Effect of Multimodal Preemptive Analgesia of Flurbiprofen Axetil, Nalbuphine, and Retrobulbar Block on Postoperative Pain and Enhanced Recovery in Patients Undergoing Oculoplastic Day Surgery: A Prospective, Randomized, Double-Blinded Study.

PURPOSE: To evaluate the effect of either flurbiprofen axetil or nalbuphine combined with retrobulbar block (RB) before surgery on postoperative pain control and enhanced recovery in day-care patients undergoing orbital implantation. METHODS: A total of 45 patients undergoing orbital implantation with general anesthesia were randomly divided into three groups: flurbiprofen axetil (1 mg/kg) combined with RB (group F), nalbuphine (0.1 mg/kg) combined with RB (group N), and placebo as normal saline with RB (group C). The primary outcome was the average pain score (numeric rating scale: 0-10) within the first 24 hours. Other outcomes including the peak pain score, paracetamol requirement, quality of recovery (QoR)-15, and adverse effects (AEs) were assessed. RESULTS: The average and peak pain scores within 24 hours after surgery in group F were significantly lower than in other groups ( p < 0.0167). Compared with group C, the NRS scores were significantly decreased at 2 and 4 hours in group F, and 2 hours in group N after surgery ( p < 0.0167), but without significant differences at other measured time points. The time to first paracetamol oral intake displayed a significant difference among the three groups ( p < 0.0167). CONCLUSION: Preemptive use of flurbiprofen axetil 1 mg/kg combined with RB is an optimal choice for multimodal analgesia for day-care patients undergoing orbital implantation in terms of efficient acute pain control, without impeding patient-enhanced recovery.

Lipid metabolism regulatory activity and adverse effects of fungi-derived butyrolactone I.

Butyrolactone I (BTL-I), a butenolide compound isolated from land or marine-derived fungi, has been reported to show diverse activities. To further study the pharmaceutical potential of BTL-I, transcriptome and bioinformatics analysis of BTL-I treated HepG2 cells were taken. BTL-I was revealed with lipid metabolism regulatory activity and confirmed by increasing the mRNA expression of related genes, such as LXRα and its target gene UGT1A1. However, the obvious chemical carcinogenesis of BTL-I was also disclosed. BTL-I could significantly increase the mRNA and protein levels of oncogenes such as CYP1A1. Molecular docking of BTL-I and its analogs were performed to understand the active or toxic effects. Although BTL-I showed attractive activities, enough attention must be paid to its adverse effects in its further development.

The Essential Oil Derived from Perilla frutescens (L.) Britt. Attenuates Imiquimod-Induced Psoriasis-like Skin Lesions in BALB/c Mice.

Psoriasis is reported to be a common chronic immune-mediated skin disease characterized by abnormal keratinocytes and cell proliferation. Perilla leaves are rich in essential oils, fatty acids, and flavonoids, which are recognized for their antioxidant and anti-inflammatory effects. In this study, the alleviating effect of essential oil (PO) extracted from Perilla frutescens stems and leaves on imiquimod (IMQ) -induced psoriasis-like lesions in BALB/c mice were investigated. Results showed that PO ameliorated psoriasis-like lesions in vivo, reduced the expression of lymphocyte antigen 6 complex locus G6D (Ly-6G), which is a marker of neutrophil activation, and inhibited the expression of inflammatory factors interleukin 1 (IL-1), interleukin 6 (IL-6), inducible nitric oxide synthase (iNOS), and cyclooxygenase 2 (COX2). In addition, PO significantly decreased the expression of cytokines such as IL-6, IL-1, interleukin 23 (IL-23), interleukin 17 (IL-17), and nuclear factor kappa-B (NF-κB). Furthermore, the down-regulation of mRNA levels of psoriasis-related pro-inflammatory cytokines, such as IL-17, interleukin 22 (IL-22), IL-23, interferon-α (IFN-α), and Interferon-γ (IFN-γ) was observed with the treatment of PO. All results show a concentration dependence of PO, with low concentrations showing the best results. These results suggest that PO effectively alleviated psoriasis-like skin lesions and down-regulated inflammatory responses, which indicates that PO could potentially be used for further studies on inflammation-related skin diseases such as psoriasis and for the treatment of psoriasis such as psoriasis natural plant essential oil resources.

Risk Factors Associated with Postoperative Discomfort After Ambulatory Strabismus Surgery Under General Anesthesia.

PURPOSE: The aim of this study was to evaluate postoperative discomfort in patients undergoing ambulatory strabismus under general anesthesia, and to identify risk factors associated with the discomfort. PATIENTS AND METHODS: A cross-sectional study was conducted among 210 consecutive patients undergoing ambulatory strabismus under general anesthesia. Postoperative discomfort including nausea, vomiting, dizziness, and headache was recorded and quantified. Univariable and multivariable logistic regression were performed to detect the risk factors associated with postoperative discomfort. RESULTS: Of 210 participants, 199 (94.76%) patients experienced mild discomfort after ambulatory strabismus surgery under general anesthesia, and 31 (14.76%), 11 (5.24%), 60 (28.57%), 23 (10.95%) patients suffered from nausea, vomiting, dizziness, and headache, respectively. A multivariate analysis indicated that female sex, the surgery on inferior rectus, and the surgery on inferior oblique were the independent risk factors for postoperative vomiting while, mild anxiety was the independent risk factor for postoperative dizziness. CONCLUSION: Patients undergoing ambulatory strabismus surgery tended to experience postoperative nausea and dizziness. Female sex, the surgery on inferior rectus, mild anxiety, and the surgery on inferior oblique were the independent predictors of postoperative discomfort.

Desflurane anesthesia compared with total intravenous anesthesia on anesthesia-controlled operating room time in ambulatory surgery following strabotomy: a randomized controlled study.

BACKGROUND: Ophthalmic ambulatory surgery is preferred to be performed under general anesthesia either by total intravenous anesthesia (TIVA) or by inhalational anesthesia to increase the patient comfort. However, anesthesia-controlled time (ACT) can cause increased non-operative operating room (OR) time which may adversely affect the ORs efficiency. This study was aimed to compare the ACT of desflurane with that of propofol-remifentanil in strabismus ambulatory surgery. METHODS: From November 2016 to December 2017, a total of 200 strabismus patients (aged 18-60 years old, and scheduled for elective ambulatory surgery at Zhongshan Ophthalmic Center) were randomly assigned to receive either propofol-based TIVA (group TIVA) or desflurane anesthesia (group DES) for maintenance of anesthesia. The primary outcome was the extubation time. Secondary outcomes included surgical time, anesthetic time, OR exit time, and Phase I and II recovery time. The intraoperative incidences of hypotension, bradycardia and oculocardiac reflex (OCR), and the incidences of any post-operative complications were recorded. Mann-Whitney U test and Chi-square or Fisher exact tests were used to compare the two groups. RESULTS: We found that the extubation time (5.5 [3.9-7.0] vs. 9.7 [8.5-11.4] min, P < 0.001) and the incidence of prolonged time to extubation (0 vs. 6%, P = 0.029) in the DES group were significantly decreased compared with those in the TIVA group. The patients in the DES group displayed shorter OR exit time as compared with that in the TIVA group (7.3 [5.5-8.7] vs. 10.8 [9.3-12.3] min, P < 0.001). The patients using desflurane exhibited more stable hemodynamics during surgery than the patients using propofol-based TIVA, as demonstrated by lower incidences of hypotension (1% vs. 22%, P < 0.001), bradycardia (2% vs. 13%, P = 0.002), and OCR (17% vs. 44%, P < 0.001). CONCLUSION: DES enhanced the ophthalmic OR efficiency by reducing the extubation time and OR exit time, and provided more stable hemodynamics intra-operatively than TIVA in patients undergoing strabismus ambulatory surgery. TRIAL REGISTRATION: ClinicalTrials.gov, No. NCT02922660; https://clinicaltrials.gov/ct2/show/NCT02922660?id=NCT02922660&draw=2&rank=1.

Room temperature readily self-healing polymer via rationally designing molecular chain and crosslinking bond for flexible electrical sensor.

Mechanically tough polymers with excellent room temperature self-healing capacity have aroused strong interest in soft electronics, electronic skins and flexible energy storage devices. However, achieving such polymers remains a challenge due to tardy diffusion dynamics. Herein, a robust and readily self-healing polymer, which is synthesized by one-pot polymerization among 2,4'-tolylene diisocyanate, isophorone diisocyanate, and poly(oxy-1,4-butanediyl), is achieved through reasonably tuning the hardness of the molecular segment and the strength of the dynamic crosslinking bond. The poly(oxy-1,4-butanediyl) that act as a soft segment can effectively avoid the microphase separation, enabling rapid chain mobility of the polymer at the room temperature. Furthermore, the dual H-bonding from 2,4'-tolylene diisocyanate segment acting as a relatively strong crosslinking bond contributes to high mechanical strength, while the weaker single H-bonding from isophorone diisocyanate segment can efficiently dissipate strain energy by bond rupture, endowing the polymer with rapid room temperature self-healing ability. Featuring state-of-the-art of robust stress strength (≈1.3 MPa), high self-healing efficiency (97% within 6 h), and large tensile strain (≈2100%), the resulting polymers are used for the fabrication of stretchable and self-healable electrical sensor, which can be employed to monitor a variety of physiological activities in real time. The described strategy is promising and universal for healable materials, displaying great potential for developing soft electronics.

A New Macrodiolide and Two New Polycyclic Chromones from the Fungus Penicillium sp. SCSIO041218.

A new macrodiolide, mangrovlide A (1) and two new polycyclic chromones, penixanthones C (2) and D (3), as well as four other known compounds (4-7), have been isolated from the mangrove sediment derived fungus Penicillium sp. SCSIO041218, cultured in the 0.25% NaCl rice substrate. The structures of the new compounds were determined by analysis of the NMR and MS spectroscopic data. Compound 1 possesses a 10-membered macrodiolide unit, while 2 and 3 are chromones with an unprecedented 6/6/6/5 polycyclic skeleton. Compounds 1-7 were evaluated for their cytotoxicities, while all the compounds displayed weak or no activity.

Intraoperative administration of intravenous flurbiprofen axetil with nalbuphine reduces postoperative pain after orbital decompression: a single-center, prospective randomized controlled trial.

PURPOSE: This study aimed to investigate postoperative analgesia achieved with intraoperative administration of intravenous flurbiprofen axetil and nalbuphine in patients undergoing orbital decompression. METHODS: Sixty-three patients undergoing orbital decompression under general anesthesia at the Zhongshan Ophthalmic Center at Sun Yat-sen University (Guangzhou, China) were randomly allocated into one of the following three groups (1:1:1): intraoperative flurbiprofen axetil 100 mg (Group 1); intraoperative nalbuphine 0.1 mg/kg (Group 2); or intraoperative flurbiprofen axetil 100 mg combined with nalbuphine 0.1 mg/kg (Group 3). The primary end point was mean postoperative pain intensity during the first 24 hours. The secondary efficacy end points were the intensity of pain and discomfort at 0, 2, 6, 10, and 24 hours after surgery and side effects at 24 hours after surgery. RESULTS: The demographic characteristics were similar among the three groups. Mean and peak postoperative pain scores during the first 24 hours in Group 3 were lower than those in Group 1 (P=0.007 and P=0.003, respectively) and Group 2 (P=0.001 and P=0.000, respectively). Additionally, the pain scores in Group 3 were significantly lower than those in Group 1 during the first 6 hours after surgery (P=0.003, 0.002, and 0.022 at 0, 2, and 6 hours, respectively) and those in Group 2 during the first 10 hours after surgery (P=0.008, 0.000, 0.001, and 0.019 at 0, 2, 6, and 10 hours, respectively). Discomfort scores were not significantly different among the three groups during the observation period, except at 2 hours after surgery, at which time the scores in Group 3 were significantly lower than those in Group 2 (P=0.033). Postoperative adverse effects and analgesic requirements were similar among the three groups. CONCLUSION: Intraoperative administration of a combination of intravenous flurbiprofen axetil and nalbuphine is superior to single-dose flurbiprofen axetil or nalbuphine in patients undergoing orbital decompression.

Robust, Stretchable, and Self-Healable Supramolecular Elastomers Synergistically Cross-Linked by Hydrogen Bonds and Coordination Bonds.

Polymeric elastomers integrated with high mechanical toughness and excellent self-healing ability can find attractive applications in electronic skin, soft robotics, and electrical devices. However, simultaneously enhancing the mechanical and self-healing properties of elastomers is still a great challenge because it is difficult to balance the effects between strong and weak cross-linking bonds. Here, a novel self-healing elastomer is developed via a one-pot polycondensation reaction between bis(3-aminopropyl)-terminated poly(dimethylsiloxane) and 2,4'-tolylene diisocyanate, followed by being coordinated with Al(III) ions by metal-coordination bonds. In this elastomer system, the quadruple hydrogen bonds not only are able to achieve rapid reformation after fracture but also can dissipate strain energy as a weak dynamic bond, endowing the elastomer with excellent self-healing ability and high stretchability, while the treble Al-coordination bonds acting as a strong dynamic bond contribute to the robust molecular networks, leading to the significantly improved robustness and elasticity of the self-healing elastomer. Owing to the accuracy design, the synthesized elastomer exhibits all the desired properties, including high tensile stress (2.6 MPa), exceptional toughness (∼14.7 MJ m-3), high stretchability (∼1700%), and excellent self-healing ability (90%). The robust self-healing elastomer enables the easy fabrication of flexible electronic skin, which will open a new avenue for next-generation electrical devices.

Extremely elastic and conductive N-doped graphene sponge for monitoring human motions.

Due to the extraordinary properties of great elasticity, ultralow density, and good electrical conduction, macroporous graphene bulk materials are the promising candidate as the sensing materials for flexible electronics. Although a large number of progresses have been made, the piezoresistive effect of graphene does not completely meet requirements for various applications yet. Herein, the nitrogen-doped graphene sponge (NGS) material with well-ordered and uniform macroscopic porous structure in long range has been developed by a simple and low-cost strategy by combining hydrothermal and thermal annealing processes. The resulting NGS possesses superior properties of a low density, large elasticity with 80% of the reversible compressibility and outstanding linear elastic region (up to 30%-40%), favorable structural stability, good electrical conductivity (1.4 S m-1), as well as the outstanding sensing performances of a fine sensitivity (1.33 kP-1), low detection limit (2% strain), excellent linear sensing range (nearly 20%), long term stability (3000 cycles), and fast response (72.4 ms). Based on these prominent performances of NGS, a new type of piezoresistive sensor is fabricated, which can successfully detect the human motions from subtle deformations, including the finger bending with the bending degree of approximately 30° and the tiny pulse perturbation of the wrist joint.

Glycosylated Natural Products From Marine Microbes.

A growing body of evidence indicates that glycosylated natural products have become vital platforms for the development of many existing first-line drugs. This review covers 205 new glycosides over the last 22 years (1997-2018), from marine microbes, including bacteria, cyanobacteria, and fungi. Herein, we discuss the structures and biological activities of these compounds, as well as the details of their source organisms.

Reducing Structural Defects and Oxygen-Containing Functional Groups in GO-Hybridized CNTs Aerogels: Simultaneously Improve the Electrical and Mechanical Properties To Enhance Pressure Sensitivity.

Three-dimensional graphene oxide-carbon nanotube (GO-CNT, abbreviated as GCNT) aerogels can find wide applications in various fields. Especially, low-density GCNT aerogels featuring both high conductivity and superelasticity are essential requirements for the construction of highly sensitive pressure sensor. However, simultaneous improvement on the electrical and mechanical properties of low-density GCNT is still a great challenge owing to their disordered microstructure, severe structural defects and massive oxygen-containing functional groups. Here, a structurally ordered and less defective GCNT aerogel featuring both high conductivity and superelasticity has been fabricated through alkali induced self-assembly of GO liquid crystals (GO LCs) and CNTs. Our methodology relies on the double roles of KOH solution as dispersant for CNTs and an inducer for the self-assembly of GO LCs nanosheets. The less-defective CNTs acting as reinforcement material contributes to the robust structure networks, leading to the significantly improved conductivity (2.4 S m-1) and elasticity (14.3 kPa) of GCNT. Benefiting from these outstanding properties of GCNT aerogels, the assembled pressure sensor exhibits an ultrahigh sensitivity of 1.22 kPa-1, rapid response time of 28 ms and excellent cycling stability, which enables it as a high-performance sensing platform to monitor various human motions in real time.

Risk factors associated with postoperative pain and discomfort in oculoplastic surgery with general anesthesia: a prospective study.

PURPOSE: To evaluate patient pain and discomfort following oculoplastic surgery performed under general anesthesia and to assess key factors associated with postoperative pain and discomfort. METHODS: A prospective observational cohort study was conducted among 212 consecutive patients who underwent oculoplastic surgery performed under general anesthesia. The patients were assessed according to quantified levels of pain and discomfort postoperatively. Analgesic requests were recorded, and responses were statistically analyzed. RESULTS: Pain and discomfort after oculoplastic surgery under general anesthesia were reported by 32.1% and 28.3% of the patients, respectively; 2.8% of the patients requested analgesic medication within 18 hours after surgery. The patients who underwent orbital decompression, secondary orbital implantation, and orbital fracture repair were more likely to develop significant postoperative pain and discomfort (P<0.001), and the patients who underwent enucleation/evisceration during orbital implantation were more likely to develop postoperative discomfort (P<0.001). The predictors of pain were smoking history, prior surgery on the operative eye, and anxiety (P<0.05), and the predictor of discomfort was anxiety (P<0.05). CONCLUSION: Patients undergoing oculoplastic surgery tend to experience postoperative pain and discomfort. Anxiety is a risk factor for both postoperative pain and discomfort, while smoking history and prior surgery on the operative eye may be associated with postoperative pain.

The Fungal Metabolites with Potential Antiplasmodial Activity.

Malaria caused by Plasmodium parasites is amongst many prevalent public health concerns in several tropical regions of the world. Nowadays, the parasite resistance patterns to most currently used drugs in therapy and insecticides have created an urgent need for new chemical entities exhibiting new modes of action and management strategies. Fungus has been proven to be an excellent source of biologically active compounds, which have been screened for antiplasmodial activity as potential sources of new antimalarial drugs. This review summarizes the current 255 natural products from fungus, which may possess antimalarial activity and can be classified as sesquiterpenes, diterpenes, sesterterpenes, alkaloids, peptides depsipeptides, xanthones, anthraquinones, anthrones, bioxanthracenes, bixanthones, preussomerins, depsidones, phenols, trichothecenes, azaphliones, macrolides, and steroids. However, the treatments available for malaria are limited. Thus, the identification of novel antimicrobial agents should be continued, and all possible strategies should be explored. Carrying forward the antimalarial screening in exited terrestrial and marine natural products library, and finding the new natural products in new resources, particularly those living in marine environments, are still important approaches to find new antimalarial agents. Unusual marine environments are associated with chemical diversity, leading to a resource of novel active substances for the development of bioactive products. Finding new antimalarial natural products in marine fungus, particularly those living in deep-sea and special marine environments, is an important approach to identify novel active agents.

High-Performance Graphene Sponges Reinforced with Polyimide for Room-Temperature Piezoresistive Sensing.

The bulk materials of three-dimensional graphene (3DG) with high network structure and excellent electrical conductivity have many potential applications in flexible electronics, but the network structure is not very stable due to weak bonding between graphene nanosheets. Here, a polyimide (PI) layer was introduced on the as-prepared 3DG sponge by vacuum infiltration-curing method. The resulting 3DG/PI composite sponges with robust 3D network structure exhibited an excellent electrical conductivity (3.7 S/cm), compression strength (175 kPa), elasticity, and flexibility, as well as outstanding compression sensitivity to resistance and stable piezoresistance effect; namely, they possess a large change in resistance in response to application of small strain and low density, and the resistance change remains favorably stable after performing 300 compress-release cycles, which means that the prepared composite sponges can find wide applications in pressure-sensing or stimulus-responsive graphene system.

Efficacy of premedication with intranasal dexmedetomidine on inhalational induction and postoperative emergence agitation in pediatric undergoing cataract surgery with sevoflurane.

STUDY OBJECTIVES: This study aimed to test the hypothesis that premedication with a single dose of intranasal dexmedetomidine (DEX) could not only reduce preoperative anxiety but also minimize the emergence agitation in children undergoing cataract surgery with sevoflurane anesthesia. DESIGN: Single-blinded, randomized, placebo-controlled clinical comparison study. SETTING: Academic medical center. PATIENTS: Ninety American Society of Anesthesiologists physical status 1 and 2 children scheduled for cataract surgery. INTERVENTIONS: Patients were randomized into 3 groups: group D1, group D2, and saline group (group C), in which the children received 1 or 2 µg/kg of intranasal DEX or saline, respectively, and each group comprises 30 patients. MEASUREMENTS: The mask induction score and the incidences of postoperative emergence agitation evaluated by the Pediatric Anesthesia Emergence Delirium scale were assessed. The emergence time, postanesthesia care unit (PACU) stay time, and any adverse events were recorded. MAIN RESULTS: The mask induction scores were significantly higher in the saline group than those in the D1 and D2 groups (P<.001). The incidences of emergence agitation in the D1 and D2 groups were significantly lower than that in the saline group (7/30 in group D1 and 3/30 in group D2 vs 24/30 in group C, P<.001). The emergence time and PACU stay time were comparable among the 3 groups (P>.05). The emergence time and PACU stay time did not differ significantly in DEX-treated groups as compared with the saline group; there were no differences between 1- and 2-µg/kg groups. None of the patients exhibited significant clinical complications. CONCLUSION: Intranasal DEX (1 or 2 µg/kg) dose independently improves the incidences of mask acceptance and prevents the incidences of postoperative emergency agitation mainly from sevoflurane without delaying the emergency time or inducing severe adverse events.

Study of the rice straw biodegradation in mixed culture of Trichoderma viride and Aspergillus niger by GC-MS and FTIR.

This study was conducted to investigate the biodegradation ability of the mixed culture of Trichoderma viride and Aspergillus niger through the study of the organic matter extracted from rice straw and the lignocellulose structure by using gas chromatography-mass spectrometer (GC-MS) and Fourier transform infrared spectroscopy (FTIR). The results of the GC-MS showed that the mixed culture possessed shorter alkane (heptane) at the end of the incubation and more kinds of organic matter (except the alkanes, 29 kinds of organic matter were detected) than the pure cultures. It could be deduced that the organic matter could indicate the degradation degree of the lignocellulose to some extent. Moreover, pinene was detected in the mixed culture on days 5 and 10, which might represent the antagonistic relationship between T. viride and A. niger. The analysis of FTIR spectrums which indirectly verified the GC-MS results showed that the mixed culture possessed a better degradation of rice straw compared with the pure culture. Therefore, the methods used in this research could be considered as effective ones to investigate the lignocellulose degradation mechanism in mixed culture.

Sinulolides A-H, new cyclopentenone and butenolide derivatives from soft coral Sinularia sp.

Eight new compounds, sinulolides A-H (1-8), along with two known compounds, α-methoxy-2,3-dimethyl-butenolide (9) and sinularone D (10), were isolated from the soft coral Sinularia sp. The structures of these compounds were elucidated on the basis of extensive spectroscopic analysis. The absolute configurations were determined on the basis of electronic circular dichroism (ECD) data analysis. Compounds 5 and 10 exhibited moderate effects for the inhibition of NF-κB activation.

Nitrite reductase genes as functional markers to investigate diversity of denitrifying bacteria during agricultural waste composting.

The purpose of this study was to investigate the diversity of denitrifier community during agricultural waste composting. The diversity and dynamics of the denitrifying genes (nirK and nirS) were determined using polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE). Relationships between physico-chemical parameters and denitrifying genes structures were simultaneously evaluated by redundancy analysis (RDA). Phylogenetic analysis indicated that nirK clones grouped into six clusters and nirS clones into two major clusters, respectively. The results showed a very high diversity of nir gene sequences within composting samples. RDA showed that the nirK and nirS gene structures were significantly related to pH and pile temperature (P < 0.05). Significant amounts of the variation (49.2 and 38.3 % for nirK and nirS genes, respectively) were explained by pH and pile temperature, suggesting that those two parameters were the most likely ones to influence, or be influenced by the denitrifiers harboring nirK and nirS genes.