Effect of butorphanol-soaked nasal packing after endoscopic nasal surgery: a double-blind, randomized, placebo-controlled trial.

OBJECTIVE: This study was designed to investigate the effect of butorphanol-soaked nasal packing on analgesia and sleep quality in patients undergoing bilateral endoscopic nasal surgery. METHODS: Sixty-six patients were enrolled and randomly allocated into three groups: group B1 (butorphanol 0.03mg/kg), group B2 (butorphanol 0.04mg/kg) and group N (control group). The primary outcome was postoperative pain scores evaluated by a Visual Analogue Scale (VAS) at 2h (T1), 8h (T2), 24h (T3) and 48h (T4) after surgery. Secondary outcome was postoperative sleep quality measured using Subjective Sleep Quality Value (SSQV). RESULTS: Postoperative VAS scores of butorphanol groups were significantly lower than the control group at T2, T3 and T4. VAS scores at each time point did not differ between groups B1 and B2. On the first and second nights after surgery, SSQV was higher in butorphanol groups than in the control group. There were no significant differences in SSQV1 and SSQV2 between group B1 and group B2. The incidence of respiratory depression, dizziness, agitation and rescue analgesic use did not show difference among three groups. CONCLUSIONS: Butorphanol-soaked nasal packing can reduce pain and improve sleep quality after bilateral endoscopic nasal surgery without increasing adverse effects. A concentration of 0.03mg/kg may be appropriate for clinical application. LEVEL OF EVIDENCE: Level 1B.

Effect of butorphanol-soaked nasal packing after endoscopic nasal surgery: a double-blind, randomized, placebo-controlled trial

Abstract Objective This study was designed to investigate the effect of butorphanol-soaked nasal packing on analgesia and sleep quality in patients undergoing bilateral endoscopic nasal surgery. Methods Sixty-six patients were enrolled and randomly allocated into three groups: group B1 (butorphanol 0.03 mg/kg), group B2 (butorphanol 0.04 mg/kg) and group N (control group). The primary outcome was postoperative pain scores evaluated by a Visual Analogue Scale (VAS) at 2 h (T1), 8 h (T2), 24 h (T3) and 48 h (T4) after surgery. Secondary outcome was postoperative sleep quality measured using Subjective Sleep Quality Value (SSQV). Results Postoperative VAS scores of butorphanol groups were significantly lower than the control group at T2, T3 and T4. VAS scores at each time point did not differ between groups B1 and B2. On the first and second nights after surgery, SSQV was higher in butorphanol groups than in the control group. There were no significant differences in SSQV1 and SSQV2 between group B1 and group B2. The incidence of respiratory depression, dizziness, agitation and rescue analgesic use did not show difference among three groups. Conclusions Butorphanol-soaked nasal packing can reduce pain and improve sleep quality after bilateral endoscopic nasal surgery without increasing adverse effects. A concentration of 0.03 mg/kg may be appropriate for clinical application. Level of Evidence Level 1B.

Characterization of cuproptosis identified immune microenvironment and prognosis in acute myeloid leukemia.

BACKGROUND: Recent studies have reported that cuproptosis, a novel cell death pathway, strongly correlates with mitochondrial metabolism. In addition, the studies reported that cuproptosis plays a role in the development of several cancers and is regulated by protein lipoylation. During cuproptosis, copper binds to the lipoylated proteins and mediates cancer progression. However, the role of cuproptosis in acute myeloid leukemia (AML) patients is yet to be explored. METHODS: This study curated seven cuproptosis-related-genes (CRGs): FDX1, DLAT, PDHB, PDHA1, DLD, LIAS, and LIPT1 to determine cuproptosis modification patterns and the CRGs signature in AML. The CIBERSORT and ssGSEA algorithms were utilized to evaluate the infiltration levels of different immune cell subtypes. A cuproptosis score system based on differentially expressed genes (DEGs) was constructed using the least absolute shrinkage and selection operator (LASSO) regression analysis. The developed cuproptosis score system was validated using two immunotherapy datasets, IMvigor210 and GSE78220. RESULTS: Three distinct cuproptosis regulation patterns were identified using the Beat AML cohort. The results demonstrated that the three cuproptosis regulation patterns were correlated with various biological pathways and clinical outcomes. Tumor microenvironment (TME) characterization revealed that the identified cuproptosis regulation patterns were consistent with three immune profiles: immune-desert, immune-inflamed, and immune-excluded. The AML patients were grouped into low- and high-score groups based on the cuproptosis score system abstracted from 486 cuproptosis-related DEGs. Patients with lower cuproptosis scores were characterized by longer survival time and attenuated immune infiltration. It was found that lower cuproptosis scores were strongly correlated with lower somatic mutation frequency. Moreover, patients with lower cuproptosis scores presented more favorable immune responses and dual clinical benefits among external validation cohorts. CONCLUSIONS: Cuproptosis phenotypes are significantly correlated with immune microenvironment complexity and variety. Cuprotopsis regulates the response of cancer cells to the immune system. Quantitatively assessing cuproptosis phenotypes in AML improves the understanding and knowledge regarding immune microenvironment characteristics and promotes the development of therapeutic interventions.

Effect of the problem-based learning method on student electroencephalograms and microcirculatory blood perfusion in the teaching of sports physiology / Efecto del método de aprendizaje basado en problemas en electroencefalogramas y perfusión sanguínea microcirculatoria de estudiantes en la enseñanza de la fisiología del deporte / Efeito do método de aprendizagem baseada em problemas em eletroencefalogramas e perfusão sanguínea microcirculatória de estudantes no ensino de fisiologia do esporte

ABSTRACT Introduction Applying the problem-based learning (PBL) method to the teaching of sports physiology. Objective This study explored the mechanism of the PBL method to improve the interest and learning effectiveness of students. Methods Twenty male students at the Physical Education College of Hubei Minzu University were randomly divided into a PBL group (10) and a traditional teaching method group (TTM). During the test, the subjects in the TTM group sat quietly listening to the experienced teacher, while the subjects in PBL group sat quietly and participated in a 20-minute group discussion under the guidance of the experienced teacher. Transcutaneous partial pressure of oxygen (TcPO2), microcirculatory blood perfusion (MBP), and alpha- and beta-band power were monitored at the beginning of and during the test. Results The mean of the PBL-group quiz score was significantly higher than that of the TTM group. In the PBL group, the alpha power of the students decreased statistically in the F3, T3, P3, and O1 channels and the beta power of the students increased statistically in the F7, F3, T3, C3, P3, and O1 as compared to the baseline values. Conclusion PBL can be an effective learning mechanism, since the students are actively engaged in the teaching of sports physiology. Level of Evidence I; Therapeutic studies - Investigating treatment results.

RESUMEN Introducción Aplicación del método de Aprendizaje Basado en Problemas (PBL), a la enseñanza de la fisiología del deporte. Objetivos Este estudio exploró el mecanismo del método PBL para ampliar el interés y la eficacia del aprendizaje de los estudiantes. Métodos Veinte estudiantes varones de la Facultad de Educación Física de la Universidad de Hubei Minzu fueron divididos aleatoriamente en el grupo PBL (10) y en un grupo de método de enseñanza tradicional (TTM). Durante la prueba, los participantes del grupo TTM permanecieron sentados y escuchando en silencio al profesor experimentado, mientras que los del grupo PBL permanecieron sentados y participaron en un debate de grupo de 20 minutos de acuerdo con la orientación del mismo profesor. La presión parcial de oxígeno transcutáneo (TcpO2), la perfusión sanguínea microcirculatoria (MBP) y la potencia de las bandas alfa y beta se monitorizaron al inicio y durante la prueba. Resultados La puntuación media del cuestionario del grupo PBL fue significativamente mayor que la del grupo TTM. En el grupo PBL, la potencia alfa de los estudiantes disminuyó estadísticamente en los canales F3, T3, P3 y O1 y la potencia beta de los estudiantes aumentó en los canales F7, F3, T3, C3, P3 y O1 en comparación con los valores de referencia. Conclusión El PBL puede ser un mecanismo de aprendizaje eficaz, ya que los estudiantes participan activamente en la enseñanza de la fisiología del deporte. Nivel de evidencia I; Estudios terapéuticos - Investigación de los resultados del tratamiento.

RESUMO Introdução Aplicação do método de aprendizagem baseada em problemas (PBL) ao ensino da fisiologia do esporte. Objetivos Este estudo explorou o mecanismo do método PBL para ampliar o interesse e a eficácia da aprendizagem dos estudantes. Métodos Vinte estudantes do sexo masculino da Faculdade de Educação Física da Universidade Hubei Minzu foram divididos randomicamente em um grupo PBL (10) e um grupo de método de ensino tradicional (TTM). Durante o teste, os participantes do grupo TTM ficaram sentados e em silêncio ouvindo o professor experiente, enquanto os do grupo PBL ficaram sentados e participaram de uma discussão em grupo de 20 minutos de acordo com a orientação do mesmo professor. A pressão parcial do oxigênio transcutâneo (TcPO2), a perfusão sanguínea microcirculatória (MPB) e a potência das bandas alfa e beta foram monitoradas no início e durante o teste. Resultados A média do escore do questionário do grupo PBL foi significativamente maior do que a do grupo TTM. No grupo PBL, o poder alfa dos estudantes diminuiu em termos estatísticos nos canais F3, T3, P3 e O1 e o poder beta dos estudantes aumentou nos canais F7, F3, T3, C3, P3 e O1 em comparação com os valores basais. Conclusão O PBL pode ser um mecanismo eficaz de aprendizagem, uma vez que os estudantes ficam ativamente engajados no ensino da fisiologia do esporte. Nível de Evidência I; Estudos terapêuticos - Investigação dos resultados do tratamento.

Effects of exercise on the cardiovascular function of rats in a sulfur dioxide polluted environment.

The purpose of the study is to further explore the combined effects of exercise and sulfur dioxide (SO2) exposure on the cardiovascular function as well as the underlying mechanisms. Rats were randomly divided into 4 groups: rest group (RG), exercise group (EG), SO2 pollution group (SG) and SO2 pollution + exercise group (SEG). Changes of aortic pressure and left ventricular pressure, Ang II concentration, ACE concentration and ACE activity in rats' myocardial tissue were observed. Compared with RG, the systolic blood pressure, pulse pressure, LVSP, +dp/dtmax and -dp/dtmax of EG increased significantly, diastolic blood pressure, resting heart rate and ACE activity decreased significantly; For rats of SG, 4 weeks SO2 exposure increased LVEDP, Ang II concentration, ACE concentration and ACE activity, decreased the +dp/dtmax and -dp/dtmax; For rats of SEG, the systolic blood pressure, pulse pressure, LVSP, +dp/dtmax and -dp/dtmax decreased significantly, HR, LVEDP, Ang II concentration, ACE concentration and ACE activity increased significantly. Results indicate that, the combination of aerobic exercise and SO2 exposure can aggravate the negative effects of SO2 inhalation on cardiovascular function. Renin-angiotensin system plays an important role in mediating the negative effect of SO2 inhalation.

Nomogram for prediction of long-term survival with hepatocellular carcinoma based on NK cell counts.

INTRODUCTION: Among all immune cells, natural killer (NK) cells play an important role as the first line of defense against tumor. The purpose of our study is to observe whether the NK cell counts can predict the overall survival of patients with hepatocellular carcinoma (HCC). METHODS: To develop a novel model, from January 2010 to June 2015, HCC patients enrolled in Beijing Ditan hospital were divided into training and validation cohort. Cox multiple regression analysis was used to analyze the independent risk factors for 1-year, 3-year and 5-year overall survival (OS) of patients with HCC, and the nomogram was used to establish the prediction model. In addition, the decision tree was established to verify the contribution of NK cell counts to the survival of patients with HCC. RESULTS: The model used in predicting overall survival of HCC included six variables (namely, NK cell counts, albumin (ALB) level, alpha-fetoprotein (AFP) level, portal vein tumor thrombus (PVTT), tumor number and treatment). The C-index of nomogram model in HCC patients predicting 1-year, 3-year and 5-year overall survival was 0.858, 0.788 and 0.782 respectively, which was higher than tumor-lymph node-metastasis (TNM) staging system, Okuda, model for end-stage liver disease (MELD), MELD-Na, the Chinese University Prognostic Index (CUPI) and Japan Integrated Staging (JIS) scores (p < 0.001). The decision tree showed the specific 5-year OS probability of HCC patients under different risk factors, and found that NK cell counts were the third in the column contribution. CONCLUSIONS: Our study emphasizes the utility of NK cell counts for exploring interactions between long-term survival of HCC patients and predictor variables.

Evaluation of a rat model of exercise-induced fatigue using treadmill running with progressively increasing load.

The mechanism behind exercise-induced fatigue is a significant topic in the field of sports physiology. Therefore, establishing and evaluating an acute exercise-induced fatigue animal model that explores the limits of the motor system may provide greater insight into these mechanisms. Heart rate is an important quantitative parameter that accurately reflects the immediate change in physical function due to exercise load. And there is likely to be an important correlation between heart rate and behavioral performance. In this study, changes in heart rate and behavioral indexes during exercise-induced fatigue were quantitatively analyzed in rats using heart rate telemetry and video methods respectively. The behavioral indexes were used as independent variables and the degree of fatigue was used as the forecast value. Ternary quadratic function curve fitting was used to deduce a formula to calculate a fatigue score: Y = 15.2548+0.4346∙xa-0.1154∙xb+0.6826∙xc+0.0044∙xa∙xb-0.0021∙xb∙xc-0.0013∙xc∙xa-0.0023∙xa2-0.0016∙xb2 (r2=0.906). It identified a linear relationship between heart rate and exercise intensity, with a plateau in heart rate occurring during difference periods. It will serve as an effective reference for the modeling of exercise-induced fatigue. In addition, it also provides a theoretical method for analyzing the correlation between peripheral and central parameters.

Vitexin induces apoptosis through mitochondrial pathway and PI3K/Akt/mTOR signaling in human non-small cell lung cancer A549 cells.

BACKGROUND: Currently, the prognosis of patients with non-small cell lung cancer (NSCLC) remains dismal; hence, it is critical to identify effective anti-NSCLC agents with limited side effects. This study aimed to evaluate the therapeutic potential of flavonoid compound vitexin in human NSCLC cells and the underlying mechanisms. RESULTS: The experimental results indicated that vitexin reduced the viability of A549 cells in a dose-dependent manner with nearly no toxicity against normal human bronchial epithelial 16HBE cells. Vitexin also dose-dependently increased A549 cell apoptosis, accompanied by the decreased Bcl-2/Bax ratio and the increased expression of cleaved caspase-3. Moreover, the in vivo anticancer activity of vitexin was further determined in nude mice bearing A549 cells. In addition, vitexin induced the release of cytochrome c from the mitochondria to the cytosol and the loss of mitochondrial membrane potential. Vitexin also significantly reduced the levels of p-PI3K, p-Akt and p-mTOR, and the pro-apoptotic effect of vitexin on A549 cells was partly blocked by SC79, an Akt activator. CONCLUSIONS: Accordingly, we believed that vitexin could be used as a potential therapeutic agent for the treatment of NSCLC in the future.

Vitexin induces apoptosis through mitochondrial pathway and PI3K/Akt/mTOR signaling in human non-small cell lung cancer A549 cells

BACKGROUND: Currently, the prognosis of patients with non-small cell lung cancer (NSCLC) remains dismal; hence, it is critical to identify effective anti-NSCLC agents with limited side effects. This study aimed to evaluate the therapeutic potential of flavonoid compound vitexin in human NSCLC cells and the underlying mechanisms. RESULTS: The experimental results indicated that vitexin reduced the viability of A549 cells in a dose-dependent manner with nearly no toxicity against normal human bronchial epithelial 16HBE cells. Vitexin also dose-dependently increased A549 cell apoptosis, accompanied by the decreased Bcl-2/Bax ratio and the increased expression of cleaved caspase-3. Moreover, the in vivo anticancer activity of vitexin was further determined in nude mice bearing A549 cells. In addition, vitexin induced the release of cytochrome c from the mitochondria to the cytosol and the loss of mitochondrial membrane potential. Vitexin also significantly reduced the levels of p-PI3K, p-Akt and p-mTOR, and the pro-apoptotic effect of vitexin on A549 cells was partly blocked by SC79, an Akt activator. CONCLUSIONS: Accordingly, we believed that vitexin could be used as a potential therapeutic agent for the treatment of NSCLC in the future.

Clinical presentation of hemophagocytic lymphohistiocytosis in adults is less typical than in children.

OBJECTIVE: Hemophagocytic lymphohistiocytosis in adults is largely underdiagnosed. To improve the rate and accuracy of diagnosis in adults, the clinical and laboratory characteristics of hemophagocytic lymphohistiocytosis were analyzed in and compared between adults and children in a Chinese cohort. METHOD: Data from 50 hemophagocytic lymphohistiocytosis patients, including 34 adults and 16 children who fulfilled the 2004 hemophagocytic lymphohistiocytosis diagnostic criteria, were collected and analyzed. RESULTS: 1. Etiological factors: The proportion of Epstein-Barr virus infection was lower in adults compared with children, whereas fungal infection and natural killer/T cell lymphoma were more frequent in adults (P<0.05). 2. Clinical manifestations and laboratory findings: Over 90% of adults and pediatric patients presented with fever, thrombocytopenia and high serum ferritin levels. However, in adults, the proportions of hepatomegaly, splenomegaly and jaundice were much lower (P<0.01) than in children, and serous cavity effusion was more frequent in adult patients (P<0.05). More children had hemoglobin <90 g/L, total bilirubin >19 mmol/L and lactate dehydrogenase >500 U/L compared with adults (P<0.05). 3. The time interval from the onset of symptoms to clinical diagnosis was significantly shorter in pediatric patients than in adults (P<0.05). CONCLUSIONS: Certain clinical features were different between the two groups. The less characteristic clinical presentation of hemophagocytic lymphohistiocytosis in adults may make the disease more difficult to diagnose. Our findings suggest that hemophagocytic lymphohistiocytosis should be considered when an adult patient presents with the above-mentioned symptoms.

Clinical presentation of hemophagocytic lymphohistiocytosis in adults is less typical than in children

OBJECTIVE: Hemophagocytic lymphohistiocytosis in adults is largely underdiagnosed. To improve the rate and accuracy of diagnosis in adults, the clinical and laboratory characteristics of hemophagocytic lymphohistiocytosis were analyzed in and compared between adults and children in a Chinese cohort. METHOD: Data from 50 hemophagocytic lymphohistiocytosis patients, including 34 adults and 16 children who fulfilled the 2004 hemophagocytic lymphohistiocytosis diagnostic criteria, were collected and analyzed. RESULTS: 1. Etiological factors: The proportion of Epstein-Barr virus infection was lower in adults compared with children, whereas fungal infection and natural killer/T cell lymphoma were more frequent in adults (P<0.05). 2. Clinical manifestations and laboratory findings: Over 90% of adults and pediatric patients presented with fever, thrombocytopenia and high serum ferritin levels. However, in adults, the proportions of hepatomegaly, splenomegaly and jaundice were much lower (P<0.01) than in children, and serous cavity effusion was more frequent in adult patients (P<0.05). More children had hemoglobin <90 g/L, total bilirubin >19 mmol/L and lactate dehydrogenase >500 U/L compared with adults (P<0.05). 3. The time interval from the onset of symptoms to clinical diagnosis was significantly shorter in pediatric patients than in adults (P<0.05). CONCLUSIONS: Certain clinical features were different between the two groups. The less characteristic clinical presentation of hemophagocytic lymphohistiocytosis in adults may make the disease more difficult to diagnose. Our findings suggest that hemophagocytic lymphohistiocytosis should be considered when an adult patient presents with the above-mentioned symptoms.