Sublobectomy and lymph node sampling are adequate for patients with invasive lung adenocarcinoma presenting as pure ground glass nodules.

PURPOSE: In this study, we aimed to investigate the prognosis of invasive lung adenocarcinoma that manifests as pure ground glass nodules (pGGNs) and confirm the effectiveness of sublobectomy and lymph node sampling in patients with pGGN-featured invasive adenocarcinoma (IAC). MATERIALS AND METHODS: We retrospectively enrolled 139 patients with pGGN-featured IAC, who underwent complete resection in two medical institutions between January 2011 and May 2022. Stratification analysis was conducted to ensure balanced baseline characteristics among the patients. The 5-year overall survival (OS) and disease-free survival (DFS) rates were compared between the groups using Kaplan-Meier survival curves and log-rank test. RESULTS: The 5-year OS and DFS rates for patients with IAC presenting as pGGNs after surgery were 96.5% and 100%, respectively. No lymph node metastasis or recurrence was observed in any of the enrolled patients. There was no statistically significant difference in the 5-year OS between patients who underwent lobectomy or sublobectomy, along with lymph node resection or sampling. CONCLUSION: IAC presented as pGGNs exhibited low-grade malignancy and had a relatively good prognosis. Therefore, these patients may be treated with sublobectomy and lymph node sampling.

Clinical efficacy of adjunctive esketamine anesthesia in electroconvulsive therapy for major depressive disorders: A pragmatic, randomized, controlled trial.

Electroconvulsive therapy (ECT) is an effective treatment for depression, and esketamine has been shown to have antidepressant effects. However, it is currently unclear whether adjunctive esketamine can enhance the clinical efficacy of ECT in real-world clinical practice. In this pragmatic clinical trial, patients with major depression were randomly assigned into two groups: patients received 0.25 mg/kg esketamine plus propofol (esketamine group) or the same volume of saline (control group) plus propofol. Results indicated that there was no difference in response and remission rates between the two groups. However, patients receiving esketamine had a higher remission rate of SI and lower psychotic scores. Patients receiving esketamine also required a lower electric dose, but the seizure duration and cognitive function were comparable between the two groups. Diastolic blood pressure increased after esketamine injection, but there was no increased risk of hypertension. Furthermore, incidence of delirium and confusion were comparable between the groups. Conclusively, adjunctive esketamine anesthesia does not provide any advantage in improving the response and remission rates of ECT. However, it can improve remission of SI and alleviate accompanying psychotic symptoms in depressive patients. With adjunctive usage, the adverse cardiovascular and neuropsychiatric events associated with esketamine appear to be tolerable.

Clinical Effect of Ultrasound-Guided Adductor Block on Postoperative Analgesia After Total Knee Replacement.

Objective: To explore the clinical effects of ultrasound-guided adductor block (UGAB) on postoperative analgesia after total knee replacement. Methods: From March 2022 to June 2022, 60 patients in the First Affiliated Hospital of Chongqing Medical University were included. They were divided into control (n = 30) and ultrasonic groups (n = 30). They all received total knee arthroplasty. Before total knee arthroplasty, patients in the control and ultrasonic groups underwent general anesthesia and UGAB, respectively. Visual Analogue Scale (VAS) was used to assess the pain. The time of the first straight leg elevation and the first landing time were recorded. Knee joint function was evaluated. Information about the dosage of tramadol intramuscular injection and the number of times patient-controlled analgesia pump pressing was collected. The serum levels of interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) were detected. Results: Compared with the control group, UGAB increased the rate of muscle contraction and relaxation and total and relaxation after total knee replacement in the ultrasonic group (P < .05). UGAB reduced VAS scores of pain during passive activity after operation (P < .05). UGAB also facilitated the first straight leg lifting time after the operation and the time of the first landing after the operation (P < .05). Meanwhile, UGAB reduced the dose of tramadol and press times of the self-control analgesia pump after operation (P < 0.05). UGAB also suppressed postoperative IL-6 and hs-CRP levels and increased postoperative joint range of motion (P < .05). Conclusion: UGAB promotes early recovery of knee function with high safety in patients undergoing total knee replacement, with reduced postoperative pain and inflammatory reaction.

Detecting tea tree pests in complex backgrounds using a hybrid architecture guided by transformers and multi-scale attention mechanism.

BACKGROUND: Tea pests pose a significant threat to tea leaf yield and quality, necessitating fast and accurate detection methods to improve pest control efficiency and reduce economic losses for tea farmers. However, in real tea gardens, some tea pests are small in size and easily camouflaged by complex backgrounds, making it challenging for farmers to promptly and accurately identify them. RESULTS: To address this issue, we propose a real-time detection method based on TP-YOLOX for monitoring tea pests in complex backgrounds. Our approach incorporates the CSBLayer module, which combines convolution and multi-head self-attention mechanisms, to capture global contextual information from images and expand the network's perception field. Additionally, we integrate an efficient multi-scale attention module to enhance the model's ability to perceive fine details in small targets. To expedite model convergence and improve the precision of target localization, we employ the SIOU loss function as the bounding box regression function. Experimental results demonstrate that TP-YOLOX achieves a significant performance improvement with a relatively small additional computational cost (0.98 floating-point operations), resulting in a 4.50% increase in mean average precision (mAP) compared to the original YOLOX-s. When compared with existing object detection algorithms, TP-YOLOX outperforms them in terms of mAP performance. Moreover, the proposed method achieves a frame rate of 82.66 frames per second, meeting real-time requirements. CONCLUSION: TP-YOLOX emerges as a proficient solution, capable of accurately and swiftly identifying tea pests amidst the complex backgrounds of tea gardens. This contribution not only offers valuable insights for tea pest monitoring but also serves as a reference for achieving precise pest control. © 2023 Society of Chemical Industry.

Trajectories and risk factors of persistent cough after pulmonary resection: A prospective two-center study.

BACKGROUND: Persistent cough is one of the most frequent complications following lung cancer surgery. To promote optimal recovery, we conducted a study to investigate the trajectories of coughing symptoms and their impact on quality of life (QOL), as well as to identify potential risk factors of persistent cough after pulmonary resection (CAP). METHODS: This prospective observational study assessed patients who underwent pulmonary resection for lung tumor at two medical centers in China. Persistent CAP was evaluated before surgery, at discharge, and 1, 3, and 6 months following surgery using visual analog scale (VAS), cough symptom score (CSS), and Leicester Cough Questionnaire in Mandarin Chinese (LCQ-MC). Univariate and multivariate logistic regression analyses were conducted to explore independent risk factors for persistent CAP. RESULTS: Of the 506 enrolled patients, 130 patients were diagnosed with persistent CAP with an incidence of 25.69%. Compared to the noncough group, patients with persistent CAP reported significantly higher VAS (p < 0.001) and CSS scores (p < 0.001) and experienced worse QOL (p < 0.001) for up to 6 months, particularly at 1 month following surgery. Multivariable regression analysis revealed that a duration of anesthesia exceeding 156 min (odds ratio [OR]: 1.847, 95% confidence interval [CI]: 1.156-2.951, p = 0.010) and gastroesophageal acid reflux (GER) (OR: 3.870, 95% CI: 2.376-6.304, p < 0.001) were independent risk factors of persistent CAP. CONCLUSION: Patients who suffer from persistent CAP face a substantial burden and diminished QOL for an extended period compared to noncough patients. Moreover, prolonged duration of anesthesia and postoperative GER are potential risk factors of persistent CAP.

Whole genome sequencing provides evidence for Bacillus velezensis SH-1471 as a beneficial rhizosphere bacterium in plants.

Bacillus is widely used in agriculture due to its diverse biological activities. We isolated a Bacillus velezensis SH-1471 from the rhizosphere soil of healthy tobacco, which has broad-spectrum antagonistic activity against a variety of plant pathogenic fungi such as Fusarium oxysporum, and can be colonized in the rhizosphere of a variety of plants. This study will further explore its mechanism by combining biological and molecular biology methods. SH-1471 contains a ring chromosome of 4,181,346 bp with a mean G + C content of 46.18%. We identified 14 homologous genes related to biosynthesis of resistant secondary metabolite, and three clusters encoded potential new antibacterial substances. It also contains a large number of genes from colonizing bacteria and genes related to plant bacterial interactions. It also contains genes related to environmental stress, as well as genes related to drug resistance. We also found that there are many metabolites in the strain that can inhibit the growth of pathogens. In addition, our indoor pot test found that SH-1471 has a good control effect on tomato wilt, and could significantly improve plant height, stem circumference, root length, root weight, and fresh weight and dry weight of the aboveground part of tomato seedlings. Therefore, SH-1471 is a potential biological control strain with important application value. The results of this study will help to further study the mechanism of SH-1471 in biological control of plant diseases and promote its application.

Differential Responses of Bacterial and Fungal Communities to Siderophore Supplementation in Soil Affected by Tobacco Bacterial Wilt (Ralstonia solanacearum).

Siderophores secreted by microorganisms can promote ecological efficiency and could be used to regulate the unbalanced microbial community structure. The influence of the siderophore activity of Trichoderma yunnanense strain 2-14F2 and Beauveria pseudobassiana strain (2-8F2) on the physiological/biochemical functions and community structure of soil microbes affected by tobacco bacterial wilt (TBW) was studied. DNS Colorimetry and Biolog-eco plates were used to quantify the impacts of strain siderophores on soil enzyme activities and microbial metabolism. Based on Illumina MiSeq high-throughput sequencing, the soil 16S rDNA and ITS sequences were amplified to dissect the response characteristics of alpha/beta diversity and the structure/composition of a soil microbial community toward siderophores. The KEGG database was used to perform the PICRUSt functional prediction of the microbial community. We found that siderophores of 2-14F2 and 2-8F2, at certain concentrations, significantly increased the activities of sucrase (S-SC) and urease (S-UE) in the TBW soil and enhanced the average well color development (AWCD, carbon source utilization capacity) of the microbial community. The metabolic capacity of the diseased soil to amino acids, carbohydrates, polymers, aromatics, and carboxylic acids also increased significantly. The response of the bacterial community to siderophore active metabolites was more significant in alpha diversity, while the beta diversity of the fungal community responded more positively to siderophores. The relative abundance of Actinobacteria, Chloroflexi, and Acidobacteria increased and was accompanied by reductions in Proteobacteria and Firmicutes. LEfSe analysis showed that Pseudonocardiaceae, Gemmatimonas, Castellaniella, Chloridiumand and Acrophialophora altered the most under different concentrations of siderophore active metabolites. The PICRUSt functional prediction results showed that siderophore increased the abundance of the redox-related enzymes of the microbial community in TBW soil. The BugBase phenotypic prediction results showed that the siderophore activity could decrease the abundance of pathogenic bacteria. The study concludes that siderophore activity could decrease the abundance of pathogenic bacteria and regulate the composition of the microbial community in TBW soil. The activities of sucrase (S-SC) and urease (S-UE) in TBW soil were significantly increased. Overall, the siderophore regulation of community structures is a sustainable management strategy for soil ecosystems.

A retrospective case series of electroconvulsive therapy in the management of depression and suicidal symptoms in adolescents.

OBJECTIVE: Major depressive disorder (MDD) with suicidal symptoms is common in adolescents. Electroconvulsive therapy (ECT) is highly effective in the treatment of MDD. We have described its use and outcome in a case series of adolescents with depression and suicidal symptoms receiving ECT. METHODS: We analyzed 362 adolescents aged from 12 to 17 who had received ECT between year 2015 and 2021. A total of 278 subjects were found to meet the inclusion criteria, where depressive symptoms were assessed by HDRS and suicidal symptoms were assessed by HDRS item 3. Their sociodemographic, clinical, and treatment information were retrieved through these records for this study. RESULTS: The mean ± SD age of subjects was 15.41 ± 1.50 years and male sex was 14.7% (n = 41). Comorbid diagnoses were present in 104 patients (37.4%). The ECT sessions ranged from 6 to 12 times. All the patients took antidepressants, with sertraline (n = 182; 65.5%) being the most widely used. Majority of patients also received benzodiazepines. ECT was significantly effective in adolescents with depression and suicidal symptoms in evaluation by HDRS, HDRS item 3, CGI-S (p < .001) pre/post-ECT. The response rate of MDD patients was 52%, with suicidal ideation (SI) at 49%, and 54% in MDD with suicide attempt (SA). The change of CGI-S scores showed no significant differences between various subgroups of sex and comorbid (p>.05), but there were significant differences between subgroups of suicidal symptoms (p < .001). ECT was generally safe with subjective memory complaint (n = 189, 68.0%), headache (n = 150, 54.0%), body pain (n = 28, 10.1%), delirium (n = 95, 34.2%), and nausea (n = 31, 11.2%) as possible side effects following ECT. CONCLUSION: In this study, ECT was found to decrease depressive and suicidal symptoms in adolescents, and the side effect was acceptable. ECT showed better outcome for MDD with SA compared to MDD with SI.

Isovitexin restores sevoflurane­induced cognitive dysfunction by mediating autophagy through activation of the PGC­1α/FNDC5 signaling pathway.

Postoperative cognitive dysfunction is a severe neurological complication. How to improve the cognitive impairment caused by sevoflurane, a most common inhaled anesthetic, remains a question worthy of studying. Isovitexin (IVX) is a trihydroxyl flavonoid that is a naturally bioactive ingredient found in various medicinal plants and has antioxidant, anti­inflammatory and neuroprotective properties. The role of IVX in anesthetic­induced nerve injury is rarely reported and the mechanisms are unclear. In this study, we found that IVX improved the cognitive dysfunction induced by sevoflurane in rats. It inhibited sevoflurane­induced cell apoptosis. In addition, IVX increased sevoflurane­induced autophagy in rat brain. Mechanically, IVX activated the PGC­1α/FNDC5 pathway in rat brain, and depletion of FNDC5 could inhibit the neuroprotective function of IVX. In conclusion, our results suggested that IVX restored sevoflurane­induced cognitive dysfunction by mediating autophagy through the activation of the PGC­1α/FNDC5 pathway.

Enhanced Insecticidal Effect and Interface Behavior of Nicotine Hydrochloride Solution by a Vesicle Surfactant.

Nicotine hydrochloride (NCT) has a good control effect on hemiptera pests, but its poor interfacial behavior on the hydrophobic leaf leads to few practical applications. In this study, a vesicle solution by the eco-friendly surfactant, sodium diisooctyl succinate sulfonate (AOT), was prepared as the pesticide carrier for NCT. The physical chemical properties of NCT-loaded AOT vesicles (NCT/AOT) were investigated by techniques such as dynamic light scattering (DLS), small-angle X-ray scattering (SAXS), and cryogenic transmission electron microscopy (cryo-TEM). The results showed that the pesticide loading and encapsulation efficiency of NCT/AOT were 10.6% and 94.8%, respectively. The size of NCT/AOT vesicle was about 177 nm. SAXS and surface tension results indicated that the structure of the NCT/AOT vesicle still existed with low surface tension even after being diluted 200 times. The contact angle of NCT/AOT was always below 30°, which means it could wet the surface of the cabbage leaf well. Consequently, NCT/AOT vesicles could effectively reduce the bounce of pesticide droplets. In vitro release experiments showed that NCT/AOT vesicles had sustained release properties; 60% of NCT in NCT/AOT released after 24 h, and 80% after 48 h. Insecticidal activity assays against aphids revealed that AOT vesicles exhibited insecticidal activity and could have a synergistic insecticidal effect with NCT after the loading of NCT. Thus, the NCT/AOT vesicles significantly improved the insecticidal efficiency of NCT, which has potential application in agricultural production activities.

The Efficacy and Tolerability of Electroconvulsive Therapy in Psychiatric Patients with Arachnoid Cysts: A Retrospective Chart Study.

Electroconvulsive therapy (ECT) is an effective therapy for many psychiatric illnesses. However, intracranial occupying lesions are a relative contraindication to ECT. Arachnoid cysts are benign, congenital, and space-occupying lesions. Our study aimed to evaluate the efficacy and tolerability of ECT in psychiatric patients with arachnoid cysts. We retrospectively identified 62 psychiatric patients with arachnoid cysts; 43 of them underwent ECT and 19 did not. Their conditions were assessed by CGI-S and different scales depending on different diagnoses (PANSS for schizophrenia; HAMD for depression; YMRS for bipolar disorder). The side effect was assessed by TESS. Significant differences were shown in the reduced scores of the CGI-S between patients who underwent ECT and those who did not (p = 0.001), while, at the same time, there was no significant difference in their TESS score (p = 0.297). The current study found that ECT is an effective and tolerable therapy for psychiatric patients with arachnoid cysts.

Focal points of preanesthesia evaluations for electroconvulsive therapy in patients with depression: a retrospective analysis of clinical characteristics in nonremission.

BACKGROUND: This study explored the patient clinical characteristics that may affect electroconvulsive therapy (ECT) efficacy to enable improved focus during evaluations and preparation for ECT. METHODS: Patients were enrolled for ECT at the Department of Psychiatry and Anesthesiology of the First Affiliated Hospital of Chongqing Medical University from December 2017 to January 2019. The primary outcome in our study was defined as the development of nonremission. A multivariate logistic analysis was performed to identify the risk factors for nonremission. RESULTS: In total, 874 depressed patients were included in the study. After the ECT treatment, 255 cases (29.2%) exhibited nonremission. A multivariate logistic regression analysis of the variables was performed, and the results showed that atherosclerosis (OR 8.072, 95% CI 2.442 to 16.675; P = 0.001), COPD (OR 2.919, 95% CI 1.240 to 6.871; P = 0.014), diabetes (OR 2.202, 95% CI 1.115 to 4.348; P = 0.023) and smoking (OR 1.519, 95% CI 1.015 to 2.273; P = 0.042) were independent risk factors for nonremission. CONCLUSION: In the retrospective analysis, we found that atherosclerosis, diabetes, COPD and smoking may be high-risk factors for nonremission.

Set of Cytochrome P450s Cooperatively Catalyzes the Synthesis of a Highly Oxidized and Rearranged Diterpene-Class Sordarinane Architecture.

Cytochrome P450s are one of the most versatile oxidases that catalyze significant and unique chemical transformations for the construction of complex structural frameworks during natural product biosynthesis. Here, we discovered a set of P450s, including SdnB, SdnH, SdnF, and SdnE, that cooperatively catalyzes the reshaping of the inert cycloaraneosene framework to form a highly oxidized and rearranged sordarinane architecture. Among them, SdnB is confirmed to be the first P450 (or oxidase) that cleaves the C-C bond of the epoxy residue to yield formyl groups in pairs. SdnF selectively oxidizes one generated formyl group to a carboxyl group and accelerates the final Diels-Alder cyclization to furnish the sordarinane architecture. Our work greatly enriches the enzyme functions of the P450 superfamily, supplies the missing skills of the P450 synthetic toolbox, and supports them as biocatalysts in further applications toward the synthesis of new chemical entities.

Long-term follow-up in quality of life before and after endoscopic thoracic sympathicotomy in 367 patients with palmar hyperhidrosis.

BACKGROUND: Palmar hyperhidrosis (PH) hinders daily activities and deteriorates quality of life (QOL). Endoscopic thoracic sympathicotomy (ETS) is safe and efficient as the gold standard treatment for PH. So far, the long-term change of QOL after surgery has not been fully characterized, which is important to evaluate clinical benefits and helped to identify the true beneficiaries. In the current study, we aimed to investigate the long-term outcome of ETS by comparing their preoperative QOL with a follow-up QOL. METHODS: This study enrolled 367 patients with PH who underwent ETS between March 2018 and March 2019. All patients were surveyed by a web-based questionnaire adapted from de Campos Quality-of-life Questionnaire for Evaluation of Hyperhidrosis, and compared to their preoperative results. RESULTS: After a median follow-up of 14 months [interquartile range (IQR), 9-21 months], improvement in QOL was reported in 90.7% of patients. Compared to preoperative QOL [median (Md) =40, IQR, 37-45], postoperative QOL was significantly improved (Md =20, IQR, 13-23; P<0.001). A higher QOL score was noticed in patients with severer PH at diagnosis, whereas no significant difference was observed among postoperative QOL regarding the severity of PH. Subclinical compensatory hyperhidrosis (CH) occurred in 94.6% of post-ETS cases after long-term follow-up. The score of postoperative QOL was significantly positively correlated to the severity of CH (rs=0.14; P=0.009). CONCLUSIONS: Improvement in QOL sustained for a long-term period after receiving ETS for PH. Almost all patients developed subclinical CH on other body sites in the long run, with an impairment in QOL correlating with the severity of CH. Further investigations on the developing patterns of CH and clinical coping strategy are warranted to improve the long-term outcome of ETS.

Perioperative Anaphylaxis from a Perspective of Temperature.

Perioperative anaphylaxis poses a special challenge due to its unique condition with the additive effects of surgery and anesthesia, which tends to be more difficult to recognize, diagnose, and manage, resulting in potentially fatal outcomes. Appropriate prevention and treatment benefits patients and reduces mortality and morbidity. Significant body temperature changes occur during anaphylaxis and/or anesthesia, which correlates with the outcomes. During the perioperative period, body temperature and anaphylaxis bidirectionally interact with each other, and anaphylaxis is generally deteriorated by hypothermia, which is usually required in cardiac surgeries. Perioperative factors, such as surgery and anesthesia, affect body temperature and anaphylaxis. The complicated role of body temperature and its application in the diagnosis of perioperative anaphylaxis and prediction of the outcomes are still unclear. To date, a profile of body temperature change during perioperative anaphylaxis is lacking, which requires further study. This literature review was conducted with updated data on perioperative anaphylaxis from the perspective of temperature as a component aiming to bring attention to and offer some cues for improving perioperative prevention and management for perioperative medical teams.Supplemental data for this article is available online at https://doi.org/10.1080/08941939.2021.1922553 .

Parecoxib ameliorates renal toxicity and injury in sepsis-induced mouse model and LPS-induced HK-2 cells.

Parecoxib is a selective COX-2-specific inhibitor, which has been demonstrated to inhibit sepsis-induced systemic inflammation, but its role in sepsis-induced acute kidney injury has not been studied. This study was designed to investigate the effects of Parecoxib on sepsis-induced acute kidney injury. In this study, the mice sepsis model was established using an internationally recognized cecal ligation and puncture (CLP). Hematoxylin-eosin staining was performed to examine kidney injury. Biochemical kit was used to detect the expression of BUN and Cre in serum, and ELISA was used to detect the expression of inflammatory factors in renal tissue. Tunel staining was used to detect tissue apoptosis. Furthermore, CCK-8 assay was used to detect the cell viability of HK-2 cells and RT-qPCR was used to detect the expression of LPS-induced inflammatory factors in HK-2 cells.TUNEL staining was used to detect the level of cell apoptosis. Finally, the expressions of COX-2, p-NF-kB P65, p-IKKß, NF-kB P65, IKKß, Kim1, NGAL, iNOS, VEGF, VEGFR2, CD31 and apoptosis-related proteins in renal tissues and HK-2 cells were detected by Western blot. We discovered that parecoxib could alleviate renal pathological changes, reduce renal function injury, and inhibit renal pathology to inhibit the release of inflammatory factors in renal tissue. Parecoxib inhibited sepsis induced microvascular damage and apoptosis in renal tissue. Parecoxib reduced the inflammation and apoptosis of renal tubular epithelial cells induced by LPS. Our data suggest that Parecoxib ameliorates sepsis-induced kidney injury, and may have potential as a novel therapeutic method for treating sepsis-induced kidney injury.

Labor Analgesia reduces the risk of postpartum depression: A cohort study.

BACKGROUND: Postpartum depression (PPD) is a frequent mental disorder after delivery. In China, most parturients give birth with the assistance of labor analgesia (LA) or by cesarean section (CS); however, it is still unclear whether these two approaches reveal different effects on PPD. METHODS: One hundred and ninety-eight patients with single pregnancy at full term were allocated to receive either group LA or group CS. Maternal and neonatal variables in the perinatal period were recorded. Multivariate logistical regression analysis was conducted to evaluate the associated factors of PPD. RESULTS: The incidence of PPD in group LA was lower than in group CS. Besides, eight factors were found to be potential predictors of PPD. Multivariate logistic model showed that LA was a protective factor against PPD. However, high family income and Edinburgh postnatal depression scale (EPDS) scores at 3 days postpartum were associated with an increased risk of PPD. CONCLUSION: LA could reduce the incidence of PPD in women with single pregnancy at full term. Family income and EPDS scores in the early postpartum period were also related with PPD. Large sample size studies are needed to verify the impact of LA on the psychological states of postpartum women.

Perioperative Exercise Intention and Influencing Factors: A Multi-Centered Cross-Sectional Study.

Objectives: This study aimed to evaluate the level and factors affecting the perioperative exercise intention in China. Design: This study was a cross-sectional survey in Southwest China. Methods: Four hundred and ninety nine participants were randomly sampled in eight medical centers from November 23, 2020 to November 27, 2020. The survey included sociodemographic information and a 24-item modified questionnaire, which aimed to evaluate the attitude toward daily exercise, perception of perioperative exercise, social support and the perioperative exercise intention. A multivariable linear regression model was used to evaluate the effect of different items on the patients' intention for perioperative exercise. Results: A total of 523 responses (95.09%) were collected and 499 (95.41%) were analyzed. The level of exercise intention of the patients during the perioperative period was: 14.83% planned to exercise every day in the hospital, 21.04% planned to exercise every other day, and 35.87% planned to exercise every week. Intensity of daily exercise (P = 0.016), positive attitude of daily exercise (P < 0.001), positive attitude of perioperative exercise (P < 0.001) and social support (P < 0.001) were positively associated with the intention for perioperative exercise. Female (P = 0.012), non-tertiary center (P = 0.011), and preoperative anxiety (P = 0.023) was negatively associated with it. Conclusions: The intention for perioperative exercise was low in Southwest China. The authors aimed to relieve preoperative anxiety, promote the education of perioperative exercise, design perioperative exercise programs, and provide more social support from medical staff and family for inpatients undergoing elective surgery.

Reduced Synaptic Plasticity Contributes to Resistance Against Constant-Stimulus Electroconvulsive Treatment in a Rat Model of Stress-Induced Depression.

PURPOSE: Depression is a common mood disorder in humans worldwide. Electroconvulsive therapy (ECT) remains the most effective treatment for patients with drug-resistant or severe depression; however, during ECT, electrical resistance can occur, antagonizing ECT efficacy. We aimed to investigate how depressed patients develop resistance to electric shocks during ECT. METHODS: Rats exposed to chronic unpredictable stress exert similar impairments in hippocampal synaptic plasticity as those in depressed humans, including hippocampal neuronal atrophy and reduced synaptic function and synapse-related proteins. Therefore, a rat model was used to model depressive-like behaviors in the current study. Depression-like behavior was stimulated in Sprague Dawley (SD) rats that were then randomized into six groups: control group (C); a rat model of stress-induced depression group (D); and four groups in which a rat model of stress-induced depression received one, three, five, or seven electroconvulsive shocks (ECS; DE1, DE3, DE5, and DE7). The sucrose preference test (SPT) and Morris water maze (MWM) were utilized to evaluate anhedonia and spatial learning and memory in rats, respectively. Synaptic plasticity was recorded electrophysiologically in terms of field excitatory postsynaptic potential (fEPSP) and long-term potentiation (LTP). RESULTS: The rat model of stress-induced depression triggered a decrease in the sucrose preference percentage (SPP) and the baseline fEPSP slope relative to those observed for the C group, and these changes were significantly rescued by ECT in a shock number-dependent manner within five shocks. However, the rat model of stress-induced depression displayed an increase in the escape latency and a decrease in space exploration time, in addition to decreased LTP relative to those in the C group, which was further augmented by ECT in a shock number-dependent manner within five shocks. CONCLUSION: Changes in synaptic plasticity might be responsible for the development of resistance against constant-stimulus ECT in a rat model of stress-induced depression.

Prevalence and predictors of chronic postsurgical pain after colorectal surgery: A prospective study.

AIM: The aim was to investigate the incidence, characteristics and the potential predictors of chronic postsurgical pain (CPSP) after colorectal surgery. METHOD: Patients who underwent colorectal surgery at our institution from July 2014 to December 2016 were prospectively enrolled in this study. Perioperative potential demographic, clinical and psychological predictors for CPSP were collected. The follow-up visits were conducted through telephone interviews at 3 and 6 months postoperatively. The interview questionnaire comprised items regarding pain intensity, frequency, site, analgesic administration and impact on activities of daily living. RESULTS: A total of 624 patients completed the 6-month follow-up and were included in the analysis. CPSP was reported by 32.1% of these patients at 3 months and 21.8% at 6 months after colorectal surgery. The pain interfered with several activities of daily living in a considerable proportion of CPSP cases. At 3 months, the identified predictors of CPSP were young age, preoperative abdominal pain and pain elsewhere, preoperative anxiety and depression, longer duration of surgery, and high pain intensity on movement within 24 h after surgery. Predictors of CPSP at 6 months were young age, preoperative abdominal pain, preoperative anxiety, longer duration of surgery, and high pain intensity on movement within 24 h after surgery. CONCLUSION: Chronic pain after colorectal surgery is a common complication associated with young age, preoperative abdominal pain and pain elsewhere, preoperative anxiety and depression, longer duration of surgery, and high pain intensity on movement within 24 h after surgery.