Antibacterial, Fatigue-Resistant, and Self-Healing Dressing from Natural-Based Composite Hydrogels for Infected Wound Healing.

The treatment of infected wounds faces substantial challenges due to the high incidence and serious infection-related complications. Natural-based hydrogel dressings with favorable antibacterial properties and strong applicability are urgently needed. Herein, we developed a composite hydrogel by constructing multiple networks and loading ciprofloxacin for infected wound healing. The hydrogel was synthesized via a Schiff base reaction between carboxymethyl chitosan and oxidized sodium alginate, followed by the polymerization of the acrylamide monomer. The resultant hydrogel dressing possessed a good self-healing ability, considerable compression strength, and reliable compression fatigue resistance. In vitro assessment showed that the composite hydrogel effectively eliminated bacteria and exhibited an excellent biocompatibility. In a model of Staphylococcus aureus-infected full-thickness wounds, wound healing was significantly accelerated without scars through the composite hydrogel by reducing wound inflammation. Overall, this study opens up a new way for developing multifunctional hydrogel wound dressings to treat wound infections.

Submonolayer biolasers for ultrasensitive biomarker detection.

Biomarker detection is key to identifying health risks. However, designing sensitive and single-use biosensors for early diagnosis remains a major challenge. Here, we report submonolayer lasers on optical fibers as ultrasensitive and disposable biosensors. Telecom optical fibers serve as distributed optical microcavities with high Q-factor, great repeatability, and ultralow cost, which enables whispering-gallery laser emission to detect biomarkers. It is found that the sensing performance strongly depends on the number of gain molecules. The submonolayer lasers obtained a six-order-of-magnitude improvement in the lower limit of detection (LOD) when compared to saturated monolayer lasers. We further achieve an ultrasensitive immunoassay for a Parkinson's disease biomarker, alpha-synuclein (α-syn), with a lower LOD of 0.32 pM in serum, which is three orders of magnitude lower than the α-syn concentration in the serum of Parkinson's disease patients. Our demonstration of submonolayer biolaser offers great potentials in high-throughput clinical diagnosis with ultimate sensitivity.

Metatranscriptome analysis unveils the mechanisms of zero-valent iron enhancing reactivation of starvation hydrolysis acidification sludge by inducing high-level gene expression.

Hydrolysis acidification (HA) is a promising method for wastewater treatment and resource recovery. However, the extended time required for bacterial reactivation after starvation or a change in living conditions often poses a challenge to the efficient operation of the system. Although the addition of zero-valent iron (ZVI) could enhance HA performance, its effects on sludge reactivation in the HA process are not fully understood. In this study, ZVI was employed to accelerate sludge reactivation and its involved genetic mechanisms were unveiled. The results demonstrated that ZVI addition activated the sludge within 35 days with stable HA performance. Sludge characteristics revealed that ZVI improved active biomass, enzyme activity (by 11.4 % âˆ¼ 26.7 %), ETS activity (by 566 %), and cell viability, with a higher concentration of MLVSS, live cells, more microbial byproducts in EPS, and relative abundance of HA bacteria (63.41 %). Moreover, metatranscriptome analysis showed that ZVI upregulated the expression of genes related to key enzymes in carbohydrate degradation metabolism, biosynthesis of electron transfer media such as heme and ubiquinone, and biosynthesis of vital cofactors like vitamin B12 and folate during microbial growth and metabolism. These findings suggest that ZVI enhanced electron transfer, bacterial growth, and metabolism, resulting in effective starch conversion and VFAs generation. Overall, these results deepen our understanding of the mechanism by which ZVI enhanced HA sludge reactivation, providing valuable information for addressing sludge starvation issues in HA systems.

Incidence and risk factors of postoperative acute myocardial injury in noncardiac patients: A systematic review and meta-analysis.

INTRODUCTION: Postoperative myocardial injury after noncardiac surgery is common and is associated with short- and long-term morbidity and mortality. However, the incidence and risk factors for postoperative acute myocardial injury (POAMI) are currently unknown due to inconsistent definitions. METHODS: We systematically searched PubMed and Web of Science to identify studies that applied the change value of preoperative and postoperative cardiac troponins to define cardiac injury. We estimated the pooled incidence, risk factors, and 30-day and long-term mortality of POAMI in noncardiac patients. The study protocol was registered with PROSPERO, CRD42023401607. RESULTS: Ten cohorts containing 11,494 patients were included for analysis. The pooled incidence of POAMI was 20% (95% CI: 16% to 23%). Preoperative hypertension (OR: 1.47; 95% CI: 1.30 to 1.66), cardiac failure (OR: 2.63; 95% CI: 2.01 to 3.44), renal impairment (OR: 1.66; 95% CI: 1.48 to 1.86), diabetes (OR: 1.43; 95% CI: 1.27 to 1.61), and preoperative beta-blocker intake (OR: 1.65; 95% CI: 1.10 to 2.49) were the risk factors for POAMI. Age (mean difference: 2.08 years; 95% CI: -0.47 to 4.62), sex (male, OR: 1.16; 95% CI: 0.77 to 1.76), body mass index (mean difference: 0.35; 95% CI: -0.86 to 1.57), preoperative coronary artery disease (OR: 2.10; 95% CI: 0.85 to 5.21), stroke (OR: 0.90; 95% CI: 0.50 to 1.59) and preoperative statins intake (OR: 0.65; 95% CI: 0.21 to 2.02) were not associated with POAMI. Patients with POAMI had higher preoperative hsTnT levels (mean difference: 5.92 ng/L; 95% CI: 4.17 to 7.67) and lower preoperative hemoglobin levels (mean difference: -1.29 g/dL; 95% CI: -1.43 to -1.15) than patients without. CONCLUSION: Based on this meta-analysis, approximately 1 in 5 of noncardiac patients develop POAMI. However, the lack of a universally recognized definition for POAMI, which incorporates diverse cardiac biomarkers and patient groups, poses a challenge in accurately characterizing its incidence, risk factors, and clinical outcomes.

Mixed Feedings and Necrotizing Enterocolitis: The Proportion of Human Milk Matters.

Objectives: Impact of the proportion of human milk (HM) in mixed feeding on necrotizing enterocolitis (NEC) remains unknown. This study explores the influence of different proportions of HM on the risk of NEC. Materials and Methods: A retrospective cohort study was performed in infants with very low birth weight (VLBW). A spline smoothing curve was used to evaluate the dose-dependent association between HM and the risk of NEC. Univariate and multivariate analyses were performed to detect the association between the proportion of HM and NEC. Results: Twenty-four infants developed NEC, with 4 (1.9%) in the high HM group, 18 (28.1%) in the low HM group, and 2 (8.0%) in the exclusive formula group (p < 0.001). After adjusting for the relevant confounders, low HM (proportion of HM ≤54%) (OR 33.526, 95% confidential interval [CI] 7.183-156.475, p < 0.001) and exclusive formula feeding (OR 8.493, 95% CI 1.107-65.187, p = 0.040) significantly increased the incidence of NEC, compared with the high HM feeding (proportion of HM >54%). Similarly, low HM was independently associated with an increased risk of feeding intolerance compared with high HM feeding (OR 4.383, 95% CI 2.243-8.564, p < 0.001). Conclusion: A low ratio of HM (≤54%) significantly increased the risk of intestinal complications in VLBW infants. Mixed feeding should relate to the proportion of HM in premature infants.

Development and validation of a risk assessment scale for pathological scarring.

To develop a risk assessment scale for pathological scarring and validate its psychometric properties. This was a methodological study. Researchers developed the scale based on a literature review, qualitative study and Delphi expert consultation. Subsequently, 409 patients participated in the study to test the psychometric properties of the scale. We evaluated construct validity, content validity, internal consistency reliability, and interrater reliability. The researchers developed a scale consisting of three dimensions and 12 items. Factor analysis extracted a total of four common factors that accounted for 62.22% of the total variance. The results revealed that the item-content validity index (I-CVI) ranged from 0.67 to 1, while the scale-content validity index (S-CVI) was 0.82. Internal consistency reliability: Cronbach's α of the items ranged from 0.67 to 0.76, while Cronbach's α of the whole scale was 0.74. Interrater reliability: the Kappa number was 0.73. The final scale showed adequate construct validity, content validity, and reliability. It is appropriate for use in research and clinical practice settings to identify patients with a risk of pathological scarring. Further study is needed to confirm the scale's validity and reliability in other settings and populations.

Learning from the Brain: Bioinspired Nanofluidics.

The human brain completes intelligent behaviors such as the generation, transmission, and storage of neural signals by regulating the ionic conductivity of ion channels in neuron cells, which provides new inspiration for the development of ion-based brain-like intelligence. Against the backdrop of the gradual maturity of neuroscience, computer science, and micronano materials science, bioinspired nanofluidic iontronics, as an emerging interdisciplinary subject that focuses on the regulation of ionic conductivity of nanofluidic systems to realize brain-like functionalities, has attracted the attention of many researchers. This Perspective provides brief background information and the state-of-the-art progress of nanofluidic intelligent systems. Two main categories are included: nanofluidic transistors and nanofluidic memristors. The prospects of nanofluidic iontronics' interdisciplinary progress in future artificial intelligence fields such as neuromorphic computing or brain-computer interfaces are discussed. This Perspective aims to give readers a clear understanding of the concepts and prospects of this emerging interdisciplinary field.

Response of aerobic activated sludge to edible oil exposure: Extracellular polymeric substance (EPS) characteristics and microbial community.

Aerobic activated sludge is widely used to degrade edible oil wastewater in wastewater treatment plants. During this process, the observed poor organics removal performance might be caused by poor sludge settling performance, which might be influenced by extracellular polymeric substances (EPS) and the structure of the microbial community. However, this hypothesis was not confirmed. Thus, this study investigated the response of activated sludge to 50% and 100% edible oil exposure in comparison to glucose, focusing on organics removal performance, characteristics of sludge, EPS, and microbial community structure. Results showed that both concentrations of edible oil influenced the systems' performance, although 100% edible oil showed more significant negative effects than 50% edible oil. The mechanisms behind the influence of edible oil on the aerobic activated sludge system and the differences between the different concentrations of edible oil were revealed. The worse system performance in the edible oil exposure system was due to the worse sludge settling performance, which was significantly affected by edible oil (p < 0.05). The sludge settling performance was mainly inhibited by promoting the formation of floating particles and the enrichment of filamentous bacteria in the 50% edible oil exposure system; biosurfactant secretion was also speculated as the reason, in addition to the above factors, in the 100% edible oil exposure system. The macroscopic largest floating particles, highest total relative abundance of foaming bacteria and biosurfactant production genera (34.32%), lowest surface tension (43.7 mN/m), and highest emulsifying activity (E24 = 25%) of EPS in 100% edible oil exposure systems provide strong evidence.

Mechanistic insight into the degradation of ciprofloxacin in water by hydroxyl radicals.

Ciprofloxacin (CIP), an effective antibacterial drug, is widely used to treat bacterial infections in humans and animals. However, drug pollution from residues and the development of resistant genes may pose serious ecological risks. Among the known methods of CIP degradation, advanced oxidation technology initiated by hydroxyl radicals exhibits great potential. However, an in-depth study of the degradation mechanism is difficult because of the limitations of the testing methods. In this study, CIP oxidation by hydroxyl radicals was evaluated using density functional theory (DFT), and the thermodynamics, kinetics, and toxicity were investigated. The results show that CIP oxidation occurs mainly through the piperazine ring, benzene ring, and CC. High reactivity is achieved in the initial reactions, where only five reactions are not thermodynamically spontaneous. Reactions involving direct hydrogen abstraction by oxygen in this system are superior to the indirect reactions. Some theoretically predicted products, such as P6 and P11, are consistent with those reported in previous experiments, indicating that the theoretical study can provide supplementary information about the oxidation paths. The branching ratios for the hydrogen atom abstraction and addition reactions were 37. 45% and 62.55%, respectively. Finally, this reaction system is completely nontoxic based on toxicity assessment.

Zero-valent iron effectively enhances valuable products generated from wastewater containing 2-bromo-4,6-dinitroaniline during hydrolysis acidification process: Performance and mechanisms.

Treatment to remove 2-bromo-4,6-dinitroaniline (BDNA) from wastewater is urgently needed owing to its carcinogenicity, mutagenicity, and teratogenicity. Hydrolysis acidification (HA) is widely used to treat wastewater to improve biodegradability and resource utilization. Thus, a zero-valent iron (ZVI)-coupled HA system was operated to treat BDNA-containing wastewater for the first time, with emphasis on the performance and enhanced mechanisms. The improved results for BDNA removal efficiency and B/C ratio and the decreased acute toxicity suggested that ZVI addition benefited the formation of advantageous products for subsequent biological treatment. The volatile fatty acids (VFAs) ratio (CHAc:CHPr:CHBu) was optimized from 21:5:4 to 29:5:6, which benefited the utilization of wastewater resources for lipid generation. ZVI characterization, density functional theory (DFT) calculations, extracellular polymeric substances (EPS) analysis, molecular ecological network analysis (MENA), and redundancy analysis (RDA) of the microbial community further revealed that the enhanced mechanisms were summarized as beneficial interactions between ZVI and microorganisms. The ZVI was protected from excessive corrosion and lowered the oxidation-reduction potential (ORP), a key environmental factor, resulting in differences in microbial communities. These differences were presented as the enrichment of keystone species (e.g., Lactococcus), which function in BDNA reduction and VFAs generation. Moreover, ZVI promoted electron transfer, as proven by the high electron transfer capacity (ETC) of 0.452 and 0.361 µmol e-/g VSS in the RZVI and blank systems, respectively.

Performance and mechanisms of enhanced hydrolysis acidification by adding different iron scraps: Microbial characteristics and fate of iron scraps.

HA, as one of low-carbon pre-treatment technology could be enhanced by packing of iron or iron oxide powder for enhancing the transformation of large molecular weight to generate volatile fatty acids (VFAs) for fuel production. However, the controversy of iron strengthening the HA and inherent drawbacks of iron oxide, such as poor mass transfer, and difficult recovery, limit this pretreatment technology. Clean and rusty iron scraps were packed into an HA system to address these issues while focusing on the system performance and the response of core bacterial and fungal microbiomes to iron scrap exposure. Results showed that clean and rusty iron scraps can significantly improve the HA performance while considering hydrolysis efficiency (HE), acidification efficiency (AE) and VFAs production, given that VFAs ratios (Cacetate: Cpropionate: Cbutyrate) were changed from the 14:5:1 to 14:2:1 and 29:4:1, respectively, and the obtained VFAs ratios in iron scraps addition systems were more closely to the optimal VFAs ratio for lipids production. Redundant and molecular ecological network analyses indicated that iron scraps promote the system stability and acidogenesis capacity by boosting the complexity of microbes' networks and enriching core functional microbes that show a positive response to HA performance, among which the relative abundance of related bacterial genera was promoted by 19.71 and 17.25% for RRusty and RClean systems. Moreover, except for the differences between the control and iron scraps addition systems, the findings confirmed that the RRusty system is slightly different from the RClean one, which was perhaps driven by the behavior of 6.20% of DIRB in RRusty system and only 1.16% of homoacetogens in RClean system when considering the microbial community and fate of iron scraps. Totally, the observed results highlight the application potential of the iron scrap-coupled HA process for the generation of VFAs and provide new insights into the response of different iron scraps in microbes communities.

An Infant With Interstitial Lung Disease of Rare Cause.

CASE PRESENTATION: An 11-month-old boy was admitted to our hospital because of "recurrent cough with intermittent dyspnea for more than 8 months, aggravated for 1 month." The baby began experiencing a recurrent milk-choking problem within 1.5 months after birth. He had been hospitalized four times, but the symptoms recurred. One month previously, the symptoms were aggravated and a chest CT scan performed at outside hospital showed interstitial changes. Pediatric bronchoscopy revealed bronchial inflammatory features, with hemosiderin-laden macrophages being found in BAL fluid (BALF). Also, periodic acid-Schiff (PAS) staining showed positive results, which indicated the possibility of pulmonary alveolar proteinosis (PAP) or idiopathic pulmonary hemosiderosis (IPH).

Application of Fenton sludge coupled hydrolysis acidification in pretreatment of wastewater containing PVA: Performance and mechanisms.

Hydrolysis acidification (HA) is widely used in pretreatment of macromolecular refractory wastewater to improve its biodegradability. However, because the biological activity could be inhibited by macromolecular substances to a certain extent, its application is limited. In this study, polyvinyl alcohol (PVA), as a classic macromolecular pollutant in TPD wastewater, was treated by the Fenton sludge-coupled HA process to investigate the effects of Fenton sludge addition on the HA performance and identify the probable mechanisms behind it. The results showed that approximately 40% of macromolecular PVA was hydrolyzed into small molecular substances with molecular weight (Mw) < 105 in the Fenton sludge-added reactor. Meanwhile, acidification efficiency (AE), volatile fatty acid production increased by 20.8% and 92.05 mg/L with Fenton sludge addition. The values of BOD5/COD changed from 0.091 of influent to 0.26 and 0.32 of effluent from the simple HA process and Fenton sludge addition HA process, respectively. These results proved that biodegradability was improved by the two processes and the Fenton sludge addition had a positive effect on HA. Further analysis found that 2-lines ferrihydrite involved in Fenton sludge might serve as an electron acceptor to participate in extracellular respiratory. Besides, the Fe2+ observed a positive effect of the sludge characteristics in agreement with the higher activity of dehydrogenase and extracellular polymeric substances (EPS) production. This study suggested that Fenton sludge can be recycled and used as an iron source to enhance HA for industrial wastewater pretreatment.

Protective effects of Baicalin injection on severe acute pancreatitis through regulating follistatin-like-1 signaling pathway by down-regulating miR-429 expression in mice

Abstract In China, Scutellaria is used for treating inflammatory-related diseases. Baicalin is the main active component of Scutellaria and has protective effects on acute pancreatitis. However, the mechanism of Baicalin is still unclear. In this study, the protective effects of baicalin on acute pancreatitis induced by taurocholate and its mechanism are investigated. In this study, mice were randomly divided into three groups: sham operation, model, and treatment groups. Acute pancreatitis in mice was induced by intraperitoneal injection of taurocholate (35 mg/kg). The treatment group was given baicalin (100 mg/kg) 2 h before acute pancreatitis induction. The mRNA expression levels of miR-429, nuclear factor kappa B65(NF-kB65), toll-like receptor 4(TLR4), TNF receptor associated factor6 (TRAF6), NF-kappa-B inhibitor(IkB), Follistatin-like 1 (FSTL1), and interleukin-1 receptor-associated kinase (IRAK) in the liver tissues 24 h after intraperitoneal injection were detected by RT-PCR. Then, the expression levels of NF-kB65, p-NF-κB65, TLR4, TRAF6, IkB, FSTL1, IRAK, p- IRAK, and p- IkB-а proteins were detected by Western blot. IL-6, TNF-α and IL-1 ß in plasma were measured by ELISA, and histopathological changes in the pancreases of the mice were observed. The results showed that after baicalin treatment, miR-429 expression in the pancreatic tissues and the expression levels of NF-kB65, TLR4, TRAF6, p-IkB-а, FSTL1, and p-IRAK decreased. Similarly, pancreatic myeloperoxidase (MPO) activity and the plasma levels of IL-6, TNF-а, IL-12, IL-1ß1, endotoxin, serum amylase, and lipase were reduced. Thus, the pancreatic injury induced by taurocholate was alleviated. The present study indicates that pretreatment with Baicalin can alleviate acute pancreatic injury induced by taurocholate in mice. The mechanism may be associated with the decreased miR-429 expression, reduced FSTL1 signaling pathway activity, TLR4 and TLR4/MyD88 signaling pathway inhibition, and reduced pancreatic inflammation. FSTL1 is the regulatory target for miR-429

A sequentially bioconjugated optofluidic laser for wash-out-free and rapid biomolecular detection.

Microstructures can improve both sensitivity and assay time in heterogeneous assays (such as ELISA) for biochemical analysis; however, it remains a challenge to perform the essential wash process in those microstructure-based heterogeneous assays. Here, we propose a sequential bioconjugation protocol to solve this problem and demonstrate a new type of fiber optofluidic laser for biosensing. Except for acting as an optical microresonator and a microstructured substrate, the miniaturized hollow optical fiber (HOF) is used as a microfluidic channel for storing and transferring reagents thanks to its capability in length extension. Through the capillary action, different reagents were sequentially withdrawn into the fiber for specific binding and washing purposes. By using the sequentially bioconjugated FOFL, avidin molecules are detected based on competitive binding with a limit of detection of 9.5 pM, ranging from 10 pM to 100 nM. It is demonstrated that a short incubation time of 10 min is good enough to allow the biomolecules to conjugate on the inner surface of the HOF. Owing to its miniaturized size, only 589 nL of liquid is required for incubation, which reduces the sample consumption and cost for each test. This work provides a tool to exploit the potential of microstructured optical fibers in high-performance biosensing.

Visible light-driven oxidative coupling of dibenzylamine and substituted anilines with a 2D WSe2 nanomesh material.

A novel 2D WSe2 nanomesh material was synthesized with a 3D SBA-15 mesoporous material via a nanocasting strategy. The formation of the 2D sheet-like nanomesh structure of WSe2 inside a 3D confined pore space is mainly attributed to the synergistic effect arising from the crystal self-limitation growth caused by the layered crystal structure of the WSe2 material and to the space-limitation effect coming from the unique pore structure of the SBA-15 template. The 2D WSe2 nanomesh material possesses extremely high exposure of crystal layer edges, making it an excellent photocatalyst. It shows good visible light-driven photocatalytic performance in oxidative coupling of dibenzylamine and 2-amino/hydroxy/mercaptoanilines to prepare a group of heterocyclic compounds, including benzimidazoles, benzoxazoles and benzothiazoles with oxygen as the sole oxidant. A gram-scale experiment was also carried out to exhibit the scope of this method.

Prognostic value of tertiary lymphoid structure and tumour infiltrating lymphocytes in oral squamous cell carcinoma.

Tertiary lymphoid structures (TLS) are ectopic lymphoid structures in cancers that are largely associated with favourable prognosis. However, the prognostic value of TLSs in oral squamous cell carcinoma (OSCC) is largely unknown, and the association between tumour infiltrating lymphocytes (TILs) and TLSs has been rarely explored in OSCC. In this study, associated markers of TLS, including peripheral node address (PNAd) in high endothelial venules, CD20 in B cells and CD3 in T cells, were examined in 168 OSCC patients, and survival analysis was performed between TLS-positive and TLS-negative cohorts. We detected the presence of TILs by staining CD8+ cytotoxic T cells and CD57+ NK cells as well. TLSs appeared as highly organized structures in 45 (26.8%) cases. TLS-positive patients had a better 5-year overall survival (OS) rate (88.9% vs. 56.1%, P < 0.001) and relapse-free survival (RFS) rate (88.9% vs. 63.4%, P = 0.002). Moreover, the presence of TLS was an independent prognostic factor for both the 5-year OS rate (hazard ratio [HR] = 3.784; 95% confidence interval [CI], 1.498-9.562) and RFS rate (HR = 3.296; 95% CI, 1.279-8.490) in multivariate analysis. Furthermore, a higher density of CD8+ T cells and CD57+ NK cells was found in TLS-positive sections than in TLS-negative counterparts (P < 0.001), and their combination provided a higher predictive accuracy (AUC = 0.730; 95% CI, 0.654-0.805). In conclusion, our results suggest that TLS is an independent positive prognostic factor for OSCC patients. These findings provide a theoretical basis for the future diagnostic and therapeutic value of TLSs in OSCC treatment.

Mass production of thin-walled hollow optical fibers enables disposable optofluidic laser immunosensors.

Disposable biosensors are of great importance in disease diagnosis due to their inherent merits of no cross-contamination and ease of use. Optofluidic laser (OFL) sensors are a new category of sensitive biosensors; however, it is challenging to cost-effectively mass-produce them to achieve disposability. Here, we report a disposable optofluidic laser immunosensor based on thin-walled hollow optical fibers (HOFs). Using a fiber draw tower, the fabrication parameters, including drawing speed and gas flow rate, are explored, and the HOF geometry is precisely controlled, which allows identical laser microring resonators to be distributed along the fibers. The disposable OFL immunosensor detects the protein concentration in the HOF through a wash-free immunoassay. Enabled by the disposable sensors, the statistical characteristics of 80 tests for each concentration greatly reduces the bioassay uncertainty. A low coefficient of variation (CV) of 3.3% confirms the high reproducibility of the disposable HOF-OFL sensors, and the mean of the normal distribution of the logarithmic OFL intensity serves as the sensing output. A limit of detection of 11 nM within a short assay time of 15 min is achieved. These disposable immunosensors possess the advantages of low cost, high reproducibility, fast assay, and low-volume consumption of sample and reagents. We believe that this work will inspire disposable optofluidics through the mass production of multifunctional microstructured optical fibers.

[Application of standardized venous thromboembolism prevention program in burn patients].

OBJECTIVE: To develop a standardized venous thromboembolism (VTE) prevention program for burn patients and verify its safety and effectiveness by comparing with traditional thrombus prophylaxis. METHODS: All burn patients admitted and met selection criteria betweem April 2017 and September 2018 were included. Patients between January 2018 and September 2018 were included as the interventional group to implement standardized VTE prevention programs, while patients between April 2017 and December 2017 were included as the control group and traditional active and passive exercises were used to prevent VTE. There was no significant difference in the age, gender, ethnic group, marriage, education, occupation, type and site of the injury, burn area, operation time, and hospital stay between the two groups ( P>0.05), which was comparable. The incidence of VTE, number of cases of tissue or organ hemorrhage, survival rate of skin grafting, and time of wound healing were compared. RESULTS: The incidence of VTE was obviously lower in the interventional group (1.56%, 1/64) than in the control group (10.17%, 6/59) ( χ 2=-2.05, P=0.04). No bleeding occurred in any tissue or organ in the two groups. The survival rate of skin grafting and the time of wound healing were 89.06% (57/64) and (11.78±3.08) days respectively in the interventional group and 91.53% (54/59) and (11.66±2.30) days respectively in the control group; and the differences between the two groups were not statistically significant ( χ 2=0.21, P=0.65; t=-0.22, P=0.83). CONCLUSION: The standardized VTE prevention program can effectively prevent the occurrence of VTE, and its safety is relatively high.

Dexmedetomidine preconditioning attenuates ischemia/reperfusion injury in isolated rat hearts with endothelial dysfunction.

BACKGROUND AND PURPOSES: Dexmedetomidine preconditioning (DP) can mimic pharmacological preconditioning and induce cardiac protection. There are controversies on the roles of coronary endothelia in cardioprotection of dexmedetomidine. Herein, we tested the hypothesis that protection of dexmedetomidine is not endothelial dependent in heart against myocardial ischemia/reperfusion (I/R) injury. METHODS: Langendorff-perfused rat hearts were pretreated by 60 mM of potassium to produce endothelial dysfunction (ED), then medicated with dexmedetomidine, and subsequently subjected to 30 min of global ischemia followed by 60 min of reperfusion. To investigate the cardioprotective effect of dexmedetomidine in heart with ED, isolated rat hearts were randomly divided into the following six groups: sham, I/R, DP, ED, ED + I/R, and ED + DP + I/R. Heart rates, left ventricular function, and coronary perfusion pressure were assessed for each heart. Infarct size was evaluated by triphenyltetrazolium chloride staining. High-sensitivity cardiac troponin T (hs-cTNT) of coronary flow perfusion was determined. RESULTS: After the isolated hearts with pretreatment of 60 mM of potassium chloride, diastolic function of coronary endothelia in performance of response to histamine was significantly decreased (P < 0.05). DP attenuated I/R-induced infarct size of the left ventricle (P < 0.05) and decreased hs-cTNT (P < 0.05). Additionally, left ventricular developed pressure, +dp/dtmax, and -dp/dtmax were elevated in rat hearts pretreated with dexmedetomidine. Furthermore, dexmedetomidine-mediated cardiac protection against I/R injury was still remained in isolated hearts with coronary ED. CONCLUSION: Continuous perfusion of 60 mM of potassium for 10 min can produce coronary ED in isolated rat hearts. Dexmedetomidine maintains its protective function against I/R injury in heart with coronary ED. Myocardial protection of dexmedetomidine is non-endothelial function dependent in alleviating I/R injury.