Increased plasma total homocysteine (tHcy) and high sensitivity C-reactive protein (hsCRP) levels are independent risk factors for cardiovascular disease. However, the predictive value of tHcy in combination with hsCRP in patients with stroke is not known. To determine the relationship between tHcy and hsCRP, we enrolled 291 patients with first-onset stroke (196 ischemic and 95 hemorrhagic). Plasma tHcy and hsCRP levels were measured and subsequent vascular events and deaths were determined over a 5-year period. Using the arbitrary cutoff for tHcy (<18 μmol/L and ≥18 μmol/L) and hsCRP (<1 mg/L, 1-3 mg/L and >3 mg/L), the patients were divided into 6 groups. Survival analysis showed that the probability of death or new vascular events during a 5-year follow-up increased according to tHcy and hsCRP levels (P<0.01). The relative risk (RR) of death or new vascular events was 4.67 (95% CI, 1.96 to 11.14, P=0.001) in patients with high tHcy (≥18 μmol/L) and hsCRP (>3 mg/L) compared with those with low tHcy (<18 μmol/L) and hsCRP (<1 mg/L). The increased tHcy level (≥18 μmol/L) combined with increased hsCRP level (>3 mg/L) was still significantly associated with the risk of death or new vascular events (RR, 4.10, 95% CI, 1.61 to 10.45, P=0.003) even when adjusted for other risk factors at inclusion. The combination of increased tHcy and hsCRP levels had a stronger predictive value than increased hsCRP alone or increased tHcy level alone. Further studies are required to evaluate the potential decrease in risks associated with lowering both Hcy and hsCRP levels in patients that present with both increased tHcy and hsCRP.

The field of artificial intelligence is rapidly evolving, and there has been an interest in its use to predict the risk of lymph node metastasis in T1 colorectal cancer. Accurately predicting lymph node invasion may result in fewer patients undergoing unnecessary surgeries; conversely, inadequate assessments will result in suboptimal oncological outcomes. This narrative review aims to summarize the current literature on deep learning for predicting the probability of lymph node metastasis in T1 colorectal cancer, highlighting areas of potential application and barriers that may limit its generalizability and clinical utility.

Pain is normally treated with oral nonsteroidal anti-inflammatory agents and opioids. These drugs are dangerous and are responsible for many hospitalizations and deaths. It is much safer to use topical preparations made from plants to treat pain, even severe pain. Topical preparations must contain compounds that penetrate the skin, inhibit pain receptors such as transient receptor potential cation channels and cyclooxygenase-2, to relieve pain. Inhibition of pain in the skin disrupts the pain cycle and avoids exposure of internal organs to large amounts of toxic compounds. Use of topical pain relievers has the potential to save many lives, decrease medical costs and improve therapy.

Image-guided surgery potentially enhances intraoperative safety and outcomes in a variety of craniomaxillofacial procedures. We explore the efficiency of one intraoperative navigation system in a single complex craniofacial case, review the initial and recurring costs, and estimate the added cost (e.g., additional setup time, registration). We discuss the potential challenges and benefits of utilizing image-guided surgery in our specific case and its benefits in terms of educational and teaching purposes and compare this with traditional osteotomies that rely on a surgeon's thorough understanding of anatomy coupled with tactile feedback to blindly guide the osteotome during surgery. A 13-year-old presented with untreated syndromic multi-suture synostosis, brachycephaly, severe exorbitism, and midface hypoplasia. For now, initial costs are high, recurring costs are relatively low, and there are perceived benefits of imaged-guided surgery as an excellent teaching tool for visualizing difficult and often unseen anatomy through computerized software and multi-planar real-time images.
Adolescent ; Craniosynostoses ; Humans ; Osteotomy ; Surgery, Computer-Assisted* ; Synostosis

OBJECTIVETo investigate the roles of sympathetic and vagus nerves in hypotension and bradycardia induced by fentanyl.

METHODSFourteen rabbits were divided into 2 groups: normal and vagotomized rabbits. Rabbits were anesthetized, paralyzed, and artificial ventilated. Right renal sympathetic nerve was exposed and prepared for recording electrical activity. Fentanyl was injected intravenously in incremental doses of 1, 4, 15, 30, and 50 microg/kg at 10 minutes intervals.

RESULTSFentanyl significantly reduced the spontaneous activity of renal sympathetic nerve, mean arterial pressure, and heart rate above a total dose of 20 microg/kg in both normal and vagotomized rabbits. However, normal rabbits spontaneous sympathetic nerve activity and mean arterial pressure were more depressed than vagotomized rabbits at total doses of 50 and 100 microg/kg. There were no significant difference in the reduction of heart rate between normal and vagotomized rabbits.

CONCLUSIONFentanyl induction of bradycardia and hypotension in rabbits is mainly due to depression of sympathetic nerve activity.

Analgesics, Opioid ; pharmacology ; Animals ; Blood Pressure ; drug effects ; Fentanyl ; pharmacology ; Heart Rate ; drug effects ; Kidney ; innervation ; Rabbits ; Sympathetic Nervous System ; drug effects ; physiology ; Vagotomy

Objective To explore the outcomes of computer-assisted design of therapeutic personalized footwear for diabetic foot.Methods Fifty-eight cases of diabetic foot were included in the study.Ten items of data from theses patients were measured with methods provided by Salford University.All characteristics of the footwear were calculated with computer.Shoes were specially designed with the formula and computational method provided by Safford university.All patients had worn the shoes for 13 months.Special questionnaires were used to measure the outcomes.Results Thirty-two cases had been followed up for one month,25 cases for 2 months,25 cases for 3 months and 42 cases for 13 months.The score had improved from 67.94±15.14 before wearing the shoes to 78.13±1.44 thirteen months after wearing.The health score of the foot had improved.There was significant difference between before and after wearing the footwears.Conclusion Special-designed diabetic shoes play an important role in the prevention of ulcer for diabetic foot patients.Computational method and data model obtained from Salford university needs to be modified when applying it for Chinese.

Objective: : Angiolipomas are usually found in the subcutaneous tissue of the trunk and limbs. Spinal angiolipomas (SALs) are uncommon and have rarely been reported. We report a series of nine SALs patients who received surgical treatment in our department. To summarize the clinical characteristics of SALs, propose our surgical strategies, and evaluate the effects of the operation. Methods: : This was a retrospective review of nine SALs patients who received surgical treatment from August 2015 to March 2020. Total or subtotal resection was determined by the axial localization (dorsal or ventral) and the extent of intervertebral foramen involvement. The outcomes were assessed based on the modified Japanese Orthopaedic Association (mJOA) scoring system utilized before surgery and at various follow-up points. Results: : Among the nine patients, the mean mJOA score before surgery was 6.6±2.3, compared with 10.1±1.1 at the last follow-up time point (33.4±11.8 months). All patients achieved good outcomes, even in cases of subtotal resection. Conclusion : Early surgical resection of SALs is recommended, and the specific procedures should be determined by the axial localization (dorsal or ventral) and the extent of intervertebral foramen involvement. Most of the patients had a good prognosis, even in cases of subtotal resection.

PURPOSE: This literature review was performed to assess the effect of raisins on human health. METHODS: A review of Medline was conducted using the keywords: ‘raisins, raisins and health, raisins and cardiovascular disease (CVD), raisins and cancer, raisins and diabetes, raisins and fiber, raisins and colon health, raisins and antioxidants, raisins and inflammation, raisins and dental caries’. The reference lists from previous review articles on raisins and human health and the California Raisin Marketing Board files were reviewed for additional studies. RESULTS: Raisins have one of the highest polyphenolic content and antioxidant ORAC levels compared to other traditional dried fruits. Many of the polyphenols in raisins are well assimilated and bioavailable. Raisin consumption reduces low density lipoprotein (LDL) cholesterol, blood pressure and blood sugar, when compared to equal caloric carbohydrate snacks and is associated with a reduced risk of CVD. The anti-inflammatory and cancer chemopreventive effects of raisins are mixed. Raisin consumption reduces intestinal transit time and positively affects gut microbiota. Raisins produce sustained energy during long term athletic competitions equal to traditional sports energy gels, shots and jelly beans. Raisins produce a non-cariogenic oral environment and do not fit the American Academy of Pediatrics criteria to be considered a choking hazard. CONCLUSIONS: Based on the review of literature, consumption of raisins provide numerous health benefits for promoting general wellness and in the prevention of many chronic diseases including: CVD, type 2 diabetes mellitus (T2DM) gastrointestinal diseases, and dental caries.
Airway Obstruction ; Antioxidants ; Blood Glucose ; Blood Pressure ; California ; Cardiovascular Diseases ; Cholesterol ; Chronic Disease ; Colon ; Dental Caries ; Diabetes Mellitus, Type 2 ; Fruit ; Gastrointestinal Diseases ; Gastrointestinal Microbiome ; Gels ; Humans* ; Inflammation ; Insurance Benefits ; Lipoproteins ; Marketing ; Pediatrics ; Polyphenols ; Snacks ; Sports ; Vitis*

Non-enzymatic nitrite induced collagen cross-linking results in changes reminiscent of age-related damage and parallels the well-known model system, non-enzymatic glycation. We have recently observed that nitrite modification of basement membrane proteins can induce deleterious effects on overlying retinal pigment epithelial cells in studies relevant to age-related macular degeneration. The present work was undertaken in order to confirm 3-nitro-tyrosine (3-NT) as a product of the reaction and to identify the site specificity of nitration in collagen IV, a major component of basement membranes. Human collagen type IV was modified via incubation with 200 mM NaNO2 (pH=7.38) for one week at 37degrees C. The modified protein was prepared in 2 different ways, including acid hydrolysis and trypsin digestion for site specificity determination. The samples were analyzed by LC/MS using a C12 RP column. Site specificity was determined from tandem MS/MS data utilizing TurboSEQUEST software and the Swiss-Prot sequence database. 3-NT was detected in protein digests and acid hydrolysates of nitrite modified collagen IV. Positive identification with standard 3-NT was confirmed by identical Rt, lambda(max)=279 nm and 355 nm, and m/z=227. Analyses of tryptic digests identified four sites of tyrosine nitration, alpha1(IV)Y348, alpha1(IV)Y534, alpha2(IV)Y327, and alpha2(IV)Y1081. These sites are located in the triple-helical region of the protein and provide clues regarding potential sites for nitrite modification in collagen type IV.
Tyrosine/*metabolism ; Tandem Mass Spectrometry ; Substrate Specificity ; Nitrites/*metabolism ; Humans ; Collagen Type IV/*metabolism ; Chromatography, Liquid ; Binding Sites