (NOVA1) was chosen as target gene of miR-582-5p by bioinformatics analysis and Luciferase reporter assay. Moreover, overexpression of NOVA1 could impair tumor suppression role of miR-582-5p on OS cell behaviors. CONCLUSIONS: MiR-582-5p exerts tumor-suppressive role on OS cell behaviors via targeting NOVA1 in vitro, which will help us to understand the mechanisms underlying OS progression.

Relevance of electrical current distribution to the forced flow and grain refinement in solidified Al-Si hypoeutectic alloy.

Significant grain refinement in cast metals can be achieved through the application of electric currents during the solidification process. The present paper investigates the distribution of electric currents on the grain size of solidified Al-7wt.%Si alloy under the application of electric current with constant parameters flowing through two parallel electrodes into the melt within a cylindrical mould. The distribution of electric current was controlled by applying an electrical insulation material coating, boron nitride (NB), to the sidewall of the electrodes. Experimental results showed that the employment of these insulated electrodes can reduce grain size in comparison with the reference case of electrodes without BN coating. Flow measurements were performed in Ga-20wt.%In-12wt.%Sn liquid metal. Higher intensity forced flow occurred when the sidewall of the electrodes was insulated. In order to understand the underlying mechanism behind the stronger forced flow, corresponding numerical simulations were performed to reveal the distributions of the electric current, magnetic field, Lorentz force, and the resultant forced flow. The results achieved indicate that the mechanism of grain refinement driven by electric current is dendrite fragmentation induced by forced flow. In addition, a novel approach to enhance the grain refinement without additional input of current energy was developed.

Effect of cigarette tax increase on cigarette consumption in Taiwan.

OBJECTIVES: This study evaluates the effect of a 5 New Taiwan Dollar (NTD 5) Health and Welfare Tax increase on the consumption of domestic and imported cigarettes and cigars. METHODS: Using statistics published annually from 1971 through 2000, we set up a model based on the Central Bureau of Statistics (CBS) demand model to estimate price and expenditure elasticity coefficients of cigarettes and cigars. RESULTS: Our results showed that the price elasticity coefficients for domestic and imported cigarettes were -0.644 and -0.822. The consumption of imported cigarettes was reduced by 7.51 packs per capita, and the consumption of domestic cigarettes was reduced by 15.21 packs per capita. Total per capita consumption of cigarettes was reduced by 22.72 packs (18%). CONCLUSIONS: From the public health and financial perspectives, the increase in this excise tax on tobacco to the Taiwan government will have significant effect in reducing cigarette consumption; it will also generate additional tax revenues.

[Clinical study of 76 cases of counterattack induced by acute organic phosphorus pesticides intoxication].

76 cases of counterattack induced by acute organic phosphorus pesticides intoxication were analysed. The activity of cholinesterase did not show a significant difference before the counterattack as compared to that after the counterattack (P > 0.05). The average dosage of atropine for pre-atropinization was 58.6 +/- 2.7 mg/h and it was 203.9 +/- 17.7 mg/h between the post-counterattack and the second atropinization (P < 0.01). Compared the mortality in reaching and non-reaching the second atropinization was 22.8% VS 100% (P < 0.01). The survival rate was 37.5% in collaborating blood transfusion cases and 20.6% in noncollaborating ones (P > 0.05). We also studied on the treatment, mechanism, precursory symptoms, causes of death, degrees of intoxication and pesticide types etc.

[Prognosis of severe organic phosphorus pesticide intoxication and the effect of atropine treatment: analysis of 506 cases].

The results of atropine treatment in 506 cases of severe organic phosphorus pesticide intoxication are reported. Among the variables which might effect the results of treatment, the average dosage of atropine was related intimately to the prognosis (standard coefficient of regression bi = 0.4702, P less than 0.01). When the average drug dosage was 40-80 ng/h, the mortality was 26.6% and much lower than other groups (P less than 0.01). Intravenous administration given at regular intervals was better than continuous drip; the mortality dropped to 61.2% from 90.9% (P less than 0.01). Both inadequate atropinization and atropine intoxication were less frequently seen during intermitten injection (P less than 0.01).

[Determination of ethyl paraben in shengmaiyin oral liquid using gas chromatography].

This paper describes a gas chromatographic method for the determination of preservative--ethyl paraben in shengmaiyin Oral Liquid. The method is simple, rapid and accurate. The recovery is good (99.5%), and the coefficient of variation is 0.288%.

[Clinical application of the medial multiplex flap pedicled with the posterior tibial vessel].

OBJECTIVE: To investigate the clinical results of the medial multiplex flap pedicled with the posterior tibial vessel. METHODS: Twelve cases with soft tissue defects and bone defects of limbs were treated with the medial multiplex flap pedicled with the posterior tibial vessel from September 1992 to May 1999. Among them, bone and soft tissue defects following opened fracture in 7 cases, chronic ulcer following chronic osteomyelitis in 2 cases, melanoepithelioma in 2 cases, bone and soft tissue defects following osteoma resection in 1 case. The bone defect area was from 2.5 cm x 5.0 cm to 4.5 cm x 11.0 cm. Free graft was performed in 5 cases, bridged transposition in 3 cases and reversal transposition in 4 cases, among them, periosteal myocutaneous flap with autogenous or allogeneic bone grafting in 8 cases, myocutaneous flap in 4 cases. The area of the flaps from 6 cm x 8 cm to 12 cm x 25 cm. RESULTS: All flaps were healed by first intention, but in the distal fragments of bigger flaps were partially necrosed in 2 cases. In 10 cases bone healing were obtained after 16 weeks of operation according to the X-ray photos. All cases were followed up from 6 to 18 months. All cases achieved satisfactory result but 1 case died because of lung metastasis of osteoma. CONCLUSION: The multiplex graft pedicled with the posterior tibial vessel is an ideal graft for repairing the large soft tissue defects and bone defects, because it has such advantages as adequate blood supply, big vascular diameter, long pedicle and big dermatomic area.

The biphasic effects of some opiates and opioid peptides on the rat vas deferens.

It has been found that the effects of opiates and opioid peptides on RVD are of two types. Compounds of the first type such as Etor, Eton, fentanyl and prodine derivatives, Met- and Leu-Enk and DADL are biphasic in nature. At lower concentrations (10(-8)-10(-5) M) they have inhibitory effects and at higher concentrations (10(-5)-10(-4) M) they are excitatory. Compounds of the second type, such as Mor, benzomorphan derivates, Cyc and SKF and the antagonist Nx have virtually no or only weakly inhibitory effects but may antagonize the inhibitory effect produced by the first group of compounds at lower concentrations. MC belongs to the second type, but it cannot antagonize the inhibitory effect of beta-End. The results are discussed in terms of multiple receptors, the high and low affinity binding sites, and the interrelationship between receptors.

Fast optical switching via stimulated Raman adiabatic passage.

We demonstrate a new approach to fast optical switching with a technique based on stimulated Raman adiabatic passage in which a laser pulse switches the probe field on and off via another coupling pulse. This new kind of optical switching is not limited by the decay rate of an excited state and can operate in the subnanosecond time domain. The experimental observation in Rb atomic vapor is in good agreement with numerical simulations.

[Irreversible action of the opioid agonist alpha-CAM and its reaction with SH groups at opioid receptor binding sites].

7 alpha-Bis (beta-chloroethyl)amino-methyl-6,14-endoethenotetrahydrooripavine (alpha-CAM) was found to bind to opioid receptors irreversibly and react directly with sulfhydryl (SH) groups in P2 preparations of rat brain. The P2 preparations were pretreated as follows: protection of the SH groups at the opioid receptor binding sites by morphine or etorphine, and inactivation of the SH groups outside the binding sites by N-ethylmaleimide (NEM), followed by removal of the morphine or etorphine by washing. alpha-CAM was still able to bind the pretreated P2 preparations in an irreversible manner. The results indicate that the formation of covalent bonds between alpha-CAM and the SH groups of opioid receptor binding sites is possibly one of the biochemical mechanisms of the irreversible action of alpha-CAM.

Solubilization and purification of opioid receptor molecules of rat brain.

A P2 membrane preparation of rat brain (without cerebellum) was solubilized with CHAPS in Tris containing DTT and trypsin inhibitor. Two opiate ligands, 10b and 10cd, prepared by Liu et al, were employed consecutively in affinity chromatography, from which OPR's were eluted with Nx. The eluate was subsequently passed through a WGA affinity column and the OPR's eluted with N-GluNAc. This eluate was further purified and concentrated by preparative granular gel isoelectric focusing on SG200. Two protein peaks appeared separately at pH 5 and 7.8. The eluates from both peaks were examined for protein contents using the silver staining method, and binding activity was measured by RRA with 3H-etor. The results revealed that both samples contained active OPR purified to over 80,000 fold. The Mr was estimated by gel filtration to be 52 kD and 42 kD for OPR in the pH 5 and pH 7.8 samples respectively. OPR in the pH 5 sample have been determined to be of mu-type by their binding activity with 3H-ohm.