[Ultrasound-guided continuous fascia iliaca compartment block for perioperative pain management in elderly patients undergoing hip fracture surgery]

OBJECTIVE

To study the effect of ultrasound-guided fascia iliaca compartment block on perioperative analgesia and postoperative complications in geriatric patients with hip fractures.

METHODS

A total of 127 elderly patients undergoing hip fracture surgery from January 2021 to September 2021 were randomized to receive ultrasound-guided continuous fascia iliaca compartment block(group F) either intravenous analgesia control group(group C). There were 62 cases in group F, including 19 males and 43 females with an average age of (82.4±7.2) years old ranging from 66 to 95 years old, involving 25 femoral neck fractures and 37 femoral intertrochanteric fractures. There were 65 cases in control group, including 18 males and 47 females, with an average age of (81.4±8.7) years old ranging from 65 to 94 years old, involving 29 femoral neck fractures and 36 femoral intertrochanteric fractures. The visual analogue scale(VAS), minimental state examination (MMSE), observer's assessment of alertness/sedation(OAA/S) scale, modified Bromage score, postoperative complications and general conditions during hospitalization in two groups were observed.

RESULTS

The resting and exercise VAS at 30 min after block, anesthesia placement and 6, 24 and 48 h after surgery were lower than those in group C(P<0.05). In group F, MMSE scores at 12 h before surgery, and 1, 3 d after surgery and OAA/S scores at 3 d after surgery were higher than those in group C(P<0.05). The incidence of adverse effects and the number requiring additional analgesia were lower than those in group C(P<0.05). Group F had better perioperative analgesia satisfaction and hospital stay than group C(P<0.05). But there was no significant difference regarding Bromage score and 30-day mortality between two group(P>0.05).

CONCLUSION

Ultrasound-guided continuous fascia iliacus space block was safe and effective for elderly patients with hip fracture, and could significantly reduce perioperative pain, improve postoperative cognitive function, and reduce postoperative complications, thereby shortening hospital stay and improving the quality of life during hospitalization.

Salicylic acid-primed defence response in octoploid strawberry 'Benihoppe' leaves induces resistance against Podosphaera aphanis through enhanced accumulation of proanthocyanidins and upregulation of pathogenesis-related genes

BACKGROUND

Podosphaera aphanis, a predominately biotrophic fungal pathogen, causes significant yield losses of strawberry. China is the largest strawberry producer in the world, and selecting for powdery mildew-resistant cultivars is desirable. However, the resistance mechanism against P. aphanis in the octoploid strawberry remains unclear.

RESULTS

To understand possible mechanisms of disease resistance, we inoculated strawberry leaves with P. aphanis, and examined the expression profiles of candidate genes and the biochemical phenotypes in strawberry leaves of two groups. The unigenes obtained from ddH₂O- and SA-pretreated leaves resulted in a total of 48,020 and 45,896 genes, respectively. KEGG enrichment showed that phenylpropanoid biosynthesis and plant hormone signal transduction pathways were enriched to a noticeable extent. DEG analysis showed that key TFs genes associated with the SA signaling pathway could play important role in the strawberry-P. aphanis interaction. In particular, FaWRKY70, FaJAZ1 and FaMYC2-like, involved in regulating the antagonistic effect of SA and JA signaling pathway, leading to increased expression of SA-responsive genes (in particular PR1, PR2, PR3, and PR5) compared to a decline in expression of JA-responsive genes (FaJAR1, FaAOS, and FaLOX2). Furthermore, SA pretreatment induced accumulation of PAs by activating the MBW complex and inhibit powdery mildew growth.

CONCLUSIONS

This study describes the role of the proanthocyanidins (PAs), pathogenesis-related (PR) genes, SA, and transcription factors in regulatory model against P. aphanis, which coincided with an early activation of defense, leading to the accumulation of PAs and the PR proteins.

Effects of different levels of soluble PD-L1 protein on the growth of Lewis lung cancer transplanted tumor

To investigate the effects of different doses of soluble PD-L1 (soluble form of Programmed death ligand 1, sPD-L1) protein on Lewis lung cancer cells, flow cytometry was used to detect the expression of PD-L1 (Programmed death ligand 1) on the surface of Lewis lung cancer cell lines and the expression of PD-1 on the surface of T lymphocytes in peripheral blood and spleen cells of C57BL/6 mice. A Lewis lung cancer animal model of C57BL/6 mice was established by transplanting Lewis lung cancer cells subcutaneously. The sPD-L1 protein was injected into the abdominal cavity of the mouse (sPD-L1 Ig) (working dose: 2.5, 5, 10 μg per mouse), while the sPD-L1 control protein was injected as a control. The growth of Lewis lung cancer xenografts was observed. On the 18th day after tumor cell inoculation, T lymphocyte subsets in mouse spleen were determined by flow cytometry. The PD-1 molecules on the surface of Lewis lung cancer cell line, C57BL/6 mouse spleen T lymphocytes and peripheral blood T lymphocytes were positively expressed. Compared with the control group, the volume of the transplanted tumor of Lewis lung cancer in C57BL/6 mice was larger with 10 μg sPD-L1 I g injection (P less than 0.05), and no significant difference was observed in tumor volume with 2.5 μg and 5 μg injection (P > 0.05). A certain level of soluble PD-L1 (10 μg/ mouse) could promote the growth of transplanted tumors of Lewis lung cancer in C57BL/6 mice.

Factor structures of Taiwanese teachers' ratings of ADHD: a comparison with U.S. studies

The purpose of this study was to compare factor structures from Taiwanese teachers' ratings with diagnostic definitions of attention-deficit/hyperactivity disorder (ADHD) as described in the DSM-III-R, DSM-IV, and ICD-10; to examine how factor structures of Taiwanese teachers' ratings of ADHD symptoms compare with factor structures reported in research using school-based American participants; and to examine gender differences. One hundred and twenty-one homeroom teachers from six public elementary schools in Taipei County, Taiwan, rated two boys and two girls randomly selected from their homerooms using the ADHD checklist. Findings from this study support the concurrent validity of the DSM-IV ADHD factor structures of hyperactivity-impulsivity and inattention. Comparability of these findings with school-based U.S. studies suggests the cross-cultural congruency of behaviors associated with ADHD.

The therapeutic effects of oil-soluble hysterosalpingography contrast medium following water-soluble hysterosalpingography contrast medium

Previous studies have revealed that patients who underwent hysterosalpingography (HSG) with an iol-soluble contrast medium (OSCM) rather than a water-soluble contrast medium (WSCM) had higher subsequent fertility rates. In this randomized prospective study, the fertility rates among 109 patients following HSG were found to be 31% (19/61) in the WSOM group and 38% (18/48) in the WSOM + OSCM group. No significant difference was noted between these two groups, whether their infertility was associated with endocrine factor, male factor, endometriosis, mechanical factor or some other unexplained factor.