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ImportancePostoperative ileus is common after abdominal surgery, and small clinical studies have reported that intraoperative administration of dexmedetomidine may be associated with improvements in postoperative gastrointestinal function. However, findings have been inconsistent and study samples have been small. Further examination of the effects of intraoperative dexmedetomidine on postoperative gastrointestinal function is needed.ObjectiveTo evaluate the effects of intraoperative intravenous dexmedetomidine vs placebo on postoperative gastrointestinal function among older patients undergoing abdominal surgery.Design, setting, and participantsThis multicenter, double-blind, placebo-controlled randomized clinical trial was conducted at the First Affiliated Hospital of Anhui Medical University in Hefei, China (lead site), and 12 other tertiary hospitals in Anhui Province, China. A total of 808 participants aged 60 years or older who were scheduled to receive abdominal surgery with an expected surgical duration of 1 to 6 hours were enrolled. The study was conducted from August 21, 2018, to December 9, 2019.InterventionsDexmedetomidine infusion (a loading dose of 0.5 μg/kg over 15 minutes followed by a maintenance dose of 0.2 μg/kg per hour) or placebo infusion (normal saline) during surgery.Main outcomes and measuresThe primary outcome was time to first flatus. Secondary outcomes were postoperative gastrointestinal function measured by the I-FEED (intake, feeling nauseated, emesis, physical examination, and duration of symptoms) scoring system, time to first feces, time to first oral feeding, incidence of delirium, pain scores, sleep quality, postoperative nausea and vomiting, hospital costs, and hospital length of stay.ResultsAmong 808 patients enrolled, 404 were randomized to receive intraoperative dexmedetomidine, and 404 were randomized to receive placebo. In total, 133 patients (60 in the dexmedetomidine group and 73 in the placebo group) were excluded because of protocol deviations, and 675 patients (344 in the dexmedetomidine group and 331 in the placebo group; mean [SD] age, 70.2 [6.1] years; 445 men [65.9%]) were included in the per-protocol analysis. The dexmedetomidine group had a significantly shorter time to first flatus (median, 65 hours [IQR, 48-78 hours] vs 78 hours [62-93 hours], respectively; P

With the rapid development of mobile Internet,smart terminal has become an indispensable part of people’s daily life and work.In the process of using smart terminal,a large number of APP operation process records will be generated.By analyzing the user’s APP operation process records,the user’s behaviors in the operation process and the user’s behavior pattern can be obtained,which can help developers maintain and improve the APP software.Existing user behavior analysis is biased towards operation analysis and thebehaviors extraction for user’s operation is lacked.An APP user behaviors analysis method based on convolution neural network is proposed.At first,the APP operations are analyzed,and the user operations in the original APP operation record information are extracted.Then the correlation between APP operation and user’s behaviors is mined,and the similarity matrix between APP operations and APP user’s behaviors is constructed.Finally,the behaviors of users will be extracted.Experiments show that this method can extract and identify the user’s behaviors in the records of APP operationprocess effectively,which will be helpful to explore the deep meaning of user’s behaviors.

Myocardial ischemia/reperfusion (I/R) injury greatly contributes to myocardial tissue damage in patients with coronary disease, which eventually leads to heart failure. Long noncoding RNAs (lncRNAs) have an emerging role in the process of myocardial I/R injury. Our previous work revealed the protective role of miR‐374a‐5p against myocardial I/R injury. In this study, we explored the role of lncRNA TTTY15 and its potential interaction mechanisms with miR‐374a‐5p in myocardial I/R injury. The expression of TTTY15 was increased both in vitro and in vivo after myocardial I/R injury models according to quantitative real‐time polymerase chain reaction. Various assays were conducted to evaluate the regulatory relationship among TTTY15, miR‐374a‐5p, FOXO1, and autophagy in H9c2 and HL‐1 cells. The results showed that TTTY15 suppresses autophagy and myocardial I/R injury by targeting miR‐374a‐5p. We found that TTTY15 regulates miR‐374a‐5p, thus affecting FOXO1 expression and autophagy in myocytes during I/R. Furthermore, in an in vivo mouse model of myocardial I/R injury, suppression of TTTY15 successfully alleviated myocardial I/R injury. Our results reveal a novel feedback mechanism in which TTTY15 regulates miRNA processing and a potential target in myocardial I/R injury. TTTY15 is a promising therapeutic target for treating myocardial I/R injury. [ABSTRACT FROM AUTHOR]

Our current understanding of the Cambrian carbon cycle mostly comes from geologically rapid carbon isotope excursions (CIEs) of marine carbonate. In addition to carbon cycle indicators, stable carbon isotopes of marine carbonates can be used as stratigraphic correlation tools. Previous studies have recognized 10 CIEs in the Cambrian, but only 3 of them appear to have global significance. This limits the application of CIEs in chronostratigraphic correlation of Cambrian successions with the 10 successive stages. Here, we present a continuous carbon isotope record from a stratigraphically complete Cambrian section at Xiaoerbulak, Aksu region in the Tarim Basin, Xinjiang, China. Its comparison with more than 40 sections across the world shows the carbon isotope record of the Cambrian can be divided into 10 units based on the variation patterns. Each pattern has occurrences in at least two Cambrian tectonic plates, suggesting global significance. A generalized curve consisting of the 10 patterns, Carbon Isotope Pattern Curve (CIPC) has been compiled. Based on the fossil records, the 10 patterns are correlated with the 10 stages of the chronostratigraphic system of the Cambrian. The pattern Angularianis correlated with Fortunian Stage and the lower half of Stage 2, Dampingian with the upper part of Stage 2, Boxian with Stage 3, Rabbitian with Stage 4, Chairian with the lower half of Wuliuan, Zigzagian with the upper Wuliuan Stage, Stickian with the Drumian and Guzhangian stages, Towerian with the Paibian Stage and Lower Jiangshan Stage, Shelfian with Upper Jiangshan Stage and the lower half of Stage 10, and Hillian with the upper half of Stage 10.We suggest that the application of CIPC makes the chronostratigraphy of non‐fossiliferous successions realizable. [ABSTRACT FROM AUTHOR]