Postoperative analgesic efficacy of nefopam after anorectal surgery: a retrospective observational study

Objective: To examine the effectiveness of nefopam on postoperative pain control after anorectal surgeries. Methods: We retrospectively reviewed the electronic medical records of patients who underwent anorectal surgeries from January 2019 to March 2022 at two medical centers. The data were divided into nefopam and conventional groups. The primary outcome was the number of patients who requested additional opioids in the 24-h postoperative period. The secondary outcomes were numeric rating pain scores (NRPS) within a 24-h postoperative period and analgesic drugs-related side effects. Results: Eighty-seven patients in the conventional group and 60 in the nefopam group were recruited. The nefopam group reported less additional opioid consumption than the conventional group in all dimensions of analysis, including overall, adjusted to anesthetic techniques and types of surgery. However, these did not reach statistical significance (P = 0.093). Only patients in the nefopam group who underwent hemorrhoidectomy under TIVA or spinal anesthesia significantly required fewer additional opioids (P = 0.016, 60% mean difference). Similarly, the 24-h postoperative morphine consumption was lower in the nefopam group (mean difference = -3.4, 95%CI: 0.72,6.08). Furthermore, significantly lower NRPS were reported in the nefopam group during the 12-18 h postoperative period (P = 0.009). On the other hand, analgesic drugs related side effects were similar in both groups. Conclusions: The administration of nefopam after major anorectal surgery is beneficially evident in reducing postoperative opioid requirements. (AU)

Analysis on migration of HIV/AIDS cases and related factors in Liangshan Yi Autonomous Prefecture in Sichuan province, 2020 / 中华流行病学杂志

Objective: To analyze the migration of the HIV/AIDS cases and related factors in Liangshan Yi autonomous prefecture (Liangshan). Methods: According to HIV/AIDS Comprehensive Response Information Management System of China Information System for Disease Control and Prevention, a total of 28 772 HIV/AIDS cases who had follow-up records in Liangshan in 2020 were included in the survey. The migration of the HIV/AIDS cases was described and the related factors were analyzed using multiple logistic regression models, and the migration destinations of the HIV/AIDS cases were mapped. Results: Among the 28 772 HIV/AIDS cases, 20.89% (6 010/28 772) had migration in 2020. Multivariate logistic regression analysis showed that among the HIV/AIDS cases, the migration related factors included being aged 15-24 years (compared with being aged 0-14 years, OR=2.74, 95%CI:2.04-3.69) and ethnic group (compared with Han ethnic group, OR=2.44, 95%CI:2.19-2.72), having education level of junior high school (compared with having education level of primary school or below, OR=1.25, 95%CI:1.14-1.38), being unmarried (compared with being married, OR=1.29, 95%CI:1.20-1.39), being engaged in business services (compared with being engaged in farming, OR=1.96, 95%CI:1.31-2.92), receiving antiviral treatment <1 year (compared with receiving antiviral treatment >3 years, OR=1.42, 95%CI:1.26-1.61), having recent CD4+T lymphocytes (CD4) counts >500 cells/μl (compared with having recent CD4 counts <200 cells/μl, OR=1.15, 95%CI:1.03-1.29). The geographical distribution maps showed that among all cities in Sichuan, Xichang (13.26%, 797/6 010) and Chengdu (10.12%,608/6 010) were the main migration destinations of the HIV/AIDS cases, and the provinces outside Sichuan where the HIV/AIDS cases would like to migrate to were mainly Guangdong (18.19%, 1 093/6 010) and Zhejiang provinces (7.67%, 461/6 010) in 2020. The HIV/AIDS cases who migrated where Liangshan, within Sichuan province, and to other provinces accounted for 27.67% (1 663/6 010), 15.34% (922/6 010) and 56.99% (3 425/6 010), respectively. Conclusions: More attention should be paid to the mobility characteristics and the classification management of HIV/AIDS cases according to their characteristics in Liangshan. Timely access to information on changes in the place of work and residence of HIV/AIDS cases should be warranted when they have migration. Good referrals and management for mobility of HIV/AIDS cases in different places should be made to reduce loss to follow-up and improving interventions.

Serum metabolomics of Tibetan medicine Ershiwuwei Songshi Pills against chronic cholestasis in mice / 中国中药杂志

A chronic cholestasis model was induced in mice by feeding a diet containing 3,5-diethoxycarbonyl-1,4-dihydro-2,4,6-trimethylpyridine(DDC). The effects of Ershiwuwei Songshi Pills(ESP) on endogenous metabolites in mice with chronic cholestasis were investigated by metabolomics analysis based on liquid chromatography-mass spectrometry(LC-MS). The results showed that ESP was effective in improving pathological injury and reducing serum levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST), alkaline phosphatase(ALP), and total bile acid in the model mice. Meanwhile, 13 common differential metabolites were revealed in metabolomic screening between the model/control group and the model/ESP group, including uric acid, glycolaldehyde, kynurenine, flavin adenine dinucleotide, L-3-phenyllactic acid, I-urobilin, leukotriene D4(LTD4), taurocholic acid, trioxilin A3, D-inositol-1,4-diphosphate, PC [16:0/20:2(11Z,14Z)], PC[14:0/22:2(13Z,16Z)], and PC[20:4(5Z,8Z,11Z,14Z)/20:4(5Z,8Z,11Z,14Z)]. After ESP intervention, the levels of all 13 differential metabolites were significantly retraced, and pathway analysis showed that ESP achieved its therapeutic effect mainly by affecting arachidonic acid metabolism, glycerophospholipid metabolism, tryptophan metabolism, and primary bile acid biosynthesis. This study elucidated the mechanism of action of ESP against chronic cholestasis based on metabolites.

Mechanism of Tibetan medicine Ershiwuwei Songshi Pills in regulating intestinal flora and improving non-alcoholic steatohepatitis / 中国中药杂志

This study aimed to investigate the effect of Tibetan medicine Ershiwuwei Songshi Pills(ESP) on the intestinal flora of non-alcoholic steatohepatitis(NASH) mice. Forty-eight male C57 BL/6 mice were randomly divided into the control group, model(methionine-choline-deficient, MCD) group, high-(0.8 g·kg~(-1)), medium-(0.4 g·kg~(-1)), and low-dose(0.2 g·kg~(-1)) ESP groups, and pioglitazone(PGZ, 10 mg·kg~(-1)) group, with eight mice in each group. Mice in the control group were fed with normal diet, while those in the remaining five groups with MCD diet for five weeks for inducing NASH. During modeling, they were gavaged with the corresponding drugs. The changes in body mass, daily water intake, and daily food intake were recorded. At the end of the experiment, the liver tissues were collected and stained with hematoxylin-eosin(HE) for observing the pathological changes, followed by oil red O staining for observing fat accumulation in the liver. The levels of serum aspartate aminotransferase(AST) and alanine aminotransferase(ALT) and triglyceride(TG) in liver tissue were measured. The changes in intestinal flora of mice were determined using 16 S rRNA high-throughput sequencing technology. The results showed that compared with the model group, the high-, medium-and low-dose ESP groups and the PGZ group exhibited significantly lowered AST and ALT in serum and TG in liver tissues and alleviated hepatocellular steatosis and fat accumulation in the liver. As demonstrated by 16 S rRNA sequencing, the abundance index and diversity of intestinal flora decreased in the model group, while those increased in the ESP groups. Besides, the Firmicutes to Bacteroidetes ratio decreased at the phylum level. In the alteration of the composition of intestinal flora, ESP reduced the abundance of Erysipelotrichia and Faecalibaculum but increased the abundance of Desulfovibrionaceae, Rikenellaceae, Lachnospiraceae, and Ruminococcaceae. This study has revealed that ESP has a protective effect against NASH induced by MCD diet, which may be related to its regulation of the changes in intestinal flora, alteration of the composition of intestinal flora, and inhibition of the intestinal dysbiosis.

Impact factors of motion artifacts in chest dual-energy X-ray radiography / 中国医学影像技术

Objective: To observe the predilection sites of motion artifacts on chest DR dual-energy subtraction images, and to analyze the impact factors. Methods: Dual-energy subtraction chest images of 128 cases were analyzed. The position of motion artifacts were observed, and the length and width were measured and compared, and the correlations of heart rate and motion artifacts at different sites were analyzed. Results: Among 128 cases of dual-energy subtraction chest images, 115 cases showed black-and-white striped motion artifacts, 87 (75.65%) at left ventricular segment, 82 (71.30%)at aortic arch segment, 60 (52.17%)at right cardiac margin, 42 (36.52%) at diaphragmatic margin, 30 (26.09%)at left atrial auricular pulmonary segment and 27 (23.48%) at superior vena cava. Statistical differences of the mean length and width of motion artifacts were found among left ventricular segment, aortic arch segment and right cardiac margin (F=4.59, 3.46, both P<0.05). Heart rate was positively correlated with motion artifacts at left ventricular segment and aortic arch segment (r=1.00, 0.99, both P<0.05). Conclusion: Cardiac pulsation and breathing exercises can cause occurrence of motion artifacts in chest DR dual-energy subtraction images, mostly located at left ventricular segment and aortic arch segment. The faster the heart rate, the more obvious the motion artifacts.

Changes in histopathology and ultrastructure of corneal epithelium in TgAPPswePS1 transgenic mice / 眼科新进展

Objective To investigate the histopathological and ultrastructural changes in the corneal epithelium in TgAPPswePS1 transgenic mice.Methods TgAPPswePS1 transgenic mice were randomly divided into experimental group (A and B sub-group) and control group.There were 15 APPswe/PSEN1dE9 transgenic mice (15-18 months old) with Alzheimer's disease (AD) in the experimental A group,and 15 APPswe/PSEN1 dE9 transgenic AD mice (8 months old) mice in the experimental B group,as well as 10 wild-type mice (8 months old) in the control group.Then,the histopathological and ultrastructural changes and the expression of amyloid β-protein (Aβ) in the corneal epithelium of the mice were detected,and finally,the apoptosis of corneal epithelial cells were observed by TUNEL assay.Results The thickness of corneal epithelium in the control group,A and B sub-group of the experimental group was (23.567 ± 2.123) μm,(15.456 ± 1.439) μm and (20.104 ± 1.763) μm,respectively.Meanwhile,murine corneal epithelial cells presented the histopathological changes of disorderly arrangement,decreased layers of cells and irregular morphology in the experimental group compared with the control group.Under transmission electron microscope,the microvilli on the surface of corneal epithelium was flat and significantly decreased in the A and B sub-group when compared with the control group.Moreover,Aβ positive expression in the experimental group was significantly upregulated compared with the control group;and the apoptotic number of the corneal epithelium in the B sub-group [(5.631 ± 2.471) cells] was smaller than that in the A sub-group [(16.329 ±3.542) cells],with the significant difference(P ＜ 0.05).Conclusion There are changes in the histopathology and ultrastructure of the corneal epithelium and the expression of Aβ in TgAPPswePS1 transgenic mice compared with wild-type mice,which are associated with the age of mice.

Modulating the Voltage-sensitivity of a Genetically Encoded Voltage Indicator

Saturation mutagenesis was performed on a single position in the voltage-sensing domain (VSD) of a genetically encoded voltage indicator (GEVI). The VSD consists of four transmembrane helixes designated S1-S4. The V220 position located near the plasma membrane/extracellular interface had previously been shown to affect the voltage range of the optical signal. Introduction of polar amino acids at this position reduced the voltage-dependent optical signal of the GEVI. Negatively charged amino acids slightly reduced the optical signal by 33 percent while positively charge amino acids at this position reduced the optical signal by 80%. Surprisingly, the range of V220D was similar to that of V220K with shifted optical responses towards negative potentials. In contrast, the V220E mutant mirrored the responses of the V220R mutation suggesting that the length of the side chain plays in role in determining the voltage range of the GEVI. Charged mutations at the 219 position all behaved similarly slightly shifting the optical response to more negative potentials. Charged mutations to the 221 position behaved erratically suggesting interactions with the plasma membrane and/or other amino acids in the VSD. Introduction of bulky amino acids at the V220 position increased the range of the optical response to include hyperpolarizing signals. Combining The V220W mutant with the R217Q mutation resulted in a probe that reduced the depolarizing signal and enhanced the hyperpolarizing signal which may lead to GEVIs that only report neuronal inhibition.

Influence of Stress on Oral Health Practice of High School Students / 치위생과학회지

The purpose of this study was to examine the impact of the self-perceived stress of high school students on their oral health care and the relationship between stress and oral health care. The subjects in this study were the students in four different high schools located in Chungcheongnam-do, on whom a self-administered survey was conducted. The answer sheets from 939 respondents were analyzed by PASW Statistics ver.18.0 for Windows. The girls were more stressed than the boys about their studies, appearance and material resource, and the sophomores felt more stress about their home and studies. The group whose academic achievement was good in the past semester had the lowest stress about home and material resource, and the group whose economic standard was higher were less stressed about appearance and material resource. As a result of comparing their oral health care by general characteristics, the groups who were sophomores and whose academic achievement was good in the past semester were most excellent in that regard, and the students whose economic standard was higher and whose average weekly allowances were larger took better care of their oral health. Concerning the influential factors for oral health care, stress about peer relationship was positively related, and stress about material resource was negatively related. Given the findings of the study, the development of oral health care programs that include how to relieve stress is required, and more intensive education is necessary as well. Besides, education for school personnel in charge of student health management and the development of related manuals are both required.

Prevalence, detection, management, and control of hypertension in the population of Mongolian and Han nationalities with age ≥ 55 years in a pastoral area of Inner Mongolia Autonomous Region / 中华心血管病杂志

<p><b>OBJECTIVE</b>To know about the status of hypertension among Mongolian and Han aged older than 55 years living in pastoral area of the Inner Mongolia Autonomous Region.</p><p><b>METHODS</b>Stratified sampling method was adopted and 9146 people aged 55 years or older were selected, blood pressure measurement and related information were collected, prevalence, awareness, treatment and control rates of hypertension were analyzed.</p><p><b>RESULTS</b>The hypertension crude prevalence rate of Mongolian and Han subjects was 54.10% (standardized prevalence rate was 53.93%), in which, the Mongolian and Han subjects crude hypertension prevalence rate was 52.96% and 54.73% respectively (standardized prevalence rate was 53.44% and 55.08% respectively), and there was no statistically significant (P = 0.104). Among the male gender, awareness rate, treatment rate and control rate of hypertension was 61.03%, 46.73% and 11.87% respectively. Among the female gender, awareness rate, treatment rate and control rate of hypertension was 67.58%, 56.55% and 14.03% respectively. Among Mongolian and Han subjects, difference of hypertension prevalence of different age groups was statistically significant (P values were 0.032 and 0.000), Among Mongolian subjects, difference of hypertension awareness of different age groups was statistically significant (P = 0.000). Among Han subjects, difference of hypertension awareness rates, treatment rates, and control rates of different age groups were statistically significant (P values were 0.000, 0.047 and 0.043).</p><p><b>CONCLUSION</b>Hypertension prevalence rate among Han and Mongolian people older than 55 years living in pastoral area of Inner Mongolia Autonomous Region is high while the awareness, treatment and control rates of hypertension are rather low.</p>

The Interface between Cytoskeletal Aberrations and Mitochondrial Dysfunction in Alzheimer's Disease and Related Disorders

The major defining pathological hallmarks of Alzheimer's disease (AD) are the accumulations of Abeta in senile plaques and hyperphosphorylated tau in neurofibrillary tangles and neuropil threads. Recent studies indicate that rather than these insoluble lesions, the soluble Abeta oligomers and hyperphosphorylated tau are the toxic agents of AD pathology. Such pathological protein species are accompanied by cytoskeletal changes, mitochondrial dysfunction, Ca2+ dysregulation, and oxidative stress. In this review, we discuss how the binding of Abeta to various integrins, defects in downstream focal adhesion signaling, and activation of cofilin can impact mitochondrial dysfunction, cytoskeletal changes, and tau pathology induced by Abeta oligomers. Such pathological consequences can also feedback to further activate cofilin to promote cofilin pathology. We also suggest that the mechanism of Abeta generation by the endocytosis of APP is mechanistically linked with perturbations in integrin-based focal adhesion signaling, as APP, LRP, and beta-integrins are physically associated with each other.

Herniated Nucleus Pulposus during Pregnancy / 대한주산의학회잡지

A herniated nucleus pulposus (HNP) during pregnancy has been a rare occurrence with a reported incidence of 1:10,000 case. It is hard to diagnose because of the potentially hazardous effect of ionizing radiation to the fetus when complaining back pain during pregnancy. In this case, magnetic resonance imaging (MRI) provide safe and useful modality and in general, back pain usually respond readily to conservative treatment. Cauda equina syndrome or severe and/or progressive neurologic deficit is a medical emergency that necessitates prompt surgery during pregnancy. She admitted at 31 weeks gestation for sudden development of right leg paresthesia and ankle motor weakness, an MRI showing compression on right nerve root at the level of L5~S1. After 4 weeks treated with bed rest and analgesics, we delivered by cesarean section and laminectomy at the same time. We have experienced a pregnancy with HNP, so report of this case with brief review of literature.

Perinatal Outcomes of Twin-Twin Transfusion Syndrome according to Clinical Stage based on Sonographic findings / 대한산부인과학회지

OBJECTIVE: After classifing the twin-twin transfusion syndrome (TTTS) according to clinical stage by Quintero, we reviewed effectiveness and usefulness of clinical stage by Quintero in diagnosis and treatment of TTTS. METHODS: Twelve cases (16%) were diagnosed as TTTS among 75 examples (31.3%) of monochorionic twin pregnancy out of 240 cases of twin pregnancy born in our hospital between Mach 2000 and June 2004. For TTTS, the clinical stage was decided at the time of initial diagnosis, and any changes of it were observed according to the developments of pregnancy. Neonate was regarded as alive when 5 minutes Apgar score was above 7 after birth. Also we observed the vascular anastomosis of placenta, and classified the method of treatments and its results according to each clinical stage. RESULTS: Two cases were classified into the clinical stage 1 through 4 each, and 4 cases in the clinical stage 5. The higher the clinical stage, the shorter the duration between diagnosis and delivery (p<0.05). In cases of both survivors, compared to no survivors, the interval between diagnosis and delivery were long (p<0.05). In the clinical stage 4 and 5, we found many cases that didn't have placental vascular anastomosis between artery and artery, and in this case, there revealed poor perinatal outcomes. For 4 cases that fell in the clinical stage 1 and 2 and 4, we performed amnioreduction and for one case in the clinical stage 2, we did amnioseptostomy at the same time. In 4 cases with amnioreduction or amnioseptostomy, survival rate was 38%. CONCLUSION: The clinical classification system of TTTS by ultrasound would be helpful for planning treatments and also for predicting the outcomes.