Effect of Remimazolam on Induction and Maintenance of General Anesthesia in Kidney Transplant Patients.

Purpose: This study aims to evaluate the effect of remimazolam on induction and maintenance of general anesthesia in kidney transplant patients. Methods: 120 patients undergoing kidney transplant were divided into two groups: Propofol group (Group P) and Remimazolam group (Group R). Anesthesia induction: remimazolam had injected IV at a dose of 0.15-0.35 mg/kg in Group R, while propofol had injected IV at a dose of 2.0-2.5 mg/kg in Group P. Anesthesia maintenance: remimazolam was injected IV at a dose of 0.3-1.0 mg·kg-1·h-1 and propofol was injected IV at a dose of 1-12 mg·kg-1·h-1 in Group R, propofol was injected IV at a dose of 3-12 mg·kg-1·h-1 in Group P. All patients have the same remaining anesthesia durgs. Results: Compared with Group P, in Group R the time of disappearance of the eyelash reflex and the time to drop to 60 in BIS was longer (P < 0.05), the time of awakening was shorted (P < 0.05), the MAP of T6 was fluctuated less (P < 0.05), the incidence of hypotension and injection pain during induction was reduced (P < 0.001), the incidence of intraoperative bradycardia during operation was reduced (P < 0.05), the dosages of sedatives drug during maintenance was reduced (P < 0.05). There was no statistically significant difference in postoperative renal function between the two groups of patients (P > 0.05). Conclusion: Remimazolam can be safely and effectively used for the induction and maintenance of general anesthesia in kidney transplant patients.

Polydopamine-Coated Kaempferol-Loaded MOF Nanoparticles: A Novel Therapeutic Strategy for Postoperative Neurocognitive Disorder.

Purpose: The primary objective of this study was to develop an innovative nanomedicine-based therapeutic strategy to alleviate Postoperative Neurocognitive Disorder (PND) in patients undergoing surgery. Patients and Methods: To achieve this goal, polydopamine-coated Kaempferol-loaded Metal-Organic Framework nanoparticles (pDA/KAE@ZIF-8) were synthesized and evaluated. The study involved encapsulating Kaempferol (KAE) within ZIF-8 nanoparticles, followed by coating with polydopamine (PDA) to enhance biocompatibility and targeted delivery. The characterization of these nanoparticles (NPs) was conducted using various techniques including Scanning Electron Microscopy, Fourier-Transform Infrared Spectroscopy, X-ray Diffraction, and Ultraviolet-Visible spectroscopy. The efficacy of pDA/KAE@ZIF-8 NPs was tested in both in vitro and in vivo models, specifically focusing on their ability to penetrate the blood-brain barrier and protect neuronal cells against oxidative stress. Results: The study found that pDA/KAE@ZIF-8 NPs efficiently penetrated the blood-brain barrier and were significantly taken up by neuronal cells. These nanoparticles demonstrated remarkable Reactive Oxygen Species (ROS) scavenging capabilities and stability under physiological conditions. In vitro studies showed that pDA/KAE@ZIF-8 NPs provided protection to HT-22 neuronal cells against H2O2-induced oxidative stress, reduced the levels of pro-inflammatory cytokines, and decreased apoptosis rates. In a PND mouse model, the treatment with pDA/KAE@ZIF-8 NPs significantly improved cognitive functions, surpassing the effects of KAE alone. This improvement was substantiated through behavioral tests and a noted reduction in hippocampal inflammation. Conclusion: The findings from this study underscore the potential of pDA/KAE@ZIF-8 NPs as an effective nanotherapeutic agent for PND. This approach offers a novel direction in the postoperative care of elderly patients, with the potential to transform the therapeutic landscape for neurocognitive disorders following surgery. The application of nanotechnology in this context opens new avenues for more effective and targeted treatments, thereby improving the quality of life for patients suffering from PND.

Effects of dexmedetomidine as an adjuvant to ropivacaine or ropivacaine alone on duration of postoperative analgesia: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Ropivacaine is a long-acting local anesthetic that is used to treat postoperative pain. Adjuvant use of dexmedetomidine in regional anesthesia may prolong the duration of analgesia. The objective of this systematic review and meta-analysis was to investigate the duration and effect of ropivacaine alone vs. ropivacaine in combination with dexmedetomidine for postoperative analgesia. METHODS: The PubMed, EMBASE, Web of Science, and Google Scholar databases were searched for randomized controlled trials (RCTs) of ropivacaine alone or ropivacaine in combination with dexmedetomidine for regional anesthesia. The primary outcome was duration of analgesia, defined as the time from onset of the block to the time of the first analgesic request or initial pain report. Secondary outcomes were duration of sensory block, duration of motor block, consumption of sufentanil for analgesia, length of hospital stay, and incidence of postoperative nausea and vomiting. RESULTS: Eighteen studies with 1148 patients were included. Overall quality of the RCTs, as assessed by the Jadad scale, was high. The meta-analysis demonstrated that ropivacaine combined with dexmedetomidine significantly prolonged the duration of postoperative analgesia from local anesthetics compared to ropivacaine alone (WMD: 4.14h; 95%CI: 3.29~5.0h; P<0.00001; I2 = 99%). There was evidence of high heterogeneity between studies. The duration of sensory and motor block was significantly increased, and consumption of sufentanil for analgesia and the incidence of postoperative nausea and vomiting were significantly reduced in patients who received ropivacaine combined with dexmedetomidine compared to ropivacaine alone. There was no significant difference in length of hospital stay. CONCLUSIONS: Compared to ropivacaine alone, ropivacaine combined with dexmedetomidine significantly prolonged the duration of postoperative analgesia and sensory and motor block, and reduced consumption of sufentanil for analgesia and the incidence of postoperative nausea and vomiting, across an array of surgeries.

[Effects of External Carbon Sources on Ultimate Nitrogen Removal Performance and Microbial Community in Secondary Effluent Treating Process].

Adding external carbon sources is an important method for advanced nitrogen removal of secondary effluent in wastewater treatment plants (WWTPs). In order to compare the denitrification performance and economy of different carbon sources sufficiently, as well as the effect of long-term addition of carbon sources on the microbial population structure, four single carbon sources (methanol, ethanol, glucose, and sodium acetate) and four types of composite carbon sources were prepared by mixing sodium acetate and ethanol with a higher reaction rate and cheap glucose. The results showed that the effluent ρ(NOx--N) concentration of all systems was less than 1.0 mg·L-1 during the experiment. For single-carbon source systems, ethanol had the fastest denitrification rate, followed by sodium acetate and methanol; that of the glucose was the slowest. In the composite carbon source systems, the sodium acetate/glucose (1:1) with COD/ρ(N) was 6, which was equivalent to the results of sodium acetate/glucose (1:3), ethanol/glucose(1:1), and ethanol/glucose (1:3) with COD/ρ(N) of 9, 10, and 10, respectively. The sodium acetate/glucose (1:1) system had the fastest reaction rate and the best economy. High-throughput sequencing results showed that after more than 70 days of operation, the structure of the microbial community had changed completely. In the glucose-related system, the abundance of Candidatus Saccharibacteria, which is not popular in typical nitrogen removal systems, increased from 1.16% of seed sludge to 47.37%, and Saccharibacteria_genera_incertae_sedis correspondingly became the dominant community. This study not only provides a more comprehensive comparison for the selection of carbon sources in WWTPs with ultimate nitrogen removal but also provides basic data for the role of carbon sources in the domestication of microbial communities.

Advanced treatment of effluent from municipal wastewater treatment plant by strengthened ecological floating bed.

The performance of eological floating bed (EFB) with novel carbon source (CS) and reed biochar substrate (RBS) derived from reed straw (RS) was evaluated for the advanced treatment of effluent from wastewater treatment plants (WWTPs). The average carbon releasing capacity of CS was 4.50 mg/g, and the P adsorption capacity of RBS was 0.39 mg/g. The additional CS and RBS increased the average removal efficiencies of total nitrogen (TN) and total phosphorus (TP) by 57.6% and 46.7%, respectively. Furthermore, the high-throughput sequencing results revealed significantly different microbial species richness and diversity due to the CS and RBS. Some genera related to nitrogen removal, such as Pseudomonas, Rhodobacter, Hydrogenophaga, Bradyrhizobium, Acinetobacter and Thiobacillus, were enriched in the EFB with CS and RBS. This study provided a suitable method for effectively treating low C/N wastewater such as WWTPs effluent using EFB strengthened by processed wetland plant.