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Background: Lack of motivation and behavioral abnormalities are the hallmarks of postpartum depression (PPD). Severe uterine contractions during labor are pain triggers for psychiatric disorders, including PPD in women during the puerperium. Creating biomarkers to monitor PPD may help in its early detection and treatment. It has been suggested that uterine contraction-induced labor pain plays a role in the emergence of this syndrome. Therefore, abnormal electroencephalography (EEG) patterns during the first stage of labor may provide useful information. Here, we propose that aberrant EEG patterns caused by painful uterine contractions may be predictive markers for PPD. Methods: This study is a single-centre prospective cohort planned for 331 parturients for vaginal delivery in the maternity ward of Zhujiang Hospital from 2022 to 2023. At baseline, online or paper-based questionnaires, including the Edinburgh Postnatal Depression Scale (EPDS) and demographic data, will be collected when the parturient is admitted to labor. EEG, electrocardiography (ECG) and electrohysterography (EHG) signals will be monitored and recorded during the first stage of labor in the ward. Follow-up will be taken at the postpartum timepoints of day 3, day 42, and 3, 6 and 12 months, respectively. Power spectral density and functional connections will be quantified. The connections between PPD severity and EEG measurements as a function of time will be assessed using linear mixed-effects models. Maternal age, parity, and whether oxytocin is used during labor, all have an impact on the incidence of PPD, hence a stratified analysis will be carried out. Discussion: We expect EEG changes caused by painful uterine contractions in the first labor may predict early PPD. The results from this study may act as a predictor for the development of PPD which may enhance long-term quality of life for the parturient and her offspring. Trial registration. Name of registry: EEG Alterations of Uterine Contractions in the First Stage of Labor Predicting PPD. Trial registration number: NCT05217251; registration date on the ClinicalTrial.gov platform: February, 1/2022. [ABSTRACT FROM AUTHOR]

Author(s): Hai-Bo Deng [sup.1] , Feng-Xian Li [sup.1] , Ye-Hua Cai [sup.1] , Shi-Yuan Xu [sup.1] Author Affiliations: (Aff1) 0000 0004 1771 3058, grid.417404.2, Department of Anesthesiology, Zhujiang Hospital of [...], As inhaled anesthetics are widely used, medical staff have inevitably suffered from exposure to anesthetic waste gases (WAGs). Whether chronic exposure to WAGs has an impact on the health of medical staff has long been a common concern, but conclusions are not consistent. Many measures and equipment have been proposed to reduce the concentration of WAGs as far as possible. This review aims to dissect the current exposure to WAGs and its influence on medical staff in the workplace and the environment, and summarize strategies to reduce WAGs.

Background: Catheter jamming is an emerging and possibly underrated complication.Objective: To find the criteria for determining if the catheter cannot be removed through the mechanical analysis of fracture tension and fracture strain (εf) of Peripheral Inserted Central Catheters (PICC).Method: We removed 30 pieces of PICC catheters from patients and recorded the indwelling time. Those with an indwelling time shorter than 12 weeks belonged to the short-term group. Those with an indwelling time longer than 12 weeks belonged to the long-term group. The first half of the same catheter is section A, and the second half is section B. The fraction tension and fracture strain of the catheter were measured, and statistical analysis was conducted.Results: The fracture tension of catheter in sections A and B were 5.8917 ± 1.0095 and 6.0670 ± 0.8066 Newtons respectively (p= 0.393) and the fracture strain of catheter in sections A and B were 6.0611 ± 1.0810 and 6.2543 ± 0.7187 Newtons respectively (p= 0.343). The fracture tension of catheter in short-term and long-term group were 6.0696 ± 0.9414 and 5.9192 ± 0.8972 Newtons respectively (p= 0.535) and the fracture strain of catheter in short-term and long-term group were 6.0067 ± 0.7227 and 6.2584 ± 1.0212 respectively (p= 0.301).Conclusion: It is objective and consistent to take the catheter fracture tension as the standard. This standard would be able to accurately define the concept of catheter failure and reduce the risk of catheter fracture and the misdiagnosis of catheter failure. The catheter fracture tension and fracture strain was not affected by the catheter indwelling time. It is recommended to set the tensile force as 5 Newtons and carry it out at a speed of 100 mm/min for the catheter drawing of the PICC single-lumen silicone catheter (4.0F) from Budd Company. [ABSTRACT FROM AUTHOR]

Taking stay-green sorghum (B35) and non-stay green sorghum (Sanchisan) as test materials, a pot experiment was conducted to study their leaf osmotic adjustment and chloroplast ultrastructure at flowering and filling stages under impacts of drought stress (45% -50% of maximum field capacity). For the two sorghum lines, drought stress caused the reduction of their leaf free water content and relative water content, and increased the leaf bound water content, water saturation deficit, and electrical conductivity, with the increment or dement being larger for Sanchisan than for B35. Drought stress increased the leaf soluble sugar content and proline content, with the increment of the soluble sugar content being larger for Sanchisan and the increment of the proline content being larger for B35, while decreased the leaf soluble protein content, with the decrement being larger for Sanchisan than for B35. The chloroplast ultrastructure of both B35 and Sanchisan under drought stress was damaged to some extent, but the damaged degree was obviously lower for B35 than for Sanchisan. The findings indicated that stay-green sorghum had a greater adaptation to drought stress through stronger osmotic adjustment. Key words: stay-green; drought stress [ABSTRACT FROM AUTHOR]

Background: Cardiac damage induced by ischemic stroke, such as arrhythmia, cardiac dysfunction, and even cardiac arrest, is referred to as cerebral-cardiac syndrome (CCS). Cardiac macrophages are reported to be closely associated with stroke-induced cardiac damage. However, the role of macrophage subsets in CCS is still unclear due to their heterogeneity. Sympathetic nerves play a significant role in regulating macrophages in cardiovascular disease. However, the role of macrophage subsets and sympathetic nerves in CCS is still unclear., Methods and Results: In this study, a middle cerebral artery occlusion mouse model was used to simulate ischemic stroke. ECG and echocardiography were used to assess cardiac function. We used Cx3cr1 GFP Ccr2 RFP mice and NLRP3 -deficient mice in combination with Smart-seq2 RNA sequencing to confirm the role of macrophage subsets in CCS. We demonstrated that ischemic stroke-induced cardiac damage is characterized by severe cardiac dysfunction and robust infiltration of monocyte-derived macrophages into the heart. Subsequently, we identified that cardiac monocyte-derived macrophages displayed a proinflammatory profile. We also observed that cardiac dysfunction was rescued in ischemic stroke mice by blocking macrophage infiltration using a CCR2 antagonist and NLRP3 -deficient mice. In addition, a cardiac sympathetic nerve retrograde tracer and a sympathectomy method were used to explore the relationship between sympathetic nerves and cardiac macrophages. We found that cardiac sympathetic nerves are significantly activated after ischemic stroke, which contributes to the infiltration of monocyte-derived macrophages and subsequent cardiac dysfunction., Conclusions: Our findings suggest a potential pathogenesis of CCS involving the cardiac sympathetic nerve-monocyte-derived macrophage axis.

Objective: To compare the clinical application effects of peripherally inserted central catheter (PICC) and deep venous catheters placed through the lower limbs in adults with malignancy obviating the use of upper limb PICC., Study Design: Descriptive study., Place and Duration of Study: Department of Oncology, Beijing Shijingshan Hospital, Capital Medical University, Beijing, China between February 2017 and February 2019., Methodology: The patients enrolled in this study were assigned to PICC under ultrasound guidance group and deep venous catheterisation group. The inclusion criteria were patients with advanced malignant tumor after bilateral breast cancer lymphadenectomy or superior vena cava obstruction syndrome; bedridden patients; and patients without mental disorders; who could understand the content of this study and agreed to participate in this study. Patients with high-risk thrombosis and venous thrombosis of lower limbs were excluded. The success rate of one-time catheterisation, the length of catheterisation puncture time, the number of catheterisations, and the occurrence of catheter-related complications of the two groups were compared., Results: Ultrasound-guided PICC through the lower limbs had a higher success rate than deep venous catheterization (84.6% vs. 42.9%, p=0.046). The average length of puncture time in adults with PICC through the lower limbs under ultrasound guidance was shorter than that in the femoral vein group (24.69 ± 4.35 vs. 29.14 ± 6.02, p=0.038). No catheter-related infection was found in the two groups of patients., Conclusion: The indications for PICC through the lower limbs in adults include patients with advanced malignant tumor after bilateral breast cancer lymphadenectomy or superior vena cava obstruction syndrome, and mainly bedridden patients. This technique has certain advantages over deep venous catheterisation and is an effective choice for venous access. Key Words: Lower limb PICC, Deep venous catheterisation, Advanced malignant tumor, Bedridden.

Objective: Fentanyl-induced cough (FIC) is a common complication with a reported incidence from 18.0% to 74.4% during general anesthesia induction. FIC increases the intrathoracic pressure and risks of postoperative nausea and vomiting, yet available treatments are limited. This study was designed to investigate whether administering fentanyl via a slow intravenous fluid line can effectively alleviate FIC during induction of total intravenous general anesthesia., Methods: A total number of 1200 patients, aged 18-64 years, were enrolled, all of whom were American Society of Anesthesiologists (ASA) grade I or II undergoing scheduled surgeries. All patients received total intravenous general anesthesia, which was induced sequentially by midazolam, fentanyl, propofol, and cisatracurium injection. Patients were randomly assigned to receive fentanyl 3.5 μg/kg via direct injection (control group) or via a slow intravenous fluid line. FIC incidence and the severity grades were analyzed with the Mann-Whitney test. Other adverse reactions, such as hypotension, hypertension, bradycardia, tachycardia, hypoxemia, vomiting, and aspiration, during induction were also observed. The online clinical registration number of this study was ChiCTR-IOR-16009025., Results: Compared with the control group, the incidence of FIC was significantly lower in the slow intravenous fluid line group during induction (9.1%, 95% confidence interval (CI): 6.7%-11.4% vs. 55.9%, 95% CI: 51.8%-60.0%, P=0.000), as were the severity grades (P=0.000). There were no statistical differences between the two groups with regard to other adverse reactions (P>0.05)., Conclusions: The administration of fentanyl via a slow intravenous fluid line can alleviate FIC and its severity during induction for total intravenous general anesthesia. This method is simple, safe, and reliable, and deserves clinical expansion.

Objective: To study flavanoids extracted from onion (FEO) on the number of activated microglia and the release of proinflammatory factors in intracerebral hemorrhage (ICH) model rat at different time points, and to explore its possible mechanism for treating ICH., Methods: Totally 100 Wistar rats were used for preparing ICH model, and ICH model was successfully established in 90 of them. The 90 rats were randomly divided into the sham-operation group (n =10) , the ICH group (n =40) , the FEO group (n =40). Totally 100 [L autoblood was injected from fixed position to rats in the ICH group and the FEO group during modeling. Meanwhile, FEO at 0. 2 mL/10 g was given to rats in the FEO group, twice daily. No drug intervention was given to rats in the ICH group and the sham-operation group. Each group was further sub-divided into 5 sub-groups according to different time points such as 6, 24, 48, 72 h, and 7 days. There were 8 rats in each sub-group of the ICH group and the FEO group, 10 groups in total. There were 2 rats in each subgroup of the sham-operation group, 5 groups in total. Neurological functions at different time points were observed by Garcia JH. The injury degree of brain tissue was observed at dif- ferent time points using HE staining. Activated microglia around hematoma were observed at different time points after ICH by using immunohistochemical staining. Expressions of TNF-α and IL-1 β at different time points after ICH was detected using ELISA., Results: In the ICH group, degenerated and necrotic zone occurred around hematoma after injecting autoblood, cells were untidily arranged with irregular nucleus, partial nucleus were shrunken with lamellar interstitial edema of the medulla. As time went by, degenerated and necrotic zone was dilated; vacant zone occurred around cells; cells were unevenly distributed with reduced neuron numbers. Meanwhile, infiltration of lymphocytes and neutrophils occurred. In the FEO group after FEO intervention, necrotic cells were lesser, cell arrangement and nucleus morphology were obviously alleviated, and infiltration of inflammatory cells was reduced at corresponding time points. Compared with the sham-operation group, behavioral scores at 5 time points all decreased, the number of activated microglia was added, and expressions of TNF-α and IL-1 β in hematoma tissue increased in the ICH group (P <0. 01). Compared with the ICH group, behavioral scores at 48 and 72 h, as well as day 7 all increased, the number of activated microglia was reduced, and expressions of TNF-α and IL-1β in hematoma tissue decreased in the FEO group (P <0. 01)., Conclusion: FEO using the ethanol reflux method could improve symptoms of ICH model rats possibly by inhibiting activation of microolia and the release of proinflammatory factors around the hematoma.

Taking stay-green sorghum (B35) and non-stay green sorghum (Sanchisan) as test materials, a pot experiment was conducted to study their leaf osmotic adjustment and chloroplast ultrastructure at flowering and filling stages under impacts of drought stress (45% -50% of maximum field capacity). For the two sorghum lines, drought stress caused the reduction of their leaf free water content and relative water content, and increased the leaf bound water content, water saturation deficit, and electrical conductivity, with the increment or dement being larger for Sanchisan than for B35. Drought stress increased the leaf soluble sugar content and proline content, with the increment of the soluble sugar content being larger for Sanchisan and the increment of the proline content being larger for B35, while decreased the leaf soluble protein content, with the decrement being larger for Sanchisan than for B35. The chloroplast ultrastructure of both B35 and Sanchisan under drought stress was damaged to some extent, but the damaged degree was obviously lower for B35 than for Sanchisan. The findings indicated that stay-green sorghum had a greater adaptation to drought stress through stronger osmotic adjustment.

Objective: To assess physicians' awareness and use of guidelines for community-acquired pneumonia (CAP) published by Chinese Society of Respiratory Diseases (CSRD) and American Thoracic Society (ATS), and to investigate influences of the guidelines on the prognosis of patients with CAP., Method: A total of 210 self-completion questionnaires about CAP guidelines were received from doctors of six hospitals in Beijing. In addition, 490 serial cases of CAP collected from these hospitals admitted from January 2002 to December 2003 were retrospectively analyzed., Results: Most doctors had limited knowledge about atypical pathogens. For pulmonary physicians, only 46% (97/210) reported using the CSRD guideline. 82.4% of the doctors preferred to give initial empiric antibiotic therapy according to the patients' conditions. 79.5% (167/210) of the doctors ordered examination of the pathogens routinely and 84.3% (177/210) of them admitted its usefulness for choosing antibiotics. 84.5% (414/490) of the patients responded well to the initial empiric treatment. Patients who were treated according to the guidelines of CSRD and ATS were 229 cases and 131 cases respectively. There was no significant difference in the prognosis between patients who were treated according to the guideline and those who were not. There was no significant difference in the prognosis between cases with definite pathogens and cases without., Conclusions: The results indicate low levels of awareness and use of guidelines for the management of CAP. Fewer than half of the patients were treated according to the guidelines. However, the treatments were effective in most of the patients, and there was no significant difference in the prognosis between patients who were treated according to the guideline and those who were not, because broad-spectrum antibiotics were overused. More effective guideline implementation strategies are needed to encourage compliance with practice guidelines for the management of CAP.