Association between intraoperative dexmedetomidine and all-cause mortality and recurrence after laparoscopic resection of colorectal cancer: Follow-up analysis of a previous randomized controlled trial

BackgroundDexmedetomidine (DEX) has been widely applied in the anesthesia and sedation of patients with oncological diseases. However, the potential effect of DEX on tumor metastasis remains contradictory. This study follows up on patients who received intraoperative DEX during laparoscopic resection of colorectal cancer as part of a previous clinical trial, examining their outcomes 5 years later.MethodsBetween June 2015 and December 2015, 60 patients undergoing laparoscopic colorectal resection were randomly assigned to the DEX and control groups. The DEX group received an initial loading dose of 1μ/kg before surgery, followed by a continuous infusion of 0.3μg/kg/h during the operation and the Control group received an equivalent volume of saline. A 5-year follow-up analysis was conducted to evaluate the overall survival, disease-free survival, and tumor recurrence.ResultsThe follow-up analysis included 55 of the 60 patients. The DEX group included 28 patients, while the control group included 27 patients. Baseline characteristics were comparable between the two groups, except for vascular and/or neural invasion of the tumor in the DEX group (9/28 vs. 0/27, p = 0.002). We did not observe a statistically significant benefit but rather a trend toward an increase in overall survival and disease-free survival in the DEX group, 1-year overall survival (96.4% vs. 88.9%, p = 0.282), 2-year overall survival (89.3% vs. 74.1%, p = 0.144), 3-year overall survival (89.3% vs. 70.4%, p = 0.08), and 5-year overall survival (78.6% vs. 59.3%, p = 0.121). The total rates of mortality and recurrence between the two groups were comparable (8/28 vs. 11/27, p = 0.343).ConclusionAdministration of DEX during laparoscopic resection of colorectal cancer had a nonsignificant trend toward improved overall survival and disease-free survival.Clinical Trial Registrationhttp://www.chictr.org.cn/, identifier ChiCTRIOR-15006518

Efficacy of low-dose risperidone in combination with sertraline in first-episode drug-naive patients with schizophrenia: a randomized controlled open-label study

ObjectiveDespite advances in pharmacology, the treatment of schizophrenia (SZ) remains a challenge due to relapse after antipsychotic discontinuation and multiple adverse effects of antipsychotics. We hypothesized that a low dose of risperidone in combination with sertraline would reduce serious adverse effects without decreasing treatment response. This study aimed to examine the efficacy, safety, and tolerability of low-dose risperidone combined with sertraline to reduce risperidone dose and serious adverse effects in first-episode and medication-naive (FEMN) SZ patients.MethodsA total of 230 patients with FEMN SZ were randomly assigned to receive low-dose risperidone in combination with sertraline (RS group) or regular-dose risperidone (control group). The Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HAMD), and Personal and Social Performance Scale (PSP) were assessed at baseline and the end of the first, second, third, and sixth months. In addition, serum prolactin levels and extrapyramidal symptoms were measured at baseline and follow-up.ResultsRepeated measures ANCOVA showed significant interaction effects of treatment by time on psychotic symptoms, as well as HAMD, PSP scores, prolactin levels, and extrapyramidal symptoms (all p < 0.05). Compared with the control group, the RS group had greater decreases in PANSS total score and its subscores and HAMD score (all p < 0.01) and a greater increase in PSP total score (p < 0.01). Notably, side effects were lower in the RS group relative to the control group. Improvements in HAMD and PANSS total scores, changes in prolactin levels and gender predicted improvements in PSP from baseline to month 6.ConclusionsOur study suggests that low-dose risperidone in combination with sertraline was more effective for psychotic symptoms and psychosocial functioning, with significantly fewer adverse effects in patients with FEMN SZ.Trial registration number: ClinicalTrials.gov, NCT0407637

Kinetic studies of gas hydrate formation with low-dosage hydrate inhibitors

Pipeline blockage by gas hydrates is a serious problem in the petroleum industry. Low-dosage inhibitors have been developed for its cost-effective and environmentally acceptable characteristics. In a 1.072-L reactor with methane, ethane and propane gas mixture under the pressure of about 8.5 MPa at 4 A degrees C, hydrate formation was investigated with low-dosage hydrate inhibitors PVP and GHI1, the change of the compressibility factor and gas composition in the gas phase was analyzed, the gas contents in hydrates were compared with PVP and GHI1 added, and the inhibition mechanism of GHI1 was discussed. The results show that PVP and GHI1 could effectively inhibit the growth of gas hydrates but not nucleation. Under the experimental condition with PVP added, methane and ethane occupied the small cavities of the hydrate crystal unit and the ability of ethane entering into hydrate cavities was weaker than that of methane. GHI1 could effectively inhibit molecules which could more readily form hydrates. The ether and hydroxy group of diethylene glycol monobutyl ether have the responsibility for stronger inhibition ability of GHI1 than PVP

Responses of Soil Microbiota to Different Control Methods of the Spartina alterniflora in the Yellow River Delta

Spartina alterniflora invasion has negative effects on the structure and functioning of coastal wetland ecosystems. Therefore, many methods for controlling S. alterniflora invasion have been developed. S. alterniflora control methods can affect plant community, which results in changes in microbial communities and subsequent changes in soil ecological processes. However, the effects of controlling S. alterniflora on soil microbial communities remain poorly understood. We aimed to examine the responses of bacterial and fungal communities to invasion control methods (cutting plus tilling treatment: CT; mechanical rolling treatment: MR). Soil bacterial and fungal community diversity and composition structure were assessed using high-throughput sequencing technology. The findings of the study showed that bacterial diversity and richness in the CT treatment reduced substantially, but fungal diversity and richness did not show any remarkable change. Bacterial and fungal diversity and richness in the MR treatment were not affected considerably. In addition, the two control methods significantly changed the soil microbial community structure. The relative abundance of bacteria negatively associated with nutrient cycling increased considerably in the CT treatment. The considerable increases in the relative abundance of certain bacterial taxa in the MR treatment may promote soil nutrient cycling. Compared with mechanical rolling, soil bacterial community diversity and structure were more sensitive to cutting plus tilling

Causal association between snoring and stroke: a Mendelian randomization study in a Chinese populationResearch in context

Summary: Background: Previous observational studies established a positive relationship between snoring and stroke. We aimed to investigate the causal effect of snoring on stroke. Methods: Based on 82,339 unrelated individuals with qualified genotyping data of Asian descent from the China Kadoorie Biobank (CKB), we conducted a Mendelian randomization (MR) analysis of snoring and stroke. Genetic variants identified in the genome-wide association analysis (GWAS) of snoring in CKB and UK Biobank (UKB) were selected for constructing genetic risk scores (GRS). A two-stage method was applied to estimate the associations of the genetically predicted snoring with stroke and its subtypes. Besides, MR analysis among the non-obese group (body mass index, BMI <24.0 kg/m2), as well as multivariable MR (MVMR), were performed to control for potential pleiotropy from BMI. In addition, the inverse-variance weighted (IVW) method was applied to estimate the causal association with genetic variants identified in CKB GWAS. Findings: Positive associations were found between snoring and total stroke, hemorrhagic stroke (HS), and ischemic stroke (IS). With GRS of CKB, the corresponding HRs (95% CIs) were 1.56 (1.15, 2.12), 1.50 (0.84, 2.69), 2.02 (1.36, 3.01), and the corresponding HRs (95% CIs) using GRS of UKB were 1.78 (1.30, 2.43), 1.94 (1.07, 3.52), and 1.74 (1.16, 2.61). The associations remained stable in the MR among the non-obese group, MVMR analysis, and MR analysis using the IVW method. Interpretation: This study suggests that, among Chinese adults, genetically predicted snoring could increase the risk of total stroke, IS, and HS, and the causal effect was independent of BMI. Funding: National Natural Science Foundation of China, Kadoorie Charitable Foundation Hong Kong, UK Wellcome Trust, National Key R&D Program of China, Chinese Ministry of Science and Technology