INTRODUCTION: So far, the recovery quality after general anesthesia is still unsatisfied. Nalmefene is a drug to treat opioid overdose and reverse opioid actions. We aim to investigate the efficacy of nalmefene on optimizing the recovery quality of patients after general anesthesia. METHODS: It is a prospective, placebo-controlled, two-arm parallel groups, multicentre, double-blind, randomized (PPPMDR) clinical trial. The participants (n = 520) will be randomly assigned into two groups. Each patient will receive either: a single dose of nalmefene 0.25 µg/kg in the intervention group, or the same volume of 0.9% NaCl solution in the control group at the end of the surgery. The primary outcome will be the time interval between the end of anaesthesia and recovery endpoints achieved (Aldrete recovery score ≥ 9) in post-anesthesia care unit (PACU). The other variables are the time interval from the end of operation to extubation; Richmond Agitation Sedation Scale (RASS) score at extubation; the time at Montreal Cognitive Assessment Scale (MoCA) orientation score ≥ 5; visual analog scale (VAS) score and adverse effects including postoperative nausea and vomiting (PONV), and pruritus in PACU and 24 h postoperatively. ANALYSIS: This trial aims to study whether small dose of nalmefene can shorten the time from the end of surgery to Aldrete score ≥ 9 and improve opioid-induced side effects.This trial focuses on providing the reliable clinical evidence for satisfactory quality of recovery. ETHICS AND DISSEMINATION: This clinical trial has been approved and supported by the ethics committee of the Renji Hospital, Shanghai Jiaotong University, School of Medicine (KY2020-150); Shanghai Tongren Hospital (2021-030-01);The First Affiliated Hospital of Guangxi Medical University (2021-032); and The First Affiliated Hospital of Zhengzhou University(2021-KY-0495-003). Analysis of the study results will be submitted to a peer-reviewed journal for publication. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04713358, Registered on September 23, 2021.
Anesthesiology , Anesthetics , Drug-Related Side Effects and Adverse Reactions , Humans , Analgesics, Opioid , Prospective Studies , China , Anesthesia, General , Randomized Controlled Trials as Topic , Multicenter Studies as Topic
The neutrophil plays an important role during abdominal aortic aneurysm (AAA) formation by undergoing histone citrullination with peptidyl arginine deiminase 4 (encoded by Padi4) and releasing neutrophil extracellular traps (NETs). However, the specific role of NETs during AAA formation is elusive. We found the levels of NET components in serum and tissues were found to be significantly associated with the clinical outcome of AAA patients. Furthermore, we reported that NETs induced the synthetic and proinflammatory smooth muscle cells (SMCs) phenotype and promoted AAA formation in a Hippo-YAP pathway-dependent manner by in vitro and in vivo experiments. Padi4 or Yap global knockout mice, exhibited significantly less synthetic and proinflammatory phenotypes of SMCs and developed AAA with lower frequency and severity compared with those of controls. Further studies indicated that the phenotypic switch of SMCs was associated with NETs-regulated enrichment status of H3K4me3 and H3K27me3 at promoters of synthetic and proinflammatory genes in SMCs. Cumulatively, these data suggest that NETs contribute to AAA formation by promoting the synthetic and proinflammatory phenotype of SMCs via inhibiting the Hippo-YAP pathway. A better understanding of the molecular mechanisms that regulate NETs and SMC phenotype is important to provide suitable cellular targets to prevent AAA.
Aortic Aneurysm, Abdominal , Extracellular Traps , Animals , Mice , Extracellular Traps/metabolism , Aortic Aneurysm, Abdominal/metabolism , Phenotype , Neutrophils/metabolism , Mice, Knockout , Myocytes, Smooth Muscle/metabolism
Tobacco, Nicotiana tabacum L., is produced largely in China (~1/3 of the global market). In the monsoon summer of 2020, tobacco plant petioles, where axillary buds were removed, became black-rotten, and thick ooze appeared, when squeezed. Lesions encompassed more than half of petiole circumference. Ten tobacco fields (100 plant/field) were investigated in Liuyang, China and 5% disease severity founded in each infected field (Fig. 1A, B, C). Six infected stalks leave of different tobacco were sampled from severe field in Liuyang (N28°21', E113°52') and were surface sterilized (1% sodium hypochlorite for 3 min.), rinsed thrice in sterile distilled water, grounded, and streaked on Luria Bertani agar (LBA). After 24 hours at 28ºC, circular and convex colonies appeared. Hundred colony from ten plates were picked, amplified, and sequenced with the primer 16S-27F/16S-1492R by colony PCR (Lane et al. 1991). 16S rRNA sequence from 100 colony were assembled and fell into two sequences, either similar to Leclercia sp. (86%), or Pantoea sp. (14%). Identification and homology search was done by BLASTn analysis against NCBI and the EzBio Cloud database (Yoon et al. 2017). The Pantoea isolate HN-23 (1,408 bp, MW405831) and the other 16S sequence of 13 Pantoea showed 99.57% identity to the type strain P. endophyitca 596T (PJRT0100022) based on the EzBio Cloud database to identify novel bacteria. Colonies of HN-23 were smooth, translucent, convex with entire margin on LBA, and 1mm and 3mm (diameter), white to yellow, after 24h and 48h (Fig.1 H, I), respectively but white (Fig.1 J, K) on Nutrient Agar (NA). Phenotype of HN-23 (S-1) was performed using API 20E and API ZYM system (bioMérieux, France) and found identical to P. endophytica 596T (Gao et al. 2019). Draft genome of HN-23 (size 4.96Mbp, total Scaffold 79, Scaf N50 218,098bp and Scaf N90 61,041bp) was studied by Illumina sequencing (JAFLWX000000000) and was found to have 98.24% nucleotide identity with the genome of P. endophytica type strain 596. Average nucleotide identity (ANI) values were calculated using Ortho ANIu algorithm (Yoon et al 2017a). HN-23 had 83.89% and 83.65% ANI with P. rodasii LMG26273T and P. dispersa CCUG25232T, respectively (S-2). Six tobacco seedlings (cultivar K326, 30cm height plants grown at greenhouse at 28â and 70-80% humidity) were injected by 20µl of culture (109 CFU/ml) of HN-23 and three with dominant species Leclercia sp. HN-7, and reisolated from infected tissues. Pathogenic tissue extract and sterile water were also used as positive and negative control, respectively and experiments were performed in triplicate. After 20h, symptoms of water-soaked decay appeared in the injected leaf axils (Fig. 1D). After 2 days, a severe rot is developed (Fig.1 E). Though, the controls were symptomless (Fig.1 F, G). The bacterium was then isolated from the rotten tissues and identity was confirmed by 16S rDNA sequencing, thus fulfilling Koch's postulates. This species was also reported as endophytes to be isolated from root, stem and leaf of maize planted in diverse parts of China and identified as P. endophytica. To our knowledge, this is the first report of P. endophytica as a plant pathogen, which was firstly isolated from Tobacco planted in southern China.
Background and Aims: To evaluate endoscopic sedation research and predict research hot spots both quantitatively and qualitatively using bibliometric analysis. Methods: We extracted relevant publications from the Web of Science Core Collection (WoSCC) on 13 December 2020. We examined the retrieved data by bibliometric analysis (e.g., co-cited and cluster analysis, keyword co-occurrence) using the software CiteSpace and VOSviewer and the website of bibliometrics, the Online Analysis Platform of Literature Metrology (http://bibliometric.com/), to analyse and predict the trends and hot spots in this field. Main Results: We identified 2,879 articles and reviews on endoscopic sedation published between 2001 and 2020. Although the overall trend is increasing, with slight fluctuation in some years, there were significant increases in 2007 and 2012. In respect of the contributions on endoscopic sedation research, the United States (US) had the greatest number of publications, and it was followed by Japan and China. In addition, collaboration network analysis revealed that the most frequent collaboration was between the US and China. Six of the top ten most prolific research institutions were located in the US. The most publications on endoscopic sedation research in the past two decades were found primarily in journals on gastroenterology and hepatology. Keyword co-occurrence and co-citation cluster analysis revealed the most popular terms relating to endoscopic sedation in the manner of cluster labels; these included patient anxiety, tolerance, ketamine, propofol, hypoxia, nursing shortage, endoscopic ultrasonography, colorectal cancer, carbon dioxide insufflation, and water exchange (WE). Keyword burst detection suggested that propofol sedation, adverse event, adenoma detection rate (ADR), hypoxemia, and obesity were newly-emergent research hot spots. Conclusions: Our findings showed that hypoxia, adverse event, and ADR, along with conscious sedation and propofol sedation, have been foci of endoscopic sedation research over the past 20 years. The research focus has shifted from sedative drugs to sedative complications and endoscopy quality control, which means that there will be higher requirements and standards for sedative quality and endoscopy quality in the future.
The urchin-like Bi2S3/carbon nanotubes (Bi2S3 urchin/CNTs) composites were successfully synthesized by a microwave method. X-ray diffraction (XRD), Fourier Transform infrared spectra (FTIR), Raman spectra, diffused reflectance spectra (DRS) were used for the characterization of theobtained photocatalysts. The SEM and TEM morphology of Bi2S3 urchin/CNTs composites showed that urchin-like nanoparticles were assembled by many nanorods which grew radially from the center and nanorods were wrapped with CNTs on their end. The photocatalytic performance was studied by the degradation of methyl orange (MO) under visible light and the photodegradation efficiency of Bi2S3 urchin/CNTs hybrid materials exhibited significantly excellent photocatalytic activity. A possible mechanism for the photodegradation of MO was also suggested.
There have been considerable interests in methane detection based on infrared absorption spectroscopy for industrial and environment monitoring. The authors report on the realization of photoacoustic detection of methane (CH4) using mid-infrared distributed-feedback quantum cascade laser (DFB-QCL). The absorption line at 1316.83 cm(-1) was selected for CH4 detection, which can be reached by the self-manufactured DFB-QCL source operating in pulsed mode near 7.6 microm at room-temperature. The CH4 gas is filled to a Helmholtz resonant photoacoustic cell, which was equipped with a commercial electret microphone. The DFB-QCL was operated at 234 Hz with an 80 mW optical peak power. A detection limit of 189 parts per billion in volume was derived when the signal-to-noise ratio equaled 1.
