Association of intraoperative hypotension and severe postoperative complications during non-cardiac surgery in adult patients: A systematic review and meta-analysis.

Background: Intraoperative hypotension (IOH) is a common side effect of non-cardiac surgery that might induce poor postoperative outcomes. The relationship between the IOH and severe postoperative complications is still unclear. Thus, we summarized the existing literature to evaluate whether IOH contributes to developing severe postoperative complications during non-cardiac surgery. Methods: We conducted a comprehensive search of PubMed, Embase, Cochrane Library, Web of Science, and the CBM from inception to 15 September 2022. The primary outcomes were 30-day mortality, acute kidney injury (AKI), major adverse cardiac events (myocardial injury or myocardial infarction), postoperative cognitive dysfunction (POCD), and postoperative delirium (POD). Secondary outcomes included surgical-site infection (SSI), stroke, and 1-year mortality. Results: 72 studies (3 randomized; 69 non-randomized) were included in this study. Low-quality evidence showed IOH resulted in an increased risk of 30-day mortality (OR, 1.85; 95% CI, 1.30-2.64; P < .001), AKI (OR, 2.69; 95% CI, 2.15-3.37; P < .001), and stroke (OR, 1.33; 95% CI, 1.21-1.46; P < .001) after non-cardiac surgery than non-IOH. Very low-quality evidence showed IOH was associated with a higher risk of myocardial injury (OR, 2.00; 95% CI, 1.17-3.43; P = .01), myocardial infarction (OR, 2.11; 95% CI, 1.41-3.16; P < .001), and POD (OR, 2.27; 95% CI, 1.53-3.38; P < .001). Very low-quality evidence showed IOH have a similar incidence of POCD (OR, 2.82; 95% CI, 0.83-9.50; P = .10) and 1-year-mortality (OR, 1.66; 95% CI, 0.65-4.20; P = .29) compared with non-IOH in non-cardiac surgery. Conclusion: Our results suggest IOH was associated with an increased risk of severe postoperative complications after non-cardiac surgery than non-IOH. IOH is a potentially avoidable hazard that should be closely monitored during non-cardiac surgery.

Combined Effects of Electroacupuncture and Behavioral Training on Learning-Memory Ability and Event-Related Potential P300 in Rats with Mid/Advanced Cerebral Infarction.

BACKGROUND: The effectiveness of the combination of electroacupuncture (EA) and behavioral training (BT) for mid/advanced cerebral infarction (M/ACI) and related mechanisms remains unclear. This study aimed to investigate the combined effects on the learning-memory ability and event-related potential P300 in rats with M/ACI. METHODS: Eighty rats with M/ACI were divided into Group Model (M), Group EA, Group BT, and Group EA-BT (n = 20) according to the random number with five healthy rats in Group Control (CON). On the 6th week after modeling, EA, BT, and EA-BT were given to Group EA, Group BT, and Group EA-BT, respectively, whereas Group M and Group CON were not given any intervention. Y-maze test and P300 were recorded before and after the intervention. RESULTS: After intervention, the P300 latency was lower and the amplitude was higher in the Group EA-BT, Group EA, and Group BT than before (for latency, t = -7.638, -4.334, and -5.916; for amplitude, t = 8.125, 3.846, and 5.238; P < 0.01), with Group EA-BT superior to Group EA (for latency, t = -3.708; for amplitude, t = 3.653; P < 0.01) and Group BT (for latency, t = -2.067; for amplitude, t = 2.816; P < 0.05), with no significant difference between Group BT and EA (for latency, t = -1.439; for amplitude, t = 1.075; P > 0.05). While the performances of Y-maze tests in the Group EA-BT, Group EA, and Group BT were all better than before (t = 10.359, 4.520, and 7.791, P < 0.01), with Group EA-BT better than Group EA (t = 5.627, P < 0.01) and Group BT (t = 2.913, P < 0.01) respectively, and Group BT better than Group EA (t = 2.912, P < 0.01). CONCLUSION: EA or BT can affect P300 in rats with M/ACI, and the combination of these two methods can significantly improve the learning-memory ability.

[Regulation effects of liuwei dihuang pill, jingui shenqi pill, jiangu erxian pill containing serums on adipogenic and osteogenic differentiation-related genes expressions in the differentiation process of preadipocytes to osteoblasts].

OBJECTIVE: To study the effects of Chinese medical recipes for invigorating Shen on rat bone marrow mesenchymal stem cells (BMSCs)-derived preadipocytes' differentiation to osteoblasts. METHODS: The BMSCs were cultured using whole bone marrow adherence wall method. The BMSCs were induced to preadipocytes by classic chemical method. The osteogenic differentiation process of preadipocytes was intervened by Liuwei Dihuang Pill (LDP), Jingui Shenqi Pill (JSP), or Jiangu Erxian Pill (JEP)-containing serums (with the concentRation of 10%, on behalf of tonifying Shen yin, tonifying Shen yang, and tonifying Shen essence). Reverse transcription-real time fluorescent quantitative-PCR (RT real time qPCR) was used to detect RUNX2, ALP, BGP, BMP2, BMP4, SPP1, and IGF1 mRNA expressions of osteogenic differentiation-related genes, mRNA expressions of LPL, FABP4, and PPARgamma of adipogenic differentiation-related genes on the 6th, the 12th, and the 18th day. RESULTS: As for the osteogenic differentiation-related gene, when compared with the control group, there was no statistical difference in the gene expression level in the experimental groups on the 6th day (2.0 > Ratio > 0.5). On the 12th day, the mRNA expressions of IGF1 and Runx2 increased more significantly in the JSP group, with their relative quantification (Ratio) being 2.97 and 1.81 respectively. On the 18th day the IGF1 mRNA expression significantly increased, being the Ratio value of 3.74, 12.60, and 8.35, respectively, in the LDP group, the JSP group, and the JEP group. The SPP1 mRNA expression also significantly increased, with the Ratio value of 2.94, 3.18, and 2.62, respectively, in the LDP group, the JSP group, and the JEP group. As for adipogenic differentiation-related genes, on the 6th day, when compared with the control group, FABP4 mRNA expression significantly decreased in the LDP group and the JSP group (with the Ratio value of 0.47 and 0.40 respectively). The expression levels of other genes were all down-regulated, but not significantly. On the 12th day and 18th day, there was no statistical change in the adipogenic differentiation-related genes expressions (2.0 > Ratio > 0.5). CONCLUSIONS: Up-regulation of osteogenic differentiation-related genes expression occurred in later time, while down-regulation of adipogenic differentiation-related genes expression occurred in earlier time after treatment by Chinese medical recipes for invigorating Shen. In general, above data indicated that tonifying Shen yang was more effective in promoting osteogenic differentiation and inhibiting adipogenic differentiation of BMSCs.

[Acupoint catgut-embedding therapy: superiorities and principles of application].

OBJECTIVE: To analyze the superiorities of acupoint catgut-embedding therapy, discuss its law of clinical application and provide scientific decision-making for clinical treatment. METHODS: Literatures on acupoint catgut-embedding therapy in the recent 40 years were selected, input, examined and verified, picked up and analyzed by establishing database with the modern computer technology. RESULTS: (1) One thousand and seventy-five literatures were input. It shows that the acupoint catgut-embedding therapy has an extensive application in all departments, especially in the internal department, accounting for 48.54% (50/103) of the total disease category. It has the most extensive application on treatment of epigastric pain, with the frequency of 102 times, and obesity of 74 times. The next is surgery, accounting for 14.56% (15/103). The major application is on low back pain and leg pain with the frequency of 79 times. Psoriasis, with the frequency of 30 times, holds the major application in dermatological department. And blepharoplasty, with the frequency of 30 times, gains the most application in department of ophthalmology and otorhinolaryngology. (2) In the included literatures, selection of adjacent acupoints and distal acupoints are held as the major method of acupoint selection. The adjusted lumbar puncture needle is taken as the major tool for the acupoint catgut-embedding therapy. And catguts of different sizes are adopted for the operation. (3) Analysis of the therapeutic effect shows that acupoint catgut-embedding therapy has obvious effect in all departments, especially in surgery and dermatology, with the total effective rate over 90%. CONCLUSION: Epigastric pain, obesity, epilepsy, asthma, abdominal pain, facial paralysis and constipation of the internal medicine, low back pain and leg pain of the surgical department, psoriasis of the dermatological department and blepharoplasty of the department of ophthalmology and otorhinolaryngology are considered as the dominant diseases for acupoint catgut-embedding therapy.

[Basic rules and characteristics of acupoint application therapy based upon data mining].

OBJECTIVE: To analyze the basic characteristics of effects of acupoint application therapy in order to guide clinical decision better. METHODS: A database on acupoint application therapy was established first by collection, sorting, screening, recording, collation, data extraction, and statistical analyses of the related literature published in recent 60 years, and using modern computer system. Then, its predominant indications and application rules in clinical practice were analyzed using data mining techniques. RESULTS: Outcomes of data mining showed that the acupoint application therapy was extensively utilized in the treatment of a variety of diseases or clinical conditions (142 in total) in different clinical departments, particularly in the internal medicine which contains 51 types of clinical conditions or diseases (accounting for 35.92%). Among them, the top 3 are asthma, cough, and abdominal pain, with the appearance frequency being 161, 79 and 45 times (= articles) in the domestic journals, respectively. The second one is the paediatric department, containing 30 kinds of diseases or clinical conditions (accounting for 21.13%). Among them, cough (106 articles), asthma (104 articles) and diarrhoea (82 articles) are frequently seen. The surgery department takes the third place, involving 27 disorders (accounting for 19.01%), with lumbago-leg pain being the most (31 articles). In the departments of ophthalmology and otorhinolaryngology, 14 types of disorders (accounting for 9.86%) have been reported, with nasosinusitis being the most (56 papers). This therapy has also been used to treat 10 types of gynecopathy (7.04%) and 10 kinds of dermopathy (7.04%), with dysmenorrhea (37 articles) and shingles (6 articles) being the most. For acupoint application, complex prescriptions of Chinese herbal medicines in the forms of paste and cataplasm are frequently adopted, but with fewer application of enhancer of cutaneous penetration. Regarding the utilized acupoint, local points are often chosen. In the light of the collected papers, the highest effective rate is for dermopathy, followed by surgical problems, gynecopathy, paediatric conditions, and disorders of the internal medicine, ophthalmology and otorhinolaryngology. CONCLUSION: Acupoint application therapy has been used for 142 kinds of disorders of different clinical departments, with the dominant indications being asthma, cough, abdominal pain, facial paralysis and constipation in the internal medicine, cough, asthma and diarrhoea in the paediatrics, lumbago-leg pain in the surgery, nasosinusitis in the otorhinolaryngology, and dysmenorrhea of gynecopathy.

Feasibility and safety of magnetic-controlled capsule endoscopy system in examination of human stomach: a pilot study in healthy volunteers.

OBJECTIVE: To assess the feasibility and safety of magnetic-controlled capsule endoscopy (MCE) system for examination of human stomach. METHODS: This pilot study enrolled 34 healthy volunteers. All subjects swallowed the MCE and gas-producing powder for gastric distention. An external robot was used to generate magnetic field to manipulate MCE inside the stomach. The primary measurements included safety, gastric preparation, maneuverability and visualization of gastric mucosa. RESULTS: Gastric preparation and examination was well accepted by subjects and there were no adverse events. The examination in the stomach takes 43.8±10.0min (27-60). The cleanliness was evaluated as good in the 30 (88.2%) subjects and as moderate in 4 (11.8%) subjects. The distention of gastric cavity was evaluated as good in the 29 (85.3%) subjects and moderate in 5 (14.7%) subjects. Maneuverability of the MCE to movements of the guidance magnet robot was graded as good in 29 (85.3%) subjects and moderate in 5 (14.7%) subjects. More than 75% gastric mucosa was visualized in 27 (79.4%) subjects and 50% to 75% in 7 (20.6%) subjects. Visualization of the gastric cardia, fundus, body, angulus, antrum and pylorus was subjectively assessed as complete in 82.4%, 85.3%, 100.0%, 100.0%, 100.0% and 100.0%, respectively. Polyp and erosive lesions were found in 7 subjects. CONCLUSION: Magnetic-controlled capsule endoscopy used for examination of the human stomach is feasible and safe.

[Research on characteristics of different clinical conditions treated by red-hot acupuncture needle based on data mining needle].

OBJECTIVE: To analyze the regularities and characters of clinical application of red-hot needle therapy in ancient and modern literature of Chinese medicine by using data mining techniques, so as to provide a reference for study on the specificity of efficacy of red-hot needle therapy. METHODS: Sample data was collected from some medical books, medical cases, reports of modern journals for calculating frequent item sets by using methods of association rules of data mining. Then, the collected data was extracted, sorted out, and summed up by using our newly developed literature database platform of red-hot needle therapy in order to find out the most suitable indications of this therapy in clinical practice. RESULTS: A total of 6 categories of clinical conditions treated by red-hot needle therapy were found. Among them, the frequency times (percentages) of red-hot needle application for surgical problems appeared in journals, medical cases and medical books are 287 times (49.83%), 235 times (48.96%), 154 times (41.73%), respectively. The frequency times of red-hot needle application for disorders of internal medicine and dermatology are 276 times and 360 times. Among the 115 categories of clinical conditions or diseases treated by red-hot needle appeared in journals, arthromyodynia and struma are frequently found, with the frequency being 115 and 46 times, separately. The total effective rates of the present therapy from higher to lower are 99.46% for pediatric problems, 98.65% five sensory organs department, 97.32% surgery, 96.66% dermatology, 96.34% gynecology, and 93.95% internal medicine, respectively. Among the 97 types of clinical conditions recorded in the literature on medical cases, aural verruca is more frequently seen apart from arthromyodynia and struma. In medical books, 94 types of clinical conditions treated by red-hot needle therapy are found, including 32 types of problems of internal medicine. CONCLUSION: Data mining results show that red-hot needle therapy has been widely used in different clinical departments, and more frequently used in surgery (mainly orthopedic and general surgery), internal medicine (mainly neurology and gastroenterology), dermatology.

[Ecological stability on biological removal of iron and manganese filter under poor nutritional conditions].

To supply necessary bacteria and available nutrients, a method of returning backwashing wastewater to the bio-filter for removal of iron and manganese was used. The ecological stability of bio-filter was investigated from 3 aspects: iron and manganese removal efficiency, micro-ecological characteristics and the quantity distribution of dominant bacteria. The results indicated that, the bio-filter held strong antishock loading capability, when the system was operated at high filtration rate (10-13.9 m/h) and high manganese concentration (3.5-4.5 mg/L), a removal rate more than 98.9% of iron and manganese was achieved. Iron and manganese oxidizing bacteria are the dominant microflora in biological filtering layer, they not only adhere on filter sand materials (4.3 x 10(6) MPN/mL) to form compact biofilm, but also exist among filter materials void (6.5 x 10(6) MPN/mL) to form suspended flocs, which is very important to complete removal of iron and manganese. In the past 5 years, the bio-filter realized a continuous and stable operation and kept a high removal efficiency of iron and manganese without adding any nutrients.

UV-catalytic treatment of spent caustic from ethene plant with hydrogen peroxide and ozone oxidation.

The performance of UV/H2O2, UV/O3 and UV/H2O2/O3 oxidation systems for treating spent caustic from an ethylene plant was investigated. In UV/H2O2 system, with the increase of H2O2 dosage, removal efficiencies of COD and the ratio of biochemical oxygen demand (BOD) to chemical oxygen demand (COD) of the effluent were increased and a better performance was obtained than the H2O2 system alone. In UV/H2O2 system, removal efficiency of COD reach 68% under the optimum condition, and BOD/COD ratio was significantly increased from 0.22 to 0.52. In UV/O3 system, with the increase of O3 dosage, removal efficiency of COD and BOD/COD ratio were increased, and a better performance was obtained than the O3 system alone. Under the optimum condition, removal efficiency of COD was 54%, and BOD/COD ratio was significantly increased from 0.22 to 0.48. In UV/H2O2/O3 system, COD removal efficiency was found to be 22.0% higher than UV/O3 system.