Self-Priming Cyclic Amplification Accelerating CRISPR Sensor for Sensitive and Specific MicroRNA Analysis with No Background.

In this work, we demonstrate for the first time the application of the phosphorothioated-terminal hairpin formation and self-priming extension (PS-THSP) reaction for miRNA assays. A self-priming amplification accelerating CRISPR sensor was well-established for sensitive and specific miRNA detection by integrating the PS-THSP reaction and CRISPR/Cas12a system. The sensor consists of three steps: (1) the formation of a complete PS-THSP template in the presence of target miRNA and ligase; (2) the exponential isothermal amplification of the PS-THSP reaction under the action of DNA polymerase; (3) the activation of the CRISPR/Cas12a fluorescence system to generate signals. We used miR-21 as a model target. The sensor can achieve sensitive detection of miR-21 without the involvement of any primers, and the special design of the CRISPR proto-spacer neighbor motif (PAM) sequence effectively avoids the interference of the background signal. In addition, the sensor can not only identify single-base mutant homologous sequences but also show stable performance in complex biological matrices. We have successfully used this sensor to accurately analyze miR-21 in different cell lines and real clinical samples, demonstrating its great potential in clinical diagnosis.

Asymmetrically split DNAzyme-based colorimetric and electrochemical dual-modal biosensor for detection of breast cancer exosomal surface proteins.

Exosomal surface proteins are potentially useful for breast cancer diagnosis and awareness of risk. However, some detection techniques involving complex operations and expensive instrumentation are limited to advance to clinical applications. To solve this problem, we develop a dual-modal sensor combining naked-eye detection and electrochemical assay of exosomal surface proteins from breast cancer. Most of existing sensors rely on aptamers recognizing exosomes and generating amplified signals at the same time, which require well-designed aptamer probes to avoid difficulties in identifying exosomes. In our work, aptamers not bound by the exosomes can serve as complete templates to induce formation of G quadruplexes. The peroxidase activity of the G-quadruplex/hemin DNAzyme catalyze substrates can generate both color and electrochemical signals. The developed dual-modal sensor offers a remarkable capability to differentiate nonmetastatic, metastatic breast cancer patients, and healthy individuals through the analysis of exosomal surface proteins. The sensor's distinctive features, including its universality, simplicity, and cost-effectiveness, position it as a promising diagnostic tool in breast cancer research and clinical practice.

Triple Amplification Strategy of CHA-PER-DNAzyme for Ultrasensitive Detection of circRNA Associated with Hepatocellular Carcinoma.

Biological and clinical studies have indicated that aberrant expression of circMTO1 served as a crucial biomarker for the diagnosis and prognosis of hepatocellular carcinoma (HCC) patients as well as a potential therapeutic target. However, the detection of circRNAs currently faces challenges such as homologous linear RNA interference and low-expression abundance of certain circRNAs. Therefore, we developed a triple amplification method based on catalytic hairpin assembly (CHA) activation by back-splice junction (BSJ), resulting in CHA products that triggered primer exchange reaction to generate DNAzyme. Subsequently, DNAzyme cleaved the fluorescent reporter chain, enabling ultrasensitive detection of hepatocellular carcinoma-associated circMTO1 through the output fluorescence signal. The catalytic hairpin opening sequence within CHA specifically targeted the BSJ sequence in circRNA, thereby avoiding false positive signals observed in circRNA assays due to the recognition of homologous linear RNA molecules. Moreover, this triple amplification method facilitated sensitive detection of circRNA and addressed the issue of low-abundance expression levels associated with circMTO1 in HCC samples. Notably, our newly designed assay for detecting circRNA exhibited a linear range from 1 fM to 100 nM with a detection limit of 0.265 fM. Furthermore, it demonstrated excellent and consistent performance even within complex systems. Our proposed method enabled the specific and sensitive detection of circMTO1 in various cancer cells and blood samples from HCC patients, providing an innovative approach for investigating the role of circRNA in tumorigenesis and development while promoting its clinical application.

Transpiration rates decline under limited moisture supply along hillslopes in a humid karst terrain.

Topographic positions can mediate subsurface water availability, but its effects on tree transpiration are controversial. In humid karst regions, climax forests are usually not limited by moisture supply, even at the summit, through absorbing water from deep layers. However, little is known on the transpiration pattern and its limiting factor on the shrubland widely distributed along the karst hillslopes. In the current study, Rhus chinensis, a widely spread constructive species in natural restoration was selected. Meteorological factors, 0-300 cm soil-epikarst moisture, sap flow, and root water uptake were studied during an entire growing season to assess how hillslope positions affected transpiration. We found the mean water content in uphill was only around 60 % of that in downhill, indicating a contrasting water supply along the slope. However, there were no significant differences in the xylem isotopic composition and lc-excess which suggested the similar water uptake strategies in both uphill and downhill. R. chinensis primarily relied on the soil water rather than epikarst water (groundwater) along the hillslope because of the MixSIAR model results and more negative lc-excess values (-13.18 ‰). R. chinensis exhibited decreases of nearly half in the transpiration rate and amount in uphill compared to those in downhill. In downhill with sufficient water availability, transpiration followed the variation in atmospheric water demand. In uphill, a poor moisture supply limited tree transpiration and its response to atmospheric water demand. Our findings revealed that the early successional species did not entirely depend on atmospheric water demand, absorbing deep epikarst water as the mature forest. The transpiration rates of those species declined by nearly half to adapt to the water-limited environment along the hillslope in the humid karst region. This study can contribute to the evaluation of eco-hydrological functions during natural restoration.

Long Non-Coding RNA Detection Based on Multi-Probe-Induced Rolling Circle Amplification for Hepatocellular Carcinoma Early Diagnosis.

Long non-coding RNAs (lncRNAs) played vital roles in physiological and pathological conditions. Consistent results from cell experiments, animal experiments, and clinical studies suggested that lncRNA HULC was an oncogenic lncRNA serving as a potential diagnostic and prognostic marker of hepatocellular carcinoma. In this study, we developed a fluorescent biosensor for lncRNA HULC detection based on rolling circle amplification (RCA) induced by multi-primer probes. Multiple primer probes can not only combine with lncRNA to break its secondary structure, which was conducive to lncRNA captured by Y-shaped probes, but also trigger multiple RCA reactions to achieve signal amplification and the goal of sensitive detection of lncRNA. Compared to previous detection methods, in this scheme, we took advantage of the long sequence characteristics of lncRNA to make it a carrier that can bind multiple primers to initiate RCA. This newly designed biosensor provided a linear range from 1 pM to 100 nM with a detection limit of 0.06 pM. This method can provide a new idea for the application of isothermal amplification in detecting lncRNA. Furthermore, the application of the biosensor in liver cancer cell lines and whole blood samples from hepatocellular carcinomatosis patients also confirmed that the method had good selectivity and sensitivity to lncRNA HULC. This method offered a new way for transforming specific lncRNA into clinical application for diagnosis, prognosis, or predicting treatment response.

Physical training dedicated to table tennis athletes / Treinamento físico dedicado aos atletas de tênis de mesa / Entrenamiento físico dedicado a los deportistas de tenis de mesa

ABSTRACT Introduction Table tennis is an explosive metabolic anaerobic sport of moderate intensity. Improving the level of its athletes depends on dedicated physical training methods. The Chinese state has invested more financial support for physical training believing in the effective possibility to improve the physical fitness and abilities of its table tennis athletes. Objective This study aims to analyze the effect of special physical training on table tennis players' motor skills Methods This paper selects several table tennis players as research subjects. The volunteers were randomly divided into experimental and control groups. The experimental group adopted the exclusive physical training method. The control group underwent traditional training. Mathematical, statistical and experimental methods were used to analyze the impact of exclusive physical training on the motor skills of table tennis players. Results The test scores of the experimental group were significantly improved after four weeks and six weeks of exclusive physical training (P<0.01). There was no significant change in the three diagnostic test scores in the control group (P>0.05). After six weeks of a physical training intervention in the experimental group, the 0-score group disappeared. The distribution of the scores of the athletes gradually converges to the highest group. Conclusion Table tennis players showed good feedback on the functional intervention training protocol. Dedicated physical training positively affects the mastery, dexterity and skill in movement techniques of table tennis players. This work can provide a theoretical basis for scientific training of table tennis players. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução O tênis de mesa é um esporte anaeróbico metabólico explosivo de intensidade moderada. A melhoria do nível de seus atletas depende de métodos de treinamento físico dedicados. O estado chinês investiu mais apoio financeiro para o treinamento físico acreditando na efetiva possibilidade de aprimorar a aptidão física e as habilidades dos seus atletas de tênis de mesa. Objetivo Este estudo visa analisar o efeito do treinamento físico especial sobre as habilidades motoras dos jogadores de tênis de mesa Métodos Este trabalho seleciona vários jogadores de tênis de mesa como objetos de pesquisa. Os voluntários foram divididos aleatoriamente em grupos experimental e controle. O grupo experimental adotou o método exclusivo de treinamento físico. O grupo de controle foi submetido a um treinamento tradicional. Utilizou-se métodos matemáticos, estatísticos e experimentais para analisar o impacto do treinamento físico exclusivo sobre as habilidades motoras dos jogadores de tênis de mesa. Resultados Os resultados dos testes do grupo experimental foram significativamente aprimorados após quatro semanas e seis semanas de treinamento físico exclusivo (P<0,01). Não houve mudança significativa nas três pontuações dos testes de diagnóstico no grupo de controle (P>0,05). Após seis semanas de uma intervenção de treinamento físico no grupo experimental, o grupo de 0 pontos desapareceu. A distribuição das pontuações dos atletas converge gradualmente para o grupo mais elevado. Conclusão Os jogadores de tênis de mesa apresentaram um bom retorno sobre o protocolo de treinamento de intervenção funcional. O treinamento físico dedicado afeta positivamente o domínio, destreza e habilidade nas técnicas de movimentação dos jogadores de tênis de mesa. Este trabalho pode fornecer uma base teórica para o treinamento científico dos jogadores de tênis de mesa. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción El tenis de mesa es un deporte anaeróbico metabólico explosivo de intensidad moderada. La mejora del nivel de sus atletas depende de los métodos de entrenamiento físico específicos. El Estado chino ha invertido más apoyo financiero en el entrenamiento físico creyendo en la posibilidad efectiva de mejorar la forma física y las habilidades de sus atletas de tenis de mesa. Objetivo Este estudio tiene como objetivo analizar el efecto del entrenamiento físico especial en las habilidades motoras de los jugadores de tenis de mesa Métodos Este trabajo selecciona a varios jugadores de tenis de mesa como objetos de investigación. Los voluntarios se dividieron aleatoriamente en grupos experimentales y de control. El grupo experimental adoptó el método de entrenamiento físico exclusivo. El grupo de control fue sometido a un entrenamiento tradicional. Se utilizaron métodos matemáticos, estadísticos y experimentales para analizar el impacto del entrenamiento físico exclusivo en las habilidades motoras de los jugadores de tenis de mesa. Resultados Las puntuaciones de las pruebas del grupo experimental mejoraron significativamente tras cuatro y seis semanas de entrenamiento físico exclusivo (P<0,01). No hubo cambios significativos en las puntuaciones de las tres pruebas de diagnóstico en el grupo de control (P>0,05). Tras seis semanas de intervención de entrenamiento físico en el grupo experimental, el grupo de puntuación 0 desapareció. La distribución de las puntuaciones de los atletas converge gradualmente hacia el grupo más alto. Conclusión Los jugadores de tenis de mesa mostraron una buena respuesta al protocolo de entrenamiento de intervención funcional. El entrenamiento físico dedicado afecta positivamente a la maestría, la destreza y la habilidad en las técnicas de movimiento de los jugadores de tenis de mesa. Este trabajo puede proporcionar una base teórica para el entrenamiento científico de los jugadores de tenis de mesa. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Universal and Flexible Signal Transduction Module Based on Overload Triggering Probe Escape for Sensitive Detection of Tau Protein.

Aptamer-based methods have attracted increasing interest due to flexible engineering, but their generality is limited by the heterogeneity of signal transduction mechanisms. Given the fact that nonlinear and large molecules are more likely to make the nanosurface overloaded, we investigated a novel signal transduction process to extend the application of aptasensors. In this work, an aptamer complementary element (ACE) is designed with a primer region to serve as the signal probe, which can fully hybridize with an aptamer and be separated by magnetic beads (MBs). Upon target binding, the formed aptamer/target complex is much larger than the linear aptamer/ACE-primer dimer, causing overload of MBs on account of steric hindrance. An extra aptamer/ACE-primer can escape from the surface to the supernatant, which can be amplified by a catalytic hairpin assembly (CHA) circle. The size-dependent signal transduction and the modular design endow the method with high generality and flexibility for protein analysis. The proposed aptasensor was successfully applied to the detection of tau proteins ranging from 0.5 to 1000 ng mL-1 with a limit of detection (LOD) as low as 0.254 ng mL-1. The recovery tests in both human serum and cerebra spinal fluid confirmed the high accuracy and stability. Furthermore, a successful distinction was made between AD patients and healthy controls by the method, suggesting the possible applicability for practical analysis of tau proteins.

Highly Sensitive Detection of the Immune Checkpoint PD-L1-Positive Circulating Tumor Cells Based on Steric Hindrance.

Programmed-death ligand 1 (PD-L1), as one of major immune checkpoints, is highly expressed on cancer cells and participates in the immune escape process of tumor cells. The level of PD-L1 in patients is closely related to the efficacy of anti-PD-L1 immunotherapy, and patients with a high level have better response to immunotherapy. Therefore, PD-L1 can be an indicator of patient classification and medication guidance. In this work, we have developed a novel strategy for detecting PD-L1-positive circulating tumor cells based on steric hindrance generated after cell capture, using the primer exchange reaction (PER) amplification method. The principle is to modify a single strand containing the PD-L1 aptamer and the PER primer on the electrode surface. When PD-L1-positive circulating tumor cells exist, the aptamer will capture them. The steric hindrance generated by the captured cells due to their large volume hinders the subsequent approach of PER materials, thus hindering the occurrence of PER signal amplification. The number of HRP bound to the electrode surface is reduced, and the current signal output is inversely proportional to the number of captured cells. This method realizes convenient and sensitive detection of PD-L1-positive tumor cells and provides a new means for clinical judgment of whether patients should adopt immunotherapy.

Dapagliflozin Attenuates Sympathetic and Pressor Responses to Stress in Young Prehypertensive Spontaneously Hypertensive Rats.

BACKGROUND: SGLT2i (sodium-glucose cotransporter 2 inhibitor), a class of anti-diabetic medications, is shown to reduce blood pressure (BP) in hypertensive patients with type 2 diabetes. Mechanisms underlying this action are unknown but SGLT2i-induced sympathoinhibition is thought to play a role. Whether SGLT2i reduces BP and sympathetic nerve activity (SNA) in a nondiabetic prehypertension model is unknown. METHODS: Accordingly, we assessed changes in conscious BP using radiotelemetry and alterations in mean arterial pressure and renal SNA during simulated exercise in nondiabetic spontaneously hypertensive rats during chronic administration of a diet containing dapagliflozin (0.5 mg/kg per day) versus a control diet. RESULTS: We found that dapagliflozin had no effect on fasting blood glucose, insulin, or hemoglobin A1C levels. However, dapagliflozin reduced BP in young (8-week old) spontaneously hypertensive rats as well as attenuated the age-related rise in BP in adult spontaneously hypertensive rat up to 17-weeks of age. The rises in mean arterial pressure and renal SNA during simulated exercise (exercise pressor reflex activation by hindlimb muscle contraction) were significantly reduced after 4 weeks of dapagliflozin (Δmean arterial pressure: 10±7 versus 25±14 mm Hg, Δrenal SNA: 31±17% versus 68±39%, P<0.05). Similarly, rises in mean arterial pressure and renal SNA during mechanoreflex stimulation by passive hindlimb stretching were also attenuated by dapagliflozin. Heart weight was significantly decreased in dapagliflozin compared with the control group. CONCLUSIONS: These data demonstrate a novel role for SGLT2i in reducing resting BP as well as the activity of skeletal muscle reflexes, independent of glycemic control. Our study may have important clinical implications for preventing hypertension and hypertensive heart disease in young prehypertensive individuals.

A simple and rapid method to assay SARS-CoV-2 RNA based on a primer exchange reaction.

A simple method is proposed in this work for the detection of SARS-CoV-2 RNA based on a primer exchange reaction (PER). By ingeniously integrating the PER cascade and CRISPR/cas12a system, this method can achieve convenient detection of the target RNA in 40 min and distinguish a single-base mutation from the target sequence, demonstrating its superior analytical performance.

Dual aptamer recognition-based G-quadruplex nanowires to selectively analyze cancer-derived exosomes.

Cancer-derived exosomes have emerged as a valuable biomarker for cancer diagnosis and prognosis. However, the heterogeneity of exosomes often leads to low selectivity based on the single recognition method. Given this, we have developed a dual-aptamer recognition strategy based on G-quadruplex nanowires for selective analysis of exosomes. In this work, target exosomes were first captured by CD63 aptamers modified on magnetic beads (MBs) and then combined with AS1411 aptamer, which shows high binding affinity to nucleolin when forming stable G-quadruplex structure. Then the free myc monomer can spontaneously assemble into higher order G-wire superstructures on the allosteric AS1411, and resulting enhanced fluorescence signal, which can realize sensitive and specific analysis of the target exosomes. This dual-aptamer recognition-based method is simple and universal for different types of exosomes, which is of great significance for clinical cancer diagnosis.

Differential effects of eplerenone versus amlodipine on muscle metaboreflex function in hypertensive humans.

Numerous studies have demonstrated that sympathetic nervous system overactivation during exercise in hypertensive rodents and humans is due, in part, to an exaggerated reflex response known as the exercise pressor reflex. Our prior studies have implicated a key role of mineralocorticoid receptor activation in mediating an augmented exercise pressor reflex in spontaneously hypertensive rats, which is mitigated by blockade with eplerenone. However, the effect of eplerenone on exercise pressor reflex has not been assessed in human hypertension. Accordingly, the authors performed a randomized crossover study to compare the effects of eplerenone to another antihypertensive drug from a different class amlodipine on sympathetic nerve activity (SNA) in 14 patients with uncomplicated hypertension. The authors found that amlodipine unexpectedly augmented the increase in SNA during the second minute of isometric handgrip, which persisted into the post-exercise circulatory arrest period (∆ SNA, from rest of 15 ± 2 vs. 9 ± 2 vs. 10 ± 2 bursts/min, amlodipine vs. baseline vs. eplerenone, respectively, p < .01), suggesting an exaggerated muscle metaboreflex function. Eplerenone did not alter sympathetic responses to exercise or post-exercise circulatory arrest in the same hypertensive individuals. In conclusions, our studies provide the first direct evidence for a potentially unfavorable potentiation of muscle metaboreflex by amlodipine during isometric handgrip exercise in hypertensive patients whereas eplerenone has no significant effect. Our study may have clinical implications in terms of selection of antihypertensive agents that have the least detrimental effects on sympathetic neural responses to isometric exercise.

Biomimetic recognition strategy for efficient capture and release of circulating tumor cells.

Efficient capture and release of circulating tumor cells play an important role in cancer diagnosis, but the limited affinity of monovalent adhesion molecules in existing capture technologies leads to low capture efficiency, and the captured cells are difficult to be separated. Inspired by the phenomenon that the long tentacles of jellyfish contain multiple adhesion domains and can effectively capture moving food, we have constructed a biomimetic recognition strategy to capture and release tumor cells. In details, gold-coated magnetic nanomaterials (Au@Fe3O4 NPs) were first prepared and characterized by scanning electron microscopy, UV-vis absorption spectra, and Zeta potential. Then, the DNA primers modified on Au@Fe3O4 nanoparticles can be extended to form many radialized DNA products by rolling circle amplification. These long DNA products resemble jellyfish tentacles and contain multivalent aptamers that can be extended into three dimensions to increase the accessibility of target cells, resulting in efficient, simple, rapid, and specific cells capture. The capture efficiencies are no less than 92% in PBS buffer and 77% in blood. Subsequently, DNase I was selected to degrade biomimetic tentacles to release the captured tumor cells with high viability. This release strategy can not only improve cell viability, but also reduce a tedious release process and unnecessary costs. We believe that the proposed method can be expanded for the capture and release of various tumor cells and will inspire the development of circulating tumor cells analysis. A biomimetic recognition strategy for capture and release of circulating tumor cells has been developed. This method modified specific P1 DNA primers on Au@Fe3O4 NPs to form many radialized DNA products by rolling circle amplification. These products can efficiently capture CTCs since it contains multiple aptamers with a multivalent binding capacity. This make it a promising tool to capture and release of other tumor cells, and will inspire the development of CTC analysis.

Less Social Support for Patients With COVID-19: Comparison With the Experience of Nurses.

Context: Since December 2019, more than 80,000 patients have been diagnosed with coronavirus disease 2019 (COVID-19) in China. Social support status of COVID-19 patients, especially the impact of social support on their psychological status and quality of life, needs to be addressed with increasing concern. Objectives: In this study, we used social support rating scale (SSRS) to investigate the social support in COVID-19 patients and nurses. Methods: The present study included 186 COVID-19 patients at a Wuhan mobile cabin hospital and 234 nurses at a Wuhan COVID-19 control center. Responses to a mobile phone app-based questionnaire about social support, anxiety, depression, and quality of life were recorded and evaluated. Results: COVID-19 patients scored significantly lower than nurses did on the Social Support Rating Scale (SSRS). Among these patients, 33.9% had anxiety symptoms, while 23.7% had depression symptoms. Overall SSRS, subjective social support scores and objective support scores of patients with anxiety were lower than those of patients without anxiety. This result was also found in depression. In addition, all dimensions of social support were positively correlated with quality of life. Interestingly, in all dimensions of social support, subjective support was found to be an independent predictive factor for anxiety, depression, and quality of life, whereas objective support was a predictive factor for quality of life, but not for anxiety and depression via regression analysis. Conclusion: Medical staffs should pay attention to the subjective feelings of patients and make COVID-19 patients feel respected, supported, and understood from the perspective of subjective support, which may greatly benefit patients, alleviate their anxiety and depression, and improve their quality of life.

Development of a two-in-one integrated assay for the analysis of circRNA-microRNA interactions.

The competitive endogenous RNA hypothesis is a new mechanism of RNA dialogue, in which circRNA-miRNA interaction (cmRRI) is found to be widely involved in the regulation of gene expression in tumors and other diseases. It is urgent but challenging to develop a convenient and efficient method to study the interaction between target circRNA and the candidate miRNAs. In this work, a biosensing method that allows directly analyzing cmRRI has been developed, so as to reveal the RNA dialogue strategy. The sensing system uses a bifunctional magnetic bead for the capture of target circRNA/miRNA complex as well as the signal amplification. Based on the nature of circRNA as a miRNA sponge, only if the target circRNAs and its regulatory miRNAs coexist as a complex, can the rolling circle amplification reaction be initiated to give a fluorescent signal as the output. Compared with traditional methods where the circRNA and its regulatory miRNAs have been separately analyzed, our design allows the integrated profiling of specific cmRRI by correlation characterization of two correlative RNAs, which represents a function-oriented method. The presented method also shows the analysis of the potential binding affinity of candidate miRNAs to target circRNAs. Furthermore, we have verified the ability of the sensor to directly detect cmRRI in biological samples, which reveals the promising applicability of this method for biomedical and clinical researches in the future.

Detection of severe hypertension in a patient with neurofibromatosis type 1 during anesthesia induction: a case report.

BACKGROUND: Neurofibromatosis type 1 has a higher prevalence of pheochromocytoma and paraganglioma than the general population: 1.0-5.7% versus 0.2-0.6%. Currently, there are no generally accepted guidelines for screening for pheochromocytoma and paragangliomas in asymptomatic patients with neurofibromatosis type 1. CASE PRESENTATION: Severe hypertension developed during anesthesia induction in our patient, a 44-year-old Chinese man with neurofibromatosis type 1. We screened for catecholamine level after glioma resection, and the patient was diagnosed with combined pheochromocytoma and paraganglioma. CONCLUSIONS: A delay in diagnosis or lack of a diagnosis in pheochromocytoma and paraganglioma may increase the perioperative morbidity and mortality risk due to excess catecholamine secretion. Therefore, routine pheochromocytoma and paraganglioma screening preoperatively in patients with neurofibromatosis type 1 is very important.

Ropivacaine wound infiltration: a fast-track approach in patients undergoing thoracotomy surgery.

BACKGROUND: Postoperative pain impairs enhanced recovery in patients after various surgeries. Local use of ropivacaine has become an effective strategy for postoperative pain management. The aim of this study was to assess the effectiveness and safety of wound infiltration with ropivacaine for postoperative analgesia as a fast-track approach in patients undergoing thoracotomy surgery. MATERIALS AND METHODS: Forty adult patients with esophageal cancer scheduled for selective thoracotomy surgery were enrolled in this double-blind, randomized, controlled study. Patients were randomized (1:1) to receive ropivacaine or placebo wound infiltration before incision closure. Numerical rating score (NRS), postoperative analgesics consumption, length of hospital stay, time to anal exsufflation, defecation, ambulation, and patient satisfaction scores were recorded. Side effects including allergic reaction, nausea, vomiting, wound infection, and pneumonia were also assessed. RESULTS: NRS was significantly decreased in the ropivacaine group with less consumption of postsurgery analgesics. The ropivacaine group also showed shorter postoperative hospital stays, earlier anal exsufflation and ambulation, and higher patient satisfaction scores. However, there were no significant differences between the two groups regarding time of defecation. No allergic reactions occurred in either group. The incidences of nausea, vomiting, wound infection, and pneumonia were similar. CONCLUSIONS: The present study showed that ropivacaine wound infiltration could be a safe and effective fast-track approach for patients undergoing thoracotomy surgery.

Repeated Neonatal Sevoflurane Exposure-Induced Developmental Delays of Parvalbumin Interneurons and Cognitive Impairments Are Reversed by Environmental Enrichment.

Parvalbumin (PV) interneurons are critically involved in the cognitive processes. Based on prior investigations that environmental enrichment reverses impaired cognition after anesthetic exposure, we proposed that environmental enrichment protects PV interneurons and thereby improves sevoflurane-induced cognitive impairments. Six-day-old C57BL/6 male mice were exposed to 3 % sevoflurane or 30 % oxygen/air 2 h daily for 3 days from postnatal day 6 (P6) to P8. The mice were randomly allocated to an enriched environment for 2 h daily between P8 and P90 or a standard environment. Western blotting and immunofluorescence were used for determining PV expression in the prefrontal cortex and hippocampus. In another set of experiments, cognitive tests were assessed by the open field test (P41), Morris water maze test (P54-60), and fear conditioning tests (P42-43 and P89-90). Exposure of neonatal mice to sevoflurane resulted in a reduced freezing response in the contextual test at P43 but not P90. The PV expression in these mice was decreased at P9, P14, P28, and P42, but not at ≥P60. No colocalization of caspase-3 and 5-bromo-2-deoxyuridine or caspase-3 and PV was observed, suggesting that caspase-independent pathways may be involved in the mediation of sevoflurane-induced down-regulation of PV. The sevoflurane-exposed mice that were placed in an enriched environment exhibited normal behavior and had PV interneurons that did not differ from those in the control mice at P42-43. Neonatal sevoflurane exposure induces a reduced freezing response in the contextual test at P43 and developmental delays in PV interneurons in the prefrontal cortex and hippocampus. Placement of the sevoflurane-exposed mice in an enriched environment can prevent these abnormalities.

Effects of Potassium Magnesium Citrate Supplementation on 24-Hour Ambulatory Blood Pressure and Oxidative Stress Marker in Prehypertensive and Hypertensive Subjects.

Diet rich in fruits, vegetables, and dairy products, known as the Dietary Approaches to Stop Hypertension (DASH) diet, is known to reduce blood pressure (BP) in hypertensive patients. More recently, the DASH diet was shown to reduce oxidative stress in hypertensive and nonhypertensive humans. However, the main nutritional components responsible for these beneficial effects of the DASH diet remain unknown. Because the DASH diet is rich in potassium (K), magnesium (Mg), and alkali, we performed a randomized, double-blinded, placebo-controlled study to compare effects of potassium magnesium citrate (KMgCit), potassium chloride (KCl), and potassium citrate (KCit) to allow dissociation of the three components of K, Mg, and citrate on 24-hour ambulatory BP and urinary 8-isoprostane in hypertensive and prehypertensive subjects, using a randomized crossover design. We found that KCl supplementation for 4 weeks induced a significant reduction in nighttime SBP compared with placebo (116 ± 12 vs 121 ± 15 mm Hg, respectively, p <0.01 vs placebo), whereas KMgCit and KCit had no significant effect in the same subjects (118 ± 11 and 119 ± 13 mm Hg, respectively, p >0.1 vs placebo). In contrast, urinary 8-isoprostane was significantly reduced with KMgCit powder compared with placebo (13.5 ± 5.7 vs 21.1 ± 10.5 ng/mgCr, respectively, p <0.001), whereas KCl and KCit had no effect (21.4 ± 9.1 and 18.3 ± 8.4, respectively, p >0.1 vs placebo). In conclusion, our study demonstrated differential effects of KCl and KMgCit supplementation on BP and the oxidative stress marker in prehypertensive and hypertensive subjects. Clinical significance of the antioxidative effect of KMgCit remains to be determined in future studies.

miR-696 plays a role in hepatic gluconeogenesis in ob/ob mice by targeting PGC-1α.

MicroRNAs (miRNAs or miRs) are known to play a vital role in type 2 diabetes, and peroxisome proliferator-activated receptor-γ (PPARγ) coactivator-1α (PGC-1α) is involved in the pathogenesis of hepatic insulin resistance. However, the correlation, if any, between PGC-1α and miRNAs in the disease has not yet been determined. Thus, in the present study, we aimed to examine the correlation between PGC-1α and miRNAs in diabetes. For this purpose, we used primary hepatocytes isolated from C57BL/6 mice and ob/ob mice. First, we found an inverse correlation between miR­696 and PGC-1α protein levels in vivo. Second, in vitro evidence demonstrated that PGC-1α expression was significantly decreased by infection with pre-miR­696-LV, whereas infection with anti-miR­696-LV increased the PGC-1α protein levels. Third, a luciferase reporter assay confirmed that miR­696 directly recognizes a specific location within the 3'-untranslated region of PGC-1α transcripts. Furthermore, the biological consequences of miR­696 targeting PGC-1α were determined by measuring the expression levels of the characteristic hepatic gluconeogenic enzyme, PEPCK, which is regulated by PGC-1α in the liver via the coactivation of transcription factors. Taken together, our findings demonstrate that miR­696 plays an important role in the development of hepatic gluconeogenesis and insulin resistance through the inhibition of PGC-1α translation in the liver.