Perspectives on Protein-Nanoparticle Interactions at the In Vivo Level.

The distinct features of nanoparticles have provided a vast opportunity of developing new diagnosis and therapy strategies for miscellaneous diseases. Although a few nanomedicines are available in the market or in the translation stage, many important issues are still unsolved. When entering the body, nanomaterials will be quickly coated by proteins from their surroundings, forming a corona on their surface, the so-called protein corona. Studies have shown that the protein corona has many important biological implications, particularly at the in vivo level. For example, they can promote the immune system to rapidly clear these outer materials and prevent nanoparticles from playing their designed role in therapy. In this Perspective, the available techniques for characterizing protein-nanoparticle interactions are critically summarized. Effects of nanoparticle properties and environmental factors on protein corona formation, which can further regulate the in vivo fate of nanoparticles, are highlighted and discussed. Moreover, recent progress on the biomedical application of protein corona-engineered nanoparticles is introduced, and future directions for this important yet challenging research area are also briefly discussed.

Re-measurement and influencing factors of agricultural eco-efficiency under the 'dual carbon' target in China.

Given that agriculture is both a carbon source and sink, the sustainability goals of carbon peaking and neutrality place high demands on the green and low-carbon agricultural development in China, and the exploration of a realistic path for a sustainable agricultural development is urgently needed. Under the above 'dual carbon' target, this study focused on the key issue of how to improve China's agricultural eco-efficiency (AEE) and constructed an innovative AEE indicator system that can reflect carbon constraint and coordinated agricultural economic development, resource use and ecological environment. The super-efficient slack-based measured Data Envelopment Analysis (SBM-DEA) method, which considers undesirable outputs, was applied to re-measure the AEE of 30 provinces and cities in China from 2001 to 2020, and its spatial and temporal evolution was analysed in conjunction with kernel density estimation. The Tobit regression model was used to explore various influencing factors by region. The results show that the AEE re-measurements, which take into account the 'dual carbon' requirement, are significantly better than the traditional AEE. From 2001 to 2020, China had an overall V-shaped fluctuation curve AEE, with a small decline and several inter-annual fluctuations, and exhibited a large potential to rise. China's AEE showed a spatially uneven regional development at different stages of distribution and evident multi-polar differentiation. Inter-provincial differences were observed in China's AEE, and the vicious circle of low-level green and low-carbon agricultural development was difficult to break. Urbanisation had a significant positive effect on national and eastern AEE but a significant negative effect on central AEE. The agricultural carbon offset rate had a significant effect on AEE nationally and in the three regions. Thus, the introduction of 'dual carbon' target effectively drove the development of AEE. Agricultural industry structure inhibited the improvement of AEE nationally and in the western region. Agricultural economic development hindered the national AEE improvement but promoted that of the central region, where China showed an environment Kuznets curve. Hopefully, this study can provide data support and theoretical reference for the green and low-carbon agricultural development and help achieve the 'dual carbon' target.

CEO discretion and enterprise digital transformation.

Digital transformation is a new development opportunity available to enterprises in the digital economy and represents a comprehensive application of digital technology in production, operation, and management. This study examined the impact of Chief Executive Officer (CEO) discretion on enterprise digital transformation using data from 2007 to 2022 of A-share listed companies in Shanghai and Shenzhen exchanges in China. The results suggest that CEO discretion enhances digital transformation performance, and the degree of CEO self-confidence plays a moderating role. The greater the degree of CEO self-confidence, the stronger the impact on digital transformation. Sex, age, educational background, and experience in finance affect discretionary powers of CEOs and its effect on digital transformation. The mechanism test revealed that corporate financialisation and technological innovation investment can play a mediating role. Additional analysis revealed that the facilitative effect of CEO discretion on digital transformation is stronger for non-state and large firms. This study enriched and expanded the behavioural theory in finance and related research on the factors influencing corporate digital transformation and provided empirical evidence on how firms can follow the digital development trends and accelerate the process of corporate digital transformation.

Rotini-like MXene@LCE Actuator with Diverse and Programmable Actuation Based on Dual-mode Synergy.

Liquid crystalline elastomer (LCE) exhibits muscle-like actuation upon order-disturbed stimulus, offering ample room for designing soft robotic systems. Multimodal LCE is demonstrated to unleash the potential to perform multitasks. However, each actuation mode is typically isolated. In contrast, coordination between different actuation modes based on an MXene-doped LCE is realized, whose actuation can be triggered either by directly heating/cooling or using near-infrared light due to the photo-thermal effect of MXene. As such, the two activation modes (heat and light) not only can work individually to offer stable actuation under different conditions but also can collaborate synergistically to generate more intelligent motions, such as achieving the brake and turn of an autonomous rolling. The principle therefore can diversify the design principles for multifunctional soft actuators and robotics.

The work experience of male nursing teachers in Chinese universities: a phenomenological study.

Background: With the increase in the number of male nursing staff, more and more highly educated male nursing staff are joining the nursing higher education industry. Nevertheless, male nursing teachers in China are still a very small group in the education industry, but they have made important contributions to nursing education in China. Work experience is a key factor in the stability of the professional team and the quality of education. However, there is little research on the professional feelings of Chinese male nursing teachers. Objective: Explore the true feelings of male nursing teachers in Chinese universities about their work, understand their actual work difficulties, their sources of work stress and methods of coping with stress under the Chinese cultural background, and combine their professional expectations to provide ways to solve these problems, and help male nursing educators better apply nursing education work. Methods: This study uses an interpretive and exploratory qualitative research design method, in which the participants of male nursing teachers are selected from 30 universities with nursing majors in Zhejiang Province by the method of purpose sampling, and semi-structured in-depth interviews were used to collect data. A Van Manen process was used for data analysis. The 10th respondents were saturated. Results: Five themes were extracted in this study, namely realistic difficulties of career, positive feelings of career, sources of occupational stress, coping methods for occupational stress, and career development expectations. Conclusions: Male nursing teachers in universities can actively adjust their thoughts and behaviors and face negative professional feelings due to gender factors. But they still need more comprehension and support from educational institutions and society. The support of leaders and universities can help them better adjust to professional development and maintain a rational and stable nursing teacher team.

A study of Inter-Technology Information Management (ITIM) system for industry-education integration.

The integration of big data technology in the manufacturing process has become a norm, and as society's dependence on the digital economy increases, colleges and universities must adjust their teaching methods to cater to their students' needs. In evaluating the success of business-school partnerships, there is a need for common criteria and visualising data analysis results. However, the current educational approach presents some challenges, including a lack of practical experience with software, overemphasis on theoretical concepts, and inadequate training in problem-oriented statistical modeling and big data statistics projects. Industry-education cooperation should be leveraged to enhance the implementation of big data technology and promote its overall development. This paper analyses the shortcomings of traditional talent training models in higher education and proposes incorporating industrial education to address the gaps. The paper aims to bridge the industry-education gap by developing and implementing an Inter-Technology Information Management (ITIM) system for quality education. The ITIM system uses a fuzzy algorithm to evaluate the quality of education and provides various intelligent functional modules, such as group management, financial management, and process-to-process communication. Compared to other integration models, the proposed management system offers superior performance with an industrial education performance accuracy of 98%, an average analysis, and calculation time of 20 ms and a maximum performance efficiency of 98%.By incorporating dynamic analysis of industry education, the experimental results of the talent training model have led to improvements in teaching effectiveness, student learning, and theoretical-applied teaching quality.

How psychological contract violation impacts turnover intentions of knowledge workers? The moderating effect of job embeddedness.

When knowledge workers encounter psychological contract violations, they usually send out biased signals. Their job satisfaction decreases and their turnover intentions increase. However, in the increasingly competitive talent market, employees may not choose to leave when they encounter psychological contract violation. Based on the theoretical research results of the existing psychological contract violation, job satisfaction, turnover intention and job embeddedness, this paper analyzes the internal connections and deep relationships among the key elements by referring to the possible causes and results of the changes in the key elements. Survey technique was utilized while knowledge workers were selected as targeted respondents from specified provinces of China. A total of 392 valid questionnaires were selected by questionnaire survey. Statistical analysis was carried out by SPSS21 and AMOS23, and regression analysis was used to repeatedly verify the relationship between various elements. The results show that psychological contract violation positively predicts the turnover intention of knowledge workers, job satisfaction mediates the positive effect of psychological contract violation on turnover intention, and job embeddedness negatively regulates the positive effect of psychological contract violation on turnover intention. This study has theoretical and practical significance in enriching the theory and methods of organizational management, inspiring knowledge workers to stimulating their work potential, reducing employees' turnover intention, reducing the impact of resignation on the enterprise, and enhancing the enterprise's human resource management of knowledge workers.

Does the CFO serving as the secretary of the board affect the financial statement comparability?-evidence from China.

One person serving as both CFO and board secretary is a unique institutional feature in China. Individuals in this senior executive role are responsible for not only the preparation of financial statements but also the coordination of information disclosure. We investigate the relation between a CFO serving as board secretary and financial statement comparability. We find that a CFO serving as board secretary improves the comparability of a firm's financial statements in additional analysis. This positive effect is more significant when the CFO is female or middle-aged, or has a Bachelor's degree or higher or a financial background. This paper enriches the theoretical research on CFO's employment characteristics and the quality of financial reports, and provides reference value for improving the quality of financial reports.

Nomogram for prediction of peritoneal metastasis risk in colorectal cancer.

Objective: Peritoneal metastasis is difficult to diagnose using traditional imaging techniques. The main aim of the current study was to develop and validate a nomogram for effectively predicting the risk of peritoneal metastasis in colorectal cancer (PMCC). Methods: A retrospective case-control study was conducted using clinical data from 1284 patients with colorectal cancer who underwent surgery at the First Affiliated Hospital of Guangxi Medical University from January 2010 to December 2015. Least absolute shrinkage and selection operator (LASSO) regression was applied to optimize feature selection of the PMCC risk prediction model and multivariate logistic regression analysis conducted to determine independent risk factors. Using the combined features selected in the LASSO regression model, we constructed a nomogram model and evaluated its predictive value via receiver operating characteristic (ROC) curve analysis. The bootstrap method was employed for repeated sampling for internal verification and the discrimination ability of the prediction models evaluated based on the C-index. The consistency between the predicted and actual results was assessed with the aid of calibration curves. Results: Overall, 96 cases of PMCC were confirmed via postoperative pathological diagnosis. Logistic regression analysis showed that age, tumor location, perimeter ratio, tumor size, pathological type, tumor invasion depth, CEA level, and gross tumor type were independent risk factors for PMCC. A nomogram composed of these eight factors was subsequently constructed. The calibration curve revealed good consistency between the predicted and actual probability, with a C-index of 0.882. The area under the curve (AUC) of the nomogram prediction model was 0.882 and its 95% confidence interval (CI) was 0.845-0.919. Internal validation yielded a C-index of 0.868. Conclusion: We have successfully constructed a highly sensitive nomogram that should facilitate early diagnosis of PMCC, providing a robust platform for further optimization of clinical management strategies.

Non-bacterial cystitis secondary to pembrolizumab: A case report and review of the literature.

In recent years, immune checkpoint inhibitors were successfully introduced to various of cancer therapy. Pembrolizumab, an antibody to programmed cell death-1 (PD-1), which is was approved for treatment of any adult or pediatric, unresectable or metastatic solid tumor. However, just as chemotherapeutics, immune checkpoint inhibitors have many side effects, which are named as immune-related adverse events. Common immune-related adverse events are dermatological, gastrointestinal, or endocrine side effects. However, there have been few cases that associated adverse cystitis with immune checkpoint inhibitors in recent years. We present a case showed that cystitis can be caused by pembrolizumab, which should be identified with non-bacterial cystitis.

Management of the wound care clinic during the novel coronavirus pneumonia pandemic period: Sharing of management experience in a general hospital of China.

With the surge in the confirmed cases of the novel coronavirus pneumonia, medical resources in many countries have been put on red alert levels. The operation management systems of hospitals, including wound care clinics, must be innovated to ensure the normal operation of the hospital and meet the medical care needs of the people. At the same time, scientific control measures are also required to prevent the spread of the novel coronavirus pneumonia in the hospital. Actually, during the novel coronavirus pneumonia pandemic, emergency management methods for wound care clinics such as online appointments and remote online diagnosis and treatment, the rational arrangement of human resources, the scientific implementation of epidemic prevention and control measures, and the strict implementation of the management of the clinic environment and item disinfection measures to strengthen the management of protective materials, wound care materials, and dressing equipment by partition have been introduced and innovated, thus helping reduce the gathering of people in wound care clinics, create a safe medical environment, and avoid the spread of the novel coronavirus pneumonia caused by diagnosis and treatment.

The effects of virtual reality technology on reducing pain in wound care: A meta-analysis and systematic review.

Virtual reality (VR) technology has been widely used in clinical nursing care in recent years. We aimed to systematically evaluate the effect and safety of VR technology on pain control in wound care, to provide evidence and support for clinical wound care. We searched PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, China Biomedical Literature Database, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, and Chinese Science and Technology Journal databases for randomised controlled trials (RCTs) on the application of VR technology in wound care up to December 20, 2021. Two researchers independently assessed the quality of the included RCTs and extracted associated data. RevMan5.3 statistical software was used for data analysis. 13 RCTs involving 1258 adult patients were included, of whom 588 patients underwent VR intervention. VR technology intervention could reduce the VAS score(MD = -1.13, 95%CI:-2.01~-0.26, P < .001), pain cognition score(MD = -3.94, 95%CI:-4.59 ~ -3.30, P < .001), pain emotion score(MD = -5.21, 95%CI: -10.46 ~ -0.04, P < .001), pain sensation score (MD = -4.94, 95%CI: -9.46 ~ -0.42, P = .03) and blood pressure(MD = -4.66, 95%CI: -8.63 ~ -0.69, P = .02) during would care. There were no significant differences on the heart rate (MD = -1.85, 95%CI: -5.71 ~ -2.01, P = .45) and VR interestingness (MD = 28.96, 95%CI: -22.10 ~ 80.02, P = .27) of the VR group and control group. No publication biases among the synthesised outcomes were found (all P > .001). VR technology can effectively reduce the pain degree and sensation of patients during wound care, which may be an effective auxiliary non-drug method used for pain relief during wound care.

Atorvastatin Enhances Inhibitory Effects of Irradiation on Tumor Growth by Reducing MSH2 Expression Both in Prostate Cancer Cells and Xenograft Tumor Models.

BACKGROUND: Prostate cancer (PCa) is the fourth most common tumor in males. OBJECTIVE: This study aimed to investigate effects of atorvastatin (AS) on PCa cells proliferation and clarify the associated mechanisms. METHODS: PCa cell lines were cultured and treated with irradiation (IR) (4 Gy), AS (6 µg/ml), transfected with Bcl-2 siRNA, and then divided into different groups. Xenograft tumor mouse model was established. Bcl-2 and MSH2 gene transcription and protein expression were evaluated using RT-PCR assay and western blot assay. Plate clone formation assay was employed to examine colony formation. MTT assay was used to detect cell viabilities. Flow cytometry analysis was utilized to verify apoptosis. Co-immunoprecipitation and immuno-fluorescence assay were used to identify interaction between Bcl-2 and MSH2. RESULTS: IR significantly reduced colony formation, enhanced Bcl-2 and reduced MSH2 gene transcription in PCa cells compared to un-treated cells (p<0.05). AS significantly strengthened radio-therapeutic effects of IR on colony formation, decreased cell apoptosis and increased Bcl-2 gene transcription/protein expression in PCa cells compared to single IR treatment cells (p<0.05). AS combining IR down-regulated MSH2 gene transcription/protein expression in PCa cells compared to single IR treatment cells (p<0.05). Bcl-2 interacted with MSH2 both in PCa cells and tumor tissues administrating with AS. AS enhanced reductive effects of IR on tumor size of Xenograft tumor mice. CONCLUSION: Atorvastatin administration enhanced inhibitory effects of IR either on PCa cells or tumor size of Xenograft tumor mice. The inhibitory effects of atorvastatin were mediated by reducing MSH2 expression and triggering interaction between Bcl-2 and MSH2, both in vitro and in vivo levels.

Modular composite building in urgent emergency engineering projects: A case study of accelerated design and construction of Wuhan Thunder God Mountain/Leishenshan hospital to COVID-19 pandemic.

Wuhan Leishenshan/Leishenshan ("Leishenshan" for short) hospital is a makeshift emergency hospital for treating patients diagnosed with the novel coronavirus-infected pneumonia (NCIP). Engineering construction uses modular composite building finished products to the greatest extent, which reduces the workload of field operations and saves a lot of time. The building information model (BIM) technology assists in design and construction work to meet rapid construction requirements. Besides, based on the unmanned aerial vehicles (UAVs) data analysis and application platform, digitization and intelligence in engineering construction are improved. Simultaneously, on-site construction and overall hoisting were carried out to achieve maximum efficiency. This article aims to take the construction of Leishenshan Hospital as an example to illustrate how to adopt BIM technology and other high-tech technology such as big data, artificial intelligence, drones, and 5G for the fast construction of the fabricated steel structure systems in emergency engineering projects.

[Effects of simvastatin on pulmonary fibrosis and endothelial - mesenchymal transition in the pulmonary fibrosis tissue of rats].

Objective: To investigate the effects of simvastatin (SIM) on pulmonary fibrosis and the expression of VE-cadherin(VE-cad),vimentin(VIM) and alpha-smooth muscle actin(α-SMA)in the pulmonary fibrosis tissue of rats. Methods: Sixty healthy male SD rats were randomly divided into control group(group A), bleomycin group(group B), 5 mg SIM group (group C) and 10 mg SIM group (group D),15 rats in each group. The model of rat pulmonary fibrosis was established by itraperitoneal injection of bleomycin(5 mg/kg). Since the first day of modeling, the rats of group C and D were treated with simvastatin suspension 5 mg/(kg·d) and 10 mg/(kg·d) by intragastric administration everyday, and the rats of group A and B were treated with equal volume of saline 10 ml/(kg·d) everyday. Five rats of each group were sacrificed randomly at the 7th, 14th and 28th day. Masson staining was used to observe the morphological changes of lung tissue in rats. The degree of fibrosis in lung tissues of each group was evaluated by the content of hydroxyproline (HYP) . The microvessel density (MVD) was analyzed by immunohistochemistry,The expressions of protein and mRNA of VE-cad, VIM and α-SMA were determined by immunohistochemistry and RT-PCR. Results: ①Compared with group A, the levels of HYP and MVD, the mRNA and protein expression levels of VIM and α-SMA in lung tissues of groups B, C and D were increased significantly at the 7th, 14th and 28th day(all P＜0.05), which reached highest level at the 28th day. However, the mRNA and protein expression levels of VE-CAD were decreased significantly at the corresponding time (P＜0.05), which reached lowest level at 28th day. ②Compared with group B, the levels of HYP and MVD, the mRNA and protein expression levels of VIM and α-SMA in groups C and D were decreased at the 7th, 14th and 28th day (all P＜0.05), which were decreased more obviously in group D at the 28th day. However, the mRNA and protein expression levels of VE-CAD were increased at the corresponding time (all P＜0.05), which were increased more obviously in group D at the 28th day. Conclusion: Simvastatin can reduce the degree of pulmonary fibrosis in rats through inhibiting the process of EnMT, which can enhance the expression of VE-cad and reduce the expression of VIM and α-SMA.

miR-541-3p enhances the radiosensitivity of prostate cancer cells by inhibiting HSP27 expression and downregulating ß-catenin.

Heat shock protein 27 (HSP27), a regulator of cell survival, can enhance the resistance of cancer cells to radiotherapy. As microRNA-541-3p (miR-541-3p) was recently predicted to be a putative upstream modulator of HSP27, the present study was designed to investigate the function and mechanism underlying how miR-541-3p modulates the radiosensitivity of prostate cancer (PCa) cells by regulating HSP27. Through quantitative PCR, miR-541-3p was determined to be poorly expressed in PCa tissues relative to normal controls, whereas its expression was enhanced after radiotherapy. Consistently, miR-541-3p expression levels in PCa cells were elevated after radiation. Cell viability and proliferation and apoptosis under radiation were subsequently evaluated in response to loss-of-function of miR-541-3p. It was found that inhibition of miR-541-3p facilitated the viability and proliferation of PCa cells and promoted their apoptosis post radiation, hence reducing the radiosensitivity of LNCaP cells. Dual-luciferase reporter assay identified that miR-541-3p negatively regulated the HSP27 mRNA expression by targeting its 3'-UTR. Meanwhile, miR-541-3p overexpression inhibited the ß-catenin expression by targeting HSP27. Furthermore, HSP27 or ß-catenin overexpression was noted to significantly reverse the miR-541-3p-mediated changes in the biological functions of PCa cells post radiation, suggesting that HSP27-dependent activation of ß-catenin might be the mechanism responsible for the promotive effect of miR-541-3p on radiosensitivity. Collectively, this study suggests that miR-541-3p specifically inhibits the HSP27 expression and downregulates ß-catenin, thereby enhancing the radiosensitivity of PCa cells. Our findings highlight the underlying mechanism of the miR-541-3p/HSP27/Wnt/ß-catenin axis regarding radiotherapy for PCa.

Atorvastatin Enhances Effects of Radiotherapy on Prostate Cancer Cells and Xenograft Tumor Mice Through Triggering Interaction Between Bcl-2 and MSH2.

BACKGROUND Prostate cancer (PCa) is considered to be the 4th most common cancer in males in the world. This study aimed to explore effects of atorvastatin on colony formation of PCa cells and radio-resistance of xenograft tumor models. MATERIAL AND METHODS PCa cell lines, including PC3, DU145, and Lncap, were treated with irradiation (4 Gy) and/or atorvastatin (6 µg/mL). Cells were divided into tumor cell group, irradiation treatment group (IR group) and irradiation+atorvastatin treatment group (IR-AS group). Xenograft tumor mouse model was established. Plate clone formation assay (multi-target/single-hit model) was conducted to evaluate colony formation. Flow cytometry analysis was employed to detect apoptosis. Interaction between Bcl-2 and MSH2 was evaluated with immuno-fluorescence assay. RESULTS According to the plate colony formation assay and multi-target/single-hit model, IR-treatment significantly suppressed colony formation in PCa cells (including PC3, DU145, and Lncap cells) compared to no-IR treated cells (P<0.05). Atorvastatin remarkably enhanced inhibitive effects of irradiation on colony formation of PCa cells (P<0.05), however, the IR+AS group demonstrated no effects on apoptosis, comparing to IR group (P>0.05). Atorvastatin administration (IR+AS group) significantly reduced tumor size of IR-treated PCa cells-induced xenograft tumor mice (P<0.05). Bcl-2 interacted with MSH2 both in tumor tissues of xenograft tumor mice. CONCLUSIONS Atorvastatin administration inhibited colony formation in PCa cells and enhanced effects of radiotherapy on tumor growth of xenograft tumor mice, which might be associated with interaction between Bcl-2 and MSH2 molecule.

Prognostic significance and molecular mechanisms of adenosine triphosphate-binding cassette subfamily C members in gastric cancer.

Gastric cancer (GC) is one of the major leading causes of tumor-related deaths worldwide. Adenosine triphosphate-binding cassette subfamily C (ABCC) consists of 13 members, ABCC1 to 13, which were examined for their associations with GC.The online Kaplan-Meier Plotter database was used to determine the prognostic significance of ABCC subfamily members in GC. Stratified analyses were performed using gender, disease stage, degree of tumor differentiation, expression of human epidermal growth factor receptor 2 (HER2), and Lauren classification. Molecular mechanisms were examined using the database for annotation, visualization, and integrated discovery database.ABCC1, ABCC3, ABCC7, ABCC8, ABCC9, and ABCC10 expression showed prognostic significance in the whole population and in male and female subpopulations (all P ≤ .05). Furthermore, high expression of most ABCC family members always suggested a poor prognosis, except for ABCC7 (P > .05). Stratified analyses revealed that ABCC1, ABCC3, ABCC7, ABCC8, ABCC9, and ABCC10 expression showed prognostic significance for the whole population, as well as male and female populations. ABCC2 and ABCC9 were significantly correlated with all disease stages, while ABCC2 and ABCC6 were significantly correlated with all Lauren classifications. Expression of ABCC1, ABCC3, ABCC5, ABCC7, ABCC8, ABCC9, and ABCC10 was significantly correlated with either negative or positive of HER2 status (all P ≤ .05). Enrichment analysis indicated that these genes were involved in ATPase activity, transmembrane transport, or were ABC transporters (all P ≤ .05).ABCC1, ABCC3, ABCC7, ABCC8, ABCC9, and ABCC10 may be potential prognosis biomarkers for GC, acting as ABC transporters and via ATPase activity.

Combined hyperactive dysfunction syndrome of the cranial nerves complicated by essential hypertension: A case report.

RATIONALE: Combined hyperactive dysfunction syndrome (HDS) refers to a special type of HDS characterized by a combination of trigeminal neuralgia (TN), hemi facial spasm (HFS), and/or gloss pharyngeal neuralgia (GPN). Rostra ventrolateral medulla (RVLM) plays a crucial role in central cardiovascular regulation, and neurovascular compression of the RVLM has been identified as a contributor to essential hypertension. PATIENT CONCERNS: A 65-year-old female with a facial tic and pain located in the root of the tongue and throat on the same side; the systolic and diastolic blood pressure was approximately 170 and 100 mmHg. DIAGNOSIS: The patient was diagnosed with combined HDS (HFS-GPN) and essential hypertension. Brain magnetic resonance 3-dimensional time-of-flight imaging and digital subtraction angiography revealed vertebrobasilar artery compressed the left RVLM and contacted with the root entry zones of multiple cranial nerves. INTERVENTIONS: The patient was treated with microvascular decompression surgery OUTCOMES:: The symptoms were completely relieved, and blood pressure was well-controlled. LESSONS: The pathological association of hypertension and HDS should be highlighted, and microvascular decompression is an effective approach for relieving the hypertension.

Risk factors for postoperative delirium in patients undergoing microvascular decompression.

This study is to identify the risk factors for postoperative delirium (PODE) in patients undergoing microvascular decompression (MVD) for the treatment of primary cranial nerve disorders. We retrospectively reviewed the data of 912 patients (354 men, 558 women) with primary cranial nerve disorders (trigeminal neuralgia, 602 patients; hemifacial spasm, 296 patients; glossopharyngeal neuralgia, 14 patients) who underwent MVD in the Neurosurgery Department of Lanzhou University Second Hospital between July 2007 and June 2018. Potential risk factors for PODE were identified using univariate and multivariate stepwise logistic regression analysis.Of the 912 patients, 221 (24.2%) patients developed PODE. Patients with PODE were significantly older and significantly more likely to be male than patients without PODE. A history of hypertension, preoperative carbamazepine therapy, and postoperative sleep disturbance and tension pneumocephalus were independently associated with PODE. Variables such as body-mass index, smoking and drinking habits, cardiac disease, diabetes mellitus, cerebrovascular disease, mean operative time, affected vessel, mean blood loss, postoperative intensive care unit stay, postoperative fever (>38°C), and routine laboratory results were not associated with PODE in our patients.PODE is a common complication after MVD, and is associated with multiple risk factors, including old age, male sex, hypertension, preoperative carbamazepine use, postoperative sleep disturbance, and tension pneumocephalus.