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1.
Medicine (Baltimore) ; 103(12): e37215, 2024 Mar 22.
Article in English | MEDLINE | ID: mdl-38518001

ABSTRACT

BACKGROUND: To date, there is no standardized practice for the use of pharmacological sedatives during flexible bronchoscopy, particularly for elderly patients. This exploratory study aimed to assess the efficacy and safety of remimazolam at a single induced dose for deep sedation in elderly patients undergoing diagnostic flexible bronchoscopy (DFB), and compare with midazolam, a commonly used sedative. METHODS: A total of 100 elderly patients (age range 65-80 yr; American Society of Anesthesiologists Physical Status I-III) undergoing DFB were randomly allocated into 2 groups according to the sedatives used for induction: the remimazolam group and the midazolam group. Sedation induction was initiated by an intravenous bolus of remimazolam (0.135 mg/kg) or midazolam (0.045 mg/kg), respectively, both groups were combined with a high-dose of alfentanil (18 µg/kg), and supplemented with high-flow nasal cannula (HFNC) oxygen supply at a flow rate of 45 L/min. If the target depth of sedation was not achieved, propofol would be titrated as a rescue. The primary outcome was the success rate of sedation at a single induced dose to achieve target depth (Ramsay sedation score [RSS] = 4) during induction, intraoperative changes in vital signs, postoperative follow-up situation and incidence of post-bronchoscopy adverse events were evaluated as secondary outcomes. RESULTS: The success rate of sedation in the remimazolam group was significantly higher than that in the midazolam group (65.2% vs 39.6%, P = .013), while the incidence of extra sleep within 6 hours after procedure was lower in the remimazolam group as compared to the midazolam group (10.9% vs 31.3%, P = .016). No statistically significant differences were observed between the 2 groups regarding hemodynamic fluctuations, incidence of hypoxemia, and cough response during the procedure, as well as postoperative recall, willingness to undergo reexamination, and other post-bronchoscopy adverse events. CONCLUSIONS: Bolus administration of remimazolam offers advantages over midazolam for deep sedation in elderly patients undergoing DFB, in terms of a higher success rate of sedation and a lower incidence of extra sleep within 6 hours after procedure, though the safety profiles of both groups were favorable.


Subject(s)
Deep Sedation , Propofol , Humans , Aged , Aged, 80 and over , Midazolam , Bronchoscopy/methods , Benzodiazepines , Hypnotics and Sedatives/therapeutic use , Double-Blind Method
2.
ACS Biomater Sci Eng ; 10(4): 2451-2462, 2024 Apr 08.
Article in English | MEDLINE | ID: mdl-38429076

ABSTRACT

Myocardial infarction (MI) results in an impaired heart function. Conductive hydrogel patch-based therapy has been considered as a promising strategy for cardiac repair after MI. In our study, we fabricated a three-dimensional (3D) printed conductive hydrogel patch made of fibrinogen scaffolds and mesenchymal stem cells (MSCs) combined with graphene oxide (GO) flakes (MSC@GO), capitalizing on GO's excellent mechanical property and electrical conductivity. The MSC@GO hydrogel patch can be attached to the epicardium via adhesion to provide strong electrical integration with infarcted hearts, as well as mechanical and regeneration support for the infarcted area, thereby up-regulating the expression of connexin 43 (Cx43) and resulting in effective MI repair in vivo. In addition, MI also triggers apoptosis and damage of cardiomyocytes (CMs), hindering the normal repair of the infarcted heart. GO flakes exhibit a protective effect against the apoptosis of implanted MSCs. In the mouse model of MI, MSC@GO hydrogel patch implantation supported cardiac repair by reducing cell apoptosis, promoting gap connexin protein Cx43 expression, and then boosting cardiac function. Together, this study demonstrated that the conductive hydrogel patch has versatile conductivity and mechanical support function and could therefore be a promising candidate for heart repair.


Subject(s)
Graphite , Hydrogels , Myocardial Infarction , Rats , Mice , Animals , Hydrogels/pharmacology , Connexin 43 , Rats, Sprague-Dawley , Myocardial Infarction/surgery , Electric Conductivity , Printing, Three-Dimensional
3.
Environ Sci Pollut Res Int ; 31(1): 594-608, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38015399

ABSTRACT

This paper estimates the influences of different industries on the carbon prices and selects the industries with high market power in the carbon market. To realize price discovery in the carbon market and improve the market efficiency, we suggest that industries with higher market power should be included in the market prior to other industries. Using the LASSO regression to analyze the data from the pilot markets of China's ETS and related industrial product outputs, we find that among all related industries, the petrochemical and chemical industries affect the carbon price the most and hence should be included in China's ETS with priority. The power generation industry, though regarded as the major entity of emission control, imposes weaker influences on the carbon price. Industries that may be incorporated in China's ETS later include the transportation equipment manufacturing and the mining and metal industries.


Subject(s)
Greenhouse Gases , Industry , Commerce , Carbon/analysis , China
4.
J Environ Manage ; 351: 119626, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38052143

ABSTRACT

Changes in the air temperature tend to indirectly affect soil erosion by influencing rainfall, vegetation growth, economic development, and agricultural activities. In this study, the partial least squares-structural equation model (PLS-SEM) was used to decouple the impacts of temperature change on soil erosion in Northeast China from 2001 to 2019, and the indirect effect of temperature change on the pathways of natural and socioeconomic factors was analyzed. The results showed that temperature increase in Northeast China caused an increase in soil erosion by increasing rainfall and promoting economic development. Under the pathway of natural factors, in spring, the promoting effect on soil erosion under the influence of temperature change on rainfall was greater than the inhibiting effect on soil erosion under by the influence of temperature change on vegetation. In summer, the opposite effect was observed. Under the pathway of natural factors, over time, the promoting effect of temperature increase on soil erosion increased by 22.7%. Under the pathway of socioeconomic factors, temperature change not only aggravated soil erosion by promoting economic development, but also indirectly increased investments in agriculture and water conservation by improving the economy, thus inhibiting soil erosion to a certain extent. Over time, the contribution of temperature change to soil erosion through socioeconomic pathway was reduced by 44.4%. When the pathway of natural factors is compared with that of socioeconomics factors, temperature change imposed a more notable effect on the change in soil erosion through the socioeconomic pathway, indicating that human activities are the driving factors with a greater effect on soil erosion. Based on this, reasonable human intervention is an important means to alleviate soil erosion aggravation caused by rising temperatures.


Subject(s)
Soil Erosion , Soil , Humans , Soil/chemistry , Temperature , Conservation of Natural Resources , China
5.
Medicine (Baltimore) ; 102(48): e36362, 2023 Dec 01.
Article in English | MEDLINE | ID: mdl-38050299

ABSTRACT

RATIONALE: Some laryngeal masses are typically asymptomatic and easily ignored. However, they can be rare causes of unanticipated difficult airway, leading to critical situations such as "cannot ventilate" or "cannot ventilate and cannot intubate" during anesthesia induction. Inappropriate airway management in such scenarios can have catastrophic consequences for an anesthetized patient. Here we report a case of sudden, unanticipated difficult mask ventilation caused by an asymptomatic supraglottic mass during sedative induction, which was quickly and effectively relieved by the Heimlich maneuver and chest compression. PATIENT CONCERNS: We report a rare case of airway crisis occurred during sedative induction in a 63-year-old patient scheduled for a routine flexible bronchoscopy, and no evidence of respiratory difficulty or signs of obstruction was found in preoperative evaluation. DIAGNOSES: A detailed examination of laryngopharyngeal structure under bronchoscopy revealed a supraglottic soft-tissue mass with a size of 1.6 × 0.8 cm covering the membranous part of the glottic area, which was the true cause of difficult mask ventilation in this patient during sedative induction. INTERVENTIONS: As the unanticipated difficult mask ventilation occurred, 2-handed mask ventilation was initiated immediately for 9 attempts but failed. Fortunately, the airway crisis was successfully relieved with 2 Heimlich attempts and 3 chest compressions, and no need for a laryngeal mask airway. OUTCOMES: Once the airway crisis was relieved and the supraglottic mass was confirmed, the patient underwent a second sedative anesthesia and a successful laryngeal mask airway-assisted bronchoscopy, with no post-bronchoscopy adverse events. LESSONS: Asymptomatic supraglottic masses can cause valve-like upper airway obstruction and lead to unanticipated difficult mask ventilation. The Heimlich maneuver and chest compression may be effective in such critical situations and can serve as an emergency intervention.


Subject(s)
Heimlich Maneuver , Laryngeal Masks , Humans , Middle Aged , Intubation, Intratracheal , Laryngeal Masks/adverse effects , Anesthesia, General , Hypnotics and Sedatives
6.
Medicine (Baltimore) ; 102(37): e35227, 2023 Sep 15.
Article in English | MEDLINE | ID: mdl-37713863

ABSTRACT

RATIONALE: One of the catastrophic complications of surgical hysteroscopy is venous gas embolism (VGE), and this event could cause morbidity and in serious cases may even lead to death. However, in cases of VGE accompanied by refractory hypokalemia is rare and can significantly increase the difficulty of treatment and resuscitation. Here, we successfully treated a patient with fatal VGE during surgical hysteroscopy, accompanied by difficult resuscitation with refractory hypokalemia. PATIENT CONCERNS: We report a rare case of sudden cardiac arrest due to VGE during surgical hysteroscopy, followed by difficult resuscitation with refractory hypokalemia. DIAGNOSIS: VGE was diagnosed by a sudden decrease in EtCO2, a loud mill wheel murmur in the thoracic area, and a small number of air bubbles evacuated from the internal jugular catheter. And refractory hypokalemia was diagnosed by serum potassium levels dropping frequently to as low as 2.0 mmol/L within 36 hours of resuscitation after cardiac arrest. INTERVENTIONS: Our vigilant anesthesiologist noticed the early sign of VGE with a sudden drop in EtCO2, and as the cardiac arrest occurred, interventional maneuvers were implemented quickly including termination of the surgical procedure, adjustment of the patient's position, cardiac resuscitation, continuous chest compression, and correction of electrolyte disturbances, particularly refractory hypokalemia during the early stage of resuscitation. OUTCOMES: The patient regained consciousness 4 days after the cardiac arrest and was discharged 1 month later without any neurological deficits. LESSONS: As a relatively simple procedure, surgical hysteroscopy may have catastrophic complications. This case demonstrates the full course of fatal gas embolism and difficult resuscitation during hysteroscopic surgery, and emphasizes the importance of early detection, prompt intervention, and timely correction of electrolyte disturbances, such as refractory hypokalemia.


Subject(s)
Embolism, Air , Heart Arrest , Hypokalemia , Water-Electrolyte Imbalance , Humans , Female , Pregnancy , Hypokalemia/etiology , Hysteroscopy/adverse effects , Embolism, Air/etiology , Embolism, Air/therapy , Heart Arrest/etiology , Heart Arrest/therapy , Electrolytes
7.
Sci Rep ; 13(1): 5769, 2023 Apr 08.
Article in English | MEDLINE | ID: mdl-37031259

ABSTRACT

Low Ni alumina-forming austenitic (AFA) heat-resistant steel is an advanced high-temperature stainless steel with reduced cost, good machinability, high-temperature creep strength, and high-temperature corrosion resistance. Using the First-principles approach, this study examined the effect of Mn content on austenite stability and mechanical properties at the atomic level. Adding Mn to low Ni-AFA steel increases the unit cell volume with an accompanying increase in the absolute value of formation energy; the austenite formed more easily. The austenitic matrix binding energy decreases and remains negative, indicating austenite stability. As the Mn content increases from 3.2 to 12.8 wt%, the system's bulk modulus (B) rises significantly, and the shear modulus (G) falls. In addition, the system's strength and hardness decrease, and the Poisson ratio of the austenite matrix increases with improved elasticity; the system has excellent plasticity with an increase in the B/G. For the Fe22-Cr5-Ni3-Al2 system, with the increase of Mn content, the electron density distribution between the atoms is relatively uniform, and the electrons around the Mn atoms are slightly sparse, which will slightly reduce the structural stability of the matrix. The experiment demonstrated the matrix maintains the austenitic structure when adding 3.2-12.8 wt% Mn elements to low Ni-AFA steel. At an Mn content of 8 wt%, the overall mechanical properties of the high-Mn AFA steel are optimal, with a tensile strength of 581.64 MPa, a hardness of 186.17 HV, and an elongation of 39%.

8.
Medicine (Baltimore) ; 102(14): e33473, 2023 Apr 07.
Article in English | MEDLINE | ID: mdl-37026944

ABSTRACT

Postoperative delirium is a common postoperative complication of neurocognitive dysfunction, especially in elderly surgical patients. Postoperative delirium not only damages patients' recovery but also increases social costs. Therefore, its prevention and treatment has essential clinical and social significance. However, due to its intricate pathogenesis and limited pharmacological interventions, the effective prevention and treatment of postoperative delirium remains a thorny problem. As traditional acupuncture therapy has been shown to be an effective treatment in many neurological disorders, and in recent years, it has begun to be clinically used as an intervention for postoperative delirium. Although most clinical and animal studies confirm that multiple types of acupuncture interventions can alleviate or prevent postoperative delirium by relieving acute postoperative pain, reducing the consumption of anesthetics and analgesics, attenuating neuroinflammation and neuronal lesions, while more evidence-based medical evidence and clinical validation are needed for these encouraging effects.


Subject(s)
Acupuncture Therapy , Anesthetics , Delirium , Emergence Delirium , Humans , Delirium/etiology , Delirium/prevention & control , Postoperative Complications/prevention & control
9.
ACS Biomater Sci Eng ; 9(3): 1332-1340, 2023 03 13.
Article in English | MEDLINE | ID: mdl-36848170

ABSTRACT

The effect of glucose content on the electrochemical corrosion behavior of the Ti/ZrO2 brazing joint in simulated body fluid (SBF) was researched by the means of SEM morphologies, electrochemical and XPS analyses. Herein, pitting is observed to be a dominating corrosion model under the investigated glucose content. The pitting corrosion of the joint in 200 mg/dL SBF is minimal. In addition, the joint in 200 mg/dL SBF manifests the best corrosion resistance by electrochemical analyses, which indicates that glucose content has a bidirectional effect on corrosion of the Ti/ZrO2 brazing joint. Additionally, the corrosion current value and impedance of titanium and brazing joint are close, which indicates that their corrosion resistance is similar. Finally, the OH-, Cl-, Sn2+/Sn4+ and -COOH on the joint surface are found by XPS analysis, and the mechanism of Ti/ZrO2 brazing joint corrosion is elucidated. The study provides a novel understanding of the corrosion behavior and relevant corrosion mechanism of the Ti/ZrO2 brazing joint in body fluids with different glucose content.


Subject(s)
Body Fluids , Titanium , Corrosion , Titanium/analysis , Titanium/chemistry , Alloys/chemistry , Surface Properties , Body Fluids/chemistry
11.
Clin Lab ; 69(2)2023 Feb 01.
Article in English | MEDLINE | ID: mdl-36787570

ABSTRACT

BACKGROUND: The goal of this study was to screen for differentially expressed exosomal miRNAs in peripheral blood samples of early-onset preeclampsia and normal pregnant patients using high-throughput sequencing methods and explore their effects on the pathogenesis of preeclampsia. METHODS: Peripheral blood samples from 5 patients with early-onset preeclampsia and 5 normal pregnant women (control group) were enrolled. Then, exosomes were extracted from each sample, and the procedure was replicated three times. An Illumina HiSeq4000 sequencing platform was used to analyze exosomal miRNAs in all samples before comparison. The target genes and signaling pathway predictions and the biological function enrichments of significant and differentially expressed miRNAs were assessed using Miranda and Starbase software, as well as GO and KEGG databases. RESULTS: Compared with the control, patients in the early-onset preeclampsia group had 65 significantly and differentially expressed exosomal miRNAs in their peripheral blood samples. The results have shown that of the 65 differentially expressed miRNAs, 17, including has-miR-6855, has-miR-7151, and has-miR-6777, were up-regulated, and 48, including has-miR-1247, has-miR-29B2, and has-miR-941, were down-regulated (p < 0.05). The Miranda and TargetScanS algorithms predicted a total of 2,231 target genes from the differentially expressed miRNAs. The Go and KEGG analyses showed that the principal biological function of these target genes was the regulation of Ras protein signal transduction, histone modification, GTPase-mediated signal transduction, and transforming growth factor (TGF)-ß. Additionally, the results also showed that the major pathways involved in the regulation of these functions were the PI3K Akt, MAPK, tumor necrosis factor, and EGFR tyrosine kinase inhibition signaling pathways. CONCLUSIONS: There are significant differences in the expression profiles of exosomal miRNAs between early-onset preeclampsia patients and normal pregnant women. These differentially expressed miRNAs may not only play an important regulatory role in the occurrence of early-onset preeclampsia but also participate in its pathophysiological process through genetic regulation of a variety of biological functions and signal pathways.


Subject(s)
MicroRNAs , Pre-Eclampsia , Female , Humans , Pregnancy , Gene Expression Regulation , High-Throughput Nucleotide Sequencing , Phosphatidylinositol 3-Kinases/genetics , Phosphatidylinositol 3-Kinases/metabolism , Pre-Eclampsia/diagnosis , Pre-Eclampsia/genetics
12.
Front Pharmacol ; 13: 1036840, 2022.
Article in English | MEDLINE | ID: mdl-36339547

ABSTRACT

Sedation is recommended by most guidelines to be offered to all patients undergoing diagnostic flexible bronchoscopy (DFB) without contraindications, and the most commonly reported regimen is midazolam in combination with a short-acting opioid (fentanyl or alfentanil) to provide both sedative and antitussive effects. However, the optimal dose or ideal regimen of the combination therapy with midazolam and opioids has not yet been found. So this randomized, double-blinded clinical trial was designed and registered (ChiCTR2100049052) to assess the safety and efficacy of midazolam combined with different doses of alfentanil in DFB sedation. Our study showed that relative high doses of alfentanil (10-25 µg/kg) combined with a fixed low dose of midazolam can markedly reduce hemodynamic fluctuations, cough reactions, patients' discomforts, and improve their satisfaction in a dose-dependent manner during DFB, with no significant increase in the desaturation risks.

13.
Comput Math Methods Med ; 2022: 1345695, 2022.
Article in English | MEDLINE | ID: mdl-35799659

ABSTRACT

In order to investigate the effects of Dexmedetomidine (DEX) on postoperative anesthesia recovery time and consciousness function in elderly patients with laparoscopic colorectal tumors, 40 patients (20 in the control group and 20 in the DEX group) were selected. The DEX group was intravenously pumped at a rate of 0.8 µg/kg/h for 10 min and then continuously pumped at a rate of 0.3 µg/kg/h until 40 min before the end of the operation. The two groups were given the same amount of normal saline, with the same way of anesthesia. The results showed that the visual analog scale (VAS) score of pain in the two groups decreased signally. Compared with the control group, the inflammatory factors tumor necrosis factor (TNF-α), interleukin-1ß (IL-1ß), interleukin-6 (IL-6), and macrophage inflammatory protein (MIP-2) in the DEX group were remarkably decreased at T1 and T2 stages, with a considerable difference (P < 0.05). One month after the auxiliary diagnosis of colorectal tumor, no clear nodular, irregular shape patches, or patchy diffuse limited points were found, which indicated that the whole tumor had been removed. In summary, DEX could improve postoperative cognitive function in elderly patients who underwent the laparoscopic radical resection of colon cancer, and its mechanism was related to the reduction of inflammatory factors. Therefore, the anesthesia intervention with DEX during the operation had a positive significance for tumor resection.


Subject(s)
Cognitive Dysfunction , Colorectal Neoplasms , Dexmedetomidine , Laparoscopy , Aged , Colorectal Neoplasms/surgery , Dexmedetomidine/pharmacology , Humans , Interleukin-6 , Laparoscopy/adverse effects , Magnetic Resonance Imaging , Tumor Necrosis Factor-alpha
14.
Transp Res Part A Policy Pract ; 155: 128-141, 2022 Jan.
Article in English | MEDLINE | ID: mdl-34728910

ABSTRACT

The COVID-19 pandemic has brought unprecedented disruptions to many industries, and the transportation industry is among the most disrupted ones. We seek to address, in the context of a ride-sharing platform, the response of drivers to the pandemic and the post-pandemic recovery. We collected comprehensive trip data from one of the leading ride-sharing companies in China from September 2019 to August 2020, which cover pre-, during-, and post-pandemic phases in three major Chinese cities, and investigate the causal effect of the COVID-19 pandemic on driver behavior. We find that drivers only slightly reduce their number of shifts in response to increased COVID-19 cases, likely because they have to make a living from providing ride-sharing services. Nevertheless, conditional on working, drivers exhibit strong risk aversion: As the number of new cases increases, drivers strategically adjust the scope of their search for passengers, complete fewer trips, and as a result, make lower daily earnings. Finally, our heterogeneity analyses indicate that the effects appear to vary both across drivers and over time, with generally stronger effects on drivers who are older, more experienced, more active before the pandemic, and higher-status within the firm. Our findings have strong policy implications: These drivers tend to contribute more to the focal company, and also rely more on providing ride-sharing services to make a living. Therefore, they should be prioritized in stimulus plans offered by the government or the ride-sharing company.

15.
J Foot Ankle Surg ; 61(4): 706-712, 2022.
Article in English | MEDLINE | ID: mdl-34895821

ABSTRACT

Peripheral nerve blocks are the regional techniques in orthopedic surgeries to control postoperative pain and have early discharge from hospital. However, anesthesia protocols for foot and ankle surgeries of institutes do not include multimodal analgesics including peripheral nerve blocks. The objective of the study was to compare spinal anesthesia with peripheral nerve block against general anesthesia with peripheral nerve block for elective foot and ankle surgeries. Patients have treated for elective foot and ankle surgery under general anesthesia (using propofol, 0.05 mg/kg dezocine, and 1% sevoflurane; GA cohort, n = 112) or spinal anesthesia (using 0.5% bupivacaine, propofol, and 0.05 mg/kg dezocine; SA cohort, n = 132) or patients have treated for elective for foot and ankle surgery under general anesthesia (GL cohort, n = 115) or spinal anesthesia (SL cohort, n = 160) with the use of peripheral nerve block (the sciatic nerve blocks and adductor canal nerve blocks using 0.25% bupivacaine and 0.1 mg/kg dexamethasone). Propofol was administered in fewer amounts if anesthesia was used with the peripheral nerve block. Patients of the GL cohort were transferred to ward 36 minutes (mean) earlier than those of the SL cohort. None of the patients of the GL and the SL cohorts have received intraoperative opioid(s) for the management of pain. Patients of the GL and the SL cohorts have reported postoperative falls within 1 day after surgeries during movement. Patients of the SL cohort experienced more frequently difficulty with sleeping. Patients of the GL and the GA cohorts have reported nausea and vomiting. Only patients of the GL cohort were required usage of vasoactive drugs. The study provides information to anesthesiologists and surgeons regarding anesthesia techniques for elective foot and ankle surgeries for better surgical outcomes (Technical Efficacy Stage: 4).


Subject(s)
Anesthesia, Spinal , Propofol , Anesthesia, General , Ankle/surgery , Bupivacaine , Humans , Pain Measurement , Pain, Postoperative/drug therapy , Pain, Postoperative/prevention & control , Peripheral Nerves , Propofol/therapeutic use , Retrospective Studies
16.
J Oral Maxillofac Surg ; 80(3): 443-455, 2022 Mar.
Article in English | MEDLINE | ID: mdl-34838503

ABSTRACT

PURPOSE: Light sedation rather than intravenous sedation is preferred when patients have a low heart rate and blood pressure during maxillofacial surgery. Intranasal administration of dexmedetomidine is reported to be efficacious and safe in adults. However, dexmedetomidine could be unsuitable for routine clinical use in elderly patients because many of these patients take ß-blockers, which increase the cardiovascular effects of dexmedetomidine. The objectives of the study were to evaluate the sedative properties and safety of intranasal dexmedetomidine, regardless of concurrent ß-blocker treatment, in elderly patients who underwent maxillofacial surgery. METHODS: This study was a retrospective analysis of 535 patients aged > 65 years (American Society of Anesthesiologists physical status I or II) who were undergoing maxillofacial surgery. Very anxious patients and those with hypertension received intranasal 1 µg/kg dexmedetomidine through an intranasal mucosal atomization device before anesthesia (local ropivacaine). RESULTS: Intranasal administration of dexmedetomidine decreased the requirement for midazolam before surgery (18 of 252 vs 63 of 283, P < .0001), but increased the requirement for norepinephrine (102 of 252 vs 8 of 283, P < .0001) during or after the surgery. A combination of a ß-blocker and intranasal administration of dexmedetomidine reduced the hemodynamic parameters for an extended period. Intranasal administration of dexmedetomidine resulted in bradycardia and hypotension, regardless of concurrent ß-blocker treatment. CONCLUSIONS: Intranasal 1 µg/kg dexmedetomidine was associated with a high sedation score during the operation, but also with bradycardia and hypotension.


Subject(s)
Dexmedetomidine , Surgery, Oral , Administration, Intranasal , Adult , Aged , Humans , Hypnotics and Sedatives , Retrospective Studies
17.
J Med Case Rep ; 15(1): 417, 2021 Jul 29.
Article in English | MEDLINE | ID: mdl-34325722

ABSTRACT

BACKGROUND: Metastatic choriocarcinoma in the third trimester of pregnancy is extremely rare. CASE PRESENTATION: A 25-year-old Chinese woman (gravida 3, para 0) who was 28 weeks pregnant was admitted for sudden convulsion, aconuresis, and unconsciousness. The decision was made to perform an emergency cesarean delivery and craniotomy, hematoma clearance, and decompression. Pathological examination confirmed choriocarcinoma with brain metastasis. The patient underwent chemotherapy with the etoposide, cisplatin (EP) and etoposide, methotrexate and dactinomycin alternating with cyclophosphamide and vincristine (EMACO) regimens. A satisfactory result was achieved. CONCLUSIONS: When encountering intracranial mass or bilateral pulmonary nodules in a pregnant woman, especially one in the third trimester, metastatic choriocarcinoma should be considered.


Subject(s)
Brain Neoplasms , Choriocarcinoma , Uterine Neoplasms , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/drug therapy , Brain Neoplasms/secondary , Choriocarcinoma/drug therapy , Choriocarcinoma/pathology , Cisplatin/therapeutic use , Cyclophosphamide/therapeutic use , Dactinomycin/therapeutic use , Etoposide/therapeutic use , Female , Humans , Methotrexate/therapeutic use , Pregnancy , Pregnancy Trimester, Third , Uterine Neoplasms/drug therapy , Uterine Neoplasms/pathology , Vincristine/therapeutic use
18.
Environ Sci Pollut Res Int ; 28(15): 19367-19380, 2021 Apr.
Article in English | MEDLINE | ID: mdl-33398724

ABSTRACT

Thirty samples of sediments were taken from Bosumtwi Lake (also called Bosomtwe Lake) in Ghana and analyzed for the contents of Fe, As, Hg, Co, Cr, Ni, Cd, and Pb. Several pollution indices (enrichment factor (EF), contamination factor (CF), geoaccumulation (Igeo), and pollution load index (PLI)) were used to determine sedimentary pollution levels, and the risk of environmental exposure was calculated using Hakanson's potential ecological risk (PER) indices. The results from PER assessments have indicated that sediments from the Bosumtwi Lake present a moderate environmental risk. According to EF calculations, Hg in Bosumtwi lake sediments is the element of concern that is being severely enriched. Hg was the largest contributor to PER with a 97% risk contribution. Multivariate statistical analysis revealed that the main sources of Hg were agrochemicals and atmospheric deposition, whereas the sources of Fe, As, Co, Cr, and Ni to Bosumtwi Lake were natural processes and are derived from the local lithology. There was no strong significant correlation among the contents of the heavy metals, sediment grain sizes, and total organic carbon (TOC), suggesting their lack of control in the distribution of heavy metals, the source, and the transport pathway. Finally, it is strongly recommended to do a study on Hg bioavailability in Bosumtwi Lake sediments. These findings will be relevant to Bosumtwi Lake's profiling and historical development of heavy metal loads.


Subject(s)
Metals, Heavy , Water Pollutants, Chemical , China , Environmental Monitoring , Geologic Sediments , Ghana , Lakes , Metals, Heavy/analysis , Risk Assessment , Water Pollutants, Chemical/analysis
19.
Water Environ Res ; 93(11): 2537-2548, 2021 Nov.
Article in English | MEDLINE | ID: mdl-33513269

ABSTRACT

The total and dissolved lead, cadmium, mercury, nickel, chromium, cobalt, and arsenic in 30 water samples collected from Bosomtwe Lake were analyzed. Arsenic bioavailability was also determined using the ARSOlux test system. Except for chromium, their mean values in the study results exceeded the WHO permissible limit for potability. Cancer and non-cancer effects associated with exposure to dissolved and total metals by a child and an adult via oral and dermal routes were estimated. The hazard quotient (HQ) values obtained (except adult exposure to total arsenic of 1.71 × 1000 ) were less than unity. Between child and adult, the recorded hazard index (HI) was 0.82 and 1.75, respectively. The HI results indicate that the adult population is at risk for non-cancer health effects. Arsenic was the element of concern, and it remained biologically available for uptake by target groups. For child and adult, respectively, arsenic contributed 96.39% and 97.29% to HI values. The risk values for cancer in a child and an adult with oral and dermal exposure to dissolved and total arsenic were lower than the USEPA range. Principal component and cluster analysis identified atmospheric deposition, geogenic, and unregulated application of agrochemicals as plausible sources of water pollution in Bosomtwe Lake. PRACTITIONER POINTS: The hazard quotient (HQ) values obtained for adult exposure to total arsenic was 1.71 × 1000 . Arsenic remained biologically available for uptake by target groups. The calculated health index (HI) indicated that the adult population is at risk for non-cancer health effects. Arsenic contributed 96.39% and 97.29% to HI values for a child and an adult. Atmospheric deposition, geogenic, and unregulated application of agrochemicals were the plausible sources of water pollution in Bosomtwe Lake.


Subject(s)
Arsenic , Drinking Water , Metals, Heavy , Neoplasms , Trace Elements , Water Pollutants, Chemical , Adult , Arsenic/analysis , Child , Environmental Monitoring , Humans , Lakes , Metals, Heavy/analysis , Risk Assessment , Water Pollutants, Chemical/analysis
20.
Anal Bioanal Chem ; 413(4): 1081-1090, 2021 Feb.
Article in English | MEDLINE | ID: mdl-33247340

ABSTRACT

A sensitive electrochemical sensor was proposed via combining molecular imprinting technique with the graphene material-doped titanium nitride. The novel graphene with 3-dimensional structure displayed more binding sites and better electrochemical properties. Moreover, this study focused on coating pyrrole with electrical conductivity on the surface of silica as a monomer, and BPA as the template. The interaction made specific detection possible, between monomer and template. With a series of characterizations and electrochemical measurements, CPE (carbon paste electrode)-contained TiN-rGO composite was proved to have conductivity improved. Also, the modified polymer performed well selectivity which reflected in that it was almost impervious to distractions. Under optimized conditions, a linear dependence was observed from 0.5 to 100 nmol L-1 with a detection limit of 0.19 nmol L-1. The sensor explicated outstanding repeatability via repetitive experiment with the RSD of 0.02%, while the results of stability experiment reached the RSD of 1.90%. Eventually, it was used to analyze BPA residues in 3 kinds of daily supplies. The results indicated the potential of the sensor in environmental detection prospectively.

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