Dreaming during gastrointestinal endoscopy under propofol, ciprofol, or remimazolam anesthesia: study protocol for a parallel-design double-blind, single-center trial.

BACKGROUND: Dreaming sometimes occurs during sedation. It has been reported that factors such as different anesthetics, depth of anesthesia, age, sex, and preoperative psychological state may affect dreams. Ciprofol and remimazolam are novel choices for painless endoscopy. Herein, we aimed to investigate dreaming during gastrointestinal endoscopy under propofol, ciprofol, and remimazolam anesthesia respectively. METHODS: This is a prospective, parallel-design double-blind, single-center clinical trial. Three hundred and sixty subjects undergoing elective painless gastroscopy, colonoscopy, or gastroenteroscopy will be enrolled. Eligible subjects will undergo propofol-, ciprofol-, or remimazolam-induced anesthesia to finish the examination. Interviews about the modified Brice questionnaire will be conducted in the recovery room. Incidence of dreaming is set as the primary outcome. Secondary outcomes include type of dreams, improvement of sleep quality, evaluation of patients, incidence of insufficient anesthesia, and intraoperative awareness. Safety outcomes are the incidences of hypotension and hypoxia during examination and adverse events during recovery. DISCUSSION: This study may observe different incidences of dreaming and diverse types of dreams, which might lead to different evaluations to the anesthesia procedure. Based on the coming results, anesthesiologists can make a better medication plan for patients who are going to undergo painless diagnosis and treatment. TRIAL REGISTRATION: This trial was registered at the Chinese Clinical Trial Registry on May 18, 2023 (registration number ChiCTR2300071565).

Correlation of the spin state and catalytic property of M-N4 single-atom catalysts in oxygen reduction reactions.

The rational design of high-performance catalysts for oxygen reduction reactions (ORRs) is of great importance for large-scale applications in the field of proton-exchange membrane fuel cells and the green synthesis of H2O2. The effect of spin states of paramagnetic metal ions on the selectivity of ORRs is significant for single-atom catalysts (SACs). In this work, via spin-polarization density functional theory (DFT) calculations, we systematically investigated the popular paramagnetic metal-nitrogen graphene (M-N4-C, M = Mn, Fe, and Co) SACs to mainly focus on the correlation of spin states and catalytic performance (e.g. activity and selectivity). Both thermodynamically and kinetically, it was found that Co-N4-C (S = 1/2) has excellent 2e- oxygen reduction performance (hydrogen peroxide production) with an ultralow overpotential of 0.03 V, and the hydrogenation of OOH* is the rate-determining step (RDS) with an energy barrier of 1.20 eV. The 4e- ORR tends to occur along the OOH dissociation pathway (O* + OH*) on Co-N4-C (S = 3/2), in which OOH* decomposition is the RDS with an energy barrier of 1.01 eV. It is proved that the spin magnetic moment is the key factor to regulate the ORR property via multi-angle electronic analysis. The spin states of catalysts play a crucial role in the activity and selectivity of ORRs mainly by manipulating the bond strength between OOH and catalysts. This will provide new insights for the rational design of ORR catalysts with magnetic metals.

Rational design of bimetallic MXene solid solution with High-Performance electrocatalytic N2 reduction.

Electrocatalytic N2 reduction reaction (eNRR) was an effective alternative method for green synthesis of NH3. By combining the first-principal Density functional theory (DFT) calculations and Monte Carlo (MC) simulation, we systematacially investigated 24 types equal-ratio bimetallic MXene solid solution, involving 88 different catalysts. Our focus was on the catalytic performance of these materials in eNRR. The computational result indicate that MoW(3Mo) has high stability, selectivity (93.8 % against the hydrogen evolution reaction (HER)) and activity (UL = -0.26 V), which is significantly better than that of monometal Mo2CO2 and W2CO2. This improvement in catalytic properties is attributed to the unique electronic structure (e.g. d-band center, charge) of bimetallic MXene solid solution. In explicit solvent conditions, the microenvironment of hydrogen bond in aqueous liquid thermodynamically promotes the catalytic property for eNRR and reduce the catalytic property of HER side reaction, but the kinetic barrier is also increased due to the effect of the hydrogen-bond microenvironment on proton migration. Overall, the obtained bimetallic MXene solid solution MoW(3Mo) exhibits excellent catalytic performance in eNRR.

Salvia miltiorrhiza-asarum ointment combined with Chinese medical massage alleviates symptoms of osteoarthritis in a rat model through the Notch1/ matrix metalloproteinase-13 signaling pathway.

OBJECTIVE: This study investigated the effect of salvia miltiorrhiza-asarum ointment (SMAO) plus Chinese medical massage on knee osteoarthritis in a rat model. METHODS: Hulth's method was used to establish a Sprague-Dawley rat model of knee osteoarthritis (OA). The levels of matrix metalloproteinase-13 (MMP-13), collagen-II, aggrecan, interleukin (IL)-1ß, tumor necrosis factor-α (TNF-α), and IL-6 were measured by enzyme-linked immunosorbent assays. The joint space was assessed by a Perlove X-ray system. Histopathology was examined by hematoxylin-eosin and Safranin O staining. The mRNA and protein expression levels of Notch1, MMP-13, collagen-II, and aggrecan were measured by quantitative reverse transcription-polymerase chain reaction and Western blotting, respectively. RESULTS: SMAO plus Chinese medical massage significantly decreased the levels of MMP-13, IL-1ß, TNF-α, and IL-6, and increased serum collagen-II and aggrecan levels. Pathological injury of the knee joint was improved by SMAO treatment. mRNA and protein expression of Notch1 and MMP-13 was remarkably downregulated, but collagen-II and aggrecan levels were significantly upregulated in cartilage tissues. CONCLUSION: SMAO combined with Chinese medical massage effectively relieves OA symptoms, which may involve inhibiting inflammation through the Notch1/MMP-13 signaling pathway.

Effect of intrathecal dexmedetomidine on cesarean section during spinal anesthesia: a meta-analysis of randomized trials.

OBJECTIVE: Intrathecal dexmedetomidine has been used in spinal anesthesia during cesarean sections. The purpose of this meta-analysis was to investigate the effect of intrathecal dexmedetomidine on the adverse reactions of spinal anesthesia during cesarean section. METHODS: We searched for relevant studies using PubMed, Web of Science, and the Cochrane library. After screening studies and extracting data, we performed a meta-analysis on the effect of intrathecal dexmedetomidine during cesarean section. RESULTS: A total of 278 patients from 4 studies were included in this meta-analysis. The incidence of shivering in the dexmedetomidine groups was significantly lower than that in the placebo groups during cesarean section (RR=0.40, 95% CI [0.25, 0.65], P=0.0002). Intrathecal dexmedetomidine had no effect on nausea and vomiting (RR=1.08, 95% CI [0.68, 1.71], P=0.74), bradycardia (RR=1.33, 95% CI [0.31, 5.76], P=0.70), and hypotension during cesarean section (RR=0.78, 95% CI [0.59, 1.03], P=0.08). CONCLUSION: Intrathecal dexmedetomidine can effectively reduce the occurrence of shivering during cesarean section, but it does not affect the occurrence of nausea and vomiting, bradycardia or hypotension.

[Effects of ethanol on the function of cultured hepatocytes].

OBJECTIVE: To develop a novel culture system to investigate the effects of ethanol on the function of cultured hepatocytes. METHODS: Sandwich configuration was used to culture hepatocytes and the effects of ethanol on functions of bile excretion and protein synthesis as well as the morphology of cultured hepatocytes were observed. RESULTS: Bile canaliculi-like structures decreased and anastomatic networks disappeared in ethanol treated hepatocytes. The ability for hepatocytes to internalize, metabolize and excrete compounds into bile was indicated by FDA metabolizing in the hepatocytes. In hepatocytes without ethanol, the bile excretion was showed clearly, but in ethanol-interfered hepatocytes, no bile excretion was observed. After ethanol was given, the level of protein secretion decreased and with the time going, it became lower and lower. CONCLUSION: Hepatocytes can be seriously damaged by ethanol. The study provides a new model to investigate the mechanism of some liver diseases caused by ethanol.