Search

Objective To explore the role and mechanism of the exosomes derived from bronchoalveolar lavage fluid (BALF) of patients with chronic obstructive pulmonary disease (COPD-Exo) in regulating osteoblast differentiation. Methods A total of 6 COPD patients and 6 non-COPD patients admitted in our hospital in June 2023 were recruited, and their BALF samples were collected during the process. COPD-Exo and exosomes from the non-COPD patients (Ctrl-Exo) were extracted and identified by electron microscopy and Western blotting. Alizarin red staining and qRT-PCR were used to detect the differences in osteoblast differentiation after COPD-Exo and Ctrl-Exo intervention. Bioinformatics analysis was performed on the microRNA (miRNA) expression profiles of COPD-Exo and Ctrl-Exo in the GEO database (GSE218571) to obtain differentially expressed miRNAs. Antagomir was used to block mircoRNA function, and the miRNAs with osteogenic differentiation regulatory function were identified. Targetscan software was used to predict the downstream target genes of the miRNAs, and then these miRNAs were verified. Results Exo could be extracted from BALF of both COPD and non-COPD patients. Alizarin red staining and qRT-PCR results showed that COPD-Exo inhibited the osteogenic differentiation of human hFOB 1.19 osteoblasts (P < 0.05). Bioinformatics analysis indicated that the expression level of miR-223-3p was significantly up-regulated in COPD-Exo. Blocking miR-223-3p with Antagomir could alleviate the osteogenic differentiation of human hFOB 1.19 osteoblasts inhibited by COPD-Exo (P < 0.05). Targetscan prediction revealed that miR-223-3p may target and inhibit the expression of osteogenic differentiation-related factor FOXO3 (P < 0.05). Conclusion COPD-Exo can inhibit the osteogenic differentiation of human hFOB 1.19 osteoblasts through miR-223-3p, which may be related to the inhibition of FOXO3 expression by miR-223-3p.

Objective To evaluate the effect of intraoperative multimodal analgesia on the early postoperative quality of recovery in end-stage head and neck cancer patients undergoing open gastrostomy surgery. Methods This was a prospective, parallel, randomized controlled study. The research subjects were end-stage head and neck cancer patients who underwent elective open gastrostomy at Beijing Tongren Hospital affiliated to Capital Medical University from November 2022 to May 2023. The patients were randomly divided into local anesthesia group and multimodal analgesia group at a 1∶1 ratio. For local anesthesia group, 0.25% ropivacaine 20-30 mL was administered for local infiltration anesthesia. For multimodal analgesia group, the anesthesia method was nerve block + intravenous analgesia: ultrasound-guided left transverse abdominis plane block (0.25% ropivacaine 0.3 mL/kg)+bilateral rectus abdominis sheath block (0.25% ropivacaine 0.3 mL/kg per side)+intravenous injection of oxycodone 0.1 mg/kg, flurbiprofen 1 mg/kg, and dexamethasone 0.2 mg/kg. The primary outcome measure was the quality of requirements-15 (QoR-15) score at postoperative 24 h, while the secondary outcome measures were the QoR-15 score at postoperative 48 h, the numerical rating scale (NRS) and Bruggemann comfort scale (BCS) scores at different time points after the surgery, the first time of rescue analgesia, the first time of off-bed activity and intestinal exhaust, as well as the incidences of adverse reactions within postoperative 48 h. Results A total of 46 patients with end-stage head and neck cancer who underwent open gastrostomy and met the inclusion and exclusion criteria were ultimately enrolled, with 23 patients in multimodal analgesia group and 23 patients in local anesthesia group. There was no statistically significant difference in preoperative QoR-15 scores between the two groups (P > 0.05). Multimodal analgesia group had higher QoR-15 scores at 24 h postoperatively[(81.77±8.91) vs. (71.46±7.61), P < 0.05] and 48 h postoperatively[(86.26±7.92) vs. (80.13±6.98), P < 0.05], and the difference in QoR-15 scores at 24 h postoperatively was clinically significant. Compared with local anesthesia group, at 6 h and 24 h after surgery, the multimodal analgesia group showed a decrease in NRS scores at rest and during exercise, while the comfort BCS score increased (all P < 0.05). Multimodal analgesia group also had a delayed time for the first rescue analgesia, a reduced incidence of rescue analgesia within 48 h after surgery, an earlier time for first postoperative off-bed activity and intestinal exhaust (all P < 0.05). The incidence of adverse reactions in multimodal analgesia group and local anesthesia group was 8.70% and 13.04%, respectively, but the difference was not statistically significant (P > 0.05). Conclusion Intraoperative multimodal analgesia can effectively alleviate postoperative pain, increase the comfortable degree, shorten the first time of postoperative off-bed activity and intestinal exhaust, and accordingly improve the quality of early postoperative recovery in patients undergoing open gastrostomy.

Flexible manipulation of surface waves (SWs) radiation has been continuously intriguing enormous interests of researchers due to its promising application prospects, and metasurfaces exhibit unparalleled capability to efficiently control SWs radiation. However, existing schemes still suffer from the bottlenecks of single radiation channel and immutable radiation pattern, which are difficult to satisfy the requirements of high-integration intelligent metadevices. Herein, an ingenious strategy of the SWs radiation metadevice is proposed to independently and dynamically manipulate SWs directional radiation in four polarization channels. The waveguide port and the guided wave structure are designed to excite and propagate the desired SWs, and the programmable coding metasurface can independently convert SWs into x-polarized radiation waves, y-polarized radiation waves, left-handed circular polarized radiation waves and right-handed circular polarized radiation waves and dynamically control the corresponding radiation angles by adjusting the ON/OFF states of two positive-intrinsic-negative diodes in each spin-decoupled meta-atom. Numerous simulation and experimental results of the proof-of-concept prototype are in good agreement with the theoretical predictions, which verify the feasibility of our proposed methodology. The innovative design of four-channel SWs radiation metadevice with high radiation efficiency and broad radiation bandwidth offers an excellent platform for flexibly manipulating SWs radiation, and possesses tremendous potential in engineering application.

Vortex beams carrying orbital angular momentum (OAM) are considered to hold significant prospects in fields such as super-resolution imaging, high-capacity communications, and quantum optics. Therefore, the techniques of vortex beam generation have attracted extensive studies, in which the development of metasurfaces brings new vigor and vitality to it. However, the generation of reconfigurable vortex beams by metasurfaces at the incidence of arbitrary polarized electromagnetic (EM) waves holds challenges. In this study, an efficient and reconfigurable strategy utilizing PB phase-modulated circularly polarized waves and dynamic phase-modulated linearly polarized waves is proposed, enabling a polarization-locked fully polarization vortex beams generator. Based on this strategy, we designed and fabricated a prototype of the vortex beam generator for full polarization, which verifies the rotating Doppler effect and generates a time-varying vortex beam. All the results have been verified by simulation and measurements. In addition, the proposed strategy can be easily extended to other frequency regions and holds potential in areas such as information encryption, biosensing, and OAM multiplexing communication.

The continuous increase in communication capacity is accompanied by an increase in transmission frequency, which creates new demands on the transmission efficiency in modern. Signal relay transmission can increase the transmission distance, however, conventional repeaters relay the signal in a specified direction, which is difficult to accommodate communication when a receiving device suddenly appears around the repeater. In this work, we propose a new signal transmission repeater, which is implemented by an adaptively reconfigurable multi-beam reflective metasurface based on multispectral detection. The reconfigurable metasurface with varactor diodes is designed and the mapping of phase profiles to voltages is established by polynomial fitting method. Visual, laser, infrared and ultrasonic detectors are used to detect targets in different scenarios. Thus, the detection information is fed back to the reconfigurable metasurface for adaptively multi-beam switching. As verification, the adaptive metasurface repeater was fabricated and measured to verify our design. All the results exhibit consistency with theoretical design. Importantly, this work paves a new way to intelligent metasurfaces and may find applications in intelligent communications, smart home, etc.

Objective To compare the effects of remimazolam vs propofol on the quality of recovery in elderly patients undergoing fundus daytime surgery after general anesthesia. Methods A total of 110 elderly patients undergoing day-time fundus surgery under laryngeal mask anesthesia were randomly divided into Remimazolam group and Propofol group. Patients in Remimazolam group were induced by remimazolam, sufentanil and rocuronium, and maintained by remimazolam and remifentanil. Patients in Propofol group were induced by propofol, sufentanil and rocuronium, and maintained by propofol and remifentanil. The level of sedation was monitored by bispectral index. After surgery, patients were antagonized by flumazenil in Remimazolam group but not in propfolgroup. The quality of patients' recovery was recorded before operation and three days after operation measured by quality of recovery-15 (QoR-15) scale. Intraoperative hemodynamic data, the time to consciousness loss during induction and awakening after operation, the time for laryngeal mask removal and the incidence of adverse events after admission to post anesthesia care unit were also recorded. Results The QoR-15 score in Remimazolam group 24 hours after operation was non-inferior to that in propofol group (133.3 ±11.1 vs. 135.0±10.3; mean difference (95% CI) 1.7 (-3.9, 7.2); approving for non-inferiority). There was no significant difference in QoR-15 scores between the two groups before operation or any other setting points. Compared with Propofol group, the time to consciousness loss during induction was prolonged, and the time for awakening after operation and laryngeal mask removal were shortened in Remimazolam group (all P < 0.05). Compared with Propofol group, the hemodynamics of patients in Remimazolam group was more stable (P < 0.05). There was no significant difference in the total dosage of remifentanil, fluid, or in the incidence of adverse reactions in PACU between the two groups (P > 0.05). Conclusion In elderly patients undergoing day-time fundus surgery, induction and maintenance of anesthesia with Remimazolam could achieve the similar quality of postoperative recovery with propofol. Compared with propofol, remimazolam provide more stable hemodynamics and shorter recovery time and extubated time, contributing to higher efficiency in recovery period. [ABSTRACT FROM AUTHOR]