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Objective To compare the analgesic effect of nalbuphine and sufentanil in preventing catheter-related bladder discomfort (CRBD) after transurethral ureteroscopic lithotripsy. Methods A total of 158 male patients undergoing transurethral ureteroscopic lithotripsy with general anesthesia, classified with American Society of Anesthesiologists (ASA) physical status as grade Ⅰ to Ⅲ, aged from 25 to 65 years old, were selected as subjects. Patients were randomly divided into two groups with 79 in each group: nalbuphine group (group N) and sufentanil group (group S). Patients in group N were treated with 0.2 mg/kg nalbuphine, while those in group S were treated with 0.2 μg/kg sufentanil at the induction of general anesthesia. The other procedures and drugs for anesthesia induction and maintenance were same in two groups. The frequency and severity of CRBD postoperatively, Ramsay sedation score, respiratory depression and postoperative nausea and vomiting were examined at 0 min (T0), 10 min(T1), 20 min (T2), 30 min (T3), and 1 h (T4) after recovery from general anesthesia. Results The incidence of CRBD at T3 and T4 were significantly higher than that at T0 in two groups. Compared with group S, the incidence and severity of CRBD were significantly lower in group N at T3(P＜0.05), and the Ramsay sedation score was higher in group N at T3 (P＜0.05). However, the incidence of postoperative adverse reactions was not significantly different between the two groups. Conclusions Nalbuphine used for induction of general anesthesia, can effectively reduce the incidence and severity of CRBD in male patients after transurethral ureteroscopic lithotripsy during anesthesia recovery period with fewer adverse reactions.

Considering that many hydrological analysis methods compare and analyze the runoff before and after the construction of the reservoir, without restoring the measured data of the hydrological station, in this case, when the length of the measured data series is short, the evaluation results will be affected. In this article, based on the runoff reduction of stations affected by water conservancy projects, an improved range of variability approach (RVA) which can be applied to 1-year hydrological change analysis is proposed by coupling the hydrological variation index with the appropriate upper and lower limit theory of RVA. As Jialing river watershed is selected as the research area, the runoff depth of Beibei station is reduced, and then the improved RVA is employed to analyze the degree of change in river water regime. It is concluded that the change degree of overall hydrological index in Beibei station is high, and the prediction of variation of water regime of Beibei station can be made with the aid of simulating the operation of cascade reservoirs, with the inflow of Beibei station in flood season to reduce, and the inflow in dry season to increase. The example verifies the effectiveness of the improved RVA method, and the analysis results can provide a reference for the adjustment of the operation mode of upstream cascade reservoirs.

Background: Coronavirus disease 2019 (COVID-19) may predispose patients to thrombotic disease in the venous and arterial circulations. Methods: Based on the current debate on antiplatelet therapy in COVID-19 patients, we performed a systematic review and meta-analysis to investigate the effect of antiplatelet treatments. We searched PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science on February 1, 2023, and only included Randomized clinical trials. The study followed PRISMA guidelines and used Random-effects models to estimate the pooled percentage and its 95% CI. Results: Five unique eligible studies were included, covering 17,950 patients with COVID-19. The result showed no statistically significant difference in the relative risk of all-cause death in antiplatelet therapy versus non-antiplatelet therapy (RR 0.94, 95% CI, 0.83–1.05, P = 0.26, I2 = 32%). Compared to no antiplatelet therapy, patients who received antiplatelet therapy had a significantly increased relative risk of major bleeding (RR 1.81, 95%CI 1.09–3.00, P = 0.02, I2 = 16%). The sequential analysis suggests that more RCTs are needed to draw more accurate conclusions. This systematic review and meta-analysis revealed that the use of antiplatelet agents exhibited no significant benefit on all-cause death, and the upper bound of the confidence interval on all-cause death (RR 95% CI, 0.83–1.05) suggested that it was unlikely to be a substantiated harm risk associated with this treatment. However, evidence from all RCTs suggested a high risk of major bleeding in antiplatelet agent treatments. Conclusion: According to the results of our sequential analysis, there is not enough evidence available to support or negate the use of antiplatelet agents in COVID-19 cases. The results of ongoing and future well-designed, large, randomized clinical trials are needed. [ABSTRACT FROM AUTHOR]

Vascular endothelial growth factor receptor 2 (VEGFR2)/KDR plays a critical role in tumor growth, diffusion, and invasion. The amino acid sequence homology of KDR between mouse and human in the VEGF ligand‐binding domain was low, thus the WT mice could not be used to evaluate Abs against human KDR, and the lack of a suitable mouse model hindered both basic research and drug developments. Using the CRISPR/Cas9 technique, we successfully inserted different fragments of the human KDR coding sequence into the chromosomal mouse Kdr exon 4 locus to obtain an hKDR humanized mouse that can be used to evaluate the marketed Ab ramucirumab. In addition, the humanized mAb VEGFR‐HK19 was developed, and a series of comparative assays with ramucirumab as the benchmark revealed that VEGFR‐HK19 has higher affinity and superior antiproliferation activity. Moreover, VEGFR‐HK19 selectively inhibited tumor growth in the hKDR mouse model but not in WT mice. The most important binding epitopes of VEGFR2‐HK19 are D257, L313, and T315, located in the VEGF binding region. Therefore, the VEGFR2‐HK19 Ab inhibits tumor growth by blocking VEGF‐induced angiogenesis, inflammation, and promoting apoptosis. To our best knowledge, this novel humanized KDR mouse fills the gaps both in an animal model and the suitable in vivo evaluation method for developing antiangiogenesis therapies in the future, and the newly established humanized Ab is expected to be a drug candidate possibly benefitting tumor patients. [ABSTRACT FROM AUTHOR]