Anaesthesia provision, infrastructure and resources in the Heilongjiang Province, China: a cross-sectional observational study.

OBJECTIVE: The aim of this study was to explore the current status of the anaesthesia provision, infrastructure and resources in the Heilongjiang Province, China. DESIGN: A cross-sectional observational study of hospitals, anaesthesiologists, assistant anaesthesiologists and anaesthetic nurses in the Heilongjiang Province. SETTING: All hospitals in the Heilongjiang Province. PARTICIPANTS: The hospitals, anaesthesiologists (attending physicians, associate chief physicians and chief physicians), assistant anaesthesiologists (licenced assistant physicians, resident physicians and other trainees) and anaesthetic nurses. MAIN OUTCOME MEASURES: Standard descriptive statistics (percentages and numbers) were used to summarise the data. RESULTS: The investigation involved 1123 hospitals, 405 of these hospitals had anaesthesiology departments (36.06%). There were 2406 anaesthesiologists, 175 assistant anaesthesiologists and 409 anaesthetic nurses. The proportion of anaesthesiologists was 56.60% in tertiary hospitals, 40.15% in secondary hospitals and 3.25% in primary hospitals and ungraded hospitals, respectively. Anaesthesiologists were present in 91.20% of public hospitals and 8.80% of private hospitals. Anaesthesiologists were present in 83.55% general hospitals and 16.45% of specialised hospitals. The Heilongjiang Province has a total of 2041 operating rooms and 543 beds in recovery rooms. The number of anaesthesia cases per capita per year was 326.86. The percentages of anaesthesiologists' age ≥46, 36-45, 25-35 and <25 are 24.03%, 41.80%, 33.91% and 0.27%, respectively. The proportions of resident physicians and attending physicians were 60.87%, and the proportions of associate chief physicians and chief physicians were 39.13%. The proportions of anaesthesiologists working >12 hours, 10 hours≤time≤12 hours, 8 hours≤time<10 hours and <8 hours were 0.55%, 22.04%, 64.30% and 13.11%, respectively. CONCLUSIONS: The present study demonstrated for the first time that the proportion of anaesthesiologists in the Heilongjiang Province, China, is still insufficient. The structure of anaesthesiologists needs to be optimised.

Surgical Trauma-induced CCL2 Upregulation Mediates Lung Cancer Progression by Promoting Treg Recruitment in Mice and Patients.

Surgical removal of the tumor is currently the first-line treatment for lung cancer, but the procedure may accelerate cancer progression through immunosuppression. However, whether CCL2 (C-C motif chemokine ligand 2) enhances cancer progression by affecting regulatory T cells (Tregs) remains unknown. We found that the volume and weight of tumors were larger in the surgical trauma group than in the control group. CCL2 expression and Treg abundance were increased in tumor tissues after surgical trauma, and CCL2 expression was positively associated with Treg abundance. These results demonstrated that surgical trauma contributes to lung cancer progression by increasing CCL2 expression, thus promoting Treg recruitment.

Comparison of high-level athlete training between chinese and american universities based on the internet of things / Comparação do treinamento de atletas de alto nível entre universidades chinesas e americanas com baseado na internet das coisas / Comparación de la formación de atletas de alto nivel en colegios y universidades chinos y estadounidenses basada en la tecnología de internet de las cosas

ABSTRACT In order to improve the training quality of high-level athletes in Chinese and American universities, an athlete's sports information transmission model is designed based on the Internet of Things (IoT). The communication protocol between Ayla module and the main motion control board, Ayla module and client APP or cloud platform, and APP and cloud platform in the system is designed in detail. For the Ayla module, the most important hardware part of the system, the internal composition and software design are described. In the mobile phone client part that is closely related to the user, the MVC architecture is adopted, the singleton and agent design patterns are utilized, and the functional design of each part is elaborated, including APP interface animation, data transmission format, network communication, and database storage. The research results show that the system of this study can handle most of the athlete training information, and the prediction accuracy exceeds the traditional algorithm. This research study is of great significance for improving the training efficiency of high-level athletes and further expanding the scope of application of the IoT.

RESUMO A fim de melhorar a qualidade do treinamento de atletas de alto nível em universidades chinesas e americanas, um modelo de transmissão esportiva de informações esportivas é projetado com base na Internet das Coisas. Projetou-se em detalhes o protocolo de comunicação entre o módulo Ayla e a placa de controle principal de movimento, o módulo Ayla e o aplicativo-cliente ou a plataforma de nuvem, o aplicativo e a plataforma de nuvem no sistema. Para o módulo Ayla, a parte de hardware mais importante do sistema, a composição interna e o projeto de software são descritos. Na parte do cliente de celular intimamente relacionada com o usuário, a arquitetura MVC é adotada, e os padrões de design de singleton e agente são utilizados, e o projeto funcional de cada parte é elaborado, incluindo animação de interface APP, formato de transmissão de dados, comunicação de rede e armazenamento de banco de dados. Os resultados da pesquisa mostram que o sistema deste estudo pode lidar com a maioria das informações de treinamento de atletas, e a precisão da previsão excede o algoritmo tradicional. A pesquisa deste artigo é de grande significância para melhorar a eficiência de treinamento de atletas de alto nível e expandir ainda mais o âmbito de aplicação da Internet das Coisas.

RESUMEN A fin de mejorar la calidad del entrenamiento de atletas de alto nivel en universidades chinas y americanas, un modelo de transmisión deportiva de informaciones deportivas es proyectado basándose en la Internet de las Cosas. Se proyectó en detalles el protocolo de comunicación entre el módulo Ayla y la placa de control principal de movimiento, el módulo Ayla y el aplicativo-cliente o la plataforma de nube, el aplicativo y la plataforma de nube en el sistema. Para el módulo Ayla, la parte de hardware más importante del sistema, la composición interna y el proyecto de software son descritos. En la parte del cliente de celular íntimamente relacionada con el usuario, la arquitectura MVC es adoptada, y los estándares de diseño de singleton y agente son utilizados, y el proyecto funcional de cada parte es elaborado, incluyendo animación de interface APP, formato de transmisión de datos, comunicación de red y almacenamiento de banco de datos. Los resultados de la investigación muestran que el sistema de este estudio puede lidiar con la mayoría de las informaciones de entrenamiento de atletas, y la precisión de la previsión excede el algoritmo tradicional. La investigación de este artículo es de gran significación para mejorar la eficiencia de entrenamiento de atletas de alto nivel y expandir aún más el ámbito de aplicación de la Internet de las Cosas.

Propofol Affects Non-Small-Cell Lung Cancer Cell Biology By Regulating the miR-21/PTEN/AKT Pathway In Vitro and In Vivo.

BACKGROUND: Propofol is a common sedative-hypnotic drug traditionally used for inducing and maintaining general anesthesia. Recent studies have drawn attention to the nonanesthetic effects of propofol, but the potential mechanism by which propofol suppresses non-small-cell lung cancer (NSCLC) progression has not been fully elucidated. METHODS: For the in vitro experiments, we used propofol (0, 2, 5, and 10 µg/mL) to treat A549 cells for 1, 4, and 12 hours and Cell Counting Kit-8 (CCK-8) to detect proliferation. Apoptosis was measured with flow cytometry. We also transfected A549 cells with an microribonucleic acid-21 (miR-21) mimic or negative control ribonucleic acid (RNA) duplex and phosphatase and tensin homolog, deleted on chromosome 10 (PTEN) small interfering ribonucleic acid (siRNA) or negative control. PTEN, phosphorylated protein kinase B (pAKT), and protein kinase B (AKT) expression were detected using Western blotting, whereas miR-21 expression was examined by real-time polymerase chain reaction (RT-PCR). In vivo, nude mice were given injections of A549 cells to grow xenograft tumors; 8 days later, the mice were intraperitoneally injected with propofol (35 mg/kg) or soybean oil. Tumors were then collected from mice and analyzed by immunohistochemistry and Western blotting. RESULTS: Propofol inhibited growth (1 hour, P = .001; 4 hours, P ≤ .0001; 12 hours, P = .0004) and miR-21 expression (P ≤ .0001) and induced apoptosis (1 hour, P = .0022; 4 hours, P = .0005; 12 hours, P ≤ .0001) in A549 cells in a time and concentration-dependent manner. MiR-21 mimic and PTEN siRNA transfection antagonized the suppressive effects of propofol on A549 cells by decreasing PTEN protein expression (mean differences [MD] [95% confidence interval {CI}], -0.51 [-0.86 to 0.16], P = .0058; MD [95% CI], 0.81 [0.07-1.55], P = .0349, respectively), resulting in an increase in pAKT levels (MD [95% CI] = -0.82 [-1.46 to -0.18], P = .0133) following propofol exposure. In vivo, propofol treatment reduced NSCLC tumor growth (MD [95% CI] = -109.47 [-167.03 to -51.91], P ≤ .0001) and promoted apoptosis (MD [95% CI] = 38.53 [11.69-65.36], P = .0093). CONCLUSIONS: Our study indicated that propofol inhibited A549 cell growth, accelerated apoptosis via the miR-21/PTEN/AKT pathway in vitro, suppressed NSCLC tumor cell growth, and promoted apoptosis in vivo. Our findings provide new implications for propofol in cancer therapy and indicate that propofol is extremely advantageous in surgical treatment.

Serratus anterior plane block or thoracic paravertebral block for postoperative pain treatment after uniportal video-assisted thoracoscopic surgery: a retrospective propensity-matched study.

BACKGROUND: Reports of postoperative pain treatment after uniportal video-assisted thoracoscopic surgery are limited. Thoracic paravertebral block and serratus anterior plane block have been described recently in pain management after thoracic surgery. A comparison between these two blocks for postoperative analgesia after uniportal video-assisted thoracoscopic surgery has not been previously reported. The aim of this study was to compare the analgesic benefits of serratus plane block and thoracic paravertebral block after uniportal video-assisted thoracoscopic surgery and examined the two block types for noninferiority. METHODS: From December 2015 to May 2018, a total of 636 relevant records of patients who underwent uniportal video-assisted thoracoscopic surgery under general anaesthesia alone or with the addition of serratus plane block or thoracic paravertebral block performed preoperatively were identified. A propensity-matched analysis incorporating preoperative variables was used to compare the efficacy of postoperative analgesia in three groups. RESULTS: Overall, 123 patients were identified for analysis. Propensity score matching resulted in 41 patients in each group. The visual analogue scale scores were significantly lower in the serratus plane block group and the thoracic paravertebral block group than in the control group at the 1st, 2nd, 4th, and 6th postoperative hours. Cumulative opioid consumption was significantly lower in the serratus plane and thoracic paravertebral block groups than in the control group at 6 hrs (18.3±3.1 mg, 18.7±3.9 mg vs 21.5±4.4 mg; P=0.001) and 24 hrs (43.4±7.3 mg, 42.5±7.7 mg vs 49.3±8.8 mg; P<0.001) postoperatively. The serratus plane block group was noninferior to the thoracic paravertebral block group on pain score and opioid consumption. CONCLUSION: The addition of single-injection serratus plane or thoracic paravertebral block is associated with early analgesic benefits in patients undergoing uniportal video-assisted thoracoscopic surgery, including a reduction in the postoperative opioid consumption and pain scores. Serratus plane block is as effective as thoracic paravertebral block for reducing postoperative pain.

Characterization of variations in IL23A and IL23R genes: possible roles in multiple sclerosis and other neuroinflammatory demyelinating diseases.

Multiple sclerosis is among the most serious inflammatory demyelinating diseases (IDD). Interleukin-23A (IL23A) regulates and coordinates the activities of immune cells by interacting with its receptor IL23R and plays key roles in the pathogenesis of immune inflammatory diseases. IDD, deemed to be a kind of autoimmune diseases, may involve IL23A in the pathogenesis. The aim of this work was to validate the hypothesized involvement of IL-23A and its receptor in IDD. We sequenced the IL-23A and IL-23R genes for 206 Chinese Han IDD patients and evaluated SNPs within or near those genes. The serum levels of IL23A in IDD participants were analyzed using ELISA. The statistical analyses were conducted using Chi-Square Tests as implemented in SPSS (version 19.0). The Hardy-Weinberg equilibrium test of the population was carried out using online software OEGE. Three variants rs2066808, rs2371494, rs11575248 in IL-23A gene and one variant rs1884444 in IL-23R gene were demonstrated to be associated with the risk of MS or other IDD diseases, and the expression level of serum IL-23A in the MS patients was also altered. We conclude that variants in IL-23A and IL-23R genes were associated with the risk of MS or other IDD diseases.

Characterization of Transcriptional Repressor Gene MSX1 Variations for Possible Associations with Congenital Heart Diseases.

BACKGROUND: The human heart consists of several cell types with distinct lineage origins. Interactions between these cardiac progenitors are very important for heart formation. The muscle segment homeobox gene family plays a key role in the cell morphogenesis and growth, controlled cellular proliferation, differentiation, and apoptosis, but the relationships between the genetic abnormalities and CHD phenotypes still remain largely unknown. The aim of this work was to evaluate variations in MSX1 and MSX2 for their possible associations with CHD. METHODS: We sequenced the MSX1 and MSX2 genes for 300 Chinese Han CHD patients and 400 normal controls and identified the variations. The statistical analyses were conducted using Chi-Square Tests as implemented in SPSS (version 19.0). The Hardy-Weinberg equilibrium test of the population was carried out using the online software OEGE. RESULTS: Six variations rs4647952, rs2048152, rs4242182, rs61739543, rs111542301 and rs3087539 were identified in the MSX2 gene, but the genetic heterozygosity of those SNPs was very low. In contrast, the genetic heterozygosity of two variations rs3821949 near the 5'UTR and rs12532 within 3'UTR of the MSX1 gene was considerably high. Statistical analyses showed that rs3821949 and rs12532 were associated with the risk of CHD (specifically VSD). CONCLUSIONS: The SNPs rs3821949 and rs12532 in the MSX1 gene were associated with CHD in Chinese Han populations.