Effect of Xuebijing injection on myocardium during cardiopulmonary bypass: A prospective, randomized, double blind trial.

BACKGROUND: Cardiopulmonary bypass (CPB) is an essential procedure for maintaining the blood supply to vital organs in patients undergoing cardiac surgery. However, perioperative cardiac injury related to CPB remains a severe complication in these patients. Cardiac protection is important for patients undergoing CPB. AIM: To evaluate the potential cardioprotective efficacy of the Chinese medicine preparation Xuebijing injection (XBJ) in patients undergoing CPB. METHODS: Sixty patients undergoing cardiac surgery with CPB were randomly allocated to the XBJ and control groups (saline). XBJ was administered intravenously three times: 12 h prior to surgery, at the beginning of the surgery, and 12 h after the second injection. Cardiac function was evaluated by echocardiography 48 h after surgery. Circulating inflammation- and oxidative-stress-related markers were measured. Clinical outcomes related to intensive care unit (ICU) stay were recorded. RESULTS: Compared to control treatment, XBJ was associated with improved PaO2/FiO2 and cardiac systolic function, but reduced troponin I and creatine kinase fraction after surgery (all P < 0.05). The circulating concentrations of tumor necrosis factor-α, interleukin (IL)-1ß and IL-8 in the XBJ group were significantly lower than those in the control group (all P < 0.05), whereas the circulating concentration of IL-10 was significantly higher in the XBJ group (P < 0.05). In addition, the lengths of ICU stay and hospitalization after surgery tended to be shorter in the XBJ group than in the control group, although the differences were not significant. CONCLUSION: Perioperative administration of XBJ was associated with attenuated cardiac injury during CPB, likely via anti-inflammatory and antioxidative mechanisms.

Diannexin Can Ameliorate Acute Respiratory Distress Syndrome in Rats by Promoting Heme Oxygenase-1 Expression.

BACKGROUND: The recombinant protein diannexin can inhibit platelet-mediated events, which contribute to acute respiratory distress syndrome (ARDS). Here, we investigated the effect of diannexin and its effect on heme oxygenase-1 (HO-1) in ARDS. METHODS: A total of 32 rats were randomized into sham, ARDS, diannexin (D), and diannexin+HO-1 inhibitor (DH) groups. Alveolar-capillary permeability was evaluated by testing the partial pressure of oxygen to fraction of inspired oxygen (PaO2/FiO2) ratio, lung wet/dry weight ratio, and protein levels in the lung. Inflammation was assessed by measuring cytokine levels in the bronchial alveolar lavage fluid (BALF) and serum and nuclear factor-κB (NF-κB) in the lung tissue. Inducible nitric oxide synthase (iNOS), malondialdehyde (MDA), and myeloperoxidase (MPO) were measured to evaluate the oxidative stress response. Lung tissue pathology and apoptosis were also evaluated. We measured HO-1 expression in the lung tissue to investigate the effect of diannexin on HO-1 in ARDS. RESULTS: Compared with the ARDS group, diannexin improved PaO2/FiO2, lung wet/dry weight ratio, and protein levels in the BALF and decreased levels of cytokines and NF-κB in the lung and serum. Diannexin inhibited the oxidative stress response and significantly ameliorated pathological lung injury and apoptosis. The partial reversal of diannexin effects by a HO-1 inhibitor suggests that diannexin may promote HO-1 expression to ameliorate ARDS. CONCLUSIONS: We showed that diannexin can improve alveolar-capillary permeability, inhibit the oxidative stress response and inflammation, and protect against ARDS-induced lung injury and apoptosis.

Comparative study on the efficacy and safety of alteplase and urokinase in the treatment of acute cerebral infarction.

BACKGROUND: Acute cerebral infarction (ACI) is a common cerebrovascular disease in clinical practice. OBJECTIVE: The present study aims to investigate the efficacy and safety of alteplase and urokinase in treating ACI. METHODS: A total of 96 patients with ACI, who were treated with alteplase and urokinase, were selected as the main subjects. Among these patients, 45 patients with ultra-early acute cerebral infarction, who received intravenous thrombolysis with RT-PA (alteplase), were included in the treatment group, while 51 patients with acute cerebral infarction, who were treated with urokinase in the same time period, were included in the control group. RESULTS: The National Institute of Health Stroke Scale (NIHSS) scores were significantly lower in the treatment group and control group (P< 0.05) at two hours, seven days and 14 days after thrombolysis, when compared to those before thrombolysis. The bleeding rate was significantly lower in the control group, when compared to the treatment group (P< 0.05). CONCLUSION: The intravenous thrombolysis with urokinase or alteplase in the ultra-early stage of acute cerebral infarction can reduce the neurological injury symptoms and effectively improve the prognosis of patients with stroke. Urokinase is lower in risk of bleeding, but better in safety, when compared to alteplase.

Ac2-26 Alleviates Brain Injury after Cardiac Arrest and Cardiopulmonary Resuscitation in Rats via the eNOS Pathway.

BACKGROUND: Brain injury is the leading cause of death following cardiac arrest (CA) and cardiopulmonary resuscitation (CPR). Ac2-26 and endothelial nitric oxide synthase (eNOS) have been shown to reduce neuroinflammation. This study is aimed at determining the mechanism by which Ac2-26 protects against inflammation during brain injury following CA and CPR. METHODS: Sixty-four rats were randomized into sham, saline, Ac2-26, and Ac2-26+L-NIO (endothelial nitric oxide synthase (eNOS) inhibitor) groups. Rats received Ac2-26, Ac2-26+L-NIO, or saline after CPR. Neurologic function was assessed at baseline, 24, and 72 hours after CPR. At 72 hours after resuscitation, serum and brain tissues were collected. RESULTS: Blood-brain barrier (BBB) permeability increased, and the number of surviving neurons and neurological function decreased in the saline group compared to the sham group. Anti-inflammatory and proinflammatory factors, neuron-specific enolase (NSE) levels, and the expression of eNOS, phosphorylated (p)-eNOS, inducible nitric oxide synthase (iNOS), and oxidative stress-related factors in the three CA groups significantly increased (P < 0.05). BBB permeability decreased, and the number of surviving neurons and neurological function increased in the Ac2-26 group compared to the saline group (P < 0.05). Ac2-26 increased anti-inflammatory and reduced proinflammatory markers, raised NSE levels, increased the expression of eNOS and p-eNOS, and reduced the expression of iNOS and oxidative stress-related factors compared to the saline group (P < 0.05). The effect of Ac2-26 on brain injury was reversed by L-NIO (P < 0.05). CONCLUSIONS: Ac2-26 reduced brain injury after CPR by inhibiting oxidative stress and neuroinflammation and protecting the BBB. The therapeutic effect of Ac2-26 on brain injury was largely dependent on the eNOS pathway.

The combination of transversus abdominis plane block and rectus sheath block reduced postoperative pain after splenectomy: a randomized trial.

BACKGROUND: Splenectomy performed with a curved incision results in severe postoperative pain. The aim of this study was to evaluate the effect of transversus abdominis plane block and rectus sheath block on postoperative pain relief and recovery. METHODS: A total of 150 patients were randomized into the control (C), levobupivacaine (L) and levobupivacaine/morphine (LM) groups. The patients in the C group received only patient-controlled analgesia. The patients in the L and LM groups received transversus abdominis plane block and rectus sheath block with levobupivacaine or levobupivacaine plus morphine. The intraoperative opioid consumption; postoperative pain score; time to first analgesic use; postoperative recovery data, including the times of first exhaust, defecation, oral intake and off-bed activity; the incidence of postoperative nausea and vomiting and antiemetics use; and the satisfaction score were recorded. RESULTS: Transversus abdominis plane block and rectus sheath block reduced intraoperative opioid consumption. The patients in the LM group showed lower postoperative pain scores, opioid consumption, postoperative nausea and vomiting incidence and antiemetic use and presented shorter recovery times and higher satisfaction scores. CONCLUSIONS: The combination of transversus abdominis plane block and rectus sheath block with levobupivacaine and morphine can improve postoperative pain relief, reduce the consumption of analgesics, and partly accelerate postoperative recovery. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR 1,800,015,141, 10 March 2018.

Engineering the Core-Shell-Structured NCNTs-Ni2Si@Porous Si Composite with Robust Ni-Si Interfacial Bonding for High-Performance Li-Ion Batteries.

A new strategy has been innovatively proposed for wrapping the Ni-incorporated and N-doped carbon nanotube arrays (Ni-NCNTs) on porous Si with robust Ni-Si interfacial bonding to form the core-shell-structured NCNTs-Ni2Si@Si. The hierarchical porous silicon core was first fabricated via a novel self-templating synthesis route based on two crucial strategies: in situ thermal evaporation of crystal water from the perlite for producing porous SiO2 and subsequent magnesiothermic reduction of porous SiO2 into porous Si. Ni-NCNTs were subsequently constructed based on the Ni-catalyzed tip-growth mechanism and were further engineered to fully wrap the porous Si microparticles by forming the Ni2Si alloy at the heterojunction interface. When the prepared NCNTs-Ni2Si@Si was evaluated as the anode material for Li-ion batteries, the hierarchical porous system in the Si core and the rich void spaces in carbon nanotube arrays contributed to the remarkable accommodation of volume expansion of Si as well as the significant increase of Li+ diffusion and Si utilization. Moreover, the Ni2Si alloy, which chemically linked the Ni-NCNTs and porous Si, not only provided good electronic contact between the Si core and carbon shell but also effectively prevented the CNTs' detachment from the Si core during cycling. The multifunctional structural design rendered the whole electrode highly stable and active in Li storage, and the electrochemically active NCNTs-Ni2Si@Si electrode delivered a high reversible capacity of 1547 mAh g-1 and excellent cycling stability (85% capacity retention after 600 discharge-charge cycles) at a current density of 358 mA g-1 (0.1 C) as well as good rate performance (778 mAh g-1 at 2 C), showing great potential as an efficient and stable anode for high energy density Li-ion batteries.

[Clavicle fracture after radical neck dissection of mouth floor carcinoma misdiagnosed as cervical metastasis: a case report].

Clavicle fracture, a very rare delayed complication following radical neck dissection of oral carcinoma, is normally ignored by oral and maxillofacial surgeons. We report and analyze a male patient with clavicle fracture after primary extended excision and bilateral radical neck dissection. This case was misdiagnosed as cervical metastasis.

"Infinite Sensitivity" of Black Silicon Ammonia Sensor Achieved by Optical and Electric Dual Drives.

The microstructured and hyperdoped silicon as a superior photoelectric and photovoltaic material is first studied as a gas-sensing material. The material is prepared by femtosecond-laser irradiation on selenium-coated silicon and then fabricated as a conductive gas sensor, targeting ammonia. At room temperature, the sensitivity, response time, repeatability, distinguishability, selectivity, and natural aging effect of the sensor have been systematically studied. Results show that such black silicon has good potential for application as an ammonia-sensing material. On the basis of its unique optoelectronic properties, an additional optical drive is proposed for the formation of an optical and electric dual-driven sensor, which is achieved by asymmetric light illumination between the two electrode regions. In a certain range of applied voltage, the sensitivity is enhanced dramatically and even tends to be infinite. For the aged device with degraded sensitivity, a two-order increment is obtained for 500 ppm of NH3 under the extra optical drive. A mechanism based on Dember effect is proposed for explaining such a phenomenon.

[Association between toll-like receptors 2 and 5 polymorphisms and neonatal sepsis].

OBJECTIVE: To study the association between single nucleotide polymorphisms(SNP) in toll-like receptors (TLR) 2 and 5 genes and the susceptibility to neonatal sepsis. METHODS: One hundred and fourteen newborn infants who were diagnosed with clinical sepsis (case group) between May 2011 and January 2014 and 172 newborn infants without infection(control group) were enrolled in this study. The polymorphisms of TLR2 (rs5743708 and rs3804099) and TLR5 (rs5744105) were analyzed using a SNaPshot multiplex reaction to compare the genotypic and allelic frequencies between two groups. The relationship between TLR genotypes and susceptibility to sepsis was analyzed by logistic regression models. RESULTS: Significant differences in genotypic frequencies of TLR2 rs3804099 (C/T) and TLR5 rs5744105 (C/G) were found between the two groups (P<0.05), but there was no significant difference in allelic frequencies of all the SNPs above between the two groups (P>0.05). The genotype on TLR2 rs5743708 was GG and no mutation was found in both groups. In regression models, birth weight (OR=3.065; P<0.05) and gestational age (OR=3.301; P<0.05) were closely associated with neonatal sepsis. Sex (OR=1.107, P>0.05), polymorphisms in rs3804099 (OR=0.876; P>0.05) and polymorphisms in rs5744105 (OR=0.820; P>0.05) genes were not risk factors for neonatal sepsis. CONCLUSIONS: TLR2 and 5 polymorphisms (rs5743708, rs3804099 and rs5744105) may not serve as the susceptible gene for sepsis in newborn infants.

Reversible switching of magnetic states by electric fields in nitrogenized-divacancies graphene decorated by tungsten atoms.

Magnetic graphene-based materials have shown great potential for developing high-performance electronic devices at sub-nanometer such as spintronic data storage units. However, a significant reduction of power consumption and great improvement of structural stability are needed before they can be used for actual applications. Based on the first-principles calculations, here we demonstrate that the interaction between tungsten atoms and nitrogenized-divacancies (NDVs) in the hybrid W@NDV-graphene can lead to high stability and large magnetic anisotropy energy (MAE). More importantly, reversible switching between different magnetic states can be implemented by tuning the MAE under different electric fields, and very low energy is consumed during the switching. Such controllable switching of magnetic states is ascribed to the competition between the tensile stain and orbital magnetic anisotropy, which originates from the change in the occupation number of W-5d orbitals under the electric fields. Our results provide a promising avenue for developing high-density magnetic storage units or multi-state logical switching devices with ultralow power at sub-nanometer.

Local electrical conduction in polycrystalline La-doped BiFeO3 thin films.

Local electrical conduction behaviors of polycrystalline La-doped BiFeO3 thin films have been investigated by combining conductive atomic force microscopy and piezoelectric force microscopy. Nanoscale current measurements were performed as a function of bias voltage for different crystal grains. Completely distinct conducting processes and resistive switching effects were observed in the grain boundary and grain interior. We have revealed that local electric conduction in a grain is dominated by both the grain boundary and ferroelectric domain, and is closely related to the applied electric field and the as-grown state of the grain. At lower voltages the electrical conduction is dominated by the grain boundary and is associated with the redistribution of oxygen vacancies in the grain boundary under external electric fields. At higher voltages both the grain boundary and ferroelectric domain are responsible for the electrical conduction of grains, and the electrical conduction gradually extends from the grain boundary into the grain interior due to the extension of the ferroelectric domain towards the grain interior. We have also demonstrated that the conduction dominated by the grain boundary exhibits a much small switching voltage, while the conduction of the ferroelectric domain causes a much high switching voltage in the grain interior.

[Diagnostic accuracy of fine needle aspiration biopsy of cervical lymph node: a study of 580 cases].

OBJECTIVE: Study on the diagnostic accuracy of fine needle aspiration biopsy of cervical lymph nodes and to discuss the reasons of making a misdiagnosis. METHODS: Five hundred and eighty cases of cervical lymph node fine needle aspiration biopsy were reviewed retrospectively. Among them, histologic findings were available in 161 cases. The cytologic and histologic diagnoses were compared. RESULTS: There were altogether 226 cases of reactive lymphoid hyperplasia, 202 cases of specific inflammation, 45 cases of malignant lymphoma and 107 cases of metastatic carcinoma. The concordance rate between the cytologic and corresponding histologic diagnoses was 94.4%. The primary foci of most cases with metastatic carcinoma could be delineated by reviewing the clinical and pathologic finding. Inadequate cellularity was the main reason of making misdiagnosis and useful diagnostic clues might be obtained by careful study of the clinical findings. CONCLUSIONS: Fine needle aspiration biopsy of cervical lymph node carries a high diagnostic accuracy. It provides important clues in guiding subsequent clinical management. However, for detailed subtyping of certain disease entities such as malignant lymphoma, surgical biopsy for histologic and immunohistochemical studies are required.