Accuracy of closed-loop and open-loop propofol delivery systems by bispectral index monitoring in breast surgery patients: a prospective randomized trial.

BACKGROUND: This randomized and controlled prospective study tested the hypothesis that closed-loop Target-Controlled Infusion (TCI) of propofol would be associated with better system performance when compared with open-loop controlled delivery of propofol. METHODS: Patients scheduled for elective breast surgery were randomly assigned to two groups: a closed-loop group, in which propofol infusion was performed by a closed-loop TCI system that used the Bispectral Index (BIS) as a feedback parameter to titrate the rate of propofol infusion, and an open-loop group, in which propofol infusion was performed manually and guided by the bispectral index. RESULTS: A total of 156 patients were recruited for this study (closed-loop group n = 79; open-loop group n = 77). The Global Score (GS) of the closed-loop group was lower than that of the open-loop group (34.3 and 42.2) (p = 0.044). The proportions of time with a BIS value between 40 and 60 were almost identical in the closed-loop group and the open-loop group (68.7 ± 10.6% and 66.7 ± 13.3%) (p = 0.318). The individuals in the closed-loop group consumed more propofol compared with those in the open-loop group (7.20 ± 1.65 mg.kg-1.h-1 vs. 6.03 ± 1.31 mg.kg-1.h-1, p < 0.001). No intraoperative recall, somatic events or adverse events occurred. No significant difference in heart rate was observed between the two groups (p = 0.169). CONCLUSION: The closed-loop protocol was associated with lower BIS variability and lower out-of-range BIS values, at the cost of a greater consumption of propofol when compared to the open loop group. REGISTER NUMBER: ChiCTR-INR-17010399.

Accuracy of closed-loop and open-loop propofol delivery systems by bispectral index monitoring in breast surgery patients: a prospective randomized trial

Abstract Background: This randomized and controlled prospective study tested the hypothesis that closed-loop Target-Controlled Infusion (TCI) of propofol would be associated with better system performance when compared with open-loop controlled delivery of propofol. Methods: Patients scheduled for elective breast surgery were randomly assigned to two groups: a closed-loop group, in which propofol infusion was performed by a closed-loop TCI system that used the Bispectral Index (BIS) as a feedback parameter to titrate the rate of propofol infusion, and an open-loop group, in which propofol infusion was performed manually and guided by the bispectral index. Results: A total of 156 patients were recruited for this study (closed-loop group n = 79; open-loop group n = 77). The Global Score (GS) of the closed-loop group was lower than that of the open-loop group (34.3 and 42.2) (p = 0.044). The proportions of time with a BIS value between 40 and 60 were almost identical in the closed-loop group and the open-loop group (68.7 ± 10.6% and 66.7 ± 13.3%) (p = 0.318). The individuals in the closed-loop group consumed more propofol compared with those in the open-loop group (7.20 ± 1.65 mg.kg−1.h−1 vs. 6.03 ± 1.31 mg.kg−1.h−1, p < 0.001). No intraoperative recall, somatic events or adverse events occurred. No significant difference in heart rate was observed between the two groups (p = 0.169). Conclusion: The closed-loop protocol was associated with lower BIS variability and lower out-of-range BIS values, at the cost of a greater consumption of propofol when compared to the open loop group. Register number:ChiCTR-INR-17010399.

The No-Touch Saphenous Vein Harvesting Improves Graft Patency After Off-Pump Coronary Artery Bypass Surgery: A Propensity-Matched Analysis.

INTRODUCTION: This single-center study of propensity-matched data was performed to assess the effect of the no-touch saphenous vein (NTSV) harvesting technique on early- and long-term outcomes of patients after off-pump coronary artery bypass grafting (OPCABG) in China. METHODS: A retrospective analysis of 767 patients who underwent OPCABG in the Beijing Anzhen Hospital (June 2017 to October 2021) was performed, and their data entered the conventional saphenous vein (CSV) harvesting technique group or the NTSV group. In-hospital and follow-up outcomes were evaluated by adjusting baseline characteristics using propensity score matching (1:1). Clinical outcomes and postoperative angiographic results were compared. RESULTS: The saphenous vein graft patency rates at postoperative three months and one year for the NTSV group vs. CSV group were 99.6% vs. 96.2% (P<0.001) and 97.3% vs. 93.1% (P<0.001), respectively. The two matched groups received a significantly different cumulative incidence function of saphenous vein graft occlusion for the longer follow-up period in Kaplan-Meier curves (χ=4.330, log-rank P=0.037). No difference in early- and long-term mortality or major adverse cardiac and cerebrovascular events (MACCE) were observed between the groups. The rate of MACCE was not statistically significant different between the groups, but there was a tendency favoring the no-touch technique (9.8% CSV vs. 4.8% NTSV; P=0.067). More patients in the NTSV group developed postoperative leg wound exudation (5.4% vs. 1.2%; P=0.032) and skin numbness (22.2% vs. 8.9%; P=0.001) than in the CSV group. CONCLUSION: The NTSV is an excellent conduit to be used in OPCABG. There remains a need to reduce leg wound complications.

The No-Touch Saphenous Vein Harvesting Improves Graft Patency After Off-Pump Coronary Artery Bypass Surgery: A Propensity-Matched Analysis

ABSTRACT Introduction: This single-center study of propensity-matched data was performed to assess the effect of the no-touch saphenous vein (NTSV) harvesting technique on early- and long-term outcomes of patients after off-pump coronary artery bypass grafting (OPCABG) in China. Methods: A retrospective analysis of 767 patients who underwent OPCABG in the Beijing Anzhen Hospital (June 2017 to October 2021) was performed, and their data entered the conventional saphenous vein (CSV) harvesting technique group or the NTSV group. In-hospital and follow-up outcomes were evaluated by adjusting baseline characteristics using propensity score matching (1:1). Clinical outcomes and postoperative angiographic results were compared. Results: The saphenous vein graft patency rates at postoperative three months and one year for the NTSV group vs. CSV group were 99.6% vs. 96.2% (P<0.001) and 97.3% vs. 93.1% (P<0.001), respectively. The two matched groups received a significantly different cumulative incidence function of saphenous vein graft occlusion for the longer follow-up period in Kaplan-Meier curves (χ2=4.330, log-rank P=0.037). No difference in early- and long-term mortality or major adverse cardiac and cerebrovascular events (MACCE) were observed between the groups. The rate of MACCE was not statistically significant different between the groups, but there was a tendency favoring the no-touch technique (9.8% CSV vs. 4.8% NTSV; P=0.067). More patients in the NTSV group developed postoperative leg wound exudation (5.4% vs. 1.2%; P=0.032) and skin numbness (22.2% vs. 8.9%; P=0.001) than in the CSV group. Conclusion: The NTSV is an excellent conduit to be used in OPCABG. There remains a need to reduce leg wound complications.

Long non-coding RNA MALAT1 regulates cell proliferation and apoptosis via miR-135b-5p/GPNMB axis in Parkinson's disease cell model.

BACKGROUNDS: Parkinson's disease (PD) is a common age-related neurodegenerative disorder worldwide. This research aimed to investigate the effects and mechanism underlying long non-coding RNA metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) in PD. METHODS: SK-N-SH and SK-N-BE cells were treated with MPP+ to establish the MPP+-stimulated cell model of PD, and MALAT1 expression was determined. Then, the effects of MALAT1 depletion on cell proliferation and apoptosis were determined in the MPP+-stimulated cell model of PD. Besides, the correlations between microRNA-135b-5p (miR-135b-5p) and MALAT1 or glycoprotein nonmetastatic melanoma protein B (GPNMB) in MPP+-stimulated cell model of PD were explored. RESULTS: MALAT1 was increasingly expressed and downregulation of MALAT1 promoted cell proliferation while inhibited apoptosis in MPP+-stimulated cells. Besides, miR-135b-5p was a target of MALAT1 and directly targeted to GPNMB. Further investigation indicated that suppression of MALAT1 regulated cell proliferation and apoptosis by miR-135b-5p/GPNMB axis. CONCLUSION: Our findings reveal that MALAT1/miR-135b-5p/GPNMB axis regulated cell proliferation and apoptosis in MPP+-stimulated cell model of PD, providing a potential biomarker and therapeutic target for PD.

Long non-coding RNA MALAT1 regulates cell proliferation and apoptosis via miR-135b-5p/GPNMB axis in Parkinson's disease cell model

BACKGROUNDS: Parkinson's disease (PD) is a common age-related neurodegenerative disorder worldwide. This research aimed to investigate the effects and mechanism underlying long non-coding RNA metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) in PD. METHODS: SK-N-SH and SK-N-BE cells were treated with MPP+ to establish the MPP+-stimulated cell model of PD, and MALAT1 expression was determined. Then, the effects of MALAT1 depletion on cell proliferation and apoptosis were determined in the MPP+-stimulated cell model of PD. Besides, the correlations between microRNA-135b-5p (miR-135b-5p) and MALAT1 or glycoprotein nonmetastatic melanoma protein B (GPNMB) in MPP+-stimulated cell model of PD were explored. RESULTS: MALAT1 was increasingly expressed and downregulation of MALAT1 promoted cell proliferation while inhibited apoptosis in MPP+-stimulated cells. Besides, miR-135b-5p was a target of MALAT1 and directly targeted to GPNMB. Further investigation indicated that suppression of MALAT1 regulated cell proliferation and apoptosis by miR-135b-5p/GPNMB axis. CONCLUSION: Our findings reveal that MALAT1/miR-135b-5p/GPNMB axis regulated cell proliferation and apoptosis in MPP+-stimulated cell model of PD, providing a potential biomarker and therapeutic target for PD.