Application and Research Progress of Ultrasound-Guided Brachial Plexus Block Through Costoclavicular Space Approach in Upper Limb Surgery.

Objective: Exploring newer approaches to brachial plexus block is crucial for improving surgical outcomes and patient comfort. This study aims to review the application and research progress of ultrasound-guided brachial plexus block via the costoclavicular space approach in upper limb surgery. Methods: This study provides a comprehensive review of existing literature, studies, and clinical cases related to the costoclavicular approach. The advantages and disadvantages of conventional approaches for brachial plexus block, including the intermuscular groove method, supraclavicular method, and axillary approach, are discussed. The anatomical characteristics of the costoclavicular space are examined, and the methods of brachial plexus nerve block using ultrasound-guided costoclavicular space approach are described. It holds great promise for enhancing patient care and increasing the overall success rate of surgical procedures. Results: The costoclavicular space approach for brachial plexus block offers several advantages, including stable anatomical structure, low nerve variation rate, and clear visualization of each nerve bundle under ultrasound imaging. Compared to traditional approaches, ultrasound-guided brachial plexus block via the costoclavicular space approach has a high success rate, rapid onset of anesthesia, and high safety. Conclusion: Ultrasound-guided brachial plexus block via the costoclavicular space approach is effective and safe in upper limb surgery. It provides good anesthesia and postoperative analgesia, making it a valuable technique for various upper limb surgeries. The potential clinical significance of our findings lies in the possibility that ultrasound-guided costoclavicular space approach, with its enhanced precision and patient outcomes, could play a pivotal role in improving upper limb surgical procedures.

Assessing alterations of water level due to environmental water allocation at multiple temporal scales and its impact on water quality in Baiyangdian Lake, China.

Lakes in arid/semiarid regions face problems of insufficient inflow and degradation of water quality, which threaten the health of the lake ecosystem. Baiyangdian Lake (BYDL), the largest lake in the North China Plain, is confronted with such challenges. The objective of this study was to improve understanding of how changes in water level influence water quality in the BYDL at different temporal scales, especially related to implementations of intermittent environmental water allocation activities in the past two decades, by using data on monthly lake water level, climate factors of precipitation and temperature, and lake water quality. The Mann-Kendall method and continuous wavelet analysis revealed that the lake water level shows a significant decreasing trend after 1967, and the period of 16-year was identified as the principal period for 1950-2018. Based on cross-wavelet transform and wavelet coherence analysis, the periodic agreement and coherence between water level and climatic factors decreased after 1997, when environmental water allocations started, indicating that the influences of climatic factors, i.e., precipitation and temperature, became weak. By utilizing the cross-wavelet transform and wavelet coherence analysis methods, the relationships between lake water level and water quality parameters of chemical oxygen demand, ammonia nitrogen, total nitrogen, and total phosphorus were investigated. We found that the change in source and amount of environmental water allocation is one possible reason for the temporal evolution in joint variability between lake water level and water quality. Meanwhile, a dilution effect of freshwater allocated to BYDL was detected in the time-frequency domain. However, the result also indicates that the driving mechanism of water quality is complex due to the combined impacts of water allocation, nonpoint source pollution in the rainy season, and nutrient release from lake sediment. Our findings improve the general understanding of changes in water level in lakes located in arid and semiarid regions under climate change and intensive human activities, and also provide valuable knowledge for decision making in aquatic ecosystem restoration of BYDL and other similar lakes.

Application of Bioinformatics Methods to Identify Key Genes and Functions in Chronic Pelvic Pain.

Neuropathologic pain (NPP) occurs in most patients with chronic pelvic pain (CPP), and the unique physiological characteristics of visceral sensory neurons make the current analgesic effect of CPP patients not optimistic. Therefore, this study explored the possible biological characteristics of key genes in CPP through the bioinformatics method. CPP-related dataset GSE131619 was downloaded from Gene Expression Omnibus to investigate the differentially expressed genes (DEGs) between lumbar dorsal root ganglia (DRG) and sacral DRG, and the functional enrichment analysis was performed. A protein-protein interaction (PPI) network was constructed to search subnet modules of specific biological processes, and then, the genes in the subnet were enriched by single gene set analysis. A CPP mouse model was established, and the expression of key genes were identified by qPCR. The results showed that 127 upregulated DEGs and 103 downregulated DEGs are identified. Functional enrichment analysis showed that most of the genes involved in signal transduction were involved in the pathway of receptor interaction. A subnet module related to neural signal regulation was identified in PPI, including CHRNB4, CHRNA3, and CHRNB2. All three genes were associated with neurological or inflammatory activity and are downregulated in the sacral spinal cord of CPP mice. This study provided three key candidate genes for CPP: CHRNB4, CHRNA3, and CHRNB2, which may be involved in the occurrence and development of CPP, and provided a powerful molecular target for the clinical diagnosis and treatment of CPP.

Non-point source pollution risks in a drinking water protection zone based on remote sensing data embedded within a nutrient budget model.

A simple, transparent and reliable method for evaluating non-point source pollution (NPSP) risks to drinking water source areas lacking observational data is proposed herein. The NPSP risks are assessed by using nutrient budget models for total nitrogen and total phosphorus, making the best use of remote sensing and field survey data. We demonstrate its potential using a case study of the Chaihe Reservoir in northeastern China. Fertilizer inputs and crop-uptake outputs were estimated based on normalized difference vegetation index, which is derived from remote sensing as indicators of crop growth and production. The nutrient balances for this area showed surpluses of both N and P within the soil system. Estimated imbalances per unit area were consistent with statistical relationships derived from all Chinese counties, demonstrating that the proposed method is reliable. The surplus P amounts were higher than the standard threshold for NPSP risks, indicating the existence of a potential contamination risk of P to this drinking water source.