Search

This study was conducted to compare the efficacy of using 0.5 mg/mL povidone-iodine solution as an irrigant and coolant in reducing postoperative sequelae like swelling, trismus, and pain with the conventional normal saline irrigation during the surgical removal of the impacted lower third molar.The research was conducted out toward the MES Dental College in Perinthalmanna, Kerala, in the Department of Oral and Maxillofacial Surgery. After mandibular third-molar surgical removal, researchers studied 60 individuals, 30 of whom had normal saline irrigation (group I), and 30 of whom received 0.05% povidone-iodine irrigation (group II). The postoperative discomforts were measured on the second and seventh days after surgery, respectively. After that, the data were analyzed using SPSS. The data analysis consideredAt the second postoperative visit, patients in the povidone-iodine group reported much less pain, swelling, and reduced mouth opening than those in the normal saline group. But on the seventh postoperative day, there was not much difference between either group.Following the surgical removal of teeth, it was revealed that povidone-iodine solution (0.5 mg/mL) was more effective as irrigation and cooling aid than regular saline solution.Low-concentrated povidone-iodine is a better option in dentistry as irrigant.

To determine whether the local administration of insulin glargine compared with placebo in nondiabetic patients with venous ulcers (VUs) leads to increased wound healing.A randomized controlled trial using a split-plot design was performed in 36 adults with leg VUs25 cmAfter 7 d of treatment, the hemi-wounds treated with insulin glargine were significantly smaller, had less thermal asymmetry, more blood vessels, and more collagen content than the saline-treated side. Correlation between thermal asymmetry and the number of blood vessels was also found (rIn nondiabetic patients with chronic VUs, the topical administration of insulin glargine seems to be safe and promotes wound healing and tissue repair after 7 d of treatment.

Pancreatic intraductal pressure is related to the development of pancreatitis, including post-ERCP (endoscopic retrograde cholangiopancreatography) pancreatitis. In this study, we investigate pancreatic intraductal pressure in various mouse models of acute and chronic pancreatitis.Post-ERCP pancreatitis was induced by retrograde infusion of normal saline or radiocontrast at the constant rate of 10 or 20 μL/min. Obstructive pancreatitis was induced by ligation of the pancreatic duct followed by a single injection of caerulein and the changes of intraductal pressure were recorded in day 3 for obstructive acute pancreatitis and day 14 for obstructive chronic pancreatitis. Non-obstructive pancreatitis was induced by repetitive intraperitoneal injections of caerulein. The changes of intraductal pressure were recorded right after the last caerulein injection for non-obstructive acute pancreatitis and after the completion of 4-week caerulein injections for non-obstructive chronic pancreatitis.Elevated pancreatic intraductal pressure was observed in both normal saline and radiocontrast infusion groups and was furtherly indicated that was positively correlated with the viscosity of solution but not genders. In the models of obstructive pancreatitis, a rise in intraductal pressure was observed in both acute and chronic pancreatitis; whereas in the models of non-obstructive pancreatitis, a rise in intraductal pressure was only observed in chronic, but not acute pancreatitis.During ERCP, the elevations in pancreatic intraductal pressure are induced by increasing rate or viscous solution of infusion. During different forms of experimental acute and chronic pancreatitis, obstructive or non-obstructive etiologies of pancreatitis also induces the elevations in pancreatic intraductal pressure.

Publisher Copyright: © 2022 The Author(s) Objective: To determine whether dobutamine, norepinephrine or phenylephrine infusions alleviate hypotension in isoflurane-anaesthetized dogs administered dexmedetomidine with vatinoxan. Study design: Balanced, randomized crossover trial. Animals: A total of eight healthy Beagle dogs. Methods: Each dog was anaesthetized with isoflurane (end-tidal isoflurane 1.3%) and five treatments: dexmedetomidine hydrochloride (2.5 μg kg–1) bolus followed by 0.9% saline infusion (DEX-S); dexmedetomidine and vatinoxan hydrochloride (100 μg kg–1) bolus followed by an infusion of 0.9% saline (DEX-VAT-S), dobutamine (DEX-VAT-D), norepinephrine (DEX-VAT-N) or phenylephrine (DEX-VAT-P). The dexmedetomidine and vatinoxan boluses were administered at baseline (T0) and the treatment infusion was started after 15 minutes (T15) if mean arterial pressure (MAP) was < 90 mmHg. The treatment infusion rate was adjusted every 5 minutes as required. Systemic haemodynamics were recorded at T0 and 10 (T10) and 45 (T45) minutes. A repeated measures analysis of covariance model was used. Results: Most dogs had a MAP < 70 mmHg at T0 before treatment. Treatments DEX-S and DEX-VAT all significantly increased MAP at T10, but systemic vascular resistance index (SVRI) was significantly higher and cardiac index (CI) lower after DEX-S than after DEX-VAT. CI did not significantly differ between DEX-S and DEX-VAT-S at T45, while SVRI remained higher with DEX-S. Normotension was achieved by all vasoactive infusions in every dog, whereas MAP was below baseline with DEX-VAT-S, and higher than baseline with DEX-S at T45. Median infusion rates were 3.75, 0.25 and 0.5 μg kg–1 minute–1 for dobutamine, norepinephrine and phenylephrine, respectively. Dobutamine and norepinephrine increased CI (mean ± standard deviation, 3.35 ± 0.70 and 3.97 ± 1.24 L minute–1 m–2, respectively) and decreased SVRI, whereas phenylephrine had the opposite effect (CI 2.13 ± 0.45 L minute–1 m–2). Conclusions and clinical relevance: Hypotension in isoflurane-anaesthetized dogs administered dexmedetomidine and vatinoxan can be treated with either dobutamine or norepinephrine.

Statement of problem Whether the disinfection of polymethyl methacrylate (PMMA) dentures eliminates Candida albicans biofilm is unclear. Purpose The purpose of this in vitro study was to determine the antimicrobial effect of immersion in hydrogen peroxide (H2O2) and subsequent application of microwaves on the formation of C albicans biofilm on the surface of polished and unpolished PMMA disks. Material and methods Polished and unpolished PMMA disks (n=40) were mounted in a Center for Disease Control (CDC) biofilm reactor by adding yeast-dextrose-peptone (YPD) broth inoculated with C albicans in a cell suspension for 24 hours. After this period, the PMMA disks (n=8) were disinfected with 5 different solutions: saline solution, 1% sodium hypochlorite (NaOCl), H2O2, H2O2 microwaved at 650 W for 3 minutes (H2O2/μw), and distilled water microwaved at 650 W for 3 minutes (H2O/μw). On the polished and unpolished surface of each disk, arbitrary fluorescence units (AFU) were quantified with the live/dead bacterial viability kit (Invitrogen) by using confocal laser scanning microscopy (CLSM) to evaluate 10 different areas of each surface; these were counted as the colony-forming units (CFUs). The mean values were compared by using the Mann–Whitney U test (α=.05). Results Polished surfaces disinfected with H2O2/μw obtained the lowest viable cells (9.76 AFU) and nonviable cells (12.46 AFU) compared with H2O/μw and H2O2. In the unpolished surface the lowest mean values of viable cells (14.64 AFU) and nonviable cells (12.46 AFU) were obtained for the PMMA disks disinfected with H2O/μw compared with H2O2/μw and H2O2. Both polished and unpolished disks showed significant difference (P Conclusions H2O2 alone did not eliminate the formation of the biofilm of C albicans; however, in combination with the use of the microwave at 650 W for 3 minutes, the biofilm formation of C albicans on polished surfaces was reduced. The number of AFUs of viable-nonviable cells and CFUs depended on whether the surfaces are polished or unpolished.

Low-velocity gunshot wounds (LV-GSWs) are a common reason for emergency department visits. Optimal nonsurgical treatment has not been thoroughly studied and is not standardized. The goal of this study was to determine whether positive pressure irrigation reduces the bacterial contamination after a simulated GSW to soft tissue.Nineteen lamb shank specimens were prepared with denim inoculated with Serratia marcescens cultures. A 9-mm pistol round was fired from a distance of 3 m through the contaminated denim into the lamb shank. A culture swab was placed in the wound directly after firing, after 250 cubic-centimeters (cc) irrigation with normal saline, and after an additional 250 cc irrigation (for a total of 500 cc). Swabs were then cultured to determine the amount of bacterial growth.Before irrigation, 0 (0%) plates showed no growth, 2 (10.5%) showed rare growth, 8 (42.1%) showed few growth, 6 (31.6%) showed moderate growth, and 3 (15.8%) showed many growth. After 500 cc irrigation, 2 (10.5%) showed no growth, 1 (5.3%) showed rare growth, 11 (57.9%) showed few growth, 2 (10.5%) showed moderate growth, and 3 (15.8%) showed many growth. Fisher exact test confirmed no significant change in bacterial concentration after irrigation ( P = 0.59). A Pearson test found no correlation between irrigation and bacterial growth (r = -0.15, P = -0.25).Positive pressure irrigation with up to 500 cc normal saline did not significantly alter the quantity of bacterial growth within a simulated GSW cavity. The data suggest that bedside positive pressure irrigation may not be beneficial in the initial emergency department treatment of LV-GSWs.

© 2022 International Association of Oral and Maxillofacial SurgeonsThe aim of this study was to investigate the chondrotoxic effects of a single-dose intra-articular injection of articaine, lidocaine, and bupivacaine on the rabbit temporomandibular joint (TMJ). Twenty-four rabbits were divided into four groups: control (group 1), articaine (group 2), lidocaine (group 3), and bupivacaine (group 4). Synovial fluid samples and venous blood were taken to evaluate matrix metalloproteinase 3 (MMP-3) levels. One millilitre of local anaesthetic solution was injected in the study groups and saline solution in the control group. The rabbits were euthanized after 4 weeks and the mandibular condyles and articular discs were evaluated. On histological examination, the study group samples had irregular joint surfaces, decreased collagen, and a thinner cartilage layer. Apoptotic cells were evaluated with the TUNEL method. TUNEL-positive apoptotic cell counts were higher in all study groups compared to the control group, and the difference was significant (P < 0.001). The mean preoperative serum MMP-3 level for all groups was 5.71 ± 3.33 ng/mL, while the mean postoperative level was 22.61 ± 6.36 ng/mL; this difference was significant (P < 0.001). A single-dose intra-articular injection of local anaesthetic had apoptotic effects on chondrocytes, leading to degenerative changes in the TMJ articular structures. Articaine was found to have less harmful effects than lidocaine and bupivacaine. Intra-articular injection of local anaesthetics should be limited in the TMJ because of the potential toxic effects.

This study aimed to biochemically and histopathologically investigate the effect of sunitinib on oxidative testicular damage induced by ischemia/reperfusion in rats.Experimental animals were divided into three groups of six rats each: testicular torsion-detorsion (TTD), sunitinib+testicular torsion-detorsion (STD), and sham control (SC). Sunitinib (25mg/kg) was administered orally to the STD group by gavage. Normal saline (0.9% NaCl) was administered orally to the TTD and control groups as the solvent. One hour after administration of sunitinib and 0.9% NaCl, all animal groups were done torsion-detorsion. Then, all the rats were killed by high-dose anesthesia, and their testicles were removed. Biochemical and histopathological examinations were performed on the removed testicular tissues.Malondialdehyde; it was observed that the results in the STD group were close to those of the SC group and statistically significant lower compared to the TTD group (p=0.001). The glutathione values were statistically significantly higher in the STD group compared to the TTD group (p0.001). Nuclear factor kappa B values, revealing a statistically significant difference between the TTD and STD groups (p0.001). The TNF-α levels were measured and indicating that the results of the STD group were statistically significantly lower than those of the TTD group (p0.001). Histopathologically, animal tissues given sunitinib were observed to resemble normal tissues.Sunitinib was shown to prevent histopathological changes in testicular tissue against ischemia/reperfusion damage.

Background Pathophysiology of appendicitis is associated with the underlying inflammatory processes. Ethyl pyruvate (EP) has potent antioxidant and anti-inflammatory properties. In this study, we aimed to investigate the effects of EP on the treatment of appendicitis and to examine whether adding EP to the antibiotic treatment could increases the effectiveness of the treatment in a rat appendicitis model. Method Thirty two Wistar rats, which had previously created appendicitis, were randomly divided into 4 groups: Group 1 (0.1 ml saline solution), Group 2 (15 mg/kg ceftriaxone), Group 3 (50 mg/kg EP), Group 4 (EP 50 mg/kg + ceftriaxone 15 mg/kg). In all groups, saline solution, ceftriaxone and EP were administered intraperitoneally and the same procedure was repeated twice a day for the following five days. On day 6, the rats underwent relaparotomy and then intraabdominal findings were recorded. Histopathological examination and interleukin-6 (IL-6) level were performed on appendiceal specimens. Results Intra-abdominal adhesion score was significantly lower in Group 4 than in Group 1. Total inflammation score was significantly lower in Group 2 than in Group 1 and was significantly lower in Group 4 than in Group 3 and 1. IL-6 level was significantly lower in Group 4 than in Group 3 and 1. Conclusion We found that adding EP to the antibiotic therapy increased the efficacy of the treatment in the rat appendicitis model. Further studies are required to apply our findings to the clinical setting.

Asthma is one of the most common chronic diseases. Mucus overproduction is consistently linked to asthma morbidity and mortality. Despite the knowledge of the importance of mucus, little data exist on how mucus is transported in asthma and the immediate effects of therapeutic intervention. We therefore used microscopic optical coherence tomography (mOCT) to study spontaneous and induced mucus transport in an interleukin-13 (IL-13)-induced asthma mouse model and examined the effects of isotonic (0.9% NaCl) and hypertonic saline (7% NaCl), which are used to induce mucus transport in cystic fibrosis. Without intervention, no bulk mucus transport was observed by mOCT and no intraluminal mucus was detectable in the intrapulmonary airways by histology. Administration of ATP-γ-S induced mucus secretion into the airway lumen, but it did not result in bulk mucus transport in the trachea. Intraluminal-secreted immobile mucus could be mobilized by administration of isotonic or hypertonic saline but hypertonic saline mobilized mucus more reliably than isotonic saline. Irrespective of saline concentration, the mucus was transported in mucus chunks. In contrast to isotonic saline solution, hypertonic saline solution alone was able to induce mucus secretion. In conclusion, mOCT is suitable to examine the effects of mucus-mobilizing therapies in vivo. Although hypertonic saline was more efficient in inducing mucus transport, it induced mucus secretion, which might explain its limited benefit in patients with asthma.

This study was conducted to evaluate the protective effects of epigallocatechin-3-gallate (EGCG) against ovarian toxicity in cyclophosphamide-treated mice and to verify the possible involvement of phosphorylated Akt, FOXO3a and rpS6 in the EGCG actions. Mice received saline solution (i.p.; control) or a single dose of cyclophosphamide (200 mg/kg body weight, i.p.) or mice were pretreated with N-acetylcysteine (150 mg/kg body weight, i.p.; positive control) or with EGCG (5, 25 or 50 mg/kg body weight, i.p.) once daily for three days followed by injection with single dose of cyclophosphamide (200 mg/kg body weight, i.p.). Thereafter, the mice were euthanized, and the ovaries were harvested and destined to histological (follicular morphology and activation), immunohistochemistry (cleaved caspase-3 and TNF-α) and fluorescence (mitochondrial activity and GSH concentrations) analyses. Furthermore, we examined the participation of p-Akt, p-FOXO3a and p-rpS6 in the protective effects of EGCG in cyclophosphamide-induced ovarian damage by immunohistochemical staining. The results showed that pretreatment with N-acetylcysteine or EGCG at 25 and 50 mg/kg before cyclophosphamide administration preserved the normal follicular morphology, prevented primordial follicle loss, reduced atresia, inflammation, and mitochondrial damage, and increased GSH concentrations compared to the only cyclophosphamide treatment. Additionally, pretreatment with 25 mg/kg EGCG regulated phosphorylated Akt, FOXO3a and rpS6 after cyclophosphamide treatment. In conclusion, short-time pretreatment with 25 mg/kg EGCG can prevent follicle loss in cyclophosphamide-treated mice by reducing oxidative damage, inflammation, and apoptosis, and regulating of p-Akt, p-FOXO3a and p-rpS6.

To describe our experience with outpatient hysteroscopy for removal of intrauterine devices (IUDs) in pregnant patients, along with the pregnancy-related outcomes.Retrospectively and prospectively collected data between January 2015 and April 2021.Hysteroscopic outpatient clinic (See and Treat Clinic) at a university affiliated, tertiary medical center.Forty-one patients with an inadvertent but desired pregnancy up to 12 weeks + 6 days gestational age with an IUD in situ, with documented failed attempts of IUD removal.After ultrasonographic confirmation of IUD location, gestational age, and viability, a small-caliber hysteroscope was introduced via a vaginoscopic approach. The uterus was distended using 0.9% normal saline until a clear view was achieved. On visualization, the IUD was grasped by its strings, tail, or lateral arm using a semirigid hysteroscopic grasper. Oral antibiotic prophylaxis was prescribed in all cases.The primary outcome of interest was term delivery, from 37 weeks of gestation. Secondary outcomes included patient-reported tolerability and satisfaction, and procedure-related and pregnancy related complications.The procedure was completed successfully in all 41 patients. Thirty-three patients continued their pregnancies, resulting in 32 full-term singleton deliveries and 1 singleton preterm delivery at 33 + 4 weeks. Median gestational age at delivery was 39 weeks, with a median birthweight of 3,450 grams. Eight patients (19.5%) miscarried, 4 of these within a week of the procedure.In cases of desired pregnancy with an IUD, outpatient hysteroscopic removal of the IUD is a safe and effective management option. Broader uptake of outpatient hysteroscopy and development of hysteroscopic skills will allow more clinicians to offer patients this effective solution.

Background. Although great progress has been made over the past 2 years in the scientific understanding of the biology, epidemiology, and pathogenesis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), case morbidity and fatality rates remain a great concern and continue to challenge the healthcare resources worldwide as novel variants emerge. There is therefore an urgent need for affordable and readily available strategies to reduce viral transmission. Previous studies in non-COVID-19 patients have demonstrated that administration of low-salt (isotonic but 0.0375% Na) and isotonic saline (0.9% Na) solutions has been associated with an immediate, significant reduction in the microbial antigens and a related decline of microbial burden. The aim of the present study was to determine the effect of nasal washes with normal saline 0.9% on nasopharyngeal viral load and outcome in hospitalized patients with COVID-19 pneumonia. Methods. We performed a prospective, randomized, pilot, controlled trial in 50 patients with confirmed COVID-19 disease. Patients were randomized into two groups, the normal saline group (received normal saline 0.9% solution for nasopharyngeal wash) and the control group (no treatment). In the normal saline group, nasopharyngeal wash was performed every 4 hours for a 16-hour period. Twenty-four hours after the baseline nasopharyngeal swab (and 8 hours after the last wash in the normal saline group), a second nasopharyngeal swab was collected for the semiquantitative estimation of the SARS-CoV-2 viral load as determined by cycle threshold (Ct) values. Results. In the normal saline group, mean N gene Ct values increased significantly 24 hours after the baseline measurement [ΔCtday2−day1 = 1.87 ± 3.11 cycles, p = 0.007 (95% CI: 0.55 to 3.18)], indicating a decline in SARS-CoV-2 nasopharyngeal viral load by 8.9%. A significant decrease in mean N gene Ct values was observed in the control group, indicating an increase in viral load [ΔCtday2-day1 = −2.12 ± 2.66, p < 0.001 (95% CI: −3.20 to −1.05)] by 9.7%. The difference between the two groups 24 hours after admission and nasopharyngeal wash was 3.09 cycles ( p = 0.005 , 95% CI: 0.97 to 5.20). Conclusion. Nasal washes with normal saline effectively decreased the viral load during hospitalization and at follow-up.

Chronic neuroinflammation-induced anomalous glutamate receptor activation has been identified as one of the important factors in the pathogenesis of autism spectrum disorder (ASD). Thus, the current study was designed to elucidate the neuroprotective effect of the granulocyte colony-stimulating factor (G-CSF), a haemopoietic growth factor, an anti-inflammatory, and a neuroprotectant to decipher the underlying mechanism(s) in the valproic acid (VPA)-induced experimental model of ASD. Experimentally, the ASD rat model was induced by a single dose of VPA (600 mg/kg; i.p.) on gestation day 12.5 to the pregnant female rats. After birth, pups were treated with vehicle, normal saline 0.9% i.p., risperidone (2.5 mg/kg; i.p.), and G-CSF (10, 35, and 70 μg/kg; i.p.) from postnatal day (PND) 23 to 43. All the groups were subjected to various developmental and behavior tests from birth. The rats were sacrificed on PND 55, and their brain was excised and processed for biochemical parameters (oxidative stress, inflammatory markers, BDNF), histological examination (HE, Nissl staining), NMDA, and AMPA receptor expression by immunohistochemistry, western blot, and real-time polymerase chain reaction evaluation. Also, the possible interaction of the G-CSF with NMDA and AMPA receptors was evaluated using the

BackgroundDespite advances in minimally invasive thoracic surgery, patients remain at risk of adverse pulmonary events with suboptimal postoperative analgesia. Novel methods of regional analgesia are warranted. Our objective was to prospectively evaluate the impact of ultrasound-guided single-injection erector spinae plane (ESP) block with ropivacaine compared with placebo control on standard of care postoperative recovery in subjects undergoing video-assisted thoracoscopic surgery (VATS) wedge resection.MethodsThis prospective, randomized, placebo-controlled, double-blinded study was conducted at a tertiary thoracic surgical center. Consecutive subjects undergoing VATS wedge resection were randomized to receive a single-injection ESP block with 0.5% ropivacaine or 0.9% saline placebo, in addition to the current standard of care of multimodal analgesia including patient-controlled analgesia and surgical local anesthetic wound infiltration. The primary outcome was difference in 40-point Quality of Recovery (QoR-40) on day 1 postoperatively. The secondary outcomes included opioid consumption, Visual Analog Pain Scale (VAS) score, time spent in the postanesthesia care unit (PACU), and block-related and postoperative complications.ResultsEighty subjects were enrolled, 40 in each group, with 76 completing follow-up (38 subjects in each group). There was no difference in the median QoR-40 score between groups, 169.5 for the ropivacaine group and 172.5 for the control group (difference 3, p=0.843). No significant differences existed between groups in all secondary outcomes, with the exception of the ropivacaine group having lower VAS pain scores measured at 1 hour postoperatively and a shorter duration of stay in the PACU of 117 min.ConclusionsFollowing VATS wedge resection, the addition of an ESP block with ropivacaine to standard multimodal analgesia is unlikely to add meaningful clinical value.Trial registration numberNCT03419117.

Background: This study is part of a larger research effort to explore the molecular mechanism of hepatocellular carcinoma, reduce drug resistance and seek new targets. Objective: The objective of this study is to investigate the effect and mechanism of fibroblast growth factor receptor inhibitor AZD4547 on Sorafenib-resistant hepatoma cells. Methods: First, we constructed a Sorafenib-resistant hepatoma cell line Huh7R. Different groups of Huh7R cells were treated with Sorafenib, AZD4547, Sorafenib combined with AZD4547, and normal saline. The cell viability was detected by Cell Counting Kit-8. Then Fibroblast growth factor receptor and Toll-like receptor 4 were detected by Western blot, as well as the LC3 II/I, Beclin1, and P62. In addition, we used the autophagy inhibitor 3-methyladenine to identify the mechanism of AZD4547 combined with Sorafenib for inducing Sorafenib-resistant hepatoma cell death. Results: We find that AZD4547 combined with Sorafenib significantly inhibited the viability of Sorafenib-resistant hepatoma cell Huh7R. As for its mechanism, AZD4547 was able to inhibit fibroblast growth factor receptor activity, promote autophagy and regulate immunity. AZD4547 increased LC3 II/I, Beclin1, and Toll-like receptor 4 proteins, and decreased P62 protein level in Huh7R cells significantly when given in combination with sorafenib. Furthermore, 3-methyladenine inhibited autophagy and reversed the killing effect of the combination of AZD4547 and Sorafenib on Huh7R cells. Conclusion: The inhibition of fibroblast growth factor receptor activity by AZD4547 can significantly enhance autophagy and immune response, as well as promote the death of Sorafenib-resistant hepatoma cells.

Objective. This study was designed to establish quality standards of Burnet gels and investigate the effects and mechanism of Burnet gels on steroid-dependent dermatitis (HDD) in guinea pigs. Methods. HPLC was used to determine the content of gallic acid, Gentiopicrin, and paeonol. A total of 48 male guinea pigs were recruited and randomly divided into control group, model group, tacrolimus ointment group, and Burnet gel group (Low, medium, and high concentration). The HDD guinea pig model was established by the 0.5% clobetasol propionate tincture. After HDD model establishment, control group and model group smeared normal saline and the rest of the group with corresponding drugs for three weeks. The contents of IFN-γ, IL-4, and IgE in the guinea pig serum were detected by the ELISA; the protein expression levels of FLG, LOR, and Caspase-14 in the epidermis of guinea pigs were detected by the immunohistochemical and Western blotting method. Results. The content of gallic acid, Gentiopicrin, and paeonol was 0.30 mg/g, 1.06 mg/g, and 0.56 mg/g. Compared with the normal group, the IFN-γ, IL-4, and IgE of guinea pig serum in the model group were significantly increased; the FLG, LOR, and Caspase-14 of guinea pig epidermis in the model group were significantly decreased; compared with the model group, the IFN-γ, IL-4, and IgE of guinea pig serum in the tacrolimus ointment group and Burnet gel group were significantly decreased; the FLG, LOR, and Caspase-14 of guinea pig epidermis in the tacrolimus ointment group and Burnet gel group were significantly increased. Conclusion. Burnet gels can improve guinea pig HDD model, and the mechanism may be related to inhibiting skin inflammation and promoting the formation of epidermal skin barrier.

BackgroundUltrasound is commonly used to facilitate epidural catheter placement. However, data are lacking regarding its potential to confirm its position in the epidural space. Our aim was to visualize flow in the epidural space of patients receiving epidural analgesia for labor using color flow Doppler ultrasound.MethodsWe conducted a prospective observational cohort study that included patients who had delivered vaginally under epidural analgesia. We used a 5–2 mHz curvilinear probe in a left and right paramedian longitudinal oblique view to visualize the anterior and posterior complex at the interspace of epidural catheter insertion, one and two interspaces above and below. At each window, the color flow Doppler function was used to visualize flow within the epidural space on injection of normal saline (1 mL). If no flow was visualized at any interspace, one assessment at the level of insertion was repeated with a 1 mL air/saline mixture. We studied a convenience sample size of 40 patients.ResultsWe visualized flow in the epidural space in all 40 patients. Flow was visualized on injection of 1 mL of saline in 37/40 patients (93%). In the remaining 3/40 patients (7%), flow was visualized with an air/saline mixture. Flow on injection of saline was visualized only at the interspace of insertion in 26/37 patients (70%), at the interspace of insertion and one interspace above in 10/37 (27%), or only at one interspace above in 1/37 (3%). Flow was visualized only on the left or on the right paramedian view in 19/37 patients (51%), despite a symmetrical sensory block in all patients.ConclusionColor flow Doppler ultrasound is a feasible and fast way to determine flow in the epidural space in the obstetric population. Its potential clinical uses are confirmation of the epidural catheter position after placement, as well as troubleshooting of unsatisfactory epidural analgesia. Interestingly, our results suggest that epidural catheters predominantly remain at the interspace of insertion.Trial registration numberNCT05126745.

Seerat Mehdi,1 Fiaz-ud-Din Ahmad,1 Arslan Hussain Lodhi,1 Umair Khurshid,2 Ahmed Awais Khalid,1 Sheikh Safeena Sidiq,1 Liaqat Hussain,3 Mirza Shaharyar Baig1 1Department of Pharmacology, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan; 2Department of Pharmaceutical Chemistry, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan; 3Department of Pharmacology, Faculty of Pharmaceutical Sciences, Government College University Faisalabad, Faisalabad, PakistanCorrespondence: Fiaz-ud-Din Ahmad, Department of Pharmacology, Faculty of Pharmacy, The Islamia University of Bahawalpur, Khawaja Fareed Campus, Railway Road, Bahawalpur, 63100, Pakistan, Tel +92-320-8402376, Email fiaz.ahmad@iub.edu.pkAim: Liver regulates metabolism of biomolecules and injury of liver causes distortion of metabolic functions. This injury may be oxidative or inflammatory induced by numerous factors including alcohol, pathogens and xenobiotics. This scientific study was planned to investigate the anti-inflammatory and anti-oxidant potential of p-coumaric acid (p-CA) on Lipopolysaccharide/D-Galactosamine (LPS/D-GalN) induced liver injury.Methods: DPPH analysis, reducing power assay and HPLC analysis were performed during in-vitro studies of p-CA. Similarly, in-vivo experiments were performed using Wistar Albino rats. Normal control and intoxicated group received (5mL/kg normal saline p.o), standard treatment groups received ascorbic acid (100mg/kg p.o) and silymarin (25mg/kg p.o), while p-CA treatment groups received (100mg/kg p.o) for 28-days. After completion of 28-days, LPS/D-GalN injection (300 mg D-GalN/kg and 10 μg LPS/kg i.p.) was given at 6th, 12th and 24-hours to all groups except normal control group. Animals were sacrificed; serum and liver samples were harvested and subjected to biochemical and histological examinations, respectively.Results: The results revealed that p-CA possess strong antioxidant activity. Increased levels of leukocyte infiltration (TLC), aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), total bilirubin (TBIL), lipid panel (eg TG, TC, LDL-C, VLDL-C), whereas decreased HDL-C levels noticed in LPS/D-GalN groups as compared to normal control groups. Pro-Inflammatory markers (eg TNF-α, IL-6, IL-1β) and lipid peroxidation marker, eg malondialdehyde (MDA) increased while superoxide dismutase (SOD) and reduced glutathione (GSH) levels were decreased significantly in groups treated with LPS/D-GalN. ANOVA with Bonferroni post hoc analysis was used for statistical analysis of. H&E staining was done to assess architectural abnormalities among liver cells.Conclusion: In conclusion, p-CA could ameliorate LPS/D-GalN induced hepatic injury via regulation of immune responses, liver function enzymes, lipid profile, oxidative stress and pro-inflammatory markers.Keywords: p-coumaric acid, lipopolysaccharide, D-galactosamine, oxidative stress, inflammation

Amifostine is a powerful antioxidant that is one of the documented three chemo-radio prototectants recommended for clinical use. There is no data exploring amifostine in prevention of acute pericardial damage. We aimed to investigate whether amifostine has protective effect against acute pericardial injury due to radiotherapy in an experimental rat model.Twenty-four rats were divided into four groups: control group, radiotherapy-only group, amifostine-only group, radiotherapy+amifostine group. In groups receiving radiotherapy, hearts were irradiated with a Co 60 teletherapy device at a distance of 80 cm and 20 Gy at a depth of 2 cm. Thirty minutes before interventions, 200 mg/kg amifostine or same volume 0.9% NaCl were administered intraperitoneally. Subjects were sacrificed 24 hours after the procedure. Pericardial histopathological changes were investigated by light microscopy.There was focal inflammation of= 50% in all rats exposed-to-radiotherapy. All groups receiving radiotherapy revealed a significant increase in pericardial inflammation compared to the groups that did not receive irradiation (p0.05). There was no difference between the radiotherapy-only group and amifostine+radiotherapy group for pericardial inflammatory response (p0.05).Acute pericarditis was detected in all rats receiving radiotherapy. There was no positive effect of amifostine administration before radiotherapy on acute pericardial inflammation.

Balanced crystalloids may improve outcomes compared with saline for some critically ill adults. Lower tonicity of balanced crystalloids could worsen cerebral edema in patients with intracranial pathology. The effect of balanced crystalloids versus saline on clinical outcomes in patients with traumatic brain injury (TBI) requires further study. We planned an

Buprenorphine is perhaps the most prescribed analgesic for management of postoperative pain in mice. Although various buprenorphine formulations are effective in commonly used immunocompetent mouse strains, a knowledge gap exists regarding its efficacy in immunodeficient mice. Here we used a plantar incision to evaluate the efficacy of 3 buprenorphine formulations for attenuating postoperative mechanical and thermal hypersensitivity in the immunodeficient NSG mouse strain. We also characterized the pharmacokinetics of these formulations over a 72-h period. We hypothesized that all 3 buprenorphine formulations evaluated—the standard preparation and 2 extended-release products (Bup-HCl, Bup-ER, and Bup-XR, respectively)—would attenuate postoperative mechanical and thermal hypersensitivity resulting from a plantar incision in NSG mice. Male and female NSG mice (n= 48) were allocated to 4 treatment groups: saline (0.9% NaCl, 5 mL/kg SC once); Bup-HCl (0.1 mg/kg SC, BID for 2 d); Bup-ER (1.0 mg/kg SC once); and Bup-XR (3.25 mg/kg SC once). Mechani- cal and thermal hypersensitivity assessments were conducted 24 h before surgery and at 4, 8, 24, 48, and 72 h afterward. All groups of mice showed mechanical and thermal hypersensitivity within the first 24 h after surgery. Behavioral pain indicators (guarding, toe-touching [intermittent partial weight bearing], licking the incision, vocalizations) were observed in some mice from each group at every postoperative time point. Plasma buprenorphine was measured in a separate group of mice and concentrations surpassed the suggested therapeutic level (1.0 ng/mL) for less than 4 h for Bup-HCl, for at least 24 h for Bup-ER, and for 72 h for Bup-XR. Our results indicate that at the dosages studied, these buprenorphine formulations do not adequately attenuate postoperative mechanical and thermal hypersensitivity in the plantar incisional model in NSG mice. These findings support the need for strain-specific analgesic protocols for mice used in research.

Svrha rada: Ispitivanjem implantata od nehrđajućeg čelika 316L utvrditi djeluje li biološka tekuća (SBF-Simulated Body Fluid) sredina na biomehaničko slabljenje implantata kao posljedica jamičaste korozije. Očekivani znanstveni doprinos: Ovim istraživanjem nastoje se optimizirati svojstva implantata od čelika 316L koji se koristi u ortopedskoj i traumatološkoj kirurgiji. Materijali i metode: Četrdeset i osam (n = 48) uzoraka od nehrđajućeg čelika 316L, podijeljeni u četiri skupine od 12 uzoraka; prva skupina uronjena u SBF pH vrijednosti 7,0, druga uronjena u puferiranoj otopini mliječne kiseline pH vrijednosti 6,0, treća skupina uronjena u puferiranoj otopini mliječne kiseline pH vrijednosti 5,0 i četvrta skupina koja je kontrolna skupina te nije bila uronjena u otopine. Putem Skenirajućeg elektronskog mikroskopa (SEM) analizirao se broj po jedinici površine i dimenzije korozivnih promjena te su se pločice biomehanički testirale prije početka kod kontrolne skupine, i po završetku pokusa u ostalih skupina, kao i hrapavost. Rezultati: Za sve tri skupine koje su bile uronjene u SBF bilo je postupne progresije u promjenama po tipu jamičaste korozije i to najviše u skupini s najnižim pH (pH 5,0), odnosno s najvišom kiselošću i to od trećeg mjerenja nadalje (p = 0,003). Ako se gledaju vrijednosti unutar pojedinih vremena mjerenja, značajne razlike su između skupina pH 5,0 i pH 6,0 u četvrtom mjerenju kao i pH 5,0 i pH 7,0 u drugom mjerenju. U oba slučaja, vrijednosti površine jamica su bile najveće kod medija s najnižim pH vrijednostima. Ako promatramo dinamiku promjena unutar pojedinih skupina, značajne razlike su zabilježene samo u skupini s pH 6,0 (p = 0,001). Nije bilo značajnih razlika u vrijednostima maksimalnog progiba između ispitivanih skupina (p = 0,804). Razlike u maksimalnoj sili (N) tijekom statičkog mehaničkog opterećenja između pojedinih skupina koje su ovisno o kiselosti medija, pokazuje da je najniži medijan vrijednosti maksimalne sile bio kod kontrolne skupine: 1407 N (IQR: 1400 – 1471,5 N), a najviši kod pH 7,0: 1421,0 N (IQR: 1410,0 – 1491,5 N) iako između skupina nije bilo značajnih razlika. Zaključak: Implantati od nehrđajućeg čelika 316L u biološki simuliranom mediju razvijaju promjene po tipu jamičastih korozija, a kod onih već postojećih, znatno propagiraju u kiselijim uvjetima (najviše pH 5,0). Povezanost između jamičaste korozije i slabljenja implantata nije statistički značajna te se iz navedenog razloga nije nastavilo u stvaranju preporuka za optimizaciju debljine implantata ne bi li se izbjeglo oštećenje jamičastom korozijom., Aim: Assessing surgical 316L stainless steel to confirm the effect of biological media fluid (SBF-simulated body fluid) in weakening the implant due to pitting corrosion. Expected scientific contribution: This research is aimed to optimize the properties of implants made of 316L stainless steel used in orthopedic and trauma surgery. Materials and methods: Using forty-eight (n=48) 316L stainless steel implant samples divided into four groups of twelve samples each; the first immersed in SBF (saline 0.9% NaCl), second group immersed in a buffered lactic acid solution of pH 6.0, third group immersed in a buffered lactic acid solution of pH 5.0, and the fourth group is not immersed. The morphology and dimensions of corrosion defects analysed by a Scanning electron microscope (SEM), biomechanical tests performed at the beginning and end of the study. Results: There was a gradual increase in corrosion pits in all three groups that were immersed in SBF, with the most significant noted in the strongest acidic group (pH = 5.0), which was the case from the third measure onward (P=0.003). Upon inspecting the individual measurement times, there is a significant difference between groups of pH 5.0 and pH 6.0 in the fourth measurement, and also between the pH 5.0 and pH 7.0 groups. In both cases the surface area of the pits was the largest in the group immersed in the pH 5.0 solution. There was a significant statistical difference in the dynamics of change in only the group immersed in the pH 6.0 solution (P=0.001). There was no significant difference in maximal bending among the groups (P=0.804). The difference in the maximal force (N) during static mechanical testing of the groups was dependant on the acidity of the solution; the lowest median of maximal force was found in the control group: 1407 N (IQR: 1400 – 1471.5 N), the highest in the group of pH 7.0: 1421.0 N (IQR: 1410.0 – 1491.5 N); nonetheless, there was no significant difference between the groups. Conclusion: In concluding, 316L stainless steel implants in simulated body fluid with the lowest pH value develop corrosion pits, and additionally in existing ones, significantly progress in acidic conditions. There is no statistical significance in the relationship between pitting corrosion and the weakening of implants. The ideal thickness of the implant that would prevent pitting corrosion damage was not defined due to the irrelevance as mentioned above.

Background: In Egypt, both pregabalin and tramadol misuse increased in the last decade. Although many studies have confirmed the neurotoxic effects of tramadol, those of pregabalin are understudied. Aim of the study: evaluation of the neurotoxic effects of pregabalin compared with tramadol.Material and method: Thirty male albino rats were included in this experimental study, and they were randomly allocated into three equal groups; Group I (normal saline), Group II (Tramadol addicted), and Group III (pregabalin addicted). All rats received the commenced drugs for 1 month. Open-field tests were performed on the day of scarification, and after that, cortical samples were taken for immunohistochemical analysis and quantification of dopamine receptors' gene expression.Results: The addicted groups showed a significant decrease in weight gain at the end of the study. Open-field testing showed the upper hand of controls regarding all of the tested parameters. Tramadol has a more negative impact on the locomotor parameters compared with pregabalin. Both drugs induced relatively low dopamine-1 receptors (D1Rs) expression to dopamine-2 receptors (D2Rs), mimicking the schizophrenia model.Conclusion: Both tramadol and pregabalin were associated with neurotoxic effects in male albino rats. These effects were less noticed with pregabalin. It is suggested that long-term abuse may end in psychosis.

Pods of Caesalpinia ferrea, popularly used to treat inflammatory processes, were collected to obtain the polysaccharide-rich extract, presenting anti-inflammatory and antinociceptive effects in acute inflammation models. This study aimed to evaluate the anti-inflammatory, antinociceptive and healing activities of the polysaccharide-rich extract from Caesalpinia ferrea pods (PEp-Cf) in the rat model of cutaneous excisional wound. PEp-Cf (0.025-0.1%) or 0.9% NaCl was topically applied in the wounds at dorsal thoracic region (2×/day) during 21 days for measurement of clinical signs (hyperemia, inflammatory exudate, edema, nociception), wound size, histopathological/histomorphometric, oxidative/inflammatory markers and systemic toxicity. PEp-Cf at 0.1% reduced wound area and increased ulcer contraction [days 2 and 10 (21-78%)]. PEp-Cf reduced clinical signs [days 2 and 5 (2.2-2.8×)] and modulated the healing inflammatory phase via stimulation of epithelialization (days 10 and 14), and inhibition of polymorphonuclears [days 2 and 5 (71-74%)], protein leakage [days 2 and 5 (28-41%)], nitrate [days 2 and 5 (2.2-6×)] and malondialdehyde [days 2 and 5 (46-49%)]. PEp-Cf increased the number of blood vessels [days 5 and 7 (3.1-9.6×)], fibroblasts [days 5 and 7 (2.1-6.4×)] and collagen [days 5 to 14 (1.5-1.8×)]. In conclusion, the topical application of PEp-Cf at 0.1% accelerates the healing process of rat cutaneous wounds via modulation of the inflammatory and proliferative phases, being devoid of systemic alterations.

To determine whether intra-articular coinjection with hypertonic dextrose improves the outcome of hyaluronic acid (HA) prolotherapy for knee osteoarthritis (OA).Prospective, randomized, double-blind trial.Medical center in Taiwan.In total, 104 participants who fulfilled the American College of Rheumatology clinical and radiographic criteria for knee OA with a Kellgren-Lawrence score of 2 or 3 were recruited (N=104).The participants were blocked randomized to the treatment (HA and hypertonic dextrose) or control (HA and normal saline) group. Ultrasound-guided knee intra-articular injections were administered once a week for 3 weeks.The primary outcomes were performance-based physical function measures (regular and fastest walking speed, stair climbing time, and chair rising time), and the secondary outcomes were the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Injury and Osteoarthritis Outcome Score (KOOS). The outcome measures were assessed before the injections and at 1 week and 1, 3, and 6 months after the injections. The data were analyzed through repeated-measures analysis of covariance.Significant intergroup difference-in-differences favoring the treatment group were observed for improvements in stair climbing time (-1.6; 95% confidence interval, -8.56 to 4.16; P=.38) and WOMAC physical function (-21.2; 95% confidence interval, -126.05 to 103.83; P = .045) at 6 months. The group×time interaction effects favored the treatment group for regular (P=.001) and fastest walking speed (P=.001) and chair rising time (P=.038); WOMAC stiffness (P .001) and physical function (P = .003); and KOOS for pain (P = .035), other symptoms (P=.022), and quality of life (P=.012).Compared with HA plus normal saline coinjections, HA plus dextrose coinjections resulted in more significant improvements in stair climbing time and physical function at 6 months, effectively decreased pain, and improved physical function and physical functional performance from 1 week to 6 months. HA plus dextrose coinjections could be a suitable adjuvant therapy for patients with knee OA.

We aimed to perform a systematic review and meta-analysis of randomized controlled trials to summarize the overall association between the choice of fluid (lactated Ringer's [LR] or normal saline [NS]) and clinical outcomes in patients with acute pancreatitis.A systematic literature search was performed in electronic databases to identify eligible randomized controlled trials. Meta-analyses with the random-effects and IVhet models were used to estimate the pooled odds ratio (OR) for outcomes of interest with the administration of LR relative to NS, at 95% confidence intervals (CIs).There was a significant reduction in the odds of intensive care unit admission and development of local complications, respectively, with the administration of LR among hospitalized patients with acute pancreatitis relative to administration of NS (pooled ORs, 0.33 [95% CI, 0.13-0.81] and 0.43 [95% CI, 0.21-0.89], respectively).Our findings are able to assist clinicians in the navigation of the proper choice of fluid in patients with acute pancreatitis.

Recent studies suggest that balanced fluids improve inpatient outcomes compared to normal saline. The objective of this study was to obtain insights into clinicians' knowledge, attitudes and perceived prescribing practices concerning IV isotonic fluids and to analyze perceived prescribing in the context of actual prescribing.This study, conducted at a single center (Medical University of South Carolina), included 1) a cross-sectional survey of physicians and advanced practice providers (APPs) (7/2019-8/2019) and 2) review electronic health record (EHR) claims data (2/2018-1/2019) to quantify the prescribing patterns of isotonic fluids.Clinicians perceived ordering equivalent amounts of normal saline and balanced fluids although normal saline ordering predominated (59.7%). There was significant variation in perceived and actual ordering across specialties, with internal medicine/subspecialty and emergency medicine clinicians reporting preferential use of normal saline and surgical/subspecialty and anesthesia clinicians reporting preferential use of balanced fluids (p0.0001). Clinicians who self-reported providing care in an intensive care unit (ICU) reported more frequent use of balanced fluids than non-ICU clinicians (p = 0.03). Actual prescribing data mirrored these differences. Clinicians' self-reported use of continuous infusions (p = 0.0006) and beliefs regarding the volume of fluid required to cause harm (p = 0.003) were also associated with self-reported differences in fluid prescribing. Clinician experience, most clinical considerations (e.g., indications, contraindications, barriers to using a specific fluid), and fluid cost were not associated with differential prescribing.Persistent normal saline utilization is associated with certain specialties, care locations, and the rate and volume of fluid administered, but not with other clinical considerations or cost. These findings can guide interventions to improve evidence-based fluid prescribing.

5% of children are born with auricular deformities. Permanent recontouring can be achieved through splinting during early infancy. Beyond this time, splinting is ineffective, and patients require surgical correction. Neonatal cartilage malleability is hypothesized to be secondary to retained maternal estrogens, increasing hyaluronic acid concentration. In this article, we evaluate the efficacy of local estrogen treatments for the nonsurgical recontouring of mature auricular cartilage.Ears of New Zealand rabbits were folded and splinted and then were randomly assigned to an experimental group, n = 10 (injected estrogen, topical estrogen, saline, or untreated). Treatment ears received injected estrogen or saline twice weekly or topical estrogen daily for 4 weeks. Two weeks post-treatment, splints were removed, and ear angles were measured. Biopsies were taken for histologic and mechanical analysis, and systemic estrogen levels were assayed.Ear angles stabilized by 9 days post-splinting. Topical estrogen led to a significantly smaller resting angle (121.6° ± 13.5°) compared with saline and control (135.9° ± 11.2° and 145.3° ± 13.0°, respectively). Injected estrogen led to the most pronounced angle decrease (64.5° ± 35.3°). Ears injected with estrogen also showed a significant increase in cartilage thickness. Hyaluronic acid concentration was increased in both estrogen treatment groups compared with saline. At 3 weeks post-treatment, there was no significant differences in the elastic modulus of the cartilage or serum estrogen levels among the groups.Results show the potential result of local estrogen treatment to achieve a stable nonsurgical remodeling of mature auricular cartilage. Further study is needed to evaluate the molecular mechanism and improve the transdermal estrogen delivery to optimize treatment regimen.

The Essure® permanent contraceptive implant, comprised of four alloys (nickel-titanium, 316L stainless steel, platinum-iridium, and tin-silver solder) and Dacron (PET) fibers, has been approved for use in the US for about two decades. However, little has been published on this implant's biomaterials performance, and as this implant gains interest in terms of in vivo performance, methods of implant post-retrieval storage also need to be assessed. This study investigated the electrochemical properties and ion release profile of Essure® during storage in phosphate buffered saline (PBS), 10 mM H

The present study was designed to investigate the effects of caffeine and adrenaline administration on memory and anxiety in male rats. Rats weighing about 140-200g were used for the study. They were divided into three groups (4 animals per group). Study groups 1; a,b,c,d were healthy rats administered normal saline, 5,10 and 15mg/kg bw caffeine intraperitoneally (i.p.), respectively for 6 weeks. Study groups 2; a,b,c,d administered normal saline, 0.1, 0.2 and 0.31mg/kg bw adrenaline (i.p.), respectively for 6 weeks. Study groups 3; a,b,c,d administered normal saline, 5mg/kg caffeine (i.p.) + 0.1mg/kg adrenaline (i.p.), 10mg/kg Caffeine (i.p.) + 0.2mg/kg Adrenaline (i.p.) and 15mg/kg Caffeine (i.p.) + 0.3mg/kg Adrenaline (i.p.) respectively for 6 weeks. The result showed no significant difference in spatial memory across all animals in study groups 1: b,c,d when compared to control (a). Study groups 2: (b, c) showed increase in spatial memory when compared to control (a). 2(d) showed a significant (p

In the present study, an electrochemical-impedimetric biosensor using Saccharomyces cerevisiae as an effective biorecognition element was designed to detect caffeine. The presented biosensor consists of a previously developed stainless steel electrochemical cell constructed as a three-electrode system in the RCW side-by-side configuration. The electrochemical stability of the sensing electrode was evaluated by measuring the open circuit potential (OCP), and electrochemical impedance spectroscopy (EIS) was applied to determine the impedimetric response of the biosensor with Saccharomyces cerevisiae cells attached to the working electrode (WE) in the absence (0.9% NaCl) and presence (10 mg/mL in 0.9% NaCl) of caffeine. Moreover, the limit of detection (LOD) was determined. In this way, a new approach in biosensor development has been established, which involves assembling a low-cost and disposable electrochemical system to detect alkaloids such as caffeine. The developed biosensor represents a good candidate for detecting caffeine in beverages, foods, and drugs with the merits of time-saving, robustness, low cost, and low detection limit.

Postural habits and repetitive motion contribute toward the progress of myofascial pain by affecting overload on specific muscles, the quadratus lumborum (QL) muscle being the most frequently involved. The therapy of myofascial pain syndrome includes the release of myofascial pain syndrome using injective agents such as botulinum neurotoxin, lidocaine, steroids, and normal saline. However, an optimal injection point has not been established for the QL muscle. This study aimed to propose an optimal injection point for this muscle by studying its intramuscular neural distribution using the whole mount staining method. A modified Sihler's procedure was completed on 15 QL muscles to visualize the intramuscular arborization areas in terms of the inferior border of the 12th rib, the transverse processes of L1-L4, and the iliac crest. The intramuscular neural distribution of the QL had the densely arborized areas in the three lateral portions of L3-L4 and L4-L5 and the medial portion between L4 and L5.

Introduction Treatment for long-gap esophageal atresia (LGEA) aims at achieving primary anastomosis with minimal tension. Previous studies have shown that intramural injections with botulinum toxin type-A (BTX-A) from the adventitial side can increase the elongation of the piglet and rat esophagus before bursting, and that this effect is dose and time dependent. Our aim was to determine if endoscopic injections would be feasible, safe, and with an effect on the mechanical properties of the esophagus. Methods Twenty-two male piglets (5.15 kg) were randomized into two groups, one receiving 2 units/kg BTX-A, the other equal volume 0.9% NaCl. On day 3, the esophagus was harvested and tested in a stretch-tension machine to evaluate elongation and maximum load, followed by histological examination. Results No adverse effects to the procedure were observed. No statistically significant difference in elongation or maximum load before bursting between the treatment and placebo group was found. In histopathological analysis, inflammation and abscess formation were observed with no statistically significant difference between the two groups. Conclusion Endoscopic placement of BTX-A injections in the piglet esophagus was safe and feasible but did not result in any difference in the mechanical properties or histology of the esophagus.

Poly (lactic acid) (PLA) has been proposed as a promising orthopedic implant material, whereas insufficient mechanical strength, unsatisfied biocompatibility and inappropriate degradation rate restrict its further application. In this work, self-reinforced poly (lactic acid)-b-poly(lactide-co-caprolactone) (PLA-b-PLCL) block copolymer with long-chain branches was fabricated through two-stage orientation. Compared with smooth and hydrophobic PLA surface, the surface of PLA-b-PLCL presented micro-phase separated structure with improved hydrophilicity, and cells seeded on it showed improved adhesion/proliferation and high alkaline phosphatase (ALP) activity. After the 1st stage orientation at temperature higher than Tsubg1/sub(glass transition temperature of PLA phase), the amount of CHsub3/suband CO groups on surface of PLA-b-PLCL increased, while "groove-ridge" structure formed, resulting in enhancement of surface hydrophobicity. After the 2nd stage orientation at Tsubg1/sub ~ Tsubg2/sub(glass transition temperature of PLCL phase), surface hydrophobicity/amount of CO groups further increased and "groove-ridge" structure became more significant. Due to suitable wettability and enhanced material-cell mechanical interlocking, cell proliferation/ALP activity were improved and a continuous cell layer formed on sample surface. During in vitro degradation in phosphate buffered saline solution, by introduction of PLCL segments, the crystallinity decreased and solution absorption increased, resulting in a rapid deterioration of mechanical properties. After the 1st stage orientation, a dense microfibrillar structure with high crystallinity formed, which hindered diffusion of solution and delay hydrolytic degradation. After the 2nd stage orientation, PLCL segments were arranged more closely, resulting in a further inhibition of degradation, which was helpful for controlling the strength decay rate of PLA as bone fixation materials.

Background Stenotrophomonas maltophilia causes opportunistic infections in immunocompromised and patients in intensive care units (ICUs). An outbreak of S. maltophilia in ICU is described which highlights the importance of the risk of infection from contaminated medical devices and suction fluids in ventilated patients. Methods The investigation of the outbreak was carried out. Environmental sampling was done. This was followed by MALDI-TOF MS typing and recA gene-based-phylogeny. Results In February, S. maltophilia was reported from the central line blood of six patients from ICU within a span of two weeks. The peripheral line blood cultures were sterile in all patients. Relevant environmental sampling of the high-touch surface and fluids revealed S. maltophilia strains in normal saline used for suction and in the inspiratory circuit of two patients. The isolated strains from patients and environment (inspiratory fluid) showed a minimum of 95.41% recA gene sequence identity between each other. Strict cleaning and disinfection procedures were followed. Continuous surveillance was done and no further case of S. maltophilia was detected. Timely diagnosis and removal of central line prevented development of central-line associated blood stream infection. Conclusion This outbreak report illustrates that environmental sources like suction fluid and normal saline could be the source of S. maltophilia in ICU patients.

There is insufficient evidence of the effects of intermittent flushing with normal saline versus heparin to prevent occlusion or increased alteplase use in pediatric patients with central venous catheters.The primary objective was to evaluate the effectiveness of a new standard flushing practice in the management of central venous access devices in pediatric patients with cancer. A secondary objective was to assess the cost of heparin flushing supplies to patients and financial impact.New flushing guidelines included tunneled lines flushed with saline in the push-pause method twice daily in the inpatient setting. The outpatient setting required saline lock while receiving care and heparin lock on discharge. Alteplase usage was monitored for five months in all pediatric patients with cancer who had tunneled central lines.There was no statistically significant difference in alteplase usage rate pre- to postimplementation. A formal flushing guideline was recommended using saline and lower heparin concentrations for tunneled catheters.

Yu-Bin Liu,1 Lin Zhang,1 Xing-Chen Zhou,1 Ying Zhou,1 Yun Liu,1 Can Zheng,1 Xiao Xu,1 Pan-Pan Geng,1 Chun-Hua Hao,2 Zhuan-You Zhao,2 Chu-Tse Wu,1 Ji-De Jin1 1Department of Experimental Hematology and Biochemistry, Beijing Institute of Radiation Medicine, Beijing, 100850, People’s Republic of China; 2Center for Pharmacodynamic Research, Tianjin Institute of Pharmaceutical Research, Tianjin, 300462, People’s Republic of ChinaCorrespondence: Chu-Tse Wu; Ji-De Jin, Department of Experimental Hematology and Biochemistry, Beijing Institute of Radiation Medicine, No. 27 Taiping Road, Beijing, People’s Republic of China, Tel +86 1086-68158312 ; +86 1086-66931425, Email wuct@bmi.ac.cn; jinjide505@163.comIntroduction: Recombinant neorudin (EPR-hirudin, EH) was developed through the addition of an EPR (Glu-Pro-Arg) peptide to the amino terminus of hirudin, which can be recognized and cut by coagulation factors XIa (FXIa) and/or Xa (FXa). In this study, the low-bleeding antithrombotic effects of EH were evaluated utilizing experimental models of thrombosis in rabbits and rats to provide a test basis for clinical trials.Methods: The bleeding risks of EH and hirudin were first compared in mice by the tail-clipping method, and then the antithrombotic activity of EH was investigated in a rabbit model of arteriovenous bypass thrombosis and a rat model of thrombotic cerebral infarction.Results: In mice, intravenous administration of EH at 1.5 mg/kg and 3 mg/kg did not affect the bleeding time compared with normal saline, while the administration of hirudin at 1.5 mg/kg prolonged the bleeding time by over 3 times the administration of normal saline. Furthermore, intravenous administration of EH had a significant dose-dependent inhibitory effect on the formation and development of arteriovenous bypass thrombosis and thrombotic cerebral infarction. Compared with an equimolar dose of hirudin, the antithrombotic effect of EH was similar, while the bleeding side effects were significantly attenuated. Moreover, when the antithrombotic effects were similar, EH had a shorter bleeding time and was associated with less bleeding than low molecular weight heparin (LMWH). EH had a therapeutic effect on thrombotic cerebral infarction without increasing the occurrence of cerebral hemorrhage.Conclusion: The findings from the preclinical animal models used in this study showed that EH could not only effectively inhibit thrombus formation but also reduce the risk of bleeding.Keywords: recombinant neorudin, hirudin, antithrombotic effect, bleeding