The Effects of Perineural Dexamethasone on Rebound Pain After Nerve Block in Patients With Unicompartmental Knee Arthroplasty: A Randomized Controlled Trial.

OBJECTIVES: A single nerve block provides excellent analgesia in a short time, but rebound pain after the nerve block dissipates has attracted researchers' attention. The aim of this study was to evaluate the effect of perineural dexamethasone on rebound pain after sciatic nerve block and femoral nerve block in patients undergoing unicompartmental knee arthroplasty (UKA). METHODS: In a double-blinded fashion, we recruited 72 patients undergoing UKA, each of whom received sciatic and femoral nerve block. Patients were randomly assigned to 2 groups (n=36): X (ropivacaine only) and D (ropivacaine combined with dexamethasone). The primary outcome was the incidence of rebound pain. The secondary outcomes were rebound pain score, the duration of rebound pain, the duration of nerve block, pain score, sufentanil consumption and rescue analgesic, patient-controlled intravenous analgesia, distance walked, sleep quality score, C-reactive protein levels, and adverse effects. RESULTS: Compared with group X, the incidence of rebound pain in group D was higher, the rebound pain score was higher and the duration of the nerve block was prolonged ( P <0.05). At 12, 16, and 20 hours postoperatively, the pain scores at rest in group D were lower. At 32 and 36 hours postoperatively, the pain scores at rest in group D were higher ( P <0.05). Furthermore, patients in group D had lower levels of C-reactive protein after surgery ( P <0.05). DISCUSSION: The addition of dexmedetomidine to ropivacaine for UKA effectively prolonged the duration of nerve block and decreased C-reactive protein levels, but increased the incidence of rebound pain and rebound pain score, and had no beneficial effects on the postoperative analgesia.

Quantifying Interfacial Bonding Using Thermal Boundary Conductance at Cubic Boron Nitride/Copper Interfaces with a Large Mismatch of Phonon Density of States.

Interfacial bonding that directly influences the functional and mechanical properties of metal/nonmetal composites is commonly estimated by destructive pull-off measurements such as scratch tests, etc. However, these destructive methods may not be applicable under certain extreme environments; it is urgently necessary to develop a nondestructive quantification technique to determine the composite's performance. In this work, the time-domain thermoreflectance (TDTR) technique is applied to study the inter-relationship between interfacial bonding and interface characteristics through thermal boundary conductance (G) measurements. We think that interfacial phonon transmission capability plays a decisive role in influencing interfacial heat transport, especially for scenarios with a large mismatch of phonon density of states (PDOS). Moreover, we demonstrated this method at (100) and (111) cubic boron nitride/copper (c-BN/Cu) interfaces by both experimental and simulation efforts. The results show that the TDTR-measured G of the (100) c-BN/Cu interface (30 MW/m2·K) is about 20% higher than that of the (111) c-BN/Cu (25 MW/m2·K), which is ascribed to that higher interfacial bonding of the (100) c-BN/Cu endows it with better interfacial phonon transmission capability. In addition, detailed comparison of 10+ other metal/nonmetal interfaces exhibits similar positive relationship for interfaces with a large PDOS mismatch but negative relationship for interfaces with a small PDOS mismatch. The latter one is attributed to that extra inelastic phonon scattering and electron transport channels abnormally promoting interfacial heat transport. This work may provide some insights into quantitatively establishing inter-relationship between interfacial bonding and interface characteristics.

Research on the Professional Mentality of Hengdian Drifter's.

Background: Hengdian drifters refer to outsiders who participate in shooting film and television dramas in Hengdian. It is a special group. Single access to information, precarious nature of work, unequal treatment of gender, constraints on development, and inadequate guarantee mechanisms are all to blame. Purpose: This paper proposes to improve the ecology of the different actor industries by implementing a precise assessme. Patients and methods: This study combines qualitative and quantitative research, adopts the questionnaire survey and semi-structured interview, and carries out fieldwork by personally experiencing the life of extras to study the ecological environment of the different actor industries and the professional mentality of extras. Before participating in the study, every participant would be offered an Informed Consent Form and all particpants were guaranteed anonymity and their response will be used for a specific academic study. The Ethics Committee of the Zhejiang Normal University's, Specific academic study that will be published online. College of Teacher Education approved the study and participation of concents under 18 and the study followed the Declaration of Helsinki. Results: There are gaps in social support.Little relevant policy support and financial support have not been implemented. Industry assessment criteria are not standardized.The level of digital management is low.It is difficult to guarantee the rights of mass actors. Conclusion: Implement a precise assessment system,develop a refined talent evaluation mechanism,Ensure the accuracy and transparency of the evaluation process.Establish digital service platforms,provide a new channel for the employment of artistic talents.Strengthen media publicity,strengthen policy support,raise social awareness.

Critical Trio Exome Benefits In-Time Decision-Making for Pediatric Patients With Severe Illnesses.

OBJECTIVES: Critical illnesses caused by undiagnosed genetic conditions are challenging in PICUs. Whole-exome sequencing is a powerful diagnostic tool but usually costly and often fail to arrive at a final diagnosis in a short period. We assessed the feasibility of our whole-exome sequencing as a tool to improve the efficacy of rare diseases diagnosis for pediatric patients with severe illness. DESIGN: Observational analysis. METHOD: We employed a fast but standard whole-exome sequencing platform together with text mining-assisted variant prioritization in PICU setting over a 1-year period. SETTING: A tertiary referral Children's Hospital in Taiwan. PATIENTS: Critically ill PICU patients suspected of having a genetic disease and newborns who were suspected of having a serious genetic disease after newborn screening were enrolled. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Around 50,000 to 100,000 variants were obtained for each of the 40 patients in 5 days after blood sampling. Eleven patients were immediately found be affected by previously reported mutations after searching mutation databases. Another seven patients had a diagnosis among the top five in a list ranked by text mining. As a whole, 21 patients (52.5%) obtained a diagnosis in 6.2 ± 1.1 working days (range, 4.3-9 d). Most of the diagnoses were first recognized in Taiwan. Specific medications were recommended for 10 patients (10/21, 47.6%), transplantation was advised for five, and hospice care was suggested for two patients. Overall, clinical management was altered in time for 81.0% of patients who had a molecular diagnosis. CONCLUSIONS: The current whole-exome sequencing algorithm, balanced in cost and speed, uncovers genetic conditions in infants and children in PICU, which helps their managements in time and promotes better utilization of PICU resources.

Osthole, a potential antidiabetic agent, alleviates hyperglycemia in db/db mice.

Osthole is an agent isolated from Cnidium monnieri (L.) Cusson and Angelica pubescens and has been used to treat several diseases, including metabolic syndromes. To investigate the hypoglycemic effects of osthole in diabetic db/db mice and the underlying mechanisms of these effects by in vitro assay, diabetic db/db mice and cell experiments were utilized to understand its possible effects. Osthole significantly activated both PPARalpha and PPARgamma in a dose-dependent manner based on the results of the transition transfection assay. The activation of PPARalpha and PPARgamma by osthole also resulted in an increase in the expression of PPAR target genes such as PPAR itself, adipose fatty acid-binding protein 2, acyl-CoA synthetases, and carnitine palmitoyltransferase-1A. In vitro results suggested that osthole might be a dual PPARalpha/gamma activator, but its chemical structure differed from that of the thiazolidinedione class of antidiabetic drugs. In addition, osthole markedly activated the AMP-activated protein kinase and its downstream acetyl CoA carboxylase molecules by increasing their phosphorylation levels. Finally, obese diabetic db/db mice were treated with osthole by different administered routes, and osthole was found to markedly reduce blood glucose level. Interestingly, osthole did not reduce the blood insulin or lipid levels, two phenomena that did occur in animals treated with insulin sensitizers like PPAR agonists. These results suggest that osthole can alleviate hyperglycemia and could be potentially developed into a novel drug for treatment of diabetes mellitus.