[This retracts the article DOI: 10.3892/ol.2022.13268.].

He, Ben, Jiayue Feng, Yan Shu, Lichun Yang, Zepin He, Kanxiu Liao, Hui Zhuo, and Hui Li. Prevalence and risk factors of hyperuricemia among young and middle-aged Tibetan men living at ultrahigh altitudes: a cross-sectional study. High Alt Med Biol. 25:42-48, 2024. Background: Few studies have examined the prevalence or risk factors of hyperuricemia among populations living at ultrahigh altitudes. Here we examined the prevalence of hyperuricemia and factors associated with it among young and middle-aged Tibetan men living at ultrahigh altitudes. Methods: This cross-sectional study analyzed 672 Tibetan men 18-60 years old living on the Qinghai-Tibet Plateau (mean altitude 4,014 m) within the county of Litang in the Ganzi Tibetan autonomous prefecture of Sichuan Province, China. Demographic and clinical data were collected from self-administered questionnaires, physical examinations and laboratory tests. Participants whose blood uric acid (UA) contained >420 μmol/l were classified as having hyperuricemia. Results: Of the 672 men analyzed, 332 (49.4%) had hyperuricemia. Multivariate logistic regression showed risk of hyperuricemia to correlate positively with body mass index (per 1 U increase: odds ratio [OR] 1.172, 95% confidence interval [CI] 1.1066-1.243), triglycerides (OR 1.408, 95% CI 1.084-1.828), red blood cell count (OR 1.376, 95% CI 1.009-1.875), and creatinine level (per 1 U increase: OR 1.051, 95% CI 1.033-1.070). Conversely, risk of hyperuricemia correlated negatively with the presence of diabetes mellitus (OR 0.412, 95% CI 0.175-0.968). Subgroup analyses showed that prevalence of hyperuricemia was significantly higher among those with polycythemia than among those without it, and that UA levels correlated positively with hematocrit and hemoglobin levels. Conclusions: Hyperuricemia is an important public health problem among Tibetan men living at ultrahigh altitudes in Ganzi autonomous prefecture. The region urgently requires appropriate prevention and management efforts.

Abstract Background Dexmedetomidine has arousal sedation and analgesic effects. This study is to investigate the effect of 0.5µg/kg epidural dexmedetomidine combined with epidural anesthesia (EA) in parturients undergoing cesarean section.Methods A total of 92 parturients were randomly divided into Group R (receiveing epidural ropivacaine alone) Group RD (receiveing epidural ropivacaine with 0.5µg/kg dexmedetomidine). The primary outcome and second outcome will be intraoperative NRS pain scores and Ramsay Sedation Scale.Results All 92 parturients were included in the analysis. The NRS were significantly lower in Group RD compared to Group R at all observation timepoint (P > 0.05). Higher Ramsay Sedation Scale was found in Group RD compared to Group R (P < 0.001). No parturient has experienced sedation score of 4 and above. No significant difference regarding the incidence of hypotension, bradycardia and nausea or vomiting, Apgar scores and the overall satisfaction with anesthesia was found between Group R and Group RD (P > 0.05).Conclusion Epidural dexmedetomidine of 0.5µg/kg added slightly extra analgesic effect to ropivacaine in EA for cesarean section. The sedation of 0.5µg/kg epidural dexmedetomidine did not cause mother-baby bonding deficit. Satisfaction with anesthesia wasn’t significantly improved by epidural dexmedetomidine of 0.5µg/kg. No additional side effect allows larger dose of epidural dexmedetomidine attempt.Trial registration: This study was registered at www.chictr.org.cn (ChiCTR2000038853)

Proviral integration sitea for Moloney-murine leukemia virus (PIM) kinases are a family of highly conserved serine/tyrosine kinases consisting of three members, PIM-1, PIM-2, and PIM-3. These kinases regulate a wide range of substrates through phosphorylation and affect key cellular processes such as transcription, translation, proliferation, apoptosis, and energy metabolism. Several PIM inhibitors are currently undergoing clinical trials, such as a phase I clinical trial of Uzanserti (5) for the treatment of relapsed diffuse large B-cell lymphoma that has been completed. The current focus encompasses the structural and biological characterization of PIM, ongoing research progress on small-molecule inhibitors undergoing clinical trials, and evaluation analysis of persisting challenges in this field. Additionally, the design and discovery of small-molecule inhibitors targeting PIM in recent years have been explored, with a particular emphasis on medicinal chemistry, aiming to provide valuable insights for the future development of PIM inhibitors.

Objectives: We aimed to explore the potential role of omega-3 (ω-3) fatty acids on acne vulgaris by modulating gut microbiota. Materials and Methods: We randomly divided the untreated acne patients into two groups with or without ω-3 fatty acids intervention for 12 weeks. The Sprague Dawley (SD) rats with acne model were given isotretinoin, ω-3 fatty acids or their combination respectively. Then the colonic contents samples of the drug intervention SD rats were transferred to the pseudo sterile rats with acne model. The severity of the disease was assessed by the Global Acne Grading System (GAGS) score of the patients, and the swelling rate of auricle and the pathological section of the rat with acne model. The 16S rDNA gene sequencing was performed to detect the alteration of the gut microbiota. Results: ω-3 fatty acids could increase the diversity of the gut microbiota and regulate the flora structure positively both in the patients and rats, increase the abundance of butyric acid producing bacteria and GAGS score in the patients, and alleviate the inflammation and comedones of rats. Conclusion: Supplementation of ω-3 fatty acids could alleviate the inflammation of acne vulgaris by increasing the abundance of butyric acid producing bacteria.

The purpose of the meta-analysis was to evaluate and compare the effect of intrawound management on decreasing deep surgical site infections (SSIs) in instrumented spinal surgery (SS). The results of this meta-analysis were analysed, and the odds ratio (OR) and mean difference (MD) with 95% confidence intervals (CIs) were calculated using dichotomous or contentious random or fixed effect models. For the current meta-analysis, 29 examinations spanning from 2006 to 2022 were included, encompassing 11 181 people who had instrumented SS. Intrawound management had a significantly lower deep SSI when using vancomycin (OR, 0.34; 95% CI, 0.25-0.44, p < 0.001) and povidone-iodine as intrawound management (OR, 0.24; 95% CI, 0.13-0.42, p < 0.001) compared to control in instrumented SS subjects. The data that was looked at showed that using vancomycin and povidone-iodine as intrawound management had a much lower deep SSI than using a control group of instrumented SS subjects. However, given that some studies included a small number of subjects, attention should be given to their values.

Acute severe hypoglycemia immediately following anesthesia induction is a rare but life-threatening complication that is frequently underdiagnosed due to insufficient awareness. Among the various physiological processes influenced by opioids, alterations in blood glucose levels induced by opioids are a side effect that is commonly overlooked. The significance of this report lies in emphasizing the neglected association between opioids and hypoglycemia and highlighting the importance of close glucose monitoring to prevent hypoglycemic events in the perioperative setting. An 89-year-old man with type 2 diabetes mellitus experienced acute severe hypoglycemic episode immediately after general anesthesia induction. Baseline blood glucose level before starting anesthesia induction was 4.0 mmol/L. However, it decreased substantially to 0.96 mmol/L immediately after anesthesia induction. The patient exhibited normal serum insulin, C-peptide, and cortisol levels, alongside unremarkable renal and hepatic function. After excluding other causes of hypoglycemia, we speculate that opioids were the culprits due to the temporal association and the rapid decline in blood glucose levels. Forty milliliters of 50% dextrose were administered intravenously followed by an infusion of 5% dextrose. Recovery from anesthesia, extubation, and postoperative recovery were unremarkable. No further hypoglycemic episodes occurred during hospitalization. A precipitous and rapid decline in blood glucose following anesthesia induction is extremely uncommon. When a clinical anesthesiologist detects an abnormally low bispectral index during general anesthesia, hypoglycemia should be suspected. Instituting glucose monitoring in these situations can enable a timely diagnosis, forestalling the onset of life-threatening severe hypoglycemia.

Abstract Background Hypotension is a common side effect of spinal anesthesia during caesarean delivery. To assess the association between preoperative femoral vessel variations and postural hypotension after spinal anesthesia for cesarean section.Methods Participants who scheduled to undergo elective cesarean section with spinal anesthesia between November 2020 and June 2021 were included in this prospective study. Hypotension was systolic blood pressure decreased by at least 20% from baseline.Results Right femoral artery (RFA) peak flow velocity and the percent variance in the right femoral vein (RFV) in the left lateral decubitus position (LP) were significantly higher in the hypotension group than in the normal blood pressure group (P = 0.04 and P = 0.01). The percent variance in the RFV diameter in the LP (OR = 76.796, P = 0.016), preoperative basal heart rate (OR = 1.043, P = 0.028) were risk factors associated with hypotension during cesarean section, and weight gain during pregnancy (OR = 0.915, P = 0.047) was protective factor associated with hypotension during cesarean section. A cutoff value of 0.059% for the percent variance in the RFV had an AUC of 0.627 (95% CI: 0.508–0.757, P = 0.0045). Another cutoff value of 15.75 kg for weight change during pregnancy had an AUC of 0.617 (95% CI: 0.510–0.724, P = 0.038).Conclusions The percent variance in RFV diameter, preoperative basal heart rate and weight gain during pregnancy may be associated with postural hypotension after spinal anesthesia for cesarean section and should pay more attention in the clinical setting.Trial registration: Chinese Clinical Trial Registry (ChiCTR2000040029, 18/11/2020).

HP501 is a highly selective renal urate transporter 1 (URAT1) inhibitor used for treating hyperuricemia. This study aimed to evaluate the tolerability, pharmacokinetics, and pharmacodynamics of HP501 in male Chinese patients. Patients with hyperuricemia were sequentially assigned to receive oral doses of HP501 (30, 50, 60, 90, and 120 mg) as a single dose on Day 1 and as once-daily doses from Days 4 to 13. Safety, pharmacokinetic, and pharmacodynamic data were collected. Multiple oral doses of HP501 were well-tolerated in all the cohorts. The most common adverse events (≥ 10% of patients) of any grade regardless of drug relationship were gout flare (14 patients, 25.93%), diarrhea (12 patients, 22.22%), elevated ALT (8 patients, 14.81%), hypertriglyceridemia (7 patients, 12.96%), dry mouth (7 patients, 12.96%) and oral ulcer (7 patients, 12.96%). All adverse events were mild or moderate. The Cmax and exposure (AUC) of HP501 was approximately dose-proportional between 30 and 120 mg. A dose-dependent serum uric acid (UA)-lowering effect was observed in the dose range of 30 to 60 mg and the serum UA lowering effect was similar between 90 and 120 mg on day 13, indicating that the maximal serum UA lowering effect of HP501 was achieved at 90 mg in the patients with hyperuricemia. In conclusion, the tolerability, pharmacokinetics, and pharmacodynamics supported 90 mg HP501 for subsequent clinical studies of this highly selective URAT1 inhibitor.Clinical Trial registration: No. CTR20212259 (http://www.chinadrugtrials.org.cn/) was registered in September 2021, and No. CTR20222257 was registered in September 2022.

Osteosarcopenia is defined as the concurrent occurrence of osteopenia/osteoporosis and sarcopenia. The aim of the current study was to perform a systematic review with meta-analysis to determine the global prevalence, risk factors and clinical outcomes of osteosarcopenia. This review was registered in PROSPERO (CRD42022351229). PubMed, Cochrane, Medline and Embase were searched from inception to February 2023 to retrieve eligible observational population-based studies. Pooled osteosarcopenia prevalence was calculated with 95% confidence interval (CI), and subgroup analyses were performed. The risk factor of osteosarcopenia and its association with clinical outcomes were expressed as odds ratio (OR) and hazard ratio (HR), respectively. Heterogeneity was estimated using the I2 test. Study quality was assessed using validated instruments matched to study designs. The search identified 55158 studies, and 66 studies (64404 participants, mean age from 46.6 to 93years) were analysed in the final analysis, including 48 cross-sectional studies, 17 cohort studies and 1 case-control study. Overall, the pooled prevalence of osteosarcopenia was 18.5% (95% CI: 16.7-20.3, I2 =98.7%), including 15.3% (95% CI: 13.2-17.4, I2 =97.6%) in men and 19.4% (95% CI: 16.9-21.9, I2 =98.5%) in women. The prevalence of osteosarcopenia diagnosed using sarcopenia plus osteopenia/osteoporosis was 20.7% (95% CI: 17.1-24.4, I2 =98.55%), and the prevalence of using sarcopenia plus osteoporosis was 16.1% (95% CI: 13.3-18.9, I2 =98.0%). The global osteosarcopenia prevalence varied in different regions with 22.9% in Oceania, 21.6% in Asia, 20.8% in South America, 15.7% in North America and 10.9% in Europe. A statistically significant difference was found in the subgroups of the study population between the hospital (24.7%) and community (12.9%) (P=0.001). Frailty (OR=4.72, 95% CI: 2.71-8.23, I2 =61.1%), malnutrition (OR=2.35, 95% CI: 1.62-3.40, I2 =50.0%), female sex (OR=5.07, 95% CI: 2.96-8.69, I2 =73.0%) and higher age (OR=1.10, 95% CI: 1.06-1.15, I2 ==86.0%) were significantly associated with a higher risk for osteosarcopenia. Meta-analysis of cohort studies showed that osteosarcopenia significantly increased the risk of fall (HR=1.54, 95% CI: 1.20-1.97; I2 =1.0%, three studies), fracture (HR=2.13, 95% CI: 1.61-2.81; I2 =67.8%, seven studies) and mortality (HR=1.75, 95% CI: 1.34-2.28; I2 =0.0%, five studies). Despite the heterogeneity arising from varied definitions and criteria, our findings highlight a significant global prevalence of osteosarcopenia and its negative impact on clinical health. Standardizing diagnostic criteria for osteosarcopenia would be advantageous in the future, and early detection and management should be emphasized in this patient population.