Effect of the of remazolam toluenesulfonate and IPACK on postoperative rehabilitation and sedation in elderly patients undergoing knee arthroplasty

Purpose: To investigate the effect of the combination of remazolam toluenesulfonate and infiltration between the popliteal artery and capsule of the knee (IPACK) on the rehabilitation and sedation of elderly patients undergoing knee arthroplasty. Methods: A total of 84 elderly patients who underwent knee arthroplasty in Quzhou Affiliated Hospital of Wenzhou Medical University between January 2021 and December 2021 were given IPACK in combination with adductor canal block under ultrasound guidance. Forty (40) patients were given anesthesia with propofol + sufentanil + cis-benzene sulfonic acid atracurium (control group), while 44 patients received anesthesia with remazolam toluenesulfonate + sufentanil + cis-benzene sulfonic acid atracurium (study group). Various clinical indices in the patients were assessed Results: Relative to control, there were significantly lower visual analog scale (VAS) scores at 6 and 12 h after operation, lower frequency of post-operation pumping with PCA pump, lower frequency of remedial analgesia within 48 h after operation (p < 0.05). Moreover, the time taken for spontaneous recovery of breathing, recovery time, and extubation time were similar in the two groups (p > 0.05). The muscle strength of quadriceps femoris of the affected knee joint was higher in the study group than in the control group at 12, 24, and 48 h, after operation (p < 0.05). Conclusion: The combination of remazolam toluenesulfonate with IPACK effectively alleviate pain in elderly patients undergoing knee arthroplasty and improves sedation without increasing cognitive dysfunction. This treatment strategy has potentials for further investigation for possible large-scale application

Care burden on family caregivers of patients with dementia and affecting factors in China: A systematic review

BackgroundDementia is a chronic and progressive illness characterized by severe impairment and high dependencies. Under the influence of Chinese traditional culture, 80% of patients with dementia are watched over at home by family caregivers as primary caregivers. However, long-term care brings formidable burdens to them and reduces the quality of their life. It is necessary to find out the influencing factors of caregivers’ burden.MethodsA scoping search was conducted on eight electronic databases from 1 January 2010 to 14 June 2022: PubMed, Embase, the Cochrane Library, Web of Science, China National Knowledge Infrastructure, China VIP Database, China Biomedical Literature Database, and Wanfang Data Knowledge Service Platform. Research articles included in this review discussed the factors affecting Chinese dementia family caregivers’ care burden or stress, and the level of care burden was evaluated by a standardized care burden scale.ResultsA total of 1,888 related articles were found and 23 cross-sectional studies were eventually included. After quality assessment, 12 were of good quality and 11 were of fair quality. A total of 32 factors were identified that were associated with caregiver burden, and the results were grouped into three categories: patient, caregiver, and society. The severity of disease, poor self-care ability, neuropsychiatric symptoms, care time, number of helpers, poor health status, economic stress, poor psychological status, social support, and age were reported in many previous studies.ConclusionIn this review, the factors that affect the caregiver burden for people with dementia were clarified. By identifying these factors, hospitals, decision-makers, and communities can carry out special projects for these populations, provide appropriate assistance, or design corresponding intervention measures to reduce the caregiver burden and improve the quality of care for patients with dementia.Systematic review registration[https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42022347816]

Host Acyl Coenzyme A Binding Protein Regulates Replication Complex Assembly and Activity of a Positive-Strand RNA Virus

All positive-strand RNA viruses reorganize host intracellular membranes to assemble their replication complexes. Similarly, brome mosaic virus (BMV) induces two alternate forms of membrane-bound RNA replication complexes: vesicular spherules and stacks of appressed double-membrane layers. The mechanisms by which these membrane rearrangements are induced, however, remain unclear. We report here that host ACB1-encoded acyl coenzyme A (acyl-CoA) binding protein (ACBP) is required for the assembly and activity of both BMV RNA replication complexes. ACBP is highly conserved among eukaryotes, specifically binds to long-chain fatty acyl-CoA, and promotes general lipid synthesis. Deleting ACB1 inhibited BMV RNA replication up to 30-fold and resulted in formation of spherules that were ∼50% smaller but ∼4-fold more abundant than those in wild-type (wt) cells, consistent with the idea that BMV 1a invaginates and maintains viral spherules by coating the inner spherule membrane. Furthermore, smaller and more frequent spherules were preferentially formed under conditions that induce layer formation in wt cells. Conversely, cellular karmella structures, which are arrays of endoplasmic reticulum (ER) membranes formed upon overexpression of certain cellular ER membrane proteins, were formed normally, indicating a selective inhibition of 1a-induced membrane rearrangements. Restoring altered lipid composition largely complemented the BMV RNA replication defect, suggesting that ACBP was required for maintaining lipid homeostasis. Smaller and more frequent spherules are also induced by 1a mutants with specific substitutions in a membrane-anchoring amphipathic α-helix, implying that the 1a-lipid interactions play critical roles in viral replication complex assembly

In situ photo-crosslinked hydrogel promotes oral mucosal wound healing through sustained delivery of ginsenoside Rg1

Oral mucosal wounds exhibit an increased susceptibility to inflammation as a consequence of their direct exposure to a diverse range of microorganisms. This causes pain, slow healing, and other complications that interfere with patients’ daily activities like eating and speaking. Consequently, patients experience a significant decline in their overall quality of life. Therefore, the pursuit of novel treatment approaches is of great importance. In this study, ginsenoside Rg1, a natural active substance extracted from ginseng root, was chosen as a therapeutic agent. It was encapsulated in a screened photo-crosslinked hydrogel scaffold for the treatment of mucosal defects in the rat palate. The results demonstrated that Rg1-hydrogel possessed excellent physical and chemical properties, and that oral mucosa wounds treated with Rg1-hydrogel exhibited the greatest healing performance, as evidenced by more pronounced wound re-epithelialization, increased collagen deposition, and decreased inflammatory infiltration. Subsequent investigations in molecular biology confirmed that Rg1-hydrogel stimulated the secretion of repair-related factors and inhibited the secretion of inflammatory factors. This study demonstrated that the hydrogel containing ginsenoside Rg1 significantly promotes oral mucosal tissue healing in vivo. Based on the findings, it can be inferred that the Rg1-hydrogel has promising prospects for the therapeutic management of oral mucosal wounds

Rapid and sensitive determination of Se and heavy metals in foods using electrothermal vaporization inductively coupled plasma mass spectrometry with a novel transportation system

Rapid, sensitive and simultaneous determination of trace multi-elements in various plant food samples such as grain, oilseed, vegetable and tea is always a challenge thus far. In this work, a rapid determination method for Se, Cd, As and Pb in food samples by inductively coupled plasma mass spectrometry (ICP-MS) using slurry sampling electrothermal vaporization (SS-ETV) was developed. To improve the analytical sensitivity and precision as well as eliminate the memory effect, a gas turbulator line and signal delay device (SDD) were for the first time designed for the graphite furnace (GF) ETV coupled with ICP-MS. The signal acquisition parameters of ICP-MS, ashing and vaporization conditions, and the flow rates of carrier gas and gas turbulator were investigated for Se, Cd, As and Pb in food samples. Under the optimized conditions, the limits of determination (LODs) for Se, Cd, As and Pb were 0.5 ng g−1, 0.3 ng g−1, 0.3 ng g−1 and 0.6 ng g−1, respectively; the limits of quantification (LOQs) for Se, Cd, As and Pb were 1.7 ng g−1, 1.0 ng g−1, 1.0 ng g−1 and 1.9 ng g−1, respectively; linearity (R2) in the range of 1 to 4,000 ng g−1 was >0.999 using the standard addition method. This method was used to analyze 5 CRMs including rice, tea and soybeans, and the concentrations detected by this method were within the range of the certified values. The recoveries of Se, Cd, As and Pb in plant food matrices including grain, oilseed, celery, spinach, carrot and tea samples were 86–118% compared to the microwave digestion ICP-MS method; and the relative standard deviations (RSDs) were 1.2–8.9% for real food sample analysis, proving a good precision and accuracy for the simultaneous determination of multi-elements. The analysis time was less than 3 min, slurry preparation time < 5 min without sample digestion process. The proposed direct slurry sampling ICP-MS method is thus suitable for rapid and sensitive determination of Se, Cd, As and Pb in food samples with advantages such as simplicity, green and safety, as well as with a promising application potential in detecting more elements to protect food safety and human health

Highly directional and coherent emission from dark excitons enabled by bound states in the continuum

A double-edged sword in two-dimensional material science and technology is an optically forbidden dark exciton. On the one hand, it is fascinating for condensed matter physics, quantum information processing, and optoelectronics due to its long lifetime. On the other hand, it is notorious for being optically inaccessible from both excitation and detection standpoints. Here, we provide an efficient and low-loss solution to the dilemma by reintroducing photonics bound states in the continuum (BICs) to manipulate dark excitons in the momentum space. In a monolayer tungsten diselenide under normal incidence, we observed a giant enhancement with an enhancement factor of ~3,100 for dark excitons enabled by transverse magnetic BICs with intrinsic out-of-plane electric fields. By further employing widely tunable Friedrich-Wintgen BICs, we demonstrated highly directional emission from the dark excitons with a divergence angle of merely 7 degrees. We found that the directional emission is coherent at room temperature, unambiguously shown in polarization analyses and interference measurements. Therefore, the BICs reintroduced as a momentum-space photonic environment could be an intriguing platform to reshape and redefine light-matter interactions in nearby quantum materials, such as low-dimensional materials, otherwise challenging or even impossible to achieve

The core inflammatory factors in patients with major depressive disorder: a network analysis

IntroductionThe symptoms of major depressive disorder (MDD) vary widely. Psycho-neuro-inflammation has shown that MDD’s inflammatory factors can accelerate or slow disease progression. This network analysis study examined the complex interactions between depressed symptoms and inflammatory factors in MDD prevention and treatment.MeasuresWe gathered participants’ inflammatory factor levels, used the Hamilton Depression Scale (HAMD-17), and network analysis was used to analyzed the data. Network analysis revealed the core inflammatory (nodes) and their interactions (edges). Stability and accuracy tests assessed these centrality measures’ network robustness. Cluster analysis was used to group persons with similar dimension depressive symptoms and examine their networks.ResultsInterleukin-1β (IL-1β) is the core inflammatory factor in the overall sample, and IL-1β—interleukin-4 (IL-4) is the strongest correlation. Network precision and stability passed. Network analysis showed significant differences between Cluster 1 (with more severe anxiety/somatization and sleep disruption) and Cluster 3 (with more severe retardation and cognitive disorders), as well as between Cluster 2 (with more severe anxiety/somatization, sleep disruption and body weight) and Cluster 3. IL-1β is the core inflammatory factor in Cluster 1 and Cluster 2, while tumor necrosis factor alpha (TNF-α) in Cluster 3.ConclusionIL-1β is the central inflammatory factor in the network, and there is heterogeneity in the core inflammatory factor of MDD with specific depressive dimension symptoms as the main manifestation. In conclusion, inflammatory factors and their links should be prioritized in future theoretical models of MDD and may provide new research targets for MDD intervention and treatment

Prodrug design, synthesis and pharmacokinetic evaluation of (3′R, 4′R)-3-hydroxymethyl-4-methyl-3′, 4′-di-O-(S)-camphanoyl-(+)-cis-khellactone

3-Hydroxymethyl-4-methyl-DCK (3, HMDCK) was discovered previously as a potent HIV non-nucleoside reverse transcriptase inhibitor (NNRTIs) (EC50: 0.004 μM, TI: 6225) with a novel mechanism of action. It exerts anti-HIV activity by inhibiting the production of HIV-1 double-stranded viral DNA from a single-stranded DNA intermediate, rather than blocking the generation of single-stranded DNA from a RNA template, which is the mechanism of action of current HIV-1 RT inhibitors. However, the insufficient metabolic stability of 3 limits its further clinical development. In the current study, a series of ester prodrugs of 3 was designed and synthesized to explore the new drug candidates as NNRTIs. The l-alanine ester prodrug 10 exhibited desirable pharmacokinetic properties in vitro and in vivo and showed improved oral bioavailability of 26% in rat, and would be a potential clinical candidate as a new anti-AIDS drug