Comparison of efficacy and safety of general anesthesia alone with those of combined epidural/general anesthesia in Chinese patients with gastric cancer undergoing laparoscopy-assisted tumor resection

Purpose: To compare postoperative opioid consumption, inflammatory response, survival/clinical outcomes and safety profile of epidural combined with general anesthesia (GA) versus GA in stage 1 gastric cancer patients undergoing surgical intervention by laparoscopy.Method: Chinese patients with early-stage gastric cancer undergoing laparoscopic-assisted tumor resection were enrolled and received either epidural combined with general anesthesia (group EA + GA) or general anesthesia only (group GA) in allocation ratio of 1:1. The following efficacy variables were assessed: 1) Pain score was measured on VAS scale; 2) post-operative consumption; 3) Quality of recovery; 4) inflammatory response; and 5) survival outcome. Safety was assessed throughout the study period.Results: Data for 200 subjects were analyzed. Compared to GA alone, combination of EA + GA demonstrate significantly greater reduction in post-operative pain with decrease postoperative opioid consumption. Also, the combination of GA and EA inhibited inflammatory response when compared to patients who received GA only. Moreover, the combination of GA and EA did not demonstrate any clinical benefit in survival outcome, when compared to patients who received GA alone, indicating that GA + EA has no role in improving survival outcome among patients undergoing gastric cancer surgery. Additionally, EA + GA was also associated with a shorter length of hospital stay, compared to GA.Conclusion: Overall, the results favor the use of GA + EA in Chinese patients with early-stage gastric cancer undergoing laparoscopic-assisted tumor resection. GA + EA combination improves immune response by inhibiting the inflammatory response but has no significant effect on survival outcome

Regulatory controls of duplicated gene expression during fiber development in allotetraploid cotton.

Polyploidy complicates transcriptional regulation and increases phenotypic diversity in organisms. The dynamics of genetic regulation of gene expression between coresident subgenomes in polyploids remains to be understood. Here we document the genetic regulation of fiber development in allotetraploid cotton Gossypium hirsutum by sequencing 376 genomes and 2,215 time-series transcriptomes. We characterize 1,258 genes comprising 36 genetic modules that control staged fiber development and uncover genetic components governing their partitioned expression relative to subgenomic duplicated genes (homoeologs). Only about 30% of fiber quality-related homoeologs show phenotypically favorable allele aggregation in cultivars, highlighting the potential for subgenome additivity in fiber improvement. We envision a genome-enabled breeding strategy, with particular attention to 48 favorable alleles related to fiber phenotypes that have been subjected to purifying selection during domestication. Our work delineates the dynamics of gene regulation during fiber development and highlights the potential of subgenomic coordination underpinning phenotypes in polyploid plants. [Abstract copyright: © 2023. The Author(s).

The NLRP3 inflammasome is involved in resident intruder paradigm-induced aggressive behaviors in mice

Background: Aggressive behaviors are one of the most important negative behaviors that seriously endangers human health. Also, the central para-inflammation of microglia triggered by stress can affect neurological function, plasticity, and behavior. NLRP3 integrates stress-related signals and is a key driver of this neural para-inflammation. However, it is unclear whether the NLRP3 inflammasome is implicated in the development of aggressive behaviors.Methods: First, aggressive behavior model mice were established using the resident intruder paradigm. Then, aggressive behaviors were determined with open-field tests (OFT), elevated plus-maze (EPM), and aggressive behavior tests (AT). Moreover, the expression of P2X7R and NLRP3 inflammasome complexes were assessed by immunofluorescence and Western blot. The levels of NLRP3 and inflammatory cytokines were evaluated using enzyme-linked immunosorbent assay (ELISA) kits. Finally, nerve plasticity damage was observed by immunofluorescence, transmission electron microscope, and BrdU staining.Results: Overall, the resident intruder paradigm induced aggressive behaviors, activated the hippocampal P2X7R and NLRP3 inflammasome, and promoted the release of proinflammatory cytokines IL-1β in mice. Moreover, NLRP3 knockdown, administration of P2X7R antagonist (A804598), and IL-1β blocker (IL-1Ra) prevented NLRP3 inflammasome-driven inflammatory responses and ameliorated resident intruder paradigm-induced aggressive behaviors. Also, the resident intruder paradigm promoted the activation of mouse microglia, damaging synapses in the hippocampus, and suppressing hippocampal regeneration in mice. Besides, NLRP3 knockdown, administration of A804598, and IL-1Ra inhibited the activation of microglia, improved synaptic damage, and restored hippocampal regeneration.Conclusion: The NLRP3 inflammasome-driven inflammatory response contributed to resident intruder paradigm-induced aggressive behavior, which might be related to neuroplasticity. Therefore, the NLRP3 inflammasome can be a potential target to treat aggressive behavior-related mental illnesses

A Hybrid Short-Term Forecasting Model of Passenger Flow on High-Speed Rail considering the Impact of Train Service Frequency

Short-term forecasting of OD (origin to destination) passenger flow on high-speed rail (HSR) is one of the critical tasks in rail traffic management. This paper proposes a hybrid model to explore the impact of the train service frequency (TSF) of the HSR on the passenger flow. The model is composed of two parts. One is the Holt-Winters model, which takes advantage of time series characteristics of passenger flow. The other part considers the changes of TSF for the OD in different time during a day. The two models are integrated by the minimum absolute value method to generate the final hybrid model. The operational data of Beijing-Shanghai high-speed railway from 2012 to 2016 are used to verify the effectiveness of the model. In addition to the forecasting ability, with a definite formation, the proposed model can be further used to forecast the effects of the TSF

Kushenin Combined with Adefovir Dipivoxil or Entecavir for Chronic Hepatitis B: A Systematic Review and Meta-Analysis

Kushenin (KS) has become a traditional Chinese medicine preparation that plays an important role in treating chronic hepatitis B (CHB). Many clinical studies have discussed its curative effect and safety in combination with adefovir dipivoxil (ADV) or entecavir (ETV) for treating CHB, but there is still a lack of a systematic analysis. Therefore, this study evaluated the efficacy and safety of KS through a meta-analysis to better guide clinical treatment. Seven databases were searched to identify randomized controlled trials (RCTs) concerning KS combined with ADV or ETV for treating CHB. The primary outcomes included serum viral indices and adverse events, and the secondary outcomes were liver function indices. The risk of bias of the included RCTs was appraised by Cochrane software. STATA 15.1 and Review Manager 5.3 software were used for the meta-analysis. Thirty-two RCTs recruiting 3343 patients with CHB were collected for this meta-analysis. KS combined with ETV or ADV led to an amelioration of the CHB index to various degrees. In short, the meta-analysis indicated that the combination group, compared to the single group, showed great improvement in HBeAg seroconversion, frequency of undetectable HBV-DNA levels, loss of serum HBeAg, and loss of serum HBsAg. The combination treatment also decreased serum HBV-DNA levels when compared to the levels after the single treatment. However, KS combined with ADV or ETV displayed no remarkable difference in the incidence of adverse events or in serum ALT levels. Current evidence showed that, compared with the use of either drug alone, KS combined with ADV or ETV can improve the clinical efficacy of CHB treatment

Learning and managing stochastic network traffic dynamics: an iterative and interactive approach

This study examines the potential of an iterative and interactive approach to learn network traffic dynamics and optimise tolling strategies considering time-varying stochastic traffic. A tractable ‘truth model’ based on the stochastic Macroscopic Fundamental Diagram is developed to represent the transportation system to be learned and managed. A ‘twin model’ that mirrors the truth model is formulated and calibrated for testing and optimising tolling adjustment strategies with the help of reinforcement learning. The optimised prices are then put into the ‘truth model’ to evaluate network efficiency improvement. The above procedure is iterative and interactive, which can be applied for congestion management in the period-to-period tolling adjustment fashion. Numerical studies show that the proposed iterative and interactive pricing strategy is able to enhance network efficiency even under limited information and/or inaccurate learning of the system. This illustrates the great potential of utilising iterative and interactive frameworks for congestion management.</p

The utility of HbA1c combined with haematocrit for early screening of gestational diabetes mellitus

Abstract Aims To evaluate the utility of glycated haemoglobin A1c (HbA1c) alone and in combination with haematocrit (HCT) for screening gestational diabetes mellitus (GDM) between 12–16 gestational weeks. Methods This prospective study was carried out in the Obstetrics and Gynaecology Hospital of Fudan University from November 2014 to February 2015. In total, 690 pregnant women between 20 and 35 years old were included in this study. All subjects received a routine blood examination for HbA1c and HCT at 12–16 gestational weeks (gw) and a 75-g oral glucose tolerance test at 24–28 gw. Threshold values for the diagnosis of GDM were a plasma glucose concentration of 5.1 mmol/L after fasting, 10.0 mmol/L at 60 min, and 8.5 mmol/L at 120 min. Receiver operating characteristic curves were used to evaluate the diagnostic performance of HbA1c with or without HCT. Results One hundred seven women were diagnosis with GDM at 24–28 gw. An HbA1c cutoff value  38.8%) for the screening of GDM, the area under the receiver operating characteristic curve was 0.604 (95% [CI] 0.509, 0.701). Conclusions Whether the adoption of HbA1c as a screening test for GDM would benefit pregnant women remains to be determined. However, combining HbA1c with HCT for the screening of GDM may be a useful tool to predict GDM

The effect of impurity on miscible CO2 displacement mechanism

International audienceThe CO2 displacement is one of the gasflooding Enhanced Oil Recovery (EOR) methods. The application from volatile oil to black oil is popular mainly because CO2 requires a relatively low miscibility pressure, which is suitable to most reservoir conditions. However, CO2 always contains some impurity, such as CH4, H2S and N2, leading to the change of phase behavior and flooding efficiency. Whether the gasflooding achieves successfully miscible displacement depends on the reservoir pressure and temperature, injected solvent and crude oil compositions. So three different types of oil samples from the real field are selected and mixtures of CH4, H2S and N2 with various CO2 concentrations as the solvent are considered. After a series of experimental data are excellently matched, three nine-pseudocomponent models are generated based on the thermodynamic Equation-of-State (EoS), which are capable of accurately predicting the complicated phase behavior. Three common tools of pressure–temperature (P–T), pressure–composition (P–X) and pseudoternary diagrams are used to display and analyze the alteration of phase behavior and types of displacement mechanism. Simulation results show that H2S is favorable to attain miscibility while CH4 and N2 are adverse, and the former can reduce the Multiple Contact Miscibility (MCM) pressure by the maximum level of 1.675 MPa per 0.1 mol. In addition, the phase envelope of the mixtures CO2/H2S displacing the reservoir oil on the pseudoternary diagram behaves a triangle shape, indicating the condensing-dominated process. While most phase envelopes of CO2/CH4 and CO2/N2 exhibit the trump and bell shapes, revealing the MCM of vaporization