Publications by authors named "Han Yuan"

157 Publications

Neuroimaging Markers of Mal de Débarquement Syndrome.

Front Neurol 2021 4;12:636224. Epub 2021 Mar 4.

Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK, United States.

Mal de débarquement syndrome (MdDS) is a motion-induced disorder of oscillating vertigo that persists after the motion has ceased. The neuroimaging characteristics of the MdDS brain state have been investigated with studies on brain metabolism, structure, functional connectivity, and measurements of synchronicity. Baseline metabolism and resting-state functional connectivity studies indicate that a limbic focus in the left entorhinal cortex and amygdala may be important in the pathology of MdDS, as these structures are hypermetabolic in MdDS and exhibit increased functional connectivity to posterior sensory processing areas and reduced connectivity to the frontal and temporal cortices. Both structures are tunable with periodic stimulation, with neurons in the entorhinal cortex required for spatial navigation, acting as a critical efferent pathway to the hippocampus, and sending and receiving projections from much of the neocortex. Voxel-based morphometry measurements have revealed volume differences between MdDS and healthy controls in hubs of multiple resting-state networks including the default mode, salience, and executive control networks. In particular, volume in the bilateral anterior cingulate cortices decreases and volume in the bilateral inferior frontal gyri/anterior insulas increases with longer duration of illness. Paired with noninvasive neuromodulation interventions, functional neuroimaging with functional magnetic resonance imaging (fMRI), electroencephalography (EEG), and simultaneous fMRI-EEG have shown changes in resting-state functional connectivity that correlate with symptom modulation, particularly in the posterior default mode network. Reduced parieto-occipital connectivity with the entorhinal cortex and reduced long-range fronto-parieto-occipital connectivity correlate with symptom improvement. Though there is a general theme of desynchronization correlating with reduced MdDS symptoms, the prediction of optimal stimulation parameters for noninvasive brain stimulation in individuals with MdDS remains a challenge due to the large parameter space. However, the pairing of functional neuroimaging and noninvasive brain stimulation can serve as a probe into the biological underpinnings of MdDS and iteratively lead to optimal parameter space identification.
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http://dx.doi.org/10.3389/fneur.2021.636224DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7970001PMC
March 2021

Nucleus accumbens neurons expressing dopamine D1 receptors modulate states of consciousness in sevoflurane anesthesia.

Curr Biol 2021 Mar 5. Epub 2021 Mar 5.

Department of Anesthesiology, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Shanghai Medical College, Fudan University, Shanghai 200032, China; Department of Pharmacology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai 200032, China. Electronic address:

Although general anesthesia (GA) enables patients to undergo surgery without consciousness, the precise neural mechanisms underlying this phenomenon have yet to be identified. In addition to many studies over the past two decades implicating the thalamus, cortex, brainstem, and conventional sleep-wake circuits in GA-induced loss of consciousness (LOC), some recent studies have begun to highlight the importance of other brain areas as well. Here, we found that population activities of neurons expressing dopamine D1 receptor (D1R) in the nucleus accumbens (NAc), a critical interface between the basal ganglia and limbic system, began to decrease before sevoflurane-induced LOC and gradually returned after recovery of consciousness (ROC). Chemogenetic activation of NAc neurons delayed induction of and accelerated emergence from sevoflurane GA, whereas chemogenetic inhibition of NAc neurons exerted opposite effects. Moreover, transient activation of NAc neurons induced significant cortical activation and behavioral emergence during continuous steady-state GA with sevoflurane or deep anesthesia state with constant and stable burst-suppression oscillations. Taken together, our findings uncover that NAc neurons modulated states of consciousness associated with sevoflurane GA and may represent an area for targeting GA-induced changes in consciousness and ameliorating related adverse effects.
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http://dx.doi.org/10.1016/j.cub.2021.02.011DOI Listing
March 2021

Construction of a comprehensive nutritional index and comparison of its prognostic performance with the PNI and NRI for survival in older patients with nasopharyngeal carcinoma: a retrospective study.

Support Care Cancer 2021 Mar 8. Epub 2021 Mar 8.

Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, and Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, Guangdong, China.

Objectives: To explore the relationship between the Comprehensive Nutritional Index (CNI) and survival in older patients with nasopharyngeal carcinoma (NPC) and to compare the prognostic performance of three nutritional indicators (CNI, Prognostic Nutritional Index (PNI), and Nutritional Risk Index (NRI)) for overall survival (OS).

Methods: This retrospective study involved 309 older NPC patients in Guangzhou (China) from November 2006 to November 2017. The CNI comprised five parameters: the body mass index (BMI), usual body weight percentage (UBW%), hemoglobin (Hb) level, albumin level, and total lymphocyte count (TLC). All single nutritional indicators were evaluated before and immediately after treatment. The principal component analysis (PCA) was used for calculation of the CNI by single nutritional indicators after treatment. The cutoff point for the CNI was evaluated and logistic regression used to explore the risk factors for the CNI. Univariable, multivariable Cox regression, and Kaplan-Meier methods were applied for OS and disease-free survival (DFS) analyses. Cox proportional hazards models were used to compare the prognostic value of the CNI, PNI, and NRI for OS.

Results: All single nutritional indicators decreased significantly after treatment (P < 0.05). The CNI cutoff point for mortality was 0.027, and the logistic regression indicated more complex treatments or higher cancer stage for NPC was associated with a low CNI (HR = 0.179; 95% CI: 0.037-0.856; 0.545, 0.367-0.811, respectively). In multivariable Cox regression, the CNI remained an independent prognostic factor of OS and DFS (HR = 0.468, 95% CI: 0.263-0.832; 0.527, 0.284-0.977, respectively). Kaplan-Meier curves showed that a low CNI was associated with worse OS and DFS (P = 0.001 and 0.013, respectively). The prognostic predictive performance of the CNI was superior to that of the PNI or NRI.

Conclusions: The CNI can be recommended as an appropriate indicator reflecting the integrated nutritional status of older NPC patients. A low CNI predicted a poor survival outcome and the prognostic performance of CNI was superior to PNI or NRI.
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http://dx.doi.org/10.1007/s00520-021-06128-6DOI Listing
March 2021

Sequential CRISPR gene editing in human iPSCs charts the clonal evolution of myeloid leukemia and identifies early disease targets.

Cell Stem Cell 2021 Feb 2. Epub 2021 Feb 2.

Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address:

Human cancers arise through the sequential acquisition of somatic mutations that create successive clonal populations. Human cancer evolution models could help illuminate this process and inform therapeutic intervention at an early disease stage, but their creation has faced significant challenges. Here, we combined induced pluripotent stem cell (iPSC) and CRISPR-Cas9 technologies to develop a model of the clonal evolution of acute myeloid leukemia (AML). Through the stepwise introduction of three driver mutations, we generated iPSC lines that, upon hematopoietic differentiation, capture distinct premalignant stages, including clonal hematopoiesis (CH) and myelodysplastic syndrome (MDS), culminating in a transplantable leukemia, and recapitulate transcriptional and chromatin accessibility signatures of primary human MDS and AML. By mapping dynamic changes in transcriptomes and chromatin landscapes, we characterize transcriptional programs driving specific transitions between disease stages. We identify cell-autonomous dysregulation of inflammatory signaling as an early and persistent event in leukemogenesis and a promising early therapeutic target.
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http://dx.doi.org/10.1016/j.stem.2021.01.011DOI Listing
February 2021

Preoperative Prognostic Nutritional Index Value is Related to Postoperative Delirium in Elderly Patients After Noncardiac Surgery: A Retrospective Cohort Study.

Risk Manag Healthc Policy 2021 6;14:1-8. Epub 2021 Jan 6.

Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou City 221002, Jiangsu Province, People's Republic of China.

Purpose: Malnutrition has been considered as a risk factor for postoperative delirium (POD). The Prognostic Nutritional Index (PNI) is a validated tool for assessing nutritional status. This study aimed to investigate the association between preoperative PNI values and the occurrence of POD in elderly surgical patients.

Methods: The retrospective cohort study included 361 elderly individuals who underwent noncardiac surgery between 2018 and 2019. Perioperative data were collected from the patients' medical records. PNI was used to evaluate preoperative nutritional status. The primary outcome was the occurrence of POD. Univariate and multivariate logistic regression analyses were used to identify key factors associated with POD and assess the relationship between PNI values and the occurrence of POD. Receiver operating characteristic (ROC) curve analysis was used to assess the predictive value of PNI for POD.

Results: Seventy-two (19.9%) individuals developed postoperative delirium after surgery. Compared with patients of normal nutrition status (PNI ≥ 50), mild malnutrition (PNI 45-50) did not increase the risk of POD, while patients with moderate to severe malnutrition (PNI 40-45) (odds ratio [OR], 2.92; 95% confidence interval [CI], 1.31-6.50) and serious malnutrition (PNI < 40) (OR, 3.15; 95% CI, 1.12-8.83) were more likely to develop POD. The cut-off value of PNI was 46.05 by ROC curve analysis, the area under the curve (AUC) was 0.69 (95% CI 0.62-0.77).

Conclusion: Preoperative PNI value is related to postoperative delirium in elderly patients after noncardiac surgery.
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http://dx.doi.org/10.2147/RMHP.S280567DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7797345PMC
January 2021

Surgery-induced downregulation of hippocampal sirtuin-1 contributes to cognitive dysfunction by inhibiting autophagy and activating apoptosis in aged mice.

Am J Transl Res 2020 15;12(12):8111-8122. Epub 2020 Dec 15.

Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Wenzhou 325027, Zhejiang, China.

Objectives: Elderly patients often suffer from cognitive dysfunction following surgery. However, the mechanisms underlying this phenomenon still remain unclear. This study investigated the critical part of Sirtuin-1 (SIRT1)-mediated autophagy and apoptosis in surgery-induced cognitive impairment.

Methods: The aged (16-month-old) male C57BL/6 mice underwent anesthesia and surgery. Some mice received intraperitoneal injections of resveratrol, which is an activator of SIRT1, prior to exposure to splenectomy. To examine learning and memory behavior in different sets, the study performed a Morris water maze. Tissues from the hippocampus were harvested 1, 3 and 7 days after surgery. Western blotting and immunofluorescence analysis determined the expression of autophagy- and apoptosis- associated protein.

Results: This article demonstrated surgery but not anesthesia considerably affected memory behavior and downregulated SIRT1 expression in the aged mice. Interestingly, rescue of hippocampal SIRT1 expression ameliorated the cognitive impairment in the elderly mice under splenectomy. In addition, surgical trauma decreased Beclin-1 protein levels and the LC3-II/LC3-I ratio, while expression of p62, Bax and cleaved caspase-3 in hippocampal neurons increased. However, rescue of hippocampal SIRT1 expression considerably attenuated the surgery-induced downregulation of Beclin-1, increased the ratio of LC3-II/LC3-I, and decreased expression of p62, Bax, and cleaved caspase-3.

Conclusion: These findings suggest that surgery-induced downregulation of hippocampal SIRT1 participates in cognitive impairment after surgery by inhibiting the autophagy process and activating apoptosis.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7791497PMC
December 2020

Absolute phase retrieval for colored objects based on three phase-shifting amount codes.

Opt Express 2020 Dec;28(26):38491-38504

We propose an absolute phase retrieval method based on three phase-shifting amount codes (3-PSA-codes) to measure the colored object with one additional pattern. 3-PSA-codes adopt the coding concept of 3-digit-codes, in which the code elements of three consecutive periods are treated as a unique code word for one period. However, to measure the colored object more effectively in the proposed method, each code element is embedded into the PSA domain and retrieved from the phase difference. Fringe patterns for the wrapped phase are artfully employed in the code element retrieval. Hence, for the first time, to the best of our knowledge, the code element related to the phase can be determined by one additional pattern. It breaks the constraint that temporal methods require multiple additional patterns to overcome the adverse effect of the surface color of objects on absolute phase retrieval. Experimental results demonstrate that the proposed 3-PSA-codes have strong robustness in the measurement of the colored object.
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http://dx.doi.org/10.1364/OE.409324DOI Listing
December 2020

Amplitude of fNIRS Resting-State Global Signal Is Related to EEG Vigilance Measures: A Simultaneous fNIRS and EEG Study.

Front Neurosci 2020 3;14:560878. Epub 2020 Dec 3.

Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK, United States.

Recently, functional near-infrared spectroscopy (fNIRS) has been utilized to image the hemodynamic activities and connectivity in the human brain. With the advantage of economic efficiency, portability, and fewer physical constraints, fNIRS enables studying of the human brain at versatile environment and various body positions, including at bed side and during exercise, which complements the use of functional magnetic resonance imaging (fMRI). However, like fMRI, fNIRS imaging can be influenced by the presence of a strong global component. Yet, the nature of the global signal in fNIRS has not been established. In this study, we investigated the relationship between fNIRS global signal and electroencephalogram (EEG) vigilance using simultaneous recordings in resting healthy subjects in high-density and whole-head montage. In Experiment 1, data were acquired at supine, sitting, and standing positions. Results found that the factor of body positions significantly affected the amplitude of the resting-state fNIRS global signal, prominently in the frequency range of 0.05-0.1 Hz but not in the very low frequency range of less than 0.05 Hz. As a control, the task-induced fNIRS or EEG responses to auditory stimuli did not differ across body positions. However, EEG vigilance plays a modulatory role in the fNIRS signals in the frequency range of less than 0.05 Hz: resting-state sessions of low EEG vigilance measures are associated with high amplitudes of fNIRS global signals. Moreover, in Experiment 2, we further examined the epoch-to-epoch fluctuations in concurrent fNIRS and EEG data acquired from a separate group of subjects and found a negative temporal correlation between EEG vigilance measures and fNIRS global signal amplitudes. Our study for the first time revealed that vigilance as a neurophysiological factor modulates the resting-state dynamics of fNIRS, which have important implications for understanding and processing the noises in fNIRS signals.
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http://dx.doi.org/10.3389/fnins.2020.560878DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7744746PMC
December 2020

Effectiveness of Bundle Interventions on ICU Delirium: A Meta-Analysis.

Crit Care Med 2021 Feb;49(2):335-346

Department of Adult Care, School of Nursing, Capital Medical University, Beijing, China.

Objective: To evaluate the impact of bundle interventions on ICU delirium prevalence, duration, and other patients' adverse outcomes.

Data Sources: The Cochrane Library, PubMed, CINAHL, EMBASE, PsychINFO, and MEDLINE from January 2000 to July 2020. The protocol of the study was registered in International prospective register of systematic reviews (CRD42020163147).

Study Selection: Randomized clinical trials or cohort studies that examined the following outcomes were included in the current study: ICU delirium prevalence and duration, proportion of patient-days with coma, ventilator-free days, mechanical ventilation days, ICU or hospital length of stay, and ICU or inhospital or 28-day mortality.

Data Extraction: Using a standardized data-collection form, two authors screened the studies and extracted the data independently, and assessed the studies' quality using the Modified Jadad Score Scale for randomized clinical trials and the Newcastle-Ottawa Scale for cohort studies.

Data Synthesis: Eleven studies with a total of 26,384 adult participants were included in the meta-analysis. Five studies (three randomized clinical trials and two cohort studies) involving 18,638 patients demonstrated that ICU delirium prevalence was not reduced (risk ratio = 0.92; 95% CI, 0.68-1.24). Meta-analysis showed that the use of bundle interventions was not associated with shortening the duration of ICU delirium (mean difference = -1.42 d; 95% CI, -3.06 to 0.22; two randomized clinical trials and one cohort study), increasing ventilator-free days (mean difference = 1.56 d; 95% CI, -1.56 to 4.68; three randomized clinical trials), decreasing mechanical ventilation days (mean difference = -0.83 d; 95% CI, -1.80 to 0.14; four randomized clinical trials and two cohort studies), ICU length of stay (mean difference = -1.08 d; 95% CI, -2.16 to 0.00; seven randomized clinical trials and two cohort studies), and inhospital mortality (risk ratio = 0.86; 95% CI, 0.70-1.06; five randomized clinical trials and four cohort studies). However, bundle interventions are effective in reducing the proportion of patient-days experiencing coma (risk ratio = 0.47; 95% CI, 0.39-0.57; two cohort studies), hospital length of stay (mean difference = -1.47 d; 95% CI, -2.80 to -0.15; four randomized clinical trials and one cohort study), and 28-day mortality by 18% (risk ratio = 0.82; 95% CI, 0.69-0.99; three randomized clinical trials).

Conclusions: This meta-analysis fails to support that bundle interventions are effective in reducing ICU delirium prevalence and duration, but supports that bundle interventions are effective in reducing the proportion of patient-days with coma, hospital length of stay, and 28-day mortality. Larger randomized clinical trials are needed to evaluate the impact of bundle interventions on ICU delirium and other clinical outcomes.
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http://dx.doi.org/10.1097/CCM.0000000000004773DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7803454PMC
February 2021

Effect of Enhanced Recovery After Surgery on Postoperative Recovery and Quality of Life in Patients Undergoing Laparoscopic Partial Nephrectomy.

Front Oncol 2020 14;10:513874. Epub 2020 Oct 14.

Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Patients who underwent laparoscopic partial nephrectomy from the First Affiliated Hospital of Nanjing Medical University from May 2016 to May 2019 were randomly divided into enhanced recovery after surgery (ERAS) and control groups. The clinical indicators, preoperative and postoperative anxiety, depression, and postoperative quality of life were compared between the two groups. The recovery time, hospitalization cost, incidence of complications, and postoperative anxiety of patients in the ERAS group were lower than those of the control group. The satisfaction during hospitalization, scores of physical function, role function, emotional function, and general health status of the ERAS group were also significantly increased. Applying the ERAS to patients undergoing laparoscopic partial nephrectomy can improve their prognosis, experience of medical treatment, and life quality after surgery as well as have certain economic advantages.
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http://dx.doi.org/10.3389/fonc.2020.513874DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7592390PMC
October 2020

Task-Related Systemic Artifacts in Functional Near-Infrared Spectroscopy

Annu Int Conf IEEE Eng Med Biol Soc 2020 07;2020:948-951

Functional near-infrared spectroscopy (fNIRS) has the potential to become the next common noninvasive neuroimaging technique for routine clinical use. Compared to the current standard for neuroimaging, functional magnetic resonance imaging (fMRI), fNIRS boasts several advantages which increase its likelihood for clinical adoption. However, fNIRS suffers from an intrinsic interference from the superficial tissues, which the near-infrared light must penetrate before reaching the deeper cerebral cortex. Therefore, the removal of signals captured by SS channels has been proposed to attenuate the systematic interference. This study aimed to investigate the task-related systemic artefacts, in a high-density montage covering the sensorimotor cortex. We compared the association between LS and SS channels over the contralateral motor cortex which was activated by a hand clenching task, with that over the ipsilateral cortex where no task-related activation was expected. Our findings provide important guidelines regarding how to removal SS signals in a high-density whole-head montage.
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http://dx.doi.org/10.1109/EMBC44109.2020.9176366DOI Listing
July 2020

Hydrogen sulfide-loaded microbubbles combined with ultrasound mediate thrombolysis and simultaneously mitigate ischemia-reperfusion injury in a rat hindlimb model.

J Thromb Haemost 2021 Mar 5;19(3):738-752. Epub 2021 Feb 5.

Department of Cardiology, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Background: Thromboembolism and subsequent ischemia/reperfusion injury (IRI) remain major clinical challenges.

Objectives: To investigate whether hydrogen sulfide (H S)-loaded microbubbles (hs-Mbs) combined with ultrasound (US) radiation (hs-Mbs+US) dissolve thrombi and simultaneously alleviate tissue IRI through local H S release.

Methods: hs-Mbs were manufactured and US-triggered H S release was recorded. White and red thromboembolisms were established ex vivo and in rats left iliac artery. All subjects randomly received control, US, Mbs+US, or hs-Mbs+US treatment for 30 minutes.

Results: H S was released from hs-Mbs+US both ex vivo and in vivo. Compared with control and US, hs-Mbs+US and Mbs+US showed comparable substantial decreases in thrombotic area, clot mass, and flow velocity increases for both ex vivo macrothrombi. In vivo, hs-Mbs+US and Mbs+US caused similarly increased recanalization rates, blood flow velocities, and hindlimb perfusion for both thrombi compared with the other treatments, with no obvious influence on hemodynamics, respiration, and macrophage vitality. More importantly, hs-Mbs+US substantially alleviated skeletal muscle IRI by reducing reactive oxygen species, cellular apoptosis, and proapoptotic Bax, caspase-3, and caspase-9 and increasing antiapoptotic Bcl-2 compared with other treatments. In vitro, hypoxia/reoxygenation-predisposed skeletal muscle cells and endothelial cells treated with normal saline solution exhibited similar trends, which were largely reversed by an H S scavenger or an inhibitor of Akt phosphorylation.

Conclusion: hs-Mbs+US effectively dissolved both white and red macrothrombi and simultaneously alleviated skeletal muscle IRI through the US-triggered, organ-specific release of H S. This integrated therapeutic strategy holds promise for treating thromboembolic diseases and subsequent IRI.
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http://dx.doi.org/10.1111/jth.15110DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7986145PMC
March 2021

Alternatives to the Kaplan-Meier estimator of progression-free survival.

Int J Biostat 2020 Sep 5. Epub 2020 Sep 5.

Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.

Progression-free survival (PFS), defined as the time from randomization to progression of disease or death, has been indicated as an endpoint to support accelerated approval of certain cancer drugs by the U.S. FDA. The standard Kaplan-Meier (KM) estimator of PFS, however, can result in significantly biased estimates. A major source for the bias results from the substitution of censored progression times with death times. Currently, to ameliorate this bias, several sensitivity analyses based on rather arbitrary definitions of PFS censoring are usually conducted. In addition, especially in the advanced cancer setting, patients with censored progression and observed death times have the potential to experience disease progression between those two times, in which case their true PFS time is actually between those times. In this paper, we present two alternative nonparametric estimators of PFS, which statistically incorporate survival data often available for those patients who are censored with respect to progression to obtain less biased estimates. Through extensive simulations, we show that these estimators greatly reduce the bias of the standard KM estimator and can also be utilized as alternative sensitivity analyses with a solid statistical basis in lieu of the arbitrarily defined analyses currently used. An example is also given using an ECOG-ACRIN Cancer Research Group advanced breast cancer study.
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http://dx.doi.org/10.1515/ijb-2019-0095DOI Listing
September 2020

[Clinical evaluation of mandibular impacted third molar removed without surgical flaps].

Shanghai Kou Qiang Yi Xue 2020 Apr;29(2):221-224

Department of Stomatology, Nanjing Integrated Traditional Chinese and Western Medicine Hospital, Affiliated Hospital of Nanjing University of Chinese Medicine. Nanjing 210014, China.

Purpose: To evaluate the effect of impacted mandibular third molars extracted without surgical flaps.

Methods: Ninety-eight patients with impacted mandibular third molars were collected. A total of 112 teeth were divided into non-surgical flap group and surgical flap group. In non-surgical flap group, the teeth were removed by transection method or T-shaped truncation method, and triangular flaps were designed in the surgical flap group. Postoperative complications at 1 day, 3 days, and 1 week after operation were recorded, and statistical analysis was performed using SPSS 17.0 software package.

Results: Complications such as hemorrhage, swelling, pain, mouth opening limitation and impact on daily life at postoperative 1 day and 3 day in non-surgical flap group were significantly lower than in surgical flap group (P<0.05).There was no significant difference in average operation time between the two groups (P>0.05).

Conclusions: Impacted mandibular third molar can be removed without surgical flaps in selected patients. It helps alleviate patients'postoperative complications and improve their quality of life.
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April 2020

Rescue of HSP70 in Spinal Neurons Alleviates Opioids-Induced Hyperalgesia via the Suppression of Endoplasmic Reticulum Stress in Rodents.

Front Cell Dev Biol 2020 12;8:269. Epub 2020 May 12.

Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China.

A major unresolved issue in treating pain is the paradoxical hyperalgesia produced by the gold-standard analgesic morphine and other opioids. Endoplasmic reticulum (ER) stress has been shown to contribute to neuropathic or inflammatory pain, but its roles in opioids-induced hyperalgesia (OIH) are elusive. Here, we provide the first direct evidence that ER stress is a significant driver of OIH. GRP78, the ER stress marker, is markedly upregulated in neurons in the spinal cord after chronic morphine treatment. At the same time, morphine induces the activation of three arms of unfolded protein response (UPR): inositol-requiring enzyme 1α/X-box binding protein 1 (IRE1α/XBP1), protein kinase RNA-like ER kinase/eukaryotic initiation factor 2 subunit alpha (PERK/eIF2α), and activating transcription factor 6 (ATF6). Notably, we found that inhibition on either IRE1α/XBP1 or ATF6, but not on PERK/eIF2α could attenuate the development of OIH. Consequently, ER stress induced by morphine enhances PKA-mediated phosphorylation of NMDA receptor subunit 1(NR1) and leads to OIH. We further showed that heat shock protein 70 (HSP70), a molecular chaperone involved in protein folding in ER, is heavily released from spinal neurons after morphine treatment upon the control of K channel. Glibenclamide, a classic K channel blocker that inhibits the efflux of HSP70 from cytoplasm to extracellular environment, or HSP70 overexpression in neurons, could markedly suppress morphine-induced ER stress and hyperalgesia. Taken together, our findings uncover the induction process and the central role of ER stress in the development of OIH and support a novel strategy for anti-OIH treatment.
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http://dx.doi.org/10.3389/fcell.2020.00269DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7243285PMC
May 2020

Acute Myeloid Leukemia iPSCs Reveal a Role for RUNX1 in the Maintenance of Human Leukemia Stem Cells.

Cell Rep 2020 06;31(9):107688

Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address:

Leukemia stem cells (LSCs) are believed to have more distinct vulnerabilities than the bulk acute myeloid leukemia (AML) cells, but their rarity and the lack of universal markers for their prospective isolation hamper their study. We report that genetically clonal induced pluripotent stem cells (iPSCs) derived from an AML patient and characterized by exceptionally high engraftment potential give rise, upon hematopoietic differentiation, to a phenotypic hierarchy. Through fate-tracking experiments, xenotransplantation, and single-cell transcriptomics, we identify a cell fraction (iLSC) that can be isolated prospectively by means of adherent in vitro growth that resides on the apex of this hierarchy and fulfills the hallmark features of LSCs. Through integrative genomic studies of the iLSC transcriptome and chromatin landscape, we derive an LSC gene signature that predicts patient survival and uncovers a dependency of LSCs, across AML genotypes, on the RUNX1 transcription factor. These findings can empower efforts to therapeutically target AML LSCs.
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http://dx.doi.org/10.1016/j.celrep.2020.107688DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7786450PMC
June 2020

Percutaneous recanalization of total saphenous vein graft occlusion with excimer laser treatment.

J Geriatr Cardiol 2020 Apr;17(4):234-240

Department of Cardiology, State Key Laboratory of Organ Failure Research, Nan Fang Hospital, Southern Medical University, Guangzhou, China.

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http://dx.doi.org/10.11909/j.issn.1671-5411.2020.04.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7189262PMC
April 2020

Therapeutic ultrasound combined with microbubbles improves atherosclerotic plaque stability by selectively destroying the intraplaque neovasculature.

Theranostics 2020 22;10(6):2522-2537. Epub 2020 Jan 22.

Department of Cardiology, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China.

: The current antiangiogenic therapy for atherosclerotic plaques was mainly achieved by the use of antiangiogenic drugs, but serious side effects have limited the clinical application. The present study investigated whether therapeutic ultrasound (TUS) treatment with appropriate pressure could selectively deplete the neovasculature in vulnerable plaques to improve its stability with no side effects on the body; the underlying mechanisms were also explored. : A mouse model of advanced atherosclerosis was generated by maintaining apolipoprotein E-deficient (ApoE-/-) mice on a hypercholesterolemic diet (HCD). Plaque, skeletal muscle, mesentery and skin tissue from 114 atheroma-bearing mice were subjected to sham therapy, an ultrasound application combined with microbubbles at four different ultrasound pressures (1.0, 2.0, 3.0, 5.0 MPa), or ultrasound at 5.0 MPa alone. Microvessel density (MVD) was assessed by immunofluorescence and immunohistochemical methods. The plaque necrotic center/fiber cap (NC/FC) ratio and vulnerability index were calculated to evaluate plaque vulnerability. Twenty-four hours after TUS treatment at 3.0 MPa, the MVD in the plaque was substantially decreased by 84% (p < 0.05), while there was almost no change in MVD and neovessel density (NVD) in normal tissues, including skeletal muscle, mesentery and skin. Additionally, a marked reduction in the number of immature vessels was observed in the plaques (reduced by 90%, p < 0.05), whereas the number of mature vessels was not significantly decreased. Furthermore, TUS treatment at 3.0 MPa significantly improved plaque stability, as reflected by the NC/FC ratio and vulnerability index, which may be due to the selective destruction of intraplaque neovascularization by TUS treatment, thereby decreasing the extravasation of erythrocytes and leading to vascular inflammation alleviation and thin-cap fibroatheroma reduction. : TUS treatment at 3.0 MPa selectively depleted plaque neovessels and improved the stability of vulnerable plaques through a reduction in erythrocyte extravasation and inflammatory mediator influx, with no significant effect on normal tissue.
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http://dx.doi.org/10.7150/thno.39553DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7052908PMC
February 2021

Excitatory VTA to DH projections provide a valence signal to memory circuits.

Nat Commun 2020 03 19;11(1):1466. Epub 2020 Mar 19.

Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, 60611, USA.

The positive or negative value (valence) of past experiences is normally integrated into neuronal circuits that encode episodic memories and plays an important role in guiding behavior. Here, we show, using mouse behavioral models, that glutamatergic afferents from the ventral tegmental area to the dorsal hippocampus (VTA→DH) signal negative valence to memory circuits, leading to the formation of fear-inducing context memories and to context-specific reinstatement of fear. To a lesser extent, these projections also contributed to opioid-induced place preference, suggesting a role in signaling positive valence as well, and thus a lack of dedicated polarity. Manipulations of VTA terminal activity were more effective in females and paralleled by sex differences in glutamatergic signaling. By prioritizing retrieval of negative and positive over neutral memories, the VTA→DH circuit can facilitate the selection of adaptive behaviors when current and past experiences are valence congruent.
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http://dx.doi.org/10.1038/s41467-020-15035-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081331PMC
March 2020

Fused azole-thiazolines via one-pot cyclization of functionalized N-heterocyclic carbene precursors.

Org Biomol Chem 2020 Apr 17;18(13):2487-2491. Epub 2020 Mar 17.

Department of Chemistry, National University of Singapore, 3 Science Drive 3, 117543 Singapore, Republic of Singapore.

A one-pot two-step methodology was exploited to synthesize fused thiazoline-azolium salts via reactions of bromoalkyl-azolium salts with KSCN and NaOH. The synthetic feasibility and versatility was demonstrated by the high yield (>80%) preparation of 13 salts with different backbones, linkers and substituents. Using methylpropionato as an N-protecting group, the resulting salts could be further derivatized to their neutral azole-thiazolines. The reaction sequence proceeds via (i) Br → SCN substitution, (ii) N-heterocyclic carbene formation, (iii) carbene attack of the S atom and CN displacement in the alkyl-S-C[triple bond, length as m-dash]N unit, and (iv) methyl acrylate elimination.
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http://dx.doi.org/10.1039/c9ob02548kDOI Listing
April 2020

Protective effects of curcumin against neuroinflammation induced by Aβ25-35 in primary rat microglia: modulation of high-mobility group box 1, toll-like receptor 4 and receptor for advanced glycation end products expression.

Ann Transl Med 2020 Feb;8(4):88

Department of Anesthesiology and Perioperative Medicine, Critical Care and Pain Medicine, The Second Affiliated Hospital & Yuying Children Hospital of Wenzhou Medical University, Wenzhou 325027, China.

Background: Activated microglia induced by amyloid-beta (Aβ) release proinflammatory cytokines that can induce neurotoxicity. High-mobility group box 1 protein (HMGB1) and HMGB1-mediated inflammatory responses have been attributed with memory impairment in patients with Alzheimer's disease (AD). There is accumulating evidence to suggest curcumin is a potent anti-inflammatory polyphenol. However, whether curcumin could effectively inhibit inflammation through the suppression of HMGB1 production or HMGB1-mediated inflammatory responses in Aβ-activated microglia is still unclear.

Methods: Primary microglia were prepared from the cerebral cortices of one- to three-day-old Sprague Dawley rats. The microglia were cultured and treated with Aβ 50 µM for 24 h to prove a toxic effect. Curcumin 10 µM was administrated 1 h before Aβ treatment. The levels of HMGB1, interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) in the culture medium were analyzed by ELISA. Western blotting was conducted to assess the expression level of toll-like receptor 4 (TLR4) and the receptor for advanced glycation end products (RAGE). In addition, PC12 cells were treated with conditioned medium from microglia treated with Aβ or Aβ and curcumin, and cell viability was subsequently assessed by MTT.

Results: Curcumin was found to significantly inhibit HMGB1 expression and release in Aβ-stimulated microglia. Pretreatment with curcumin reduced TLR4 and RAGE expression. Proinflammatory cytokines such as IL-1β and TNF-α were also remarkably reduced by curcumin. In addition, curcumin protected neurons from indirect toxicity mediated by Aβ-treated microglia.

Conclusions: Curcumin effectively inhibits Aβ-induced neuroinflammation in microglia, partly by suppressing the expression of HMGB1, TLR4, and RAGE.
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http://dx.doi.org/10.21037/atm.2019.12.147DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7048970PMC
February 2020

Splicing Characterization of Variants in Four Patients With Type III Bartter Syndrome.

Front Genet 2020 21;11:81. Epub 2020 Feb 21.

Department of Nephrology, Children's Hospital of Nanjing Medical University, Nanjing, China.

Objective: Type III Bartter syndrome (BS) is caused by loss-of-function mutations in the gene encoding basolateral chloride channel ClC-Kb (), and is characterized by hypokalemic metabolic alkalosis and hyperreninemic hyperaldosteronism. Here, we investigated the molecular defects in four Chinese children with clinical manifestations of Bartter syndrome.

Methods: The genomic DNA of the four patients was screened for gene variations using whole-exome sequencing (WES). The candidate variants were validated by direct Sanger sequencing. Quantitative PCR (qPCR) was subsequently performed to confirm the whole gene deletion mutation. A minigene assay and reverse transcription PCR (RT-PCR) were performed to analyze the effect of splice variants .

Results: Our patients showed early onset age with hyponatremia, hypokalemia, hypochloremia, repeated vomiting and growth retardation, suggesting Bartter syndrome. Genetic analysis revealed that all patients carried compound heterozygous or homozygous truncating variants in the gene. In particular, we identified a novel nonsense variant c.239G > A (p.(Trp80*)), two splice site variants (c.1053-1 G > A and c.1228-2A > G), a whole gene deletion, and a novel synonymous variant c.228A > C (p.(Arg76Arg)) which located -2 bp from the 5' splice donor site in exon 3. Furthermore, our minigene analysis revealed c.228A > C, c.1053-1G > A, and c.1228-2A > G cause the skipping of exon 3, exon 12, and exon 13, respectively.

Conclusion: Our results support that the whole gene deletion is the most common mutation in Chinese patients with type III BS, and truncating and whole gene deletion variants may account for a more severe phenotype of patients. We verified the pathogenic effect of three splicing variants (c.228A > C, c.1053-1G > A, and c.1228-2A > G) which disturbed the normal mRNA splicing, suggesting that splice variants play an important role in the molecular basis of type III BS, and careful molecular profiling of these patients will be essential for future effective personalized treatment options.
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http://dx.doi.org/10.3389/fgene.2020.00081DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7047732PMC
February 2020

Whole-brain electrophysiological functional connectivity dynamics in resting-state EEG.

J Neural Eng 2020 04 2;17(2):026016. Epub 2020 Apr 2.

Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, United States of America.

Objective: Functional connectivity (FC) dynamics have been studied in functional magnetic resonance imaging (fMRI) data, while it is largely unknown in electrophysiological data, e.g. EEG.

Approach: The present study proposed a novel analytic framework to study spatiotemporal dynamics of FC (dFC) in resting-state human EEG data, including independent component analysis, cortical source imaging, sliding-window correlation analysis, and k-means clustering.

Main Results: Our results confirm that major fMRI intrinsic connectivity networks (ICNs) can be successfully reconstructed from EEG using our analytic framework. Prominent spatial and temporal variability were revealed in these ICNs. The mean dFC spatial patterns of individual ICNs resemble their corresponding static FC (sFC) patterns but show fewer cross-talks among distinct ICNs. Our investigation unveils evidences of time-domain variations in individual ICNs comparable to their mean FC level in terms of magnitude. The major contributors to these variations are from the frequency below 0.0156 Hz, in the similar range of FC dynamics from fMRI data. Among different ICNs, larger temporal variabilities are observed in the frontal attention and auditory/visual ICNs, while sensorimotor, salience, and default model networks showed less. Our analytic framework for the first time revealed quasi-stable states within individual EEG ICNs, with various strengths or spatial patterns that were reliably detected at both group and individual levels. These states all together reveal a more complete picture of EEG ICNs: (1) quasi-stable state spatial patterns as a whole for each EEG ICN are more consistent with the corresponding fMRI ICN in terms of the bilateral distribution and multi-nodes structure; (2) EEG ICNs reveal more transient patterns about within-ICN between-node communications than fMRI ICNs.

Significance: The present findings highlight the fact that rich temporal and spatial dynamics exist in ICN that can be detected from EEG data. Future studies might extend investigations towards spectral dynamics of EEG ICNs.
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http://dx.doi.org/10.1088/1741-2552/ab7ad3DOI Listing
April 2020

Dynamic Activation Patterns of the Motor Brain Revealed by Diffuse Optical Tomography

Annu Int Conf IEEE Eng Med Biol Soc 2019 Jul;2019:6028-6031

Diffuse optical tomography (DOT), a subset of functional near-infrared spectroscopy (fNIRS), is a noninvasive functional imaging modality for studying the human brain in normal and diseased conditions. It measures changes in concentrations of oxygenated hemoglobin (HbO) and deoxygenated hemoglobin (Hb) in the blood vasculature of the brain. In contrast to functional magnetic resonance imaging (fMRI), the gold standard in human brain imaging, DOT offers the advantage of higher temporal resolution, portability, lower cost, multiple contrasts and usability for persons who cannot otherwise utilize MRI-based imaging modalities, including bedridden patients and infants, etc. The goal of the present study was to evaluate performance of a DOT method in studying dynamic patterns of brain activations involving motor control. CW-fNIRS data were acquired in four sessions from a healthy male participant when he performed a motor task in a block-design experiment. Results from experimental data showed pronounced activity in the primary motor cortex (M1), contralateral to the clenching hand. It was further observed that the M1 activity was consistent over four sessions. Furthermore, temporal dynamics of motor activity at each session further revealed well-sequenced activation patterns among M1, premotor cortex (PMC), and supplementary motor area (SMA). Timed ipsilateral motor activity suppression was also observed several seconds after the onset of contralateral M1 activity. More importantly, these temporal dynamics were similarly observed in all four sessions. These preliminary results suggest that the DOT method has the sensitivity, reliability, and spatio-temporal resolutions to study activities originated from the motor cortices. A full-scope evaluation and validation in more participants on the motor system can establish it as a promising neuroimaging tool to study, such as, infants at the risk of cerebral palsy or elders with Parkinson's due to its portability and usability in clinical environments.
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http://dx.doi.org/10.1109/EMBC.2019.8857370DOI Listing
July 2019

Superficial Fluctuations in Functional Near-Infrared Spectroscopy.

Annu Int Conf IEEE Eng Med Biol Soc 2019 Jul;2019:4779-4782

Functional near-infrared spectroscopy (fNIRS) is a non-invasive optical functional neuroimaging that has seen rapid development and increasing use in studying human brain under normal and diseased conditions. Compared with blood-oxygenation-level dependent functional magnetic resonance imaging (BOLD fMRI), fNIRS offers advantages including its low cost, portability and compatibility with implanted medical devices. Thus, fNIRS can be used to monitor brain activity particularly in infants, elders and patients who are unable to undergo routine fMRI scans. However, fNIRS suffers from its susceptibility to scalp and to systemic physiological noises. Fluctuations originated from heartbeat, respiration and low-frequency oscillations lead to contamination of cerebral activity. In order to tap the full potential of fNIRS, it is essential to eliminate these confounding noises from fNIRS measurements. Therefore, the present study aims to understand the underlying relationship between superficial signals and the compound signals respectively measured by short channels and long channels of fNIRS optodes in a whole head configuration. Our results reveal that: 1) 49.56% of total variances in long-channel data are contributed by a global component shared across all long channels; 2) this global component is significantly correlated with the superficial fluctuations extracted from short-channel data. Finally, our findings indicate that compound signals measured by long channels of fNIRS are contaminated by superficial fluctuations and that careful removal of these fluctuations from long-channel data is critical in obtaining accurate images of cerebral activity with fNIRS.
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http://dx.doi.org/10.1109/EMBC.2019.8856349DOI Listing
July 2019

Efficacy and safety of prophylactic use of ketamine for prevention of postanesthetic shivering: a systematic review and meta analysis.

BMC Anesthesiol 2019 12 30;19(1):245. Epub 2019 Dec 30.

Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 2210002, Jiangsu, China.

Background: Postanesthetic shivering is a common complication of anesthesia, which accounts for much discomfort in postoperative patients and may increase postoperative complications in high-risk patients. Due to the lack of high-quality evidence, it is difficult to draw a conclusion about optimal anti-shivering medication. The main purpose of this meta-analysis was to analyze and evaluate the efficacy and safety of prophylactic use of ketamine for preventing postanesthetic shivering.

Methods: We searched the following databases: Medline, Embase, and the Cochrane Central Register of Controlled Trails for randomized controlled trials. The primary outcome observed was the difference of the incidence rate of postanesthetic shivering between ketamine group and placebo group. The secondary outcomes were the sedation score and incidence of the side effects caused by ketamine and any other drugs utilized in the studies.

Results: In this meta-analysis, we analyzed a total of 16 trials including 1485 patients. Ketamine reduced the incidence rate of postanesthetic shivering compared to a placebo (odds ratio [OR]: 0.13, 95% confidence interval [CI]: 0.06 to 0.26, P<0.01). Regarding side effects, there was no evident variability of the incidence of nausea and vomiting. Usage of ketamine was associated with a lower rate of hypotension and bradycardia when compared to a placebo. Hallucinations were more frequently observed in patients who received higher doses of ketamine. No significant difference was found in the incidence of postanesthetic shivering with ketamine versus other pharmacological interventions.

Conclusions: Ketamine can prevent postanesthetic shivering without severe side effects. However, ketamine shows no advantage over other anti-shivering drugs.
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http://dx.doi.org/10.1186/s12871-019-0910-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937868PMC
December 2019

Effects of different doses of magnesium sulfate on pneumoperitoneum-related hemodynamic changes in patients undergoing gastrointestinal laparoscopy: a randomized, double-blind, controlled trial.

BMC Anesthesiol 2019 12 20;19(1):237. Epub 2019 Dec 20.

Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.

Background: The infusion of magnesium sulfate is well known to reduce arterial pressure and attenuate hemodynamic response to pneumoperitoneum. This study aimed to investigate whether different doses of magnesium sulfate can effectively attenuate the pneumoperitoneum-related hemodynamic changes and the release of vasopressin in patients undergoing laparoscopic gastrointestinal surgery.

Methods: Sixty-nine patients undergoing laparoscopic partial gastrectomy were randomized into three groups: group L received magnesium sulfate 30 mg/kg loading dose and 15 mg/kg/h continuous maintenance infusion for 1 h; group H received magnesium sulfate 50 mg/kg followed by 30 mg/kg/h for 1 h; and group S (control group) received same volume 0.9% saline infusion, immediately before the induction of pneumoperitoneum. Systemic vascular resistance (SVR), cardiac output (CO), mean arterial pressure (MAP), heart rate (HR), central venous pressure (CVP), serum vasopressin and magnesium concentrations were measured. The extubation time, visual analogue scale were also assessed. The primary outcome is the difference in SVR between different groups. The secondary outcome is the differences of other indicators between groups, such as CO, MAP, HR, CVP, vasopressin and postoperative pain score.

Results: Pneumoperitoneum instantly resulted in a significant reduction of cardiac output and an increase in mean arterial pressure, systemic vascular resistance, central venous pressure and heart rate in the control group (P <  0.01). The mean arterial pressure (T2 - T4) systemic vascular resistance (T2 - T3), central venous pressure(T3-T5) and the level of serum vasopressin were significantly lower (P <  0.05) and the cardiac output (T2 - T3) was significantly higher (P <  0.05) in group H than those in the control group. The mean arterial pressure (T4), systemic vascular resistance (T2), and central venous pressure(T3-T4) were significantly lower in group H than those in group L (P <  0.05). Furthermore, the visual analog scales at 5 min and 20 min, the level of vasopressin, and the dose of remifentanil were significantly decreased in group H compared to the control group and group L (P <  0.01).

Conclusion: Magnesium sulfate could safely and effectively attenuate the pneumoperitoneum-related hemodynamic instability during gastrointestinal laparoscopy and improve postoperative pain at serum magnesium concentrations above 2 mmol/L.

Trial Registration: The study was retrospectively registered at Chinese Clinical Trial Registry; the registration number is ChiCTR-IPD-17011145, principal investigator: D.Y. Q., date of registration: April 13, 2017.
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http://dx.doi.org/10.1186/s12871-019-0886-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6925413PMC
December 2019

The role of work resources between job demands and burnout in male nurses.

J Clin Nurs 2020 Feb 6;29(3-4):535-544. Epub 2019 Dec 6.

School of Nursing, The South Medical University, Guangzhou, China.

Aims And Objectives: To explore the regulation role of work resources in male nurses' job burnout and job demands.

Background: Burnout syndrome affects a wide range of nurses. Although burnout and turnover rate have drawn many researchers' attention, little is known of work characteristics that may cause a high burnout and turnover rate in male nurses.

Design: A survey design was used.

Method: A total of 366 male nurses in Guangzhou hospitals were included in this survey using the Burnout Scale (MBI-GS) and the Job demands Resources Scale. Data were processed by hierarchical regression analysis. (Followed the STROBE checklist) RESULTS: The male nurse's MBI score was (2.72 ± 1.02). Job demands affected the severity of male nurses' job burnout. Work resources are in a low level, especially at the social support, reward and skill diversity. The regression coefficients β of job demands, work resources and interaction items of job demands and work resources were 0.277, 0.314 and -0.006, respectively, and both passed the significance test (p < .01).). The new explanatory quantity ΔR after introducing the interaction between job demands and working resources was also statistically significant (ΔR  = 0.254, p < .01).

Conclusion: Male nurses are at a mild level of job burnout, and work resources are in shortage. Work resources play a regulating role in job demands and burnout.

Relevance To Clinical Practice: The mild burnout may be a surface phenomenon or was a sign of trend of male nurses' intention to leave the job. Managers should pay attention to the emotional needs and mental health problems of male nurses' work environment.
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http://dx.doi.org/10.1111/jocn.15103DOI Listing
February 2020

Battery-free, lightweight, injectable microsystem for in vivo wireless pharmacology and optogenetics.

Proc Natl Acad Sci U S A 2019 10 10;116(43):21427-21437. Epub 2019 Oct 10.

Department of Materials Science and Engineering, Northwestern University, Evanston, IL 60208;

Pharmacology and optogenetics are widely used in neuroscience research to study the central and peripheral nervous systems. While both approaches allow for sophisticated studies of neural circuitry, continued advances are, in part, hampered by technology limitations associated with requirements for physical tethers that connect external equipment to rigid probes inserted into delicate regions of the brain. The results can lead to tissue damage and alterations in behavioral tasks and natural movements, with additional difficulties in use for studies that involve social interactions and/or motions in complex 3-dimensional environments. These disadvantages are particularly pronounced in research that demands combined optogenetic and pharmacological functions in a single experiment. Here, we present a lightweight, wireless, battery-free injectable microsystem that combines soft microfluidic and microscale inorganic light-emitting diode probes for programmable pharmacology and optogenetics, designed to offer the features of drug refillability and adjustable flow rates, together with programmable control over the temporal profiles. The technology has potential for large-scale manufacturing and broad distribution to the neuroscience community, with capabilities in targeting specific neuronal populations in freely moving animals. In addition, the same platform can easily be adapted for a wide range of other types of passive or active electronic functions, including electrical stimulation.
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http://dx.doi.org/10.1073/pnas.1909850116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815115PMC
October 2019

Successful revascularization of right coronary artery chronic total occlusion by the antegrade and retrograde approaches.

AME Case Rep 2019 8;3:30. Epub 2019 Aug 8.

Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China.

The treatment of chronic total occlusion (CTO) of coronary arteries allowed for a remarkable improvement in success rates and is represented by the introduction of the "Hybrid algorithm". An inability to cross the occlusion with a guidewire is the most common cause of failure of CTO revascularization. As antegrade options are limited, intervention upon the extreme angulation of the coronary artery warrants a retrograde approach. Here, we report a 58-year-old man with symptoms of effort angina complicated with three-vessel disease and CTO of the right coronary artery (RCA). Left main artery bifurcation lesions were treated with systematic two-stent strategies and intervention upon RCA CTO after three months by means of a combination of the antegrade and retrograde approaches. The RCA was eventually revascularized by the implantation of stents, and no adverse events were observed during hospitalization.
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http://dx.doi.org/10.21037/acr.2019.06.01DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6736790PMC
August 2019