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IntroductionUltrasound-guided internal branch of the upper laryngeal nerve block (USG-guided iSLN block) have been used to decrease the perioperative stress response of intubation. It is more likely to be successful than blindly administered superior laryngeal nerve blocks with fewer complications. Here, we evaluated the efficacy of USG-guided iSLN block to treat postoperative sore throat (postoperative sore throat, POST) after extubation.Methods100 patients, aged from 18 to 60 years old, ASA I~II who underwent general anesthesia and suffered from the moderate to severe postoperative sore throat after extubation were randomized into two groups(50 cases per group). Patients in group S received USG-guided iSLN block bilaterally (60mg of 2% lidocaine, 1.5ml each side), whereas those in group I received inhalation with 100 mg of 2% lidocaine and 1mg of budesonide suspension diluted with normal saline (oxygen flow 8 L /min, inhalation for 15 minutes). The primary outcome were VAS scores in both groups before treatment (T0), 10 min (T1), 30 min(T2), 1h(T3), 2 h(T4), 4h(T5), 8h(T6), 24h(T7), and 48h(T8) after treatment. The secondary outcome were satisfaction scores after treatment, MAP, HR, and SPO2 fromT0 to T8. The adverse reactions such as postoperative chocking or aspiration, cough, hoarseness, dyspnea were also observed in both groups.ResultsPatients in group S had significantly lower VAS score than that in group I at points of T1 ~ T6 (P < 0.01). HR of group S was lower than that of group I at points of T1 ~ T2and T4 (P < 0.05), and MAP was lower than that of group I at points of T1 ~ T3 (P < 0.05). Satisfaction scores of group S were higher than that of group I (P ConclusionCompared with inhalation, USG-guided iSLN block may effectively relieve the postoperative sore throat after extubation under general anesthesia and provided an ideal treatment for POST in clinical work.

Recent years have witnessed contrasting trends in summer total rainfall (STR) over the Tibetan Plateau (TP), with an increase in the northern and a decrease in the southern TP. This study identifies four significant centers of rainfall trends: eastern TP ("region A"), Qiangtang Plateau ("B"), Qaidam Basin ("C"), and the northern foothills of the Himalayas ("D"). Heavy rainfall dominates STR trends in regions A and D, accounting for 55.6% and 52.0%, respectively. In region B, moderate and light rainfall contribute almost equally, accounting for 37.3% and 44.8% of the STR trend, respectively. Region C is primarily influenced by light rainfall, explaining 71.2% of the STR trend. Notably, the contributions of different rainfall intensities to STR in each region vary annually, with region A experiencing more heavy rainfall, region B having moderate dominance but less light rainfall, and region C and D showing reduced and increased light rainfall contributions, respectively. Mechanistically, the strengthening of the upper-level westerly jet and the South Asian High, coupled with changes in moisture transport and convective available potential energy, collectively cause variations in rainfall intensity, characterizing the spatial heterogeneity in STR in the TP. [ABSTRACT FROM AUTHOR]

Variations in surface air temperature on the eastern Tibetan Plateau (TP‐SAT) during boreal summer, related to Barents‐Kara spring sea ice and summer Arctic Oscillation (AO), are investigated using observations and ERA‐5 reanalysis data during 1979–2018. Results show that the primary mode of summer eastern TP‐SAT (SAT_EOF1) is characterized by the consistent warming pattern with larger values over the northeastern TP, which is linked with the anticyclonic circulation located in the northeastern flank of the TP. This anticyclone enhances westward water vapor transport, warm temperature advection, and causes descending over the eastern TP, Descending further results in deceased middle level cloud cover and increased solar radiation, accordingly, favoring the eastern TP warming. Further statistical analysis reveals a robust connection between Barents‐Kara spring sea ice, summer AO and SAT_EOF1. Moreover, anticyclonic anomaly located in the northeastern region of the TP acts as an important driver of this consistent warming pattern over the eastern TP, which is modulated by two individual Rossby wave trains from the northwestern Russia and northwestern Atlantic. The spring sea ice in Barents‐Kara could cause decreased precipitation and reduced soil moisture in northwestern Russia during following summer, which further induces the Eurasian‐like teleconnection and affects the anticyclonic anomaly situated in the northeastern flank of the TP, thereby favoring eastern TP warming. In addition, from northwestern Atlantic to northeastern region of the TP, the Rossby wave train is mainly affected by summer AO, with positive AO causing anticyclonic anomaly over northeast of the TP, thus contributing to the TP warming. Plain Language Summary: Tibetan Plateau (TP) is a region that is easily affected by the global warming. Numerous studies have extensively documented a remarkable warming trend in the TP during boreal summer, particularly noticeable since the late 1990s. Despite these valuable observations, its mechanisms are not yet clear. In this study, we found that the anticyclonic anomaly over the northeast of TP is a crucial system affecting eastern TP warming in boreal summer. This anticyclonic anomaly leads to the strengthened westward water vapor transport and causes descending over the eastern TP. Descending, in turn, results in the reduction of middle level cloud cover and increased solar radiation. Further analysis indicated that this anomalous anticyclone is mainly modulated by two individual wave trains from the northwestern Russia and northwestern Atlantic, respectively. From northwestern Atlantic to northeastern flank of the TP, the wave train is mainly affected by the summer AO, and another is mainly driven by the spring Barents‐Kara sea ice. Those two factors account for about 36% of the summer eastern TP warming. Key Points: Anticyclonic anomaly located in the northeastern flank of the TP favors the eastern TP warmingSpring Barents‐Kara sea ice could affect this anticyclone through its influences on summer soil moisture over northwestern RussiaThis anticyclone is also modulated by the wave train from northwestern Atlantic, which is mainly affected by Arctic Oscillation [ABSTRACT FROM AUTHOR]

This study was performed to determine the effect of human umbilical cord mesenchymal stem cells (hucMSCs) treatment on pulmonary fibrosis and investigate the circFOXP1-mediated autophagic mechanism of hucMSCs treatment. Pulmonary fibrosis models were established by spraying bleomycin in mice and TGF-β1 treatment of MRC-5 cells. Results showed that hucMSCs were retained in lung and hucMSCs treatment alleviated pulmonary fibrosis. Morphological staining indicated that hucMSCs-treated mice had thinner alveolar walls, effectively improved alveolar structure, significantly reduced alveolar inflammation, and decreased collagen deposition than control mice. Fibrotic proteins, including vimentin, α-SMA, collagens I and III, and the differentiation-related protein S100 calcium-binding protein A4 was reduced considerably in the hucMSCs-treated group. The mechanistic study revealed that the inhibition of hucMSCs treatment on pulmonary fibrogenesis depended on downregulating circFOXP1, in which hucMSCs treatment promoted circFOXP1-mediated autophagy process via blocking the nuclear human antigen R (HuR) translocation and promoting the HuR degradation, leading to a marked decrease in autophagy negative regulators EZH2, STAT1, and FOXK1. In conclusion, hucMSCs treatment significantly improved pulmonary fibrosis by downregulating the circFOXP1-HuR-EZH2/STAT1/FOXK1 autophagic axis. hucMSCs can act as an effective treatment for pulmonary fibrosis. [ABSTRACT FROM AUTHOR]

In this paper, a honeycomb Si3N4 ceramic was fabricated by 3D printing with a well‐preserved structure. The effects of Si3N4 content on the rheological properties of Si3N4/sol–silica ink and the printing resolution of products were investigated. The microstructure, phase composition, liner shrinkage rate, and fracture behavior of printed samples before and after sintering were systematically characterized in detail. The results showed that the modified inks had the optimized rheological properties, and the stress–shear rate curves corresponding to each slurry could be well described by Bingham and Herschel–Bulkley fluid models. The corresponding slump rates of the printed samples with different Si3N4 to sol–silica mass ratios were all lower than 4%, and the linear shrinkage rate of all of the samples after sintering was below 20%. The fracture behavior under compressive loading of the honeycomb Si3N4 ceramics tended to be non‐catastrophic fractures both before and after sintering. The compressive strengths of all of the printed samples decreased with the increase of the Si3N4 content, and the highest compressive strength of the honeycomb ceramics could reach 131.2 MPa after sintering at 1600°C, which was about 366.9% higher than that of the samples in green state prior to the sintering. [ABSTRACT FROM AUTHOR]