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BACKGROUND: Multimodal analgesic strategy is pivotal for enhanced recovery after surgery. The objective of this trial was to assess the effect of subanesthetic esketamine vs. placebo combined with erector spinae plane block (ESPB) vs. intercostal nerve block (ICNB) on postoperative recovery following thoracoscopic lung resection. MATERIALS AND METHODS: This randomized, controlled, 2×2 factorial trial was conducted at a university hospital in Suzhou, China. One hundred adult patients undergoing thoracoscopic lung surgery were randomized to one of four groups (esketamine-ESPB, esketamine-ICNB, placebo-ESPB, and placebo-ICNB) to receive i.v. esketamine 0.3 mg/kg or normal saline placebo combined with ESPB or ICNB using 0.375% ropivacaine 20 mL. All patients received flurbiprofen axetil and patient-controlled fentanyl. The primary outcome was quality of recovery (QoR) at 24 h postoperatively, assessed using the QoR-15 scale, with a minimal clinically important difference of 6.0. RESULTS: The median age was 57 years and 52% were female. No significant interaction effect was found between esketamine and regional blocks on QoR (P=0.215). The QoR-15 score at 24 h was 111.5±5.8 in the esketamine group vs. 105.4±4.5 in the placebo group (difference=6.1, 95% CI, 4.0-8.1; P<0.001); 109.7±6.2 in the ESPB group vs. 107.2±5.6 in the ICNB group (difference=2.5, 95% CI, 0.2-4.9; P=0.033; not statistically significant after Bonferroni correction). Additionally, esketamine resulted in higher QoR-15 scores at 48 h (difference=4.6) and hospital discharge (difference=1.6), while ESPB led to a higher QoR-15 score at 48 h (difference=3.0). CONCLUSIONS: For patients undergoing thoracoscopic lung resection, subanesthetic esketamine improved QoR after surgery, while ICNB can be used interchangeably with ESPB as a component of multimodal analgesia.
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Background: Postoperative sleep disturbance (PSD) occurs frequently in patients who undergo major abdominal surgical procedures. Dexmedetomidine is a promising agent to improve the quality of sleep for surgical patients. We designed this trial to investigate the effects of two different doses of intraoperative dexmedetomidine on the occurrence of PSD in elderly patients who have major abdominal surgery. Methods: In this randomized, double-blind, controlled trial, 210 elderly patients aged ≥65 years will be randomized, with an allocation ratio of 1:1:1, to two dexmedetomidine groups (intraoperative infusion of 0.3 or 0.6 µg/kg/h) and a normal saline placebo group. The primary endpoint is the occurrence of PSD on the first night after surgery, assessed using the Athens Insomnia Scale. The secondary endpoints are (1) the incidence of PSD during the 2nd, 3rd, 5th, 7th, and 30th nights postoperatively; (2) pain at rest and on movement at 24 and 48 h postoperatively, assessed using the Numerical Rating Scale; (3) the incidence of postoperative delirium during 0-7 days postoperatively or until hospital discharge, assessed using the 3-min Confusion Assessment Method; (4) depressive symptoms during 0-7 days postoperatively or until hospital discharge, assessed using the 15-items Geriatric Depression Scale; and (5) quality of recovery on postoperative days 1, 2, and 3, assessed using the 15-items Quality of Recovery Scale. Patients' sleep data will also be collected by Xiaomi Mi Band 7 for further analysis. Discussion: The findings of this trial will provide clinical evidence for improving the quality of sleep among elderly patients undergoing major abdominal surgery. Ethics and dissemination: This trial was approved by the Ethics Committee of the First Affiliated Hospital of Soochow University (No. 2023-160). The results will be published in a peer-reviewed journal. Trial registration: Chinese Clinical Trial Registry (ChiCTR2300073163).
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Background: Labor epidural analgesia (LEA) may influence gut microbiota. We explored the association between LEA and gut microbiota for both mothers and their newborns. Methods: In this prospective cohort study, parturients aged 25-35 years with a gestational age of 37-42 weeks and planned vaginal delivery were recruited. Twenty-one parturients received LEA (the LEA group), and 24 did not (the control group). Maternal and neonatal fecal samples were collected, and the gut microbiota profiles were analyzed using the 16S rRNA gene sequencing. The impact of LEA on gut microbiota was assessed using the general liner models. Results: We showcased the gut microbiota profile from the phyla to species levels based on data on 45 mother-newborn dyads. The results of α- and ß-diversity suggested significant changes in gut microbiota between the LEA and control groups. After adjusting for baseline confounders, the administration of LEA had positive correlations with R. ilealis (ß = 91.87, adjusted P = 0.007) in mothers; LEA also had negative correlations with A. pittii (ß = -449.36, adjusted P = 0.015), P. aeruginosa (ß = -192.55, adjusted P = 0.008), or S. maltophilia (ß = -142.62, adjusted P = 0.001) in mothers, and with Muribaculaceae (ß = -2702.77, adjusted P = 0.003) in neonates. Conclusion: LEA was associated with changes in maternal and neonatal gut microbiota, and future studies are still required to assess their impact on clinical outcomes and explore the mechanisms.
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VR devices have recently been actively promoted as tools for knowledge workers and prior work has demonstrated that VR can support some knowledge worker tasks. However, only a few studies have explored the effects of prolonged use of VR such as a study observing 16 participants working in VR and a physical environment for one work-week each and reporting mainly on subjective feedback. As a nuanced understanding of participants' behavior in VR and how it evolves over time is still missing, we report on the results from an analysis of 559 hours of video material obtained in this prior study. Among other findings, we report that (1) the frequency of actions related to adjusting the headset reduced by 46% and the frequency of actions related to supporting the headset reduced by 42% over the five days; (2) the HMD was removed 31% less frequently over the five days but for 41% longer periods; (3) wearing an HMD is disruptive to normal patterns of eating and drinking, but not to social interactions, such as talking. The combined findings in this work demonstrate the value of long-term studies of deployed VR systems and can be used to inform the design of better, more ergonomic VR systems as tools for knowledge workers.
Subject(s)
Virtual Reality , Humans , Computer Graphics , FeedbackABSTRACT
PURPOSES: To evaluate radiomics from Gd-EOB-DTPA enhanced MR combined with clinical variables for stratifying hepatic functional reserve in hepatitis B virus (HBV) patients. METHODS: Our study included 279 chronic HBV patients divided 8:2 for training and test cohorts. Radiomics features were extracted from the hepatobiliary phase (HBP) MR images. Radiomics features were selected to construct a Rad-score which was combined with clinical parameters in two models differentiating hepatitis vs. Child-Pugh A and Child-Pugh A vs. B/C. Performances of these stratifying models were compared using area under curve (AUC). RESULTS: Rad-score alone discriminated hepatitis vs. Child-Pugh A with AUC = 0.890, 0.914 and Child-Pugh A vs. B/C with AUC = 0.862, 0.865 for the training and test cohorts, respectively. Model 1 [Rad-score + clinical parameters for hepatitis vs. Child-Pugh A] showed AUC = 0.978 for the test cohort, which was higher than ALBI [albumin-bilirubin] and MELD [model for end-stage liver disease], with AUCs of 0.716, 0.799, respectively (p < 0.001, < 0.001). Model 2 [Rad-score + clinical parameters for Child-Pugh A vs. B/C] showed AUC of 0.890 in the test cohort, which was similar to ALBI (AUC = 0.908, p = 0.760), and higher than MELD (AUC = 0.709, p = 0.018). CONCLUSION: Rad-score combined with clinical variables stratifies hepatic functional reserve in HBV patients.
Subject(s)
End Stage Liver Disease , Hepatitis , Humans , Hepatitis B virus , Radiomics , Contrast Media , Severity of Illness Index , Gadolinium DTPA , Magnetic Resonance Imaging/methods , Retrospective StudiesABSTRACT
Background: Postoperative delirium (POD) is a common complication following cardiac surgery and increases postoperative morbidity and mortality. Intraoperative electroencephalogram (EEG) burst suppression suggests excessively deep anesthesia and predicts POD. Use of remimazolam provides a stable hemodynamic status and an appropriate depth of anesthesia. We aim to assess remimazolam administered for anesthesia and sedation in elderly patients having cardiac surgery. Methods: This is a randomized controlled clinical trial with noninferiority design. A total of 260 elderly patients aged equal to or greater than 60 years undergoing cardiac surgery will be randomly allocated to receive remimazolam or propofol (1:1) for general anesthesia and postoperative sedation until extubation. The primary outcome is the cumulative time with EEG burst suppression which is obtained from the SedLine system. The noninferiority margin is 2.0 min. The secondary outcomes include the POD occurrence within the first 5 days postoperatively and the duration of perioperative hypotension. Discussion: This noninferiority trial is the first to evaluate the effect of perioperative remimazolam administration on EEG burst suppression, POD occurrence, and duration of hypotension in elderly patients who undergo cardiac surgery. Trial registration: Chinese Clinical Trial Registry (ChiCTR2200056353).
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INTRODUCTION: Post-induction hypotension (PIH) is a common event in elderly surgical patients and is associated with increased postoperative morbidity and mortality. This study aims to develop and validate a PIH prediction model for elderly patients undergoing elective non-cardiac surgery to identify potential PIH in advance and help to take preventive measures. METHODS AND ANALYSIS: A total of 938 elderly surgical patients (n=657 for development and internal validation, n=281 for temporal validation) will be continuously recruited at The First Affiliated Hospital of Soochow University in Suzhou, China. The main outcome is PIH during the first 15 min after anaesthesia induction or before skin incision (whichever occurs first). We select candidate predictors based on published literature, professional knowledge and clinical expertise. For model development, we will use the least absolute shrinkage and selection operator regression analysis and multivariable logistic regression. For internal validation, we will apply the bootstrapping technique. After model development and internal validation, temporal validation will be conducted in patients recruited in another time period. We will use the discrimination, calibration and max-rescaled Brier score in the temporal validation cohort. Furthermore, the clinical utility of the prediction model will be assessed using the decision curve analysis, and the results will be presented in a nomogram and a web-based risk calculator. ETHICS AND DISSEMINATION: Ethical approval was obtained from the Ethics Committee of the First Affiliated Hospital of Soochow University (Approval No. 2023-012). This PIH risk prediction model will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: ChiCTR2200066201.
Subject(s)
Anesthesia, General , Hypotension , Aged , Humans , Prospective Studies , Calibration , China/epidemiology , Hypotension/etiologyABSTRACT
Background: Depressive symptoms are common among perimenopausal women with breast cancer having modified radical mastectomy. Esketamine exerts antidepressant effects. This study aims to assess whether an intraoperative sub-anesthetic dose of esketamine prevents postoperative depressive symptoms in these patients. Methods: In this randomized, triple-blinded, placebo-controlled trial, we will enroll 130 perimenopausal women (aged 45-60 years) with breast cancer undergoing unilateral modified radical mastectomy. Patients will be randomly assigned with a 1:1 ratio to receive either esketamine (0.25 mg/kg i.v.) or normal saline after anesthesia induction and before skin incision. The primary outcome is the incidence of depressive symptoms at day 30 postoperatively, assessed using the Beck's Depression Inventory (BDI). Secondary outcomes include incidence of depressive symptoms and BDI scores at day 1, 3, and 180 postoperatively, anxiety symptoms and scores at day 1, 3, 30, and 180 postoperatively, pain intensity and quality of recovery at day 1 and 2 postoperatively, nausea and vomiting within 48 hours postoperatively, length of postoperative hospital stay, and cancer-specific outcomes. Data will be analyzed in the modified intention-to-treat population. Discussion: This is the first trial to evaluate the effects of a sub-anesthetic dose of esketamine on depressive symptoms in perimenopausal women after modified radical mastectomy. The results of this study will help to improve their mental health and recovery after breast cancer surgery. Trial Registration: Chinese Clinical Trial Registry (ChiCTR2200064348).
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Purpose: Chronic postsurgical pain (CPSP) is a common complication after thoracic surgery and associated with long-term adverse outcomes. This study aims to develop two prediction models for CPSP after video-assisted thoracic surgery (VATS). Methods and Analysis: This single-center prospective cohort study will include a total of 500 adult patients undergoing VATS lung resection (n = 350 for development and n = 150 for external validation). Patients will be enrolled continuously at The First Affiliated Hospital of Soochow University in Suzhou, China. The cohort for external validation will be recruited in another time period. The outcome is CPSP, which is defined as pain with the numerical rating scale score of 1 or higher 3 months after VATS. Univariate and multivariable logistic regression analyses will be performed to develop two CPSP prediction models based on patients' data of postoperative day 1 and day 14, respectively. For internal validation, we will use the bootstrapping validation technique. For external validation, the discrimination capability of the models will be assessed using the area under the receiver operating characteristic curve, and the calibration will be evaluated using the calibration curve and Hosmer-Lemeshow goodness-of-fit statistic. The results will be presented in model formulas and nomograms. Conclusion: Based on the development and validation of the prediction models, our results contribute to early prediction and treatment of CPSP after VATS. Trial Registration: Chinese Clinical Trial Register (ChiCTR2200066122).
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Ammonium perchlorate (AP), as an important additive component of composite propellants, is critical to the combustion performance of propellants. Herein, AP@1H,1H,2H,2H-perfluorodecyltrichlorosilane (AP@PF) was prepared by establishing a tannic acid-iron ion (TA-Fe) supramolecular self-assembly layer on the AP surface and connecting the 1H,1H,2H,2H-perfluorodecyltrichlorosilane interfacial layer. Results demonstrate that TA-Fe and 1H,1H,2H,2H-perfluorodecyltrichlorosilane are uniformly bound to the surface layer of AP. AP@PF has a lower high-temperature thermal decomposition peak compared to AP. Meanwhile, the exothermic values of low-temperature thermal decomposition (338 J/g) and high-temperature thermal decomposition (597 J/g) of AP@PF are significantly higher than those of AP. In addition, AP@PF exhibits different surface interfacial properties, such as floating on the water surface and exhibiting a static contact angle of 105° on water. AP@PF shows almost no moisture absorption after aging in humid air for 30 days. The exothermic value of the mixture of AP@PF and aluminum powder (156 J/g) is significantly higher than that of the mixture of AP and aluminum (54 J/g), and the mixture of AP@PF and aluminum powder exhibits a higher calorific value and a stronger emission spectrum. Finally, the synergistic catalytic mechanism of AP@PF on the thermal decomposition of AP and the combustion of aluminum powder is also discussed.
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Nanomedicines can effectively penetrate tumor sites compared to traditionally used drugs. However, effective drugs that reach the interior of tumors remain limited. Based on studies of the complex tumor microenvironment, we summarized the barriers restricting tumor penetration of nanomedicines in this review. Penetration barriers are mainly caused by tumor blood vessels, stroma, and cell abnormalities. The repair of abnormal tumor blood vessels and tumor stroma and adjusting the physicochemical properties of nanoparticles are considered promising strategies to improve the tumor permeation of nanomedicines. The effects of nanoparticle properties, including size, shape, and surface charge, on tumor penetration were also reviewed. We expect to provide research ideas and a scientific basis for nanomedicines to increase intratumoral permeability and improve anti-tumor effects.
Subject(s)
Antineoplastic Agents , Nanoparticles , Neoplasms , Humans , Nanomedicine , Tumor Microenvironment , Neoplasms/pathology , Pharmaceutical Preparations , Nanoparticles/chemistry , Drug Delivery Systems , Antineoplastic Agents/therapeutic useABSTRACT
OBJECTIVES: Following positive surveillance ultrasound (US), magnetic resonance imaging (MRI) is recommended for further characterization. We propose contrast-enhanced ultrasound (CEUS) shows equivalent efficacy. METHODS: This prospective institutional review board approved study recruited 195 consecutive at-risk patients with a positive surveillance US. All had CEUS and MRI. Biopsy (n = 44) and follow-up are gold standard. MRI and CEUS results are classified according to liver imaging reporting and data system (LI-RADS) and patient outcome. RESULTS: As an US-based modality, CEUS is superior in confirming findings from surveillance US, correlation in 189/195 (97%) on CEUS compared to 153/195 (79%) on MRI. Within these negative MRI examinations, there are 2 hepatocellular carcinoma (HCC) and 1 cholangiocarcinoma (iCCA) diagnosed on CEUS and proven by biopsy. From 195 patients, there are 71 malignant diagnoses from all sources, including 58 LR-5 (45 on MRI and 54 on CEUS) and 13 others, including HCC outside of LR-5 category, and LR-M with biopsy proven iCCA (3 on MRI and 6 on CEUS). CEUS and MRI show concordant results in the majority of patients (146/195, 75%), including 57/146 malignant and 89/146 benign diagnoses. There are 41/57 concordant LR-5 and 6/57 concordant LR-M. When CEUS and MRI are discordant, CEUS upgraded 20 (10 biopsy-proven) from MRI LR-3/4 to CEUS LR-5 or LR-M by showing washout (WO) that MRI failed to show. Additionally, CEUS characterized time and intensity of WO and diagnosed 13/20 LR-5 by showing late and weak WO and 7 LR-M by showing fast and marked WO. CEUS is 81% sensitive and 92% specific in diagnosing malignancy. MRI is 64% sensitive and 93% specific. CONCLUSIONS: CEUS performance is at least equivalent if not superior to MRI for initial evaluation of lesions from surveillance US.
Subject(s)
Bile Duct Neoplasms , Carcinoma, Hepatocellular , Liver Neoplasms , Humans , Carcinoma, Hepatocellular/diagnostic imaging , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/pathology , Prospective Studies , Retrospective Studies , Contrast Media , Ultrasonography/methods , Magnetic Resonance Imaging/methods , Bile Ducts, Intrahepatic/pathology , Sensitivity and SpecificityABSTRACT
BACKGROUND: Cancer metastasis is still a life threat to patients with colorectal cancer (CRC). Brain and muscle ARNT-like protein 1 (BMAL1) is an important biological proteins that can regulate the behavior of cancer cells and their response to chemotherapy. However, the role of BMAL1 in the tumorigenic phenotype of CRC remains unclear. Here, we aim to investigate the functional role and mechanisms of BMAL1 in CRC. METHODS: The mRNA expression of BMAL1 was studied using the Cancer Genome Atlas (TCGA) databases. The protein level in clinical tissues was confirmed by immunohistochemistry (IHC). The effects of BMAL1 on the epithelial-to-mesenchymal transition (EMT) and proliferation of CRC cell lines (including BMAL1 overexpressed or silencing cells) were studied by Transwell, wound healing, CCK-8 and colony formation experiments. A series of experiments were conducted to demonstrate the mechanisms of BMAL1 regulating EMT and cancer proliferation in vitro and in vivo. RESULTS: We found that BMAL1 expression was closely related to the poor prognosis of CRC. BMAL1 overexpression promoted cell proliferation and migration. Mechanistically, we found that BMAL1 may activate the epithelial-to-mesenchymal transition (EMT) pathway and induce the ß-catenin release further promotes the expression of oncogene c-Myc and the migration of colorectal cells by activating MAPK pathway. However, BMAL1 silencing achieved the opposite effect. In addition, blocking MAPK-signaling pathway with specific inhibitors of ERK1/2 and JNK can also downregulate the expressions of c-Myc in vitro. Taken together, these results suggested that the BMAL1/ c-Myc-signaling pathway may regulate the metastasis of CRC through the JNK/ERK1/2 MAPK-dependent pathway. CONCLUSIONS: Our study showed that BMAL1 promotes CRC metastasis through MAPK-c-Myc pathway. These results deepen our understanding of the relationship between BMAL1 and tumorigenic phenotypes, which may become a promising therapeutic target for BMAL1 overexpressing CRC.
Subject(s)
ARNTL Transcription Factors , Colorectal Neoplasms , Humans , ARNTL Transcription Factors/genetics , Cell Line, Tumor , Cell Movement/genetics , Cell Proliferation , Colorectal Neoplasms/pathology , Epithelial-Mesenchymal Transition/genetics , Gene Expression Regulation, Neoplastic , Signal Transduction , Proto-Oncogene Proteins c-myc/metabolism , MAP Kinase Kinase 4/metabolism , Extracellular Signal-Regulated MAP Kinases/metabolismABSTRACT
Our understanding of full-thickness endometrial regeneration after injury is limited by an incomplete molecular characterization of the cell populations responsible for the organ functions. To help fill this knowledge gap, we characterized 10,551 cells of full-thickness normal human uterine from two menstrual phases (proliferative and secretory phase) using unbiased single cell RNA-sequencing. We dissected cell heterogeneity of main cell types (epithelial, stromal, endothelial, and immune cells) of the full thickness uterine tissues, cell population architectures of human uterus cells across the menstrual cycle. We identified an SFRP4+ stromal cell subpopulation that was highly enriched in the regenerative stage of the human endometria during the menstrual cycle, and the SFRP4+ stromal cells could significantly enhance the proliferation of human endometrial epithelial organoid in vitro, and promote the regeneration of endometrial epithelial glands and full-thickness endometrial injury through IGF1 signaling pathway in vivo. Our cell atlas of full-thickness uterine tissues revealed the cellular heterogeneities, cell population architectures, and their cell-cell communications during the monthly regeneration of the human endometria, which provide insight into the biology of human endometrial regeneration and the development of regenerative medicine treatments against endometrial damage and intrauterine adhesion.
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Virtual Reality (VR) provides new possibilities for modern knowledge work. However, the potential advantages of virtual work environments can only be used if it is feasible to work in them for an extended period of time. Until now, there are limited studies of long-term effects when working in VR. This paper addresses the need for understanding such long-term effects. Specifically, we report on a comparative study $i$, in which participants were working in VR for an entire week-for five days, eight hours each day-as well as in a baseline physical desktop environment. This study aims to quantify the effects of exchanging a desktop-based work environment with a VR-based environment. Hence, during this study, we do not present the participants with the best possible VR system but rather a setup delivering a comparable experience to working in the physical desktop environment. The study reveals that, as expected, VR results in significantly worse ratings across most measures. Among other results, we found concerning levels of simulator sickness, below average usability ratings and two participants dropped out on the first day using VR, due to migraine, nausea and anxiety. Nevertheless, there is some indication that participants gradually overcame negative first impressions and initial discomfort. Overall, this study helps lay the groundwork for subsequent research, by clearly highlighting current shortcomings and identifying opportunities for improving the experience of working in VR.
Subject(s)
Computer Graphics , Virtual Reality , Humans , User-Computer InterfaceABSTRACT
A nickel-catalyzed intermolecular arylcyanation of 8-aminoquinolinyl ß,γ-unsaturated amides is reported. The three-component reaction directly afforded diverse ß-cyano γ-aryl amides with exclusive chemo- and regioselectivity. The synthetic practicality of this approach is further demonstrated through multigram scale reaction, expanded transformations of the nitrile product, late-stage modification of complex molecules, and direct drug synthesis.
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Micro-sized spherical ammonium dinitramide (ADN) crystals are successfully prepared by a facile ultrasound-assisted solvent-antisolvent recrystallization method without introducing any additives. The influences of the volume ratio of solvent to antisolvent, the antisolvent temperature and the ultrasound power on the micro-morphologies and properties of ADN crystals are studied systematically. The changes of morphology, particle size, crystal structure and melting point of the ADN crystals are characterized through scanning electron microscopy (SEM), laser particle size analyzer (LPSA), X-ray diffraction (XRD) and differential scanning calorimetry (DSC), respectively. The results show that the optimal experimental parameters for the ADN crystal of spherical morphology are as follows: the volume ratio of solvent to antisolvent is 1:50, the antisolvent temperature is 20 â, and the ultrasound power is 70 W. The predicted hexagonal-flake and spherical morphologies for the ADN are close to the experimental morphologies. The growth mechanism of the spherical ADN crystal changes with supersaturation of the ADN solution. As the degree of supersaturation increases, the growth models of the spherical ADN change from the spiral growth to the rough growth, and the morphologies of ADN change from the large-sized ADN ball to the small-sized ADN ball.
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A characteristic feature of solid tumors is their low oxygen tension, which confers resistance to radiotherapy, photodynamic therapy, and chemotherapy. Therefore, to improve treatment outcomes, it is critical to develop biomaterials capable of targeted modulation of oxygen levels in tumors. In this review, we summarize four types of oxygen-modulating biomaterials, namely, oxygen-carrying biomaterials to deliver oxygen into tumors (e.g., perfluorocarbon and hemoglobin), oxygen-generating biomaterials to promote in situ oxygen generation (e.g., MnO2, catalase, and CuO), oxygen-consuming biomaterials to starve tumors (e.g., photosensitizer, glucose oxidase, and magnesium silicide), and oxygen-circulating biomaterials capable of both providing and consuming oxygen (e.g., ENBS-B). The current literature suggests that these biomaterials are useful for anticancer therapeutics. We present the key molecular mechanisms involved in modulating oxygen levels and the potential applications of these biomaterials in the context of hypoxic tumor treatment.
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OBJECTIVE: To Establish the shielding threshold value of TP antibody ELISA for unpaid blood donors, so as to shield true positive blood donors from returning to team management. METHODS: The real serological status of 517 samples with anti-TP ELISA reactivity was determined by confirmation test of Treponema pallidum particle agglutination (TPPA). The shielding threshold of TP antibody was preliminarily determined by using 99% specificity of ROC and 95% positive predictive value of percentile method, respectively. 283 TP antibody reactivity specimens routinely tested in our laboratory were selected to determine the applicability of the initial shielding values obtained by the two methods, and finally to determine the shielding threshold values of TP antibody donors. RESULTS: The specific S/CO values of reagent A 99% were 13.33-16.18, that of reagent B 99% was 6.34, that of reagent B 99% was 13.17-19.85, and that of 95% was 6.62. Empirical evidence: 99% specific threshold shielding true positive rates of reagents A and B were 100%, 95% positive expected value shielding true positive rates were 98.4%, 99%. Final determination of 99% specific shielding threshold as a low value of blood donors shielding threshold. The shielding limits of reagent A and B were 13.33 and 13.17. CONCLUSION: The shielding threshold of TP antibody ELISA for blood donors established in this study can help to reduce the number of blood donors returning to team management.
Subject(s)
Blood Donors , Enzyme-Linked Immunosorbent Assay , Humans , Syphilis , Syphilis Serodiagnosis , Treponema pallidumABSTRACT
Alkynyl-terminated polyethylene oxide-tetrahydrofuran (ATPET) and glycidyl azide polymer (GAP) could be linked through click-chemistry between the alkynyl and azide, and the product may serve a binder for solid propellants. The effects of the energetic plasticizers A3 [1:1 mixture of bis-(2,2-dinitropropy) acetal (BDNPA) and bis-(2,2-dinitropropyl) formal(BDNPN)] and Bu-NENA [N-butyl-N-(2nitroxyethyl) nitramine] on the curing reaction between ATPET and GAP have been studied. A diffusion-ordered nuclear magnetic resonance spectroscopy (DOSY-NMR) approach has been used to monitor the change in the diffusion coefficient of cross-linked polytriazole polyethylene oxide-tetrahydrofuran (PTPET). The change in the diffusion coefficient of PTPET with A3 plasticizer is significantly higher than that of PTPET with Bu-NENA. Viscosity analysis further highlighted the difference between A3 and Bu-NENA in the curing process-the curing curve of PTPET (A3) with time can be divided into two stages, with an inflection point being observed on the fourth day. For PTPET (Bu-NENA), in contrast, only one stage is seen. The above methods, together with gel permeation chromatography (GPC) analysis, revealed distinct effects of A3 and Bu-NENA on the curing process of PTPET. X-ray Photoelectron Spectroscopy (XPS) analysis showed that Bu-NENA has little effect on the valence oxidation of copper in the catalyst. Thermogravimetric (TG) analysis indicated that Bu-NENA helps to improve the thermal stability of the catalyst. After analysis of several possible factors by means of XPS, modeling with Material Studio and TG, the formation of molecular cages between Bu-NENA and copper is considered to be the reason for the above differences. In this article, GAP (Mn = 4000 g/mol) was used to replace GAP (Mn = 427 g/mol) to successfully synthesize the PTPET elastomer with Bu-NENA plasticizer. Mechanical data measured for the PTPET (Bu-NENA) sample included ε = 34.26 ± 2.98%, and σ = 0.198 ± 0.015 MPa.