Background
Dexmedetomidine has been shown to reduce pro‐inflammatory cytokine levels in rats with sepsis and in severely ill patients. The aim of this study was to document the effects of ...dexmedetomidine on inflammatory responses during and after surgery.
Materials and Methods
Patients undergoing laparoscopic cholecystectomy were enrolled. After induction of anaesthesia, patients in the dexmedetomidine group (n = 24, group D) received a loading dose of dexmedetomidine (1.0 μg/kg), followed by infusion of dexmedetomidine at 0.5 μg/kg/h. A saline‐treated group (n = 23, group S) served as a control. Intraoperative mean arterial pressure (MAP), heart rate (HR), and amount of rescue analgesic administered as post‐anaesthetic care were compared between the groups. The pro‐inflammatory cytokines tumour necrosis factor (TNF)‐α, interleukin (IL)‐1β, and IL‐6, and anti‐inflammatory cytokines IL‐4 and IL‐10 were quantified by sandwich enzyme‐linked immunoassay at three times: after anaesthesia induction (T0), at the end of peritoneal closure (T1), and 60 min after surgery (T2). The C‐reactive protein (CRP) level and leukocyte count were measured on post‐operative day 1.
Results
At time points T1 and T2, the IL‐1β, TNF‐α, and IL‐10 levels were lower in group D than in group S (P < 0.05). The CRP level and leukocyte count on post‐operative day 1 were also lower in group D (P < 0.05), as were intraoperative MAP, HR, and amount of rescue analgesic administered after surgery.
Conclusions
Dexmedetomidine administration during surgery reduced intraoperative and post‐operative secretion of cytokines, as well as post‐operative leukocyte count and CRP level.
The Wind Imaging Interferometer (WINDII) was launched on the NASA's Upper Atmosphere Research Satellite on 12 September 1991 and operated until 2003. Its role in the mission was to measure vector ...winds in the Earth's atmosphere from 80 to 110 km, but its measurements extended to nearly 300 km. The approach employed was to measure Doppler shifts from a suite of visible region airglow lines emitted over this altitude range. These included atomic oxygen O(1S) and O(1D) lines, as well as lines in the OH Meinel (8,3) and O2 Atmospheric (0,0) bands. The instrument employed was a Doppler Michelson Interferometer that measured the Doppler shift as a phase shift of the cosinusoidal interferogram generated by single airglow lines. An extensive validation program was conducted after launch to confirm the accuracy of the measurements. The dominant wind field, the first one observed by WINDII, was that of the migrating diurnal tide at the equator. The overall most notable WINDII contribution followed from this: determining the influence of dynamics on the transport of atmospheric species. Currently, nonmigrating tides are being studied in the thermosphere at both equatorial and high latitudes. Other aspects investigated included solar and geomagnetic influences, temperatures from atmospheric‐scale heights, nitric oxide concentrations, and the occurrence of polar mesospheric clouds. The results of these observations are reviewed from a perspective of 20 years. A future perspective is then projected, involving more recently developed concepts. It is intended that this description will be helpful for those planning future missions.
Key Points
Doppler Michelson interferometers excel in atmospheric space wind measurements
Upper atmosphere winds dramatically influence atomic oxygen concentrations
The thermosphere has enormous scope for future atmospheric dynamics measurements
Aims/hypothesis
The aim of this work was to compare the glucose-lowering efficacy of dipeptidyl peptidase-4 (DPP-4) inhibitors between Asian and non-Asian patients with type 2 diabetes.
Methods
We ...searched MEDLINE, EMBASE, LILACS, CENTRAL, ClinicalTrials.gov and conference proceedings. Studies were eligible if they were randomised controlled trials with a treatment duration of at least 12 weeks, compared a DPP-4 inhibitor with a placebo as either monotherapy or oral combination therapy, had information on ethnicity and HbA
1c
values and were published or described in English. A systematic review and meta-analysis with a meta-regression analysis was conducted.
Results
Among 809 potentially relevant studies, 55 trials were included. A meta-analysis revealed that DPP-4 inhibitors lowered HbA
1c
to a greater extent in studies with ≥50% Asian participants (weighted mean difference WMD −0.92%; 95% CI −1.03, −0.82) than in studies with <50% Asian participants (WMD −0.65%; 95% CI −0.69, −0.60). The between-group difference was −0.26% (95% CI −0.36, −0.17,
p
< 0.001). The baseline BMI significantly correlated with the HbA
1c
-lowering efficacy of DPP-4 inhibitors. The RR of achieving the goal of HbA
1c
<7.0% (53.0 mmol/mol) was higher in studies with ≥50% Asian participants (3.4 95% CI 2.6, 4.7 vs 1.9 95% CI 1.8, 2.0). The fasting plasma glucose-lowering efficacy was higher with monotherapy in the Asian-dominant studies, but the postprandial glucose-lowering efficacy and changes in body weight were comparable between the two groups.
Conclusions/interpretation
DPP-4 inhibitors exhibit a better glucose-lowering efficacy in Asians than in other ethnic groups; this requires further investigation to understand the underlying mechanism, particularly in relation to BMI.
Renewable energy sources like wind energy are copiously available without any limitation. Wind turbines are used to tap the potential of wind energy, which is available in millions of MW. Reliability ...of wind turbine is critical to extract this maximum amount of energy from the wind. We reviewed different techniques, methodologies and algorithms developed to monitor the performance of wind turbine as well as for an early fault detection to keep away the wind turbines from catastrophic conditions due to sudden breakdowns. To keep the wind turbine in operation, implementation of condition monitoring system (CMS) and fault detection system (FDS) is paramount and for this purpose ample knowledge of these two types of systems is mandatory. So, an attempt has been made in this direction to review maximum approaches related to CMS and FDS in this piece of writing.
Summary
Background
To date, there has been no reliable in vitro test to diagnose aspirin‐exacerbated respiratory disease (AERD).
Objective
To investigate potential diagnostic biomarkers for AERD ...using metabolomic analysis.
Methods
An untargeted profile of serum from asthmatics in the first cohort (group 1) comprising 45 AERD, 44 patients with aspirin‐tolerant asthma (ATA), and 28 normal controls was developed using the ultra‐high‐performance liquid chromatography (UHPLC)/Q‐ToF MS system. Metabolites that discriminate AERD from ATA were quantified in both serum and urine, which were collected before (baseline) and after the lysine‐aspirin bronchoprovocation test (Lys‐ASA BPT). The serum metabolites were validated in the second cohort (group 2) comprising 50 patients with AERD and 50 patients with ATA.
Results
A clear discrimination of metabolomes was found between patients with AERD and ATA. In group 1, serum levels of LTE4 and LTE4/PGF2α ratio before and after the Lys‐ASA BPT were significantly higher in patients with AERD than in patients with ATA (P < 0.05 for each), and urine baseline levels of these two metabolites were significantly higher in patients with AERD. Significant differences of serum metabolite levels between patients with AERD and ATA were replicated in group 2 (P < 0.05 for each). Moreover, serum baseline levels of LTE4 and LTE4/PGF2α ratio discriminated AERD from ATA with 70.5%/71.6% sensitivity and 41.5%/62.8% specificity, respectively (AUC = 0.649 and 0.732, respectively P < 0.001 for each). Urine baseline LTE4 levels were significantly correlated with the fall in FEV1% after the Lys‐ASA BPT in patients with AERD (P = 0.008, r = 0.463).
Conclusions and Clinical Relevance
Serum metabolite level of LTE4 and LTE4/PGF2α ratio was identified as potential in vitro diagnostic biomarkers for AERD using the UHPLC/Q‐ToF MS system, which were closely associated with major pathogenetic mechanisms underlying AERD.
Summary
Background
Rifaximin might decrease the risk of portal hypertension‐related complications by controlling small intestinal bacterial overgrowth.
Aim
To evaluate whether rifaximin was ...associated with the risk of death and cirrhotic complications.
Methods
We conducted a retrospective study that included 1042 patients experiencing hepatic encephalopathy (HE): 421 patients without hepatocellular carcinoma (HCC; the non‐HCC cohort) and 621 patients with HCC (the HCC cohort). The primary endpoint was overall survival and secondary endpoints were recurrence of HE and the development of spontaneous bacterial peritonitis (SBP), hepatorenal syndrome (HRS) and variceal bleeding.
Results
In the non‐HCC cohort, 145 patients received rifaximin plus lactulose (the rifaximin group) and 276 patients received lactulose alone (the control group). The multivariate analysis revealed that rifaximin was significantly associated with lower risk of death (adjusted hazard ratio aHR, 0.697; P = .024) and reduced the risk of recurrent HE (aHR, 0.452; P < .001), SBP (aHR, 0.210; P < .001) and variceal bleeding (aHR, 0.425; P = .011) but not HRS (aHR, 0.598; P = .08). In the HCC cohort, 173 patients received rifaximin plus lactulose and 448 patients received lactulose. Rifaximin was not associated with the risk of death (aHR, 1.177; P = .121). Rifaximin was associated with lower risk of SBP (aHR, 0.323; P < .001) but not with variceal bleeding (aHR, 0.660; P = .104) or recurrent HE (aHR, 0.689; P = .057). The risk of Clostridium difficile‐associated diarrhoea was not different between the groups (aHR, 0.028; P = .338).
Conclusions
In patients without HCC, rifaximin treatment was significantly associated with prolonged overall survival and reduced risks of spontaneous bacterial peritonitis, variceal bleeding and recurrent hepatic encephalopathy.
Linked Content
This article is linked to Juang, Kang et al, Wang et al, and Borentain et al papers. To view these papers visit https://doi.org/10.1111/apt.14325, https://doi.org/10.1111/apt.14343, https://doi.org/10.1111/apt.14353 and https://doi.org/10.1111/apt.14516.
We show how to calculate the effective potential of SU(3) QCD which tells that the true minimum is given by the monopole condensation. To do this we make the gauge independent Weyl symmetric Abelian ...decomposition of the SU(3) QCD which decomposes the gluons to the color neutral neurons and the colored chromons. In the perturbative regime this decomposes the Feynman diagram in such a way that the conservation of color is explicit. Moreover, this shows the existence of two gluon jets, the neuron jet and chromon jet, which can be verified by experiment. In the non-perturbative regime, the decomposition puts QCD to the background field formalism and reduces the non-Abelian gauge symmetry to a discrete color reflection symmetry, and provides us an ideal platform to calculate the one-loop effective action of QCD. Integrating out the chromons from the Weyl symmetric Abelian decomposition of QCD gauge invariantly imposing the color reflection invariance, we obtain the SU(3) QCD effective potential which generates the stable monopole condensation and the mass gap. We discuss the physical implications of our result, in particular the possible existence of the vacuum fluctuation mode of the monopole condensation in QCD.
We show that the electroweak monopole can be regularized with a non-vacuum electromagnetic permittivity. This allows us to set a new BPS bound for the monopole mass, which implies that the mass may ...not be smaller than 2.98 TeV, more probably 3.75 TeV. We demonstrate that the same method can also regularize the Dirac monopole, which enhances the possibility to construct the Dirac monopole of mass of a few hundred meV in condensed matters. We discuss the physical implications of our result.
The 2019 novel coronavirus disease (COVID-19) epidemic originated in Wuhan, China and spread rapidly worldwide, leading the World Health Organization to declare an official global COVID-19 pandemic ...in March 2020. In Hong Kong, clinicians and other healthcare personnel collaborated closely to combat the outbreak of COVID-19 and minimize the cross-transmission of disease among hospital staff members. In the field of otorhinolaryngology-head and neck surgery (OHNS) and its various subspecialties, contingency plans were required for patient bookings in outpatient clinics, surgeries in operating rooms, protocols in wards and other services. Infected patients may shed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) particles into their environments via body secretions. Therefore, otolaryngologists and other healthcare personnel in this specialty face a high risk of contracting COVID-19 and must remain vigilant when performing examinations and procedures involving the nose and throat. In this article, we share our experiences of the planning and logistics undertaken to provide safe and efficient OHNS practices over the last 2 months, during the COVID-19 pandemic. We hope that our experiences will serve as pearls for otolaryngologists and other healthcare personnel working in institutes that serve large numbers of patients every day, particularly with regard to the sharing of clinical and administrative tasks during the COVID-19 pandemic.
Summary
Background
Nasal polyposis is a multi‐factorial disease associated with chronic inflammatory condition of the paranasal sinuses. Myofibroblast differentiation and extracellular matrix (ECM) ...accumulation are involved in the pathogenesis of nasal polyposis.
Objective
The aim of this study was to study the effect of trichostatin A (TSA), a histone deacetylase (HDAC) inhibitor, on transforming growth factor (TGF)‐β1‐induced myofibroblast differentiation and ECM accumulation in nasal polyp‐derived fibroblasts (NPDFs).
Methods
Nasal polyp‐derived fibroblasts were isolated from nasal polyps of patients who have chronic rhinosinusitis with nasal polyp. TSA was treated in TGF‐β1‐induced NPDFs. Expression levels of HDAC2, α‐smooth muscle actin (SMA), TGF‐β1, collagen type I, acetylated Histone H3, acetylated Histone H4, phosphorylated Smad2/3 and Smad7 were determined by RT‐PCR, western blot and/or immunofluorescent staining. The total collagen amount production was analysed by Sircol soluble collagen assay and contractile activity was measured by collagen gel contraction assay. HDAC2 inhibition by TSA or HDAC2 silencing was established by RT‐PCR and western blot. The epigenetic effect on α‐SMA gene inactivation was examined by chromatin immunoprecipitation assay. Proliferation was determined by Ki67‐positive cell staining and cytotoxicity was assessed by 3‐(4,5‐ dimethylthiazol‐2yl)‐2,5‐diphenyl‐2H‐tetrazolium bromide (MTT) assay.
Results
The expression levels of HDAC2, α‐SMA and TGF‐β1 were increased in nasal polyp tissues compared to normal inferior turbinate tissues. TSA and HDAC2 silencing inhibited expression levels α‐SMA, collagen and HDAC2. TSA induced hyperacetylation of histone and suppressed opening of α‐SMA gene promoter in TGF‐β1‐induced NPDFs. TSA inhibited TGF‐β1‐induced Smad 2/3 and rescued TGF‐β1‐suppressed Smad7 signalling pathway. Finally, TSA blocked proliferation in TGF‐β1‐induced NPDFs and has no cytotoxic effect in NPDFs.
Conclusions and Clinical Relevance
These results suggest that HDAC inhibition is associated with myofibroblast differentiation and extracelluar matrix accumulation in nasal polyposis. TSA may be useful as an inhibitor of nasal polyp growth, and thus has potential to be used as a novel treatment option for nasal polyposis.
PDF
