Efficacy and safety of intravenous dexmedetomidine as an adjuvant to general anesthesia in gynecological surgeries: A systematic review and meta-analysis of randomized controlled trials.

This study investigated the efficacy and safety of intravenous dexmedetomidine as an adjuvant to general anesthesia in patients undergoing gynecological surgery. We systemically searched for randomized controlled trials (RCTs), and performed a meta-analysis on studies that met the inclusion criteria. The primary outcomes were postoperative nausea and vomiting (PONV), bradycardia, hypotension, and 24 h opioid consumption. The secondary outcomes include postoperative shivering, postoperative pain score, intraoperative anesthetic consumption, extubation time, postoperative sedation, and the time to first flatus. Twenty-five RCTs were included in this study. Meta-analysis showed that intravenous dexmedetomidine significantly reduced the risk of PONV (RR, 0.57 [0.47, 0.68]) and postoperative shivering (RR: 0.31 [0.22, 0.42]), 24 h opioid consumption (Mean Difference: - 4.85 mg [-8.60, -1.11]) and postoperative pain score within 24 h. However, these benefits were at the cost of increased bradycardia (RR, 3.21 [2.41, 4.28]) and hypotension (RR, 2.17 [1.50, 3.14]). Notably, no serious adverse effects were reported in any of the included studies. Thus, our study showed that intravenous dexmedetomidine provided significant antiemetic and anti-shivering effects and moderate analgesic effects in patients that underwent gynecological surgery. However, its benefits should be weighed against the significantly increased risk of bradycardia and hypotension.

Fecal Protein Analysis of Dusp6 Knockout C57BL/6J Mice by Metaproteomics.

The research of obesity and gut microbiota has been carried out for years, yet the study process was in a slow pace for several challenges to conquer. As a complex status of disorder, the contributing factors refer to gut microbiota about obesity were controversial in a wide range. In terms of proteomics, 2D-DIGE technology is a powerful method for this study to identify fecal proteins from lean microbiota in Dusp6 knockout C57BL/6J mice, exploring the protein markers of the ability resisting to diet-induced obesity (DIO) transferred to the host mice after fecal microbiota transplantation. The results showed that the fecal microbiota expressed 289 proteins differentially with 23 proteins identified, which were considered to be the reasons to assist the microbiota exhibiting distinct behavior. By means of proteomics technology, we had found that differentially expressed proteins of lean microbiota determined the lean microbial behavior might be able to resist leaky gut. To sum up our study, the proteomics strategies offered as a tool to demonstrate and analyze the features of lean microbiota, providing new speculations in the behavior about the gut microbiota reacting to DIO.

Effects of Workplace Gossip on Employee Mental Health: A Moderated Mediation Model of Psychological Capital and Developmental Job Experience.

Research has demonstrated the effects of workplace gossip on employees' work attitudes and behaviors. However, little emphasis has been placed on the psychological influence of workplace gossip on employees. The present study investigated the relationships among workplace gossip, psychological capital, and individual mental health. Data were collected in three waves from 222 full-time employees of a Taiwanese tourism company to explore the effect of workplace gossip on employees' mental health. The results suggested that workplace gossip was associated with employees' mental health through psychological capital. Moreover, developmental job experience plays a moderator role in the relationships among workplace gossip, psychological capital, and mental health. A moderated mediation model was also proposed in this study.

HDL and associated factors stratified by sex and menopausal status: results from a community-based survey in Taiwan.

AIM: To investigate factors, especially modifiable factors associated with high-density lipoprotein (HDL) in Taiwanese based on sex and menopausal status. MATERIALS AND METHODS: Participants comprised 2022 men and 2392 women (1267 menopausal and 1125 non-menopausal) aged ≥30 years who resided in Pingzhen district, Taoyuan from 2006-2011. Their data, obtained through questionnaires and measurements were retrieved from the Li-Shin Hospital. RESULTS: Higher HDL was associated with total cholesterol, underweight, and alcohol drinking in both men and women. It was also associated with education, blood group B, and marital status in men as well as with age in women. Moreover, it was associated with total cholesterol, underweight, and age in both menopausal and non-menopausal women. Furthermore, it was associated with marital status in non-menopausal women and alcohol drinking in menopausal women. Lower HDL was associated with triglycerides, low-density lipoprotein (LDL), overweight, obesity, waist-hip ratio (WHR), uric acid, and smoking in both men and women and with coffee drinking in only women. It was also associated with uric acid, triglycerides, LDL, overweight, obesity, WHR, and body fat in both menopausal and non-menopausal women. Moreover, it was associated with coffee drinking in menopausal women. CONCLUSION: Modifiable factors associated with HDL differ according to sex and menopausal status. Sex and menopausal status should be considered when implementing lifestyle changes to raise HDL. For example, both men and women should maintain a normal weight as well as quit smoking.

Pneumoperitoneum complicated pneumomediastinum causing cardiovascular deterioration in a low-body-weight premature infant during laparoscopic Nissen fundoplication.

Due to smaller incisions, fewer wound injuries, and a shorter time of recovery, laparoscopic procedures are becoming increasingly popular in pediatric surgery, but the safety of their application in low-body-weight or premature infants should be a major concern. Here we present a case report of a 3-month-old premature infant, who developed a sudden change of hemodynamic instability while undergoing a laparoscopic Nissen's fundoplication for gastroesophageal reflex disease. This was thought to result from an accidental passage of massive insufflation of carbon dioxide gas across the diaphragm, leading to pneumomediastinum.

Identification of methanol-soluble compounds in sesame and evaluation of antioxidant potential of its lignans.

The methanol extract of sesame (Sesamum indicum) seeds was fractionated and purified with the assistance of conventional column chromatography to afford 29 compounds including seven furofuran lignans. Among these isolates, (+)-samin (1) was obtained from the natural source for the first time. In addition, (-)-asarinin (30) and sesamol (31) were generated by oxidative derivation from (+)-sesamolin (2) and (+)-sesamin (3), two abundant lignans found in sesame seeds. To evaluate their in vitro antioxidant potential, the seven isolated lignans (1-7) and the two derivatives (30 and 31) were examined for the scavenging activities on DPPH free radicals and superoxide anions. Moreover, the capability of chelating ferrous ions and reducing power of these sesame lignans were also measured. The results suggest that, besides the well-known sesamolin and sesamin, the minor sesame lignans (+)-(7S,8'R,8R)-acuminatolide (5), (-)-piperitol (6), and (+)-pinoresinol (7) are also adequate active ingredients and may be potential sources for nutritional and pharmacological utilization.

Epidural analgesia with low-concentration levobupivacaine combined with fentanyl provides satisfactory postoperative analgesia for colorectal surgery patients.

OBJECTIVE: Epidural patient-controlled analgesia (EPCA) with a mixture of low-concentration levobupivacaine (0.0625% or 0.1%) plus fentanyl, with basal infusion, has been extensively used for postoperative analgesia in our allied institutions. To elucidate whether these two EPCA regimens provide satisfactory analgesia, we compared the analgesia efficacy and incidence of drug-related side effects for both EPCA regimens with those of the most widely used postoperative analgesia regimen, intra-venous PCA (IVPCA) with morphine. METHODS: Data collection was performed through retrospective chart review. A total of 335 patients who underwent colorectal surgery were included. Patients received IVPCA (n = 200), EPCA with 0.0625% levobupivacaine/fentanyl (n = 45), or EPCA with 0.1% levobupivacaine/fentanyl (n = 90). The analgesia efficacy and side effects were compared. RESULTS: Pain scores with 0.0625% and 0.1% EPCA were significantly lower than those with IVPCA. Most patients were satisfied with their postoperative analgesia, and the satisfaction scores of these three groups were comparable. No patients developed respiratory depression or over-sedation. The incidence of nausea and vomiting was significantly higher with 0.1% EPCA (16.7% and 7.8%, respectively) compared with IVPCA (6.1% and 3.5%, respectively) and 0.0625% EPCA (9.3% and 2.3%, respectively). Moreover, the incidence of sensory and motor blockade was significantly higher with 0.1% EPCA (13.5% and 5.6%, respectively) than with 0.0625% EPCA (4.7% and 0%, respectively). CONCLUSION: Epidural analgesia with low-concentration levobupivacaine plus fentanyl provides satisfactory postoperative analgesia with few side effects for patients after colorectal surgery.