Efficacy of Bispectral index-monitored closed-loop targeted-controlled infusion of propofol for laparoscopic radical operation for gastric cancer

Objective:To discuss the efficacy of Bispectral index (BIS)-monitored closed-loop targeted-controlled infusion of propofol for laparoscopic radical operation for gastric cancer.Methods:A total of 106 patients with primary gastric cancer who underwent laparoscopic radical operation for gastric cancer in our hospital between August 2015 and February 2018 were chosen as the research subjects and divided into the control group (n=53) and the observation group (n=53) according to the different anesthesia methods. Control group of patients received BIS-monitored manually adjusted targeted-controlled infusion concentration of propofol, and observation group of patients received BIS-monitored closed-loop targeted-controlled infusion of propofol. The differences in hemodynamic index levels as well as serum contents of inflammatory factors and stress hormones were compared between the two groups of patients before anesthesia (T0), 30 min after surgery started (T1) and 30 min before surgery ended (T2).Results:At T0, the differences in hemodynamic index levels as well as serum contents of inflammatory factors and stress hormones were not statistically significant between the two groups. At T1 and T2, hemodynamic indexes MAP and HR levels of observation group were lower than those of control group at the corresponding time points;serum inflammatory factors sICAM-1, IL-1β, IL-8 and TNF-α contents were lower than those of control group at the corresponding time points;serum stress hormones Cor, T4 and glucagon contents were lower than those of control group at the corresponding time points.Conclusion: BIS-monitored closed-loop targeted-controlled infusion of propofol can effectively stabilize the intraoperative hemodynamics and inhibit the systemic inflammatory stress response in patients with laparoscopic radical operation for gastric cancer.

Neuroprotective effect of bispectral index-guided fast-track anesthesia using sevoflurane combined with dexmedetomidine for intracranial aneurysm embolization

Dexmedetomidine has sedative, anxiolytic, analgesic, anti-sympathetic, and anti-shivering effects. Dexmedetomidine might be effective in combination with sevoflurane for anesthesia, but prospective randomized controlled clinical trials with which to verify this hypothesis are lacking. In total, 120 patients who underwent embolization of an intracranial aneurysm were recruited from Anhui Provincial Hospital and Renmin Hospital of Wuhan University of China and randomly allocated to two groups. After intraoperative administration of 2% to 3% sevoflurane inhalation, one group of patients received pump-controlled intravenous injection of 1.0 ~tg/kg dexmedetomidine for 15 minutes followed by maintenance with 0.3 ~tg/kg/h until the end of surgery; the other group of patients only underwent pump-controlled infusion of saline. Bispectral index monitoring revealed that dexmedetomidine-assisted anesthesia can shorten the recovery time of spon- taneous breathing, time to eye opening, and time to laryngeal mask removal. Before anesthetic induction and immediately after laryngeal mask airway removal, the glucose and lactate levels were low, the S100~ and neuron-specific enolase levels were low, the perioperative blood pressure and heart rate were stable, and postoperative delirium was minimal. These findings indicate that dexmedetomidine can effectively assist sevoflurane for anesthesia during surgical embolization of intracranial aneurysms, shorten the time to consciousness and extubation, reduce the stress response and energy metabolism, stabilize hemodynamic parameters, and reduce adverse reactions, thereby reducing the damage to the central nervous system. This trial was registered at the Chinese Clinical Trial Registry （http：//www.chictr.org. cn/） （registration number： ChiCTR-IPR- 16008113）.

Comparison of 1.5% lidocaine and 0.5% ropivacaine epidural anesthesia combined with propofol general anesthesia guided by bispectral index

Objective： To compare the effects of epidural anesthesia with 1.5% lidocaine and 0.5% ropivacaine on propofol requirements, the time to loss of consciousness （LOC）, effect-site propofol concentrations, and the hemodynamic variables during induction of general anesthesia guided by bispectral index （BIS） were studied. Methods： Forty-five patients were divided into three groups to receive epidurally administered saline （Group S）, 1.5% （w/w） lidocaine （Group L）, or 0,5% （w/w） ropivacaine （Group R） Propofol infusion was started to produce blood concentration of 4 lag/ml. Once the BIS value reached 40-50, endotracheal intubation was facilitated by 0.1 mg/kg vecuronium. Measurements included the time to LOC, effect-site propofol concentrations, total propofol dose, mean arterial blood pressure （MABP）, and heart rate （HR） at different study time points. Results： During induction of anesthesia, both Groups L and R were similar for the time to LOC, effect-site propofol concentrations, total propofol dose, MABP, HR, and BIS. The total doses of propofol administered until 1 min post-intubation were significantly less in patients of Groups R and L compared with Group S. MABP and HR were significantly lower following propofol induction compared with baseline values in the three groups, or MABP was significantly increased following intubation as compared with that prior to intubation in Group S but not in Groups R and L while HR was significantly increased following intubation in the three groups. Conclusion： Epidural anesthesia with 1.5% lidocaine and 0.5% ropivacaine has similar effects on the time to LOC, effect-site propofol concentrations, total propofol dose, and the hemodynamic variables during induction of general anesthesia.

The Analysis of Human Development Index (HDI) for Categorizing the Member States of the United Nations (UN)

To categorize the nations to reflect the development status, to date, there are many conceptual frameworks. The Human Development index (HDI) that is published by the United Nations Development Programme is widely accepted and practiced by many people such as academicians, politicians, and donor organizations. However, though the development of HDI has gone through many revisions since its formulation in 1990, even the current version of the index formulation published in 2016 needs research to better understand and to gap-fill the knowledge base that can enhance the index formulation to facilitate the direction of attention such as release of funds. Therefore, in this paper, based on principal component analysis and K-means clustering algorithm, the data that reflect the measures of life expectancy index (LEI), education index (EI), and income index (II) are analyzed to categorize and to rank the member states of the UN using R statistical software package, an open source extensible programming language for statistical computing and graphics. The outcome of the study shows that the proportion of total eigen value (i.e., proportion of total variance) explained by PCA-1 (i.e., first principal component) accounts for more than 85% of the total variation. Moreover, the proportion of total eigen value explained by PCA-1 increases with time (i.e., yearly) though the amount of increase with time is not significant. However, the proportions of total eigen value explained by PCA-2 and PCA-3 decrease with time. Therefore, the loss of information in choosing PCA-1 to represent the chosen explanatory variables (i.e., LEI, EI, and II) may diminish with time if the trend of increasing pattern of proportion of total eigen value explained by PCA-1 with time continues in the future as well. On the other hand, the correlation between EI and PCA-1 increases with time although the magnitude of increase is not that significant. This same trend is observed in II as well. However, in contrast to these observations, the correlation between PCA-1 and LEI decreases with time. These findings imply that the contributions of EI and II to PCA-1 increase with time, but the contribution of LEI to PCA-1 decreases with time. On top of these, as per Hopkins statistic, the clusterability of the information conveyed by PCA-1 alone is far better than the clusterability of the information conveyed by PCA scores (i.e., PCA-1, PCA-2, and PCA-3) and the explanatory variables. Therefore, choosing PCA-1 to represent the chosen explanatory variables is becoming more concrete.

Estimating the Drought-Induced Yield Loss for Winter Wheat in a Semi-Arid Region of the Southern United States Using a Drought Index

The economy of most rural locations in the semi-arid region of Llano Estacado in the southern United States is predominantly based on agriculture, primarily beef and wheat (Triticum aestivum L.) production. This region is prone to drought and is projected to experience a drier climate. Droughts that coincide with the critical phenological phases of a crop can be remarkably costly. Although drought cannot be prevented, its losses can be minimized through mitigation measures if it is predicted in advance. Predicting yield loss from an imminent drought is an important need of stakeholders. One way to fulfill this need is using an agricultural drought index, such as the Agricultural Reference Index for Drought (ARID). Being plant physiology-based, ARID can represent drought-yield relationships accurately. This study developed an ARID-based yield model for predicting the drought-induced yield loss for winter wheat in this region by accounting for its phenological phase-specific sensitivity to water stress. The reasonable values of the drought sensitivity coefficients of the yield model indicated that it could reflect the phenomenon of water stress decreasing the winter wheat yields in this region reasonably. The values of the various metrics used to evaluate the model, including Willmott Index (0.86), Nash-Sutcliffe Index (0.61), and percentage error (26), indicated that the yield model performed fairly well at predicting the drought-induced yield loss for winter wheat. The yield model may be useful for predicting the drought-induced yield loss for winter wheat in the study region and scheduling irrigation allocation based on phenological phase-specific drought sensitivity.

Assessment of cerebrovascular reserve impairment using the breath-holding index in patients with leukoaraiosis

Many studies have demonstrated that leukoaraiosis is associated with impaired cerebrovascular reserve function. However, the definitive hemodynamic changes that occur in leukoaraiosis are not clear, and there are many controversies. This study aimed to investigate hemodynamic changes in symptomatic leukoaraiosis using transcranial Doppler ultrasonography and the breath-holding test in a Chinese Han population, from northern China. A total of 203 patients who were diagnosed with ischemic stroke or clinical chronic progressive ischemic symptoms were enrolled in this study, including 97 males and 106 females, with an age range of 43-93 years. The severity of leukoaraiosis was evaluated according to the Fazekas grading scale, and patients were divided into four groups accordingly. Grade 0 was no leukoaraiosis, and grades I, II, and III were mild, moderate, and severe leukoaraiosis, respectively, with 44, 79, 44, and 36 cases in each group. Transcranial Doppler ultrasonography and the breath-holding test were performed. The mean blood flow velocity of the bilateral middle cerebral artery was measured and the breath-holding index was calculated. The breath holding index was correlated with leukoaraiosis severity and cognitive impairment. Patients with a low breath holding index presented poor performance in the Montreal Cognitive Assessment (MoCA) and executive function tests. That is, the lower the breath holding index, the lower the scores for the MoCA and the higher for the trail-making test Parts A and B. These results indicate that the breath-holding index is a useful parameter for the evaluation of cerebrovascular reserve impairment in patients with leukoaraiosis. In addition, the breath-holding index can reflect cognitive dysfunction, providing a new insight into the pathophysiology of leukoaraiosis. This study was approved by the Ethics Committee of the Fifth Peoples Hospital of Shenyang, China (approval No. 20160301) and registered in the Chinese Clinical Trial Registry (registration number: ChiCTR1800014421).

Comparison of Entropy vs. Bispectral Index Anesthetic Depth Monitoring during Isoflurane Anesthesia in Living Donor Liver Transplantation: Observational Study

Liver transplantation (LT) recipients are known to require less anesthetic agents. Providing minimally required anesthetics while avoiding awareness is especially important in LT recipients because it would help manage perioperative hemodynamic instability with less vasopressor and fast track recovery. This study aims to compare state entropy (SE) against bispectral index (BIS) during isoflurane anesthesia in LT. We adjusted anesthesia to BIS values 40 - 60, and compared it with concomitant SE values. BIS, SE values, and anesthetic requirements according to liver failure severity, etiology and LT stages were analyzed. For BIS-SE differences, SE value that is different from the concomitant BIS by more than 15 was defined as a significant disagreement. Mann Whitney, Kruskal Wallis test and a Poisson exact test were used for analysis. The BIS-SE pair sets of 2895 from 38 patients were analyzed. BIS, SE values and anesthetic requirements were significantly lower in MELD ≥ 20 (p < 0.001 in all) and in alcoholic etiology (p < 0.001 in all). For BIS-SE differences, 320 disagreement data pairs were seen at a rate of 1.33 times/hr (95% CI = [1.19, 1.48], p < 0.001). A significant disagreement was delineated in MELD score ≥ 20 (3.04 times/hr, CI = [2.64, 3.49], p < 0.001), alcoholic etiology (3.19 times/hr, [2.67, 3.78], p < 0.001) and postreperfusion stage (1.63 times/hr, [1.43, 1.85], p < 0.001). In these significant BIS-SE differences, 95.9% (307/320 disagreement data pairs) showed higher BIS than SE. In conclusion, in high MELD and alcoholic etiology, anesthetic requirements were significantly less, and BIS and SE showed great discrepancy with lower SE values. Therefore, when SE monitoring is used during LT, anesthesiologists may need to consider that in high MELD and alcoholic etiology, SE tends to show lower values than the concomitant BIS values that are within optimal anesthetic depth ranges.

Bispectral index monitoring as an adjunct to nurse-administered combined sedation during endoscopic retrograde cholangiopancreatography

AIM:To determine whether bispectral index (BIS) monitoring is useful for propofol administration for deep sedation during endoscopic retrograde cholangiopancreatography (ERCP). METHODS:Fifty-nine consecutive patients with a variety of reasons for ERCP who underwent the procedure at least twice between 1 July 2010 and 30 November 2010. This was a randomized cross-over study, in which each patient underwent ERCP twice, once with BIS monitoring and once with control monitoring. Whether BIS monitoring was done during the first or second ERCP procedure was random. Patients were intermittently administered a mixed regimen including midazolam, pethidine, and propofol by trained nurses. The nurse used a routine practice to monitor sedation using the Modified Observer's Assessment of Alertness/Sedation (MOAA/S) scale or the BIS monitoring. The total amount of midazolam and propofol used and serious side effects were compared between the BIS and control groups. RESULTS:The mean total propofol dose administered was 53.1 ± 32.2 mg in the BIS group and 54.9 ± 30.8 mg in the control group (P = 0.673). The individual propofol dose received per minute during the ERCP procedure was 2.90 ± 1.83 mg/min in the BIS group and 3.44 ± 2.04 mg in the control group (P = 0.103). The median value of the MOAA/S score during the maintenance phase of sedation was comparable for the two groups. The mean BIS values throughout the procedure (from insertion to removal of the endoscope) were 76.5 ± 8.7 for all 59 patients in using the BIS monitor. No significant differences in the frequency of < 80% oxygen saturation, hypotension (< 80 mmHg), or bradycardia (< 50 beats/min) were observed between the two study groups. Four cases of poor cooperation occurred, in which the procedure should be stopped to add the propofol dose. After adding the propofol, the procedure could be conducted successfully (one case in the BIS group, three cases in the control group). The endoscopist rated patient sedation as excellent for all patients in both groups. All patients in both groups rated their level of satisfaction as high (no discomfort). During the post-procedural follow-up in the recovery area, no cases of clinically significant hypoxic episodes were recorded in either group. No other postoperative side effects related to sedation were observed in either group. CONCLUSION:BIS monitoring trend to slighlty reduce the mean propofol dose. Nurse-administered propofol sedation under the supervision of a gastroenterologist may be considered an alternative under anesthesiologist.

Frequency of Monthly Ejaculation at Sexual Intercourse, DNA Fragmentation Index and Fertilization Rate among Sperm Donors and Fertility-Challenged Men in Sub-Saharan Africa: Paper 2

Introduction: Heterogenous sexual intercourse often produces a powerful orgasm that stimulates the pituitary function. Studies have suggested ejaculation frequency based on age. Materials and Methods: Semi-structured questionnaires were used to collect information from subjects. Semen samples were collected from sperm donors and sub-fertile men who presented for infertility challenges. Processing and analysis of semen samples were done according to World Health Organization (WHO) guidelines. Sperm deoxyribonucleic acid (DNA) fragmentation was evaluated using the Halosperm kit. Results: Among sperm donors, those aged χ2 = 0.09, P-value = 0.81, OR = 3.2, 95% CI: 0.23, 45.19) while among sub-fertile men those aged ≥40 years were approximately 2.3 times more likely to have very low frequency of MESI compared to aged χ2 = 2.11, P-value = 0.51, OR = 2.27, 95% CI: 0.74, 9.92). The frequency of all categories of MESI was highest among sub-fertile men aged χ2 = 0.03, P-value = 0.57, OR = 2.42, 95% CI: 0.41, 14.46). Sub-fertile men aged ≥40 with diastolic hypertension (≥90 mmHg) were approximately 6 times more likely to have a low (6 - 10) frequency of MESI compared to those aged χ2 = 1.97, P-value = 0.16, OR = 6.22, 95% CI: 0.69, 55.77). Overall mean fertilization rate was significantly higher (t-test = 2.44, P-value = 0.01) among sub-fertile men aged Conclusion: Cigarette smoking, more than alcohol consumption, appears to be a major factor that significantly affects the frequency of MESI among sub-fertile men in all age groups. Frequency of MESI negatively but insignificantly correlated with systolic blood pressure.

The Bispectral Index Interest during General Anesthesia at the University Hospital of Parakou (Republic of Benin) in 2019

Background: The bispectral index (BIS) derived from the electroencephalogram is an additional means of monitoring the depth of narcosis. Objective: To compare the monitoring of the depth of narcosis by the BIS associated with clinical data versus standard monitoring at the University Hospital of Parakou in Benin in 2019. Methods: This was an observational study for descriptive and analytical purposes with prospective data collection, carried out in general surgery and intensive care unit for 4 months. The inclusion criteria were: an age ≥ 18 years, an ASA score ≤ 3, surgery under general anesthesia and informed consent of the patient. Two groups were formed: non-BIS group monitored by clinical parameters (PA, FC, FR, EtCO2, and SpO2) only and BIS group monitored by bispectral index in addition to clinical parameters. Patients were seen 48 hours after the procedure. Results: 36 patients were collected. The mean age was 40.63 ± 16.77 years with a sex ratio of 3. ASA 1 patients represented 86.11% of the sample and ASA2 patients 13.89%. The average doses of Propofol were not significantly reduced in the BIS group (p = 0.555). On the other hand, the period of intraoperative recovery (p-value = 0.007) and the NVPO (p = 0.043;OR = 0.10;95% CI [0.01 - 0.97]) were significantly reduced by the use of BIS. One case of intraoperative memorization (2.78%) was however found in the BIS group. Conclusion: The bispectral index makes it possible to significantly reduce the risk of intraoperative awakening and PONV, and not significantly reduce the consumption of Propofol.

Bispectral index in predicting the prognosis of patients with coma in intensive care unit

BACKGROUND: The bispectral(BIS) index is a processed electroencephalogram(EEG) parameter with extensive validation and demonstrated clinical utility. The study aimed to investigate the correlation between the BIS index and the prognosis of patients with coma in the ICU.METHODS: A total of 208 patients with coma in the ICU were enrolled in this study. According to the BIS value, the patients were divided into four groups: group I, BIS value 0 to 20; group II, BIS value 21 to 40; group III, BIS value 41 to 60; and group IV, BIS value greater than 60. The difference in BIS values with the differences in prognosis of patients with coma was compared between the four groups, and the prognosis of patients with coma was stratified into consciousness, coma, vegetative state, and brain death. Subsequently, the best cut-off score of BIS values calculated for determining the correlation between BIS value and mental state was proposed.RESULTS: There are no significant differences in the age and APACHE II scores between the four groups(P>0.05). An inverse correlation was observed between BIS value and mental state(r= –0.749, P=0.00). According to the ROC curve, as BIS value was greater than 42.5, there were higher sensitivity and specificity in conscious-coma patients.CONCLUSION: BIS value is correlated with the prognosis of patients with coma in ICU, and BIS value can be a useful marker for estimating the prognosis of comatose patients.

Predicting of Power Quality Steady State Index Based on Chaotic Theory Using Least Squares Support Vector Machine

An effective power quality prediction for regional power grid can provide valuable references and contribute to the discovering and solving of power quality problems. So a predicting model for power quality steady state index based on chaotic theory and least squares support vector machine (LSSVM) is proposed in this paper. At first, the phase space reconstruction of original power quality data is performed to form a new data space containing the attractor. The new data space is used as training samples for the LSSVM. Then in order to predict power quality steady state index accurately, the particle swarm algorithm is adopted to optimize parameters of the LSSVM model. According to the simulation results based on power quality data measured in a certain distribution network, the model applies to several indexes with higher forecasting accuracy and strong practicability.

The Relationship of Carotid Plaque, Intima Media Thickness (IMT), Resistivity Index (RI) and Pulsatility Index(PI) in Asian-Indian Patients with Acute Ischemic Stroke with and without Type2 DM

Aim: To determine the relationship of carotid plaque, intima media thickness (IMT), resistivity index (RI) and pulsatility index (PI) and prevalence of different risk factors with acute ischemic stroke and stroke subtypes in both diabetic and non-diabetic subjects. Materials and methods: 80 cases of acute ischemic strokes and 40 healthy controls were included in the study. The plaque, IMT, RI and PI were measured by carotid duplex ultrasound. Results: 31 subjects were Type 2 diabetic, 54 hypertensive while 25 were both diabetic and hypertensive. 23 cases (28.75%) had lacunar stroke (LACI), 32 (40%) stroke involving partial anterior circulation(PACI), 10(12.5%) stroke in posterior circulation (PACI) and 15(18.75%) stroke involving total anterior circulation(TACI) respectively. The mean IMT (0.88 ± 0.19mm), RI(0.76 ± 0.05) and PI(1.71 ± 0.19) of patients and mean IMT (0.6±0.09mm), RI (0.61 ± 0.06) and PI (1.53 ± 0.11) of controls were statistically significant (p-0.000). The mean values of IMT, PI and RI were significantly higher in diabetics (IMT-0.90 ± 0.16 VS 0.64 ± 0.11, p-0.013;PI-1.76 ± 0.20 VS 1.49 ± 0.09, P-0.000 and RI-0.76 ± 0.04 VS 0.59 ± 0.06, P-0.000) and similarly the mean values for IMT, PI and RI in hypertensives as compared to controls (IMT-0.88 ± 0.16 vs 0.65 ± 0.10, P-0.006;PI1.69 ± 0.18 vs 1.49 ± 0.09, P-0.000 and RI 0.76 ± 0.04 vs 0.59 ± 0.06, P-0.000). The mean IMT, PI and RI were increased significantly in smokers compared to controls (IMT-0.93 ± 0.20 vs 0.63 ± 0.06, P-0.000;PI-1.82 ± 0.22 vs 1.49 ± 0.09, P-0.000 and RI-0.77 ± 0.04 vs 0.59 ± 0.06, P-0.000). Type 3 plaque accounted for 27 (56.2%) cases and Type 2 plaque 12 (25%) cases. The total number of plaques in patients as compared to controls were significantly more (P-0.0034) and the mean plaque area was 46 mm2 for cases and 20 mm2 for control (P-0.0001). TACI was the most common type of ischemic stroke seen in DM (60%), HTN (66.6%) and smokers (66.7%). Plaques (73.3%), IMT (0.90 ± 0.12), PI(1.72 ± 0.14) and RI (0.76 ± 0.13) were more commonly associated with TACI subtype. On multivariate analysis using ANOVA, the mean PI was highly significant (0.000) in relation to types of plaque. Summary and Conclusions: IMT, RI, PI and plaque type are useful diagnostic parameters for acute ischemic stroke and its subtypes. They can be used as noninvasive tools for predicting and preventing ischemic stroke in smokers as well as subjects with DM and hypertension.

中国耕地非农化对经济增长贡献的地区差异分析

现阶段中国耕地非农化对经济增长贡献存在地区差异,掌握差异的主要来源和变化趋势有利于耕地非农化指标的高效调配,促进地区经济增长的协调发展。利用1989～2001年我国东、中、西部建设用地占用耕地面积和国内生产总值的分省数据,测算了以建设用地占用耕地面积和GDP增量为对象的基尼系数、加权变异系数以及泰尔指数等指标,并对泰尔指数进行因素分解得到差异的主要来源和变化趋势。结果表明:三类地区内部省际差异是总体差异的主要来源,其中东部内部差异对总体差异贡献增大、中部减小、西部有先增大后减小趋势。鉴于此,从促进资源的高效利用和保护地区间公平发展环境的角度出发,耕地非农化指标调控的重点在于三类地区各自内部省份之间的调剂。

Effects of Suhuang Zhike Capsule on Pulmonary Function, Blood Gas Analysis Index, Serum PCT and CRP Expression in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

OBJECTIVE: To observe the effects of Suhuang Zhike Capsule on pulmonary function, blood gas analysis index, serum PCT and CRP expression in patients with acute exacerbation of chronic obstructive pulmonary disease. METHODS: A total of 88 patients with acute exacerbation of chronic obstructive pulmonary disease admitted to the Department of Respiratory Medicine, Xuancheng People's Hospital of Anhui Province from December 2014 to December 2016 were randomly divided into the observation group and the control group, with 44 cases in each group. The control group was given routine clinical treatment, and the observation group was given Suhuang Zhike Capsule on the basis of the treatment method of the control group. After 7 days' treatment, the improvement of lung function indexes were observed and evaluated before and after treatment(forced expiratory volume in one second(FEV_1), forced expiratory volume occupancy in the 1^(st) second percentage of vital capacity(FEVl/FVC), peak expiatory flow(PEF)), blood gas analysis index(Arterial oxygen partial pressure(PaO_2) and arterial blood carbon dioxide partial pressure(PaCO_2), oxygenation index(OI)) and serum cytokine levels(procalcitonin(PCT) and C reactive protein(CRP). RESULTS: The total effective rate of the observation group was significantly higher than that of the control group(P < 0.05). The FEV_1, FEV_1/FVC and PEF in 2 groups were significantly increased after the treatment(P < 0.05), and the above lung function indexes in the observation group were significantly higher than the control group(P < 0.05). PaO_2 and OI were significantly increased after the treatment(P < 0.05), PaCO_2 was significantly decreased after the treatment(P < 0.05), and the improvement of above blood gas analysis indexes were significantly superior of the observation group than the control group(P < 0.05). The serum PCT and CRP levels in 2 groups were significantly decreased after the treatment(P < 0.05), and the improvement in the observation group were more significant than that in the control group(P < 0.05). CONCLUSION: Suhuang Zhike Capsule can inhibit serum inflammatory cytokine levels in patients with acute exacerbation of chronic obstructive pulmonary disease, improve blood gas analysis indicators, and improve lung functions.

A new monitoring index for ecological vulnerability and its application in the Yellow River Basin,China from 2000 to 2022

The ecological environment of the Yellow River Basin has become more fragile under the combined action of natural and manmade activities.However,the change mechanisms of ecological vulnerability in different sub-regions and periods vary,and the reasons for this variability are yet to be explained.Thus,in this study,we proposed a new remote sensing ecological vulnerability index by considering moisture,heat,greenness,dryness,land degradation,and social economy indicators and then analyzed and disclosed the spatial and temporal change patterns of ecological vulnerability of the Yellow River Basin,China from 2000 to 2022 and its driving mechanisms.The results showed that the newly proposed remote sensing ecological vulnerability index had a high accuracy,at 86.36%,which indicated a higher applicability in the Yellow River Basin.From 2000 to 2022,the average remote sensing ecological vulnerability index of the Yellow River Basin was 1.03,denoting moderate vulnerability level.The intensive vulnerability area was the most widely distributed,which was mostly located in the northern part of Shaanxi Province and the eastern part of Shanxi Province.From 2000 to 2022,the ecological vulnerability in the Yellow showed an overall stable trend,while that of the central and eastern regions showed an obvious trend of improvement.The gravity center of ecological vulnerability migrated southwest,indicating that the aggravation of ecological vulnerability in the southwestern regions was more severe than in the northeastern regions of the basin.The dominant single factor of changes in ecological vulnerability shifted from normalized difference vegetation index(NDVI)to temperature from 2000 to 2022,and the interaction factors shifted from temperature∩NDVI to temperature∩precipitation,which indicated that the global climate change exerted a more significant impact on regional ecosystems.The above results could provide decision support for the ecological protection and restoration of the Yellow River Basin.

Systemic Inflammation Response Index and weight loss as prognostic factors in metastatic pancreatic cancer: A concept study from the PANTHEIA-SEOM trial

BACKGROUND The prognostic value of the Systemic Inflammation Response Index(SIRI)in advanced pancreatic cancer is recognized,but its correlation with patients´nutritional status and outcomes remains unexplored.AIM To study the prognostic significance of SIRI and weight loss in metastatic pancreatic cancer.METHODS The PANTHEIA-Spanish Society of Medical Oncology(SEOM)study is a multicentric(16 Spanish hospitals),observational,longitudinal,non-interventional initiative,promoted by the SEOM Real World-Evidence work group.This pilot study sought to analyze the association between weight loss and inflammatory status as defined by SIRI.The cohort stems from a proof-of-concept pilot study conducted at one of the coordinating centers.Patients with pathologically confirmed metastatic pancreatic adenocarcinoma,treated from January 2020 to January 2023,were included.The index was calculated using the product of neutrophil and monocyte counts,divided by lymphocyte counts,obtained within 15 days before initiation chemotherapy.This study evaluated associations between overall survival(OS),SIRI and weight loss.RESULTS A total of 50 patients were included.66%of these patients were male and the median age was 66 years.Metastasis sites:36%liver,12%peritoneal carcinomatosis,10%lung,and 42%multiple locations.Regarding the first line palliative chemotherapy treatments:50%received gemcitabine plus nab-paclitaxel;28%,modified fluorouracil,leucovorin,irinotecan and oxaliplatin,and 16%were administered gemcitabine.42%had a weight loss>5%in the three months(mo)preceding diagnosis.21 patients with a SIRI≥2.3×10^(3)/L exhibited a trend towards a lower median OS compared to those with a SIRI<2.3×10^(3)/L(4 vs 18 mo;P<0.000).Among 21 patients with>5%weight loss before diagnosis,the median OS was 6 mo,in contrast to 19 mo for those who did not experience such weight loss(P=0.003).Patients with a weight loss>5%showed higher SIRI levels.This difference was statistically significant(P<0.000).For patients with a SIRI<2.3×10^(3)/L,those who did not lose>5%of their weight had an OS of 20 mo,compared to 11 mo for those who did(P<0.001).No association was found between carbohydrate antigen 19-9 levels≥1000 U/mL and weight loss.CONCLUSION A higher SIRI was correlated with decreased survival rates in patients with metastatic pancreatic cancer and associated with weight loss.An elevated SIRI is suggested as a predictor of survival,emphasizing the need for prospective validation in the upcoming PANTHEIA-SEOM study.

The Essence of Optimism of The Economists and Investors with Regard to the Economy of Russia

The gross domestic product of Russia,expressed in US dollars,indicates problems in the Russian economy associated with the decline in oil prices on the world energy market and the consequences of the sanctions of the United States and the European Union against Russia.The crisis situation of the Russian economy has a negative impact on the income of the population of country,represented mainly by wages.However,an economist or investor may be optimistic about Russian economic development in the medium term.This optimism is related to the economic policy of the United States.The expansion of the United States economy within the global space,based on economic growth,requires maintaining inflation within the target level and weakening the US dollar.These tasks are solved with the help of soft monetary policy of the US Federal Reserve System.The reduction of interest rates by the US Federal Reserve System against the background of inflation of the target level and the devaluation of the US dollar will contribute to economic growth in the United States,because it will lead to the depreciation of public debt,lower consumption of imports,increase in exports and trade balance,growth of production,income,consumption.The economic policy of the United States,which contributes to the devaluation of the US dollar,will also reduce the US dollar against the ruble.The optimistic view of investors-economists on the Russian economy is due to a significant strengthening of the ruble against the US dollar.Consequently,in the medium term,the gross domestic product and wages of citizens of Russia,expressed in US dollars,will significantly increase,and the purchasing power of the national currency of the country will also increase.This growth may continue until the next election of a new President of the United States in november 2020.After the election of the new President of the United States,there is a high probability of sanctions against Russia and of decline in oil prices in the world energy market in accordance with the future economic policy of the United States–two main reasons for the sharp strengthening of the US dollar against the ruble,which will cause a deeper economic crisis in Russia in the medium and long term.

Silymarin in non alcoholic fatty liver disease

AIM: This study was undertaken to evaluate the hepatic effects of silybum marianum on non alcoholic fatty liver disease (NAFLD). METHODS: In 72 patients affected by NAFLD, main metabolic, hepatic and anti-inflammatory parameters were assayed after 3 mo of a restricted diet and before silymarin treatment (twice a day orally). The brightness of liver echography texture (hepatorenal ratio brightness) was also defined at same time. These evaluations were repeated after 6 mo of treatment. RESULTS: Serum levels of some metabolic and anti-inflammatory data nonsignificantly lowered after 6 mo of silymarin. On the contrary, Steato test, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transpeptidase were significantly (P < 0.001) reduced. Instead, the AST/ALT ratio unchanged. Finally, the hepatorenal brightness ratio, as an index of hepatic steatosis, significantly (P < 0.05) dropped. CONCLUSION: The obtained results indicate that silymarin appears to be effective to reduce the biochemical, inflammatory and ultrasonic indices of hepatic steatosis. Some parameters indicative of early stage of atherosclerosis were also lowered.

Weighted Gini-Simpson Quadratic Index of Biodiversity for Interdependent Species

The weighted Gini-Simpson quadratic index is the simplest measure of biodiversity which takes into account the relative abundance of species and some weights assigned to the species. These weights could be assigned based on factors such as the phylogenetic distance between species, or their relative conservation values, or even the species richness or vulnerability of the habitats where these species live. In the vast majority of cases where the biodiversity is measured the species are supposed to be independent, which means that the relative proportion of a pair of species is the product of the relative proportions of the component species making up the respective pair. In the first section of the paper, the main versions of the weighted Gini-Simpson index of biodiversity for the pairs and triads of independent species are presented. In the second section of the paper, the weighted Gini-Simpson quadratic index is calculated for the general case when the species are interdependent. In this instance, the weights reflect the conservation values of the species and the distribution pattern variability of the subsets of species in the respective habitat induced by the inter-dependence between species. The third section contains a numerical example.