Analgesic effects of pectoserratus plane block and intermediate cervical plexus block for transaxillary endoscopic thyroidectomy: a prospective randomized controlled trial.

BACKGROUND: Transaxillary endoscopic thyroidectomy (TAET) is favored for its favorable cosmetic outcomes and the preservation of anterior cervical function. Despite these benefits, postoperative analgesia has traditionally relied on pharmacological interventions, and regional anesthetic procedures may be an alternative method. This study aimed to evaluate the efficacy of an ultrasound-guided pectoserratus plane block (PSPB) combined with an intermediate cervical plexus block (ICPB) for TAET. METHODS: Forty patients undergoing TAET were randomized into two groups: the nerve block group (N.=20) received ultrasound guided PSPB with 20 ml of 0.375% ropivacaine and ICPB with 8 mL of 0.3% ropivacaine, while the control group (N.=20) received no block. The primary outcome was the Visual Analog Scale (VAS) scores for postoperative neck and axillary pain at different time points (1, 6, 12, 24 h) during rest and movement post-TAET. The secondary outcomes included intraoperative remifentanil consumption, incidence of postoperative nausea and vomiting (PONV), number of remedial analgesic requirements, and patient satisfaction postoperatively. RESULTS: Compared to the control group, patients in the nerve block had significantly lower VAS scores of the neck and axilla whether at rest or movement, and 1, 6, 12, and 24 h postoperatively (P<0.0125). The nerve block group showed higher patient satisfaction (P<0.001). No difference was observed in intraoperative remifentanil consumption, need for rescue analgesics, or other adverse effects 48 h postoperatively. CONCLUSIONS: Ultrasound-guided PSPB with ICPB significantly alleviated postoperative pain and improved patient satisfaction with TAET.

Quality control and product differentiation of LMWHs marketed in China using 1H NMR spectroscopy and chemometric tools.

Low molecular weight heparins (LMWHs) are heterogeneous mixtures of glycosaminoglycan chains composed of mixture of different lengths and substitution patterns. Structural characterization and quality control of LMWHs have always been challenging. The Chinese drug regulatory authorities have been committed to improve the supervision standards of LMWHs to better regulate the quality and safety of LMWHs in current Chinese market. In the present paper, 80 batches of three types LMWHs (dalteparin, enoxaparin and naldroparin) marketed in China from different manufacturers were studied by 1H NMR experiments and chemometric analysis. The method can be used not only to monitor impurities and contaminants, but also to check the batch-to-batch consistency of each manufacture. Moreover, for the biosimilar LMWHs from different manufactures, they can be differentiated and clustered according to their slightly different structural compositions originated from production process. By using this method, the quality and safety of LMWHs marketed in China were initially assessed.

[Retracted] MicroRNA­491­5p suppresses cervical cancer cell growth by targeting hTERT.

Following the publication of this paper, an interested reader drew to the attention of the Office that the GAPDH control bands shown in Fig. 5 were strikingly similar to data appearing in different form in other articles by different authors. Owing to the fact that the contentious data in the above article had already been published elsewhere, or were already under consideration for publication, prior to its submission to Oncology Reports, the Editor has decided that this paper should be retracted from the Journal. The authors independently contacted the Editorial Office requesting that the paper be retracted. The Editor apologizes to the readership for any inconvenience caused. [the original article was published in Oncology Reports 34: 979­986, 2015; DOI: 10.3892/or.2015.4013].

Analgesic effect of dexmedetomidine in rats after chronic constriction injury by mediating microRNA-101 expression and the E2F2-TLR4-NF-κB axis.

NEW FINDINGS: What is the central question of this study? Dexmedetomidine has a capacity for sedation, anti-anxiety and analgesia with minimal suppression of respiratory function; what is its role in neuropathic pain and what is the involvement of miRNAs? What is the main finding and its importance? Dexmedetomidine attenuates inflammation and apoptosis and the stimulation of TLR4-NF-κB signalling in rat spinal cord via miR-101 overexpression and E2F2 downregulation. ABSTRACT: The significant analgesic effect of dexmedetomidine (Dex) has been underscored in neuropathic pain (NPP), but the underlying mechanism remains unclear. This study explored the functional effect of Dex on microRNA (miR)-101-regulated E2 promoter binding factor 2 (E2F2) with the engagement of Toll-like receptor 4 (TLR4)-nuclear factor-κB (NF-κB) signalling. Chronic constriction injury (CCI) was performed to generate an NPP rat model. The expression of miR-101, E2F2 and TLR4-NF-κB signalling-relevant proteins was assessed by RT-quantitative PCR, immunoblotting and immunohistochemistry. Inflammatory factors were detected by enzyme-linked immunosorbent assay. The results showed that Dex increased mechanical withdrawal threshold and thermal latency to withdraw. The expression of interleukin (IL)-6, IL-8 and tumour necrosis factor-α was increased in CCI rats, but these trends were reversed by Dex. In addition, Dex repressed caspase-9 expression and apoptotic cell numbers in spinal cord tissues in CCI rats. Moreover, the expression of E2F2 was significantly increased, while miR-101 was diminished in CCI rats, which was reversed by Dex. Furthermore, miR-101 inhibitor, E2F2 restoration or administration of a TLR4-specific agonist weakened the effect of Dex. Together, these results suggest that Dex has the capacity to ameliorate NPP by regulating the miR-101-E2F2-TLR4-NF-κB axis in rats subjected to CCI.

Function of Adenosine 2A Receptor in High-Fat Diet-Induced Peripheral Neuropathy.

Peripheral diabetic neuropathy (DPN) is a complication observed in up to half of all patients with type 2 diabetes. DPN has also been shown to be associated with obesity. High-fat diet (HFD) affects glucose metabolism, and the impaired glucose tolerance can lead to type 2 diabetes. There is evidence to suggest a role of adenosine 2A receptors (A2ARs) and semaphorin 3A (Sema3a) signaling in DPN. The link between the expression of Sema3a and A2AR in DPN was hypothesized, but the underlying mechanisms remain poorly understood. In this study, we investigated the regulation of Sema3a by A2AR in the spinal cord and the functional implications thereof in DPN. We examined the expression of A2ARs and Sema3a, as well as Neuropilin 1 and Plexin A, the coreceptors of Sema3a, in the dorsal horn of the lumbar spinal cord of an animal model with HFD-induced diabetes. Our results demonstrate that HFD dysregulates the A2AR-mediated Sema3a expression, with functional implications for the type 2 diabetes-induced peripheral neuropathy. These observations could stimulate clinical studies to improve our understanding on the subject.

Universal isocontours for dissipative Kerr solitons.

Dissipative Kerr solitons can be generated within an existence region defined on a space of normalized pumping power versus cavity-pump detuning frequency. The contours of constant soliton power and constant pulse width in this region are studied through measurement and simulation. Such isocontours impart structure to the existence region and improve understanding of soliton locking and stabilization methods. As part of the study, dimensionless, closed-form expressions for soliton power and pulse width are developed (including Raman contributions). They provide isocontours in close agreement with those from the full simulation, and, as universal expressions, can simplify the estimation of soliton properties across a wide range of systems.

Towards visible soliton microcomb generation.

Frequency combs have applications that extend from the ultra-violet into the mid-infrared bands. Microcombs, a miniature and often semiconductor-chip-based device, can potentially access most of these applications, but are currently more limited in spectral reach. Here, we demonstrate mode-locked silica microcombs with emission near the edge of the visible spectrum. By using both geometrical and mode-hybridization dispersion control, devices are engineered for soliton generation while also maintaining optical Q factors as high as 80 million. Electronics-bandwidth-compatible (20 GHz) soliton mode locking is achieved with low pumping powers (parametric oscillation threshold powers as low as 5.4 mW). These are the shortest wavelength soliton microcombs demonstrated to date and could be used in miniature optical clocks. The results should also extend to visible and potentially ultra-violet bands.

Single-mode dispersive waves and soliton microcomb dynamics.

Dissipative Kerr solitons are self-sustaining optical wavepackets in resonators. They use the Kerr nonlinearity to both compensate dispersion and offset optical loss. Besides providing insights into nonlinear resonator physics, they can be applied in frequency metrology, precision clocks, and spectroscopy. Like other optical solitons, the dissipative Kerr soliton can radiate power as a dispersive wave through a process that is the optical analogue of Cherenkov radiation. Dispersive waves typically consist of an ensemble of optical modes. Here, a limiting case is studied in which the dispersive wave is concentrated into a single cavity mode. In this limit, its interaction with the soliton induces hysteresis behaviour in the soliton's spectral and temporal properties. Also, an operating point of enhanced repetition-rate stability occurs through balance of dispersive-wave recoil and Raman-induced soliton-self-frequency shift. The single-mode dispersive wave can therefore provide quiet states of soliton comb operation useful in many applications.

Linear-regression-based approach for loss extraction from ring resonators.

This Letter proposes and demonstrates a linear-regression-based loss-extraction model that is applicable for all-pass rings and symmetrically and asymmetrically coupled add-drop rings. The model is derived by transforming the transmission spectra of a ring into linear relationships with no approximation. An all-pass ring resonator is fabricated to verify the model, and the experimental results indicate that the proposed model is more reliable than previously reported models [Opt. Express14, 3872 (2006)OPEXFF1094-408710.1364/OE.14.003872; Opt. Express15, 10553 (2007)OPEXFF1094-408710.1364/OE.15.010553; and J. Lightwave Technol.16, 1308 (1998)JLTEDG0733-872410.1109/50.701410].

Robust polarization-insensitive strip-slot waveguide mode converter based on symmetric multimode interference.

Strip-slot waveguide mode converters for TE0 have been widely investigated. Here we demonstrate a polarization-insensitive converter numerically and experimentally. The polarization-insensitive performance is achieved by matching the optical field distribution of the 2-fold image of the Multimode Interference (MMI) and the TE0 (TM0) mode of a slot waveguide. The working principle for this MMI-based mode converter is thoroughly analyzed with the quantitatively evaluated optical field overlap ratio that is theoretically derived from the orthonormal relation of eigenmodes. Based on the analysis, the MMI-based polarization-insensitive converters are then simulated and fabricated. The simulation and measurement results indicate that the proposed scheme is a robust design since it is not only polarization-insensitive but also wavelength-insensitive and fabrication-tolerant. Moreover, the mode converter is as small as 1.22 µm × 4 µm while the measured conversion efficiencies are 95.9% for TE0 and 96.6% for TM0. All these excellent properties make the proposed mode converter an ideal solution for coupling light between strip and slot waveguides when both TE and TM polarizations are considered.

Athermal and flat-topped silicon Mach-Zehnder filters.

Athermal and flat-topped transmissions are the two main requirements for a silicon WDM filter. A Mach-Zehnder (MZ) filter which simultaneously satisfies these two requirements has been experimentally demonstrated in this paper. A combination of strip waveguide and hybrid strip-slot waveguide is introduced for athermalization, and two-stage interference is utilized for flat-topped transmission. The temperature dependent wavelength shift is measured to be ~-5 pm/K while the best 1 dB bandwidth is 5.5 nm with 14.7 nm free spectral range (FSR). The measured minimum insertion loss is only 0.4 dB with a device dimension of 170 µm × 580 µm. Moreover, Such a MZ filter is compatible with the state-of-art CMOS-fabrication process and its minimum feature size is as large as 200 nm.

Effect of laryngeal mask airway placement on the optimal site and success rate of venipuncture via the right internal jugular vein.

The placement of a laryngeal mask airway (LMA) changes the relative positions of the common carotid artery (CCA) and right internal jugular vein (IJV), thereby affecting venipuncture via the right IJV. Therefore, we went on to determine the optimal site for puncturing the IJV after LMA-Supreme™ placement. In this study, forty-six patients were placed with a LMA-Supreme™ (size 3 or 4), and the right IJV was punctured at either of the three points (anterior, middle or posterior point). The CCA diameters and overlap between the right IJV and CCA were recorded before and after the LMA-Supreme™ placement. Finally, the success rates of IJV puncturing at the three aforementioned points were compared. We found that the size of the LMA-Supreme™ had no effect on patient respiration during the procedure. Overlap between the right IJV and CCA at the anterior and middle points was significantly increased after size 3 LMA-Supreme™ placements; Size 4 masks decreased the CCA diameters at the middle and posterior points, and significantly increased overlap between the right IJV and CCA at all the three points; IJV punctures performed after placement of size 3 LMA-Supreme™ had higher success rate than those performed after placement of size 4 masks, and were less likely to result in accidental arterial puncture. In conclusion, our study demonstrated that placement of size 3 LMA-Supreme™ caused little change in overlapping between the right IJV and CCA and the incidence of accidental arterial puncture; particularly for punctures performed at the posterior point. Therefore, we recommend venipuncture at the posterior point after placement of a LMA-Supreme™.

MicroRNA-491-5p suppresses cervical cancer cell growth by targeting hTERT.

MicroRNAs (miRNAs) are small non-coding RNAs that have been shown to regulate a variety of biological processes by targeting messenger RNA. MicroRNA-491-5p (miR-491-5p), an important miRNA, has been demonstrated to be involved in the processes of initiation and progression in several tumors. However, the precise biological function of miR-491-5p and its molecular mechanism in cervical cancer cells remain elusive. The present study was carried out to investigate the clinical significance and prognostic value of miR-491-5p expression in cervical cancer, and to evaluate the role of miR-491-5p and the underlying molecular mechanisms involved in cervical cancer. The results showed that miR-491-5p expression was significantly downregulated in cervical cancer tissues when compared with the corresponding adjacent normal tissues (P<0.001), and the value was negatively associated with advanced International Federation of Gynecology and Obstetrics (FIGO) stage, high histological grading and lymph node metastasis (P<0.01). The enforced expression of miR-491-5p in cervical cancer cells significantly inhibited proliferation, migration and invasion, induced cell apoptosis, and suppressed the tumor growth of the mouse model of HeLa cells. In addition, the dual-luciferase reporter assay revealed that human telomerase reverse transcriptase (hTERT) was identified as a novel target gene of miR-491-5p. Notably, it was found that miR-491-5p regulated the PI3K/AKT signaling pathway. These results suggested that targeting miR-491-5p is a strategy for blocking the development of cervical cancer.

Arbitrary-ratio 1 × 2 power splitter based on asymmetric multimode interference.

Free choice of splitting ratio is one of the main properties of a power splitter required in integrated photonics, but conventional multimode interference (MMI) power splitters can only obtain a few discrete ratios. This Letter presents both numerical and experimental results of an arbitrary-ratio 1×2 MMI power splitter, which is constructed by simply breaking the symmetry of the multimode region. In the new device, the power splitting ratio can be adjusted continuously from 100:0 to 50:50, while the dimension of the multimode section stays in the range of 1.5×(1.8-2.8) µm. The experimental data also indicate that the proposed arbitrary-ratio splitter keeps the original advantages of MMI devices, such as low excess loss, weak wavelength dependence, and large fabrication tolerance.

Strip-slot waveguide mode converter based on symmetric multimode interference.

Optical mode mismatch makes coupling between strip and slot waveguides a tough issue in integrated photonics. This Letter presents both numerical and experimental results of a strip-slot mode converter based on symmetric multimode interference (MMI). Distinct from previous reported converters which gradually convert the mode through sharp tips, the proposed solution makes full use of the symmetry of the two-fold image of MMI, and its field distribution similarity with a slot waveguide to convert the mode. A converter based on this mechanism is able to convert light from a TE-polarized fundamental mode of a strip waveguide to that of a slot waveguide, and vice versa. Strip-slot waveguide coupling though this mode converter has a measured efficiency of 97% (-0.13 dB), and the dimensions are as small as 1.24×6 µm. Further analysis shows that the proposed converter is highly tolerant to fabrication imperfections, and is wavelength-insensitive.

Low loss, high-speed single-mode half-disk resonator.

This work proposes a new type of resonator: a single-mode half-disk resonator. Half of the resonator is solid, allowing large electrical or mechanical contacts, and a single-mode operation can be retained. A systematic design method is demonstrated and analyzed. For a 3 µm radius, the simulation predicts an internal Q-factor as high as 2.4×105, and a loaded Q-factor of ~9000 is measured in experiments, comparable even with uncontacted microrings of bigger radii. The large contacts will improve the performance of a wide range of active devices. We present the contact resistance of a vertical PN junction modulator based on this structure, which can be reduced to nearly an order of magnitude, enabling a much faster modulation speed.

Lidocaine attenuates lipopolysaccharide-induced inflammatory responses in microglia.

BACKGROUND: Lidocaine has been used as a local anesthetic with anti-inflammatory properties, but its effects on neuroinflammation have not been well defined. In the present study, we investigated the prophylactic effects of lidocaine on lipopolysaccharide (LPS)-activated microglia and explored the underlying mechanisms. MATERIALS AND METHODS: Microglial cells were incubated with or without 1 µg/mL LPS in the presence or absence of lidocaine, a p38 mitogen-activated protein kinase (p38 MAPK) inhibitor (SB203580), a nuclear factor-kappa B (NF-κB) inhibitor (pyrrolidine dithiocarbamate), or small interfering RNA. The protein and expression levels of inflammatory mediators, such as monocyte chemotactic protein 1, nitric oxide, prostaglandin E2, interleukin 1ß, and tumor necrosis factor α were measured using enzyme-linked immunosorbent assays and real-time polymerase chain reaction. The effect of lidocaine on NF-κB and p38 MAPK activation was evaluated using enzyme-linked immunosorbent assays, Western blot analysis, and electrophoretic mobility shift assay. RESULTS: Lidocaine (≥2 µg/mL) significantly inhibited the release and expression of nitric oxide, monocyte chemotactic protein 1, prostaglandin E2, interleukin 1ß, and tumor necrosis factor α in LPS-activated microglia. Treatment with lidocaine also significantly inhibited the phosphorylation of p38 MAPK and the nuclear translocation of NF-κB p50/p65, increased the protein levels of inhibitor kappa B-α. Furthermore, our study shows that the LPS-induced release of inflammatory mediators was suppressed by SB203580, pyrrolidine dithiocarbamate, and small interfering RNA. CONCLUSIONS: Prophylactic treatment with lidocaine inhibits LPS-induced release of inflammatory mediators from microglia, and these effects may be mediated by blockade of p38 MAPK and NF-κB signaling pathways.