Prevention of postoperative nausea and vomiting after orthognathic surgery: a scoping review.

INTRODUCTION: Postoperative nausea and vomiting (PONV) is one of the most common adverse events following orthognathic surgery. It's a distressing feeling for patients and continues to be the cause of postoperative complications such as bleeding, delayed healing, and wound infection. This scoping review aims to identify effective PONV prophylaxis strategies during orthognathic surgery that have emerged in the past 15 years. METHODS: We searched Pubmed, Cochrane Controlled Register of Trials, and Embase from 2008 to May 2023. Studies meeting the following criteria were eligible for inclusion: (1) recruited patients undergo any orthognathic surgery; (2) evaluated any pharmacologic or non-pharmacologic method to prevent PONV. Studies meeting the following criteria were excluded: (1) case series, review papers, or retrospective studies; (2) did not report our prespecified outcomes. RESULTS: Twenty-one studies were included in this review. Pharmacological methods for PONV prevention include ondansetron and dexamethasone (3 studies), peripheral nerve block technique (4 studies), dexmedetomidine (1 study), pregabalin (2 studies), nefopam (2 studies), remifentanil (1 study), propofol (2 studies), and penehyclidine (1 study). Non-pharmacologic methods include capsicum plaster (1 study), throat packs (2 studies) and gastric aspiration (2 studies). CONCLUSIONS: Based on current evidence, we conclude that prophylactic antiemetics like dexamethasone, ondansetron, and penehyclidine are the first defense against PONV. Multimodal analgesia with nerve block techniques and non-opioid analgesics should be considered due to their notable opioid-sparing and PONV preventive effect. For the non-pharmacological methods, throat packs are not recommended for routine use because of their poor effect and serious complications. More prospective RCTs are required to confirm whether gastric aspiration can prevent PONV effectively for patients undergoing orthognathic surgery.

Winter drainage and film mulching cultivation mitigated CH4 emission by regulating the function and structure of methanogenic archaeal and fermenting bacterial communities in paddy soil.

Winter flooding of harvested rice fields is a typical cropping system in mountainous areas, which emits considerable amounts of CH4. Plastic film mulching cultivation is recognized as an important rice cultivation practice in paddy field for water-saving irrigation. However, the effects of these managements on CH4 emissions in paddy soil and the underlying microbial mechanism are unclear. A field experiment was carried out with the application of winter drainage followed by traditional rice cultivation (WD), winter drainage followed by plastic film mulching cultivation (MC), as well as winter flooding followed by traditional rice cultivation (WF) as control in hilly paddy fields. We investigated the CH4 emissions, functional (CH4 production rate, 13C isotope) and structural (abundance, structure) responses of soil methanogenic archaeal and fermenting bacterial communities during rice season. Shifting the fields from WF into WD and MC substantially mitigated CH4 emissions by 62.3% and 59.2%, respectively, paralleled with the enhancement of soil Eh and the reductions of soil DOC content. Compared with WF, WD and MC both significantly decreased CH4 production rates and the copy numbers of mcrA gene. Moreover, an increasing contribution of hydrogenotrophic methanogenesis (from 30.7% to 50.0%) to total CH4 production was observed during the conversion from WF to MC under an anaerobic incubation, paralleled with the decreased acetate content and increased δ13C values of acetate-methyl and total acetate. The communities of methanogenic archaea and fermenting bacteria strongly responded to the shift from WF to WD, while MC only showed significant effects on the methanogenic archaeal communities. Compared with WF, WD and MC significantly increased the relative abundance of Methanothrix, Methanosarcina and Methanocella, while those of Methanoregula, Massilia and Geobacter were decreased. The co-occurrence networks showed that WD and MC induced the loss of mixed methanogenic fermentation modules, indicating the decrease in functional biodiversity and redundancy of fermenting bacterial and methanogenic archaeal communities.The findings suggest that WD and MC approach mitigate CH4 emission by regulating the function and structure of methanogenic archaeal and fermenting bacterial communities in paddy soil, which represent the effective management strategies considering the water availability and CH4 mitigation in paddy-field agriculture.

Gastrointestinal modifications and bioavailability of brown seaweed phlorotannins and effects on inflammatory markers.

Brown seaweeds such as Ascophyllum nodosum are a rich source of phlorotannins (oligomers and polymers of phloroglucinol units), a class of polyphenols that are unique to Phaeophyceae. At present, there is no information on the bioavailability of seaweed polyphenols and limited evidence on their bioactivity in vivo. Consequently, we investigated the gastrointestinal modifications in vitro of seaweed phlorotannins from A. nodosum and their bioavailability and effect on inflammatory markers in healthy participants. In vitro, some phlorotannin oligomers were identified after digestion and colonic fermentation. In addition, seven metabolites corresponding to in vitro-absorbed metabolites were identified. Urine and plasma samples contained a variety of metabolites attributed to both unconjugated and conjugated metabolites (glucuronides and/or sulphates). In both urine and plasma, the majority of the metabolites were found in samples collected at late time points (6-24 h), suggesting colonic metabolism of high-molecular-weight phlorotannins, with three phlorotannin oligomers (hydroxytrifuhalol A, 7-hydroxyeckol, C-O-C dimer of phloroglucinol) identified in urine samples. A significant increase of the cytokine IL-8 was also observed. Our study shows for the first time that seaweed phlorotannins are metabolised and absorbed, predominantly in the large intestine, and there is a large inter-individual variation in their metabolic profile. Three phlorotannin oligomers present in the capsule are excreted in urine. Our study is the first investigation of the metabolism and bioavailability of seaweed phlorotannins and the role of colonic biotransformation. In addition, IL-8 is a possible target for phlorotannin bioactivity.

Fabrication of osmotic pump tablets utilizing semisolid extrusion three-dimensional printing technology.

The utilization of three-dimensional (3D) printing technology is prevalent in the fabrication of oral sustained release preparations; however, there is a lack of research on 3D-printed osmotic pump tablets. A 3D-printed core-shell structure bezafibrate osmotic pump tablet was developed based on the characteristics of rapid absorption and short half-life of bezafibrate, utilizing semisolid extrusion (SSE) 3D printing technology. First, the properties of different shell materials were investigated to define the composition of the shell, and ultimately, the optimal formulation was found to be ethyl cellulose:cellulose acetate:polyethylene glycol = 2:1:2. The formulation of the tablet core was defined based on the printing performance and release behavior. The formulation consisted of bezafibrate, lactis anhydrous, sodium bicarbonate, sodium alginate, polyethylene oxide and sodium dodecyl sulfate at a ratio of 400:400:300:80:50:50. The tablet was capable of achieving zero-order release. The physicochemical properties were also characterized. The pharmacokinetic data analysis indicated that there were no statistically significant differences in the pharmacokinetic parameters between the 3D-printed tablets and the reference listed drugs. There was a strong correlation between the in vitro and in vivo results for the 3D-printed tablets. The results showed that SSE printing is a practical approach for manufacturing osmotic pump tablets.

Ionic regulation whey protein composition on membrane fouling during ultrafiltration process analyzed by HPLC.

In order to meet the market demand and avoid the increase of operation amount and cleaning cost in the process of ultrafiltration, it is particularly important to find more practical and efficient methods to control and improve membrane fouling. In this study, the ions in the ultrafiltration process were regulated to affect membrane surface proteins composition (lactoferrin, α-lactalbumin, ß-lactoglobulin A and ß-lactoglobulin B) and delay membrane fouling. It was found that Na+ (21 mmol/L), Zn2+ (0.25 mmol/L) and K+ (44 mmol/L) was added at 4 min, 8 min and 12 min, respectively during ultrafiltration process. The continuous regulation slowed down the decline rate of membrane flux and reduced the content of α-lactalbumin, ß-lactoglobulin A and ß-lactoglobulin B on the membrane surface analyzed by HPLC. This could reduce the irreversible membrane fouling of proteins cake resistance. Furthermore, the ions concentration was also investigated after filtration. The concentration of K+ was increased significantly and other ions concentration was not significantly changed after continuous regulation such Na+, Mg2+, Zn2+ and Ca2+ compared to control. Therefore, dynamic ionic regulation of whey protein ultrafiltration process is a simple and effective method, which provides technical theoretical basis for optimizing and improving membrane technology.

Anesthesia management for patient with bipolar disorder complicated with hypothyroidism during oral surgery: a case report.

Bipolar disorder is a major mental illness that is difficult to treat and has a high degree of recurrence. This article reports general anesthesia for oral surgery in a patient with bipolar disorder complicated with hypothyroidism. It also discusses the rational application of antipsychotic drugs and anesthetics with reference to the literature to improve the understanding of the disease and help patients with mental disorders complete the surgical treatment quietly and smoothly.

Generic imprinted fiber array strategy for high-throughput and ultrasensitive simultaneous determination of multiple neonicotinoids.

Herein, a new generic fiber array based on molecular imprinting solid-phase microextraction (MIP-SPME) technology, was described to enrich trace multiple neonicotinoids with high flux from the food matrix. To begin with adsorption experiments coupled with theoretical calculations provided universal means for selecting the preferred template molecule clothianidin (CLT). Results demonstrated that the CLT-MIP fiber array exhibited significantly superior enrichment ability of 1189-2356-folds for six neonicotinoids compared with two kinds of commercial fiber arrays. Furthermore, the practicability of the CLT-MIP fiber array was verified by simultaneously determining multiple neonicotinoids in tea and honey samples. The CLT-MIP fiber array showed a limit of detection (LOD) of 0.03-0.58 µg/L for six neonicotinoids. The method also exhibited satisfactory recoveries ranging from 85.4% to 116.8% with RSD (n = 3) less than 8.8%. The imprinted fiber array has the advantages of high-throughput, predominant reproducibility, and accurate quantitation multi-component, and it may open up a new mean to efficiently enrich high-throughput and simultaneously detect multiple compounds from food samples.

Hydrothermal carbonization of kitchen waste: An analysis of solid and aqueous products and the application of hydrochar to paddy soil.

Hydrothermal carbonization (HTC) technology can potentially be used to safely and sustainably utilize kitchen waste (KW). However, the characteristics of HTC solid products (hydrochar) and aqueous products (HAP) based on different types of KW have not yet been clarified. Here, four types of KW, cellulose-based (CL), skeleton-based (SK), protein-based (PT), and starch-based (ST) KW, were used for HTC at 180 °C, 220 °C, and 260 °C. The basic physicochemical properties and structures of hydrochars and HAP were analyzed, and the effects of different hydrochars on rice growth were characterized. HTC decreased the H/C and O/C of KW. All hydrochars were acidic (3.12 to 6.78) and the pH values increased with the HTC temperature, while high HTC temperature reduced the porosity of hydrochars. HTC promoted the enrichment of total carbon (up to 78.1 %), total nitrogen (up to 62.6 %), and total phosphorus (up to 171.6 %) in KW. More carbon (60.7-88.0 %) and nitrogen (up to 87.4 %) were present in the hydrochars than in the HAP. The relative content of C1s increased and O1s decreased in CL and ST hydrochars as the HTC temperature increased, while the opposite pattern was observed for SK and PT hydrochars. The dissolved organic matter (DOM) of different hydrochars and HAP were mainly humus-like substances. The biodegradability of the DOM in HAP was often higher than the corresponding hydrochar, and their DOM biodegradability increased with the HTC temperature. The content of heavy metals from different hydrochars did not exceed the relevant thresholds of fertilizer standards. Rice grain yield increased by 3.7-11.1 % in the hydrochar treatments without phosphate fertilizer addition compared with the control treatment. The results of this study provide new theoretical and empirical insights into the potential for HTC technology to be used for the recycling of KW and its products in the agricultural environment.

Influence of polyethylene terephthalate microplastic and biochar co-existence on paddy soil bacterial community structure and greenhouse gas emission.

Microplastic (MP) contamination is ubiquitous in agricultural soils. As a cost-effective soil amendment, biochar (BC) often coincides with MP exposure. However, little research has been conducted regarding the independent and combined effects of MPs and BC on the soil microbiome and N2O/CH4 emissions. Therefore, in this study, polyethylene terephthalate (PET) and wheat straw-derived BC were used, respectively, as representative MP and BC during an entire rice growth period. The high-throughput sequencing results showed that PET alone lowered bacterial diversity by 26.7%, while PET and BC co-existence did not induce apparent change. The relative abundances of some microbes (e.g., Cyanobacteria, Verrucomicrobia, and Bacteroidetes) that are associated with C and N cycling were changed at the phylum and class levels by all the treatments. In comparison with the control, the treatment of BC, PET, and their co-existence reduced the cumulative CH4 emissions by 50%, 53%, and 61%, respectively. The higher mitigation by BC + PET may be the result of higher soil Eh and a consequently lower methanogenesis functional gene mcrA abundance in the treated soils. In addition, BC and PET alone, as well as their combined treatment, increased the abundance of nitrification genes, enhancing the soil nitrification process. However, the relative contribution of the nitrification process to N2O emission was possibly lower than that of denitrification, in which the N2O reductase gene nosZ was found to be the primary gene regulating N2O emissions. BC alone increased nosZ abundance by 42.3%, thereby showing the potential in suppressing N2O emission. In contrast, when BC was co-added with PET, the nosZ abundance lowered possibly because of increased soil aeration, and thus its cumulative N2O emission was 38% higher than the BC treatment. Overall, these results demonstrated that BC and PET function differently in soil ecosystems when they coexisted.

Zinc ions coordinated carboxymethyl chitosan-hyaluronic acid microgel for pulmonary drug delivery.

Microgel affords a porous and swollen microstructure for the establishment of pulmonary delivery system with sustained released properties. Here, we report a microgel (with the diameter around 4 µm) prepared with a precipitation method, synthesized by coordinating Zn2+ to the Schiff base cross-linked carboxymethyl chitosan and glycol split hyaluronate. The microgel has shown well swollen and pH sensitive behaviors, high safety and biocompatibility in vitro. Besides, the biomaterial could escape from macrophage phagocytosis, a key factor contribute to quick drug clearance in the lung after co-incubated with RAW 264.7 cells. In consist with this, the bovine serum albumin loaded in the microgel showed sustained release behavior in 24 h in vitro; meanwhile, the drug had a retention time up to 36 h in the lung and followed by clearance in ICR mice through pulmonary administration. Thus, our microgel platform provides a promising candidate for pulmonary drug delivery systems with controlled release rate.

Travel-related infections in mainland China, 2014-16: an active surveillance study.

BACKGROUND: Transmission of infection through international travel is a growing health issue, and the frequency of imported infection is increasing in China. We aimed to quantify the total number of infections imported into mainland China by arriving travellers. METHODS: We actively surveyed arriving travellers at all 272 international entry-exit ports in mainland China. Suspected cases were detected through fever screening, medical inspection, self-declaration, and reporting by on-board staff. Participants completed a standardised questionnaire with questions about demographics, their travel itinerary (including detailed information about all countries or regions visited), and clinical manifestations. Nasopharyngeal swabs, sputum samples, faecal samples, vomitus, blood, and serum were collected as appropriate for diagnoses. Diagnosis was made by specific laboratory tests according to the national technical guidelines. Infections were classified as respiratory, gastrointestinal, vector-borne, blood-transmitted and sex-transmitted, or mucocutaneous. We divided arriving travellers into two groups: travellers coming from countries other than China, and travellers coming from Hong Kong, Macau, and Taiwan. We integrated surveillance data for 2014-16, calculated incidences of travel-related infections, and compared the frequency of infections among subgroups. FINDINGS: Between Jan 1, 2014, and Dec 31, 2016, 22 797 cases were identified among 805 993 392 arriving travellers-an overall incidence of 28·3 per million. 45 pathogens were detected in participants: 18 respiratory (19 662 cases), ten gastrointestinal (189 cases), seven vector-borne (831 cases), seven blood-transmitted and sex-transmitted (1531 cases), and three mucocutaneous (584 cases). Both the overall number and incidence of infection were more than five times higher in 2016 than in 2014. Case numbers and incidences also varied substantially by province, autonomous region, and municipality. Overall, 17 643 (77%) infections were detected by fever screening, but 753 (49%) blood-transmitted and sex-transmitted infections were identified through medical inspection. 14 305 (73%) cases of respiratory infection and 96 (51%) of gastrointestinal infections were in tourists. Tuberculosis, hepatitis A virus, vector-borne, and blood-transmitted and sex-transmitted infections were common among Chinese labourers who worked abroad. Dengue and malaria were most commonly diagnosed in travellers arriving from Africa. 12 126 (93%) of the 12 985 cases arriving from Hong Kong, Macau, or Taiwan were respiratory infections. Hand, foot, and mouth disease accounted for 2·90% of infections in travellers from Hong Kong, Macau, or Taiwan and 0·31% of infections in international travellers. INTERPRETATION: This report is the first to characterise the profile of travel-related infections among arriving travellers in mainland China. Our findings should increase public awareness of the potential risk of imported infections, and help health-care providers to make evidence-based health recommendations to travellers. FUNDING: The Natural Science Foundation of China.

[Real-time irrigation forecast of cotton mulched with plastic film under drip irrigation based on meteorological date].

It is important to improve the real-time irrigation forecasting precision by predicting real-time water consumption of cotton mulched with plastic film under drip irrigation based on meteorological data and cotton growth status. The model parameters for calculating ET0 based on Hargreaves formula were determined using historical meteorological data from 1953 to 2008 in Shihezi reclamation area. According to the field experimental data of growing season in 2009-2010, the model of computing crop coefficient Kc was established based on accumulated temperature. On the basis of crop water requirement (ET0) and Kc, a real-time irrigation forecast model was finally constructed, and it was verified by the field experimental data in 2011. The results showed that the forecast model had high forecasting precision, and the average absolute values of relative error between the predicted value and measured value were about 3.7%, 2.4% and 1.6% during seedling, squaring and blossom-boll forming stages, respectively. The forecast model could be used to modify the predicted values in time according to the real-time meteorological data and to guide the water management in local film-mulched cotton field under drip irrigation.

Effects of Incorporating Carboxymethyl Chitosan into PMMA Bone Cement Containing Methotrexate.

Treatment of bone metastases usually includes surgical resection with local filling of methotrexate (MTX) in polymethyl methacrylate (PMMA) cement. We investigated whether incorporating carboxymethyl chitosan (CMCS) in MTX-PMMA cement might overcome disadvantages associated with MTX. To determine the optimal CMCS+MTX concentration to suppress the viability of cancer cells, an integrated microfluidic chip culturing highly metastatic lung cancer cells (H460) was employed. The mechanical properties, microstructure, and MTX release of (CMCS+MTX)-PMMA cement were evaluated respectively by universal mechanical testing machine, scanning electron microscopy (SEM), and incubation in simulated body fluid with subsequent HPLC-MS. Implants of MTX-PMMA and (CMCS+MTX)-PMMA cement were evaluated in vivo in guinea pig femurs over time using spiral computed tomography with three-dimensional image reconstruction, and SEM at 6 months. Viability of H460 cells was significantly lowest after treatment with 57 µg/mL CMCS + 21 µg/mL MTX, which was thus used in subsequent experiments. Incorporation of 1.6% (w/w) CMCS to MTX-PMMA significantly increased the bending modulus, bending strength, and compressive strength by 5, 2.8, and 5.2%, respectively, confirmed by improved microstructural homogeneity. Incorporation of CMCS delayed the time-to-plateau of MTX release by 2 days, but increased the fraction released at the plateau from 3.24% (MTX-PMMA) to 5.34%. Relative to the controls, the (CMCS+MTX)-PMMA implants integrated better with the host bone. SEM revealed pores in the cement of the (CMCS+MTX)-PMMA implants that were not obvious in the controls. In conclusion, incorporation of CMCS in MTX-PMMA appears a feasible and effective modification for improving the anti-tumor properties of MTX-PMMA cement.

In vitro toxicity evaluation of 25-nm anatase TiO2 nanoparticles in immortalized keratinocyte cells.

Titanium dioxide (TiO(2)) nanoparticles (NPs) are massively fabricated and widely used in daily life, and thus potential risk has been posed to human health. However, the mechanism of the interaction between TiO(2) NPs and cells is still unclear. In this study, the interaction of anatase TiO(2) NPs with HaCaT cells is studied in vitro with multi-techniques. The TiO(2) NPs not only insert into cells through endocytic pathway but also penetrate into the cell. The TiO(2) NPs could produce reactive oxygen species (ROS) after dispersion spontaneously. Furthermore, the interaction between TiO(2) NPs and cellular components might also generate ROS. The ROS generation could lead to cellular toxicity if the level of ROS production overwhelms the antioxidant defense. Cytoskeletal components, particularly the microfilaments and microtubules, cause modifications upon exposure to TiO(2) NPs. With all results, the toxicological effects of TiO(2) NPs on HaCaT cell can be simplified into six events.