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This study aimed to investigate the effects of esketamine (Esk) combined with dexmedetomidine (Dex) on postoperative delirium (POD) and quality of recovery (QoR) in elderly patients undergoing thoracoscopic radical lung cancer surgery.
Methods
In this prospective, randomized, and controlled study, 172 elderly patients undergoing thoracoscopic radical lung cancer surgery were divided into two groups: the Esk + Dex group (n = 86) and the Dex group a (n = 86). The primary outcome was the incidence of POD within 7 days after surgery and the overall Quality of Recovery−15 (QoR − 15) scores within 3 days after surgery. Secondary outcomes included postoperative adverse reactions, extubation time, PACU stay, and hospitalization time. Serum levels of IL-6, IL-10, S100β protein, NSE, CD3+, CD4+, and CD8+ were detected from T0 to T5.
Results
Compared with the Dex group, the incidence of POD in the Esk + Dex group was significantly lower at 7 days after surgery (14.6% vs 30.9%; P = 0.013). The QoR − 15 score was significantly increased 3 days after surgery (P < 0.01). Levels of IL-6 and CD8+ were significantly decreased, and IL − 10 levels were significantly increased at T1-T2 (P < 0.05). At T1-T4, NSE levels were significantly decreased, while CD3+ and CD4+/CD8+ values were significantly increased (P < 0.01). At T1-T5, serum S100β protein concentration decreased significantly, and CD4+ value increased significantly (P < 0.01). The incidence of nausea/vomiting and hyperalgesia decreased significantly 48 hours after surgery (P < 0.01). The duration of extubation, PACU stay, and postoperative hospitalization were significantly shortened.
Conclusions
Esketamine combined with dexmedetomidine can significantly reduce the POD incidence and improve the QoR in patients undergoing thoracoscopic radical lung cancer surgery, which may be related to the improvement of cellular immune function.
A blunted hypothalamic–pituitary–adrenal (HPA) axis response to acute stress is associated with psychiatric symptoms. Although the prefrontal cortex and limbic areas are important regulators of the HPA axis, whether the neural habituation of these regions during stress signals both blunted HPA axis responses and psychiatric symptoms remains unclear. In this study, neural habituation during acute stress and its associations with the stress cortisol response, resilience, and depression were evaluated.
Methods
Seventy-seven participants (17–22 years old, 37 women) were recruited for a ScanSTRESS brain imaging study, and the activation changes between the first and last stress blocks were used as the neural habituation index. Meanwhile, participants' salivary cortisol during test was collected. Individual-level resilience and depression were measured using questionnaires. Correlation and moderation analyses were conducted to investigate the association between neural habituation and endocrine data and mental symptoms. Validated analyses were conducted using a Montreal Image Stress Test dataset in another independent sample (48 participants; 17–22 years old, 24 women).
Results
Neural habituation of the prefrontal cortex and limbic area was negatively correlated with cortisol responses in both datasets. In the ScanSTRESS paradigm, neural habituation was both positively correlated with depression and negatively correlated with resilience. Moreover, resilience moderated the relationship between neural habituation in the ventromedial prefrontal cortex and cortisol response.
Conclusions
This study suggested that neural habituation of the prefrontal cortex and limbic area could reflect motivation dysregulation during repeated failures and negative feedback, which might further lead to maladaptive mental states.
Methylation at DNA, RNA and protein levels plays critical roles in many cellular processes and is associated with diverse differentiation events, physiological activities and human diseases. To aid in the diagnostic and therapeutic design for cancer treatment utilising methylation, this review provides a boutique yet comprehensive overview on methylation at different levels including the mechanisms, cross-talking and clinical implications with a particular focus on cancers. We conclude that DNA methylation is the sole type of methylation that has been largely translated into clinics and used for, mostly, early diagnosis. Translating the onco-therapeutic and prognostic values of RNA and protein methylations into clinical use deserves intensive efforts. Simultaneous examination of methylations at multiple levels or together with other forms of molecular markers represents an interesting research direction with profound clinical translational potential.
Cognition and sleep deficits occur in amnestic mild cognitive impairment (aMCI) and vascular cognitive impairment-no dementia (VCIND). However, how memory and sleep deficits differ between aMCI and VCIND remains unclear.
Methods:
Fifty aMCI and 50 VCIND patients and 38 sex- and age-matched healthy controls (HCs) were administered the Hopkins Verbal Learning Test-Revised (HVLT-R), Trail Making Test-A/B (TMT-A/B), Wisconsin Card Sorting Test (WCST), Paced Auditory Serial Addition Test (PASAT), Symbol Digit Modalities Test (SDMT), Benton Judgment of Line Orientation (JLO) test, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Insomnia Severity Index (ISI) to quantify cognitive deficits and subjective sleep disturbance.
Results:
Compared with VCIND patients, aMCI patients had lower HVLT-R scores for total recall (p < 0.001), delayed recall (p < 0.001) and recognition (p = 0.001), and for total-recall (p = 0.002) and delayed-recall (p < 0.001) semantic clustering ratios (SCRs). However, VCIND patients exhibited more obvious executive dysfunction (TMT-A, p < 0.001; TMT-B, p < 0.001; WCST, p < 0.001), lower information processing speed (PASAT, p = 0.003; SDMT, p < 0.001), and more severe sleep disturbance (PSQI, p < 0.001; ESS, p < 0.001; ISI, p < 0.001). Additionally, sleep quality and efficiency were related to total and delayed recall (all r values from −0.31 to −0.60, p < 0.05) in aMCI and VCIND.
Conclusions:
aMCI and VCIND differ in cognitive function, memory strategy and sleep impairment; these characteristics are helpful to identify and distinguish patients with very early cognitive impairment. Our results also suggest that memory deficits are associated with sleep disturbance in aMCI and VCIND.
The distribution of the endemic threatened plant Camellia changii Ye (Family Theaceae) is restricted to a small area in southern China, and little else is known about its status in the wild. To provide information for the conservation of C. changii we investigated its distribution, population size and structure, and habitat, and assessed its conservation status. Surveys confirmed that the species grows in a narrow band along both sides of a 4 km long segment of a stream in Ehuangzhang Nature Reserve, under the discontinuous canopy of a secondary evergreen broadleaved forest on well-drained, acidic sandy loam soil. We found a total of 1,039 individuals of C. changii. The population has a high flowering rate but a low seed-setting rate. The population appears to be in decline because no seedlings and few young plants were evident. Our findings indicate that C. changii should be categorized as Critically Endangered on the IUCN Red List. We have recommended an integrated species-conservation plan for the species that includes patrolling the Ehuangzhang Nature Reserve to prevent plant removal, establishing an ex situ living collection that contains the entire wild genetic diversity (accomplished by grafting of short cuttings from all wild individuals), facilitating propagation for commercial use, and implementing reintroduction to augment the wild population.
By using the 1-m reflecting telescope at Weihai Observatory of Shandong University, the transit observations of seven stars are carried out to accurately estimate the physical parameters of extrasolar planets. Besides, a new high-resolution spectrograph (WES) was installed on this telescope for radial velocity measurements on exoplanets, we will show some preliminary results.
The aims of the present study were to examine the serum amino acid profiles in obese and non-obese women and investigate the relationships between the serum amino acids and inflammation and oxidative stress in a human case–control study. Serum amino acids, inflammatory biomarkers (C-reactive protein and IL-6) and oxidative biomarkers (superoxide dismutase, malondialdehyde and glutathione peroxidase) were measured and compared in 235 obese women and 217 non-obese controls. The relationships between serum amino acids and inflammatory and oxidative biomarkers were examined using multiple linear regression. Among the amino acids determined, serum histidine, arginine, threonine, glycine, lysine and serine were found to be significantly lower in obese women as compared to non-obese controls (P < 0·001). The difference was the greatest for histidine (P < 0·001). In obese women, both histidine and arginine were negatively associated with inflammation and oxidative stress. In non-obese controls, histidine was negatively associated with oxidative stress. The findings in this study indicate that the metabolism of amino acids is abnormal in obese women in whom histidine and arginine have close relationships with inflammation and oxidative stress.
The business meeting of Division X in the IAU 2009GA took place in three sessions during the day of August 6, 2009. The meeting, being well attended, started with the approval for the meeting agenda. Then the triennium reports were made in the first session by the president of Division X, Ren-Dong Nan, and by the chairs of three working groups: “Historic Radio Astronomy WG” by Wayne Orchiston, “Astrophysically Important Lines WG” by Masatoshi Ohishi, and “Global VLBI WG” by Tasso Tzioumis (proxy chair appointed by Steven Tingay). Afterwards, a dozen reports from observatories and worldwide significant projects have been presented in the second session. Business meeting of “Interference Mitigation WG” was located in the third session.
Division X provides a common theme for astronomers using radio techniques to study a vast range of phenomena in the Universe, from exploring the Earth's ionosphere or making radar measurements in the Solar System, via mapping the distribution of gas and molecules in our own Galaxy and in other galaxies, to study the vast explosive processes in radio galaxies and QSOs and the faint afterglow of the Big Bang itself.
Obstruction to the pulmonary venous return is a frequent associated anomaly in patients with isomerism of the right atrial appendages. Yet, preoperative diagnosis by means of either cross-sectional echocardiography or cardiac catheterization can be intriguing. Indeed, the presence of two morphologically right lungs reduce considerably the size of window for precordial echocardiography. Also, in the presence of severe pulmonary stenosis or atresia, it can be difficult at cardiac catheterization to enter the pulmonary trunk. In these patients, construction of a systemic-to-pulmonary artery anastomosis will almost inevitably result in pulmonary edema. Between May 1984 and December 1988, five patients with isomerism of the right atrial appendages, severely decreased pulmonary blood flow and concealed obstruction to the pulmonary venous return were admitted to our hospital. A modified Blalock Taussig shunt by interposition of a polytetrafluoroethylene prosthesis was performed in each patients and all of them developed pulmonary edema. Three patients died despite appropriate medical treatment. The remaining two patients were successfully treated by banding of the Blalock shunt. This was performed in the first patient at the time of the initial surgery, when prior to closure of chest, pulmonary edema became manifest. The second patient who developed pulmonary edema early postoperatively, underwent cardiac catheterization to confirm the clinical diagnosis of obstruction to the pulmonary venous return. Reduction of blood flow through the Blalock shunt with resolution of edema was initially achieved by means of a partially occluding balloon catheter. Pulmonary edema recurred one week later because of rupture of the balloon and the patient eventually underwent a successful banding of the Blalock shunt through a left thoracotomy. We conclude that preoperative assessment of the pulmonary venous return is mandatory in patients with right isomerism and reduced pulmonary blood flow. Construction of a modified Blalock-Taussig shunt in the presence of concealed obstruction to the pulmonary venous return will almost inevitably cause pulmonary edema. Banding of the Blalock shunt can be successful, as observed in our experience, for the management of this serious complication.
Division X provides a common theme for astronomers using radio techniques to study a vast range of phenomena in the Universe, from exploring the Earth's ionosphere or making radar measurements in the Solar System, via mapping the distribution of gas and molecules in our own Galaxy and in other galaxies, to study the vast explosive processes in radio galaxies and QSOs and the faint afterglow of the Big Bang itself.
Broadband near-infrared (IR) luminescence in transparent alkali gallium silicate glass-ceramics containing Ni2+-doped β-Ga2O3 nanocrystals was observed. This broadband emission could be attributed to the 3T2g (3F) → 3A2g (3F) transition of octahedral Ni2+ ions in glass-ceramics. The full width at half-maximum (FWHM) of the near-IR luminescence and fluorescent lifetime of the glass-ceramic doped with 0.10 mol% NiO were 260 nm and ∼1220 μs, respectively. It is expected that transparent Ni2+-doped β-Ga2O3 glass-ceramics with this broad near-IR emission and long fluorescent lifetime have potential applications as super-broadband optical amplification media.
There have been important advances in radio astronomy in the last three years. New discoveries both at the galactic and extragalactic scale have been reported over this period and we highlight here several of them. The outstanding results of the Wilkinson Microwave Anisotropy Probe satellite, allowing an accurate determination of the main cosmological constants, are certainly among the most important. At the international level, the consolidation of the Atacama Large Millimeter Array project, with participation of the USA, Europe, and Japan and an estimated cost of around one billion US dollars, takes the construction of radio telescopes to a new level of complexity and potential. We also include the Progress Report of the Working Group on Historic Radio Astronomy, that includes a description of the duties and activities of this recently created working group.
Aluminum oxynitride (AlON) is a nitrogen-stabilized defective spinel phase of alumina (y-Al2O3). Its structure has not been well understood so far. Solid-state27 Al magic-angle spinning nuclear magnetic resonance and quantum chemistry calculation are used to characterize y-Al2O3 and AMON ceramics in the present study. The resonance spectra clearly show different units (e.g. [AlN4], [AlO4] and [AlO6]) and vary with composition. The calculation shows that the vacancy located at octahedral site is more stable than that located at the tetrahedral site, and nitrogen atoms preferentially replace oxygen atoms in the tetrahedral site, which is in agreement with the experimental analysis by nuclear magnetic resonance.
Sendust is limited in its application due to its brittleness. This paper shows the brittleness of sendust ribbon made by rapid quenching can be improved by microalloying of boron with negligible influence on its magnetic properties. The mechanims of boron effect on its properties is discussed.
The compact steep spectrum radio sources, 3C119, 3C287 and 3C343, are identified with QSO'S of redshift 0.46, 1.055 and 0.988 and visual magnitude 20.0, 17.7 and 20.6 respectively. The overall physical extent of each source is −500 pc (Fanti et al. 1985, 1986). Here we present the results of new global VLBI 18 cm observations which have been combined with MERLIN data to improve the U-V coverage. The data were mapped using the CALTECH and AIPS software packages and also using OLAF software system developed in Jodrell Bank for 3C119 and 3C343.
A large fraction of sources in flux limited radio samples consists of compact steep spectrum (CSS) sources (Fanti et al. 1987). These objects have their dominant emission on kiloparsec scales and are found in a variety of active galaxies, including Seyfert II's, peculiar galaxies and quasars. Observations of very nearby CSS sources have shown good correlations between their complex radio structures and optical emission-line gas suggesting violent interactions between jets and dense gas in their ambient interstellar media (van Breugel et al. 1984). Similar jet/gas interactions may occur in more distant and more powerful CSS sources.
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