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OBJECTIVE Stellate ganglion block (SGB) is a commonly used sympathetic nerve block technique that may have benefits for patients with aneurysmal subarachnoid hemorrhage (aSAH) in the early stage. Cerebral vasospasm (CVS), one of the most common complications of aSAH, is accompanied by an abnormal increase in cerebral blood flow velocity (CBFV) and neurological dysfunction. In this pilot study the authors sought to determine the feasibility of early SGB for CVS in aSAH patients by observing the incidence of symptomatic CVS. METHODS Prior to receiving surgical treatment, patients with aSAH were randomly assigned to the SGB group or the non-SGB group. The primary outcome was the incidence of symptomatic CVS within 14 ± 2 days after the onset of aSAH. As a higher CBFV is often associated with CVS and a poor prognosis, the mean CBFV of the middle cerebral artery was observed immediately after surgery and on postoperative days 1, 2, 3, 5, and 7. Other secondary outcomes included transcranial Doppler (TCD)/CTA-type CVS, delayed cerebral ischemia during hospitalization, new cerebral infarction within 3 months, adverse events (AEs), and clinical prognosis. RESULTS Symptomatic CVS occurred in 40% of patients in the non-SGB group and in 20% in the SGB group (RR 0.50, 95% CI 0.22–1.16). Continuous TCD sonography revealed that the postoperative mean CBFV was lower in the SGB group than in the non-SGB group (F = 3.608, p = 0.02). In addition, the percentages of patients with CVS evaluated by TCD (TCD-CVS) and total new infarctions within 3 months were also significantly lower than those in patients with CVS (TCD-CVS 36.7% vs 70%, RR 0.52, 95% CI 0.31–0.89, and total new infarctions 26.7% vs 53.3%, RR 0.50, 95% CI 0.25–0.99). In terms of AEs and mortality, there were no significant differences between the two groups. CONCLUSIONS This pilot study demonstrated for the first time, to the authors’ knowledge, that early SGB is feasible and has the potential to reduce the risk of CVS and improve the prognosis of aSAH. This method may be a new treatment for patients with aSAH that may have more advantages than traditional therapeutic drugs and is worth further study. Clinical trial registration no.: NCT04691271 (ClinicalTrials.gov)

There is continued controversy regarding the optimal anesthetic technique for endovascular therapy in patients with acute posterior circulation ischemic stroke. To compare the clinical outcomes general anesthesia (GA) and non-GA, we performed a systematic review and meta-analysis of randomized controlled trials and observational studies focused on the anesthetic management for endovascular therapy in patients with acute posterior circulation stroke, without language restriction. In addition, we compared clinical outcomes among the studies with different non-GA types (conscious sedation or local anesthesia). Outcome variables were functional independence, excellent outcomes, favorable outcomes, mortality, successful recanalization, hemodynamic instability, intracerebral hemorrhage, and respiratory or vascular complications. Eight studies including 1777 patients were identified. Although GA was associated with a lower odds of functional independence at 90 days (odds ratio [OR]: 0.55; 95% confidence interval [CI] 0.38 to 0.81; P=0.009), substantial heterogeneity was noted (I2=65%). Subgroup analysis showed that GA was associated with higher odds of mortality than conscious sedation (OR: 1.83; 95% CI, 1.30 to 2.57; I2=0%), but there was no difference between GA and local anesthesia (I2=0%). Interestingly, subgroup analysis did not identify a relationship between functional independence and GA compared with local anesthesia (OR: 0.90; 95% CI, 0.64 to 1.25; P=0.919; I2=0%). This meta-analysis demonstrates that GA is associated with worse outcomes in patients with acute posterior circulation stroke undergoing endovascular therapy based on current studies.

This study examined the internal mechanism of miR-210-3p/CELF2 in LUSC. Expression data of mRNAs and miRNAs in LUSC were acquired from TCGA and subjected to differential expression analysis. qRT-PCR was applied to examine miR-210-3p and CELF2 expression. Besides, western blot was utilized to evaluate protein expression of CELF2 and PI3K/AKT pathway-related proteins. Dual-luciferase reporter analysis was conducted to validate targeting relationship between miR-210-3p and CELF2. Additionally, CCK-8, colony formation, transwell and flow cytometry were employed to respectively test proliferation, migration, invasion abilities and cell cycle distribution. Xenograft tumor models were used to evaluate the influence of miR-210-3p and CELF2 on tumor growth. MiR-210-3p was highly expressed, while CELF2 was less expressed in LUSC cells. Besides, miR-210-3p could downregulate CELF2 expression. Cell functional assay verified that miR-210-3p accelerated aggressive behaviors of LUSC cells. Additionally, rescue assay suggested that miR-210-3p downregulated CELF2 level to stimulate LUSC cell phenotypes and cell cycle progression through PI3K/AKT pathway. Moreover, miR-210-3p/CELF2 stimulated the tumor growth in vivo. To sum up, miR-210-3p modulated CELF2 expression, thus affecting cell phenotypes and cell cycle distribution in LUSC through PI3K/AKT pathway.

Background Perioperative pain management is one of the most challenging issues for patients with spinal neoplasms. Inadequate postoperative analgesia usually leads to severe postsurgical pain, which could cause patients to suffer from many other related complications. Meanwhile, there is no appropriate analgesic strategy for patients with spinal neoplasms. Methods/design This is a protocol for a randomized double-blind controlled trial to evaluate the effect of esketamine combined with pregabalin on postsurgical pain in spinal surgery. Patients aged 18 to 65 years scheduled for spinal neoplasm resection will be randomly allocated into the combined and control groups in a 1:1 ratio. In the combined group, esketamine will be given during the during the surgery procedure until 48-h postoperative period, and pregabalin will be taken from 2 h before the surgery to 2 weeks postoperatively. The control group will receive normal saline and placebo capsules at the same time points. Both groups received a background analgesic regimen by using patient-controlled intravenous analgesia (containing 100 μg sufentanil and 16 mg ondansetron) until 2 days after surgery. To ensure the accuracy and reliability of this trial, all the researchers and patients will be blinded until the completion of this study. The primary outcome will be the proportion of patients with acute moderate-to-severe postsurgical pain (visual analog scale, VAS ≥ 40, range: 0–100, with 0, no pain; 100, the worst pain) during the 48-h postoperative period. The secondary outcomes will include the maximal VAS scores (when the patients felt the most intense pain over the last 24 h before being interviewed) at 0–2 h, 2–24 h, 24–48 h, and 48–72 h after leaving the operating room and 24 h before discharge; the incidence of acute moderate-to-severe postsurgical pain at each other time point; chronic postsurgical pain assessment; neuropathic pain assessment; and the incidence of drug-related adverse events and other postoperative complications, such as postoperative delirium and postoperative nausea and vomiting (PONV). Discussion The aim of this study was to evaluate the effect of esketamine combined with pregabalin on acute postsurgical pain in patients undergoing resection of spinal neoplasms. The safety of this perioperative pain management strategy will also be examined. Trial registration ClinicalTrials.gov NCT05096468. Registered on October 27, 2021

Introduction Stellate ganglion block has been reported to expand cerebral vessels and alleviate vasospasm after aneurysmal subarachnoid hemorrhage. However, the causal relationship between early stellate ganglion block and cerebral vasospasm prevention has not yet been established. Methods/design This is a single-center, prospective, randomized, controlled, blinded-endpoint assessment trial to explore the effectiveness and safety of early stellate ganglion block as a preventive treatment for cerebral vasospasm and delayed cerebral ischemia. A total of 228 patients will be randomized within 48 h of aneurysmal subarachnoid hemorrhage onset in a 1:1 ratio to two groups with an additional e-SGB or only a camouflaging action before craniotomy aneurysm clipping. The primary efficacy outcome is the incidence of symptomatic vasospasm within 14 days after aSAH. Further safety and efficacy parameters include the incidence of radiographic vasospasm, new cerebral infarction, postoperative delirium, and complications up to 90 days, postoperative cerebral hemodynamics, mini-mental state examination, the modified Rankin scale and all-cause mortality up to 90 days.Discussion This is the first randomized controlled trial to explore the effectiveness and safety of early stellate ganglion block as a preventive treatment to reduce cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage. If the result is positive, it may provide a new direction for the prevention and treatment of cerebral vasospasm and delayed cerebral ischemia.Trial registration ClinicalTrials.gov NCT04691271

The mTOR pathway serves an important role in the development of insulin resistance induced by obesity. Exercise improves obesity‑associated insulin resistance and hepatic energy metabolism; however, the precise mechanism of this process remains unknown. Therefore, the present study investigated the role of rapamycin, an inhibitor of mTOR, on exercise‑induced expression of hepatic energy metabolism genes in rats fed a high‑fat diet (HFD). A total of 30 male rats were divided into the following groups: Normal group (n=6) fed chow diets and HFD group (n=24) fed an HFD for 6 weeks. The HFD rats performed exercise adaptation for 1 week and were randomly divided into the four following groups (each containing six rats): i) Group of HFD rats with sedentary (H group); ii) group of HFD rats with exercise (HE group); iii) group of HFD rats with rapamycin (HR group); and iv) group of HFD rats with exercise and rapamycin (HER group). Both HE and HER rats were placed on incremental treadmill training for 4 weeks (from week 8‑11). Both HR and HER rats were injected with rapamycin intraperitoneally at the dose of 2 mg/kg once a day for 2 weeks (from week 10‑11). All rats were sacrificed following a 12‑16 h fasting period at the end of week 11. The levels of mitochondrial and oxidative enzyme activities, as well as of the expression of genes involved in energy metabolism were assessed in liver tissues. Biochemical assays and oil red staining were used to assess the content of hepatic triglycerides (TGs). The results indicated that exercise, but not rapamycin, reduced TG content in the liver of HFD rats. Further analysis indicated that rapamycin reduced the activity of cytochrome c oxidase, but not the activities of succinate dehydrogenase and β‑hydroxyacyl‑CoA dehydrogenase in the liver of HFD rats. Exercise significantly upregulated the mRNA expression of peroxisome proliferator‑activated receptor γ coactivator 1 β, while rapamycin exhibited no effect on the mRNA expression levels of hepatic transcription factors associated with energy metabolism enzymes in the liver of HFD rats. Collectively, the results indicated that exercise reduced TG content and upregulated mitochondrial metabolic gene expression in the liver of HFD rats. Moreover, this mechanism may not involve the mTOR pathway.

In this study, the migration characteristics and environmental risk of heavy metals (HMs) during the thermal dechlorination process of fly ash (FA) are investigated. The influence of dechlorination...

In this study, we develop a better understanding of the mechanisms by which corporate environmental ethics influences performance through the adoption of substantive actions. The empirical results of a moderated mediating analysis show that firms with higher environmental ethics are more likely to implement green marketing programs, consisting of the green production, pricing, distribution, and promotion programs and then improve firm performance. It is also observed that closure mechanism negatively moderates the mediation effect of green marketing programs because it leads to low trust and unwillingness to internal cooperation. These findings indicate that the value of corporate environmental ethics could not be determined in a vacuum, both strategy and people do matter when pursuing environmentally driven performance.

In the advancement of photonics technologies, all-optical systems are highly demanded in ultrafast photonics, signal processing, optical sensing, and communication. All-optical devices are the core elements to visualize the next generation of photonics integration systems and optical interconnection. As a result, the venture of new optoelectronic materials that able to cater to different optical properties is a highlighted research direction in photonics technologies. The emerging of two-dimensional (2D) black phosphorus (BP) has provided great potential in the evolution of photonics technologies. Owing to the optical properties of 2D materials, including unique mechanical, electronic, photonic, and thermal anisotropy, tunable and direct bandgap, and high mobility of an energy bandgap, third-order nonlinearity, nonlinear absorption, and the thermo-optics coefficient can be a tailor for different types of optical applications. Since the past decade, the explorations of 2D materials in photonics applications have to extend to all-optical modulators, all-optical switches, and all-optical wavelength converters that covered visible and near-infrared wavelength range. Herein, we review all-optical devices based on the 2D layer materials, especially BP from principle, synthesis, and its device and application. Finally, we commented on the perspectives and challenges on the future of the potential applications of 2D materials.

Clinically available near-infrared spectroscopy (NIRS) devices use two to five wavelengths of light to measure the relative amounts of oxyhemoglobin and deoxyhemoglobin in tissue to determine tissue hemoglobin oxygen saturation (StO2). In addition to StO2, broadband NIRS devices (using hundreds of wavelengths of light) may be able to measure the oxidation state of mitochondrial cytochrome aa3 (Cytox) which reflects the subcellular energetic state. We hypothesize that broadband NIRS devices can measure Cytox independent of changes in hemoglobin saturation. In this prospective non-randomized study, 20 male Sprague-Dawley rats (300 g) were anesthetized with isoflurane, tracheally intubated, and ventilated with 100% O2 containing 2% isoflurane. They were subsequently instrumented with a broadband NIRS device that used a halogen light source coupled to an emitting fibreoptic cable. Three receiving fibreoptic cables were utilized; one analyzed the light source and the other two were directed at the base of the skull. Each receiving fibre was connected to a spectrometer to measure light intensity. Sodium cyanide (NaCN) 5 mg·kg−1 iv was injected in order to produce cytochrome aa3 reduction. Two to three minutes after injection, oxygen was eliminated and 100% nitrogen (i.e., anoxia) was used for ventilation in order to induce a reduction in both cytochrome aa3 and hemoglobin desaturation. Changes in the cytochrome oxidation state and hemoglobin oxygenation were calculated using a broadband algorithm and compared before and after both the NaCN and anoxia interventions. The NaCN injection resulted in a decrease in median [interquartile range (IQR)] deoxyhemoglobin (−0.014 [−0.29 to −0.005] arbitrary units [AU]; P < 0.001), an increase in oxyhemoglobin (0.013 [−0.011 to 0.031] AU; P < 0.001), and a reduction in cytochrome aa3 (−0.015 [−0.020 to −0.011] AU; P < 0.001). Anoxia resulted in an increase in median [IQR] deoxyhemoglobin (0.13 [0.11 to 0.18] AU; P < 0.001), a decrease in oxyhemoglobin (−0.17 [−0.22 to −0.15] AU; P < 0.001), and a reduction in cytochrome aa3 (−0.04 [−0.06 to −0.03] AU; P < 0.001). Broadband NIRS can effectively measure the directionality of changes in both Cytox and StO2 by uncoupling the cytochrome and hemoglobin signals through inhibition of the electron transport chain and anoxia.

Background Dexmedetomidine, a sedative agent, provides neuroprotection when administered during or before brain ischaemia. This study was designed to determine whether dexmedetomidine post-treatment induces neuroprotection against subarachnoid haemorrhage (SAH) and the mechanisms for this effect. Methods Subarachnoid haemorrhage was induced by endovascular perforation to the junction of the right middle and anterior cerebral arteries in adult rats. Dexmedetomidine was applied immediately or 2 h after onset of SAH. Neurological outcome was evaluated 2 days after SAH. Right frontal cortex area 1 was harvested 24 h after SAH for western blotting. Results Subarachnoid haemorrhage reduced neurological scores and increased brain oedema and blood–brain barrier permeability. These effects were attenuated by dexmedetomidine post-treatment. Neuroprotection by dexmedetomidine was abolished by PD98095, an inhibitor of extracellular signal-regulated kinase (ERK) activation. Phospho-ERK, the activated form of ERK, was increased by dexmedetomidine; this activation was inhibited by PD98095. Conclusions Dexmedetomidine post-treatment provides neuroprotection against SAH. This effect appears to be mediated by ERK.

bObjective:/bTo evaluate the efficiency and safety of endoscopic trans-fistula drainage (ETFD) for gastroesophageal anastomotic fistula with para-fistula abscess after esophagectomy.bMethods:/bAmong 456 esophageal cancer patients receiving esophagectomy between February 2012 and February 2017 in Sir Run Run Shaw Hospital, 15 cases were diagnosed as gastroesophageal anastomotic fistula with para-fistula abscess after surgery. Seven cases received ETFD treatment (ETFD group), and 8 cases received conventional treatment (control group). Recovery of inflammatory markers and fistula, length of hospital stay after esophagectomy and total medical expenses were compared between ETFD group and control group.bResults:/bAll patients recovered in ETFD group. Time of white cell count returning to normal and decline of C-reactive protein, time of fistula healing and length of hospital stay after esophagectomy in ETFD group were significantly shorter than those of control group (alliP/i0.05). And medical expenses in ETFD group was also lower (iP/i0.05).bConclusion:/bETFD is effective and safe for gastroesophageal anastomotic fistula with para-fistula abscess after esophagectomy.

Objectives:Transfusing RBCs stored for longer than 14 days (old RBC) in humans is common. This transfusion can injure organs, such as lungs and kidneys. We determined whether transfusion with old RBC injured brain.Design:Prospective, controlled animal study.Setting:University research laboratory.Sub

Dexmedetomidine is often used in anesthesia and critical care medicine practice to sedate patients. Its neuroprotective effects have been shown in various ischemic and hemorrhagic brain injury models of animals. Randomized clinical trials have indicated that dexmedetomidine can improve outcome of patients under intensive care. Clinical trials are needed to determine whether dexmedetomidine can provide neuroprotection against ischemic and hemorrhagic stroke.

Clinically available near-infrared spectroscopy (NIRS) devices use two to five wavelengths of light to measure the relative amounts of oxyhemoglobin and deoxyhemoglobin in tissue to determine tissue hemoglobin oxygen saturation (StOIn this prospective non-randomized study, 20 male Sprague-Dawley rats (300 g) were anesthetized with isoflurane, tracheally intubated, and ventilated with 100% OThe NaCN injection resulted in a decrease in median [interquartile range (IQR)] deoxyhemoglobin (-0.014 [-0.29 to -0.005] arbitrary units [AU]; P0.001), an increase in oxyhemoglobin (0.013 [-0.011 to 0.031] AU; P0.001), and a reduction in cytochrome aaBroadband NIRS can effectively measure the directionality of changes in both Cyt

An in vitro regeneration system with a 100% efficiency rate was developed in peppermint [Mentha x piperita] using 5- to 7-mm-long second internode stem segments of 3-wk-old stock plants. Shoots developed at sites of excision on stem fragments either directly from the cells or via primary calluses. The optimal medium for maximum shoot initiation and regeneration contained Murashige and Skoog (MS) salts, B5 vitamins, thidiazuron (TDZ, 11.35 μM), ZT (4.54 μM), 10% coconut water (CW), 20 g l−1 sucrose, 0.75% agar, adjusted to pH 5.8. A frequency of 100% shoot initiation was achieved, with an average of 39 shoots per explant. This regeneration system is highly reproducible. The regenerated plants developed normally and were phenotypically similar to Black Mitcham parents.

This paper presents a 6-bit phase shifter for UHF RFID application. An unbalanced H-network attenuator is adopted to improve the linearity for handling the large cancelling signal and simultaneously achieve impedance matching. A newly-modified encoding, which can reduce three quarters of digital standard cells, is proposed. Based on a standard 0.18-μm CMOS technology, simulated results illustrate that the rms phase error and gain error are less than 0.21° and 0.3 dB over the 0.8-1 GHz band. The input P1dB is large than 10 dBm at all phase-control states. The total current consumption is 1.0 mA with a 3.3 V supply voltage.

This paper presents three different low-power CMOS transceivers (TRx) for ZigBee, RFID and BLE designed at USTC. These TRx are compatible with three different IEEE standards. Firstly a highly integrated low-power 2.4GHz TRx with a low-IF receiver for IEEE 802.15.4 WPAN is briefed. Next, the TRx for Bluetooth Low Energy BLE 4.0 in standard 130nm CMOS is presented. Then, a low power UHF RFID Reader transceiver based on self-jammer cancellation is introduced.

This paper describes a wideband LNA with linearity enhancement and noise improvement covering the frequency range of 0.2–5 GHz. The double capacitive cross-coupling technique is employed to exploit transconductance nonlinearity cancellation and improve the noise performance at low frequency. The proposed LNA is simulated in a standard 0.13-μm CMOS technology. The LNA achieves an input-referred third-order intercept point of 9–11.5 dBm, a noise figure of 2.74–3.58 dB, a voltage gain of 17.0–19.2 dB, and an input impedance matching of less than −10 dB along the entire band. The power consumption is only 3.0 mW with a 1.5 V power supply.

In this paper, we examine Voltage Controlled Oscillator (VCO) design techniques to be used in different transmitter applications. These transmitters, with their unique specifications such as fast oscillation start-up, fast locking or proper capacitor bank design, require different VCO design considerations. We first look at a fast on-off LC-VCO used to realize OOK IR-UWB transmitter. It is implemented in 0.18μm CMOS process and achieves 2Mbps at 236μW power consumption. Next, we examine injection locking LC-VCO employed to achieve efficient QPSK/O- QPSKB modulation. Through proper capacitor bank design, an EVM of 6.4% has been demonstrated at data rate of 50Mbps with the low reported energy efficiency of 118pJ/bit. The area consumption is only 0.28mm2 in 0.18μm CMOS process.

This paper reports an ultra-low power received signal strength indicator (RSSI) for low frequency (LF) wake-up receiver. Topology theory analysis and subthreshold operation are performed to lower power consumption. Each gain stage of the subthreshold limiting amplifier (LA) employs cascade diode-connected loads to obtain high output impedance while maintaining low power. An offset cancelation circuit with different tail currents, which also operates in the subthreshold region, is employed to reduce the DC offset voltage. Unbalanced source-coupled pairs of subthreshold devices adopted in the full-wave rectification are optimized. A 45[Formula: see text]dB input dynamic range and [Formula: see text][Formula: see text]dB indicating error are achieved at 125[Formula: see text]KHz frequency. The prototype occupies an active area of 0.39[Formula: see text][Formula: see text][Formula: see text]0.28[Formula: see text]mm using CSMC 0.153-[Formula: see text]m complementary metal-oxide-semiconductor (CMOS) technology. With a 1.8[Formula: see text]V supply voltage, the overall current consumption is only 6[Formula: see text][Formula: see text]A.

According to the current problems in software reliability, the factors that affect the reliability of software products and the causes of software failure are analyzed in the paper. Matlab Linear regression function is used in a simple model which can predict software reliability. The results show that the model is not only easy but also valid.

In this paper, we use the 4He+—H elastic recoil detection to measure the hydrogen content with depth and to study the hydrogen incorporation with oxygen in semi‐insulating polysilicon (SIPOS) film; we also show that the Si—H bond stretching‐vibration frequencies from both infrared measurements and calculations of electronegativity, then discuss the behavior and the role of hydrogen in the SIPOS film.

Using porous silicon as a sacrificial layer with a large distance from the structure to the substrate, the porous Si micromachining is a new generation surface micromachining technology. A sketch of the special self-made 3-cavity electrochemical device used for anodisation and a detailed description of the porous film formation parameters were given int his paper. Anodisation is performed with current density 40 mA/cm2 for 60 minutes. Formation parameters and amounts of several major impurities of porous-Si layer are studied. The porous-Si layer was removed in 1 percent KOH and then the flow channel with depth of 50 micrometers was formed. A 0.2 micrometers Ni-Cr thin film was deposited and patterned on the Si3N4+ poly-Si microbridge as a thermistor. The analysis model was introduced and met quite well with the experiment. The results of the fast response and low power dissipation are reported in this paper.© (1996) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.