Thoracic paravertebral nerve block combined laryngeal mask airway with preservation of spontaneous breathing can accelerate postoperative recovery.

OBJECTIVE: This study aimed to examine the potential benefits of Thoracic Paravertebral Nerve Block (TPVB) coupled with Laryngeal Mask Airway (LMA) and the maintenance of spontaneous breathing anesthesia, in contrast to general anesthesia utilizing double-lumen endobronchial intubation, on promoting recovery following thoracoscopic surgery. PATIENTS AND METHODS: A randomized controlled trial was carried out involving sixty patients set for Video-Assisted Thoracoscopic Surgery (VATS) at the Affiliated People's Hospital of Jiangsu University from February 2021 to January 2022. Patients were randomized to either the TPVB and LMA with spontaneous breathing anesthesia group (non-intubation group, NI group) or the general anesthesia with double-lumen endobronchial intubation group (Intubation group, I group). The primary outcome measured was the duration of hospitalization. Secondary outcomes included early postoperative rehabilitation indicators, postoperative complications, Visual Analogue Score (VAS), and inflammatory response markers. RESULTS: Patients in the NI group experienced significantly shorter hospital stays than those in the I group (p < 0.05). Early postoperative recovery, assessed by metrics including the first exhaust time, food intake time, first ambulation time, and duration of chest-tube placement, was superior in the NI group (p < 0.05). Postoperative complications such as nausea and vomiting, pulmonary infection, atelectasis, sore throat, and hoarseness, along with cortisol and C-reactive protein (CRP) levels at the end of the operation and 24 h post-operation, and VAS values within the first 12 h post-operation, were significantly lower in the NI group (p < 0.05). However, blood loss, operation time, and VAS values at 24 h and 48 h post-surgery showed no significant differences between the two groups. CONCLUSIONS: Our findings suggest that TPVB, in conjunction with LMA and spontaneous breathing anesthesia, may expedite postoperative recovery in patients undergoing VATS.

Structural evolution in Au- and Pd-based metallic glass forming liquids and the case for improved molecular dynamics force fields.

The results of a combined experimental and computational investigation of the structural evolution of Au81Si19, Pd82Si18, and Pd77Cu6Si17 metallic glass forming liquids are presented. Electrostatically levitated metallic liquids are prepared, and synchrotron x-ray scattering studies are combined with embedded atom method molecular dynamics simulations to probe the distribution of relevant structural units. Metal-metalloid based metallic glass forming systems are an extremely important class of materials with varied glass forming ability and mechanical processibility. High quality experimental x-ray scattering data are in poor agreement with the data from the molecular dynamics simulations, demonstrating the need for improved interatomic potentials. The first peak in the x-ray static structure factor in Pd77Cu6Si17 displays evidence for a Curie-Weiss type behavior but also a peak in the effective Curie temperature. A proposed order parameter distinguishing glass forming ability, 1/ST,q1-1, shows a peak in the effective Curie temperature near a crossover temperature established by the behavior of the viscosity, TA.

Breakdown of the Stokes-Einstein relationship and rapid structural ordering in CuZrAl metallic glass-forming liquids.

The results of a combined structural and dynamical study of Cu-Zr-Al metallic glass forming liquids are presented. Containerless high-energy x-ray scattering experiments made using electrostatic levitation are combined with molecular dynamics simulations to probe the onset of rapid structural ordering as well as the temperature-dependent diffusivity and viscosity in three liquids: Cu49Zr45Al6, Cu47Zr45Al8, and Cu43Zr45Al12. These compositions were chosen because they are reported to have dramatically different glass forming-ability. Experimental data show that the first peak in the x-ray static structure factor displays evidence for a Curie-Weiss type behavior, but also a peak in the effective Curie temperature. The evidence provided here for the onset of cooperativity, marked by a crossover temperature, TA (which is usually above the liquidus temperature), is accompanied by the onset of development of more spatially extended structural order in the liquids. Based on the molecular dynamics simulations, each of the liquids exhibits a clear breakdown of the Stokes-Einstein relation at a temperature near, but below, the crossover temperature, TA. The breakdown is manifest as a rapid reduction in the relative diffusion coefficients between Cu, Zr, and Al.

Expression of miR-29 and STAT3 in osteosarcoma and its effect on proliferation regulation of osteosarcoma cells.

OBJECTIVE: STAT3 has been shown to be involved in the occurrence, progression, and resistance of various tumors. The abnormal expression of miR-29 is associated with the pathogenesis of osteosarcoma. The bioinformatics analysis showed a targeting relationship between miR-29 and STAT3 3'-UTR. This study investigated whether miR-29 regulates the STAT3 expression and affects the proliferation and apoptosis of osteosarcoma cells. PATIENTS AND METHODS: The tumor tissues of osteosarcoma patients were collected, and the adjacent tissues were used as controls to detect the expression of miR-29 and STAT3. The Dual-Luciferase Gene Reporter Assay validated the regulatory relationship between miR-29 and STAT3. The expression of miR-29 and STAT3 in normal osteoblasts hFOB1.19, osteosarcoma SJSA-1, and MG-63 was measured. SJSA-1 cells were divided into miR-NC group and miR-29 mimic group. Cell apoptosis and proliferation were detected by flow cytometry. RESULTS: Compared with adjacent tissues, miR-29 expression was decreased, and STAT3 expression was increased in osteosarcoma. There was a targeted regulation relationship between miR-29 and STAT3. Compared with hFOB1.19 cells, miR-29 expression in osteosarcoma SJSA-1 and MG-63 cells was decreased, with increased STAT3 expression. The transfection of miR-29 mimic significantly decreased the expression of STAT3 and p-STAT3 in SJSA-1 cells, inhibited cell proliferation, and increased cell apoptosis. CONCLUSIONS: Decreased miR-29 expression plays a role in the increase of the STAT3 expression and in the promotion of the pathogenesis of osteosarcoma. Increasing the expression of miR-29 can inhibit the proliferation of osteosarcoma cells and promote apoptosis by decreasing STAT3 expression.

Maintenance of the contractile phenotype in corpus cavernosum smooth muscle cells by Myocardin gene therapy ameliorates erectile dysfunction in bilateral cavernous nerve injury rats.

The pathophysiology of erectile dysfunction post radical prostatectomy is not clearly clarified, and the low efficacy of traditional PDE5i treatment remains a major complaint in contemporary practice. This study aimed to demonstrate phenotypic modulation in bilateral cavernous nerve injury (BCNI) rats within 7 days, and subsequently validate gene therapy with Myocardin (Mycod) by maintaining a contractile phenotype in corpus cavernosum smooth muscle cells. Initially, 36 male rats were randomly divided into BCNI and negative control (NC) groups for histological and phenotypic molecular measurements at 3, 5, and 7 days. Afterwards, an additional 30 rats received a single intra-cavernous injection of 50 µL PBS, Ad-Myocd (1 × 1011  pfu/ml) or Ad-vector for 10 animals each, namely the NC+PBS, BCNI+Ad-Myocd, and BCNI+Ad-vector groups. Finally, the validity and mechanism of Myocd transfection was explored at 21 days in vivo and 48 h in vitro. Western blotting showed canonical declines in Myocd, α-SMA, and Calponin expression, as well as elevated Osteopontin (OPN) expression, before corporeal morphological and SM-to-collagen ratio changes at day 5 after injury. Overexpression of Myocd maintained the contractile phenotype of corpus cavernosum smooth muscle cells, ameliorated bilateral cavernous nerve injury rat erectile dysfunction, as well as promoted cell contractility and suppressed proliferative capacity. Simultaneously, confocal imaging revealed up-regulation and co-localization of serum response factor in gene-transferred cells. In conclusion, our study is the first to investigate corpus cavernosum smooth muscle cells phenotypes in the early stages of cavernous injury model rats, and Myocd reversed phenotypic modulation by activating serum response factor. The experimental results demonstrated the validity of gene therapy for erectile dysfunction.

[The clinical impact of artery-first approach combined with vascular resection and reconstruction in the treatment of pancreatic head carcinoma].

Objective: To evaluate the application of artery first, combined vascular resection and reconstruction in the treatment of pancreatic head carcinoma. Methods: The clinical data of 13 patients with pancreatic head cancer were retrospectively analyzed from February 2014 to March 2016 in the Affiliated Hospital of Xiamen University. Preoperative computed tomography of high resolution layer or magnetic resonance imaging examination demonstrated pancreatic head carcinoma, as well as close adhesion, stenosis, compression or displacement of superior mesenteric vein or portal vein wall. In the operation, the artery first approach was used and the whole arterial blood supply in the head of the pancreas was fully exposed and interdicted. Finally, en block resection and vascular resection and reconstruction was adopted. Results: 12 of 13 patients had pancreatoduodenectomy synchronously with vascular resection and reconstruction; the other patient had these two surgery sequentially. Four patients received blood vessel wedge resection, five had segmental resection combined with end to end suture, and four had segmental resection combined with artificial vascular graft reconstruction. Operation time was (327.2±65.5) minutes, and the amount of blood loss was (472.6±226.4) millilitres. One patient suffered from delayed gastric emptying, and two patients had pancreatic fistula. All patients recovered from postoperative complications by conservative treatment. No patients developed biliary fistula, gastrointestinal fistula, abdominal infection, pulmonary infection, diarrhea, hypoglycemia or other complications, and none died in perioperative period. Postoperative pathological findings confirmed the diagnosis of pancreatic ductal adenocarcinoma. Mean tumor diameter was (4.2±1.5)cm, and (3.8±1.5) metastasis were found in (13.6±2.5) resected lymph nodes. In 11 cases, the tumor cells were found in the outer membrane of blood vessels, 2 cases were found to have tumor invasion in the inner membrane, and all the resection margins were negative. All patients were followed up, and 2 patients died of liver metastasis 11 months and 18 months after operation, respectively. One patient survived with local recurrence of tumor 13 months after surgery. Other patients had no tumor recurrence and metastasis. Conclusions: The artery first approch combined vascular resection and reconstruction is safe effective and feasible in the treatment of pancreatic head carcinoma. It can improve the ablation rate of pancreatoduodenectomy.

[Health literacy level and influence factors of occupational population in one province].

Objective: To understand health literacy (HL) status of occupational population in work place and provide the basis of developing for HL standards and specific intervention strategies. Methods: Being selected by stratified cluster sampling, 3507 employees in 13 companies wthin Hebei Province were investigated by questionnaire. Results: The survey was conducted with 3507 questionnaires, the valid rate was about 97.83%. There were a total of 2629 men (76.62%) and 802 women (23.38%) . The overall level of HL was 32.24%. Health literacy level (HLL) of three aspects are: basic knowledge and concepts 52.03%, healthy life-style and behavior 26.00%, and health related skills 40.25%, the HL rate of six health issues as scientific view of health, prevention of communicable diseases, prevention of chronic diseases, safety and first aid, basic medical care and health information are 61.59%, 28.62%, 21.95%, 75.20%, 32.99% and 49.17% respectively. The group aged 25-34 had the highest HLL (43.95%) ; the higher culture degree, the higher the level of health literacy (P<0.05) . The HLL of the occupational population in Hebei province was 32.24%, which was close to the HLL of the national occupational population, but higher than that of general population in Hebei province and in the whole country. Conclusions: The HLL of the occupational population in Hebei province which was close to the HLL of the national occupational population. HLL of basic knowledge and concepts is higher than that of healthy life-style and behavior and health related skills, the health literacy rate of prevention of communicable diseases and chronic diseases were low. Age, culture degree and type of industry are important influence factors.

[Application of benchmark dose on renal injury in people chronically exposed to lead].

Objective: To screen sensitive indicators of renal injury in lead workers using benchmark dose method. Methods: Of the 486 subjects,116 did not occupationally contact to lead as a control. The blood lead was considered as exposure biomarker, while Uß2-MG and UNAG as effect biomarkers for renal injury. The BMD and BMDL of blood lead were estimated at the 10% benchmark response using BMDS Version 2.6. Results: There was statistical rise in blood lead between the lead group and control group (P<0.05) ; and the blood lead level was divided into four groups by quarterback spacing method, among which UNAG was statistically different (P<0.05) . There was an increased prevalence of abnormal rates of Uß2-MG and UNAG with increasing blood lead concentration (P<0.05) , after trend chi-square test. BMD and BMDL of UNAG and Uß2-MG were 602.784/431.838 µg/L and 130.398/100.981 µg/L caculated by Log-Probit model, respectively. Conclusions: Occupational lead exposure may cause kidney damage, and UNAG could be as a more sensitive marker for monitoring early renal injury than Uß2-MG.

[The relationship of vitamin D receptor gene and blood lead: a meta-analysis].

OBJECTIVE: The correlation of vitamin D receptor (VDR) gene polymorphism and blood lead level had been in doult, which allowed us to write this article. METHODS: Relevant studies about the blood lead and VDR B/b gene polymorphism which published from 1979-2015, were searched in multiple bibliographic databases, such as: CNKI, Wanfang Database, PUBMED. Of the ten references selceted, three were divided into two groups which were classified as different researches, so there were thirteen studies in the meta-analysis. According to the level of blood lead, the studies were analyzed by three groups: normal group, low dose grou and high dose group. The analysis was performed by stata 12.0 software. RESULTS: The blood lead level of VDR B/b genotype was significantly difference in all the three groups (P<0.05) , but there were apparent heterogeneity between normal group and low dose group (P<0.05, I(2)=84.2%; P<0.05, I(2)=88.9%) , except the high dose group (P>0.05, I(2)=12.7%) ; after adjusted, all showed no heterogeneity, and the results were still the same. CONCLUSION: The genotype of VDR may be correlated with blood lead, and the levels of blood lead varied with different genetypes.

Metabolic syndrome and risk for ED: a meta-analysis.

There are many recent observational studies on metabolic syndrome (MS) and the risk for ED, and it is still inconclusive whether MS increases the risk for ED. This meta-analysis aims to detect a relationship between MS and ED. We identified eligible studies by searching PubMed, Embase and the Cochrane Library for articles published before August 2013. Adjusted relative risks (RR) with 95% confidence interval (CI) were calculated using random-effects or fixed-effects models. A total of 10 studies involving 4092 participants were included in the meta-analysis. MS was associated with an increased incidence of ED (RR=1.60, 95% CI=1.27-2.02, P<0.001), with significant evidence of heterogeneity among these studies (P for heterogeneity <0.001, I(2)=92.9%). The subgroup and sensitivity analyses confirmed the stability of the results and no publication bias was detected. The present meta-analysis suggests that MS is significantly associated with the risk for ED. Large-scale and well-designed prospective studies are required to further investigate the association between MS and risk for ED.

Characteristics of unrecognised bipolar disorder in patients treated for major depressive disorder in China: general versus psychiatric hospitals.

OBJECTIVES: Bipolar disorder is often misdiagnosed as major depressive disorder. Such misdiagnosis partly depends on the type of treatment setting. This study compared general hospital psychiatric units with psychiatric hospitals in China with respect to basic demographic and clinical characteristics of patients with unrecognised bipolar disorder who are treated for major depressive disorder. METHODS: Patients treated for major depressive disorder were consecutively examined in 13 health centres (6 general hospital psychiatric units and 7 psychiatric hospitals) in China. Their socio-demographic and clinical features were recorded using a standardised protocol and data collection procedure. The DSM-IV diagnoses were established using the Mini-International Neuropsychiatric Interview. RESULTS: Of the 1487 patients included in the study, 309 (20.8%) were diagnosed with bipolar disorder. There was no significant difference between general hospital psychiatric units and psychiatric hospitals in the ratio of all types of unrecognised bipolar disorders (χ2 = 0.008, degrees of freedom = 1, p = 0.9) and bipolar II disorders (χ2 = 3.1, degrees of freedom = 1, p = 0.08). The proportions of unrecognised bipolar I disorders (χ2 = 4.1, degrees of freedom = 1, p = 0.04) differed significantly between the 2 types of study site. Multivariate analyses showed that patients with bipolar I disorders with more seasonal depressive episodes were more likely to receive treatment in general hospital psychiatric units (odds ratio = 3.3, 95% confidence interval = 1.1-9.8). CONCLUSION: Patients with bipolar I disorders receiving treatment in general hospital psychiatric units had different clinical characteristics compared to their counterparts treated in psychiatric hospitals in China.

A new cell culture system for infection with hepatitis B virus that fuses HepG2 cells with primary human hepatocytes.

Hepatitis B virus (HBV) infection exhibits a very narrow host range and shows a strong tropism for liver parenchymal cells, however none of the previously established experimental models can reproduce the natural process of HBV infection. In the present study, primary human hepatocytes were fused with HepG2 cells to establish the hybrid HepCHLine-4 cell line with high susceptibility to HBV. The HepCHLine-4 cells expressed HBV-specific antigen when co-incubated with HBV-positive serum from a hepatitis B patient. Post-infection, HBV relaxed circular DNA and covalently closed circular DNA were detected in HepCHLine-4 cells using a nested polymerase chain reaction, and HBV-specific particles were visualized by electron microscopy of the culture media of HepCHLine-4 cells. HepG2 cells were not susceptible to HBV infection under the same conditions. The HepCHLine-4 cells can be sub-cultured for > 12 months while maintaining susceptibility to HBV and may, therefore, be useful for studying HBV infection and the viral life cycle in human hepatocytes.

Experimental and numerical study on particle distribution in a two-zone chamber.

Better understanding of aerosol dynamics is an important step for improving personal exposure assessments in indoor environments. Although the limitation of the assumptions in a well-mixed model is well known, there has been very little research reported in the published literature on the discrepancy of exposure assessments between numerical models which take account of gravitational effects and the well-mixed model. A new Eulerian-type drift-flux model has been developed to simulate particle dispersion and personal exposure in a two-zone geometry, which accounts for the drift velocity resulting from gravitational settling and diffusion. To validate the numerical model, a small-scale chamber was fabricated. The airflow characteristics and particle concentrations were measured by a phase Doppler Anemometer. Both simulated airflow and concentration profiles agree well with the experimental results. A strong inhomogeneous concentration was observed experimentally for 10 µm aerosols. The computational model was further applied to study a simple hypothetical, yet more realistic scenario. The aim was to explore different levels of exposure predicted by the new model and the well-mixed model. Aerosols are initially uniformly distributed in one zone and subsequently transported and dispersed to an adjacent zone through an opening. Owing to the significant difference in the rates of transport and dispersion between aerosols and gases, inferred from the results, the well-mixed model tends to overpredict the concentration in the source zone, and under-predict the concentration in the exposed zone. The results are very useful to illustrate that the well-mixed assumption must be applied cautiously for exposure assessments as such an ideal condition may not be applied for coarse particles.

Comparison of a new Eulerian model with a modified Lagrangian approach for particle distribution and deposition indoors.

Understanding of aerosol dispersion characteristics has many scientific and engineering applications. It is recognized that Eulerian or Lagrangian approach has its own merits and limitations. A new Eulerian model has been developed and it adopts a simplified drift-flux methodology in which external forces can be incorporated straightforwardly. A new near-wall treatment is applied to take into account the anisotropic turbulence for the modified Lagrangian model. In the present work, we present and compare both Eulerian and Lagrangian models to simulate particle dispersion in a small chamber. Results reveal that the standard k-ε Lagrangian model over-predicts particle deposition compared to the present turbulence-corrected Lagrangian approach. Prediction by the Eulerian model agrees well with the modified Lagrangian model.

[Chemical constituents from the fruit of Rosa bella Rehd. et Wils].

OBJECTIVE: To investigate the chemical constituents from the fruit of Rosa bella and its bioactivity. METHOD: The compounds were isolated from the methanol extract by column chromatography, then identified by 1H, 13C NMR and by comparison with authentic samples. The unorganized hoptoad heart was used for testing the contracting force of cardiac muscle and enzymology for measuring the bloody lipid of serum in rats. RESULT: Seven compounds were isolated and identified as pomolic acid, tiliroside, euscaphic acid, daucosterol, quercetin, oleanolic acid and beta-sitosterol, respectively. In the concentration of 0.4-1.0 mg.ml-1, the methanol extract had obvious cardiotonic effect. While at 400 mg.kg-1, there are no obvious effect to the TC, HDL-ac and TG of serum in rats. CONCLUSION: The isolated compounds may be the active components of this plant.

A non-invasive method for evaluating cirrhotic portal hypertension by administration of 99mTc-MIBI per rectum.

A study was performed to evaluate radio-isotopic imaging using technetium-99m hexakis 2-methoxyisobutyl isonitrile administered per rectum to assess portal collateral circulation. The heart-liver ratios (H/L; mean +/- standard deviation) in 15 controls, 13 cases of histologically confirmed viral hepatitis and 57 cirrhosis patients were 0.27 +/- 0.11, 0.43 +/- 0.14 and 1.00 +/- 0.28, respectively (P < 0.001). Among the cirrhosis patients those with the Child-Pugh classification A, B and C had H/L of 0.56 +/- 0.14, 1.00 +/- 0.20 and 1.19 +/- 0.26, respectively (P < 0.001). A high value of H/L was associated with a high risk of hepatic encephalopathy (1.25 +/- 0.17, P < 0.01) and oesophageal varices (1.02 +/- 0.20, P < 0.01). There were associations between H/L and serum bilirubin (P < 0.01), albumin (P < 0.05) and prothrombin time (P < 0.05). The results also showed a good correlation between H/L and portal vein pressure measured during operation in 13 patients (P < 0.001, r = 0.87). The regression equation: y = 6.77 + 32.5 H/L, allowed portal vein pressure to be estimated. The prognostic value of the test was supported by the fact that good correlations were observed between the H/L ratio and widely accepted prognostic classification (Child-Pugh). It is suggested that this new method could be a reliable non-invasive way to give an indication of the degree of portasystemic shunting to evaluate the prognosis and to follow up the effects of medications for reducing portal hypertension in patients with cirrhotic portal hypertension.

Anastomotic false aneurysm following abdominal aortic aneurysmectomy and prosthetic grafting.

Anastomotic false aneurysm (AFA) of the aorta is a potentially lethal complication after prosthetic grafting. Nineteen aneurysms were encountered in 18 patients within a 30-year period (1960-1991). There were 10 men and 8 women, aged 27-80 years (mean 58 years). In 14 patients, the prostheses were made of silk, in 2 were PTFE, and in 1 each Dacron or silk-Dacron cross-weaved. Patients with an intact AFA had a pulsatile abdominal mass, abdominal pain, an occluded graft and peripheral emboli. Five patients were asymptomatic. Clinical onset of AFA varied from 2 weeks to 12 years (mean 5 years). The accurate rate of diagnosis of single plane angiography was 75% (3 of 4), and computed tomography 100% (ten of ten). Ultrasound was used only once and suggested an AFA. Four AFAs were less than 5cm in diameter. Five patients refused operation and died in 2 years from rupture. Operative mortality was 11% (1 of 9). Treatment was resection of AFA and replacement with a new graft. Life-long follow-up is required for patients with an aortic aneurysm. All ratroperitoneal AFAs should be resected, since the outcome of rupture is poor.

[Diagnostic value of heart-liver nuclein ratio in cirrhotic portal hypertension].

A new method for evaluating portal systemic collaterals with administering 99mTc-MIBI per rectum was described in 80 cases. The heart to liver uptake ratio (H/L) in 15 healthy subjects was 0.267 +/- 0.1, slightly increased (0.455 +/- 0.13) in 8 patients with viral hepatitis and significantly increased in 68 cirrhotics. There was a good correlation between H/L ratio and the Child-Pugh classification with the ratio in Child A group of 0.57 +/- 0.12, in Child B group of 1.0 +/- 0.19, and in Child C group of 1.19 +/- 0.25 respectively (P < 0.01). For the diagnosis of portal hypertension, tentatively taking the ratio of > or = 0.62 as positive the sensitivity was 96%, specificity 89%, and accuracy 94%. The authors believe that 99mTc-MIBI imaging is a noninvasive method very useful in evaluating porta-systemic shunts.