Intraoperative Sufentanil Consumption and the Risk of Postoperative Nausea and/or Vomiting: A Retrospective Observational Study

INTRODUCTION

Post-operative nausea and/or vomiting (PONV) is a common post-operative adverse reaction and has been associated with post-operative sufentanil injection. The assessment of the relationship between intraoperative opioid consumption and PONV has been understudied. This study examined the relationship between intraoperative sufentanil administration and PONV.

METHODS

This was a single-center retrospective observational study. Patients who underwent video-assisted thoracoscopic surgery under general anesthesia with the preoperative thoracic paravertebral block between January 2017 and June 2020 at the Peking University People's Hospital were recruited for this study. Patients were grouped into two groups according to whether or not PONV occurred on postoperative day 1 (POD1). The factors associated with PONV were analyzed using logistic regression.

RESULTS

A total of 2733 patients, 1510 males and 1223 females, were included in this study. Among them, 143 patients developed PONV, a 5.2% (143/2733) PONV incidence. Logistic regression analysis showed that female, nonsmoking, sufentanil patient-controlled intravenous analgesia (PCIA), POD1 opioids consumption, and a time-weighted average of intraoperative sufentanil (twSuf) were associated with PONV. All patients were further divided into four subgroups based on intraoperative twSuf. Logistic regression analysis revealed that twSuf higher than 0.21 μg kg-1 h-1 was an independent risk factor for PONV.

CONCLUSIONS

Intraoperative sufentanil injection with a twSuf higher than 0.21 μg kg-1 h-1 increased the risk of PONV in patients undergoing thoracoscopic surgery under general anesthesia after a preoperative thoracic paravertebral block.

Dietary pattern interfered with the impacts of pesticide exposure by regulating the bioavailability and gut microbiota

Dietary intake is an essential way for pesticides to enter the human body. The effects of dietary pattern on the risks of pesticides and what diet can reduce the damage are largely unknown. Here, it is found that Mediterranean diet and Vegetarian diet could alleviate insulin resistance and obesity induced by chlorpyrifos, while Western diet could aggravate that. Gut microbiota and chlorpyrifos bioavailability mediated by the diets were involved in these effects. Both the dietary pattern and chlorpyrifos could change the composition of gut microbiota. Chlorpyrifos caused gut dysbacteriosis which was an important reason for the induced metabolic syndrome. Mediterranean diet and Vegetarian diet could maintain gut microbiota homeostasis and increase intestinal bacteria producing short-chain fatty acids, repair the gut microbiota and intestinal barrier damaged by chlorpyrifos. High dietary fat intake increased the bioavailability of chlorpyrifos, which aggravated the gut dysbacteriosis and destruction of intestinal integrity. Thus, the amount of endotoxin entering the blood increased and caused low-grade inflammation, which was also an important pathway of metabolic syndrome. The results suggested that although it was almost impossible to avoid the exposure to pesticides in modern life, healthy diets could regulate beneficial gut microbiota and alleviate the risk of pesticide exposure.

The transcription factors of tall fescue in response to temperature stress

Tall fescue (Festuca arundinacea) is an important grass species worldwide, but temperature stress severely affects its distribution and yield. Transcription factors (TFs), as the master switches in sophisticated regulatory networks, play essential roles in plant growth development and abiotic stress responses. In this study, the comparative transcriptome analysis was performed to explore the commonalities and differences in the response of TFs to the heat (40 °C), cold (10 °C) and control (22 °C) conditions. A total of 877 TF genes belonging to 35 families were identified. Most of them (784) were differentially expressed genes (DEG), indicating TF genes actively responded to temperature stress. The expression of bZIP and GTF family members was up-regulated when exposed to both heat and cold, but conversely, the expression of the most WRKY and NAC families members decreased. The HSF and GTE families and DREB2B were up-regulated upon heat, while bHLH, MYB, HD-ZIP and ERF families were elevated under cold stress. The TFs involved in 'Plant hormone signal transduction', 'Plant-pathogen interaction', 'Circadian rhythm' play major roles in responding to temperature stresses. The results showed the temperature threats up-regulated the expression of stress tolerance-related genes, and down-regulated those genes associated with growth and disease resistance, indicating TFs exert crucial roles in plant adaptation to an adverse environment. This study profiled the responsive pattern of TFs to temperature stresses, partially explained the mechanism of adaptations of cold-season forage crops and screened many candidate stress-tolerant TF genes.

[Clinical features and outcomes in relapsing and monophasic patients with anti-leucine-rich glioma-inactivated 1 encephalitis]

Objective: To analyze the differences of clinical characteristics and outcomes between relapsing and monophasic patients with anti-leucine-rich glioma-inactivated 1 (anti-LGI1) encephalitis. Methods: Medical records of confirmed anti-LGI1 encephalitic patients who underwent immunotherapy were retrospectively collected from January 2015 to January 2019 in the first affiliated hospital of Zhengzhou University. Clinical data, treatment methods, duration of treatment and outcomes were analyzed between the relapsing and monophasic groups. Results: Among the 33 anti-LGI1 encephalitic patients, there were 12 and 21 cases in the relapsing and monophasic groups, respectively. No difference was found in age, sex, precipitating factors, intensive care unit (ICU) admission, symptoms and modified Rankin Scale (mRS) score in the acute phase (P>0.05). As to the lab test and image examination, no statistic difference was found in serum and cerebral spinal fluid (CSF) positive rate, hyponatremia, abnormal rate of electrocardiogram (ECG), electroencephalogram (EEG), CSF and magnetic resonance imaging (MRI) and lesion locations (P>0.05). No difference was found in time to diagnose the disease between the 2 groups (P>0.05). The median immunotherapy period was 102.5 days in relapsing group and 194.0 days in monophasic group, with a statistic difference (P=0.001). No patients had bad outcomes in the monophasic group at the last follow-up, while 6 patients had poor outcomes in the relapsing group (4 patients died). The patients in relapsing group had a worse prognosis compared to those in the monophasic group (P=0.007). Conclusions: Relapse is common in anti-LGI1 encephalitis. Patients in the relapsing group received a shorter term of immunotherapy and had worse outcomes than those in the monophasic group.

Spectral broadening in femtosecond pulse written filamentary waveguides in periodically poled lithium niobate

The authors report the filamentary waveguide formation and the significant spectral broadening based on periodically poled lithium niobate substrate. The modified morphology contributes to the combined effects of optical diffraction and self-focusing with the dependence on pulse intensity. Up to 4 times broadening of the FF wave and about 47 nm spanning of the SH wave with the pump power of 19.5 mW are achievable under 1550 nm excitation. Spectral evolution by cubic nonlinearity inside the waveguide has been obtained numerically, and provides a reasonable agreement with the experimental results.

Signed frequency offset measurement for direct detection DPSK system with a chromatic dispersion offset

We demonstrated a method for the measurement of signed frequency offset between optical source and delay interferometer (DI) for 10 Gb/s DPSK signals based on asynchronous delay-tap sampling technique with a chromatic dispersion (CD) offset. The demodulated DPSK signals show asymmetrical property and amplitude shoulder appears on the waveforms with frequency offset and a fixed CD offset together. The delay-tap sampling scatter plots also show the asymmetry related to the asymmetrical signal distortion. Our proposed method cannot only realize the measurement of the magnitude of frequency offset but also the polarity. The measurement range is from -2 GHz to +2 GHz and the sensitivity can reach ±100MHz. The simulation and experimental results are demonstrated and in good agreement.

Overexpression of WNT2 and TSG101 genes in colorectal carcinoma

Colorectal carcinoma (CRC) arises as a result of mutational activation of oncogenes coupled with inactivation of tumour suppressor genes. Mutations in APC, K-ras and p53 have been commonly reported. In a previous study by our group, the tumour susceptibility gene 101 (TSG101) were found to be persistently upregulated in CRC cases. TSG101 was reported to be closely related to cancers of the breast, brain and colon, and its overexpression in human papillary thyroid carcinomas and ovarian carcinomas had previously been reported. The wingless-type MMTV integration site family member 2 (WNT2) is potentially important in the Wnt/beta-catenin pathway and upregulation of WNT2 is not uncommon in human cancers. In this study, we report the investigation for mutation(s) and expression pattern(s) of WNT2 and TSG101, in an effort to further understand their role(s) in CRC tumourigenesis. Our results revealed no mutation in these genes, despite their persistent upregulation in CRC cases studied.