Ph Group Research Articles

GO/PAMAM as a High Capacity Adsorbent for Removal of Alizarin Red S: Selective Separation of Dyes

Adsorption of Alizarin Red S (ARS) on graphene oxide/poly(amidoamine) (GO/PAMAM) was studied at different ARS initial concentrations, temperatures, pHs, shaking rates and contact times. Adsorption sites of GO/PAMAM were phenolic -OHgroup of GO and amine groups (-NH2, -NH3+ and -NHR2+) of PAMAM dendrimer moieties of GO/PAMAM. At pH = 2 and 318 K, maximum adsorption capacity of the adsorbent was 1275.2 mg g-1 which is one of the highest capacity in the literature. Thus, GO/PAMAM in this work acted as a superadsorbent for ARS. At the incipient of adsorption, molecules were adsorbed on sites that was reaction-controlled step, (Ea = 114.5 kJ mol-1). Adsorption of on the remaining sites was diffusion-controlled. In alkaline media, two other types of ARS molecules were identified during that were adsorbed on and sites. Further increasing the pH of the solution, decreased the number these two sites and yielded a reduced adsorption capacity . Methylene blue (MB), thionine (Th), pyronin Y (PY), acridine orange (AO), methyl blue (MEB) and janus green (JG) dyes were selectively separated from their mixtures with ARS molecules using GO/PAMAM at pH of 2. The used adsorbent was recycled efficiently by using ethylenediamine very fast.

Levels of Gene Expression of Immunological Biomarkers in Peri-Implant and Periodontal Tissues.

This study compared the gene expression of the immunoinflammatory markers interleukin (IL)-6, IL-1ß, and tumor necrosis factor alpha (TNF-α), the matrix metalloproteinases (MMP)-1, -2, -8, and -9, and the tissue inhibitors of matrix metalloproteases (TIMP)-1 and -2 in the gingival tissue of individuals with periodontal and peri-implant disease. The study population included individuals with four periodontal statuses: periodontal health (PH group, n = 20); periodontitis (P group, n = 20); peri-implant health (PIH group, n = 20), and peri-implantitis (PI group, n = 20). Gingival biopsies were collected from one tooth per patient according to the inclusion criteria of each group. The mRNA levels of IL-6, IL-1ß, TNF-α, MMP-1, MMP-2, MMP-8, MMP-9, TIMP-1, and TIMP-2 were evaluated by qPCR. The levels of IL-1ß were significantly higher in the PI group when compared to the other groups (p < 0.05), while the levels of IL-6 were significantly higher in the groups with periodontal and peri-implant disease when compared with the healthy groups (p < 0.05); however, the levels of IL-6 did not differ between the PI and P groups (p > 0.05). For all other studied biomarkers, no significant differences were observed between groups (p > 0.05). IL-6 and IL-1ß presented higher levels of mRNA in diseased periodontal and peri-implant tissues. However, the expression of metalloproteinases and their inhibitors did not differ between the different periodontal statuses.

Abstract 15290: 4D-flow MRI Intracardiac Flow Hemodynamic Patterns Can Phenotype Different Subtypes of Pulmonary Hypertension

Introduction: Idiopathic Pulmonary Arterial Hypertension (PH-Type I) and PH due to pulmonary disease (PH-Type III) arise from different pathophysiologic processes, yet they both culminate in increased right ventricular (RV) afterload and eventual RV failure. Previous work has demonstrated that 4D-Flow MRI-derived intracardiac vorticity (ω) correlates with markers of ventricular interdependency and diastolic dysfunction in PH. However, no investigation has attempted to use both ω and standard markers of ventricular function to phenotype PH subgroups. Hypothesis: 4D-Flow MRI can detect differences in diastolic dysfunction that make it possible to phenotype patients with Type I and Type III PH. Methods: Type I PH patients (n=12, mean age 61yrs), Type III PH patients (n=15, mean age 63yrs), and healthy controls (n=10, mean age 58yrs) underwent standard cardiac MRI as well as 4D-Flow MRI to determine RV intracardiac flow markers including early (ω-E) and late (ω-A) diastolic vorticity. Standard MRI-based RV and LV size and function markers were also collected. Results: ω-E was decreased in the Type I PH group compared to the Type III PH group (P=0.035) and to controls (P&lt;0.001). There was no difference in ω-E between the Type III group and controls (P=0.216). RVEF was decreased in both the Type I (P&lt;0.001) and Type III (P=0.012) group compared to controls. There was no difference in RVEF between the Type I and Type III groups (P=0.917). RVEDV was increased in both the Type I (P=0.008) and Type III (P=0.006) groups compared to controls. No significant differences were noted between groups when assessing (ω-A) and other RV or LV standard volume and functional indices. Conclusion: Our results indicate that 4D-Flow MRI can distinguish among different PH subtypes using intracardiac diastolic vorticity. Comparative studies with standard echocardiography and catheterization are necessary to assess the sensitivity of 4D-Flow MRI to detect diastolic dysfunction.

Abstract 17308: Unsupervised K-means Clustering to Identify Signatures of Right Ventricle Dysfunction in Patients With Pulmonary Hypertension

Introduction: Right ventricular (RV) function is a determinant of mortality in patients with pulmonary hypertension but current assessments are based on individual variables. Unsupervised k-means clustering can be used as an unbiased approach to determine distinct patient groups based on RV dysfunction. The aim of the study was to use unsupervised clustering to identify clinically meaningful RV phenotypes. Methods: Participants were identified from the University of Arizona PH registry (n=213). Patients with missing hemodynamic RV function data were excluded (n=23). Unsupervised clustering (k-means) was applied to variables of systolic and diastolic ventricular function including: max dP/dt/RVSP, Ees, Ea, Ees/Ea, max dP/dt, min dP/dt, RV EDP, β and Eed. Linear discriminant analysis (LDA) was performed to determine the weight of variables in cluster assignment. Results: Participants without PH (n=41) and World Symposium Pulmonary Hypertension (WSPH) Groups 1 (n=104), 2 (n=22), 3 (n=28), 4 (n=12), 5 (n=2) were assigned to four clusters based on the elbow method (Figure 1A). Two major determinants of cluster assignment were arterial elastance (Ea) and end systolic elastance (Ees). Participants with WSPH Group 1 were distributed across clusters (Figure 1B). Degree of RV dysfunction was highest in cluster 4 with increased Ees and Ea compared to other clusters (Figure 1C). Eed, Ees/Ea and mPAP (61 ± 22 mmHg) were increased compared to clusters 1 and 3. Sex, Ethnicity, BMI and cardiac output were not significant between clusters. Cluster 4 had increased PVR (11.1 ± 5.5 WU), and decreased PA compliance (1.2 ± 0.6 mmHg/ml) compared to other clusters. Conclusions: Unsupervised k-means clustering based on hemodynamic measures of RV function identified four distinct RV dysfunction phenotypes ranging from mild to severe.

Effects of Probiotics on Prevalence of Ventilator-Associated Pneumonia in Multitrauma Patients Hospitalized in Neurosurgical Intensive Care Unit: A Randomized Clinical Trial

Background: Probiotics may have a role in preventing ventilator-associated pneumonia (VAP) by inhibiting the natural flora from transforming into pathogenic flora. Objective: Therefore, this study aimed to investigate the effects of probiotics on the prevalence of VAP in multitrauma patients hospitalized in a neurosurgical intensive care unit (ICU). Methods: This randomized clinical trial was performed between 2018 and 2019 with the participation of 150 patients hospitalized in theNeurosurgical ICU. After randomizing the participants (using the permutable blocking method) into the intervention (probiotic) and control (placebo) groups, the interventions were implemented. The participants received one capsule every 12 hours by gavage and their VAP symptoms were evaluated and recorded. Data were inputted into SPSS22 and then compared using the chi-square, independent t-test, Fisher's exact tests, and repeated measures ANOVA. Results: The prevalence of VAP was significantly lower in the intervention group than the control group (p=0.001). A significant difference was observed between the two groups in pH (p=0.029) and WBC (p=0.042). The between-group difference was not significant in other variables. Conclusion: Probiotics are effective in reducing the prevalence of VAP in trauma patients hospitalized in ICU.

Cardiac evaluation in patients with scleroderma_results from screening of pulmonary hypertension in systemic lupus erythermatosus (SOPHIE) study

Abstract Background Pulmonary hypertension (PH) and cardiac involvement were considered as the important prognostic factors in patients with scleroderma. The purpose of this study is to investigate the PH prevalence and related cardiovascular events in patients with scleroderma who were enrolled for screening of PH in systemic lupus erythermatosus (SOPHIE) study. Methods One hundred and ninety-four patients with scleroderma were enrolled in this study. Clinical characteristics were collected, all of patients were received echocardiography for screening of the probability of PH using tricuspid regurgitation jet velocity and other echocardiographic “PH” signs. Additionally, Blood test, B type natriuretic peptide (BNP), serum autoantibodies, and 6 minutes walk test, as well as electrocardiograph, were performed in those patients. Results Forty (20.6%) patients were divided into intermediate/ high probability PH group (IHPH), 154 Patients were divided into none/ low probability PH group (NLPH). Patients in IHPH group were older compared to NLPH group and has a higher proportion of males (20% VS 7.8%.NLPH), dermatomyositis (10% VS 1.9%.NLPH), and stage 3 chronic kidney disease (7.5% VS 1.3%.NLPH), with a shorter 6MWT distance (390.2±108.3 VS 444.9±88.5.NLPH). B-type natriuretic peptide (BNP) level (181.4±323.8 VS 51.1±61.8. NLPH) and the proportion of BNP level larger than 100 pg/ml (40% VS 10.3%.NLPH) were increased in IHPH group. No significant difference was observed in serum autoantibodies including anti-Scl-70, anti-centromere, anti-RNP, and antiphospholipid antibody between two groups. Thirty-six (18.6%) patients occurred arrythmias, 3 patients (1.6%) with atrial fibrillation and all belong to the IHPH group, patients in IHPH group presented a higher proportion of premature atrial complex (7.5% VS 1.0%.NLPH) and sinus tachycardia (5% VS 0.6%.NLPH), no significant difference was observed in arrythmias in terms of atrial-ventricular blockage or ventricular conduction blockage. Forty patients (20.6%) occurred abnormal electrical activities, the main difference between two groups were lie in T wave abnormality (20% vs 3.9%. NLPH) and P wave high voltage (7.5% VS 0%.NLPH). Receiver operating characteristic (ROC) curve revealed that BNP larger than 100pg/ml to predict PH with sensitivity (52.9%) and specificity (88.2%). Multiple logistic regression analysis indicates age (OR, 1.1; 95% CI, 1.0, 1.10), BNP (OR, 1.0; 95% CI, 1.0, 1.02), diastolic blood pressure (OR, 1.0; 95% CI, 0.91, 0.98) significantly affected right ventricular systolic pressure. Conclusions Patients with scleroderma belonged to IHPH group are relatively older than that of NLPH group and manifested with a higher proportion of males, dermatomyositis, more severely chronic kidney disease, arrhythmias, and abnormal electrical activities. Increased age, BNP levels, and diastolic blood pressure can serve as the predicting factors for pulmonary hypertension in patients with scleroderma. Figure 1 Funding Acknowledgement Type of funding source: None

Pulmonary hypertension in patients with interstitial pneumonia with autoimmune features.

Pulmonary hypertension in interstitial lung diseases is associated with increased mortality and hospitalizations and reduced exercise capacity. Interstitial pneumonia with autoimmune features (IPAF) is a recently described interstitial lung disease. The characteristics of pulmonary hypertension in IPAF patients are unknown. We sought to characterize patients with IPAF based on their echocardiographic probability of pulmonary hypertension and compare patients with and without pulmonary hypertension identified by right heart catheterization. We conducted a retrospective study of patients seen in the interstitial lung disease clinic from 2015 to 2018. Forty-seven patients with IPAF were identified. Patients were classified into low, intermediate and high echocardiographic pulmonary hypertension probabilities. A sub-group analysis of patients with pulmonary hypertension and without pulmonary hypertension (IPAF-PH vs. IPAF-no PH) identified by right heart catheterization was also performed. Linear regression analysis was performed to study the association between 6-min-walk-distance (6MWD) and pulmonary vascular resistance (PVR) while adjusting for age and body mass index. Right ventricular hypertrophy (>5 mm), right ventricular enlargement (>41 mm) and right ventricular systolic dysfunction defined as fractional area change% ≤35 was present in 76%, 24%, and 39% of patients, respectively. Pulmonary hypertension was identified in 12.7% of patients. IPAF-PH patients had higher mean pulmonary artery pressure and lower cardiac output compared to the IPAF-no PH group (34 mmHg vs. 19 mmHg, p = 0.002 and 4.0 vs. 5.7 L/min, p = 0.023, respectively). Lower 6MWD was associated with higher PVR on regression analysis (p = 0.002). Pulmonologists should be aware that a significant number of IPAF patients may develop pulmonary hypertension. Reduced 6MWD may suggest the presence of pulmonary hypertension in IPAF patients.

Discrimination of physiological tremor from pathological tremor using accelerometer and surface EMG signals.

Although careful clinical examination and medical history are the most important steps towards a diagnostic separation between different tremors, the electro-physiological analysis of the tremor using accelerometry and electromyography (EMG) of the affected limbs are promising tools. A soft-decision wavelet-based decomposition technique is applied with 8 decomposition stages to estimate the power spectral density of accelerometer and surface EMG signals (sEMG) sampled at 800 Hz. A discrimination factor between physiological tremor (PH) and pathological tremor, namely, essential tremor (ET) and the tremor caused by Parkinson's disease (PD), is obtained by summing the power entropy in band 6 (B6: 7.8125-9.375 Hz) and band 11 (B11: 15.625-17.1875 Hz). A discrimination accuracy of 93.87% is obtained between the PH group and the ET & PD group using a voting between three results obtained from the accelerometer signal and two sEMG signals. Biomedical signal processing techniques based on high resolution wavelet spectral analysis of accelerometer and sEMG signals are implemented to efficiently perform classification between physiological tremor and pathological tremor.

Asymmetric Cyanation of Activated Olefins with Ethyl Cyanoformate Catalyzed by Ti(IV)-Catalyst: A Theoretical Study

The reaction mechanism and origin of asymmetric induction for conjugate addition of cyanide to the C=C bond of olefin were investigated at the B3LYP-D3(BJ)/6-31+G**//B3LYP-D3(BJ)/6-31G**(SMD, toluene) theoretical level. The release of HCN from the reaction of ethyl cyanoformate (CNCOOEt) and isopropanol (HOiPr) was catalyzed by cinchona alkaloid catalyst. The cyanation reaction of olefin proceeded through a two-step mechanism, in which the C-C bond construction was followed by H-transfer to generate a cyanide adduct. For non-catalytic reaction, the activation barrier for the rate-determining C-H bond construction step was 34.2 kcal mol−1, via a four-membered transition state. The self-assembly Ti(IV)-catalyst from tetraisopropyl titanate, (R)-3,3′-disubstituted biphenol, and cinchonidine accelerated the addition of cyanide to the C=C double bond by a dual activation process, in which titanium cation acted as a Lewis acid to activate the olefin and HNC was orientated by hydrogen bonding. The steric repulsion between the 9-phenanthryl at the 3,3′-position in the biphenol ligand and the Ph group in olefin raised the Pauli energy (ΔE≠Pauli) of reacting fragments at the re-face attack transition state, leading to the predominant R-product.

Assessment of Antiplaque and Anti-Gingivitis Efficacy of Mouthwashes Prepared from Neem and Mango Extracts.

Objectives:This study aimed to determine the minimum inhibitory concentration (MIC) of mouthwashes prepared from neem and mango extracts against Streptococcus mutans (S. mutans) in vitro. Their taste acceptability and effects on plaque index (PI), gingival index (GI) and salivary pH were also evaluated and compared with chlorhexidine (CHX) in children.Materials and Methods:Dry extracts of neem and mango twigs were prepared and their MIC against S. mutans was determined. The effective MIC was used to prepare mouthwashes from the two extracts. Three parallel groups of children (n=30) used either neem, mango or 0.2% CHX mouthwash for 21 days. The PI and GI were recorded at baseline and at 7 and 21 days. The salivary pH and taste acceptability were also assessed.Results:The MIC of both extracts was achieved at 25% concentration. There was a significant difference between the GI score of mango group compared with neem and CHX at the three time points (P<0.001). There was no significant difference between the neem and mango groups in PI (P=0.674). There was no significant difference among the three groups in salivary pH either (P=0.817). Intragroup comparison showed significant reductions in PI, GI and salivary pH in all the three groups after 21 days (P<0.001).Conclusion:Neem and mango mouthwashes can be used as effective alternatives to CHX in children.

Prenatal hypoxia attenuated contraction of offspring coronary artery associated with decreased PKCβ Ser660 phosphorylation and intracellular calcium

AimsPrenatal hypoxia (PH) could affect peripheral vascular tone of the offspring, thus increasing the risk of cardiovascular diseases in adult. However, it's still unknown whether functions of coronary arteries (COA) in adult offspring would be influenced by PH. The present study aimed at effects of PH on vascular tone of COA and its related mechanisms. MethodsCoronary arteries of adult offspring exposed to hypoxic or normoxic circumstances during gestational day 5 to 21 were collected. Wire myograph system, whole-cell patch clamp technique, IonOptix MyoCam system, PCR, and western blot were used to detect vascular function of adult offspring COA. Key findingsPH significantly attenuated serotonin- and phorbol 12, 13-dibutyrate (PDBu)-induced constriction. Iberiotoxin potentiated PDBu-induced constriction and the effect was augmented by PH, however, no significant differences were found in whole-cell BKCa channel currents and its protein expression. Nifedipine inhibited PDBu-mediated constriction and the inhibitory effect was reduced in PH group, and whole-cell calcium channel current was decreased in offspring COA. Besides, PH reduced the capability of calcium release from the endoplasmic reticulum in COA. The phosphorylated PKCβ protein expression at Ser660 site, not Thr641 site, was significantly decreased in PH offspring. Chronic hypoxia during pregnancy attenuated PDBu-mediated constriction in offspring COA, presumably through decreased phosphorylated PKCβ at serine660 sites and decreased intracellular calcium-related weaker PKC activation. SignificanceThe findings provided new information on the influence of prenatal hypoxia on COA, and suggested potential use of PKCβ-serine660 for early prevention of coronary heart diseases in developmental origins.

Remediation of cadmium-contaminated coastal saline-alkaline soil by Spartina alterniflora derived biochar

Following oil extraction in the wetland of the Yellow River Delta, heavy metal contamination of coastal saline-alkaline soil, especially with cadmium (Cd), has become a serious environmental problem in some regions. Biochar application has been proposed to remedy Cd-contaminated soil, but the remediation effect is related to preparation conditions of biochar (e.g., pyrolysis temperature and raw material) and soil properties. The invasive plant, Spartina alterniflora, produces a high amount of biomass, making it suitable for biochar production in coastal China. We investigated the effect of S. alterniflora-derived biochar (SDB) pyrolyzed at four temperatures (350, 450, 550, and 650°C) crossed with three addition ratios (1, 5, and 10%) and control on Cd contamination of coastal saline-alkaline soil. Pyrolysis temperature affected pH, surface area, and functional groups of SDB. SDB markedly improved soil pH and soil organic matter, but the degree of improvement was affected by pyrolysis temperature and addition ratio. SDB significantly altered available Cd content in soil, but reduced it only at low pyrolysis temperatures (350 and 450°C). Available Cd content had a positive correlation with soil pH (R2=0.298, P<0.01), but was not related to salinity and soil organic matter content. Thus, SDB pyrolyzed at 350°C with 5% addition was optimal for passivating Cd in coastal saline-alkaline soil, since available Cd content in soil decreased mostly (by 26.9%). These findings act as a reference for the development of an application strategy for SDB to ameliorate Cd-contaminated coastal saline-alkaline soil.

Maternal and paternal histories differentially influence risks for diabetes, insulin secretion and insulin resistance in a Chinese population.

Aims/IntroductionTo investigate the differential effects of maternal versus paternal history of diabetes on the risks for diabetes and prediabetes, as well as on insulin secretion and resistance in Chinese individuals.Materials and MethodsFrom the 2007 to 2008 China National Diabetes and Metabolism Disorders Study, 39,244 participants were included and divided into four categories: negative parental history, paternal history only (PH), maternal history only (MH), and both paternal and maternal history.ResultsThe age‐ and sex‐standardized prevalence rates of diabetes in the negative parental history, PH, MH, and both paternal and maternal history groups were 8.59, 12.56, 15.86 and 29.81%, respectively. The prevalence rates of impaired glucose metabolism were 24.13, 25.41, 31.13 and 50.80%, with the prevalence in the MH group being significantly higher than that in the PH group. Compared with that in the FH0 group, the risks of diabetes in the PH, MH, and both paternal and maternal history groups were 2.01‐, 2.67‐ and 6.37‐fold greater, and the risks of impaired glucose metabolism were 1.28‐, 1.65‐ and 3.45‐fold greater. In addition, MH had a significantly greater impact on impaired glucose metabolism than PH (P MHvsPH = 0.0292). Regression analyses suggested MH was associated with homeostatic model assessment for β‐cell function (β[SE] = −0.0910[0.0334], P = 0.0065), insulinogenic index (−0.1866[0.0550], P = 0.0007), homeostatic model assessment for insulin resistance (0.0662[0.0227], P = 0.0036) and Matsuda Index [−0.0716(0.0203), P = 0.0004]. PH was specifically associated with homeostatic model assessment for insulin resistance (0.1343[0.0267], P < 0.0001) and Matsuda Index (−0.1566[0.0243], P < 0.0001), but the effects were stronger than those of MH (P MHvsPH = 0.0431, 0.0054).ConclusionsMH and PH differentially influence the risks for diabetes, insulin secretion, and insulin resistance in the Chinese population, suggesting they participate in the pathogenesis of diabetes through different mechanisms.

EKSTRAKSI DAN KARAKTERISASI GELATIN TULANG KAMBING KACANG MENGGUNAKAN NEUTRASE

This study aims was to evaluate the characteristics of the gelatine derivate from Kacang goat bone extracted enzymatically using neutrase at different enzyme concentrations. The neutrase treatments, namely GTK-N0 (gelatin with neutrase 0%), GTK-N1 (Gelatin with 0.25% neutrase), GTK-N2 (Gelatin with neutrase 0.5%) and GTK-N3 (Gelatin with neutrase 0,75%). The bones sample used the bones from local Kacang goat aged 6 to 12 months. The study used was a randomized complete design (Oneway ANOVA) with 4 enzyme concentration treatments with 5 replications each treatment. The parameters observed were gelatin yields, the proximate analysis was performed on goat bones and gelatin (water content, ash, fat, and crude protein), pH, gel strength, viscosity, and functional groups of gelatin FTIR. The results showed that the application of the neutrase enzyme at the 0.25% level had the significant effect on the characteristics of the gelatin produced. The conclusion of this study neutrase can be used for enzymatically extracting gelatin from the bones of local Kacang goat and produced the gelatin characteristics that can be used for food applications.

The efficacy and safety of intrathecal dexmedetomidine for parturients undergoing cesarean section: a double-blind randomized controlled trial

BackgroundThe efficacy and safety of spinal anesthesia by intrathecal dexmedetomidine (DEX) for parturients undergoing cesarean section are still lack of evidence. This aim of our study was to evaluate the efficacy and safety of intrathecal DEX for parturients undergoing cesarean section to provide more data evidence for intrathecal applications.MethodsThree hundred parturients undergoing cesarean section under spinal anesthesia were randomly assigned into three groups: group B: 9.0 mg (1.2 ml) of 0.75% bupivacaine with saline (1 ml); group FB: 9.0 mg (1.2 ml) of 0.75% bupivacaine with 20 μg of fentanyl (1 ml); group DB: 9.0 mg (1.2 ml) of 0.75% bupivacaine with 5 μg of DEX (1 ml). Intraoperative block characteristics, parturients’ postoperative quality of recovery, maternal and neonatal outcomes and the plasma concentration of DEX were measured. All parturients were followed up for 30 days to determine whether nerve injury occurred.ResultsCompared with group B, the duration of sensory block in group FB and group DB were significantly prolonged (108.4 min [95% Confidence Interval (CI) = 104.6–112.3] in group B, and 122.0 min [95% CI = 116.8–127.3] in group FB, 148.2 min [95% CI = 145.3–151.1] in group DB). The overall score of quality recovery in group DB (71.6 [95% CI = 71.0–72.2]) was significantly higher than that in group FB (61.5 [95% CI = 60.8–62.2]) and group B (61.7 [95% CI = 61.0–62.4]). There was no statistically significant difference among the three groups for PH, PaO2, and PaCO2 of newborn. The plasma concentration of DEX in umbilical artery and umbilical vein was low and cannot be detected. The 30-days follow-up of parturients did not show any new onset of back, buttock or leg pain or paresthesia.ConclusionsDEX is a potential local anesthetic adjuvant that the intrathecal combination of 5 μg DEX can safely exhibit a facilitatory block effect and improve parturients’ recovery quality.Trial registrationChinese Clinical Trial Registry (Registration number # ChiCTR1900022019; Date of Registration on March 20th, 2019).

Evaluation of Real-Time Three-Dimensional Echocardiography in Right Ventricular Function and Hemodynamics in Patients with Idiopathic Pulmonary Hypertension

Objective: Oriented with the assessment on real-time echocardiography based upon three dimensions (RT-3DE) in estimating right ventricular function and hemodynamics in the patients undergoing idiopathic pulmonary hypertension. Methods: Sixty patients living with idiopathic pulmonary hypertension admitted to our hospital from September 2018 to June 2019 were enrolled. Another 20 healthy examiners were selected as healthy controls. According to pulmonary systolic blood pressure, 60 patients were divided into 20 mild patients, 20 moderate ones as well as 20 severe ones. RT-3DE was used to measure right heart structure related parameters in all subjects, including left ventricular transverse diameter (LVTD), right ventricular transverse diameter (RVTD), right ventricular global end diastolic volume (EDV), right ventricular ejection fraction (RVEF). End-systolic volume (ESV), stroke volume (SV), as well as hemodynamic parameters, including pulmonary systolic pressure (SPAP), right heart output (RCO), pulmonary diastolic blood pressure (DPAP), pulmonary arterial pressure (MPAP). The differences in right heart structure parameters and hemodynamic parameters betwixt the PH Group and the healthy control Group were compared. In addition, conventional two-dimensional echocardiography (2DE) and RT-3DE were used to compare the images of the patients who had serious pulmonary hypertension and those of the Control Group to analyze the tricuspid annulus systolic displacement (TAPSE), the Tei index, and the tricuspid annulus systolic peak velocity (S’) value. The Result is that SPAP, DPAP, and MPAP achieved higher level in the PH Group compared to those in the Healthy Group, and P &lt; 0005, the difference took on statistical significance. Those data of SPAP, DPAP and MPAP in the moderate and severe PH Group were higher than those in the mild PH Group, and P &lt; 0005, the difference was of statistical significance. The RCO of the patients from the PH Group as well as the Healthy Group got under comparison, and P &lt; 0005. They presented statistics-based dramatic difference. In addition, RCO showed a gradual decline in the patients who came down with mild, moderate, and serious PH, and the results were statistically significant. In addition, the comparison between RT-3DE and conventional echocardiography shows that RT-3DE has higher accuracy and diagnostic value.

Assessing the impact of adding acetazolamide to oral or intravenous sodium bicarbonate as compared with intravenous bicarbonate monotherapy as urinary alkalinization in adults receiving high-dose methotrexate

High-dose methotrexate (HD-MTX) requires urine alkalinization to pH ≥ 7 for adequate excretion to prevent toxicity. Due to shortages of IV sodium bicarbonate (IV-NaHCO3), few reports have demonstrated utility of oral bicarbonate (PO-NaHCO3); however, the addition of acetazolamide (Acet) has not been well described. Our study compares outcomes between alkalinization methods of IV-NaHCO3 monotherapy versus IV-NaHCO2 + Acet and PO-NaHCO3 + Acet. A single-center, IRB exempt, retrospective review was conducted from Jan 2016 to Sept 2019 of adults receiving HD-MTX ≥ 500mg/m2. The primary outcome was time from start of alkalinization to pH ≥ 7. Secondary outcomes included time from start of alkalinization to initiation of HD-MTX, time to MTX clearance, length of stay (LOS), percentage of urine pH assessments < 7, and incidence of MTX toxicity. Statistical analysis was performed using SAS9.4 with alpha 0.05. Overall demographics (n = 196 HD-MTX cycles for 55 patients) include a mean age 55years, HD-MTX dose ~ 5400mg/m2, and 69% with a diagnosis of lymphoma. Adjusting for baseline demographic differences among groups, median time from first dose alkalinization to pH ≥ 7 and to start of HD-MTX was longer for those receiving IV-NaHCO3 (n = 41) vs either IV-NaHCO3 + Acet (n = 70) or PO-NaHCO3 + Acet (n = 76) (p = 0.0001). HD-MTX clearance to a level < 0.1μmol/L was not improved with the addition of Acet. No difference existed among groups for pH results < 7, LOS, or incidence of MTX toxicity (p > 0.05). Addition of Acet to NaHCO3 reduces time to pH ≥ 7 and initiation of HD-MTX but does not appear to improve LOS, MTX toxicities, or time to MTX clearance.

Control of cellular adhesiveness in hyaluronic acid‐based hydrogel through varying degrees of phenol moiety cross‐linking

Current hyaluronic acid-based hydrogels often cause cytotoxicity to encapsulated cells and lack the adhesive property required for effective biomedical and tissue engineering applications. Provision of the cell-adhesive surface is an important requirement to improve its biocompatibility. An aqueous solution of hyaluronic acid possessing phenolic hydroxyl (HA-Ph) moieties is gellable via a horseradish peroxidase (HRP)-catalyzed oxidative cross-linking reaction. This study evaluates the effect of different degrees of cross-linked Ph moieties on cellular adhesiveness and proliferation on the resultant enzymatically cross-linked HA-Ph hydrogels. Mechanical characterization demonstrated that the compression force of engineered hydrogels could be tuned in the range of 0.05-35 N by changing conjugated Ph moieties in the precursor formulation. The water contact angle and water content show hydrophobicity of hydrogels increased with increasing content of cross-linked Ph groups. The seeded mouse embryo fibroblast-like cell line and human cervical cancer cell line, on the HA-Ph hydrogel, proved cell attachment and spreading with a high content of cross-linked Ph groups. The HA-Ph with a higher degree of Ph moieties shows the maximum degree of cell adhesion, spreading, and proliferation which presents this hydrogel as a suitable biomaterial for biomedical and tissue engineering applications.

A Comparative Study on Growth and Metabolism of Eriocheir sinensis Juveniles Under Chronically Low and High pH Stress

This study elucidates the effects of chronic pH stress on the growth and metabolic response of juvenile Chinese mitten crab Eriocheir sinensis. Crabs were exposed under normal pH (control, pH = 8.0 ± 0.20), low pH (pH = 6.5 ± 0.20), and high pH (pH = 9.5 ± 0.20) in an 8-week trial. Both low and high pH suppressed weight gain but low pH had more adverse effects. No difference was observed on survival, crude lipid, and protein. Acidic stress significantly reduced protein efficiency. The malondialdehyde (MDA) content in hepatopancreas was highest at low pH. The superoxide dismutase (SOD) activity in hepatopancreas and total hemocyte counts (THC) in the stress groups were higher than that in the control. Crabs under high pH had the highest ACP and AKP activities, but there was no significant difference between the control and low pH groups. In the transcriptome analysis, 500.0M clean reads were obtained from the control, low pH, and high pH groups, and assembled into 83,025 transcripts. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways were analyzed to obtain the significantly changed pathways involving differently expressed genes. Ten and eight pathways in metabolism were significantly changed in low pH vs control and high pH vs control groups, respectively. According to the reported functions of these pathways, most of them participated in carbohydrate metabolism. The metabolism pathway analysis indicates the increases of stress resistance, glucose metabolism, and molting activities under chronically pH stress. This study suggests that low pH has more negative impact on crab growth, and oxidative phosphorylation is the main source of energy source under low pH stress, while aerobic glycolysis supplies most energy under high pH stress.

Factors of Reflux Episodes With Post-reflux Swallow-induced Peristaltic Wave in Gastroesophageal Reflux Disease.

Background/AimsIt is known that post-reflux swallow-induced peristaltic wave (PSPW) index represents the chemical clearance of the esophagus. However, few studies have explored why some reflux episodes could induce PSPW while others in the same patient could not. The purpose of this study is to investigate the characteristics of reflux episodes which could elicit PSPW.MethodsIn this study, 269 reflux episodes were detected, of which 90 with a PSPW and 179 without a PSPW. Comparisons were made between the characteristics of reflux episodes with a PSPW and without a PSPW. The characteristics were including nadir pH, pH drop, proximal extent (cm, sec), ascending velocity (cm/sec), volume clearance time, acid clearance time, percentage acidic (%), 15 to 60-minute acid burden (seconds), and 15- to 60-minute volume burden (seconds). The characteristics between the 2 groups were compared through performing Wilcoxon signed rank test.ResultsReflux episodes followed by a PSPW were significantly associated with a higher proximal extent than those without a PSPW. After the reflux episodes, higher volume clearance time and larger volume burden were more likely to trigger a PSPW. However, there were no significant differences between the 2 groups in nadir pH, pH drop, ascending velocity, acid clearance time, percentage acidic, or acid burden.ConclusionsThe role of acid seems to be less important in a reflux episode inducing a PSPW. Proximal reflux episodes are more likely to induce a PSPW. The depression of volume clearance may also be an important factor in eliciting a PSPW.