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OBJECTIVE: The study aimed to assess the impact of the enhanced recovery after surgery (ERAS) pathways and the reduced use of opioids on postoperative outcomes in elderly colorectal cancer (CRC) patients who underwent laparoscopic surgery under general anesthesia (GA). PATIENTS AND METHODS: Clinical data from 99 elderly patients who underwent laparoscopic CRC surgery in the First Affiliated Hospital of Hebei North University from April 2021 to April 2023 were retrospectively analyzed and grouped based on the method of pain control measures received. Of 99 patients, 51 received conventional doses of opioid drugs (conventional group), and 48 patients were treated with reduced doses of opioids based on the principles of ERAS (lowdose group). Perioperative characteristics, postoperative pain level, cognitive function, serum biochemical index levels, and adverse reactions were compared between the two groups. RESULTS: The first exhaust time, defecation time, and bedtime activity time of the low-dose group were compared to the conventional group (p<0.05). On the first day after the surgery, the mini-mental state examination (MMSE) score of the low-dose group was higher than the conventional group (p<0.05). After the surgery, the levels of serum brain-derived neurotrophic factor (BDNF) decreased in both groups, while the levels of neuron-specific enolase (NSE) and 5-hydroxytryptamine (5-HT) increased. However, compared to the conventional group, the low-dose group had higher levels of BDNF and lower levels of NSE and 5-HT (p<0.05). The incidence of adverse reactions in the low-dose group was lower than that in the conventional group (p<0.05). CONCLUSIONS: ERAS protocol and the reduced use of opioid drugs in CRC patients who underwent surgery under GA is associated with an analgesic effect that is comparable to that of conventional opioid use. Reduced dosage of opioid drugs lessened cognitive impairment and lowered the incidence of adverse reactions in surgical patients with CRC. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study aimed to evaluate the efficacy of different dexamethasone doses in the perioperative period of total hip arthroplasty (THA). PATIENTS AND METHODS: We randomly divided 180 patients into three groups: three perioperative saline injections (Group A, placebo); two perioperative doses of 15 mg dexamethasone plus a postoperative saline injection at 48 h (Group B); and three perioperative doses of dexamethasone (10 mg) (Group C). Primary outcomes were postoperative pain at rest and while walking. We also recorded consumption of analgesics and antiemetics, incidence of postoperative nausea and vomiting (PONV), C-reactive protein (CRP) and interleukin-6 (IL-6) levels, postoperative length of stay (p-LOS), range of motion (ROM), nausea, Identity-Consequence-Fatigue-Scale (ICFS), and severe complications (e.g., incidence of surgical site infection, SSI and gastrointestinal bleeding, GIB). RESULTS: Group B and C had significantly lower pain scores at rest than Group A on postoperative day 1. Group B and C also had significantly lower dynamic pain score, CRP, and IL-6 than Group A on postoperative day 1, 2, and 3. Patients in Group B and C had lower PONV incidence, reduced use of analgesics and antiemetics, improved ROM, shorter p-LOS, lower VAS nausea score, and lower ICFS than Group A patients. On postoperative day 3, patients in Group C had significantly lower dynamic pain and ICFS scores, IL-6, and CRP than Group B patients, as well as higher ROM. None of the groups exhibited SSI or GIB. CONCLUSIONS: Dexamethasone provides short-term advantages in reducing pain, PONV, inflammation, and ICFS, and increasing ROM in the early postoperative period after THA. Dexamethasone efficacy in reducing post-THA pain, inflammation, and PONV at 10 mg and 15 mg is similar during the first 48 h. Dexamethasone (30 mg) divided into three 10 mg doses was superior to two doses (15 mg) in reducing pain, inflammation, and ICFS, as well as in increasing ROM on postoperative day 3. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of the study was to evaluate the efficacy of aggressive warming combined with tranexamic acid (TXA) during total hip arthroplasty (THA). PATIENTS AND METHODS: A total of 832 patients who underwent THA from October 2013 to June 2019 were divided into three groups according to the order of admission. There were 210 patients from October 2013 to March 2015 in group A, 302 patients from April 2015 to April 2017 in group B, and 320 patients from May 2017 to June 2019 in group C. Group A was the control group and was not given any measures. Group B was administered intravenously with 15 mg/kg TXA before skin incision and 3 h later without aggressive warming. Group C was administered intravenously with 15 mg/kg TXA before skin incision and 3 h later with aggressive warming. We evaluated the differences in the intraoperative blood loss, changes in core body temperature of patients at different stages during the operation, postoperative drainage, hidden blood loss, transfusion rate, drop of hemoglobin (Hb) on postoperative day 1 (POD1), prothrombin time (PT) of POD1, average hospitalization day, and complications. RESULTS: There were statistically significant differences among the three groups during the intraoperative blood loss, intraoperative changes in core body temperature, postoperative drainage, hidden blood loss, blood transfusion rate, drop of Hb on POD1 and average hospital stay (p<0.05). There was no statistical difference in PT on POD1 and the incidence of complications (p>0.05). CONCLUSIONS: Aggressive warming combined with TXA can significantly reduce the blood loss and transfusion rate of THA, and accelerate the recovery. We also observed that it does not increase the postoperative complications. [ABSTRACT FROM AUTHOR]

Long-term low temperatures restrict the regrowth of winter wheat (Triticum aestivum L.), thus decreasing agricultural output. Non-enzymatic expansins, which are related to plant growth, have been reported to respond to drought, salinity, and low-temperature stress. We obtained an expansin 3 gene, TaEXPA9. It is located in winter wheat cv. Dongnong with high cold hardiness. We analyzed the expression patterns of TaEXPA9-A/B/D in this cultivar and conducted a subcellular localization analysis of TaEXPA9-A/B/D in the onion epidermis. Transgenic Arabidopsis thaliana line with EXPA9-A/B/D overexpression was obtained to examine the effects of the orthologous genes of these expansins on plant growth and low-temperature stress resistance. The results showed that EXPA9-A/B/D expression significantly increased at 4 °C, it was higher in the roots than in shoots, and EXPA9-A/B/D was localized in the cell wall. The roots were welldeveloped in the transgenic A. thaliana, and the growth-related markers and setting rate were better than in the wildtype. Recovery was stronger in the transgenic plants after freezing stress. At low-temperature stress, the antioxidant enzyme activities and content of osmoregulatory substances in the TaEXPA9-A/B/D-overexpressing A. thaliana plants were significantly higher than in the wild-type plants, and the degree of membrane lipid peroxidation was lower. In summary, TaEXPA9 orthologous genes participate in the low-temperature stress response, and they might be of great importance in molecular breeding. [ABSTRACT FROM AUTHOR]

Long-term low temperatures restrict the regrowth of winter wheat (Triticum aestivum L.), thus decreasing agricultural output. Non-enzymatic expansins, which are related to plant growth, have been reported to respond to drought, salinity, and low-temperature stress. We obtained an expansin 3 gene, TaEXPA9. It is located in winter wheat cv. Dongnong with high cold hardiness. We analyzed the expression patterns of TaEXPA9-A/B/D in this cultivar and conducted a subcellular localization analysis of TaEXPA9-A/B/D in the onion epidermis. Transgenic Arabidopsis thaliana line with EXPA9-A/B/D overexpression was obtained to examine the effects of the orthologous genes of these expansins on plant growth and low-temperature stress resistance. The results showed that EXPA9-A/B/D expression significantly increased at 4 °C, it was higher in the roots than in shoots, and EXPA9-A/B/D was localized in the cell wall. The roots were welldeveloped in the transgenic A. thaliana, and the growth-related markers and setting rate were better than in the wildtype. Recovery was stronger in the transgenic plants after freezing stress. At low-temperature stress, the antioxidant enzyme activities and content of osmoregulatory substances in the TaEXPA9-A/B/D-overexpressing A. thaliana plants were significantly higher than in the wild-type plants, and the degree of membrane lipid peroxidation was lower. In summary, TaEXPA9 orthologous genes participate in the low-temperature stress response, and they might be of great importance in molecular breeding. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the therapeutic effects of ticagrelor and clopidogrel on patients with acute myocardial infarction (AMI) and its effect of lncRNA BANCR. PATIENTS AND METHODS: A total of 169 AMI patients admitted to our hospital from June 2015 to July 2018 were prospectively selected, of which 82 patients treated with clopidogrel were enrolled in the clopidogrel group (CG) and 87 patients treated with ticagrelor were enrolled in the ticagrelor group (TG). The therapeutic effect, serum IncRNA BANCR, platelet count, maximum platelet aggregation rate, serum troponin I (cTnI), serum creatine kinase isoenzyme (CK-MB), and serum high sensitivity C-reactive protein (hs-CRP) levels of the two groups of patients were detected and compared before and after treatment. The incidence of adverse reactions (ADR) and the occurrence of major adverse cardiovascular events (MACE) within 6 months after treatment were recorded and compared, and the predictive value of BANCR on therapeutic effect and MACE occurrence was analyzed. RESULTS: The therapeutic effect of TG was remarkably better than that of CG (p<0.05), and the improvement of serum BANCR, platelet count, maximum platelet aggregation rate, cTnI, CK-MB, hs-CRP levels of the TG were remarkably better than that of CG (p<0.05). The incidence of ADR and MACE in the TG were notably lower than the CG (p<0.05). The expression of BANCR in the serum of patients with better therapeutic effect was significantly lower than that of patients with invalid treatment (p<0.05). The expression of BANCR in the serum of patients without MACE was significantly lower than that of patients with MACE (p<0.05). BANCR had high predictive value for both therapeutic effect and occurrence of MACE. CONCLUSIONS: The effect of ticagrelor on AMI patients is significantly better than clopidogrel, and has higher safety. It can effectively reduce the content of BANCR in the serum of AMI patients, which is worthy of further promotion in clinical practice. Moreover, the predictive value of BANCR for the efficacy of AMI patients and the occurrence of MACE was high. [ABSTRACT FROM AUTHOR]

Summary: The use of environmental covariates to predict soil spatial variation is a widely adopted approach to digital soil mapping. However, commonly used covariates such as topography, landform and vegetation are often ineffective for estimating soil variation in areas of low relief. Recent studies have shown the effectiveness of a new covariate called land surface dynamic feedback (LSDF) for digital soil mapping in such areas. The construction of LSDF relies on remote sensing (RS) data with high temporal resolution to record the drying process after a rain event. The trade‐off of obtaining high temporal resolution with RS data is that they are often of low spatial resolution. To overcome this limitation, our study uses the ESTARFM (enhanced spatial and temporal adaptive reflectance fusion model) algorithm to fuse MODIS and Landsat 8 data to obtain images that benefit from the high temporal resolution of MODIS and high spatial resolution of Landsat. The LSDF was then derived from the fused images to predict soil texture in a case study in north Xuancheng, Anhui Province. Compared with particle‐size fractions estimated with LSDF derived from the original MODIS data, the results were more accurate and produced more spatial detail when mapped. We conclude that the ESTARFM algorithm can improve the spatial resolution of high temporal resolution RS data and offers an effective approach to derive more accurate measures of LSDF for digital soil mapping in areas of low relief. Highlights: We propose a new method to combine different remote sensors to predict soil properties in a low relief area.We constructed a land surface dynamic feedback model with high spatial resolution for digital soil mapping.The fusion process improved prediction the most in areas with complex and heterogeneous land cover.Accuracy improved with the mapping of finer spatial detail compared to the original MODIS data. [ABSTRACT FROM AUTHOR]