Alcohol drinking triggered decrease of oxidative balance score is associated with high all-cause and cardiovascular mortality in hypertensive individuals:findings from NHANES 1999–2014

BACKGROUND Oxidative stress is closely associated with hypertensive outcomes.The oxidative balance score(OBS)measures oxidative stress exposure from dietary and lifestyle elements.The objective of this study was to investigate the association between OBS and mortality in hypertensive patients.METHODS This study included 7823 hypertensive patients from the National Health and Nutrition Examination Survey(NHA-NES)1999-2014.Several models,including Cox regression,restricted cubic splines(RCS),Kaplan-Meier survival analysis,subgroup,and sensitivity analyses,were exploited to investigate the relationship between OBS and the risk of mortality.RESULTS Controlling for all potential confounders,a significantly inverse association was observed between elevated OBS and all-cause[hazard ratio(HR)=0.90,95%CI:0.85-0.95]and cardiovascular mortality(HR=0.85,95%CI:0.75-0.95).With adjustment for covariates,significant associations between lifestyle OBS and mortality risks diminished,whereas associations between dietary OBS and these mortality risks remained robust(all-cause mortality:HR=0.91,95%CI:0.86-0.96;cardiovascular mortality:HR=0.85,95%CI:0.76-0.96).RCS demonstrated a linear relationship between OBS and all-cause and cardiovascular mortality risk(P_(nonlinear)=0.088 and P_(nonlinear)=0.447,respectively).Kaplan-Meier curves demonstrated that the mortality rate was lower with a high OBS(P<0.001).The consistency of the association was demonstrated in subgroup and sensitivity analyses.RCS after stratification showed that among current drinkers,those with higher OBS had a lower risk of mortality compared with former or never drinkers.CONCLUSIONS In hypertensive individuals,there was a negative association between OBS and all-cause and cardiovascular mortality.Encouraging hypertensive individuals,especially those currently drinking,to maintain high levels of OBS may be beneficial in improving their prognosis.

Utilization of deep neuromuscular blockade combined with reduced abdominal pressure in laparoscopic radical gastrectomy for gastric cancer:An academic perspective

BACKGROUND Few studies have examined the specific efficacy of deep neuromuscular blockade(NMB)combined with pneumoperitoneal pressure reduction in laparoscopic radical gastrectomy(LRG)in the elderly.AIM To investigate the application effect of deep neuromuscular blockade(NMB)combined with reduced pneumoperitoneum pressure in LRG for gastric cancer(GC)in elderly patients and its influence on inflammation.METHODS Totally 103 elderly patients with GC treated in our hospital between January 2020 and January 2022 were retrospectively analyzed.Among them,45 patients treated with surgery based on deep NMB and conventional pneumoperitoneum pressure were assigned to the control group,while the rest of the 58 patients who underwent surgery based on deep NMB and reduced pneumoperitoneum pressure were assigned to the observation group.The two groups were compared in the changes of the Leiden-surgical rating scale score,serum tumor necrosis fact-α(TNF-α)and interleukin 6(IL-6)before and after therapy.The visual analogue scale(VAS)was adopted for evaluating the shoulder pain of patients at 8 h,24 h and 48 h after the operation.The driving pressure of the two groups at different time points was also compared.Additionally,the operation time,pneumoperitoneum time,infusion volume,blood loss,extubation time after surgery,residence time in the resuscitation room,TOF%=90%time and post-anesthetic recovery room(PACU)stay time were all recorded,and adverse PACU-associated respiratory events were also recorded.The postoperative hospitalization time and postoperative expenses of the two groups were counted and compared.RESULTS No significant difference was found between the two groups at the time of skin incision,60 minutes since the operation and abdominal closure after surgery(P>0.05).The observation group exhibited significantly lower VAS scores than the control group at 24 and 48h after surgery(P<0.05).Additionally,the observation group had significantly lower driving pressure than the control group at 5 min and 60 min after the establishment of pneumoperitoneum(P<0.05).Additionally,the two groups were similar in terms of the operation time,pneumoperitoneum time,infusion volume,blood loss,extubation time after surgery,residence time in the resuscitation room and TOF%=90%time(P>0.05),and the observation group showed significantly lower TNF-αand IL-6 Levels than the control group at 24 h after therapy(P<0.05).Moreover,the incidence of adverse events was not significantly different between the two groups(P>0.05),and the observation group experienced significantly less hospitalization time and postoperative expenses than the control group(P<0.05).CONCLUSION Deep NMB combined with reduced pneumoperitoneum pressure can decrease the VAS score of shoulder pain and inflammatory reaction,without hindering the surgical vision and increasing adverse PACU-associated respiratory events,and can thus shorten the hospitalization time and treatment cost for patient.

N-methyl-D-aspartate receptor subunit 1 regulates neurogenesis in the hippocampal dentate gyrus of schizophrenia-like mice

N-methyl-D-aspartate receptor hypofunction is the basis of pathophysiology in schizophrenia. Blocking the N-methyl-D-aspartate receptor impairs learning and memory abilities and induces pathological changes in the brain. Previous studies have paid little attention to the role of the N-methyl-D-aspartate receptor subunit 1 (NR1) in neurogenesis in the hippocampus of schizophrenia. A mouse model of schizophrenia was established by intraperitoneal injection of 0.6 mg/kg MK-801, once a day, for 14 days. In N-methyl-D-aspartate-treated mice, N-methyl-D-aspartate was administered by intracerebroventricular injection in schizophrenia mice on day 15. The number of NR1-, Ki67- or BrdU-immunoreactive cells in the dentate gyrus was measured by immunofluorescence staining. Our data showed the number of NR1-immunoreactive cells increased along with the decreasing numbers of BrdU- and Ki67-immunoreactive cells in the schizophrenia groups compared with the control group. N-methyl-D-aspartate could reverse the above changes. These results indicated that NR1 can regulate neurogenesis in the hippocampal dentate gyrus of schizophrenia mice, supporting NR1 as a promising therapeutic target in the treatment of schizophrenia. This study was approved by the Experimental Animal Ethics Committee of the Ningxia Medical University, China (approval No. 2014-014) on March 6, 2014.

Neuraxial adjuvants for prevention of perioperative shivering during cesarean section: A network meta-analysis following the PRISMA guidelines

BACKGROUND Perioperative shivering is clinically common during cesarean sections under neuraxial anesthesia,and several neuraxial adjuvants are reported to have preventive effects on it.However,the results of current studies are controversial and the effects of these neuraxial adjuvants remain unclear.AIM To evaluate the effects of neuraxial adjuvants on perioperative shivering during cesarean sections,thus providing an optimal choice for clinical application.METHODS A systematic review and network meta-analysis were conducted following the PRISMA (Preferred Reported Items for Systematic Review and Meta-analysis) guidelines.Analyses were performed using Review Manager 5.3 and Stata 14.0.We searched PubMed,EMBASE,Web of Science,and Cochrane Central databases for eligible clinical trials assessing the effects of neuraxial adjuvants on perioperative shivering and other adverse events during cesarean sections.Perioperative shivering was defined as the primary endpoint,and nausea,vomiting,pruritus,hypotension,and bradycardia were the secondary outcomes.RESULTS Twenty-six studies using 9 neuraxial adjuvants for obstetric anesthesia during caesarean sections were included.The results showed that,compared with placebo,pethidine,fentanyl,dexmedetomidine,and sufentanil significantly reduced the incidence of perioperative shivering.Among the four neuraxial adjuvants,pethidine was the most effective one for shivering prevention (OR = 0.15,95%CI: 0.07-0.35,surface under the cumulative ranking curve 83.9),but with a high incidence of nausea (OR = 3.15,95%CI: 1.04-9.57) and vomiting (OR = 3.71,95%CI: 1.81-7.58).The efficacy of fentanyl for shivering prevention was slightly inferior to pethidine (OR = 0.20,95%CI: 0.09-0.43),however,it significantly decreased the incidence of nausea (OR = 0.34,95%CI: 0.15-0.79) and vomiting (OR = 0.25,95%CI: 0.11-0.56).In addition,compared with sufentanil,fentanyl showed no impact on haemodynamic stability and the incidence of pruritus.CONCLUSION Pethidine,fentanyl,dexmedetomidine,and sufentanil appear to be effective for preventing perioperative shivering in puerperae undergoing cesarean sections.Considering the risk-benefit profiles of the included neuraxial adjuvants,fentanyl is probably the optimal choice.

Environmental constraints on the inter-genus variation in the scaling relationship between leaf nitrogen and phosphorus concentrations

Aims The scaling relationship between nitrogen(N)and phosphorus(P)concentrations([N]and[P],respectively)in leaves manifests plants’relative investment between the two nutrients.However,the variation in this relationship among taxa as well as its causes was seldom described.Methods The analysis was based on a dataset including 2483 leaf samples from 46 genera of angiosperm woody plants from 1733 sites across China.We calculated the leaf N–P scaling exponent(βL)with an allometric equation([N]=α[P]β),for each genus,respectively.We then performed phylogenetic path analyses to test how the climate and soil niche conditions of these genera contributed to the inter-genus variation inβL.Important Findings The genera living with lower soil P availability presented a more favoured P uptake relative to N,as shown by the higherβL,suggesting a resistant trend to P limitation.Additionally,genus-wiseβL was positively correlated with soil N–P scaling exponents(β_(S)),implying that the variation in leaf nutrients is constrained by the variability in their sources from soil.Finally,climatic factors including temperature and moisture did not affectβL directly,but could have an indirect influence by mediating soil nutrients.Phylogeny did not affect the inter-genus variation inβL along environmental gradients.These results reveal that the trade-off between N and P uptake is remarkably shaped by genus niches,especially soil nutrient conditions,suggesting that theβL could be considered as a functional trait reflecting characteristics of nutrient utilization of plant taxa in response to niche differentiation.

Association between atmospheric concentration of particulate matters and inpatient and outpatient visits for chronic respiratory diseases in Xiamen, China

Exposure to airborne particulate matters(fine particulate matter[PM2.5]and inhalable particulate matter[PM10])causes acute exacerbation of chronic respiratory diseases and even death in some patients.[1,2]Here,we studied the association between airborne pollutants(PM2.5,PM10,ozone[O_(3)]),weather conditions(mean air temperature,wind force),and outpatient and inpatient visits for chronic respiratory diseases(bronchitis,emphysema and chronic obstructive pulmonary disease[COPD],bronchiectasis)in Xiamen,China.