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Background: Laparoscopy involves inspecting the abdomen and pelvis using an endoscope. Carbon dioxide (CO2) is the gas that is commonly used to insufflate the abdomen so as to facilitate the surgical view. Aim: The present study was under taken to determine the Metabolic effects of carbon dioxide insufflation during laparoscopic surgery. Methods: An observational study on 50 patients above 18 years of age with physical status of American Society of Anaesthesiologists (ASA) Class I and II after obtaining approval from institutional ethical committee and consent of the patient was conducted in the Postgraduate Department of Anaesthesiology and Critical Care, Government Medical College Srinagar. Results: There was a progressive decrease in the pH during pneumoperitoneum in keeping with the hypercarbia. An increase towards baseline was observed during recovery but pH was still significantly lower than baseline 15 minutes into recovery (p<0.118). The Pco2 increased after 15 mins Co2 insufflation & peaked at 30 mins with mean & SD 42.82,2.775 & 46.16,2.909 respectively which was statically significant. Etco2 also increased after 15 mins of Co2 insufflation & peaked at 30 mins with mean 41.56 & 44.50 respectively which was statically significant. Similarly, Hco3 decreased over period of time with peak decrease at 30 mins of Co2 insufflation with mean 23.70, SD 1.919 & range 19-27. Conclusion: Co2 insufflation does bring metabolic changes in Ph, Pco2, Etco2 & HCO3 but with proper monitoring & management laparoscopic procedure can be safely performed.
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Objective:To analyze the changes of metabolic indexes and other characteristics in patients with primary aldosteronism (PA) and improve the understanding of PA.Methods:From January 2017 to August 2020, 91 PA patients who were clearly diagnosed and met the inclusion conditions in Tangshan workers Hospital, Hebei Medical University were selected as the observation object (PA group), and 112 patients diagnosed as essential hypertension (EH) in the same period were included as the control (EH group). A retrospective case-control study was conducted to compare the differences of blood glucose, blood lipid, homocysteine, blood potassium, creatinine, uric acid, aldosterone, renin, plasma aldosterone to renin ratio (ARR), blood pressure and waist circumference between the two groups. The measurement data of normal distribution were compared by independent sample t-test. The non normal distribution data are represented by M (Q 1, Q 3), and the rank sum test is used for inter group comparison. Comparison of counting data χ2 inspection. Logistic regression was used in multivariate analysis. Results:Univariate analysis showed that serum potassium, renin and ARR were (3.37±0.39) mmol/L, 1.61 (0.34, 7.23) ng/L and 96.85 (26.06, 506.10) in PA group and (3.91±0.59) mmol/L, 12.81 (1.90, 82.45) ng/L and 13.22 (1.06, 54.63) in EH group ( t=3.35, z=6.24, z=55.40, all P<0.001). In PA group, systolic blood pressure was (190.80±20.30) mmHg, diastolic blood pressure was (117.70±12.89) mmHg, waist circumference was (91.67±9.38) cm, and in EH group, systolic blood pressure was (177.01±12.89) mmHg, diastolic blood pressure was (101.39±9.34) mmHg, waist circumference was (86.59±9.07) cm. There were significant differences between the two groups ( t=5.88, 10.44, 3.90; all P<0.001). Multivariate logistic regression analysis showed that waist circumference (OR=1.065, 95% CI 1.007-1.118, P<0.001), systolic blood pressure (OR=1.053, 95% CI 1.034-1.077, P<0.001), diastolic blood pressure (OR=1.054, 95% CI 1.031-1.077, P<0.001), and ARR (OR=1.170, 95% CI 1.115-1.228, P<0.001) were the risk factors for PA. Conclusion:Compared with essential hypertension, PA patients have higher blood pressure, ARR and waist circumference, lower blood potassium and renin levels. Systolic blood pressure, diastolic blood pressure, ARR and waist circumference are the risk factors of PA. Strengthening the screening and treatment of PA in high-risk groups is helpful to better avoid the risk of target organ damage.
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RNA viruses cause a multitude of human diseases, including several pandemic events in the past century. Upon viral invasion, the innate immune system responds rapidly and plays a key role in activating the adaptive immune system. In the innate immune system, the interactions between pathogen-associated molecular patterns and host pattern recognition receptors activate multiple signaling pathways in immune cells and induce the production of pro-inflammatory cytokines and interferons to elicit antiviral responses. Macrophages, dendritic cells, and natural killer cells are the principal innate immune components that exert antiviral activities. In this review, the current understanding of innate immunity contributing to the restriction of RNA viral infections was briefly summarized. Besides the main role of immune cells in combating viral infection, the intercellular transfer of pathogen and host-derived materials and their epigenetic and metabolic interactions associated with innate immunity was discussed. This knowledge provides an enhanced understanding of the innate immune response to RNA viral infections in general and aids in the preparation for the existing and next emerging viral infections.
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Humans , Immunity, Innate , Interferons , RNA , RNA Viruses , Virus DiseasesABSTRACT
Introduction This is the first study to examine the in vitro susceptibility and the expression of virulence factors in Candida species in the presence of Pimenta pseudocaryophyllus (Gomes) L.R. Landrum (Myrtaceae), a Brazilian plant known as paucravo. Additionally, the mechanisms of action of the crude ethanol extract and the ethyl acetate and aqueous fractions of this plant were investigated. Methods The in vitro susceptibility of Candida was tested using the broth microdilution method, whereas an XTT reduction assay was used for biofilms. Adherence was determined by counting the number of yeast cells that adhered to 100 oral epithelial cells, and hyphal formation was verified in the hyphal induction medium M199. Flow cytometry with propidium iodide and FUN-1 was performed to assess the mechanism of action. Results The results revealed that the crude ethanol extract and the ethyl acetate and aqueous fractions of P. pseudocaryophyllus inhibited the growth of Candida isolates at a minimal inhibitory concentration (MIC) ranging from 64 to 256µg/mL, whereas the 50% sessile minimal inhibitory concentration (SMIC50) ranged from 512 to >1,024µg/mL. Adherence and hyphal formation were significantly reduced in the presence of the crude ethanol extract and both fractions. Although cell membrane injury was detected, the predominant mechanism of action appeared to be the alteration of yeast metabolism, as demonstrated by flow cytometry. Conclusions Our results indicated that antifungal activity reduced the expression of virulence factors in yeast via the alteration of yeast metabolism, suggesting that the crude extract of P. pseudocaryophyllus and its fractions may contain novel antifungal agents. .