ABSTRACT
High-temperature superconducting wires have many large-scale, niche applications such as commercial nuclear fusion as well as numerous other large-scale applications in the electric power industry and in the defense, medical and transportation industries. However, the price/performance metric of these coated conductor wires is not yet favorable to enable and realize most large-scale applications. Here we report on probing the limits of Jc (H, T) possible via defect engineering in heteroepitaxially deposited high-temperature superconducting thin-films on coated conductor substrates used for long-length wire fabrication. We report record values of Jc (H, T) and pinning force, Fp (H, T) in (RE)BCO films with self-assembled BaZrO3 nanocolumns deposited on a coated conductor substrate. A Jc of ~190 MA/cm2 at 4.2 K, self-field and ~90 MA/cm2, at 4.2 K, 7 T was measured. At 20 K, Jc of over 150 MA/cm2 at self-field and over 60 MA/cm2 at 7 T was observed. A very high pinning force, Fp, of ~6.4 TN/m3 and ~4.2 TN/m3 were observed at 7 T, 4.2 K and 7 T, 20 K respectively. We report on the highest values of Jc and Fp obtained to date for all fields and operating temperatures from 4.2 K to 77 K. These results demonstrate that significant performance enhancements and hence far more favorable price/performance metrics are possible in commercial high-temperature superconducting wires.
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Regarding the limited information on species protein differences between sheep, goat, and cow milk, the differentially expressed proteins in sheep, goat, and cow milk and their functional differences are analyzed using label-free proteomics technology to identify potential biomarkers. 770 proteins and 2914 peptide segments were identified. The statistical analysis showed significant differences in the relative abundances of the 74 proteins among the sheep, goat, and cow milk. CSN3 and LALBA can be used as potential biomarkers for goat milk, XDH can be used as potential biomarkers for cow milk, and CTSB and BPIFB1 can be used as potential biomarkers for sheep milk. The functional analysis using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes showed that these significantly different proteins were enriched by different pathways including thyroid hormone synthesis and glycerol phospholipid metabolism. The data revealed differences in the amounts and physiological functions of the milk proteins of different species, which may provide an important basis for research on the nutritional composition of dairy products and adulteration identification technology.
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BACKGROUND: Invasive fungal infections pose a substantial threat to patients in healthcare settings globally. Recent changes in the prevalence of fungal species and challenges in conducting reference antifungal susceptibility testing emphasize the importance of monitoring fungi and their antifungal resistance. METHODS: A two-phase surveillance project was conducted in Beijing, China, involving 37 centres across 12 districts, from January 2012 to December 2013 and from January 2016 to December 2017. FINDINGS: We found that the proportion of Candida albicans in intensive care units (ICUs) during 2016-2017 exhibited a significant decline compared with the 2012-2013 period, although it remained the most predominant pathogen. In contrast, the prevalence of Nakaseomyces glabratus (formerly Candida glabrata) and Candida tropicalis notably increased during the two-phase surveillance. The high prevalence of C. tropicalis and its resistance to azole drugs posed a serious threat to patients in ICUs. The pathogens causing invasive fungal infections in Beijing were relatively sensitive to echinocandins. While C. albicans continued to exhibit susceptibility to azoles, the resistance and growth rates of C. tropicalis towards azoles were particularly prominent. Concerns were raised due to the emergence of multiple, short-term isolates of Clavispora lusitaniae and Candida parapsilosis complex in neonatal ICUs, given their similarity in antifungal susceptibilities. Such occurrences point towards the potential for transmission and persisting presence of these pathogens within the ICU environment. CONCLUSIONS: Our study complements existing data on the epidemiology of invasive fungal infections. It is imperative to exercise cautious medication management for ICU patients in Beijing, paying particular attention to azole resistance in C. tropicalis.
Subject(s)
Antifungal Agents , Azoles , Drug Resistance, Fungal , Intensive Care Units , Humans , Intensive Care Units/statistics & numerical data , Antifungal Agents/pharmacology , Azoles/pharmacology , Beijing/epidemiology , Prevalence , Invasive Fungal Infections/epidemiology , Invasive Fungal Infections/microbiology , Invasive Fungal Infections/drug therapy , Microbial Sensitivity Tests , Epidemiological Monitoring , Candida/drug effects , Candida/isolation & purification , Candida/classification , Adult , Male , Female , Infant, Newborn , Middle AgedABSTRACT
ADHD is a common chronic neurodevelopmental disorder and is characterized by persistent inattention, hyperactivity, impulsivity and are often accompanied by learning and memory impairment. Great evidence has shown that learning and memory impairment of ADHD plays an important role in its executive function deficits, which seriously affects the development of academic, cognitive and daily social skills and will cause a serious burden on families and society. With the increasing attention paid to learning and memory impairment in ADHD, relevant research is gradually increasing. In this article, we will present the current research results of learning and memory impairment in ADHD from the following aspects. Firstly, the animal models of ADHD, which display the core symptoms of ADHD as well as with learning and memory impairment. Secondly, the molecular mechanism of has explored, including some neurotransmitters, receptors, RNAs, etc. Thirdly, the susceptibility gene of ADHD related to the learning and impairment in order to have a more comprehensive understanding of the pathogenesis. Key words: Learning and memory, ADHD, Review.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Memory Disorders , Attention Deficit Disorder with Hyperactivity/psychology , Attention Deficit Disorder with Hyperactivity/genetics , Humans , Animals , Memory Disorders/psychology , Memory Disorders/etiology , Learning , Disease Models, Animal , Learning Disabilities/psychology , Learning Disabilities/etiology , MemoryABSTRACT
Objective: Quantified MRCP imaging data was used as a reference for design and preparation of a modified percutaneous transhepatic cholangio drainage (PTCD) tube. Methods: 3.0 T upper abdominal MR and MRCP imaging data of 2 300 patients treated from July 2015 to July 2020 at the Department of Radiology of the Affiliated Cancer Hospital of Zhengzhou University were screened and a total of 381 patients diagnosed with biliary duct structures were identified. Causative etiologies among these patients included pancreatic adenocarcinoma (pancreatic head), cholangiocarcinoma, ampullary carcinoma, as well as intrahepatic and/or extrahepatic bile duct dilation. An improved PTCD tube was designed based on MRCP quantification of left and right hepatic and common hepatic duct length. Results: In the setting of biliary obstruction caused by malignancy, the distance of the left hepatic duct from its origin to the point of left and right hepatic duct confluence was 15.9±3.8 mm, while the distance of the right hepatic duct from its origin to the point of left and right hepatic duct confluence was 12.4±3.2 mm; the length of the bile duct from its origin to the point of left and right hepatic duct confluence was 34.0±8.1 mm. The improved PTCD tube design incorporated an altered length of the drainage orifice. Conclusion: MRCP imaging of the biliary tract is effective for measuring biliary tract length in the setting of pathological dilation. Based on our biliary tract measurements, a modified PTCD tube was designed to more effectively meet drainage requirements and manage biliary obstruction caused by Bismuth-Corlette type â ¡ and â ¢ malignancies.
Subject(s)
Adenocarcinoma , Cholestasis , Pancreatic Neoplasms , Humans , Cholangiopancreatography, Magnetic Resonance , DrainageABSTRACT
Objective: To evaluate the application value of reducing tube voltage and iodine delivery rate according to body weight in coronary CT angiography (CCTA). Methods: A prospective randomized controlled study. A total of 297 subjects, 172 males and 125 females, aged [M (Q1, Q3)]60.0 (50.0, 68.0) years, who underwent CCTA examination in Peking University Third Hospital due to clinically suspected coronary heart disease from May to December 2022 were included. According to the odd or even visit dates, the subjects were randomly divided into test group (n=156) and control group (n=141). The subjects in both groups were divided into four sub-groups according to body weight: 50-59 group, 60-69 kg group, 70-79 kg group and 80-89 kg group, respectively. The CCTA images were reconstructed with hybrid iterative algorithm(KARL 3D) with levels of 6 and 8, respectively. 100 kVp and iodine flow rate 1.1, 1.3, 1.4 and 1.5 gI/s recommended by the domestic CCTA application guidelines were used in the control group, while the tube voltage and iodine flow rate were reduced in the test group based on the guidelines and body weight:70 kVp and 0.8 g I/s in 50~59 kg group, 80 kVp and 1.0 gI/s in 60~69 kg group, 80 kVp and 1.1 gI/s in70~79 kg group, and 100 kVp and 1.5 gI/s in 80~89 kg group, respectively. The CT values and standard deviation (SD) of aortic root, proximal left anterior descending branch (LAD) and distal right coronary artery (RCA) luminal CCTA, the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of coronary artery CT images, subjective coronary scores and effective radiation dose (ED) were compared between the both groups. One-way ANOVA or Wilcoxon test was used to analyze the differences of above indicators between the groups to evaluate the application value of low voltage and low iodine flow rate based on weight in coronary CCTA. Results: CT values of aortic root, LAD proximal CT values and SD values of aortic root [411.4 (377.2, 439.8) HU, (366.3±42.9) HU, 26.5±2.3] in the test group were all higher than those in the control group [379.00 (335.2, 415.9) HU, (355.0±46.9) HU and 24.8±2.3]. The differences were statistically significant (all P<0.05), and the other parameters were not statistically significant (all P>0.05). The total subjective image quality score in test group were superior to those in the control group (all P<0.05). The total ED and contrast agent dosage [2.07 (1.52, 3.28) mSv and (38.28±9.68) ml] in CCTA examination in the test group were lower than those in the control group [3.30(2.32, 4.44) mSv and (45.31±5.63) ml], and the differences were statistically significant (all P<0.05). The dosage of ED and contrast agent in the test group was decreased by 37.3% and 15.5%, respectively. Conclusion: Combined with KARL 3D,it is feasible to reduce contrast medium and ED by setting the tube voltage and iodine flow rate of CCTA according to the weight of the subject, which can further reduce the radiation dose and contrast agent dosage of CCTA.
Subject(s)
Computed Tomography Angiography , Iodine , Male , Female , Humans , Aged , Computed Tomography Angiography/methods , Contrast Media , Prospective Studies , Radiation Dosage , Coronary Angiography/methods , Tomography, X-Ray Computed/methods , Body Weight , Radiographic Image Interpretation, Computer-Assisted/methodsABSTRACT
BACKGROUND: Serum lipid levels are associated with cancer risk. However, there still have uncertainties about the single and combined effects of low lipid levels on cancer risk. METHODS: A prospective cohort study of 33,773 adults in Shanghai between 2016 and 2017 was conducted. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels were measured. Cox proportional hazard models were used to assess the association of single and combined lipids with overall, lung, colon, rectal, thyroid gland, stomach, and female breast cancers. The effect of the combination of abnormal lipid score and lifestyle on cancer was also estimated. RESULTS: A total of 926 incident cancer cases were identified. In the RCS analysis, hazard ratios (HRs) of overall cancer for individuals with TC < 5.18 mmol/L or with LDL-C < 3.40 mmol/L were higher. Low TC was associated with higher colorectal cancer risk (HR [95% CI] = 1.76 [1.09-2.84]) and low HDL-C increased thyroid cancer risk by 90%. Abnormal lipid score was linearly and positively associated with cancer risk, and smokers with high abnormal lipid scores had a higher cancer risk, compared to non-smokers with low abnormal lipid scores (P < 0.05). CONCLUSIONS: Low TC levels were associated with an increased risk of overall and colorectal cancer. More attention should be paid to participants with high abnormal lipid scores and unhealthy lifestyles who may have a higher risk of developing cancer. Determining the specific and comprehensive lipid combinations that affect tumorigenesis remains a valuable challenge.
Subject(s)
Colorectal Neoplasms , Lipids , Adult , Humans , Female , Prospective Studies , Cholesterol, LDL , Cholesterol, HDL , Risk Factors , China/epidemiology , TriglyceridesABSTRACT
Social devaluation of being overweight is common in daily life, but little is known about the weight stigma in romantic relationships. The present study investigated the roles of maladaptive and adaptive coping strategies in the relation between the experience of weight stigma in romantic relationships and depressive symptoms in men and women, respectively. Analyses of gender differences and structural equation modeling yielded several findings. First, while men and women experienced similar levels of weight stigma from their romantic partners, women were more likely to use exercise avoidance, disengagement coping, and reappraisal coping strategies, and to exhibit more depressive symptoms than men. Second, men who experienced weight stigma tended to cope with it through exercise avoidance and disengagement coping, which were related to greater depressive symptoms. Men also coped with weight stigma adaptively via reappraisal coping, which was additionally associated with more positive affect. Third, the relation between the experience of weight stigma and depressive symptoms in women was only explained by using disengagement coping. These findings extend the understanding of weight stigma to a specific context and provide some insight that future interventions to reduce the impacts of weight stigma should be tailored accordingly for men and women.
Subject(s)
Adaptation, Psychological , Weight Prejudice , Male , Humans , Female , Depression , Coping SkillsABSTRACT
When a magnon passes through two-dimensional magnetic textures, it will experience a fictitious magnetic field originating from the 3×3 skew-symmetric gauge fields. To date, only one of the three independent components of the gauge fields has been found to play a role in generating the fictitious magnetic field, while the other two are perfectly hidden. In this Letter, we show that they are concealed in the nonlinear magnon transport in magnetic textures. Without loss of generality, we theoretically study the nonlinear magnon-skyrmion interaction in antiferromagnets. By analyzing the scattering features of three-magnon processes between the circularly polarized incident magnon and breathing skyrmion, we predict a giant Hall angle of both the confluence and splitting modes. Furthermore, we find that the Hall angle reverses its sign when one switches the handedness of the incident magnons. We dub this the nonlinear topological magnon spin Hall effect. Our findings are deeply rooted in the bosonic nature of magnons that the particle number is not conserved, which has no counterpart in low-energy fermionic systems and may open the door for probing gauge fields by nonlinear means.
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As a prevalent neurodevelopmental disease, attention-deficit hyperactivity disorder (ADHD) impairs the learning and memory capacity, and so far, there has been no available treatment option for long-term efficacy. Alterations in gene regulation and synapse-related proteins influence learning and memory capacity; nevertheless, the regulatory mechanism of synapse-related protein synthesis is still unclear in ADHD. LncRNAs have been found participating in regulating genes in multiple disorders. For instance, lncRNA Metastasis Associated Lung Adenocarcinoma Transcript 1 (MALAT1) has an essential regulatory function in numerous psychiatric diseases. However, how MALAT1 influences synapse-related protein synthesis in ADHD remains largely unknown. Here, our study found that MALAT1 decreased in the hippocampus tissue of spontaneously hypertensive rats (SHRs) compared to the standard controls, Wistar Kyoto (WKY) rats. Subsequent experiments revealed that MALAT1 enhanced the expression of neurexin 1 (NRXN1), which promoted the synapse-related genes (SYN1, PSD95, and GAP43) expression. Then, the bioinformatic analyses predicted that miR-141-3p and miR-200a-3p, microRNAs belonging to miR-200 family and sharing same seed sequence, could interact with MALAT1 and NRXN1 mRNA, which were further confirmed by luciferase report assays. Finally, rescue experiments indicated that MALAT1 influenced the expression of NRXN1 by sponging miR-141-3p/200a-3p. All data verified our hypothesis that MALAT1 regulated synapse-related proteins (SYN1, PSD95, and GAP43) through the MALAT1-miR-141-3p/200a-3p-NRXN1 axis in ADHD. Our research underscored a novel role of MALAT1 in the pathogenesis of impaired learning and memory capacity in ADHD and may shed more light on developing diagnostic biomarkers and more effective therapeutic interventions for individuals with ADHD.
Subject(s)
Attention Deficit Disorder with Hyperactivity , MicroRNAs , RNA, Long Noncoding , Rats , Animals , Attention Deficit Disorder with Hyperactivity/genetics , RNA, Long Noncoding/genetics , RNA, Long Noncoding/metabolism , Rats, Inbred WKY , MicroRNAs/genetics , MicroRNAs/metabolism , Gene Expression RegulationABSTRACT
Objective: To investigate the risk factors and construct a nomogram model for predicting the occurrence of cirrhotic portal vein thrombosis in patients combined with esophagogastric variceal bleeding (EVB). Methods: Clinical data on 416 cirrhotic PVT cases was collected from the First Hospital of Lanzhou University between January 2016 and January 2022. A total of 385 cases were included after excluding 31 cases for retrospective analysis. They were divided into an esophagogastric variceal bleeding group and a non-esophagogastric variceal bleeding group based on the clinical diagnosis. The esophagogastric variceal group was then further divided into an EVB group and a non-bleeding group. All patients underwent gastroscopy, serology, and imaging examinations. The risk factors of PVT combined with EVB were identified by univariate analysis using SPSS 26. The prediction model of cirrhotic PVT in patients combined with EVB was constructed by R 4.0.4. The prediction efficiency and clinical benefits of the model were evaluated by the C-index, area under the receiver operating characteristic curve, calibration plots, and decision curve. The measurement data were examined by a t-test or Mann-Whitney U test. The counting data were tested using the χ(2) test or the Fisher exact probability method. Results: There were statistically significant differences in the etiology, Child-Pugh grade,erythrocyte count, hematocrit, globulin, and serum lipids between the esophageal and non-esophageal varices groups (P < 0.05). There were statistically significant differences in etiology, erythrocyte count, hemoglobin, hematocrit, neutrophil percentage, total protein, globulin, albumin/globulin, urea, high-density lipoprotein cholesterol, calcium, and neutrophil lymphocyte ratio (NLR) between the EVB and non-bleeding groups (P < 0.05). Multivariate logistic regression analysis showed that etiology (OR = 3.287, 95% CI: 1.497 ~ 7.214), hematocrit (OR = 0.897, 95% CI: 0.853 ~ 0.943), and high-density lipoprotein cholesterol (OR = 0.229, 95% CI: 0.071 ~ 0.737) were independent risk factors for cirrhotic PVT patients combined with EVB. The constructed normogram model predicted the probability of bleeding in patients. The nomogram model had shown good consistency and differentiation (AUC = 0.820, 95% CI: 0.707 ~ 0.843), as verified by 10-fold cross-validation (C-index = 0.799) and the Hosmer-Lemeshow goodness of fit test (P = 0.915). The calibration plot and the decision curve suggested that the prediction model had good stability and clinical practicability. Conclusion: The risk factors for EVB occurrence include etiology, erythrocyte, hemoglobin, hematocrit, percentage of neutrophils, total protein, globulin, albumin/globulin, urea, high-density lipoprotein cholesterol, calcium, and NLR in patients with cirrhotic liver. The constructed prediction model has good predictive value, and it can provide a reference for medical personnel to screen patients with high bleeding risk for targeted treatment.
Subject(s)
Esophageal and Gastric Varices , Globulins , Varicose Veins , Venous Thrombosis , Humans , Liver Cirrhosis/pathology , Esophageal and Gastric Varices/complications , Portal Vein/pathology , Nomograms , Retrospective Studies , Calcium , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/pathology , Risk Factors , Venous Thrombosis/complications , Varicose Veins/complications , Varicose Veins/pathology , Hemoglobins , Urea , Lipoproteins, HDL , Cholesterol , AlbuminsABSTRACT
Freezing is an effective means to extend the shelf-life of meat products. However, freezing and thawing processes lead to physical (e.g., ice crystals formation and freezer burn) and biochemical changes (e.g., protein denaturation and lipid oxidation) in meat resulting in loss of quality. Over the last two decades, several attempts have been made to produce thawed meat with qualities similar to that of fresh meat to no avail. This is due to the fact that no single technique exists to date that can mitigate all the quality challenges caused by freezing and thawing. This is further confounded by the consumer perception of frozen meat as lower quality compared to equivalent fresh-never-frozen meat cuts. Therefore, it remains challenging for the meat industry to produce high quality frozen meat and increase consumer acceptability of frozen products. This review aimed to provide an overview of the applications of novel freezing and thawing technologies that could improve the quality of thawed meat including deep freezing, high pressure, radiofrequency, electro-magnetic resonance, electrostatic field, immersion solution, microwave, ohmic heating, and ultrasound. This review will also discuss the development in processing strategies such as optimising the ageing of meat pre- or post-freezing, and the integration of freezing and thawing in one process/regime to collapse the difference in quality between thawed meat and fresh-never-frozen equivalents.
Subject(s)
Meat , Freezing , Meat/analysisABSTRACT
OBJECTIVE: To investigate the correlations between carotid plaque characteristics and cerebral blood flow (CBF) in patients with unilateral moderate to severe carotid stenosis using high-resolution magnetic resonance imaging (HR-MRI) and 3D pseudo-continuous arterial spin labeling (3D pcASL). METHODS: A total of 43 patients with unilateral moderate to severe carotid stenosis were recruited. The degree of carotid stenosis, maximum wall thickness (Max WT) and normalized wall index (NWI) were measured using HR-MRI. The plaque characteristics were analyzed. Presence or absence of plaque components including intraplaque hemorrhage (IPH), lipid-rich necrotic nucleus (LRNC), calcification and ulcer were identified, and the grades of calcification and LRNC were recorded. CBF values within the region of interest representing the bilateral middle cerebral artery distribution were acquired using 3D pcASL. Paired sample t test was used to compare the differences of CBF values between the index side and the contralateral side. Spearman correlation analysis was conducted to evaluate the correlations of CBF values with the degree of carotid stenosis, Max WT and NWI. The differences of CBF values between the patients with or without IPH and ulcer were compared using Mann-Whitney U test. Different levels of calcification and LRNC were compared by Kruskal-Wallis test, respectively. RESULTS: The ave-rage degree of carotid stenosis at the index side was 77.30%±11.79%. The mean CBF value of the index side was (46.77±11.65) mL/(100 g·min), and that of the contralateral side was (49.92±9.95) mL/(100 g·min), and the difference was statistically significant (t=-2.474, P=0.017). The mean Max WT and NWI of the carotid plaques at the index side was (6.40±1.87) mm and 62.91%±8.87%, respectively. There were no significant correlations of CBF values with the degrees of stenosis, Max WT and NMI (P>0.05). Plaque composition analysis showed that the CBF values of the index side were different when there was calcification or not and the degrees of calcification were different (P=0.030), but there were no differences between the CBF values on the index sides with or without IPH, ulcer and LRNC. CONCLUSION: In patients with unilateral moderate to severe carotid stenosis, calcification might affect CBF perfusion. When there is no calcification, the plaque components need attention.
Subject(s)
Calcinosis , Carotid Stenosis , Plaque, Atherosclerotic , Humans , Carotid Stenosis/diagnostic imaging , Ulcer/pathology , Magnetic Resonance Imaging/methods , Plaque, Atherosclerotic/diagnostic imaging , Carotid Arteries/chemistry , Carotid Arteries/pathology , Hemorrhage , Magnetic Resonance Spectroscopy , Cerebrovascular CirculationABSTRACT
Objectives: To study the association between metals mixture exposure and DNA oxidative damage using mixture analysis methods, and to explore the most significant exposure factors that cause DNA oxidative damage. Methods: Workers from steel enterprises were recruited in Shandong Province. Urinary metals were measured by using the inductively coupled plasma mass spectrometry method. The level of urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) was determined by using the ultra-high performance liquid chromatography-mass spectrometry method. Bayesian kernel machine regression (BKMR), elastic net regression and quantile g-computation regression were used to analyze the association between urinary metals and urinary 8-OHdG. Results: A total of 768 subjects aged (36.15±7.40) years old were included in the study. BKMR, elastic net regression and quantile g-computation all revealed an overall positive association between the mixture concentration and increased urinary 8-OHdG. The quantile g-computation results showed that with a 25% increase in metal mixtures, the urinary 8-OHdG level increased by 77.60%. The elastic net regression showed that with a 25% increase in exposure risk score, the urinary 8-OHdG level increased by 26%. The BKMR summarized the contribution of individual exposures to the response, and selenium, zinc, and nickel were significant contributors to the urinary 8-OHdG elevation. Conclusion: Exposure to mixed metals causes elevated levels of DNA oxidative damage, and selenium, zinc, and nickel are significant exposure factors.
Subject(s)
Nickel , Selenium , Humans , Adult , Nickel/toxicity , Bayes Theorem , Metals/toxicity , 8-Hydroxy-2'-Deoxyguanosine , Oxidative Stress/physiology , Zinc , DNA DamageABSTRACT
The two most commonly used airway management techniques during general anaesthesia are supraglottic airway devices and tracheal tubes. In older patients undergoing elective non-cardiothoracic surgery under general anaesthesia with positive pressure ventilation, we hypothesised that a composite measure of in-hospital postoperative pulmonary complications would be less frequent when a supraglottic airway device was used compared with a tracheal tube. We studied patients aged ≥ 70 years in 17 clinical centres. Patients were allocated randomly to airway management with a supraglottic airway device or a tracheal tube. Between August 2016 and April 2020, 2900 patients were studied, of whom 2751 were included in the primary analysis (1387 with supraglottic airway device and 1364 with a tracheal tube). Pre-operatively, 2431 (88.4%) patients were estimated to have a postoperative pulmonary complication risk index of 1-2. Postoperative pulmonary complications, mostly coughing, occurred in 270 of 1387 patients (19.5%) allocated to a supraglottic airway device and 342 of 1364 patients (25.1%) assigned to a tracheal tube (absolute difference -5.6% (95%CI -8.7 to -2.5), risk ratio 0.78 (95%CI 0.67-0.89); p < 0.001). Among otherwise healthy older patients undergoing elective surgery under general anaesthesia with intra-operative positive pressure ventilation of their lungs, there were fewer postoperative pulmonary complications when the airway was managed with a supraglottic airway device compared with a tracheal tube.
Subject(s)
Laryngeal Masks , Humans , Aged , Laryngeal Masks/adverse effects , Intubation, Intratracheal/methods , Airway Management/methods , Anesthesia, General/methods , Postoperative Complications/epidemiology , Postoperative Complications/etiology , LungABSTRACT
Objective: To investigate the relationship between serum lysophosphatidylcholine (LPC) level and the health index of the elderly. Methods: A total of 251 subjects were selected from the 2016 baseline survey of the Yongfu Longevity Cohort in Guangxi Province among whom 66, 63 and 122 were in the young and middle-aged group (≤59 years old), the young group (60-89 years old) and the longevity group (≥90 years old), respectively. Demographic data were collected and related indicators of height, weight, blood pressure and lipid metabolism were measured. The cognitive and physical functions of the elderly were assessed by the results of the simple mental state scale and the daily living activity scale to construct the health index of the elderly. The serum levels of LPC16â¶0, LPC18â¶0, LPC18â¶1 and LPC18â¶2 were determined by liquid chromatography-tandem mass spectrometry, and the differences among different ages and health status groups were compared. The logistic regression model was used to analyze the relationship between the serum LPC level and the health index of the elderly. Results: With the increase in age, the proportion of female subjects increased, and the rate of smoking and drinking decreased. BMI, TC, TG, LDL-C, diastolic blood pressure, and the four LPCs levels decreased with the increase of age, and systolic blood pressure levels increased with the increase of age (all P values<0.05). There was no significant difference in HDL-C levels among age groups (P>0.05). With the decline of health status in the elderly, serum levels of LPC16â¶0, LPC18â¶0, LPC18â¶1 and LPC18â¶2 showed a downward trend (all P values<0.001). After adjusting for age and gender, only LPC18â¶0 was associated with the health status in old age [OR (95%CI): 0.48 (0.25-0.92)]. For every 1 standard deviation (16.87 nmol/L) increase in serum LPC18â¶0 concentration, the risk of poor health status in old age decreased by 52%. Conclusion: Serum LPC18â¶0 was associated with the health status in old age independent of age and sex.