Superiority of sugammadex in preventing postoperative pulmonary complications.

BACKGROUND: Postoperative pulmonary complications often lead to increased mortality and financial burden. Residual paralysis plays a critical role in postoperative pulmonary complications. This meta-analysis was performed to determine whether sugammadex overmatches neostigmine in reducing postoperative pulmonary complications. METHODS: PubMed, Embase, Web of Science, Medline through Ovid, Cochrane Library, Wanfang, China National Knowledge Infrastructure, and Chinese BioMedical Literature Databases were searched from their inception to 24 June, 2021. Random effects models were used for all analyses. Cochrane risk of bias tool was used to assess the quality of RCTs, while Newcastle Ottawa Quality Assessment Scale was used to assess for the quality of cohort studies. RESULTS: Seventeen studies were included in the meta-analysis. Pooled data from cohort studies showed reversing neuromuscular blocking with sugammadex had less risk of compound postoperative pulmonary complications (relative risk [RR]: 0.73; 95% confidence interval [CI]: 0.60-0.89; P  = 0.002; I2  = 81%), pneumonia (RR: 0.64; 95% CI: 0.48-0.86; I2  = 42%) and respiratory failure (RR: 0.48; 95% CI: 0.41-0.56; I2  = 0%). However, pooled data from RCTs did not show any difference between the two groups in pneumonia (RR: 0.58; 95% CI: 0.24-1.40; I2  = 0%) and no respiratory failure was reported in the included RCTs. The difference was not found between sugammadex and neostigmine about atelectasis in pooled data from either RCTs (RR: 0.85; 95% CI: 0.69-1.05; I2  = 0%) or cohort studies (RR: 1.01; 95% CI: 0.87-1.18; I2  = 0%). CONCLUSION: The evidence of superiority of sugammadex was limited by the confounding factors in cohort studies and small scale of RCTs. Whether sugammadex precedes neostigmine in preventing pulmonary complications after surgery is still unknown. Well-designed RCTs with large scale are needed. REGISTRATION: PROSPERO ( https://www.crd.york.ac.uk/PROSPERO/ ); CRD 42020191575.

Isolation of Spiroplasma citri from Flowers and Seeds Collected from Infected Periwinkles.

Isolations were attempted from flowers, stems, and seeds from six Spiroplasma citri-infected periwinkles and from flowers and stems from two healthy plants. Each flower was separated into four parts: petals, sepals, pistils, and corolla tubes. A total of 140 seeds from infected plants were germinated, with a germination rate of 59%. Two and three months after germination, 25 plants from seeds were sampled for the isolation of S. citri. The average spiroplasma cells g-1 of diseased pistils, sepals, petals, corolla tubes, or stems was 1.87 × 108, 1.9 × 107, 1.89 × 106, 3.7 × 106, or 2.35 × 106, respectively. The number of cells isolated from pistils was significantly higher than that from stems, whereas the numbers from sepals, corolla tubes, and petals were comparable to those from stems. No spiroplasma was isolated from flower parts of two healthy plants, from seeds, or from samples collected from 25 plants grown from seeds. Results indicated that flowers were good sources for the isolation of S. citri and confirmed that there is no seed transmission of the S. citri infection in periwinkles.