Effect of esketamine on postoperative depressive symptoms in patients undergoing thoracoscopic lung cancer surgery: A randomized controlled trial.

Background: Depressive symptoms are common among patients with lung cancer. We aimed to assess the effects of esketamine on postoperative depressive symptoms after thoracoscopic lung cancer surgery. Methods: In this randomized, double-blind, placebo-controlled trial, 156 patients undergoing thoracoscopic lung cancer surgery were randomly allocated in a 1:1 ratio to receive intravenous esketamine (intraoperatively and in patient-controlled analgesia until 48 h postoperatively) or normal saline placebo. The primary outcome was the proportion of patients with depressive symptoms at 1 month postoperatively, assessed using the Beck Depression Inventory-II (BDI-II). Secondary outcomes included depressive symptoms at 48 h postoperatively, hospital discharge and 3 months postoperatively, BDI-II scores, anxious symptoms, Beck Anxiety Inventory scores, Quality of Recovery-15 (QoR-15) scores, and 1- and 3-month mortality. Main results: A total of 151 patients (75 in the esketamine group and 76 in the normal saline group) completed the 1-month follow-up. The esketamine group had a significantly lower incidence of depressive symptoms at 1 month compared to the normal saline group (1.3% vs. 11.8%; risk difference = -10.5, 95%CI = -19.6% to -0.49%; p = 0.018). After excluding patients without lung cancer diagnosis, the incidence of depressive symptoms was also lower in the esketamine group (1.4% vs. 12.2%; risk difference = -10.8, 95%CI = -20.2% to -0.52%; p = 0.018). The secondary outcomes were similar between groups, except that the esketamine group had higher QoR-15 scores at 1 month postoperatively (median difference = 2; 95%CI = 0 to 5; p = 0.048). The independent risk factors for depressive symptoms were hypertension (odds ratio = 6.75, 95%CI = 1.13 to 40.31; p = 0.036) and preoperative anxious symptoms (odds ratio = 23.83, 95%CI = 3.41 to 166.33; p = 0.001). Conclusion: Perioperative administration of esketamine reduced the incidence of depressive symptoms at 1 month after thoracoscopic lung cancer surgery. History of hypertension and preoperative anxious symptoms were independent risk factors for depressive symptoms.Clinical trial registration: Chinese Clinical Trial Registry http://www.chictr.org.cn, Identifier (ChiCTR2100046194).

[Potential nest predators of Syrmaticus reevesii based on camera traps and artificial nests.] / åŸºäºŽçº¢å¤–ç›¸æœºæŠ€æœ¯å’Œäººå·¥å·¢è¯•éªŒåˆ†æžç™½å† é•¿å°¾é›‰å·¢æ½œåœ¨æ•é£Ÿè€ .

In order to understand the background of the field breeding ecology of Reeves's pheasant (Syrmaticus reevesii) inside and outside of protected area, an investigation on nest predation rate, potential nest predators and the habitat factors affecting nest predation was conducted at Dongzhai National Nature Reserve, Henan Province and Pingjingguan Village, Hubei Province, which were protected and non-protected area, respectively. The fieldwork was conducted from March to July 2014, and artificial nests (taking eggs as bait), camera traps and habitat plots were used at these two sites to catch information about nest predation. Experiments were designed in two rounds, including the early-breeding stage (March to April) and mid-breeding stage (May to June). We placed 149 artificial ground nests with 62 randomly picked nest sites, each monitored by one camera. The working days of all cameras were 1315 days, and we finally obtained 7776 pictures and 6950 video clips. The results showed that the rate of nest predation outside the protected areas (Pingjingguan) was higher than that in nature reserve (Dongzhai), with highly significant diffe-rences both in early-breeding and mid-breeding stages. In two stages, more nest predator species (11 and 6 species in two stages, respectively) occurred in Pingjingguan than in Dongzhai (7 and 5 species, respectively). In Pingjingguan, Glires and Corvidae were top predators, while in Dongzhai Raccoon dog (Nyctereutes procyonoides) was firstly ranked. Slope degree and arbor canopy cover were positively related with the nest predation rate in Pingjingguan, while fallen leaves coverage had significant influence on nest predation in Dongzhai. We also found wild Reeves's pheasant paid visits to 13 artificial nests for 18 times by viewing the pictures and video clips.

Residue 544 in domain III of the Bacillus thuringiensis Cry1Ac toxin is involved in protein structure stability.

A unique residue W544 in the beta18-beta19 loop of the Bacillus thuringiensis Cry1Ac toxin has been implicated in its toxicity. In this study, the effects of mutations at this residue on protein stability during protease treatment, UV irradiation, and preservation were examined. Residue 544 of Cry1Ac was involved in maintaining structural stability, and substitution of a polar group at this position was unfavorable to protein stability. One mutant, W544F, produced larger crystals and was more stable. This mutant showed greater resistance to UV radiation than the wild type Cry1Ac but retained equal toxicity. This is the first report showing that residue 544 in the Cry1Ac domain III plays a significant role in toxin structural stability. Our W544F mutant is a significant development in terms of field applications of Cry1Ac toxin.

GABAA receptor partially mediated propofol-induced hyperalgesia at superspinal level and analgesia at spinal cord level in rats.

AIM: To observe effects of propofol on nociceptive response at superspinal and spinal level in rats. METHODS: Two hundreds and fifty-eight Sprague-Dawley male rats were randomized into thirty-two groups. Propofol and bicuculline were microinjected into lateral ventricle (icv), ventrolateral periaqueductal gray (vlPAG), intrathecal (ith), and intraperitoneal (ip). The noxious responses were evaluated by hot plate and formalin test. RESULTS: In hot-plate test, systemic and superspinal administration of propofol (40 mg.kg(-1) ip, 100 microg in 10 microL, icv, and 4 microg in 0.4 microL vlPAG microinjection) produced hyperalgesia (P<0.01). Hyperalgesia induced by vlPAG microinjection of propofol was significantly antagonized by 69.8 %, 71.2 %, 98.8 % at 10, 20, and 30 min by microinjection of bicuculline (10 ng in 0.4 microL, vlPAG) (P<0.01). Analgesia induced by ith propofol (100 microg.10 microL(-1)) was antagonized about 81.3 %, 54.8 %, 80.8 %, and 97.4 % at 10, 20, 30 and 40 min by ith bicuculline (P<0.05). In formalin test, systemic and superspinal administration of propofol (40 mg.kg(-1) ip, 4 microg in 0.4 microL, vlPAG) also produced hyperalgesia (P<0.01). The increased formalin pain scores were antagonized about 57.1 % by bicuculline (10 ng, vlPAG) (P<0.05) at 60 min after formalin injection. The decreased formalin pain scores induced by ith propofol (100 microg in 10 microL) were antagonized about 66.7 % at 30 min by ith bicuculline (P<0.05) after formalin injection. Hyperalgesia produced by ip propofol in both hot plate and formalin test could not be antagonized by vlPAG administration of bicuculline. CONCLUSION: GABAA receptor partly mediated propofol-induced hyperalgesia at superspinal and analgesia at spinal cord in rats.