Determination of 27 volatile organic compounds in exhaled breath by thermal desorption-gas chromatography-mass spectrometry / 环境与职业医学

Background Volatile organic compounds (VOCs) in exhaled breath are closely associated with respiratory diseases and are linked to various metabolic reactions in the human body. A quantitative analytical method can provide technical support for studying VOCs related to various diseases. Objective To establish a thermal desorption-gas chromatography-mass spectrometry (TD-GC-MS) method for the determination of 27 VOCs in exhaled breath. Methods VOCs in exhaled breath were collected using a Bio-VOC sampler and enriched with Tenax TA thermal desorption tubes before TD-GC-MS analysis. Standards were collected using thermal desorption tubes and optimized for thermal desorption conditions as well as chromatographic and mass spectrometric conditions: The separation of the 27 VOCs was achieved by an optimized temperature program, the improvement of sensitivity by optimizing quantitative ions, and the increase of VOCs desorption efficiency by optimizing thermal desorption time and temperature. Limit of detection, limit of quantification, accuracy, precision, and stability of the proposed method were investigated by spiking with a blank gas bag, and exhaled breath samples from 20 healthy individuals were collected for an application study of the proposed method. Results The thermal desorption temperature was 280 ℃, and desorption time was 6 min. A VF-624ms chromatographic column was selected for the separation of target substances. The initial temperature of heating program was 35 ℃, maintained for 1 min, and then increased to 100 ℃ at a heating rate of 3 ℃·min−1 for 1 min, followed by increasing to 210 ℃ at a heating rate of 28 ℃·min−1 for 5 min. A quantitative analysis was conducted with a single ion monitoring (SIM) mode. Under these conditions, the 27 VOCs showed good linear relationships in their respective concentration ranges and the correlation coefficients were higher than 0.9990. The limits of detection of the method were in the range of 0.01-0.13 nmol·mol−1, the limits of quantification were in the range of 0.02-0.44 nmol·mol−1, and the spiked recoveries were in the range of 80.1%-120.5%, with intra-batch and inter-batch precision ≤ 18.8% and 17.9% respectively. All substances can be stored at room temperature (23-28 °C) for 7 d and at 4 °C for 14 d. The proposed method was applied to exhaled breath samples from 20 subjects with detection rates≥ 80% (except for trans-2-pentene and decane) and a concentration range of 0.00-465.50 nmol·mol−1. Conclusion The established TD-GC-MS method for quantification of VOCs in exhaled breath is characterized by high sensitivity and good accuracy, and is suitable for quantitative determination of VOCs in exhaled breath, which can provide technical support for the study of exhaled breath VOCs.

Identification of Dalbergia odorifera and Its Counterfeits by HS-GC-MS / 中国实验方剂学杂志

ObjectiveTo screen the differential markers by analyzing volatile components in Dalbergia odorifera and its counterfeits， in order to provide reference for authentication of D. odorifera. MethodThe volatile components in D. odorifera and its counterfeits were detected by headspace gas chromatography-mass spectrometry（HS-GC-MS）， and the GC conditions were heated by procedure（the initial temperature of the column was 50 ℃， the retention time was 1 min， and then the temperature was raised to 300 ℃ at 10 ℃ for 10 min）， the carrier gas was helium， and the flow rate was 1.0 mL·min-1， the split ratio was 10∶1， and the injection volume was 1 mL. The MS conditions used electron bombardment ionization（EI） with the scanning range of m/z 35-550. The compound species were identified by database matching， the relative content of each component was calculated by the peak area normalization method， and principal component analysis（PCA）， orthogonal partial least squares-discrimination analysis（OPLS-DA） and cluster analysis were performed on the detection results by SIMCA 14.1 software， and the differential components of D. odorifera and its counterfeits were screened out according to the variable importance in the projection（VIP） value>2 and P<0.05. ResultA total of 26， 17， 8， 22， 24 and 7 volatile components were identified from D. odorifera， D. bariensis， D. latifolia， D. benthamii， D. pinnata and D. cochinchinensis， respectively. Among them， there were 11 unique volatile components of D. odorifera， 6 unique volatile components of D. bariensis， 3 unique volatile components of D. latifolia， 6 unique volatile components of D. benthamii， 8 unique volatile components of D. pinnata， 4 unique volatile components of D. cochinchinensis. The PCA results showed that， except for D. latifolia and D. cochinchinensis， which could not be clearly distinguished， D. odorifera and other counterfeits could be distributed in a certain area， respectively. The OPLS-DA results showed that D. odorifera and its five counterfeits were clustered into one group each， indicating significant differences in volatile components between D. odorifera and its counterfeits. Finally， a total of 31 differential markers of volatile components between D. odoriferae and its counterfeits were screened. ConclusionHS-GC-MS combined with SIMCA 14.1 software can systematically elucidate the volatile differential components between D. odorifera and its counterfeits， which is suitable for rapid identification of them.

Aspectos por considerar en autopsias por intoxicación aguda con monóxido de carbono, el asesino silente. A propósito de dos casos / Aspects to consider in autopsies for acute carbon monoxide poisoning, the silent killer. About two cases

El monóxido de carbono (CO) es un gas que se produce durante la combustión incompleta de diferentes materiales orgánicos. Una vez que se inhala, se absorbe hacia la sangre, ejerciendo su efecto a nivel sistémico. Se une fuertemente a la hemoglobina, y forma la carboxihemoglobina lo que provoca una disminución del transporte de oxígeno a los tejidos y dependiendo de su concentración puede ser mortal. Los hallazgos comúnmente encontrados en la autopsia son color rojo cereza en la piel y órganos, así como edema pulmonar, entre otros. El diagnóstico de intoxicación por CO se basa en la medición post mortem de carboxihemoglobina en sangre, por lo que se deben tomar muestras para cuantificar estos niveles. Con respecto al manejo en estos casos, se presenta dos casos correspondientes a la autopsia médica legal en las que se estableció como causa de muerte la intoxicación por monóxido de carbono.

Carbon monoxide (CO) is a gas that is produced during the incomplete combustion of different organic materials. Once inhaled, it is absorbed into the blood, exerting its effect at the systemic level. It strongly binds to hemoglobin, and forms carboxyhemoglobin, which causes a decrease in oxygen transport to the tissues and, depending on its concentration, can be fatal. The findings commonly found in the autopsy are cherry red color in the skin and organs, as well as pulmonary edema, among others. The diagnosis of CO poisoning is based on the postmortem measurement of carboxyhemoglobin in the blood, so samples must be taken to quantify these levels. Regarding the handling of these cases, two cases corresponding to the legal medical autopsy are presented in which carbon monoxide poisoning was established as the cause of death.

Patrones de actividad de mamíferos alrededor de la línea transportadora de gas natural de Camisea en la Reserva Comunal Machiguenga, Cusco, Perú

En el presente trabajo se estudia la actividad horaria de los mamíferos que habitan el área circundante a la línea transportadora de gas de Camisea que atraviesa la Reserva Comunal Machiguenga. Desde febrero del 2020 hasta enero del 2021, se realizó un registro fotográfico mediante cámaras trampa dispuestas a lo largo de la tubería de gas. Los patrones de actividad se estimaron mediante la función de densidad de Kernel. Durante el periodo de estudio, se registraron 25 especies de mamíferos. Se encontró que Dasyprocta kalinowskii y Eira barbara presentan un patrón de actividad diurno; mientras que Cuniculus paca, Tapirus terrestris, Dasypus spp. y Mazama spp. presentan un patrón predominantemente nocturno. Se sugiere que los patrones de actividad observados estarían influenciados por varios factores como la exclusión competitiva entre D. kalinowskii y C. paca, disponibilidad estacional del alimento para T. terrestris, variación de temperatura y precipitación para Dasypus spp., restricciones filogenéticas en Mazama spp., y segregación temporal con otros carnívoros para E. barbara. Se destaca la importancia de la colaboración entre las empresas del rubro energético, las comunidades nativas y las organizaciones gubernamentales.

The present study investigates the hourly activity patterns of mammals inhabiting the area surrounding the Camisea gas pipeline that crosses the Machiguenga Communal Reserve. From February 2020 to January 2021, a photographic record was conducted using camera traps placed along the gas pipeline. Activity patterns were estimated using Kernel density functions. During the study period, 25 mammal species were recorded. It was found that Dasyprocta kalinowskii and Eira barbara exhibit a diurnal activity pattern, whereas Cuniculus paca, Tapirus terrestris, Dasypus spp., and Mazama spp. display predominantly nocturnal behavior. It is suggested that observed activity patterns could be influenced by various factors such as competitive exclusion between D. kalinowskii and C. paca, seasonal food availability for T. terrestris, temperature and precipitation variations for Dasypus spp., phylogenetic constraints in Mazama spp., and temporal segregation with other carnivores for E. barbara. The significance of collaboration between energy industry companies, native communities, and governmental organizations is emphasized.

Hemoglobina Denver, una causa de desaturación en oximetría de pulso. Reporte de caso en un paciente pediátrico / Hemoglobin Denver, a cause of desaturated pulse oximetry. A pediatric case report

Las hemoglobinopatías son trastornos genéticos que afectan a la molécula de hemoglobina (Hb). Las mutaciones en las cadenas a o b que alteran el tetrámero de Hb pueden modificar la capacidad de la molécula para unirse al oxígeno. Las hemoglobinopatías con baja afinidad al oxígeno pueden presentarse con cianosis y una lectura alterada de la oximetría de pulso, lo que lleva a pruebas innecesarias y, a veces, invasivas para descartar afecciones cardiovasculares y respiratorias. En el siguiente reporte de caso, presentamos a una paciente pediátrica, asintomática, que se presentó a la consulta por detección de desaturación en oximetría de pulso. Las pruebas de laboratorio iniciales mostraron una anemia normocítica, normocrómica. Las muestras de gas venoso demostraron una p50 elevada. Después de extensas herramientas de diagnóstico, se diagnosticó una variante de Hb con baja afinidad al oxígeno, Hb Denver.

Hemoglobinopathies are genetic disorders that affect the hemoglobin (Hb) molecule. Mutations in the alpha or beta chains altering the Hb tetramer may modify the molecule's oxygen-binding capacity. Hemoglobinopathies with low oxygen affinity may occur with cyanosis and an altered pulse oximetry reading, leading to unnecessary and sometimes invasive tests to rule out cardiovascular and respiratory conditions. In the case report described here, we present an asymptomatic pediatric patient who consulted for desaturated pulse oximetry. Her initial laboratory tests showed normocytic, normochromic anemia. Venous blood gas samples showed an elevated p50. After using extensive diagnostic tools, a variant of Hb with low oxygen affinity was diagnosed: Hb Denver.

The deceptive coloboma

Background: Scleral fistulas are known to develop following blunt trauma in patients with retinochoroidal coloboma. These cases can be managed by surgical options such as silicone buckles, or with glue and scleral patch graft. Some cases have been shown to close spontaneously. We report the first?ever case managed by vitrectomy, endophotocoagulation, and gas tamponade. Purpose: We present a rare and interesting case of an atypical choroidal coloboma with traumatic scleral fistula due to blunt trauma manifesting with hypotony?related disc edema, maculopathy, and chorioretinal folds, which was managed surgically with vitrectomy, endophotocoagulation, and gas tamponade with a good anatomical and visual outcome. Synopsis: The video contains the case description and surgical management of a traumatic scleral fistula in a patient with atypical superotemporal choroidal coloboma. The patient developed hypotonic maculopathy and disc edema after 3 months following a blunt trauma sustained in a road traffic accident. A scleral fistula was suspected at the temporal edge of the coloboma but could not be accurately localized. In addition, due to the edge effect of the coloboma, the external repair was difficult. Hence, vitrectomy with internal tamponade was attempted. Highlights: The video highlights a different surgical approach to managing a traumatic scleral fistula at the edge of a retinochoroidal coloboma. There was a risk of leakage of intravitreal fluid into the orbit through the fistula; however, the gas bubble gave a better tamponade due to higher surface tension. It sealed the fistula presumably by creating a trap?door?like effect. The endophotocoagulation helped create adhesion between the tissues at the edge of the coloboma effectively sealing it. This was followed by a rapid recovery of the hypotony?related problems with good vision. Traumatic scleral fistula, at a difficult place such as the edge of a coloboma, can be successfully closed from an internal approach with vitrectomy, endolaser, and gas tamponade.

Pulmonary function tests in compressed natural gas pump workers in Surat city

Background: Various studies have known abatements in lung function and several other health problems associated with longstanding air pollution exposure. One of the most cost-effective and environmental alternative of conventional fuels (petrol and diesel) is compressed natural gas (CNG). The increasing use of CNG as a fuel (as it is safe and cheap as compare to the conventional fuels) can add one more bug to the list of work-related disease. Aims and Objectives: This study is to evaluate the respiratory functions of CNG pump workers. Materials and Methods: The present study was held on 82 male subjects. The study group included of non-smoking healthy adult males, age group of 20–40 years working in different CNG stations in Surat city for >6 months and 8 h per day. The control group included of non-smoking healthy adult males, age group of 20–30 years working or studying in the Surat Municipal Institute of Medical Education and Research (SMIMER). Results: Out of 82 male subjects, 30 subjects were control and 52 subjects were CNG station workers. The study group comprised of 52 healthy non-smokers in the age group of 20–40 years working in different CNG station in Surat city for >6 months and 8 h/day. The control group comprised of 30 healthy non-smokers males between the age group of 20–30 years working or studying in the SMIMER. Conclusion: In this study, we have not found statistically significant deterioration in pulmonary functions of CNG pump workers when compared to controls.

Estimation of Lipid and Fatty Acids Composition over the Ground Part of Nepeta olgae Regel (L.) Plants Growing in Namangan Region

The article is devoted to the study of lipids and fatty acid composition of the above-ground part of the Nepeta olgae Regel (L.) plant of the Laminaceae family. It was found that the content of neutral lipids (NL) is 5.54%, PL - 6.12%, and total lipids (NL, PL) - 11.66%. Of the neutral lipids, the unsaponifiable substances (HB) had a bright yellow color, which is explained by a small amount of carotenoids (88.87 mg%). Glycolipids dominate in PL. Among the unsaponifiable substances were found biologically active components such as hydrocarbons, carotenoids, aliphatic alcohols, sterols and triterpenols. Phytosterols were the main component of unsaponifiable NS. Quantitative and qualitative analysis of fatty acids from the plant Nepeta olgae Regel (L.) was carried out by gas chromatography (GC). 28 acids were identified, of which 11 compounds are saturated, and 7 compounds are unsaturated fatty acids. Of the fatty acids, the main ones are linolenic 18:3 (35.48), palmitic 16:0 (33.38%), as well as ?-3 polyunsaturated fatty acids, including eicosanoic 20:1, cis-11,14-eicosadienoic 20:2, 8,11,14-eicosatriene 20:3 + arachidonic 20:4. Extracts of Nepeta olgae Regel (L.) were distinguished by a high content of polyunsaturated acids, which determines their potential biological activity.

Carbon Monoxide Poisoning from Heavy Cigarette Smoking Presenting as Delusion in a Patient with a History of Chronic Schizophrenia (Methamphetamine Induced)

We describe a case of carbon monoxide poisoning in a 54-year-old male from heavy cigarette smoking presenting as delusions. The patient has a history of methamphetamine-induced schizophrenia now in remission for 2 years, and not on any psychotropics and is drug-free.

A RARE PRESENTATION OF MASSIVE PNEUMOPERITONEUM FOLLOWING INGESTION OF LIQUID NITROGEN SNACK WITHOUT IDENTIFIABLE GASTROINTESTINAL PERFORATION

A 26 year old male patient presented with abdominal distension following ingestion of liquid nitrogen and was diagnosed to have massive pneumoperitoneum both clinically and radiologically. Patient underwent emergency laparotomy in search of perforation, the stomach, Intestines was examined and no hollow viscous perforation was found. All abdominal contents were normal, no tissue necrosis or haemorrhage, no free ?uid or bleeding was found in the abdomen. Two abdominal drains were placed in the lesser sac and the pelvis and abdomen were closed. The patient was stable post operatively and tolerated oral feeds and discharged on 7th post operative day. Our study revealed that despite of having massive pneumoperitoneum, site of perforation cannot be identi?ed

Neumoencéfalo, una revisión de literatura

El neumoencéfalo corresponde a la presencia de aire intracraneal y, en general, es asintomático y autolimitado. Puede ocurrir posterior a trauma, cirugía craneofacial, defectos congénitos, infección, neoplasia o de forma espontánea. El neumoencéfalo a tensión es una emergencia neuroquirúrgica, en la que se acumula aire intracraneal de forma continua que genera un efecto de masa. Clínicamente, se caracteriza por cefalea y un deterioro neurológico marcado. A pesar de ser poco frecuente, es relevante considerar el neumoencéfalo a tensión como una posible complicación en pacientes con antecedente de neurocirugía y/o cirugía otorrinolaringológica, debido a que es una patología potencialmente grave. El diagnóstico es clínico e imagenológico, y requiere de un alto índice de sospecha. Un manejo oportuno es relevante para prevenir la herniación y la muerte.

Pneumocephalus refers to the presence of air in the cranial cavity, and in general, is self-limited and asymptomatic. It can occur after trauma, craniofacial surgery, due to congenital defects, infection, neoplasia or spontaneously. Tension pneumocephalus is a neurosurgical emergency in which intracranial air accumulates continuously, causing a mass effect. It presents with headache and marked neurological deterioration. Despite being rare, it is relevant to consider tension pneumocephalus as a possible complication in patients with a history of neurosurgery and/or otolaryngology surgery, as it can be life-threatening. Diagnosis requires a high index of suspicion and imagenologic confirmation. Timely management is relevant to prevent herniation and death.

Psychosocial Risks and Mental Disorders among Mexican Oil Workers / Riesgos psicosociales y trastornos mentales en trabajadores petroleros mexicanos / Riscos psicossociais e transtornos mentais em trabalhadores petrolíferos mexicanos

The psychosocial risks faced by workers can influence their health as well as job performance and satisfaction. However, this phenomenon among Mexican workers in the oil industry has not been well studied. The purpose of this study was to analyze the association of stress and job-related burnout with mental disorders among oil workers in the southeastern region of Mexico. Materials and methods: This cross-sectional and analytical study included 501 workers from the onshore oil industry in the southeastern region of Mexico. The Work Burnout Inventory, the Symptoms of Stress Inventory, and the Goldberg General Health Questionnaire (ghq 28) were applied between October and November, 2016. Chi-square test was used to analyze the relationship between variables and the odds ratio was determined to establish the level of risk for mental disorders. Results: Moderate levels of stress (21.4l %), efficacy (41.5 %), cynicism (30.6 %), and exhaustion (39.7 %) were observed. Mental disorders were noted in 11.8 % of workers. Stress and burnout were associated with mental disorders (p < 0.05). Finally, workers who experienced stress and job burnout were more likely to have mental disorders (or = 12.96; 95 % ci [7.03­23.94]; p = 0.00). Conclusions:Stress and job burnout are risk factors for mental disorders among Mexican oil workers.

los riesgos psicosociales en los trabajadores tienen influencia en la salud, rendimiento del trabajo y satisfacción laboral; sin embargo, poco se ha estudiado este fenómeno en los trabajadores mexicanos de la industria petrolera. El objetivo fue analizar la asociación entre estrés y desgaste laboral y trastornos en los trabajadores de la industria petrolera terrestre de la región sureste de México. Materiales y métodos: diseño transversal y analítico. La muestra estuvo integrada por 501 trabajadores. Los instrumentos utilizados fueron el Inventario de Desgaste Laboral, el Inventario de Síntomas de Estrés y el Cuestionario de Salud General de Goldberg (ghq 28). Se aplicaron los instrumentos entre octu-bre y noviembre de 2016. Se utilizó la prueba de chi cuadrado para analizar la relación entre las variables, y se determinaron odds ratio para establecer el nivel de riesgo a trastornos mentales. Resultados: se encontraron niveles moderados de estrés (21.4l %), eficacia (41.5 %), cinismo (30.6 %) y agotamiento (39.7 %). Se encontró presencia de trastornos mentales en el 11.8 % de los trabajadores. El estrés y las dimensiones del desgaste laboral se asociaron con los trastornos mentales (p < 0.05). Finalmente, los tra-bajadores que presentaron estrés y desgaste laboral tuvieron mayor probabilidad de sufrir trastornos mentales (or= 12.96; ic 95 % [7.03-23.94]; p = 0.00). Conclusiones: el estrés y el desgaste laboral representan factores de riesgo para presentar trastornos mentales en los trabajadores petroleros mexicanos.

os riscos psicossociais nos trabalhadores influenciam a saúde, o desempenho no trabalho e a satisfação no trabalho, no entanto, esse fenômeno tem sido pouco estudado em trabalhadores mexi-canos da indústria petrolífera. O objetivo do estudo foi analisar a associação do estresse e desgaste no trabalho com transtornos em trabalhadores da indústria petrolífera terrestre da região sudeste do México. Materiais e métodos: desenho transversal e analítico. A amostra foi composta por 501 trabalha-dores. Os instrumentos utilizados foram o Inventário de Desgaste Laboral, o Inventário de Sintomas de Estresse e o Questionário de Saúde Geral de Goldberg (ghq 28). Os instrumentos foram aplicados entre outubro e novembro de 2016. O teste qui-quadrado foi utilizado para analisar a relação entre as variáveis e o odds ratio foi determinado para estabelecer o nível de risco para transtornos mentais. Resultados: foram encontrados níveis moderados de estresse (21,4l %), eficácia (41,5 %), cinismo (30,6 %) e exaustão (39,7 %). A presença de transtornos mentais foi encontrada em 11,8 % dos trabalhadores. O estresse e as dimensões de desgaste laboral foram associadas aos transtornos mentais (p < 0,05). Por fim, os trabalhadores que apresentavam estresse e desgaste laboral apresentaram maior probabilidade de apresentar transtornos mentais (or = 12,96; ic 95 % [7,03-23,94]; p = 0,00). Conclusões: o estresse e desgaste laboral representam fatores de risco para o desenvolvimento de transtornos mentais em trabalhadores petrolíferos mexicanos.

Persistent organic pollutants distribution in plasma lipoprotein fractions / Distribuição persistente de poluentes orgânicos em frações de lipoproteínas plasmáticas

Abstract This study determines the associations among serum lipid profiles, risk of cardiovascular disease, and persistent organic pollutants. Using Gas chromatography technique, the intensity of toxic pollutant residues in serum samples of Hypertensive patients were measured. Based on statistical analysis, the effects of different covariates namely pesticides, age, systolic blood pressure, diastolic blood pressure, and lipid profile duration was checked using the logistic regression model. Statistical computation was performed on SPSS 22.0. The P-values of F-Statistic for each lipid profile class are greater than 0.01 (1%), therefore we cannot reject the null hypothesis for all cases. The estimated coefficients, their standard errors, Wald Statistic, and odds ratio of the binary logistic regression model for different lipid profile parameters indicate if pesticides increase then the logit value of different lipid profile parameters changes from -0.46 to -0.246 except LDL which increases by 0.135. The study reports a significantly increased threat of cardiovascular disease with increased concentrations of toxic pollutants.

Resumo Este estudo determina as associações entre o perfil lipídico sérico, o risco de doença cardiovascular e os poluentes orgânicos persistentes. Por meio da técnica de cromatografia gasosa, mediu-se a intensidade dos resíduos de poluentes tóxicos em amostras de soro de pacientes hipertensos. Com base na análise estatística, os efeitos de diferentes covariáveis ​​- ou seja, pesticidas, idade, pressão arterial sistólica, pressão arterial diastólica e duração do perfil lipídico - foram verificados usando o modelo de regressão logística. O cálculo estatístico foi realizado no SPSS 22.0. Os valores P da estatística F para cada classe de perfil lipídico são maiores que 0,01 (1%), portanto não podemos rejeitar a hipótese nula para todos os casos. Os coeficientes estimados, seus erros padrão, estatística de Wald e odds ratio do modelo de regressão logística binária para diferentes parâmetros do perfil lipídico indicam se os pesticidas aumentam, então o valor logit de diferentes parâmetros do perfil lipídico muda de -0,46 para -0,246, exceto LDL, que aumenta em 0,135. O estudo relata um aumento significativo da ameaça de doença cardiovascular com aumento das concentrações de poluentes tóxicos.

Do Dipteryx alata Vogel seedlings recover the quality and the photosynthetic and antioxidant responses in the post-flooding? / Mudas de Dipteryx alata Vogel recuperam a qualidade e as respostas fotossintéticas e antioxidantes no pós-alagamento?

Abstract Dipteryx alata Vogel is a tree species widely found in Cerrado, settling preferentially in well drained soils. Studies related to ecophysiology of D. alata may contribute to the decision making about using seedlings of this species in projects aimed at the recovery of degraded areas where seasonal flooding happens. This study aimed to assess the effects of flooding on photosynthetic and antioxidant metabolism and quality of D. alata seedlings cultivated or not under flooding during four assessment periods (0, 20, 40, and 60 days), followed by 100 days after the end of each assessment period (0+100, 20+100, 40+100, and 60+100 days), allowing verifying the potential for post-flooding recovery. Flooded plants showed lower photosynthetic efficiency than non-flooded plants, regardless of the periods of exposure. However, this efficiency was recovered in the post-flooding, with values similar to that of the non-flooded seedlings. Moreover, the damage to FV/FM was evidenced by an increase in the period of exposure to flooding, but recovery was also observed at this stage of the photosynthetic metabolism. Seedling quality decreased under flooding, not varying between periods of exposure, but remained lower although the increase observed in the post-flooding period, with no recovery after flooding. The occurrence of hypertrophied lenticels associated with physiological changes and an efficient antioxidant enzyme system might have contributed to the survival and recovery of these seedlings. Thus, this species is sensitive to flooding stress but capable of adjusting and recovering metabolic characteristics at 100 days after the suspension of the water stress, but with no recovery in seedling quality. Thus, we suggested plasticity under the cultivation condition and determined that the time of 100 days is not enough for the complete resumption of growth.

Resumo Dipteryx alata Vogel é uma arbórea de ampla ocorrência no Cerrado, se estabelecendo preferencialmente em solos bem drenados. Estudos referentes à ecofisiologia de D. alata em podem contribuir para a tomada de decisão sobre o uso de mudas dessa espécie em programas de recuperação de áreas degradadas sujeitas a alagamento temporário. Objetivamos com essa pesquisa avaliar os efeitos do alagamento no metabolismo fotossintético e antioxidante, além da qualidade de mudas dessa espécie, cultivadas ou não sob alagamento durante quatro períodos de avaliação (0, 20, 40 e 60 dias) seguidos de 100 dias após o término de cada período (0+100, 20+100, 40+100, 60+100 dias), possibilitando verificar o potencial de recuperação pós-alagamento. Observamos que as plantas alagadas apresentaram menor eficiência fotossintética e danos em FV/FM entretanto houve recuperação dessas características no pós alagamento. A qualidade das mudas reduziu sob alagamento não variando entre os períodos de exposição e embora tenha aumentado no pós-alagamento manteve-se menor não se recuperando. A ocorrência de lenticelas hipertrofiadas associadas a alterações fisiológicas e um eficiente sistema enzimático antioxidante devem ter contribuído para a sobrevivência e recuperação metabólica dessas mudas. Diante disso, sugerimos que a espécie é sensível ao estresse por alagamento, mas capaz de se ajustar e recuperar as características metabólicas 100 dias após a suspensão deste estresse hídrico, no entanto a qualidade da mudas não apresentou recuperação, assim, sugerimos plasticidade diante da condição de cultivo e ressaltamos que o tempo de 100 dias não é suficiente para a completa retomada do crescimento.

Effect of lung protective ventilation on lung ventilation function, serum serum Clara cell protein 16 level and prognosis in patients undergoing gynecological laparoscopic surgery / 中国医师进修杂志

Objective:To analyze the effect of lung protective ventilation on lung ventilation function and serum Clara cell protein 16 (CC16) level in patients undergoing gynecological laparoscopic surgery.Methods:The clinical data of 80 gynecological patients who underwent laparoscopic surgery in Yancheng City Jianhu County People′s Hospital from October 2018 to December 2020 were randomly divided into group A and group B by random number table, each group with 40 cases. The patients in group A were treated with intermittent positive-pressure ventilation, and the patients in group B were ventilated with whole course ventilation mode. The pulmonary ventilation function, CC16 level and postoperative pulmonary complications were observed before anesthesia, 10 min of pneumoperitoneum, 30 min of pneumoperitoneum, 5 min of pneumoperitoneum stop and 2 h after operation. The patients were divided into groups according to whether with pulmonary complications, and their pulmonary ventilation function and serum CC16 level were compared. The predictive value of the above indexes for pulmonary complications was analyzed by receiver operating characteristic (ROC) curve.Results:Repeated measurement analysis of variance showed that alveolar arterial oxygen differential pressure (PA-aDO 2) were significant differences in time point factors, time point interaction factors and group factors ( P<0.05); CC16 index were significant differences in time point factor and group factor ( P<0.05). According to the observation from postoperative to discharge, 4 patients (10.0%) in group A had pulmonary complications, 15 cases (37.5%) had pulmonary complications in group B, the levels of PA-aDO 2 and CC16 in patients with complications were significantly higher than those in patients without complications: group A:(332.9 ± 2.0) mmHg (1 mmHg = 0.133 kPa) vs. (290.4 ± 13.2) mmHg, (53.5 ± 1.5) μg/L vs. (39.5 ± 6.5) μg/L; group B: (339.1 ± 8.8) mmHg vs. (305.7 ± 17.9) mmHg, (41.5 ± 4.2) μg/L vs. (39.7 ± 5.8) μg/L, there were statistical differences ( P<0.05). ROC curve analysis showed that the area under the curve(AUC) of PA-aDO 2 and CC16 in predicting pulmonary complications in group A were 0.882 and 0.833, in group B was 0.885 and 0.731. Conclusions:Lung protective ventilation has little effect on lung ventilation function and serum CC16 in patients with gynecological laparoscopic surgery, and the probability of pulmonary complications is lower. The pulmonary ventilation function and CC16 have certain value in predicting postoperative pulmonary complications.

Prediction of short term clinical outcomes in low Apgar score neonates using umbilical artery blood gas analysis plus amplitude integrated electroencephalography / 中国新生儿科杂志

Objective:To study the predictive values of umbilical artery blood gas analysis(UABG) plus amplitude-integrated electroencephalography(aEEG) monitoring within 6 h after birth for early complications and short term neurological outcomes in low Apgar score neonates.Methods:From January 2020 to February 2022, neonates with gestational age (GA) ≥35 weeks and 1 min or 5 min Apgar score ≤7 admitted to NICU of our hospital were retrospectively reviewed. According to UABG pH values, the neonates were assigned into pH<7.2 group and pH ≥7.2 group, and further grouped into abnormal aEEG group and normal aEEG group. The ttest, rank sum test and χ2 test were used to compare laboratory results, incidences of diseases, physical growth and neurological prognosis at 6 month of age. Results:A total of 105 neonates with low Apgar scores were enrolled, including 73 cases in the pH<7.2 group and 32 cases in the pH≥7.2 group. In the pH<7.2 group, 52(71.2%) had abnormal aEEG and 21 had normal aEEG. In the pH≥7.2 group, 6(18.8%) had abnormal aEEG and 26 had normal aEEG. The incidence of abnormal aEEG in the pH<7.2 group was higher than the pH≥7.2 group ( P<0.001). The degree of aEEG abnormality was negatively correlated with UABG pH ( r=-0.463, P<0.001). In the pH<7.2 group, the levels of creatine kinase isozymes (CK-MB), activated partial thromboplastin time and the incidence of hypoxic-ischemic encephalopathy (HIE) in neonates with abnormal aEEG were significantly higher than those with normal aEEG, and the head circumference (HC) at 6 month was significantly smaller in neonates with abnormal aEEG (all P<0.05). In the pH≥7.2 group, the level of CK-MB, incidences of HIE and respiratory failure in neonates with abnormal aEEG were higher than those with normal aEEG, HC at 6 month was smaller and the incidence of adverse neurological prognosis was higher in neonates with abnormal aEEG (all P<0.05). Conclusions:UABG plus aEEG monitoring within 6 h after birth shows predictive values for early complications and short term neurological outcomes in low Apgar scores neonates.

Clinical value of esophageal-jejunal Orvil TM anastomosis and Overlap anastomosis in laparos-copic radical total gastrectomy of adenocarcinoma of esophagogastric junction / 中华消化外科杂志

Objective:To investigate the clinical value of esophageal-jejunal OrVil TM anas-tomosis and Overlap anastomosis in laparoscopic radical total gastrectomy of adenocarcinoma of esophagogastric junction (AEG). Methods:The retrospective cohort study was conducted. The clinicopathological data of 112 patients with AEG who were admitted to the First Hospital of Jilin University from July 2017 to August 2022 were collected. There were 87 males and 25 females, aged (64±8)years. All 112 patients underwent laparoscopic total gastrectomy and D 2 lymphadenectomy, in which 61 cases with esophageal-jejunal OrVil TM anastomosis were divided into the OrVil TM group, 51 cases with esophageal-jejunal Overlap anastomosis were divided into the Overlap group. Observa-tion indicators: (1) surgical situations; (2) postoperative complications; (3) influencing factors for patients undergoing esophageal-jejunal OrVil TM anastomosis. Measurement data with normal distri-bution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the non-parameter test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Logistic regression model was used for multivariate analysis. Results:(1) Surgical situations. The esophageal invasion length and tumor diameter was 1.0(0.7,2.0)cm and (6.3±2.7)cm in patients of the OrVil TM group, versus 0.2(0.1,0.5)cm and (4.7±2.2)cm, respectively, in patients of the Overlap group, showing significant differences in the above indicators between the two groups ( Z=?6.14, t=3.26, P<0.05). (2) Postoperative complications. Cases with complications ≥Ⅲa grade of Clavien-Dindo classification, cases with respiratory system complications, cases with hydrothorax were 13, 17, 13 in the OrVil TM group, versus 4, 5, 4 in the Overlap group, showing significant differences in the above indicators between the two groups ( χ2=3.91, 5.74, 3.91, P<0.05). Cases underwent readmission within postoperative 30 days were 3 and 1 in the OrVil TM group and the Overlap group, respectively, and all patients recovered after symptomatic treatment. There were 2 cases died after operation in the OrVil TM group and none of patients died after operation in the Overlap group. (3) Influencing factors for patients undergoing esophageal-jejunal OrVil TM anastomosis. Results of multivariate analysis showed that esophageal invasion length was an independent factor influencing for patients undergoing esophageal-jejunal OrVil TM anastomosis ( odds ratio=8.25, 95% confidence interval as 3.41?19.96, P<0.05). Conclusions:Compared with esophageal-jejunal Overlap anastomosis, choosing the esophageal-jejunal Orvil TM anastomosis during laparoscopic radical total gastrectomy can take benefit to the proximal margin of patients with AEG. However, the ratios of complications ≥ Ⅲa grade of Clavien-Dindo classification, respiratory system complications and hydrothorax associated to OrVil TM anastomosis are relatively increased. Esophageal invasion length is an independent influencing factor for patients undergoing esophageal-jejunal OrVil TM anastomosis.

Progress of research and technical in minimally invasive surgery for gastric cancer / 中华消化外科杂志

Gastric cancer is one of the most common malignant tumors in the world, and its incidence and mortality are among the top of malignant tumors in China. Since Kitano et al com-plete the first laparoscopic radical gastrectomy for gastric cancer in the world in 1992, the laparos-copic technology has developed rapidly. After more than 30 years of exploration and practice, the clinical diagnosis and treatment of gastric cancer in China has also made considerable progress. A large number of clinical studies at home and abroad have confirmed that laparoscopic radical gas-trectomy is no less effective than traditional open surgery in the short and long term. Laparoscopic radical gastrectomy has the characteristics of less trauma, faster recovery of gastrointestinal func-tion, less postoperative pain, and shorter average hospital stay. It has gradually replaced open surgery as the mainstream surgical method for gastric cancer. As the concept of surgical treatment for gastric cancer continues to update, emerging minimally invasive technologies continue to emerge, including robotic surgery systems and indocyanine green tracing technology, which are increasingly used in gastric cancer surgery, making gastric cancer surgery more minimally invasive and accurate, the quality of perigastric lymph node dissection and the domestic gastric cancer surgery technology further improving. Based on the relevant research at home and abroad, the authors review and summarize the latest progress in recent years with the topic of minimally invasive surgery for gastric cancer, aiming to systematically describe the current situation and future prospects of gastric cancer surgery. It is believed that in the future, the clinical diagnosis and treatment of gastric cancer in China will be more standardized, minimally invasive and accurate, more high-quality multicenter clinical research will be carry out and the diagnosis and treatment of gastric cancer will be further improved in China.

Effect of repeated episodes of ventricular fibrillation and defibrillation on arterial acid-base and electrolytes changes in a swine model / 中华急诊医学杂志

Objective:To investigate changes in arterial acid-base and electrolytes after repeated episodes of ventricular fibrillation (VF) and defibrillation in a swine model.Methods:Sixteen Peking white swine, weighting (32±2.5) kg, were placed with temporary pacemaker electrodes via the left femoral vein into the right ventricle after anesthesia. Then VF was electrically induced by using a programmed electrical stimulation instrument. An arterial cannula was inserted into the left femoral artery to measure mean arterial blood pressure and cardiac output using a PiCCO monitor, with blood samples collected. The pigs were randomly divided into two group: the manual defibrillation group (MD, n=8) and the automated external defibrillation group (AED, n=8). The first defibrillation was attempted with the manufacturer’s dose (150 J) for 15 s after the successful induction of VF in the MD group. If spontaneous circulation was not recovered, 2-min chest compression and subsequent defibrillation (200 J) were attempted. For the AED group, the defibrillation was delivered following voice prompts of the AED. After the return of spontaneous circulation, the pig was allowed to stabilize for 30 min, followed by the induction of the next episode of VF. The above process was repeated five times. Arterial blood gas, cardiac biomarkers, and hemodynamic variables were measured at 30 min after the return of spontaneous circulation. Results:All pigs were successfully induced VF five times and defibrillated successfully. There were no significant changes in heart rate and mean arterial blood pressure between the two groups after repeated episodes of VF and defibrillation. Compared with baseline measurements, cardiac output tended to decrease after repeated episodes of VF and defibrillation but was not statistically significant (all P>0.05). There were no significant differences in arterial pH, HCO 3-, sodium, and lactic acid in the two groups between each measurement time point and baseline values after repeated VF (all P>0.05), but potassium levels in the two groups decreased with time, and the difference was statistically significant compared with the baseline measurement (all P<0.05). There were no significant differences in myoglobin, creatine kinase isoenzyme-MB, and cardiac troponin I for the two groups compared with baseline values after repeated episodes of VF and defibrillation or various episodes of VF between the two groups (all P > 0.05). Conclusions:Repeated episodes of VF and defibrillation have no significant effect on pH balance, but significantly decrease blood potassium. Clinical approaches (MD vs. AED) do not affect defibrillation effect, with no significant differences in hemodynamic variables and myocardial injuries.

Factors influencing bilirubin elevation and its correlation with UGT1A1 gene polymorphism in the early postoperative period of transjugular intrahepatic portosystemic shunt / 中华肝脏病杂志

Objective: To investigate the factors influencing total bilirubin elevation and its correlation with UGT1A1 gene polymorphism in the early postoperative period of transjugular intrahepatic portosystemic shunt (TIPS). Methods: 104 cases with portal hypertension and esophageal variceal hemorrhage (EVB) treated with elective TIPS treatment were selected as the study subjects and were divided into a bilirubin-elevated group and a normal bilirubin group according to the total bilirubin elevation level during the early postoperative period. Univariate analysis and logistic regression were used to analyze the factors influencing total bilirubin elevation in the early postoperative period. PCR amplification and first-generation sequencing technology were used to detect the polymorphic loci of the UGT1A1 gene promoter TATA box, enhancer c.-3279 T > G, c.211G > A, and c.686C > A. Logistic regression was used to analyze the correlation of four locus alleles and genotypes with elevated total bilirubin in the early postoperative period. Results: Among the 104 cases, 47 patients were in the bilirubin elevated group, including 35 males (74.5%) and 12 females (25.5%), aged (50.72 ± 12.56) years. There were 57 cases in the normal bilirubin group, including 42 males (73.7%) and 15 females (26.3%), aged (51.63 ± 11.10) years. There was no statistically significant difference in age (t = -0.391, P = 0.697) and gender (χ(2) = 0.008, P = 0.928) between the two groups of patients. Univariate analysis revealed that preoperative alanine transaminase (ALT) level (χ(2) = 5.954, P = 0.015), total bilirubin level (χ(2) = 16.638, P < 0.001), MELD score (χ(2) = 10.054, P = 0.018), Child-Pugh score (χ(2) = 6.844, P = 0.022), and postoperative portal vein branch development (χ(2) = 6.738, P = 0.034) were statistically significantly different between the two groups. Logistic regression analysis showed that preoperative ALT level, total bilirubin level, and portal vein branch development after TIPS were correlated with the elevated total bilirubin in the early postoperative period. The polymorphism of the c.211G > A locus of the UGT1A1 gene correlation had elevated total bilirubin in the early postoperative period of TIPS. The risk of elevated total bilirubin was increased in the population carrying allele A (P = 0.001, OR = 4.049) in the early postoperative period. Allelic polymorphisms in the TATA box promoter region and enhancer c.-3279 T > G and c.686C > A had no statistically significant difference between the bilirubin-elevated group and the normal bilirubin group. Conclusion: The preoperative ALT level, total bilirubin level, and portal vein branch development are correlated with the elevated total bilirubin in early postoperative patients. The polymorphisms of the UGT1A1 gene and enhancer c.211G > A are correlated with the occurrence of elevated total bilirubin in the early postoperative period of TIPS. Allele A carrier may have a higher risk of elevated total bilirubin in the early postoperative period.