Safety and efficacy of etomidate and propofol anesthesia in elderly patients undergoing gastroscopy: A double-blind randomized clinical study

The aim of the present study is to compare the safety, efficacy and cost effectiveness of anesthetic regimens by compound, using etomidate and propofol in elderly patients undergoing gastroscopy. A total of 200 volunteers (65–79 years of age) scheduled for gastroscopy under anesthesia were randomly divided into the following groups: P, propofol (1.5–2.0 mg/kg); E, etomidate (0.15-0.2 mg/kg); P+E, propofol (0.75–1 mg/kg) followed by etomidate (0.075-0.1 mg/kg); and E+P, etomidate (0.075-0.01 mg/kg) followed by propofol (0.75–1 mg/kg). Vital signs and bispectral index were monitored at different time points. Complications, induction and examination time, anesthesia duration, and recovery and discharge time were recorded. At the end of the procedure, the satisfaction of patients, endoscopists and the anesthetist were evaluated. The recovery (6.1±1.2 h) and discharge times (24.8±2.8 h) in group E were significantly longer compared with groups P, P+E and E+P (P<0.05). The occurrence of injection pain in group P+E was significantly higher compared with the other three groups (P<0.05). In addition, the incidence of myoclonus and post-operative nausea and vomiting were significantly higher in group P+E compared with the other three groups (P<0.05). There was no statistical difference among the four groups with regards to the patients' immediate, post-procedure satisfaction (P>0.05). Furthermore, there was no difference in the satisfaction of anesthesia, as evaluated by the anesthetist and endoscopist, among the four groups (P>0.05). The present study demonstrates that anesthesia for gastroscopy in elderly patients can be safely and effectively accomplished using a drug regimen that combines propofol with etomidate. The combined use of propofol and etomidate has unique characteristics which improve hemodynamic stability, cause minimal respiratory depression and less side effects, provide rapid return to full activity and result in high levels of satisfaction

Synthesis of A Spacer-Armed Disulfated Tetrasaccharide of SB1a, A Carbohydrate Hapten Associated with Human Hepatocellular Carcinoma

A disulfated tetrasaccharide fragment with a spacer arm of human hepatocellular carcinoma carbohydrate antigen SB1a, namely, 2-aminoethyl 3-O-sulfo-β-d-galactopyranosyl-(1→3)-2-acetamido-2-deoxy-β-d-galactopyranosyl-(1→4)-3-O-sulfo-β-d-galactopyranosyl-(1→4)-β-d-glucopyranoside was synthesized via a [2+1+1] block building mode. In the last coupling step toward the trisaccharide acceptor 8, benzoyl protected galactosyl bromide donor 14 was found to be much more reactive than the acetyl-protected donors. A disulfated tetrasaccharide fragment with a spacer arm of human hepatocellular carcinoma carbohydrate antigen SB1a was synthesized via a [2+1+1] block building mode

ηc\eta_c production at LHC and indications on the understanding of J/ψJ/\psi production

We present a complete evaluation for the prompt $\eta_c$ production at the LHC at next-to-leading order in $\alpha_s$ in nonrelativistic QCD. By assuming heavy quark spin symmetry, the recently observed $\eta_c$ production data by LHCb results in a very strong constraint on the upper bound of the color-octet long distance matrix element $1S0$ of $J/\psi$. We find this upper bound is consistent with our previous study of the $J/\psi$ yield and polarization and can give good descriptions for the measurements, but inconsistent with some other theoretical estimates. This may provide important information for understanding the nonrelativistic QCD factorization formulism.Comment: 5 pages, 2 figures, published version in PR

Poly[(6-carboxy­picolinato-κ3 O 2,N,O 6)(μ3-pyridine-2,6-dicarboxyl­ato-κ5 O 2,N,O 6:O 2′:O 6′)dysprosium(III)]

In the title complex, [Dy(C7H3NO4)(C7H4NO4)]n, one of the ligands is fully deprotonated while the second has lost only one H atom. Each DyIII ion is coordinated by six O atoms and two N atoms from two pyridine-2,6-dicarboxyl­ate and two 6-carboxy­picolinate ligands, displaying a bicapped trigonal-prismatic geometry. The average Dy—O bond distance is 2.40 Å, some 0.1Å longer than the corresponding Ho—O distance in the isotypic holmium complex. Adjacent DyIII ions are linked by the pyridine-2,6-dicarboxyl­ate ligands, forming a layer in (100). These layers are further connected by π–π stacking inter­actions between neighboring pyridyl rings [centroid–centroid distance = 3.827 (3) Å] and C—H⋯O hydrogen-bonding inter­actions, assembling a three-dimensional supra­molecular network. Within each layer, there are other π–π stacking inter­actions between neighboring pyridyl rings [centroid–centroid distance = 3.501 (2) Å] and O—H⋯O and C—H⋯O hydrogen-bonding inter­actions, which further stabilize the structure

Phosphocreatine Preconditioning Attenuates Apoptosis in Ischemia-Reperfusion Injury of Rat Brain

Phosphocreatine (PCr) is an endogenous compound containing high-energy phosphate bonds. It has been confirmed that PCr is effective in preventing and treating cardiac and renal ischemia-reperfusion injury. In this study, rat cerebral ischemia-reperfusion injury models were constructed. Apoptotic cells in the cortex region were measured by TUNEL method. Malondialdehyde (MDA) content was detected by chromatometry, and calmodulin (CaM) activity was detected by ELISA. Compared with sham-operated group (sham group), TUNEL-positive cells, MDA, and level of CaM activity increased in ischemia-reperfusion group (I/R group) and PCr preconditioning group (PCr group); compared with I/R group, TUNEL-positive cells, MDA content, and level of CaM activity decreased in PCr group. This study indicated that PCr can decrease the morphological damage and the neuron apoptosis of the ischemia-reperfusion injury brain through attenuating abnormalities of calcium balance and production of oxygen free radicals

Heat Shock Protein 70 Protects the Heart from Ischemia/Reperfusion Injury through Inhibition of p38 MAPK Signaling.

BackgroundHeat shock protein 70 (Hsp70) has been shown to exert cardioprotection. Intracellular calcium ([Ca2+]i) overload induced by p38 mitogen-activated protein kinase (p38 MAPK) activation contributes to cardiac ischemia/reperfusion (I/R) injury. However, whether Hsp70 interacts with p38 MAPK signaling is unclear. Therefore, this study investigated the regulation of p38 MAPK by Hsp70 in I/R-induced cardiac injury.MethodsNeonatal rat cardiomyocytes were subjected to oxygen-glucose deprivation for 6 h followed by 2 h reoxygenation (OGD/R), and rats underwent left anterior artery ligation for 30 min followed by 30 min of reperfusion. The p38 MAPK inhibitor (SB203580), Hsp70 inhibitor (Quercetin), and Hsp70 short hairpin RNA (shRNA) were used prior to OGD/R or I/R. Cell viability, lactate dehydrogenase (LDH) release, serum cardiac troponin I (cTnI), [Ca2+]i levels, cell apoptosis, myocardial infarct size, mRNA level of IL-1β and IL-6, and protein expression of Hsp70, phosphorylated p38 MAPK (p-p38 MAPK), sarcoplasmic/endoplasmic reticulum Ca2+-ATPase2 (SERCA2), phosphorylated signal transducer and activator of transcription3 (p-STAT3), and cleaved caspase3 were assessed.ResultsPretreatment with a p38 MAPK inhibitor, SB203580, significantly attenuated OGD/R-induced cell injury or I/R-induced myocardial injury, as evidenced by improved cell viability and lower LDH release, resulted in lower serum cTnI and myocardial infarct size, alleviation of [Ca2+]i overload and cell apoptosis, inhibition of IL-1β and IL-6, and modulation of protein expressions of p-p38 MAPK, SERCA2, p-STAT3, and cleaved-caspase3. Knockdown of Hsp70 by shRNA exacerbated OGD/R-induced cell injury, which was effectively abolished by SB203580. Moreover, inhibition of Hsp70 by quercetin enhanced I/R-induced myocardial injury, while SB203580 pretreatment reversed the harmful effects caused by quercetin.ConclusionsInhibition of Hsp70 aggravates [Ca2+]i overload, inflammation, and apoptosis through regulating p38 MAPK signaling during cardiac I/R injury, which may help provide novel insight into cardioprotective strategies

NLO results with operator mixing for fully heavy tetraquarks in QCD sum rules

We study the mass spectra of $\overline{Q}Q\overline{Q}Q (Q = c, b)$ systems in QCD sum rules with the complete next-to-leading order (NLO) contribution to the pertabative QCD part of the correlation functions. Instead of meson-meson or diquark-diquark currents, we use diagonalized currents under operator renormalization. Numerical results show that the NLO corrections are very important for the $\overline{Q}Q\overline{Q}Q$ system, because they not only give significant contributions but also reduce parameter dependence and makes Borel platform more distinct, especially for the $\overline{b}b\overline{b}b$ in the $\overline{MS}$ scheme. We find that the operator mixing induced by NLO corrections is crucial to understand the color structure of the states. We use currents that have good perturbative convergence in our phenomenological analysis. We get three $J^{PC} = 0^{++}$ states, with masses $6.35^{+0.20}_{−0.17}$ GeV, $6.56^{+0.18}_{−0.20}$ GeV and $6.95^{+0.21}_{−0.31}$ GeV, respectively. The first two seem to agree with the broad structure around 6.2∼6.8 GeV measured by the LHCb collaboration in the $J/\psi J/\psi$ spectrum, and the third seems to agree with the narrow resonance X(6900). For the 2$^{++}$ states we find one with mass $7.03^{+0.22}_{−0.26}$ GeV, which is also close to that of X(6900), and another one around 7.3 GeV but with larger uncertainties

Numerical simulation analysis of multi-physical coupling field with abrasive flow precision polishing variable-aperture tube

In the fields of aerospace, precision machinery and energy, there are variable-diameter tubes for many key components. Abrasive flow polishing technology is an effective precision polishing technology for finishing the workpiece with an internal cavity structure. This technology can improve the quality of part finishing, reduce stress concentration, and reduce the surface roughness of the workpiece, and ultimately can improve the performance of the workpiece. In this paper, variable-aperture tube is taken as the research object, and the characteristics of abrasive flow in the multi-physics coupling field are studied by numerical simulation, and the collision removal effect between the abrasive particle and the wall surface is analyzed. We also discussed the control law of the abrasive grain flow processing quality and provided theoretical guidance for abrasive grain flow polishing of this type of part

NLO results with operator mixing for fully heavy tetraquarks in QCD sum rules

We study the mass spectra of $\overline{Q}Q\overline{Q}Q (Q = c, b)$ systems in QCD sum rules with the complete next-to-leading order (NLO) contribution to the perturbative QCD part of the correlation functions. Instead of meson-meson or diquark-antidiquark currents, we use diagonalized currents under operator renormalization. We find that differing from conventional mesons $\overline{q}q$ and baryons $qqq$, a unique feature of the multiquark systems like $\overline{Q}Q\overline{Q}Q$ is the operator mixing or color configuration mixing induced by NLO corrections, which is crucial to understand the color structure of the states. Our numerical results show that the NLO corrections are very important for the $\overline{Q}Q\overline{Q}Q$ system, because they not only give significant contributions but also reduce the scheme and scale dependence and make Borel platform more distinct, especially for the $\overline{b}b\overline{b}b$ in the $\overline{MS}$ scheme. We use currents that have good perturbation convergence in our phenomenological analysis. With the $\overline{MS}$ scheme, we get three $J^{PC} = 0^{++}$ states, with masses $6.35^{+0.20}_{−0.17}$ GeV, $6.56^{+0.18}_{−0.20}$ GeV and $6.95^{+0.21}_{−0.31}$ GeV, respectively. The first two seem to agree with the broad structure around 6.2 ~ 6.8 GeV measured by the LHCb collaboration in the $J/\psi J/\psi$ spectrum, and the third seems to agree with the narrow resonance X(6900). For the 2$^{++}$ states we find one with mass $7.03^{+0.22}_{−0.26}$ GeV, which is also close to that of X(6900), and another one around $7.25^{+0.21}_{−0.35}$ GeV, which has good scale dependence but slightly large scheme dependence

Distinct roles of NMB and GRP in itch transmission

A key question in our understanding of itch coding mechanisms is whether itch is relayed by dedicated molecular and neuronal pathways. Previous studies suggested that gastrin-releasing peptide (GRP) is an itch-specific neurotransmitter. Neuromedin B (NMB) is a mammalian member of the bombesin family of peptides closely related to GRP, but its role in itch is unclear. Here, we show that itch deficits in mice lacking NMB or GRP are non-redundant and Nmb/Grp double KO (DKO) mice displayed additive deficits. Furthermore, both Nmb/Grp and Nmbr/Grpr DKO mice responded normally to a wide array of noxious stimuli. Ablation of NMBR neurons partially attenuated peripherally induced itch without compromising nociceptive processing. Importantly, electrophysiological studies suggested that GRPR neurons receive glutamatergic input from NMBR neurons. Thus, we propose that NMB and GRP may transmit discrete itch information and NMBR neurons are an integral part of neural circuits for itch in the spinal cord