Secondary metabolites from the fungus Cladosporium xylophilum.

A new cladosporol derivative xylophilum A (1), together with 10 known compounds (2-11), were isolated from the rice fermentation of the fungus Cladosporium xylophilum. Their structures were established by extensive spectroscopic methods and comparison of their NMR data with literatures. The antimicrobial activity of compound 1 against 11 kinds of pathogenic microbial was evaluated, but no significant activity was found (MIC >100 µg/ml).

A new illudane sesquiterpene from the edible fungus Pholiota nameko.

Fungi have different genetic expression abilities and biosynthetic pathways under different cultivation conditions, which can produce various secondary metabolites. The "one strain many compounds" strategy is used to activate silent biosynthetic genes of fungi to produce various compounds, which is an effective method. In order to discover various new compounds in the edible fungus Pholiota nameko, a fermentation strategy involving precursor feeding and enzyme inhibitor addition has been employed. A new illudane sesquiterpene (1), along with one known indole diterpenoid alkaloid, cladosporine A (2) were isolated from the extracts of liquid culture of P. nameko. The new compound was identified by combination of 1D and 2D NMR, MS, optical rotation, and ECD calculations. We conducted experiments on the cytotoxicity of all isolated compounds on three cancer cell lines, but we did not observe any significant cytotoxicity (IC50 > 40 µM).

A modular approach to enhancing cell membrane-coated nanoparticle functionality using genetic engineering.

Since their initial development, cell membrane-coated nanoparticles (CNPs) have become increasingly popular in the biomedical field. Despite their inherent versatility and ability to enable complex biological applications, there is considerable interest in augmenting the performance of CNPs through the introduction of additional functionalities. Here we demonstrate a genetic-engineering-based modular approach to CNP functionalization that can encompass a wide range of ligands onto the nanoparticle surface. The cell membrane coating is engineered to express a SpyCatcher membrane anchor that can readily form a covalent bond with any moiety modified with SpyTag. To demonstrate the broad utility of this technique, three unique targeted CNP formulations are generated using different classes of targeting ligands, including a designed ankyrin repeat protein, an affibody and a single-chain variable fragment. In vitro, the modified nanoparticles exhibit enhanced affinity towards cell lines overexpressing the cognate receptors for each ligand. When formulated with a chemotherapeutic payload, the modularly functionalized nanoparticles display strong targeting ability and growth suppression in a murine tumour xenograft model of ovarian cancer. Our data suggest genetic engineering offers a feasible approach for accelerating the development of multifunctional CNPs for a broad range of biomedical applications.

Research progress in artificial intelligence assisted diabetic retinopathy diagnosis.

Diabetic retinopathy (DR) is one of the most common retinal vascular diseases and one of the main causes of blindness worldwide. Early detection and treatment can effectively delay vision decline and even blindness in patients with DR. In recent years, artificial intelligence (AI) models constructed by machine learning and deep learning (DL) algorithms have been widely used in ophthalmology research, especially in diagnosing and treating ophthalmic diseases, particularly DR. Regarding DR, AI has mainly been used in its diagnosis, grading, and lesion recognition and segmentation, and good research and application results have been achieved. This study summarizes the research progress in AI models based on machine learning and DL algorithms for DR diagnosis and discusses some limitations and challenges in AI research.

Synthesis of diarylmethyl thioethers via a DABCO-catalyzed 1,6-conjugate addition reaction of p-quinone methides with organosulfur reagents.

A rapid and simple method was developed for the synthesis of diarylmethyl thioethers via a DABCO-catalyzed 1,6-conjugate addition reaction of para-quinone methides (p-QMs) with organosulfur reagents. A series of diarylmethyl thioethers were synthesized at 13-85% yields by this method. After that, the antibacterial activities of synthesized diarylmethyl thioethers and their derivatives were evaluated. The MIC range (µg mL-1) against Staphylococcus aureus ATCC 25923 and clinically isolated methicillin-resistant S. aureus was 8-128 and 64-128, respectively.

Genetically engineered cellular nanoparticles for biomedical applications.

In recent years, nanoparticles derived from cellular membranes have been increasingly explored for the prevention and treatment of human disease. With their flexible design and ability to interface effectively with the surrounding environment, these biomimetic nanoparticles can outperform their traditional synthetic counterparts. As their popularity has increased, researchers have developed novel ways to modify the nanoparticle surface to introduce new or enhanced capabilities. Moving beyond naturally occurring materials derived from wild-type cells, genetic manipulation has proven to be a robust and flexible method by which nanoformulations with augmented functionalities can be generated. In this review, an overview of genetic engineering approaches to express novel surface proteins is provided, followed by a discussion on the various biomedical applications of genetically modified cellular nanoparticles.

Effect of low-dose esketamine on remifentanil-induced postoperative hyperalgesia / 中华麻醉学杂志

Objective:To evaluate the effects of low-dose esketamine on remifentanil-induced postoperative hyperalgesia in the patients.Methods:Ninety-six American Society of Anesthesiologist Physical Status classificationⅠ or Ⅱ patients, aged 18-60 yr, with body mass index of 18-30 kg/m 2, scheduled for elective thyroidectomy under general anesthesia, were divided into 3 groups ( n=32 each) using a random number table method: control group (group C), esketamine administered before anesthesia induction group (group K1), and esketamine administered immediately after the end of surgery group (group K2). Esketamine 0.4 mg/kg was intravenously injected in group K1, and the equal volume of normal saline was given instead in C and K2 groups at 5 min before anesthesia induction. Anesthesia was induced by intravenous injection of propofol, remifentanil and rocuronium. Remifentanil was intravenously infused at a rate of 0.3 μg · kg -1·min -1 and 1.5%-2.5% sevoflurane was inhaled for anesthesia maintenance. Esketamine 0.4 mg/kg was intravenously injected in group K2 and the equal volume of normal saline was given instead in C and K1 groups immediately after the end of surgery. The mechanical pain thresholds of surgical incision and forearm of non-dominant hand were measured at 1 day before surgery and 30 min, 6 h, 24 h and 48 h after surgery, and flurbiprofen axetil was intravenously injected for rescue analgesia when the NRS score≥4 or the patient needed sedation. The intensity of pain was estimated using numeric rating scale at 30 min, 6 h, 24 h and 48 h after surgery. The intraoperative consumption of remifentanil, use of vasoactive drugs, recovery time, tracheal extubation time, duration of PACU stay, postoperative rescue analgesia and adverse reactions were recorded. Results:Compared with C group, the mechanical pain threshold around surgical incision and of the forearm of non-dominant hand was significantly increased at 30 min and 6 h after surgery in K1 and K2 groups ( P<0.05). Compared with C and K1 groups, the emergence time, tracheal extubation time, and duration of PACU stay were significantly prolonged, and the incidence of hallucinations and increased glandular secretion was increased in group K2 ( P<0.05). There were no significant differences in the consumption of remifentanil, intraoperative utilization rate of atropine and ephedrine, numeric rating scale scores at each time point after surgery, incidence of postoperative nausea and vomiting, and rate of rescue analgesia among the three groups ( P>0.05). Conclusions:Intravenous injection of small dose of esketamine (0.4 mg/kg) before anesthesia induction and immediately after the end of surgery can reduce postoperative hyperalgesia induced by remifentanil, and administration before anesthesia induction provides better efficacy in the patients.

Molten Salt Self-Template Synthesis Strategy of Oxygen-Rich Porous Carbon Cathodes for Zinc Ion Hybrid Capacitors.

Porous carbon materials are widely used in capacitive energy storage devices because of their chemical stability, low cost, and controllable textures. Molten salt self-template methods are powerful and sustainable synthesis strategies for preparing porous carbons with tunable pore textures and surface chemistries. Herein, we propose a self-template synthesis strategy for preparing oxygen-rich porous carbons (ORC) by directly carbonizing potassium chloroacetate (ClCH2COOK) as the single carbon source. The potassium chloride salts generated in the carbonization play the roles of the template and etchant agent in the pore formation process. The as-prepared ORC samples feature abundant mesopores (average pore sizes of 1.95-2.19 nm and mesopore ratio of 36.4%), high specific surface areas (1410-1886 m2 g-1), and high oxygen doping levels (4.3-8.2 atom %). The zinc ion hybrid capacitors with an ORC cathode exhibited an ultrahigh capacitance of 308 F g-1 at 0.5 A g-1 and a high energy density of 136.5 Wh kg-1 at a power density of 570 W kg-1. Density functional theory demonstrates that oxygen-containing functional groups are conducive to the adsorption of Zn ions. Our work proposes a general synthesis methodology for the synthesis of oxygen-rich porous carbons for a variety of electrochemical energy storage devices.

Optimization strategy of anesthesia for modified electroconvulsive therapy in patients with major depressive disorder: low-dose esketamine combined with propofol / 中华麻醉学杂志

Objective:To evaluate the optimization efficacy of low-dose esketamine combined with propofol in the patients with major depressive disorder undergoing modified electroconvulsive therapy (MECT).Methods:Fifty-six American Society of Anesthesiologists physical statusⅠor Ⅱ patients, aged 18-64 yr, scheduled for MECT for the first time, were assigned into esketamine plus propofol group (group EP, n=28) and propofol group (group P, n=28) according to a ratio of 1∶1 by the random number table method.Esketamine 0.25 mg/kg was intravenously injected before anesthesia induction in group EP, while the equal volume of normal saline was given instead in group P. Propofol and succinylcholine were then intravenously injected to perform MECT in two groups.The primary outcomes were the remission rate and response rate, and the secondary outcomes included the number of MECT required for response and remission, the seizure duration, energy inhibition index and consumption of propofol for each MECT, and the occurrence of therapy-related adverse reactions and relapse. Results:Compared with group P, the remission rate and response rate were significantly increased, and the number of MECT required for response and remission was decreased, the seizure duration was prolonged, and energy inhibition index was increased, the consumption of propofol was reduced ( P<0.05), and no significant change was found in the incidence of therapy-related adverse reactions and relapse in group EP ( P>0.05). Conclusions:Low-dose esketamine combined with propofol can enhance the efficacy of MECT and shorten the course of therapy without increasing therapy-related adverse reactions in the patients with major depression.

Efficacy of remimazolam combined with propofol for sedation in pediatric patients undergoing outpatient dental root canal treatment / 中华麻醉学杂志

Objective:To evaluate the effect of remimazolam combined with propofol for sedation in the pediatric patients undergoing outpatient root canal treatment.Methods:Seventy pediatric patients of either sex, aged 2-6 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, with an expected treatment time<1 h, scheduled for elective outpatient root canal treatment, were divided into 2 groups ( n=35 each) using a random number table method: propofol group (P group) and remimazolam plus propofol group (RP group). Induction of anesthesia was as follows: propofol 1-3 mg/kg was intravenously injected until BIS value was less than 60 in group P, and remimazolam 0.2 mg/kg and propofol 1-3 mg/kg were intravenously injected until BIS value was less than 60 in group RP.Anesthesia maintenance was as follows: propofol 6-12 mg·kg -1·h -1 was intravenously infused in group P, and remimazolam 0.3 mg·kg -1·h -1 and propofol 6-12 mg·kg -1·h -1 were intravenously infused in group RP.The BIS value was maintained at 50-70 during operation.Spontaneous breathing was kept, and oxygen was inhaled through a nasal catheter with oxygen flow rate of 2-3 L/min in both groups.The amount of propofol consumed during induction and maintenance periods and the total consumption were recorded.The onset time of sedation, duration of operation, emergence time and duration of post-anesthesia care unit stay were recorded.The adverse reactions such as intraoperative respiratory depression, hypotension, bradycardia, coughing and body movement, emergence agitation and postoperative nausea and vomiting were recorded. Results:Compared with group P, the amount of propofol consumed during induction and maintenance periods and the total consumption were significantly reduced, the onset time of sedation was prolonged, the emergence time and duration of post-anesthesia care unit stay were shorted, the incidence of respiratory depression was decreased ( P<0.05), and no significant change was found in the incidence of duration of operation, hypotension, bradycardia, body movement or emergence agitation in group RP ( P>0.05). No intraoperative coughing or postoperative nausea and vomiting was found in two groups. Conclusions:The combination of remimazolam and propofol provides better efficacy than propofol alone when used for sedation in the pediatric patients undergoing outpatient dental root canal treatment.

Comparison of the diagnostic performance in the hepatocellular carcinoma with cirrhosis between the 2017 and 2018 versions of LI-RADS based on Gd-EOB-DTPA enhanced MRI / 中华放射学杂志

Objective:To compare the diagnostic performance in the hepatocellular carcinoma(HCC) with cirrhosis between the 2017 version of liver imaging reporting and data system (LI-RADS v2017) and 2018 version of LI-RADS (LI-RADS v2018) based on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI.Methods:Clinical data of 213 patients with 246 hepatic lesions with cirrhosis who underwent Gd-EOB-DTPA enhanced MRI in the Third Affiliated Nantong Hospital of Nantong University from October 2015 to July 2020 were retrospectively collected. The MRI major features and LR categories of lesions were respectively reviewed by two radiologists according to LI-RADS v2017 and LI-RADS v2018, respectively. Taking postoperative histopathological results or follow-up imaging as references, with the LR-5 and LR-4+LR-5 as the diagnosis of HCC, the sensitivity, specificity and accuracy of the LI-RADS v2017 and LI-RADS v2018 were evaluated, respectively. The McNemar test or Fisher exact test was used to compare the diagnostic performance between the two LI-RADS versions.Results:In 246 hepatic lesions, 165 were HCCs, 31 were non-HCC malignancies and 50 were benign lesions. Due to the threshold growth and more simplified definition and changes in the LR-5 classification criteria in LI-RADS v2018, the categories of 38 (15.4%, 38/246) lesions were changed. The threshold growths of 84.6% (33/39) lesions in v2017 were reclassified to subthreshold growth in v2018. Using LI-RADS v2018, 10 lesions were down-categorized compared with LI-RADS v2017, including LR-5 to LR-4 in 7 lesions and LR-4 to LR-3 in 3 lesions, and 28 lesions were up-categorized LR-4 to LR-5, in which 25 were small HCC. With LR-5 as the diagnosis criteria of HCC, the sensitivity and accuracy of LI-RADS v2018 were 66.7% (110/165) and 73.6% (181/246); and the sensitivity and accuracy of LI-RADS v2017 were 55.8% (92/165) and 67.5% (166/246), both with statistical differences (χ2=4.13, P=0.001, χ2=6.20, P<0.001). No significant difference was found in the specificity values of LI-RADS v2018 and v2017 [87.7% (71/81) vs. 91.4% (74/81)], χ2=0.59, P=0.442). Compared with v2017, LI-RADS v2018 increased the sensitivity in the diagnosis of small HCC lesions (10-19 mm) [62.9% (56/89) vs. 40.4% (36/89), χ2=9.00, P<0.001]. With LR-4+LR-5 as the diagnostic criteria of HCC, there was no significant difference in the sensitivity, specificity and accuracy of LI-RADS v2017 and v2018 in the diagnosis of HCC (all P>0.05). Conclusions:Based on Gd-EOB-DTPA enhanced MRI, LI-RADS v2018 has higher sensitivity and similar specificity in the diagnosis of HCC compared to v2017, especially in the diagnosis of small HCC (10-19 mm).

Characteristics of fusion gene expression in acute lymphoblastic leukemia / 中华病理学杂志

Objective: To analyze the genetic landscape of 52 fusion genes in patients with de novo acute lymphoblastic leukemia (ALL) and to investigate the characteristics of other laboratory results. Methods: The fusion gene expression was retrospectively analyzed in the 1 994 patients with de novo ALL diagnosed from September 2016 to December 2020. In addition, their mutational, immunophenotypical and karyotypical profiles were investigated. Results: In the 1 994 patients with ALL, the median age was 12 years (from 15 days to 89 years). In the panel of targeted genes, 15 different types of fusion genes were detected in 884 patients (44.33%) and demonstrated a Power law distribution. The frequency of detectable fusion genes in B-cell ALL was significantly higher than that in T-cell ALL (48.48% vs 18.71%), and fusion genes were almost exclusively expressed in B-cell ALL or T-cell ALL. The number of fusion genes showed peaks at<1 year, 3-5 years and 35-44 years, respectively. More fusion genes were identified in children than in adults. MLL-FG was most frequently seen in infants and TEL-AML1 was most commonly seen in children, while BCR-ABL1 was dominant in adults. The majority of fusion gene mutations involved signaling pathway and the most frequent mutations were observed in NRAS and KRAS genes. The expression of early-stage B-cell antigens varied in B-cell ALL patients. The complex karyotypes were more common in BCR-ABL1 positive patients than others. Conclusion: The distribution of fusion genes in ALL patients differs by ages and cell lineages. It also corresponds to various gene mutations, immunophenotypes, and karyotypes.

Relationship between micronutrients supplementation during periconceptional period and serum concentration of vitamin E in the 1st trimester of gestational period / 北京大学学报(医学版)

OBJECTIVE@#To explore the association of maternal periconceptional folic acid or multiple micronutrients supplementation during periconceptional period and the serum vitamin E (Vit.E) concentration in the 1st trimester of gestational period.@*METHODS@#A retrospective cohort study was conducted based on the prenatal health care system and clinical laboratory information system. Totally, 22 171 pregnant women who had their prenatal health care and gave birth in Tongzhou Maternal & Child Health Hospital of Beijing from Jan. 2016 to Dec. 2018 were recruited. The usage patterns of nutritional supplements [folic acid (FA) or multiple micronutrients (MM)] during periconceptional period were independent variables, and serum Vit.E concentration and serum Vit.E concentration≥11.2 mg/L in the 1st trimester of gestational period were outcome variables for generalized linear regression model and Logistic regression model, respectively, to analyze the relationships between the independent and outcome variables.@*RESULTS@#The range of the serum Vit.E concentration in the 1st trimester of gestational period was 5.2-24.0 mg/L, and the median concentration was 10.1 (8.8-11.6) mg/L; the excess rate of the serum Vit.E of those who took MM supplementation was 0.3%, and the rates for the groups of FA only or no nutritional supplements used were both 0.1%. Compared with women without nutritional supplement or the women taking FA, the women who took MM had higher serum Vit.E levels in the 1st trimester of gestational period (both P < 0.05). The women taking FA or MM initiated before the conception showed that the serum Vit.E concentration in the 1st trimester of gestational period was higher than that after the conception (P < 0.05), and the serum Vit.E concentration of women who took regularly was higher than that of irregular taking (P < 0.05); with taking compliance elevated, the serum Vit.E concentration of the two groups of women taking FA or MM increased (P < 0.05). The risk of serum Vit.E concentration≥11.2 mg/L among the women taking MM was higher than that of the women without nutritional supplements or taking FA only [odds ratio (OR)=1.36, 95% confidence interval (95%CI): 1.21-1.53; OR=1.39, 95%CI: 1.31-1.48)]; women who took FA or MM showed a lower risk for serum Vit.E concentration≥11.2 mg/L of taking it after the conception than before, the ORs (95%CI) were 0.86 (95%CI: 0.77-0.96) and 0.88 (95%CI: 0.81-0.95), respectively; the women taking the two supplements regularly had higher risk for serum Vit.E concentration≥11.2 mg/L than irregular taking, the ORs (95%CI) were 1.16 (95%CI: 1.05-1.29) and 1.13 (95%CI: 1.04-1.22) for FA and MM users, respectively; with the compliance increasing, the women taking MM had a higher risk of serum Vit.E levels≥11.2 mg/L in the 1st trimester [OR (95%CI) was 1.10 (1.07-1.14)], but for FA users, the OR (95%CI) was 1.04(1.00-1.08).@*CONCLUSION@#Vit.E nutritional status in women in early gestational period in Beijing was generally good, and the excess rate of serum Vit.E was higher in women who took MM during periconceptional period than those without nutritional supplement or taking FA only, suggesting that women need to consider their own Vit.E nutritional status to choose the type of nutritional supplements during periconceptional period, so as to avoid related health hazards.

Value of modified gastroscopic laryngeal mask airway for airway management under general anesthesia in patients with liver cirrhosis undergoing endoscopic esophageal variceal ligation / 中华麻醉学杂志

Objective:To evaluate the value of modified gastroscopic laryngeal mask airway (LMA) for airway management under general anesthesia in the patients with liver cirrhosis undergoing endoscopic esophageal variceal ligation (EVL).Methods:Sixty-two American Society of Anesthesiologists physical status Ⅱor Ⅲ patients with liver cirrhosis of either sex, aged 25-64 yr, with body mass index of 18-30 kg/m 2, undergoing endoscopic EVL with general anesthesia, were divided into 2 groups ( n=31 each) using a random number table method: tracheal tube group (group T) and modified gastroscopic LMA group (group L). After induction of anesthesia, a tracheal tube was inserted in group T, and a modified gastroscopic LMA was inserted and the patients were mechanically ventilated to maintain P ETCO 2 at 30-40 mmHg in group L. Successful tracheal intubation or insertion of modified gastroscopic LMA, successful ligator insertion and duration of ligator insertion were recorded.The occurrence of intraoperative hypotension, bradycardia and hypoxemia and consumption of propofol and remifentanil were recorded.At 1 min after tracheal intubation or right placement of LMA (T 1), immediately after the ligator insertion (T 2) and at the end of operation (T 3), Peak (P peak) and mean (P mean) airway pressure were monitored, and airway leak pressure in group L was measured.The extubation time, duration of post-anesthesia care unit stay and bucking during extubation were recorded.The occurrence of sore throat and nausea and vomiting was recorded within 6 h after operation.Postoperative satisfaction scores of endoscopists and patients were also recorded. Results:Sixty-one patients were finally enrolled in the study, with 31 in group T and 30 in group L. Compared with group T, no significant changes were found in the success rate of tracheal intubation or LMA placement, success rate of ligator insertion, P mean at each time point, incidence of postoperative nausea and vomiting, and postoperative satisfaction score of endoscopists ( P>0.05), duration of the ligator insertion was significantly shortened, P peak at each time point was decreased, the incidence of intraoperative hypotension and bradycardia was decreased, the consumption of propofol and remifentanil was reduced, the incidence of bucking during extubation and postoperative sore throat was reduced, and extubation time and duration of post-anesthesia care unit stay was shortened, and satisfaction scores of patients were increased in group L ( P<0.05). No hypoxemia was found in two groups.Airway leak pressure was maintained at 24-26 cmH 2O at each time point in group L. Conclusions:Modified gastroscopic LMA can be safely and effectively used for airway management under general anesthesia in the patients with liver cirrhosis undergoing EVL.

Effect of obesity on dose-effect relationship of remimazolam when combined with alfentanil in painless gastroscopy / 中华麻醉学杂志

Objective:To evaluate the effect of obesity on the dose-effect relationship of remimazolam when combined with alfentanil in painless gastroscopy.Methods:American Society of Anesthesiologists physical status Ⅰor Ⅱ patients of both sexes, scheduled for elective painless gastroscopy, aged 18-64 yr, were divided into 2 groups according to the body mass index (BMI): normal (BMI 19-24 kg/m 2) group and obese (BMI≥28 kg/m 2) group.Alfentanil 5 μg/kg combined with remimazolam was given intravenously in all the patients, and the dose of remimazolam was determined by the modified Dixon′s up-and-down method.The initial dose of remimazolam was 0.25 mg/kg, and each time the dose was increased or decreased by 0.05 mg/kg based on the sedative effect.The response was defined as positive when the responses that affected the operation of examination developed during insertion of the gastroscope and within the first 2 min of examination such as swallowing, bucking or body movement.This process was repeated until the seventh intersection occurred.The 50% effective dose (ED 50), 95% effective dose (ED 95), and 95% confidence interval ( CI) of remimazolam were calculated by probit method. Results:There were 26 patients in normal group and 18 patients in obese group.The ED 50 (95% CI) of remimazolam was 0.196 (0.087-0.274) mg/kg, and the ED 95 (95% CI) was 0.322 (0.256-1.397) mg/kg in normal group.The ED 50 (95% CI) of remimazolam was 0.125 (0.102-0.148) mg/kg, and the ED 95 (95% CI) was 0.161 (0.141-0.242) mg/kg in obese group.The ED 50 and ED 95 were significantly lower in obese group than in normal group ( P<0.001). Conclusions:Obesity increases the potency of remimazolam when combined with alfentanil 5 μg/kg in the patients undergoing painless gastroscopy.

Platelet-rich plasma has better mid-term clinical results than traditional steroid injection for plantar fasciitis: A systematic review and meta-analysis.

INTRODUCTION: Recently, local platelet-rich plasma (PRP) injection has been gradually used in the treatment of plantar fasciitis (PF). However, compared with traditional steroid injection, the clinical results of local PRP injection for PF patients remain controversial. Therefore, we performed a systematic review to focus on two questions as follows: (1) is PRP more effective than steroid to relieve pain in PF patients? (2) is PRP more effective than steroid to improve the foot and ankle function of PF patients? HYPOTHESIS: The PRP could be more effective to relieve pain and improve the foot and ankle function in PF patients. MATERIAL AND METHODS: We systematically searched electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, PubMed, Web of Science, and Embase) from inception to October 20, 2019. The data of clinical results, including visual analogue scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) scores, were extracted and analyzed. RESULTS: Finally, twelve randomized controlled trials (RCT), involving 653 PF patients, were enrolled. All enrolled trials were considered to be of high quality. The results showed that the VAS of the PRP group was significantly lower than that of the steroid group at 6-month (p=0.02), 1-year (p=0.02), and 1.5-year (p<0.00001) follow-up. The AOFAS scores of the PRP group were significantly higher than that of the steroid group at 1-year (p=0.005) follow-up. DISCUSSION: Compared to local steroid injection, local autologous PRP injection is more effective in relieving pain and improving the foot and ankle function at mid-term follow-up. LEVEL OF EVIDENCE: II; Systematic review and Meta-analysis.

Effects of mind-body exercise on cardiopulmonary function, blood pressure, and quality of life in CHD patients: A protocol for systematic review and meta-analysis.

BACKGROUND: Coronary heart disease (CHD) is one of the highest mortality diseases in the world, which seriously threatens human health and quality of life (QOL). The purpose of this study is to systematically analyze the effects of mind-body exercise on cardiopulmonary function, blood pressure and QOL in CHD patients, and to provide scientific evidence-based exercise prescription for patients with coronary heart disease. METHODS: This research review will include the following electronic databases from its establishment to December 2020: PubMed, EMBASE, Web of Science, Cochrane Library, the Chinese National Knowledge Infrastructure, the Chinese Science and Technology Periodical Database, and Wanfang. Objective to search randomized controlled trials (RCTs) about the effects of mind-body exercise on cardiopulmonary function, blood pressure and QOL in patients with coronary heart disease. CONCLUSION: This systematic review and meta-analysis will provide strong evidence for the efficacy and safety of mind-body exercise in patients with coronary heart disease. SYSTEMATIC REVIEW REGISTRATION: INPLASY202120016. ETHICS AND DISSEMINATION: Ethical approval will not be necessary since this systematic review and meta-analysis will not contain any private information of participants or violate their human rights.

Prevalence of SARS-CoV-2 Contamination on Food Plant Surfaces as Determined by Environmental Monitoring.

ABSTRACT: The SARS-CoV-2 pandemic has presented new challenges to food manufacturers. During the early phase of the pandemic, several large outbreaks of coronavirus disease 2019 (COVID-19) occurred in food manufacturing plants resulting in deaths and economic loss, with approximately 15% of personnel diagnosed as asymptomatic for COVID-19. Spread by asymptomatic and presymptomatic individuals has been implicated in large outbreaks of COVID-19. In March 2020, we assisted in implementation of environmental monitoring programs for SARS-CoV-2 in zones 3 and 4 of 116 food production facilities. All participating facilities had already implemented measures to prevent symptomatic personnel from coming to work. During the study period, from 17 March to 3 September 2020, 1.23% of the 22,643 environmental samples tested positive for SARS-CoV-2, suggesting that infected individuals were actively shedding virus. Virus contamination was commonly found on frequently touched surfaces such as doorknobs, handles, table surfaces, and sanitizer dispensers. Most processing plants managed to control their environmental contamination when they became aware of the positive findings. Comparisons of positive test results for plant personnel and environmental surfaces in one plant revealed a close correlation. Our work illustrates that environmental monitoring for SARS-CoV-2 can be used as a surrogate for identifying the presence of asymptomatic and presymptomatic personnel in workplaces and may aid in controlling infection spread.

Comparison of effects of remimazolam and propofol on quality of postoperative recovery in aged patients with goal-directed hemodynamic management strategies / 中华麻醉学杂志

Objective:To compare the impact of remimazolam and propofol on the quality of postoperative recovery in aged patients with goal-directed hemodynamic management strategies.Methods:Ninety patients of either sex, aged 65-80 yr, with body mass index of 18-28 kg/m 2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, scheduled for elective laparoscopic gastrointestinal tumor surgery, were divided into 2 groups ( n=45 each) using a random number table method: remimazolam group (group R) and propofol group (group P). Anesthesia was induced as follows: remimazolam 6 mg·kg -1·h -1 was intravenously infused in group R, and propofol 2 mg/kg was intravenously injected in group P. Anesthesia was maintained as follows: remimazolam 0.5-1.0 mg·kg -1·h -1 was intravenously infused in group R, propofol 4-12 mg·kg -1·h -1 was intravenously infused in group P, and BIS values were maintained at 40-60 during operation.Both groups adopted a goal-directed hemodynamic management strategy during operation, and the volume infused and vasoactive drugs were adjusted according to stroke volume variation of 4%-12% and cardiac index of 2.5-4.0 L ·min -1·m -2.The 40-item Quality-of-Recovery scale (QoR-40) was used to assess the quality of postoperative recovery.QoR-40 score was performed 1 day before surgery, 3 days after surgery and 30 days after surgery.The intraoperative consumption of vasoactive drugs and occurrence of intraoperative hypotension and bradycardia were recorded, and the concentration of lactic acid was measured before operation, after operation and 24 h after operation in the two groups.The recovery time of consciousness, tracheal extubation time, duration of postanesthesia care unit stay and postoperative length of hospital stay were recorded.The occurrence of postoperative complications was also recorded. Results:Compared with P group, the incidence of intraoperative hypotension and bradycardia was significantly decreased, the consumption of dopamine and norepinephrine was reduced, the concentration of lactic acid was decreased, QoR-40 scores were increased at 3 and 30 days after operation, the postoperative length of hospital stay was shortened, and the incidence of postoperative complications was decreased in group R ( P<0.05). Conclusion:Remimazolam provides better efficacy than propofol in improving the quality of postoperative recovery in elderly patients with goal-directed hemodynamic management strategy.

Efficacy of remazolam combined with remifentanil anesthesia for radical surgery for gastric cancer in frail aged patients / 中华麻醉学杂志

Objective:To evaluate the efficacy of remazolam combined with remifentanil anesthesia for radical surgery for gastric cancer in frail aged patients.Methods:One hundred and twenty patients of either sex, aged 65-75 yr, with body mass index 18-28 kg/m 2, with simple frailty questionnaire score 3-5 points, undergoing elective laparoscopic radical gastric cancer surgery, were divided into 3 groups ( n=40 each) according to the random number table method: propofol combined with remifentanil group (P group), low-dose remazolam combined with remifentanil group (B1 group) and high-dose remazolam combined with remifentanil group (B2 group). Induction of anesthesia was as follows: propofol 2 mg/kg was intravenously injected in group P, remazolam 6 and 12 mg·kg -1·h -1 were intravenously infused in group B1 and group B2, respectively, and alfentanil and rocuronium were intravenously injected after loss of consciousness in three groups.Anesthesia maintenance was as follows: propofol 4-12 mg·kg -1·h -1 was intravenously infused in group P, remazolam 0.5-1.0 mg·kg -1·h -1 was intravenously infused in B1 and B2 groups, remifentanil 0.05-0.20 μg·kg -1·h -1 was intravenously infused in three groups, and intravenous rocuronium was injected intermittently to maintain the BIS value at 45-55 intraoperatively.The time to loss of consciousness, recovery time of consciousness and time of tracheal extubation were recorded.The occurrence of injection pain during induction of anesthesia, intraoperative cardiovascular events, intraoperative awareness, and respiratory depression, nausea and vomiting, and drowsiness during postanesthesia care unit were recorded. Results:Compared with group P, the time to loss of consciousness was significantly prolonged, the incidence of injection pain, intraoperative hypotension and bradycardia was decreased, and the incidence of postoperative somnolence was increased in B1 and B2 groups ( P<0.05). The time to loss of consciousness was significantly shorter in group B2 than in group B1 ( P<0.05). There was no statistically significant difference in the recovery time of consciousness, time of tracheal extubation, postoperative respiratory depression and incidence of nausea and vomiting among the three groups ( P>0.05). Conclusion:Remazolam combined with remifentanil anesthesia can be safely and effectively used for radical surgery for gastric cancer in frail aged patients.