Objective     To investigate the clinical characteristics and risk factors for perioperative lung surgery patients with SARS‐CoV‐2 Omicron variant infection. Methods     The clinical data of patients who underwent lung surgery at the Department of Thoracic Surgery, Renmin Hospital of Wuhan University from December 1, 2022 to January 9, 2023 were retrospectively analyzed. The patients were divided into an infection group and a non-infection group according to whether they were infected with SARS-CoV-2. And the clinical data of two groups were collected and compared. Multiple linear regression analysis was used to explore the risk factors affecting the time of hospitalization. Results     A total of 70 patients were enrolled in this study, including 36 (51.4%) males and 34 (48.6%) females at a median age of 61.0 (49.0, 66.8) years. There were 28 patients in the infection group and 42 patients in the non-infection group. The proportion of preoperative abnormal coagulation function and the risk of postoperative pulmonary infection in perioperative patients infected with SARS-CoV-2 were higher than those in the non-infection group (P<0.05). Subgroup analysis found that patients with preoperative SARS-CoV-2 infection were more likely to have pulmonary infection after surgery, but did not prolong the time of hospitalization or increase the risk of severe disease rate. The patients with postoperative SARS-CoV-2 infection had worse clinical prognosis, including longer time of hospitalization (P=0.004), higher ICU admission rate (P=0.000), higher lung infection rate (P=0.003) and respiratory failure rate (P=0.000). Multiple linear regression analysis showed that gender and extent of surgery were independent risk factors for prolonged hospitalization time. Conclusion     Preoperative infection with SARS-CoV-2 Omicron variant will increase the risk of pulmonary infection, but it will not affect the clinical prognosis. However, postoperative infection with SARS-CoV-2 Omicron variant will still prolong the time of hospitalization, increase the ICU rate, and the risk of pulmonary complications.

Today, there is greater awareness on the association between oral diseases and respiration diseases after the outbreak of COVID-19. However, confusion regarding the oral health management and medical risk prevention for patients with chronic airway diseases has been remained among dental clinicians. Therefore, the dental experts of the Fifth General Dentistry Special Committee, Chinese Stomatological Association, combined with the experts of respiratory and critical care medicine, undertook the formation of consensus on the oral health management of patients with chronic airway diseases in order to help dental clinicians to evaluate medical risks and make better treatment decision in clinical practice. In the present consensus report, the relationship of oral diseases and chronic airway diseases, the oral health management and the treatment recommendations of patients with chronic airway diseases are provided.
COVID-19 ; Consensus ; Humans ; Oral Health ; Oral Medicine

Objective: The relationship between serum uric acid (SUA) levels and glycemic indices, including plasma glucose (FPG), 2-hour postload glucose (2h-PG), and glycated hemoglobin (HbA1c), remains inconclusive. We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population. Methods: The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study. A total of 105,922 community-dwelling adults aged ≥ 40 years underwent the oral glucose tolerance test and uric acid assessment. The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models. Results: A total of 30,941 men and 62,361 women were eligible for the current analysis. Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels, but with different inflection points in men and women. The thresholds for FPG, 2h-PG, and HbA1c for men and women were 6.5/8.0 mmol/L, 11.0/14.0 mmol/L, and 6.1/6.5, respectively (SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices). Conclusion An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes, while the inflection points were reached earlier in men than in women.
Aged ; Asian Continental Ancestry Group ; Blood Glucose/analysis* ; China/epidemiology* ; Cohort Studies ; Diabetes Mellitus/blood* ; Female ; Glucose Tolerance Test ; Glycated Hemoglobin A/analysis* ; Glycemic Index ; Humans ; Male ; Middle Aged ; Uric Acid/blood*

BACKGROUND: In the preliminary study, extracorporeal circulation system simulated physiological environment has been applied in limb preservation, significantly prolonging the severed limb preserving time. OBJECTIVE: To study the effect of enhancement-perfusion by extracorporeal circulation system on the blood supply of ischemic lower limbs. METHODS: Eighteen adult Bama mini pigs were equally randomized into three groups: group A (no intervention), groups B and C (establishing the ischemic model by arteria cruralis ligation at the right posterior lower limb). At 4 weeks after modeling, the model pigs in the group C received enhancement-perfusion therapy 1 hour per day. One week later, the situations of angiography were detected by digital radiography. The tibialis anterior separated from each pig was used to test the microvessel density by hematoxylin-eosin staining. The expression levels of vascular endothelial growth factor in the skeletal muscle and serum samples were monitored by western blot and ELISA, respectively. RESULTS AND CONCLUSION: Both diameter and distal collateral circulation of the arteria cruralis in the group C were much better than those in the group B. The microvessel density in the group C was significantly higher than that in the group B (P < 0.05), but the insignificant difference between groups A and C was found (P > 0.05). Both histionic and serum levels of vascular endothelial growth factor were significantly increased in the groups B and C compared with the group A, especially in the group C (P < 0.05). In summary, the enhancement-perfusion therapy by extracorporeal circulation system can considerably ameliorate blood supply of lower limbs, providing a promising method for treatment of ischemic lower limbs.

BACKGROUNDBispectral index (BIS) is considered very useful to guide anesthesia care in elderly patients, but its use is controversial for the evaluation of the adequacy of analgesia. This study compared the BIS changes in response to loss of consciousness (LOC) and loss of somatic response (LOS) to nociceptive stimuli between elderly and young patients receiving intravenous target-controlled infusion (TCI) of propofol and remifentanil.

METHODSThis study was performed on 52 elderly patients (aged 65-78 years) and 52 young patients (aged 25-58 years), American Society of Anesthesiologists physical status I or II. Anesthesia was induced with propofol administered by TCI. A standardized noxious electrical stimulus (transcutaneous electrical nerve stimulation, [TENS]) was applied (50 Hz, 80 mA, 0.25 ms pulses for 4 s) to the ulnar nerve at increasing remifentanil predicted effective-site concentration (Ce) until patients lost somatic response to TENS. Changes in awake, prestimulus, poststimulus BIS, heart rate, mean arterial pressure, pulse oxygen saturation, predicted plasma concentration, Ce of propofol, and remifentanil at both LOC and LOS clinical points were investigated.

RESULTSBISLOCin elderly group was higher than that in young patient group (65.4 ± 9.7 vs. 57.6 ± 12.3) (t = 21.58, P < 0.0001) after TCI propofol, and the propofol Ce at LOC was 1.6 ± 0.3 μg/ml in elderly patients, which was significantly lower than that in young patients (2.3 ± 0.5 μg/ml) (t = 7.474, P < 0.0001). As nociceptive stimulation induced BIS to increase, the mean of BIS maximum values after TENS was significantly higher than that before TENS in both age groups (t = 8.902 and t = 8.019, P < 0.0001). With increasing Ce of remifentanil until patients lost somatic response to TENS, BISLOSwas the same as the BISLOCin elderly patients (65.6 ± 10.7 vs. 65.4 ± 9.7), and there were no marked differences between elderly and young patient groups in BISawake, BISLOS, and Ce of remifentanil required for LOS.

CONCLUSIONIn elderly patients, BIS can be used as an indicator for hypnotic-analgesic balance and be helpful to guide the optimal administration of propofol and remifentanil individually.

TRIAL REGISTRATIONCTRI Reg. No: ChiCTR-OOC-14005629; http://www.chictr.org.cn/showproj.aspx?proj=9875.

Adult ; Aged ; Electroencephalography ; drug effects ; Female ; Humans ; Male ; Middle Aged ; Movement Disorders ; physiopathology ; Pain ; physiopathology ; Piperidines ; pharmacology ; Propofol ; pharmacology ; Transcutaneous Electric Nerve Stimulation ; Unconsciousness ; physiopathology

Objective To investigate the effects of ligustilide (LIG) on extracellular recombinant human heat shock protein 60 (HSP60) induced inflammatory reactions in the THP-1 cells and the related mechanisms.Methods THP-1 cells were differentiated to macrophages by incubation with phorbol-12-myristate-13-acetate (PMA).The immunofluorescence method was used to screen the optimum transfection concentration of MyD88 siRNA.The macrophages were divided into six groups (n =3),including blank control (siRNA transfection reagent),model (siRNA transfection reagent + HSP60 10 mg/L),negative control (MyD88 negative control + HSP60 10 mg/L),LIG group(siRNA transfection reagent + HSP60 10 mg/L +LIG 20 mg/L),RNA interfering(RNAi) group(MyD88 siRNA + HSP60 10 mg/L) and RNAi + LIG group (MyD88 siRNA + HSP60 10 mg/L + LIG 20 mg/L).The protein expression level of MyD88 and phosphonuclear factor-κB (p-NF-κB) in macrophages and the level of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in the culture supernatant were assessed by Western blot analyses or ELISA,respectively.Results (1)The protein expression levels of MyD88 (1.196 ± 0.125 vs.0.341 ± 0.063,P ＜ 0.01) and p-NF-κB(0.817 ±0.034 vs.0.312 ±0.046,P ＜0.01) were significantly higher in the model group than those in the blank control group.The protein expression levels of MyD88 (0.554 ± 0.043) and p-NF-κB(0.538 ±0.063) in the RNAi group were significantly lower than those in the model group (all P ＜0.01) but significantly higher than those in the blank control group (all P ＜ 0.05).The protein expression levels of MyD88(0.694 ±0.087,P ＜0.05) and p-NF-κB(0.669 ±0.043,P ＜0.01)in the LIG group were markedly lower than those in the model group,but higher than those in the RNAi group (P ＜ 0.05) and the blank control group (P ＜ 0.01).The protein expression levels of MyD88 (0.409 ± 0.069) and p-NF-κB(0.395 ±0.046) in the RNAi + LIG group were significantly lower than in the model group (all P ＜ 0.01) and in the LIG group (P ＜ 0.05 or 0.01),and were similar to the blank control group (P ＞ 0.05).The expression level of p-NF-κB in the RNAi + LIG group was significantly lower than in the RNAi group (P＜0.05).(2) The contents ofTNF-α((312.24±28.69) ng/Lvs.(5.99 ±1.03) ng/L,P＜ 0.01) and IL-6 ((233.45 ± 57.77) ng/L vs.(2.25 ± 0.67) ng/L,P ＜ 0.01) were significantly higher in the model group than in the blank control group.The contents of TNF-α((235.66 ±25.12) ng/L) and IL-6((131.59 ± 13.99) ng/L) were significantly lower in the RNAi group than in the model group (P ＜0.01) The contents of TNF-α ((258.13 ± 44.80) ng/L) and IL-6 ((175.92 ± 28.27) ng/L) were also significantly lower in the LIG group than in the model group (P ＜ 0.05) while the content of IL-6 was significantly higher in the LIG group than in the RNAi group(P ＜0.01).The contents of TNF-α((88.57 ± 16.10) ng/L) and IL-6((59.99 ± 10.31) ng/L) were significantly lower in the RNAi + LIG group than those in the model group,the RNAi group and the LIG group (P ＜ 0.05 or 0.01).Conclusions The MyD88/NF-κB signaling pathway is one of the key signaling pathways of human HSP60 induced inflammation in THP-1 cells.Ligustilide could exhibit the anti-inflammatory effect probably by inhibiting the MyD88/NF-κB signaling pathway.

Objective To evaluate the diagnostic and therapeutic effects of endoscopic retrograde cholangiopancreatography (ERCP) in biliary papillomatosis. Methods Data of 6 patients, who underwent ERCP and diagnosed as biliary papillomatosis from 2000 to 2008, were retrospectively analyzed. Results There were 3 males and 3 females, with the mean age of onset at 72.8 years (range 52-83 years). Recurrent cholangitis and jaundice were common presentations in all patients, with 5 patients having right upper abdominal pain and 3 others exhiting fever and algor. History of partial hepatectomy was observed in 2 patients. Endoscopic findings included dilated papillary orifice with mucin discharge in 5 patients and papillary-occupying lesion in 1 patient. Multiple filling defects in the lumen of the biliary system in dilated common bile duct were detected in all patients, accompanied with extra-hepatic ducts dilatation in 3, right intra-hepatic duct dilatation in 1, and major pancreatic duct dilation in 1. Of 6 patients, 5 underwent multiple ERCP, inclucling stents and endoscopic nasobiliary drainage (ENBD), and have survived for 10-30 months. Another 83-year-old patient underwent palliative endoscopic treatment with balloons, baskets and ENBD, but died of cholangitis 10 days after the procedure. Conclusion This case series reports the typical endoscopic findings of biliary papiliomatosis. For inoperable or postoperative recurrent patients, endoscopic palliative treatment is a safe, convenient and effective procedure.

Objective To explore the clinical significance and the dynamic changes of serum anti-inflam-mation factor interleukin-10(IL-10)and inflammatory factor interleukin-8(IL-8)in cerebral infarction.Methods The serum levels of IL-10 and IL-8 in 30 patients were measured by double-antibody sandwich enzyme-linked inunu-nosorbent assay(ELISA)on days 1.3,7 and 14 respectively after infarction.Results The serum levels of IL-10 and IL-8 were higher in patients than those in control group on days 1,3 and 7(P<0.05).Conclusion IL-10 and IL-8 are involved in the pathophysiology of acute cerebral infarction.

Electrochemical behaviors, electrochemical kinetics and electrochemical determination of sulfamethoxazole (SMZ) at both glassy carbon electrode (GCE) and multi-wall carbon nanotubes-Nafion modified glassy carbon electrode (MWCNTs-Nafion/GCE) were investigated by cyclic voltammetry (CV), chronocoulometry (CC), chronoamperometry (CA), linear scan voltammetry (LSV) and amperometric i-t curve. The experimental results showed that the electrochemical oxidation of SMZ was sluggish on GCE, but the oxidation peak current of SMZ increased significantly at MWCNTs-Nafion/GCE in comparison with that at the bare GCE, which indicated that MWCNTs-Nafion/GCE could catalyze the electrochemical oxidation of SMZ very well. The plot of oxidation peak currents versus the square roots of the scanning rates for the redox in the potential range of 10-1,000 mV x s(-1) showed a straight line, as expected for a diffusion-limited electrochemical process for SMZ electrochemical oxidation. At the bare GCE and MWCNTs-Nafion/GCE the oxidation peak current was linearly proportional to the concentration of SMZ over the concentration range 5.0 x 10(-5)-2.5 x 10(-3) mol x L(-1) and 1.0 x 10(-5)-6.0 x 10(-3) mol x L(-1). The detection limits were 1.0 x 10(-5) and 5.0 x 10(-7) mol x L(-1). The relative standard deviation was between 0.85% -1.98% and the recovery was in the range of 98%-101.2%. This MWCNTs-Nafion/GCE could be applied in SMZ electrochemical determination with satisfied results. The proposed method can be applied to the determination of SMZ in tablet samples with satisfied results.
Catalysis ; Electrochemistry ; methods ; Electrodes ; Fluorocarbon Polymers ; chemistry ; Kinetics ; Nanotubes, Carbon ; Oxidation-Reduction ; Sulfamethoxazole ; analysis ; chemistry