Effect of esketamine on haemodynamic fluctuations in patients undergoing hysteroscopic surgery: A prospective, double-blind randomized clinical trial.

AIMS: We explored whether esketamine anesthesia during hysteroscopic surgery can reduce intraoperative hemodynamic fluctuations and improve patient benefit. METHODS: A total of 170 patients undergoing hysteroscopic surgery were enrolled, and 151 patients were finally included in the analysis, among which 19 used vasoactive drugs during surgery. Patients were randomly assigned to either the esketamine anesthesia group (E group) or the sufentanil anesthesia group (S group). The primary outcomes were blood pressure and heart rate during the surgery. Secondary outcomes included resistance to laryngeal mask insertion, demand for propofol and remifentanil, nausea and vomiting, Richmond Agitation and Sedation Scale (RASS), dizziness and pain intensity after resuscitation, vasoactive medication treatment, hospitalization time and expenses. RESULTS: E group had a more stable heart rate, systolic blood pressure, diastolic blood pressure and mean blood pressure than the S group (p < 0.001). Patients in E group had a higher demand for propofol (p < 0.001) but better RASS scores (p < 0.001) after resuscitation. The incidence of intraoperative vasoactive medication use was higher in the S group (18.4% vs. 6.7%, p = 0.029). There were no statistically significant differences in terms of resistance to laryngeal mask insertion, remifentanil demand, time required for resuscitation, postoperative pain, dizziness, nausea or vomiting. CONCLUSIONS: Compared with sufentanil, esketamine-induced anesthesia during hysteroscopic surgery can reduce intraoperative hemodynamic fluctuations and the incidence of intraoperative vasoactive medication. Although esketamine-induced anesthesia may increase the demand for propofol during surgery, it does not affect the anesthesia recovery time and the quality of patient recovery is better.

Control of climate and physiography on runoff response behavior through use of catchment classification and machine learning.

Understanding of runoff response changes (RRC) is essential for water resource management decisions. However, there is a limited understanding of the effects of climate and landscape properties on RRC behavior. This study explored RRC behavior across controls and predictability in 1003 catchments in the contiguous United States (CONUS) using catchment classification and machine learning. Over 1000+ catchments are grouped into ten classes with similar hydrological behavior across CONUS. Indices quantifying RRC were constructed and then predicted within each class of the 10 classes and over the entire1000+ catchments using two machine learning models (random forest and CUBIST) based on 56 indicators of catchment attributes (CA) and 16 flow signatures (FS). This enabled the ranking of the important influential factors on RRC. We found that (i) CA/FS-based clusters followed the ecoregions over CONUS, and the impact of climate on RRC seemed to overlap with physiographic attributes; (ii) CUBIST outperforms the random forest model both within the cluster and over the whole domain, with a mean improvement of 39 % (depending on clusters) within clusters. Runoff sensitivity was better predicted than runoff changes; (iii) FS related to runoff ratio, average, and high flow are the most important for RRC, whereas climate (evaporation and aridity) is a secondary factor; and (iv) RRC patterns are substantial in the dominant factor space. High total changes and catchment characteristic-induced changes occurred mainly at 100°west longitude. The elasticity of climate and catchment characteristics was found to be high in spaces with high evaporation and low runoff ratios and low in spaces with low evaporation and high runoff ratios. Uncertainties existed in the number of catchments between clusters which was verified using a fuzzy clustering algorithm. We recommend that future research that clarifies the impact of uncertainty on hydrological or catchment behavior should be conducted.

Curcumin Alleviates ß Amyloid-Induced Neurotoxicity in HT22 Cells via Upregulating SOD2.

Curcumin protects neuronal cells exposed to ß amyloid (Aß); the mechanism, however, is still obscure. The aim of this study is to determine whether the type 2 superoxide dismutase (SOD2) mediates curcumin-induced protective effects in Aß-treated neuronal cells. In this study, the HT22 neuronal cells were exposed to Aß to imitate neuronal injury in Alzheimer's disease (AD). After 24-h treatment, 10 µM Aß decreased cell viability and mitochondrial functions, including mitochondrial complex activities and mitochondrial membrane potential (MMP), and also downregulated anti-oxidants SOD2, glutathione (GSH), and catalase (CAT) levels (P < 0.05), meanwhile, increased lactic dehydrogenase (LDH) release, apoptosis level, intracellular reactive oxygen species (ROS) and mitochondrial superoxide accumulation (P < 0.05). And, co-administration of 1 µM curcumin significantly reduced the Aß-induced cell injury and oxidative damage above (P < 0.05). Downregulating SOD2 by using small interfering RNA (siRNA), however, significantly abolished the curcumin-induced protective and anti-oxidative effects in HT22 cells (P < 0.05); the scramble (SC)-siRNA did not cause marked effects on the curcumin-induced protective effects (P > 0.05). These findings showed that curcumin can alleviate Aß-induced injury in neuronal cells, and SOD2 protein may mediate the neuroprotective effects.

Risk factors for HIV/syphilis infection and male circumcision practices and preferences among men who have sex with men in China.

OBJECTIVE: To investigate factors associated with HIV infection and the frequency and willingness of male circumcision among men who have sex with men (MSM) in Chengdu city, China. METHODS: A cross-sectional survey provided information on participants' demographics, risk behaviors, circumcision, and uptake of HIV prevention services. RESULTS: Of 570 participants, 13.3% were infected with HIV and 15.9% with syphilis. An estimated 43.0% of respondents reported having unprotected receptive anal intercourse, and 58.9% reported having ≥2 male sexual partners in the past 6 months. Multivariable logistic regression revealed that syphilis, more male sex partners, predominantly receptive anal intercourse, and exclusively receptive male sex were associated with HIV infection. Higher level of education and peer education service were inversely associated with HIV infection. Nearly a fifth (18.0%) of participants were circumcised. More than half of uncircumcised participants expressed willingness to be circumcised. CONCLUSION: This study reveals a high prevalence of HIV and syphilis among MSM in Chengdu province of China. The frequency of unprotected receptive anal intercourse and multiple male sexual partnerships highlight the urgency for an effective comprehensive HIV prevention strategy. Although the willingness to accept male circumcision (MC) is high, further research is needed to assess the protective effective of MC among MSM.

Electrochemiluminescence immunosensor for tumor markers based on biological barcode mode with conductive nanospheres.

A novel sandwich-type electrochemiluminescence (ECL) immunosensor was developed for highly sensitive and selective determination of tumor markers based on biological barcode mode. N-(4-aminobutyl)-N-ethylisoluminol (ABEI) and the second antibody (Ab2) were simultaneously immobilized on conductive nanospheres to construct ABEI/Ab2-CNSs probes, which could form sandwich immunocomplex by Ab2 and emit ECL signals by ABEI. The gold layer coated on the surface of the conductive nanospheres could extend the outer Helmholtz plane (OHP) of the ECL immunosensor effectively. Benefited from it, all ABEI molecules immobilized on conductive nanospheres would act as biological barcode to give in-situ ECL signals without interfering with the activity of the second antibody. In such a case, the sensitivity of the ECL immunosensor would be greatly improved because an antigen molecule would correspond to ECL signals of thousands of ABEI molecules. Using prostate specific antigen (PSA) as a model tumor marker, the ECL intensity was found to increase with the logarithm of PSA concentration with a wide linear range from 0.04 to 10 fg/mL. In addition, specificity, stability, reproducibility, regeneration and application were satisfactory. Therefore, this developed ECL immunosensor has a potential for practical detection of disease-related proteins besides tumor markers in the clinical diagnostics.

Multiplex electrochemiluminescence immunoassay of two tumor markers using multicolor quantum dots as labels and graphene as conducting bridge.

A multiplex electrochemiluminescence (ECL) immunoassay for simultaneous determination of two different tumor markers, alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA), using multicolor quantum dots as labels and graphene as conducting bridge was developed. Herein, a typical sandwich immune complex was constructed on the glass carbon electrode, with QDs525 and QDs625 labeled on secondary anti-AFP and anti-CEA antibodies, respectively, thus to obtain distinguishable ECL signals. Because most of those QDs labeled on secondary antibodies were beyond the space domain of the ECL reaction, graphene was used as a conducting bridge to promote the electron transfer between QDs and the electrode, leading to about 30-fold enhancement of the ECL intensity. Experimental results revealed that the multiplex electrochemiluminescence immunoassay enabled the simultaneous monitoring of AFP and CEA in a single run with a working range of 0.001-0.1 pg/mL. The detection limit (LOD) for both analytes at 0.4 fg/mL was very low. No obvious cross-reactivity was found. Precision, recovery and stability were satisfactory. This novel multiplex ECL immunoassay provided a simple, sensitive, specific and reliable alternative for the simultaneous detection of tumor markers in clinical laboratory.