Intravenous analgesics for pain management in postoperative patients: a comparative study of their efficacy and adverse effects

Purpose: To compare the effectiveness of post-operative pain management and associated adverse effects of ketamine and nefopam.Methods: In total, 78 American Society of Anesthesiologists (ASA) grade 1 and 2 patients who had undergone abdominal surgery were given 3 mg of intravenous (IV) morphine as post-operative analgesia. Patients who still had pain were randomly selected (n = 48) and separated into three groups, and infused with isotonic saline (n = 15), 3 mg/kg/h ketamine (n = 17), or 3 mg/kg nefopam (n = 16), respectively. Verbal rating scale (VRS), visual analogue scale (VAS), satisfactory scores, and total morphine consumption, as well as several adverse events were determined.Results: VRS and VAS scores, and morphine consumption were significantly lower (p < 0.05) in the entire analgesic group than in the saline group. However, ketamine appeared to provide better (p < 0.05) analgesic activity. The satisfactory score was concomitantly elevated (p < 0.05) in the ketamine group. Moreover, the occurrence of adverse events was substantially lower (p < 0.05) in the ketamine group and was equivalent to nefopam group except sedation.Conclusion: The combination of ketamine with morphine provides optimal pain relief in abdominal surgery patients and show fewer adverse effects than nefopam, thus achieving overall better satisfaction.Keywords: Post-operative pain, Abdominal surgery, Adverse effects, Morphine, Ketamine, Nefopa

2,2′-(1,10-Phenanthrolin-2-ylimino)di­ethanol

In the title compound, C16H17N3O2, symmetry-related mol­ecules are linked into one-dimensional chains along the a axis by a combination of inter­molecular O—H⋯N and O—H⋯O hydrogen bonds and weak π–π stacking inter­actions with a centroid–centroid distance of 3.5494 (12) Å

Adaptive Self-Occlusion Behavior Recognition Based on pLSA

Human action recognition is an important area of human action recognition research. Focusing on the problem of self-occlusion in the field of human action recognition, a new adaptive occlusion state behavior recognition approach was presented based on Markov random field and probabilistic Latent Semantic Analysis (pLSA). Firstly, the Markov random field was used to represent the occlusion relationship between human body parts in terms an occlusion state variable by phase space obtained. Then, we proposed a hierarchical area variety model. Finally, we use the topic model of pLSA to recognize the human behavior. Experiments were performed on the KTH, Weizmann, and Humaneva dataset to test and evaluate the proposed method. The compared experiment results showed that what the proposed method can achieve was more effective than the compared methods

Roles of Pro- and Anti-Inflammatory Cytokines in the Pathogenesis of SLE

SLE is an autoimmune inflammatory disease in which various pro- and anti-inflammatory cytokines, including TGF-β, IL-10, BAFF, IL-6, IFN-α, IFN-γ, IL-17, and IL-23, play crucial pathogenic roles. Virtually, all these cytokines can be generated by both innate and adaptive immune cells and exert different effects depending on specific local microenvironment. They can also interact with each other, forming a complex network to maintain delicate immune homeostasis. In this paper, we elaborate on the abnormal secretion and functions of these cytokines in SLE, analyze their potential pathogenic roles, and probe into the possibility of them being utilized as targets for therapy

Effect of a poloxamer 407-based thermosensitive gel on minimization of thermal injury to diaphragm during microwave ablation of the liver.

AIM: To assess the insulating effect of a poloxamer 407 (P407)-based gel during microwave ablation of liver adjacent to the diaphragm. METHODS: We prepared serial dilutions of P407, and 22.5% (w/w) concentration was identified as suitable for ablation procedures. Subsequently, microwave ablations were performed on the livers of 24 rabbits (gel, saline, control groups, n = 8 in each). The P407 solution and 0.9% normal saline were injected into the potential space between the diaphragm and liver in experimental groups. No barriers were applied to the controls. After microwave ablations, the frequency, size and degree of thermal injury were compared histologically among the three groups. Subsequently, another 8 rabbits were injected with the P407 solution and microwave ablation was performed. The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN) and creatinine (Cr) in serum were tested at 1 d before microwave ablation and 3 and 7 d after operation. RESULTS: In vivo ablation thermal injury to the adjacent diaphragm was evaluated in the control, saline and 22.5% P407 gel groups (P = 0.001-0.040). However, there was no significant difference in the volume of ablation zone among the three groups (P \u3e 0.05). Moreover, there were no statistical differences among the preoperative and postoperative gel groups according to the levels of ALT, AST, BUN and Cr in serum (all P \u3e 0.05). CONCLUSION: Twenty-two point five percent P407 gel could be a more effective choice during microwave ablation of hepatic tumors adjacent to the diaphragm. Further studies for clinical translation are warranted

Associations of retinol-binding protein 4 with oxidative stress, inflammatory markers, and metabolic syndrome in a middle-aged and elderly Chinese population

BACKGROUND: Retinol-binding protein 4 (RBP4), a novel adipokine secreted by adipocytes and the liver, has elevated levels in type 2 diabetes mellitus (T2DM). However, its association with human metabolic diseases remains controversial. The present study was designed to investigate the associations of plasma RBP4 levels with oxidative stress, inflammatory markers, and metabolic syndrome (MetS) in a Chinese population. METHOD: We evaluated plasma RBP4 levels in a cross-sectional sample of 1748 Chinese men and women aged 50 to 70 years in Guangzhou using an in-house developed and validated sandwich ELISA. Plasma glucose, insulin, lipid profile, serum adiponectin, adipocyte fatty acid-binding protein (A-FABP), 8-iso-prostaglandin F2α (8-iso PGF2α), 13-(S)-hydroxyoctadecadienoic acid (13-HODE), high-sensitivity C-reactive protein (hsCRP), interleukin 6 (IL6), monocyte chemotactic protein 1 (MCP1) and tumor necrosis factor α (TNFα) were all measured. MetS was defined according to the updated National Cholesterol Education Program Adult Treatment Panel III criteria for Asian Americans. RESULTS: Circulating RBP4 levels were positively correlated with A-FABP (r = 0.104, P < 0.001), 8-iso PGF2α (0.236, P < 0.001), and 13-HODE (0.204, P < 0.001) and were inversely correlated with HDL cholesterol (r = −0.072, P = 0.004). After multivariable adjustment, the RBP4 levels were strongly associated with MetS and its components. The ORs (95% CIs) for the comparisons of the extreme quartiles of RBP4 were 3.46 (2.87, 4.42) for MetS, 5.92 (4.47, 8.02) for hypertriglyceridemia, 1.42 (1.11, 1.68) for reduced HDL cholesterol, 1.87 (1.48, 2.36) for central obesity and 2.74 (2.15, 3.36) for hyperglycemia (all P < 0.001). When we further controlled for adipokines, markers of oxidative stress and proinflammatory response, the association of RBP4 with central obesity was abolished but not the association with other MetS components. CONCLUSIONS: Plasma RBP4 levels are associated with an adverse profile of oxidative stress and inflammatory markers and an increased risk of MetS in this Chinese population. These associations are independent of conventional risk factors

Activation of Nlrp3 Inflammasomes Enhances Macrophage Lipid-Deposition and Migration: Implication of a Novel Role of Inflammasome in Atherogenesis

Although Nlrp3 inflammasome activation in macrophages has been shown to be critical for the development of atherosclerosis upon atherogenic stimuli, it remains unknown whether activated Nlrp3 inflammasomes by other non-atherogenic stimuli induce alterations in macrophages that may contribute in the concert with other factors to atherogenesis. Thus, the present study tested the hypothesis that activation of Nlrp3 inflammasomes by ATP, which is a classical non-lipid danger stimulus, enhances the migration of macrophage and increases lipids deposition in macrophages accelerating foam cell formation. We first demonstrated that extracellular ATP (2.5 mM) markedly increased the formation and activation of Nlrp3 inflammasomes in bone marrow macrophages (BMMs) from wild type (Asc+/+) mice resulting in activation of caspase-1 and IL-1β production. In these Asc+/+ macrophages, such stimulation of inflammasomes by non-lipid ATP was similar to those induced by atherogenic stimuli such as cholesterol crystals or 7-ketocholesterol. Both non-lipid and lipid forms of stimuli induced formation and activation of Nlrp3 inflammasomes, which were prevented by Asc gene deletion. Interestingly, Asc+/+ BMMs had dramatic lipids accumulation after stimulation with ATP. Further, we demonstrated that large amount of cholesterol was accumulated in lysosomes of Asc+/+ BMMs when inflammasomes were activated by ATP. Such intracellular and lysosomal lipids deposition was not observed in Asc−/− BMMs and also prevented by caspase-1 inhibitor WEHD. In addition, in vitro and in vivo experiments revealed that migration of Asc+/+ BMMs increased due to stimulation of Nlrp3 inflammasomes, which was markedly attenuated in Asc−/− BMMs. Together, these results suggest that activation of Nlrp3 inflammasomes remarkably increases the susceptibility of macrophages to lipid deposition and their migration ability. Such novel action of inflammasomes may facilitate entry or retention of macrophages into the arterial wall, where they form foam cells and ultimately induce atherosclerosis

Structured Generation and Exploration of Design Space with Large Language Models for Human-AI Co-Creation

Thanks to their generative capabilities, large language models (LLMs) have become an invaluable tool for creative processes. These models have the capacity to produce hundreds and thousands of visual and textual outputs, offering abundant inspiration for creative endeavors. But are we harnessing their full potential? We argue that current interaction paradigms fall short, guiding users towards rapid convergence on a limited set of ideas, rather than empowering them to explore the vast latent design space in generative models. To address this limitation, we propose a framework that facilitates the structured generation of design space in which users can seamlessly explore, evaluate, and synthesize a multitude of responses. We demonstrate the feasibility and usefulness of this framework through the design and development of an interactive system, Luminate, and a user study with 8 professional writers. Our work advances how we interact with LLMs for creative tasks, introducing a way to harness the creative potential of LLMs