Search

Objective To analyze the impact factors for unplanned discontinuation of patient-controlled intravenous analgesia (PCIA) within 24 h after thoracic surgery so as to prevent over-use of medical resources. Methods Clinical data of patients with thoracic surgery in Peking Union Medical College Hospital from April 1, 2018 to March 31, 2019 were reviewed. Patients were divided into two groups according to the duration time from the start to the end of PCIA: group A(≤24 h) and group B(＞24 h). Univariate analysis and logistic multivariate regression were used to compare the demographic characteristics, anesthesia/surgery type, PCIA regimen and adverse effect between the two groups. Results A total of 371 patients were included in this study. Univariate analysis showed that the proportion of patients stopped PCIA in 24 hours was higher in female patients than that in male patients (16.8%/39.4%). The proportion of PCIA stop in 24 hours after thoracoscopic surgery was higher than that after thoracotomy (31.4%/19.7%). In PCIA, patients who used morphine were more likely to stop using postoperative PCIA within 24 hours than those who used oxycodone and sufentanil, and patients who used oxycodone were more likely to stop using PCIA within 24 hours than those who used sufentanil (60%/40.5%/25.3%). The proportion of patients who stopped using 5-HT3 receptor blocker in PCIA within 24 hours was lower than that of those who did not (14.9%/30.6%). Patients who were of sedation at the time of follow-up were less likely to stop using PCIA within 24 hours than those who did not have sedation (25.3%/41.8%). Patients who complained of postoperative nausea were more likely to stop using PCIA within 24 hours than those who did not(62.1%/17.3%).The proportion of patients with postoperative vomiting who stopped using PCIA within 24 hours was higher than those without postoperative vomiting (64%/22.1%). Logistic multivariate analysis showed that female, thoracoscopic surgery, intraoperative inhalation of nitrous oxide, postoperative nausea and postoperative vomiting were related with unplanned discontinuation of PCIA within 24 h after thoracic surgery. Conclusions For patients undergoing thoracic surgery,the application of postoperative PCIA should be comprehensively evaluated according to the patient's personal situation, surgery type, and the risk of postoperative nausea/vomiting.

Background: Schistosomiasis is a relatively neglected parasitic disease that afflicts more than 250 million people worldwide, for which the control strategy relies mainly on mass treatment with the only available drug, praziquantel (PZQ). This approach is not sustainable and is a priority for developing novel drug candidates for the treatment and control of schistosomiasis. Methodologys/Principal findings: In our previous study, we found that DW-3-15, a kind of PZQ derivative, could significantly downregulate the expression of the histone acetyltransferase of Schistosoma japonicum (SjHAT). In this study, several commercially available HAT inhibitors, A485, C646 and curcumin were screened in vitro to verify their antischistosomal activities against S. japonicum juveniles and adults. Parasitological studies and scanning electron microscopy were used to study the primary action characteristics of HAT inhibitors in vitro. Quantitative real-time PCR was employed to detect the mRNA level of SjHAT after treatment with different HAT inhibitors. Our results demonstrated that curcumin was the most effective inhibitor against both juveniles and adults of S. japonicum, and its schistosomicidal effects were time- and dose dependent. However, A485 and C646 had limited antischistosomal activity. Scanning electron microscopy demonstrated that in comparison with DW-3-15, curcumin caused similar tegumental changes in male adult worms. Furthermore, both curcumin and DW-3-15 significantly decreased the SjHAT mRNA level, and curcumin dose-dependently reduced the SjHAT expression level in female, male and juvenile worms. Conclusions: Among the three commercially available HATs, curcumin was the most potent against schistosomes. Both curcumin and our patent compound DW-3-15 markedly downregulated the expression of SjHAT, indicating that SjHAT may be a potential therapeutic target for developing novel antischistosomal drug candidates. Author summary: Schistosomiasis is a zoonotic parasitic disease caused by Schistosoma spp. infection. Due to the lack of effective vaccines for schistosomiasis, PZQ is the only available drug chosen for the treatment and control of schistosomiasis in most developing countries. Drug resistance due to long-term, large-scale and single-agent use has been a great concern. Therefore, there is an urgent need for new therapies. In our previous study, we developed the patented compound DW-3-15 (patent no. ZL201110142538.2), which has significant and stable antiparasitic activity, and can significantly decrease the expression of S. japonicum histone acetyltransferase (SjHAT). As we known, HATs are a class of epigenetic enzymes that are crucial for chromatin restructuring and transcriptional regulation in mammals and in parasitic development, and are thus promising targets for antischistosomal therapeutic development. In this study, we assessed three commercial HATs, including two selective p300/CBP inhibitors A485 and C646, and one natural compound, curcumin. Our results demonstrated that curcumin had the most potent worm-killing efficacy against S. japonicum juveniles and adults. In contrast, A485 and C646 displayed no effects on adult worms or mild effects on juveniles. Moreover, curcumin caused severe damage to the tegument of male worms, and the damage was similar to that of DW-3-15. Coincidentally, both curcumin and DW-3-15 significantly downregulated the expression of SjHAT, indicating that SjHAT might be an effective target for the development of novel therapeutic drugs. The screening and identification of selective HAT inhibitors may be a promising strategy for developing novel antischistosomal agents. [ABSTRACT FROM AUTHOR]

Abilities to encode and remember events in their spatiotemporal context (episodic memory) rely on brain regions that mature late during childhood and are supported by sleep. We compared the temporal dynamics of episodic memory formation and the role of sleep in this process between 62 children (8-12 years) and 57 adults (18-37 years). Subjects recalled "what-where-when" memories after a short 1-hr retention interval or after a long 10.5-hr interval containing either nocturnal sleep or daytime wakefulness. Although children showed diminished recall of episodes after 1 hr, possibly resulting from inferior encoding, unlike adults, they showed no further decrease in recall after 10.5 hr. In both age groups, episodic memory benefitted from sleep. However, children's more effective offline retention was unrelated to sleep.

In the chemistry community, catalytic asymmetric synthesis of furan‐based compounds bearing both axial and central chirality has proven to be a significant but challenging issue owing to the importance and difficulty in constructing such frameworks. In this work, we have realized the first catalytic asymmetric synthesis of five‐five‐membered furan‐based compounds bearing both axial and central chirality via organocatalytic asymmetric (2+4) annulation of achiral furan‐indoles with 2,3‐indolyldimethanols with uncommon regioselectivity. By this strategy, furan‐indole compounds bearing both axial and central chirality were synthesized in high yields with excellent regio‐, diastereo‐, and enantioselectivities. Moreover, theoretical calculations were conducted to provide an in‐depth understanding of the reaction pathway, activation mode, and the origin of the selectivity. [ABSTRACT FROM AUTHOR]

Objectives: To investigate whether the integration of high‐frequency ultrasound (HFUS) to routine clinical examinations could improve diagnostic performance and management decision for pigmented skin tumors. Methods: Three general practitioners trained previously and a dermatologist independently assessed pigmented skin tumors and rendered management decision based on clinical examinations alone or clinical examinations integrating HFUS. Results: After integrating HFUS, the diagnostic area under the curve (AUC) (0.658–0.693 versus 0.848, all P <.05) and specificity (46.6–58.6% versus 89.7%, all P <.05) for pigmented skin malignancies were improved for general practitioners, meanwhile unnecessary biopsy rate reduced (42.9–53.6% versus 10.7%, P <.001). To the dermatologist, the diagnostic AUC (0.822 versus 0.949, P <.001), sensitivity (81.7% versus 96.7%, P =.012) and specificity (0.828 versus 0.931, P =.031) improved significantly, meanwhile both missed biopsy rate (14.5% versus 4.8%, P =.031) and unnecessary biopsy rate (19.6% versus 7.1%, P =.016) decreased. Additionally, the diagnostic performance of the general practitioner with integrating HFUS could be comparable with the dermatologist based on clinical examinations alone (all P >.05). Conclusions: As a complementary tool of clinical examinations, HFUS could help physicians differentiate pigmented skin malignancies and manage decision. [ABSTRACT FROM AUTHOR]

The utilization of water elite genetic resources to develop new wheat varieties is an effective approach to deal with the challenges of climate change and rapid population growth. The MYB (v-myb avian myeloblastosis viral oncogene homolog) transcription factors are one of the largest families of transcription factors in plants and are involved in plant growth and development and in the regulation of biotic and abiotic stresses. In this study, 19 SNPs and 15 SNPs were identified in TaPHRi-4A and TaPHRi-4B, respectively, and the molecular markers were developed based on these SNPs. Association analysis showed that Hap-4B-I was the elite haplotype with high Total number of spikelet per spike (NCS). Hap-4B-I was further confirmed to be beneficial for improving wheat spike traits by creating two backcross introgression population lines. Fluorescence quantitative polymerase chain reaction of TaPHRi revealed that the relative expression level of TaPHRi genes in young spikelets of Hap-4B-I haplotype was higher than that of Hap-4B-II haplotype. In addition, the heterologous expression of TaPHRi in rice resulted in more panicle branches, which also confirmed the involvement of TaPHRI in the regulation of NCS. The geographic and temporal distribution of wheat modern varieties revealed that although Hap-4B-II accounted for the largest proportion of modern varieties in China, the proportion of Hap-4B-I was gradually increasing as wheat breeding time progressed. In conclusion, TaPHRI was a positive regulator of NCS in wheat. Therefore, the molecular markers developed in this study could be an important source of marker-assisted selection and genetic improvement in wheat. [ABSTRACT FROM AUTHOR]

Sucrose synthase (SUS) is one of the most important enzymes catalysing the synthesis and cleavage of sucrose, and it also plays a crucial role in multiple plant biological processes. However, SUS has been scarcely reported in banana which accumulates large amounts of starch in its fruit. In this genome-wide study on banana, nine SUS genes were identified in each of the two subgenomes (A and B) for the first time, which were clustered into three distinct groups. Those in the group II underwent further duplications. In the transcriptome analysis of Baxijiao (BX, AAA) and Fenjiao (FJ, ABB) banana, four MaSUSs (MaSUS-2.1, -2.2, -2.3, and -3.2) and five MbSUSs (MbSUS-2.1, -2.2, -2.3, -2.4, and -3.2) were expressed during fruit development, with MaSUS2.2/MbSUS2.2 being the most highly expressed. Transient overexpression of MaSUS2.2 resulted in a significant increase in its transcription, which was consistent with significantly enhanced starch content in banana fruits. Its function was further identified by its transient silencing expression in banana fruit discs, which led to a significant reduction in total starch content. Taken together, the results show that multiple SUS genes, especially SUS2.2, play an important role in starch accumulation in banana fruit. [ABSTRACT FROM AUTHOR]