Experimental and Therapeutic Medicine

Association between CIRP expression and hypoxic‑ischemic brain injury in neonatal rats Lifang Chen, Qiaohuan Tian, Weihua Wang View Abstract ❯
Combined dynamic spectral imaging and routine colposcopy strategy for the diagnosis of pre‑cancerous cervical lesions Dan Liu, Wanliang Hu View Abstract ❯
Danon disease: Two patients with atrial fibrillation in a single family and review of the literature Shaohua Guo, Linghuan Zhou, Renping Wang, Zhixin Lv, Hongzun Xu, Baoli Han, Panagiotis Korantzopoulos, Fuli Hu, Tong Liu View Abstract ❯
Clinical significance of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in acute cerebral hemorrhage with gastrointestinal hemorrhage, and logistic regression analysis of risk factors Yu Zou, Wei Zhang, Chuanjun Huang, Yangqing Zhu View Abstract ❯
Efficacy of continuous intravenous pumping of insulin for patients with diabetes complicated with perianal abscess and the effect on inflammatory cytokines Zhifeng Zhong, Huaying Huang, Yuejun Han, Wuzhen Dong View Abstract ❯
Effects of Achyranthes bidentata alcohol on proliferation capacity of osteoblasts and miRNA in Runx2 Shan Hua, Xuexue Zhang View Abstract ❯
Probiotic effect on Helicobacter pylori attachment and inhibition of inflammation in human gastric epithelial cells Hanyi Song, Long Zhou, Dongyan Liu, Lihui Ge, Yan Li View Abstract ❯
Methylation‑regulated ZNF545 inhibits growth of the p53‑mutant KYSE150 cell line by inducing p21 and Bax Yu Fan, Yu Wang, Shaozhi Fu, Duan Liu, Sheng Lin View Abstract ❯
Eldecalcitol, an active vitamin D analog, effectively prevents cyclophosphamide‑induced osteoporosis in rats Wei Wang, Yuan Gao, Hongrui Liu, Wei Feng, Xiaoyan Li, Jie Guo, Minqi Li View Abstract ❯
LINK‑A lncRNA participates in the pathogenesis of glioma by interacting with survivin Xia Hua, Guangxing Li, Zhongtao Liu, Zhanfeng Niu View Abstract ❯
Mechanical loading mediates human nucleus pulposus cell viability and extracellular matrix metabolism by activating of NF‑κB Kai Zhang, Chao Xue, Ning Lu, Peng Ren, Haiwen Peng, Yao Wang, Yan Wang View Abstract ❯
Diagnostic value of echocardiography in fetal cardiac malformation and clinical classification Bo Wang, Jianning Li, Juan Yin View Abstract ❯
A seven‑miRNA expression‑based prognostic signature and its corresponding potential competing endogenous RNA network in early pancreatic cancer Xue Bai, Donglan Lu, Yan Lin, Yufeng Lv, Liusheng He View Abstract ❯
Renal impact of high‑loading‑dose statin pre‑cardiac catheterization in patients with chronic kidney disease and long‑term statin use Chang Hou, Bo Zheng, Xin‑Gang Wang, Bin Zhang, Qiu‑Ping Shi, Ming Chen View Abstract ❯
Protective effect of rivaroxaban on arteriosclerosis obliterans in rats through modulation of the toll‑like receptor 4/NF‑κB signaling pathway Xinjiang Lou, Zhi Yu, Xiaoxia Yang, Jie Chen View Abstract ❯
MALAT1 overexpression promotes the proliferation of human periodontal ligament stem cells by upregulating fibroblast growth factor 2 Pei Chen, Yanhong Huang, Yarong Wang, Shaobing Li, Hongxing Chu, Mingdeng Rong View Abstract ❯
Investigation of analgesic dose of nalbuphine combined with remifentanil after radical gastrectomy Yang Zhang, Rongfang Zhang, Nannan Ding View Abstract ❯
Effects of ivabradine hydrochloride combined with trimetazidine on myocardial fibrosis in rats with chronic heart failure Dongwen Ma, Tong Xu, Guoqiang Cai, Xilin Wu, Zhendong Lei, Xinmei Liu, Junying Li, Ning Yang View Abstract ❯
miR‑125a‑5p inhibits the expression of NLRP3 by targeting CCL4 in human vascular smooth muscle cells treated with ox‑LDL Jiawang Wang, Qiong Wu, Jing Yu, Xufen Cao, Zesheng Xu View Abstract ❯
Downregulation of miR‑3934‑5p enhances A549 cell sensitivity to cisplatin by targeting TP53INP1 Aijun Ren, Zhenzhen Wen, Liangjie Zheng View Abstract ❯
A novel quantitative method for estimating bone mineral density using B‑mode ultrasound and radiofrequency signals‑a pilot study on patients with rheumatoid arthritis Violeta‑Claudia Bojincă, Claudiu C. Popescu, Raluca‑Daniela Decianu, Andrei Dobrescu, Șerban Mihai Bălănescu, Andra‑Rodica Bălănescu, Mihai Bojincă View Abstract ❯
Enhanced autophagy alleviates injury during hindlimb ischemia/reperfusion in mice Chenshu Liu, Meixiu Peng, Liang Zheng, Yang Zhao, Rui Wang, Qiao Su, Sifan Chen, Zilun Li View Abstract ❯
7,8‑Dihydroxyflavone activates Nrf2/HO‑1 signaling pathways and protects against osteoarthritis Dawei Cai, Wan Feng, Jun Liu, Longhai Jiang, Sichun Chen, Tangbo Yuan, Chen Yu, Hao Xie, Dawei Geng, Jian Qin View Abstract ❯
Expression of apolipoprotein M and its association with adiponectin in an obese mouse model Liu Yang, Tie Li, Shuiping Zhao, Saidan Zhang View Abstract ❯
Peripheral immune cell markers in children with recurrent respiratory infections in the absence of primary immunodeficiency Adriana Narcisa Munteanu, Mihaela Surcel, Radu‑Ionuț Huică, Gheorghița Isvoranu, Carolina Constantin, Ioana Ruxandra Pîrvu, Carmen Chifiriuc, Coriolan Ulmeanu, Cornel Ursaciuc, Monica Neagu View Abstract ❯
Combination of metformin and p38 MAPK inhibitor, SB203580, reduced myocardial ischemia/reperfusion injury in non‑obese type 2 diabetic Goto‑Kakizaki rats Jantira Sanit, Eakkapote Prompunt, Punyanuch Adulyaritthikul, Nuttikarn Nokkaew, Podsawee Mongkolpathumrat, Kantapich Kongpol, Anusak Kijtawornrat, Soontaree Petchdee, Stephanie Barrère‑Lemaire, Sarawut Kumphune View Abstract ❯
Causes of and treatment options for dislocation following total hip arthroplasty (Review) Yian Lu, Haijun Xiao, Feng Xue View Abstract ❯
Gestational weight management and pregnancy outcomes among women of advanced maternal age Juan Lin, Yuelin Fu, Qing Han, Jianying Yan, Rongxin Chen, Huale Zhang View Abstract ❯
Reduction of miR-29a-3p induced cardiac ischemia reperfusion injury in mice via targeting Bax Liang Zhang, Jian Zhang, Qiguang Tong, Guannan Wang, Hongling Dong, Zhonglu Wang, Qi Sun, Hangyu Wu View Abstract ❯
Metachromatic leukodystrophy: Characterization of two (p.Leu433Val, p.Gly449Arg) arylsulfatase A mutations Yangyang Wang, Xiang Chen, Chan Liu, Shamin Wu, Qingfeng Xie, Quan Hu, Shan Chen, Yiwei Liu View Abstract ❯
Anti‑inflammatory and anti‑apoptosis activity of taraxasterol in ulcerative colitis in vitro and in vivo Lu Che, Ya Li, Ruifeng Song, Cuihong Qin, Weiwei Hao, Bingxue Wang, Lei Yang, Puji Peng, Feng Xu View Abstract ❯
Effect of heme oxygenase 1 and renin/prorenin receptor on oxidized low‑density lipoprotein‑induced human umbilical vein endothelial cells Xin Gong, Congyang Liu, Hongling Wang, Jinying Fan, Cuihong Jiang, Yong Zou View Abstract ❯
Association of pregnancy‑associated plasma protein A and vascular endothelial growth factor with pregnancy‑induced hypertension Zhengzheng Zhang, Hao Xu, Xiao Liu, Pan Li, Wensheng Du, Qiuyu Han View Abstract ❯
Function and mechanism of pyrin and IL‑10 in the regulation of the inflammasome in pulmonary vascular endothelial cells following hemorrhagic shock Xin Jin, Yongxing Yao, Xing Lu, Peng Xu, Yanfei Xia, Shengmei Zhu View Abstract ❯
Comparison of dexmedetomidine with propofol as sedatives for pediatric patients undergoing magnetic resonance imaging: A meta‑analysis of randomized controlled trials with trial sequential analysis Yong Tang, Juan Meng, Xinxian Zhang, Jiong Li, Qiang Zhou View Abstract ❯
Population pharmacokinetic analysis of linezolid in patients with different types of shock: Effect of platelet count Dongdong Wang, Xiaofei Zheng, Yang Yang, Xiao Chen View Abstract ❯
Cadmium induces A549 cell migration and invasion by activating ERK Huijuan Zhai, Teng Pan, Haiyan Yang, Haiyu Wang, Yadong Wang View Abstract ❯
Effect of pidotimod combined with azithromycin on children with mycoplasma pneumonia and the expression levels of IL-10 and G-CSF in serum Hongxing Shi, Limin Lan, Xianghong Lv, Lizhi Sun View Abstract ❯
Effects of thyroid diseases on pregnancy outcomes Min Zhou, Min Wang, Juming Li, Xiaohui Luo, Minxiang Lei View Abstract ❯
Investigation into the expression levels of MAGEA6 in esophageal squamous cell carcinoma and esophageal adenocarcinoma tissues Jun Hao, Shuying Li, Jintao Li, Zhu Jiang, Maliha Ghaffar, Minglian Wang, Runqing Jia, Su Chen, Yangjunqi Wang, Yi Zeng View Abstract ❯
Gefitinib suppresses cervical cancer progression by inhibiting cell cycle progression and epithelial‑mesenchymal transition Jianyun Zheng, Jianxin Yu, Min Yang, Li Tang View Abstract ❯
lncRNA SCAL1 inhibits inducible nitric oxide synthase in lung cells under high‑glucose conditions Ping Li, Ning Zhang, Fen Ping, Yanfeng Gao, Lei Cao View Abstract ❯
Bioinformatics identification of potential genes and pathways in preeclampsia based on functional gene set enrichment analyses Xue Li, Yanning Fang View Abstract ❯
Effect of saphenous vein diameter and reflux time on stump length after cyanoacrylate closure Jeongin Kim, Jin Hyun Joh, Ho‑Chul Park View Abstract ❯
Immune promotive effect of bioactive peptides may be mediated by regulating the expression of SOCS1/miR‑155 Caixia Chen, Xiulan Su, Zhiwei Hu View Abstract ❯
Long non‑coding RNA H19 knockdown inhibits the cell viability and promotes apoptosis of thyroid cancer cells through regulating the PI3K/AKT pathway Xiaoyu Li, Qinghuai Li, Xiao Jin, Hao Guo, Yong Li View Abstract ❯
Smartphone‑assisted endoscopic surgery via Kocher's point for intraventricular hemorrhage caused by thalamic hemorrhage: A comparison with external ventricular drainage Xin Ge, Xinhua Xu, Xinguang Yu, Xiaolei Chen, Duo Li, Yanhua Xu, Yue Zhang View Abstract ❯
MicroRNA‑6852 suppresses glioma A172 cell proliferation and invasion by targeting LEF1 Jialiang Wang, Haipeng Liu, Kebin Zheng, Shuai Zhang, Wei Dong View Abstract ❯
Notch‑1 inhibition reduces proliferation and promotes osteogenic differentiation of bone marrow mesenchymal stem cells Ying He, Lijin Zou View Abstract ❯
Association between abdominal obesity and liver steatosis and fibrosis among patients with chronic hepatitis B measured by Fibroscan Jing Sun, Yanfang Li, Xuying Sun, Youde Liu, Danxia Zheng, Lijuan Fan View Abstract ❯
Isopsoralen ameliorates H2O2‑induced damage in osteoblasts via activating the Wnt/β‑catenin pathway Yu‑Peng Li, Bin Wu, Jie Liang, Fei Li View Abstract ❯
miR‑448 promotes progression of non‑small‑cell lung cancer via targeting SIRT1 Hongfeng Qi, Haifeng Wang, Dabin Pang View Abstract ❯
Commiphora myrrha inhibits itch‑associated histamine and IL‑31 production in stimulated mast cells Jae Young Shin, Denis Nchang Che, Byoung Ok Cho, Hyun Ju Kang, Jisu Kim, Seon Il Jang View Abstract ❯
Wnt3a downregulates thyroid hormone‑induced osteocalcin expression in osteoblasts Kazuhiko Fujita, Takanobu Otsuka, Tetsu Kawabata, Go Sakai, Woo Kim, Rie Matsushima‑Nishiwaki, Osamu Kozawa, Haruhiko Tokuda View Abstract ❯
Role and effective therapeutic target of gut microbiota in NAFLD/NASH (Review) Qun Liu, Shousheng Liu, Lizhen Chen, Zhenzhen Zhao, Shuixian Du, Quanjiang Dong, Yongning Xin, Shiying Xuan View Abstract ❯
Clinical characteristics and phenotype distribution in 10 Chinese patients with X‑linked adrenoleukodystrophy Ming‑Rui Jia, Wen‑Zhen Wu, Chuan‑Ming Li, Xiao‑Hui Cai, Lin Zhang, Fang Yan, Chan Zhu, Ming‑Hong Gu View Abstract ❯
Acute remote ischemic preconditioning alleviates free radical injury and inflammatory response in cerebral ischemia/reperfusion rats Xian‑Liang Meng, Dong‑Lin Zhang, Shi‑Hua Sui View Abstract ❯
TLR4 gene in the regulation of periodontitis and its molecular mechanism Weijuan Qi, Xi Yang, Ning Ye, Shujun Li, Qianqian Han, Jinyu Huang, Buling Wu View Abstract ❯
Aberrant expression of long non‑coding RNAs in peripheral blood mononuclear cells isolated from patients with gouty arthritis Xiaowu Zhong, Yuanhong Peng, Hebin Liao, Chengjiao Yao, Jiulong Li, Qibin Yang, Yonglong He, Yufeng Qing, Xiaolan Guo, Jingguo Zhou View Abstract ❯
COL6A1 knockdown suppresses cell proliferation and migration in human aortic vascular smooth muscle cells Zongxiang Chen, Qingjian Wu, Chengjun Yan, Juan Du View Abstract ❯
Protective role of thymoquinone in sepsis‑induced liver injury in BALB/c mice Fei Wang, Xiong Lei, Yue Zhao, Qinggong Yu, Qianwei Li, Hui Zhao, Zuowei Pei View Abstract ❯
Blue laser magnifying endoscopy in the diagnosis of chronic gastritis Ying Zhu, Fang Wang, Yan Zhou, Gui‑Li Xia, Ling Dong, Wen‑Hua He, Bing Xiao View Abstract ❯
Identification of potential agents for thymoma by integrated analyses of differentially expressed tumour‑associated genes and molecular docking experiments Xiao‑Dong Wang, Peng Lin, Yu‑Xin Li, Gang Chen, Hong Yang, Yun He, Qing Li, Ruo‑Chuan Liu View Abstract ❯
Sodium ferulate attenuates high‑glucose‑induced oxidative injury in HT22 hippocampal cells Jiangpei Zhao, Lerong Liu, Lingxiao Zhang, Jing Lv, Xueli Guo, Xia Li, Tongfeng Zhao View Abstract ❯
The effect of bone marrow mesenchymal stem cell and nano‑hydroxyapatite/collagen I/poly‑L‑lactic acid scaffold implantation on the treatment of avascular necrosis of the femoral head in rabbits Le Wang, Leixin Xu, Changliang Peng, Guoxin Teng, Yu Wang, Xiaoshuai Xie, Dongjin Wu View Abstract ❯
PC‑1 NF suppresses high glucose‑stimulated inflammation and extracellular matrix accumulation in glomerular mesangial cells via the Wnt/β‑catenin signaling Liangxiang Xiao, Yingying Chen, Yang Yuan, Bo Xu, Qing Gao, Ping Chen, Tianying Zhang, Tianjun Guan View Abstract ❯
Oxygen‑induced circRNA profiles and coregulatory networks in a retinopathy of prematurity mouse model Huiting Zhou, Huihui Song, Yi Wu, Xiang Liu, Jing Li, He Zhao, Miaomiao Tang, Xiaoyuan Ji, Lu Zhang, Yuanyuan Su, Yao He, Kehong Feng, Yang Jiao, Hua Xu View Abstract ❯
Rapid progression and recovery of massive gastric mucosal damage complicated by Henoch‑Schönlein purpura in a patient with liver cirrhosis: A case report Tae‑Geun Gweon, Jung Hyun Kwon View Abstract ❯
Retrospective follow-up analysis of the transcriptomic patterns of cytokines, cytokine receptors and chemokines at preconception and during pregnancy, in women with post-partum depression Maria Cristina Petralia, Emanuela Mazzon, Paolo Fagone, Luca Falzone, Placido Bramanti, Ferdinando Nicoletti, Maria Sofia Basile View Abstract ❯
Altered spontaneous brain activity patterns in patients with retinal vein occlusion indicated by the amplitude of low‑frequency fluctuation: A functional magnetic resonance imaging study Yuan‑Yuan Wu, Qing Yuan, Biao Li, Qi Lin, Pei‑Wen Zhu, You‑Lan Min, Wen‑Qing Shi, Yong‑Qiang Shu, Qiong Zhou, Yi Shao View Abstract ❯
Comparison of endovascular treatment for middle cerebral artery aneurysm with a low‑profile visualized intraluminal support stent or pipeline embolization device Peng Lu, Ye Zhang, Huanjiang Niu, Yirong Wang View Abstract ❯
Calcitonin protects rat chondrocytes from IL‑1β injury via the Wnt/β‑catenin pathway Mingxiao Bai, Lei Ge, Hui Chen, Qunhua Jin View Abstract ❯
Effect of metformin on the proliferation, apoptosis, invasion and autophagy of ovarian cancer cells Ge Zou, Jie Bai, Dandan Li, Yan Chen View Abstract ❯
The effect of an alternative chromosome 17 probe on fluorescence in situ hybridization for the assessment of HER2 amplification in invasive breast cancer Zhigao Xu, Peipei Xu, Wei Fan, Ben Huang, Qingyuan Cheng, Zheng Zhang, Ping Wang, Mingxia Yu View Abstract ❯
Using computerized tomography perfusion to measure cerebral hemodynamics following treatment of traumatic brain injury in rabbits Kefei Chen, Feihu Dai, Guangxu Li, Jirong Dong, Yuhai Wang View Abstract ❯
Eldecalcitol effects on osteoblastic differentiation and function in the presence or absence of osteoclastic bone resorption Jie Bu, Juan Du, Lina Shi, Wei Feng, Wei Wang, Jie Guo, Tomoka Hasegawa, Hongrui Liu, Xuxia Wang, Minqi Li View Abstract ❯
Berberine exhibits antioxidative effects and reduces apoptosis of the vaginal epithelium in bacterial vaginosis Xiuzhen Ma, Junfeng Deng, Xinmu Cui, Qi Chen, Weihua Wang View Abstract ❯
Expression of β‑catenin and MMP‑8 in gingival crevicular fluid and gingival tissue indicates the disease severity of patients with chronic periodontitis Lilei Zhu, Yao Yao, Jian Liu, Jingyu Wang, Hui Xie View Abstract ❯
Identification of aberrantly methylated differentially expressed genes in glioblastoma multiforme and their association with patient survival Miao Zhang, Xintong Lv, Yuanjun Jiang, Guang Li, Qiao Qiao View Abstract ❯
Expression and role of CaMKII and Cx43 in a rat model of post‑stroke depression Shuiliang Tao, Mengmeng Jia, Tao Qiu View Abstract ❯
Isoimperatorin enhances 3T3‑L1 preadipocyte differentiation by regulating PPARγ and C/EBPα through the Akt signaling pathway Tiantuan Jiang, Xiaochen Shi, Zunqiang Yan, Xin Wang, Shuangbao Gun View Abstract ❯
Characterization and identification of human immortalized granulosa cells derived from ovarian follicular fluid Ai Ai, Zhengya Tang, Yali Liu, Sha Yu, Bin Li, He Huang, Xiangsheng Wang, Yilin Cao, Wenjie Zhang View Abstract ❯
Oral administration of Urtica macrorrhiza Hand.‑Mazz. polysaccharides to protect against cyclophosphamide‑induced intestinal immunosuppression Zhongjuan Wang, Yanhua Li, Chongjing Wang, Hongying Xia, Yueqin Liang, Zhongkun Li View Abstract ❯
Analysis of Treg/Th17 cells in patients with tongue squamous cell carcinoma Changfu Liu, Zhou Tong, Jingyu Tan, Zengxi Xin View Abstract ❯
Effect of mild hypothermia on the expression of IL-10 and IL-18 in neonates with hypoxic ischemic encephalopathy Hongwei Wu, Gang Liu, Xia Yang, Qing Liu, Zhenguang Li View Abstract ❯
Long non‑coding RNA NEAT1 modulates hypoxia/reoxygenation‑induced cardiomyocyte injury via targeting microRNA‑520a Hua‑Jun Wu, Guan‑Min Tang, Ping‑Yang Shao, Hong‑Xing Zou, Wei‑Feng Shen, Ming‑De Huang, Hang‑Hai Pan, Chang‑Lin Zhai, Gang Qian View Abstract ❯
Effect of sepsis on the action potential and cardiac serotonin response in rats Zheng-Jiang Liu, Hua Liu, Changdong Wu, Kedong Xue View Abstract ❯
Cardiac resynchronization therapy coronary venous left ventricular lead removal and reimplantation: Experience from a single center in China Wencheng Zheng, Ding Li, Xuebin Li, Feng Ze, Long Wang, Jiangbo Duan, Cuizhen Yuan View Abstract ❯
Comprehensive analysis of histone modification‑associated genes on differential gene expression and prognosis in gastric cancer Xiangyu Meng, Yan Zhao, Jingwei Liu, Lu Wang, Zhe Dong, Tao Zhang, Xiaohu Gu, Zhichao Zheng View Abstract ❯
Upregulation of suppressor of cytokine signaling 3 ameliorates spinal degenerative disease in adolescents by mediating leptin and tumor necrosis factor‑α levels Xiao‑Ming Tang, Jian Dai, Hai‑Lang Sun View Abstract ❯
Ventricular tachycardia and heart failure in a patient of mid‑ventricular obstructive hypertrophic cardiomyopathy with apical aneurysm: A case report Xin Zhang, Xingbin Liu View Abstract ❯
Irreversible electroporation ablation of end‑stage metastatic retroperitoneal lesions: Report on three cases and literature review Tian'an Jiang, Qiyu Zhao, Guo Tian, Xinhua Chen, Liming Wu View Abstract ❯
Correlation between the tuberculin skin test and T‑SPOT.TB in patients with suspected tuberculosis infection: A pilot study Jing Yang, Weiliang Kong, Ning Xv, Xiaoping Huang, Xueqing Chen View Abstract ❯
A novel mutation of FOXC1 in a Chinese family with Axenfeld‑Rieger syndrome Xing Wu, Hai‑Nan Xie, Tong Wu, Wei Liu, Lan‑Lam Chen, Zhao‑Hui Li, Da‑Jiang Wang, Yi Wang, Hou‑Bin Huang View Abstract ❯
Supplementation of triple viable probiotics combined with dietary intervention is associated with gut microbial improvement in humans on a high‑fat diet Leimin Qian, Renyuan Gao, Jianming Huang, Huanlong Qin View Abstract ❯
Acute cytomegalovirus infection in an immunocompetent patient with ulcerative colitis: A case report Toshihide Maeda, Hiroyasu Sakai, Noritaka Ozawa, Tomohiko Sugiyama, Jun Takada, Masaya Kubota, Takashi Ibuka, Yohei Shirakami, Hiroshi Araki, Masahito Shimizu View Abstract ❯
Clinicopathological and biological analysis of PIK3CA mutation and amplification in cervical carcinomas Sultana Razia, Kentaro Nakayama, Kohei Nakamura, Tomoka Ishibashi, Masako Ishikawa, Toshiko Minamoto, Kouji Iida, Yoshiro Otsuki, Satoru Nakayama, Noriyoshi Ishikawa, Satoru Kyo View Abstract ❯
MicroRNA‑503 serves an oncogenic role in retinoblastoma progression by directly targeting PTPN12 Yang Cheng, Wei Liu View Abstract ❯
Efficacy of short‑term intensive treatment with insulin pump to improve islet β‑cell function in newly diagnosed type 2 diabetes via inhibition of oxidative stress Hai‑Tong Liu, Yan Gao View Abstract ❯
Incidence of fatalities of road traffic accidents associated with alcohol consumption and the use of psychoactive drugs: A 7-year survey (2011-2017) Athanasia H. Papalimperi, Sotirios A. Athanaselis, Areti D. Mina, Ioannis I. Papoutsis, Chara A. Spiliopoulou, Stavroula A. Papadodima View Abstract ❯
Ropivacaine vs. levobupivacaine: Analgesic effect of combined spinal‑epidural anesthesia during childbirth and effects on neonatal Apgar scores, as well as maternal vital signs Qiuju Cheng, Weiqiang Zhang, Yanling Lu, Jinhai Chen, Hang Tian View Abstract ❯
Silencing of long non‑coding RNA NCK1‑AS1 inhibits cell proliferation and migration via inhibition of microRNA‑134 in cervical cancer Lu Huang, Xiaoqin Gan, Li He, Luying Wang, Jie Yu View Abstract ❯
Dexmedetomidine reduces inflammation in traumatic brain injury by regulating the inflammatory responses of macrophages and splenocytes Mengyao Ding, Ying Chen, Hengfei Luan, Xiaobao Zhang, Zhibin Zhao, Yong Wu View Abstract ❯
MicroRNA‑548b inhibits proliferation and invasion of hepatocellular carcinoma cells by directly targeting specificity protein 1 Haile Qiu, Gehong Zhang, Bin Song, Junmei Jia View Abstract ❯
SIRT1 is dispensable for maturation of hematopoietic stem cell in the bone marrow niche Su Min Park, Jayoung Kim, Chae Mi Hong, Dong Hoon Shin, Jee Yeon Kim, Do Youn Park, Dong Hyun Sohn, Yun Hak Kim, Sang‑Mo Kwon, Jae Ho Kim, Sun Sik Bae, Koanhoi Kim, Chi Dae Kim, Chi‑Dug Kang, Dongjun Lee View Abstract ❯
Correlation between coronary stenosis and Toll‑like receptors 2 and 4 levels in Chinese Zhuang patients with coronary heart disease Zhaohe Huang, Yan Liu, Limei Liang, Wenjing Liu, Suren R. Sooranna, Jianjiao Mo, Li Liu, Zhile Li, Kela Li, Jun Guo View Abstract ❯
[Retracted] Microarray profiling of long non­coding RNAs associated with idiopathic pulmonary arterial hypertension Bing Han, Peili Bu, Xiao Meng, Xiaoyang Hou View Abstract ❯

10-12 October, 2019, Mystras Grand Palace Resort, Sparta, Greece 24nd World Congress on Advances in Oncology & 24th International Symposium on Molecular Medicine 8-9 October 2019, Pre-Congress Workshop: 'SNP genotyping and rare mutation detection in cancer with molecular methods'

7-9 May, 2019, Grand Hotel, Duca D'Este, Rome, Italy 26 th International Symposium on Molecular Medicine

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Cardiovascular Medicine

Unusual presentation of acute pulmonary hypertension in a patient with bilateral pneumonia and hypertrophic cardiomyopathy The incidence of acute pulmonary hypertension (APH) in hospitalized patients with pneumonia is not known with certainty, although a mild and/or moderate pulmonary hypertension is often detected by transthoracic echocardiography in these patients. We describe a rare case of pneumonia of uncertain etiology that clinically manifested with APH and S1Q3T3 pattern on ECG in a patient with hypertrophic cardiomyopathy. In the present case, a pre-capillary component due to severe acute lung injury and simultaneously a post-capillary component due to elevated left ventricular filling pressures were the two main pathophysiological mechanisms of APH. Correspondence to Andrea Sonaglioni, MD, Ospedale San Giuseppe MultiMedica IRCCS, Via San Vittore 12, 20123 Milano, Italy Tel: +00 39 333 9237137; e-mail: sonaglioniandrea@gmail.com Received 3 February, 2019 Revised 5 March, 2019 Accepted 14 July, 2019 © 2019 Italian Federation of Cardiology. All rights reserved.

Prolonged sustained ventricular fibrillation in a patient with dextrocardia and a left ventricular assist device No abstract available

Mid-term outcome following second-generation cryoballoon ablation for atrial fibrillation in heart failure patients: effectiveness of single 3-min freeze cryoablation performed in a cohort of patients with reduced left ventricular systolic function Purpose Currently, information on the mid-term outcome of cryoballoon ablation (CB-A) for drug-resistant atrial fibrillation in patients with reduced left ventricular systolic function is limited. Methods Thirty-eight consecutive patients with paroxysmal or persistent atrial fibrillation (84.2% male), with median left ventricular ejection fraction of 37.3% were included in our study. All patients underwent the procedure with the 28-mm cryoballoon advance. Results There were no mayor complications related to the CB-A procedure. Median follow-up was 26.5 ± 13.7 months. The freedom from atrial fibrillation after a blanking period of 3 months was 42.9% in our cohort of patients. During the follow-up period, 13 patients underwent at least a new electrophysiological procedure. After a single procedure, the univariate predictors of clinical recurrence after the blanking period were age and persistent atrial fibrillation. Conclusion Second-generation CB-A of atrial fibrillation seems feasible and safe in patients with heart failure with reduced ejection fraction and heart failure with mid-range ejection fraction, in terms of complications rate and number of applications per vein. All pulmonary veins could be isolated with the 28-mm cryoballoon advance only. Correspondence to Gian B. Chierchia, MD, PhD, Heart Rhythm Management Center, UZ Brussel-VUB, Laarbeeklaan 101, 1090, Brussels, Belgium. Tel: +32 024766009; fax: +32024776851; e-mail: gbchier@yahoo.it Received 18 January, 2019 Revised 19 June, 2019 Accepted 7 July, 2019 © 2019 Italian Federation of Cardiology. All rights reserved.

Percutaneous coronary interventions for stable ischemic heart disease in Italy Aims Although the benefits of percutaneous coronary interventions (PCIs) in patients with stable chronic ischemic heart disease (SIHD) are controversial, a large number of PCIs are currently performed in SIHD patients, frequently after coronary angiography (ad-hoc procedures), without the use of fractional flow reserve (FFR) to identify patients most likely to benefit from PCI. Methods Assessment of regional variations in PCI for SIHD performed in Italy in 2017 and correlation of the regional number of PCI per million inhabitants with the use of FFR were performed using the data reported in the registry of the Italian Society of Interventional Cardiology (SICI-GISE) registry for the year 2017. Results PCI for SIHD accounted for 44.5% of all PCI performed in Italy with large variations among the Italian regions. There was a significant and inverse relationship between the use of FFR and the PCI number per million inhabitants performed for SIHD in the various Italian regions (P = 0.01). In the Veneto region, where local authorities mandated Heart Team reports to select the most appropriate treatment choice in multivessel disease patients, the rate of ad-hoc procedures was significantly lower than the national average. Conclusion PCI for SIHD patients represent almost half of all procedures currently performed in Italy with regional variations inversely related to physiologic guidance use. The mandatory assessment by the Heart Team to select the most appropriate treatment choice in multivessel disease patients is associated with a significantly lower number of ad-hoc procedures. Correspondence to Stefano De Servi, MD, FESC, Unita' di Cardiologia, IRCCS Multimedica, Milan, Italy Tel: +39 02 24209590; e-mail: stefano.deservi@multimedica.it Received 24 February, 2019 Revised 25 March, 2019 Accepted 28 April, 2019 © 2019 Italian Federation of Cardiology. All rights reserved.

Does mitral regurgitation reduce the risk of thrombosis in atrial fibrillation and flutter? Aims Blood stasis is the main cause of left atrial thrombosis (LAT) in atrial tachyarrhythmias. The high-velocity flow inside the left atrium, due to mitral valve regurgitation, may prevent clot formation but the topic has never been investigated in large-scale studies. The aim of our study was to evaluate whether the presence and degree of mitral regurgitation have a protective role against LAT risk. Methods A total of 1302 consecutive adult patients with paroxysmal or persistent atrial fibrillation or flutter undergoing cardioversion, submitted to transesophageal echocardiography, were retrospectively enrolled in the study. The study population was divided into three groups according to the mitral regurgitation degree: absent, mild-to-moderate and severe. Results Among 1302 patients enrolled in the study, patients without mitral regurgitation were 248 (19%), those with mild-to-moderate 970 (75%), whereas 84 had severe mitral regurgitation (6%). LAT incidence was significantly lower in patients with severe mitral regurgitation compared with those with mild-to-moderate (mitral regurgitation) (2.4 vs. 8.9%, P < 0.05), and similar to subjects without mitral regurgitation (2.4%). Conclusion Despite patients with severe regurgitation having clinical and echo characteristics predisposing to LAT (higher age, heart failure, higher atrial size, lower ventricular function) thrombosis prevalence was significantly lower than for those with mild-to-moderate mitral regurgitation. The percentage of LAT in severe mitral regurgitation cases was very low and similar to that of cases without regurgitation which were characterized by lower age, normal left ventricular function or other risk factors, reinforcing the hypothesis of a protecting role against atrial thrombosis of mitral regurgitation. Correspondence to Ugo Limbruno, MD, Cardiological Department, Misericordia Hospital, Via Senese, 58100 Grosseto, Italy E-mail: ulimbru@tin.it Received 26 March, 2019 Revised 1 May, 2019 Accepted 1 July, 2019 © 2019 Italian Federation of Cardiology. All rights reserved.

Reliability of noninvasive hemodynamic assessment with Doppler echocardiography: comparison with the invasive evaluation Aims The study aimed at evaluating the reliability and reproducibility of various noninvasive echocardiographic techniques for the estimation of the main hemodynamic parameters in clinical practice. Methods A total of 84 patients with a generic indication of right heart catheterization (RHC) executed a transthoracic echocardiography shortly before or after the RHC. All the parameters necessary for a noninvasive hemodynamic evaluation of right atrial pressure, pulmonary artery pressure (PAP), pulmonary capillary wedge pressure, pulmonary vascular resistance and cardiac output were acquired and the agreement with the invasive measures was evaluated by a Bland–Altman analysis. Results Noninvasive evaluation of right atrial pressure showed a moderate and low correlation with RHC using inferior vena cava parameters (r = 0.517) and tricuspid E/E′ ratio (sensitivity 0.23, specificity 0.72), respectively. PAPs estimation from the tricuspid regurgitation peak velocity had a good correlation (r = 0.836) and feasibility (82.1%), as well as PAPm from tricuspid regurgitation mean gradient (r = 0.78, applicability 72.6%) and from pulmonary acceleration time (sensitivity 0.85, specificity 0.5, applicability 92.9%). Pulmonary capillary wedge pressure multiparametric evaluation, as suggested by the 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging recommendations, showed a good correlation (sensitivity 0.96, specificity 0.59). The noninvasive evaluation of pulmonary vascular resistance and cardiac output did not prove to be clinically accurate. Conclusion Various hemodynamic parameters can be adequately estimated with noninvasive methods. In particular, a multiparametric approach for the evaluation of left ventricle filling pressures is advisable and the 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging recommendations are reliable even in a heterogeneous population with a significant quota of precapillary pulmonary hypertension. Correspondence to Marco de Scordilli, Department of Medical Science, Surgery and Health (DCSMCS), University of Trieste, Ospedale di Cattinara, Via Rossetti, 51, 34141 Trieste, Italy Tel: +39 3497644274; e-mail: marco.descordilli@gmail.com Received 14 March, 2019 Revised 4 July, 2019 Accepted 7 July, 2019 © 2019 Italian Federation of Cardiology. All rights reserved.

Multimodality imaging for early diagnosis and treatment of primary cardiac diffuse 'double-expressor' lymphoma Primary cardiac double-expressor lymphoma represents a rare subtype of diffuse large B-cell lymphoma, especially in immunocompetent patients. To date, only a few sporadic cases of primary cardiac double-expressor lymphoma have been reported in medical literature. Multimodality imaging can be very helpful in these patients for early diagnosis and treatment of this type of lymphoma, allowing potential improvement of the outcome. Correspondence to Loris Roncon, MD, Department of Cardiology, Santa Maria della Misericordia Hospital, Via Tre Martiri 140, 45100 Rovigo, Italy Tel: +39 0425393286; e-mail: loris.roncon@aulss5.veneto.it Received 30 April, 2019 Revised 9 July, 2019 Accepted 10 July, 2019 Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.jcardiovascularmedicine.com). © 2019 Italian Federation of Cardiology. All rights reserved.

Mid-term repair durability after MitraClip implantation in patients with functional mitral regurgitation Background The aim of this study was to identify variables that are associated with the durability of percutaneous repair of secondary mitral regurgitation at 6-month follow-up. Methods and results Thirty-five consecutive patients with functional mitral regurgitation scheduled for MitraClip implant were enrolled. Left ventricular (LV) volumes and function and mitral valve characteristics were assessed before and immediately after MitraClip implantation using three-dimensional transesophageal echocardiography. Five patients with an unsuccessful procedure were excluded. The other patients were subdivided according to repair durability: group 1 with a durable repair (19 patients, 65%) and group 2 with significant mitral regurgitation recurrence (11 patients, 35%). At baseline, group 1 patients had smaller and more elliptical mitral valve annulus (1055 ± 241 vs. 1273 ± 359 mm2, P = 0.02 and 125 ± 11 vs. 117 ± 16%, P = 0.02), a smaller left atrial volume (54.1 ± 26 vs. 71.5 ± 20 ml, P = 0.005) and lower systolic pulmonary artery pressure (38 ± 11 vs. 49 ± 12 mmHg, P = 0.03). Baseline LV end systolic volume had a linear correlation with the 3D annulus area (P = 0.048) and an inverse correlation with annulus ellipticity (P = 0.021). Group 1 patients showed an increase in annulus ellipticity after MitraClip (125 ± 17 vs. 141 ± 23%, P = 0.014). Conclusion Percutaneous mitral valve repair leads to a significant and stable mitral regurgitation reduction in a large number of patients. Annulus dimensions and remodeling as well as left atrial area and pulmonary hypertension seem to be associated with durability of the procedure. Correspondence to Sara Cimino, MD, Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, 'Sapienza' University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Roma, Italy Tel: +39 6 49979048; fax: +39 6 49979060; e-mail: sara.cimino@uniroma1.it Received 3 January, 2019 Revised 1 July, 2019 Accepted 7 July, 2019 © 2019 Italian Federation of Cardiology. All rights reserved.

Prognosis in patients with microvascular angina: a clinical follow-up The prognosis of patients with microvascular angina (MVA) has been reported to be good. In 10–20% of the cases, the symptoms of angina progressively worsen during follow-up, becoming more frequent and prolonged, absorbing lower workloads or even increasing at rest and becoming less sensitive, or even refractory, to drug therapy. The frequency and intensity of angina episodes require frequent medical visits, hospital admissions, absences from work, thus determining a high social cost of the disease. To obtain further information on this clinical controversy, we performed a clinical follow-up of of 132 patients with diagnosis of microvascular angina. Correspondence to Vincenzo Sucato, MD, Unit of Cardiology, ProMISE Department, Paolo Giaccone Hospital, University of Palermo, Via Del Vespro n 129, 90127 Palermo, Italy E-mail: odisseos86@gmail.com Received 11 February, 2019 Accepted 7 July, 2019 © 2019 Italian Federation of Cardiology. All rights reserved.

Performance of the Durata implantable cardioverter defibrillator lead: results of an independent multicenter study Aims The high rate of implantable cardioverter defibrillator (ICD) lead failures related to the Sprint Fidelis' and Riata's design have raised serious concerns about the reliability of ICD leads. The St. Jude Medical Durata family of leads replaced the preceding Riata line following increased rates of lead failure (1.17% per year). The aim of our study was to evaluate the long-term performance of the Durata lead. Methods Eight hundred and eighteen Durata ICD leads were implanted in 11 Italian centers. The incidence of lead failure, defined as a sudden rise in long-term pacing or defibrillation impedance and/or a sudden change in R-wave amplitude and capture thresholds, was assessed. The incidences of lead dislodgment and lead perforation were also evaluated. Results During a median follow-up of 1353 days (3.7 years; 25–75th interquartile range 806–1887 days) lead failure occurred in 16/818 leads (0.54%/year). The overall survival, free of lead failure, was 98.9% at 3 years, 98.2% at 4 years and 97.5% at 5 years. Lead dislodgment occurred in 12/818 leads with an incidence of 0.4%/year. No cases of cardiac perforation were reported. No major adverse events were reported except for two cases of inappropriate shocks as a consequence of failure or dislodgment. Conclusion Our study suggests that the Durata lead does not engender a higher risk of failure. Overall survival, free from lead failure, was found to be higher than previously reported for the Riata lead. Correspondence to Roberto Rordorf, MD, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology – Foundation IRCCS Policlinico San Matteo, P.le Golgi 19, 27100 Pavia, Italy Tel: +39 0382 501276; fax: +39 0382 503161; e-mail: r.rordorf@smatteo.pv.it Received 19 February, 2019 Revised 27 May, 2019 Accepted 7 July, 2019 © 2019 Italian Federation of Cardiology. All rights reserved.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Anaesthesiology

Analgesic efficacy of ultrasound-guided interscalene block vs. supraclavicular block for ambulatory arthroscopic rotator cuff repair: A randomised noninferiority study BACKGROUND Ultrasound-guided interscalene block (ISB) is the reference technique for pain control after ambulatory upper limb surgery, but supraclavicular block (SCB) is an alternative. OBJECTIVES The aim of this study was to compare the efficacy of SCB vs. ISB in patients undergoing ambulatory arthroscopic rotator cuff repair (ARCR), with the hypothesis of noninferiority of SCB analgesia compared with ISB. DESIGN A randomised, single-blind, noninferiority study. SETTING Hôpital Privé Jean Mermoz, Centre Paul Santy, Lyon, France. PATIENTS Ambulatory ARCR patients. INTERVENTION Patients were randomly allocated (1 : 1) to receive a single injection SCB or ISB, as well as general anaesthesia. All patients received a postoperative analgesic prescription for home use before leaving hospital (including fast-acting oral morphine sulphate). Patients completed a telephone questionnaire on days 1 and 2 postsurgery. MAIN OUTCOME MEASURES Primary endpoint was oral morphine consumption (mg) during the first 2 days postsurgery. If the difference between mean morphine consumption in the SCB vs. ISB group was less than 30 mg, noninferiority of SCB compared with ISB would be demonstrated. Secondary evaluation criteria included pain scores (numerical rating scale), duration of motor and sensory blockade, and satisfaction with treatment. RESULTS The per-protocol cohort included 103 patients (SCB = 52, ISB = 51) (57% men, median age 58 years). Mean morphine consumption in the 48 h postsurgery was 9.4 vs. 14.7 mg in the SCB and ISB groups, respectively (difference −5.3, P < 0.001). The upper limit of the 95% CI was less than 30 mg, demonstrating noninferiority of SCB compared with ISB. No difference was observed between the two groups in terms of pain scores or the duration of motor or sensory blockade. Overall, 98% of patients in the SCB group vs. 90% in the ISB group were satisfied with their treatment. CONCLUSION SCB is as effective as ISB in terms of postoperative analgesia based on oral morphine consumption in patients undergoing ambulatory ARCR. Trial registration: EudraCT number: 2016-A00747-47. Correspondence to Julien Cabaton, MD, Department of Anaesthesiology, Hôpital Privé Jean Mermoz, Centre Paul Santy, 24, avenue Paul Santy, Lyon 69008, France E-mail: cabaton.md@orthosanty.fr This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 © 2019 European Society of Anaesthesiology

Virtual reality exposure before elective day care surgery to reduce anxiety and pain in children: A randomised controlled trial BACKGROUND Pre-operative anxiety in children is very common and is associated with adverse outcomes. OBJECTIVE The aim of this study was to investigate if virtual reality exposure (VRE) as a preparation tool for elective day care surgery in children is associated with lower levels of anxiety, pain and emergence delirium compared with a control group receiving care as usual (CAU). DESIGN A randomised single-blind controlled trial. SETTING A single university children's hospital in the Netherlands from March 2017 to October 2018. PATIENTS Two-hundred children, 4 to 12 years old, undergoing elective day care surgery under general anaesthesia. INTERVENTION On the day of surgery, children receiving VRE were exposed to a realistic child-friendly immersive virtual version of the operating theatre, so that they could get accustomed to the environment and general anaesthesia procedures. MAIN OUTCOME MEASURES The primary outcome was anxiety during induction of anaesthesia (modified Yale Preoperative Anxiety Scale, mYPAS). Secondary outcomes were self-reported anxiety, self-reported and observed pain, emergence delirium, need for rescue analgesia (morphine) and parental anxiety. RESULTS A total of 191 children were included in the analysis. During induction of anaesthesia, mYPAS levels (median [IQR] were similar in VRE, 40.0 [28.3 to 58.3] and CAU, 38.3 [28.3 to 53.3]; P = 0.862). No differences between groups were found in self-reported anxiety, pain, emergence delirium or parental anxiety. However, after adenoidectomy/tonsillectomy, children in the VRE condition needed rescue analgesia significantly less often (55.0%) than in the CAU condition (95.7%) (P = 0.002). CONCLUSION In children undergoing elective day care surgery, VRE did not have a beneficial effect on anxiety, pain, emergence delirium or parental anxiety. However, after more painful surgery, children in the VRE group needed rescue analgesia significantly less often, a clinically important finding because of the side effects associated with analgesic drugs. Options for future research are to include children with higher levels of anxiety and pain and to examine the timing and duration of VRE. TRIAL REGISTRATION Netherlands Trial Registry: NTR6116 (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6116). Correspondence to Elisabeth M.W.J. Utens, (Kp-2865), P.O. Box 2060, 3000 CB Rotterdam, the Netherlands E-mail: e.utens@erasmusmc.nl This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 © 2019 European Society of Anaesthesiology

Comparison of neostigmine vs. sugammadex for recovery of muscle function after neuromuscular block by means of diaphragm ultrasonography in microlaryngeal surgery: A randomised controlled trial BACKGROUND Postoperative residual neuromuscular blockade or curarisation (PORC) is a risk directly related to the use of neuromuscular blocking agents during surgical procedures. Acceleromyography is distressing for conscious patients when assessing PORC. Diaphragm ultrasonography could be a valid alternative. OBJECTIVES The primary objective was to achieve a 28% lower incidence of PORC in patients who, after rocuronium administration, received neostigmine or sugammadex at 30 min after surgery. To assess PORC, diaphragm ultrasonography was used, and thickening fractioning [the difference of thickness at the end of inspiration (TEI) and at the end of expiration (TEE), normalised for TEE (TEI − TEE/TEE)] was measured. PORC was defined as thickening fractioning of 0.36 or less. The secondary object was the comparison, in the two treatment groups, of the return to baseline thickening fractioning at 30 min after surgery (ΔTF30). DESIGN Prospective, double-blind, single-centre randomised study. SETTING University Hospital Careggi, Florence, Italy. PATIENTS Patients of American Society Anesthesiologists' physical status 1 or 2, 18 to 80 years, receiving rocuronium during microlaryngeal surgery. INTERVENTIONS At the end of surgery participants were randomised to receive neostigmine (NEO group) or sugammadex (SUG group) as the reversal drug. Thickening fractioning and ΔTF30 were evaluated at baseline and at 0, 10 and 30 min after surgery. MAIN OUTCOME MEASURES TEE and TEI at each time point. RESULTS A total of 59 patients with similar demographic characteristics were enrolled. An association between lack of recovery (thickening fractioning ≤0.36) and drug treatment was only observed at 0 min (SUG vs. NEO, P < 0.05). Concerning ΔTF, at 30 min more patients in the SUG group returned to baseline than those in the NEO group (P < 0.001), after adjusting for side (P = 0.52), baseline thickening fractioning (P < 0.0001) and time of measurement (P < 0.01). CONCLUSION We found an early (0 min) but not long-lasting (30 min) association between diaphragm failure and treatment allocation; a full recovery in baseline diaphragm function was observed only in patients receiving sugammadex. We cannot exclude that further differences have not been found due to interpatients variability in assessing diaphragm contractility by ultrasonography. TRIAL REGISTRATION EudraCT Identifier: 2013-004787-62, Clinicaltrials.gov Identifier: NCT02698969. Correspondence to Iacopo Cappellini, Section of Anesthesiology and Intensive Care, Department of Health Sciences, University of Florence, Largo Brambilla 3, 50134 Florence, Italy E-mail: jacopocappellini@gmail.com © 2019 European Society of Anaesthesiology

Neuraxial labour analgesia is associated with a reduced risk of maternal depression at 2 years after childbirth: A multicentre, prospective, longitudinal study BACKGROUND Severe labour pain is an important risk factor of postpartum depression, and early depression is associated with an increased risk of long-term depression; whereas the use of epidural analgesia during labour decreases the risk of postpartum depression. OBJECTIVE To investigate whether neuraxial labour analgesia was associated with a decreased risk of 2-year depression. DESIGN This was a multicentre, prospective, longitudinal study. SETTING The study was performed in Peking University First Hospital, Beijing Obstetrics and Gynecology Hospital and Haidian Maternal and Child Health Hospital in Beijing, China, between 1 August 2014 and 25 April 2017. PATIENTS Five hundred ninety-nine nulliparous women with single-term cephalic pregnancy preparing for vaginal delivery were enrolled. MAIN OUTCOME MEASURE Depressive symptoms were screened with the Edinburgh Postnatal Depression Scale at delivery-room admission, 6-week postpartum and 2 years after childbirth. A score of 10 or higher was used as the threshold of depression. The primary endpoint was the presence of depression at 2 years after childbirth. The association between the use of neuraxial labour analgesia and the development of 2-year depression was analysed with a multivariable logistic regression model. RESULTS Five hundred and eight parturients completed 2-year follow-up. Of these, 368 (72.4%) received neuraxial analgesia during labour and 140 (27.6%) did not. The percentage with 2-year depression was lower in those with neuraxial labour analgesia than in those without (7.3 [27/368] vs. 13.6% [19/140]; P = 0.029). After correction for confounding factors, the use of neuraxial analgesia during labour was associated with a significantly decreased risk of 2-year depression (odds ratio 0.455, 95% confidence interval 0.230 to 0.898; P = 0.023). CONCLUSION For nulliparous women with single-term cephalic pregnancy planning for vaginal delivery, the use of neuraxial analgesia during labour was associated with a reduced risk of maternal depression at 2 years after childbirth. TRIAL REGISTRATION www.chictr.org.cn: ChiCTR-OCH-14004888 and ClinicalTrials.gov: NCT02823418. Correspondence to Dong-Xin Wang, MD, PhD, Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, No. 8 Xishiku Street, Beijing 100034, China Tel: +86 10 83572784; fax: +86 10 66551057; e-mail: wangdongxin@hotmail.com Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.ejanaesthesiology.com). This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 © 2019 European Society of Anaesthesiology

Guidewire-assisted vs. direct radial arterial cannulation in neonates and infants: A randomised controlled trial BACKGROUND Cannulation of the radial artery is challenging to perform in neonates and infants because of the small vessel size. OBJECTIVE To compare guidewire-assisted with direct radial artery cannulation in neonates and infants. DESIGN A randomised controlled study. SETTING A tertiary university hospital from 7 August 2017 to 4 July 2018. PATIENTS Ninety neonates and infants who required radial artery cannulation during general anaesthesia. INTERVENTIONS All patients were allocated randomly into the guidewire group (guidewire-assisted cannulation, n=45) or control group (direct cannulation, n=45). Radial artery cannulation was performed under general anaesthesia. The contralateral radial artery was used if the arterial cannulation was not successful within two attempts. After the second failure in the contralateral radial artery, the case was considered a failure. MAIN OUTCOME MEASURES The primary outcome was the first-attempt success rate of radial artery cannulation. The secondary outcomes included the overall success rate, overall procedure time, number of attempts and use of the contralateral radial artery for radial artery cannulation. RESULTS The guidewire group showed a higher first-attempt success rate [76 vs. 56%; P = 0.046; odds ratio (OR) 2.47, 95% confidence interval (CI) of odds 1.01 to 6.08] and overall success rate (96 vs. 76%; P = 0.007; OR 6.96; 95% CI 1.44 to 33.52) than the control group. The overall procedure time was not significantly different between the guidewire group (median [IQR] 36 [28.0 to 70.5] s) and control group (98 [23.5 to 465.0] s; P = 0.400). There was no difference in the median number of attempts between the two groups (P = 0.454). However, use of the contralateral radial artery was significantly lower in the guidewire group (17.8%) than in the control group (40%; P = 0.020; OR 0.324, 95% CI 0.12 to 0.86). Kaplan–Meier analysis of the overall procedure time to successful radial artery cannulation showed that the overall success rate was significantly higher in the guidewire group than in the control group (P = 0.019). CONCLUSION For radial artery cannulation in neonates and infants, guidewire-assisted radial artery cannulation showed superiority over the direct technique in terms of first-attempt success rate and overall success rate without delaying the procedure time. TRIAL REGISTRATION Clinicaltrials.gov (identifier: NCT03217019). Correspondence to Prof Jin-Tae Kim, Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehakno, Jongnogu, Seoul 03080, Republic of Korea Tel: +82 2 2072 3295; fax: +82 2 745 5587; e-mail: jintae73@gmail.com © 2019 European Society of Anaesthesiology

Does programmed intermittent epidural bolus improve childbirth conditions of nulliparous women compared with patient-controlled epidural analgesia?: A multicentre, prospective, controlled, randomised, triple-blind study BACKGROUND Epidural analgesia may change the mechanics of childbirth. These changes are related to the concentration of the local anaesthetic used epidurally but probably also to its mode of delivery into the epidural space. OBJECTIVE To determine whether the administration of programmed intermittent epidural boluses (PIEB) improves the mechanics of second-stage labour compared with patient-controlled epidural analgesia (PCEA) with a background infusion. DESIGN Prospective, controlled, randomised, triple-blind study. SETTING Multicentre study including four level III maternity units, January 2014 until June 2016. PATIENTS A total of 298 nulliparous patients in spontaneous labour were randomised to a PIEB or PCEA group. INTERVENTION After epidural initiation with 15 ml of 0.1% levobupivacaine containing 10 μg of sufentanil, patients received either an hourly bolus of 8 ml (PIEB) or a continuous rate infusion of 8 ml h−1 (PCEA): the drug mixture used was levobupivacaine 0.1% and sufentanil 0.36 μg ml−1. MAIN OUTCOME MEASURES The primary outcome was a composite endpoint of objective labour events: a posterior occiput position in the second stage, an occiput position at birth, waiting time at full cervical dilatation before active maternal pushing more than 3 h, maternal active pushing duration more than 40 min, and foetal heart rate alterations. Vaginal instrumental delivery rates, analgesia and motor blockade scores were also recorded. RESULTS From the 298 patients randomised, data from 249 (124 PIEB, 125 PCEA) were analysed. No difference was found in the primary outcome: 48.0% (PIEB) and 45.5% (PCEA) of patients, P = 0.70. In addition, no difference was observed between the groups for each of the individual events of the composite endpoint, nor in the instrumental vaginal delivery rate, nor in the degree of motor blockade. Despite an equivalent volume of medication in the groups, a significantly higher analgesia score at full dilatation was observed in the PIEB group, odds-ratio = 1.9 (95% confidence interval, 1.0 to 3.5), P = 0.04. CONCLUSION The mechanics of the second stage did not differ whether PIEB or PCEA was used. Analgesic conditions appeared to be superior with PIEB, especially at full dilation. TRIAL REGISTRATION Clinical trial number: NCT01856166. Correspondence to Estelle Morau, CHU Arnaud de Villeneuve, 34295 Montpellier Cedex 5, France E-mail: estelle.morau@hotmail.fr © 2019 European Society of Anaesthesiology

Patient safety and the role of the Helsinki Declaration on Patient Safety in Anaesthesiology: A European survey BACKGROUND The Helsinki Declaration on Patient Safety was launched in 2010 by the European Society of Anaesthesiology and the European Board of Anaesthesiology. It is not clear how widely its vision and standards have been adopted. OBJECTIVE To explore the role of the Helsinki Declaration in promoting and maintaining patient safety in European anaesthesiology. DESIGN Online survey. SETIING A total of 38 countries within Europe. PARTICIPANTS Members of the European Society of Anaesthesiology who responded to an invitation to take part by electronic mail. MAIN OUTCOME MEASURES Responses from a 16-item online survey to explore each member anaesthesiologist's understanding of the Declaration and compliance with its standards. RESULTS We received 1589 responses (33.4% response rate), with members from all countries responding. The median [IQR] response rate of members was 20.5% [11.7 to 37.0] per country. There were many commonalities across Europe. There were very high levels of use of monitoring (pulse oximetry: 99.6%, blood pressure: 99.4%; ECG: 98.1% and capnography: 96.0%). Protocols and guidelines were also widely used, with those for pre-operative assessment, and difficult and failed intubation being particularly popular (mentioned by 93.4% and 88.9% of respondents, respectively). There was evidence of widespread use of the WHO Safe Surgery checklist, with only 93 respondents (6.0%) suggesting that they never used it. Annual reports of measures taken to improve patient safety, and of morbidity and mortality, were produced in the hospitals of 588 (37.3%) and 876 (55.7%) respondents, respectively. Around three-quarters of respondents, 1216, (78.7%) stated that their hospital used a critical incident reporting system. Respondents suggested that measures to promote implementation of the Declaration, such as a formal set of checklist items for day-to-day practice, publicity, translation and simulation training, would currently be more important than possible changes to its content. CONCLUSION Many patient safety practices encouraged by the Declaration are well embedded in many European countries. The data have highlighted areas where there is still room for improvement. Correspondence to Andrew F. Smith, Department of Anaesthetics, Royal Lancaster Infirmary, Lancaster LA1 4RP, UK Tel: +00 44 7768 226361; e-mail: andrew.f.smith@mbht.nhs.uk © 2019 European Society of Anaesthesiology

Effectiveness of a visual noise warning system on noise levels in a surgical ICU: A quality improvement programme BACKGROUND The effects of noise are harmful to patients in the ICU environment, and the latter are particularly noisy places. High noise levels seem to be a factor in sleep disturbance, which can, in turn, result in increased morbidity. LOCAL PROBLEM High noise levels are a recognised problem in ICUs worldwide. OBJECTIVE(S) The goal was to estimate the effect of a visual noise-warning system on noise levels in a surgical ICU before and after its implementation. DESIGN A quality improvement initiative. SETTING A 12-bedded surgical ICU in a tertiary care university hospital. PATIENTS A total of 148 adult nonintubated and nonsedated patients completed the study, during a 6-week period. INTERVENTION Noise levels were continuously recorded using a Type II sound level meter for 6 weeks. The study was divided into three phases. The first 2 weeks, baseline noise levels were measured (phase I). In week 3 of the study, a visual noise warning system (SoundEar II) that changed colour depending on noise levels within the ICU was installed and implemented (phase II). The alarm system was set to light up green at levels below 55 dBA, orange at levels between 55 and 60 dBA and red at levels above 60 dBA. The device was switched off at the beginning of week 5 and the sound level meter continued recording noise levels for another 2 weeks (phase III). RESULTS Mean night-time noise level was 55.98 dBA in the preintervention phase, 54.14 dB during the intervention, and 54.98 dBA in the postintervention phase. Mean noise level was reduced statistically significantly by 1.35 dBA, and there was a sustained reduction of 0.86 dBA from the baseline noise level 2 weeks after SoundEar II was switched off. CONCLUSION Visual noise warning systems can be effective in achieving a reduction in noise levels in critical care units. Correspondence to Miriam de Nadal, Department of Anesthesiology and Intensive Care, Hospital Universitari Vall d'Hebron, Ps Vall d'Hebron 119-129, 08035 Barcelona, Spain Tel: +34 932746004; e-mail: minadal@vhebron.net © 2019 European Society of Anaesthesiology

Comparison between the new fully automated viscoelastic coagulation analysers TEG 6s and ROTEM Sigma in trauma patients: A prospective observational study BACKGROUND Viscoelastic coagulation testing is increasingly used to diagnose trauma-induced coagulopathy. Two fully automated analysers, TEG 6s and ROTEM Sigma, were launched recently. No previous studies have compared these devices in trauma paients. OBJECTIVE The aim of this study was to evaluate whether both fully automatic devices deliver comparable results. DESIGN Prospective observational study. SETTING Level one trauma centre from August 2017 to September 2018. PATIENTS A total of 105 blood samples from 67 trauma patients were analysed simultaneously on TEG 6s and ROTEM Sigma. MAIN OUTCOME MEASURES TEG 6s assays kaolin (CK), RapidTEG (CRT), kaolin with heparinase (CKH) and functional fibrinogen were compared with ROTEM Sigma assays INTEM, EXTEM, HEPTEM and FIBTEM. TEG 6s functional fibrinogen level was compared with plasma fibrinogen concentration, measured using the Clauss method. Correlations were classified as weak (Spearman correlation coefficient 0.20 to 0.39), moderate (0.40 to 0.59), strong (0.60 to 0.79) or very strong (≥0.80). RESULTS The TEG 6s parameters reaction time, kinetic time and α-angle (CK, CRT and CKH assays) mostly showed strong correlations with the corresponding ROTEM parameters clotting time, clot formation time and α-angle (INTEM, EXTEM and HEPTEM assays). The exceptions were CRT reaction time vs. EXTEM clotting time, and CK α-angle vs. INTEM α-angle, which correlated moderately. Absolute values for many of these parameters showed significant differences between the two devices. Very strong correlations and similar absolute values were observed between TEG 6s maximum amplitude (CRT, CK and CKH assays) and ROTEM maximum clot firmness (EXTEM, INTEM and HEPTEM assays). Correlations were also very strong for functional fibrinogen maximum amplitude vs. FIBTEM maximum clot firmness and functional fibrinogen level vs. Clauss fibrinogen concentration, but absolute values were significantly different. CONCLUSION Strong to very strong correlations were observed between corresponding TEG 6s and ROTEM Sigma parameters. However, absolute values showed significant differences for most of the measurements. Correspondence to Herbert Schöchl, MD, Department of Anaesthesiology and Intensive Care Medicine, AUVA Trauma Centre Salzburg, Academic Teaching Hospital of the Paracelsus Medical University, Dr Franz Rehrl Platz 5, 5020 Salzburg, Austria; Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Trauma Research Centre, Vienna, Austria E-mail: herbert.schoechl@auva.at Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.ejanaesthesiology.com). © 2019 European Society of Anaesthesiology

A systematic review of randomised controlled trials investigating prehabilitation before major intra-abdominal cancer surgery: An analysis of prehabilitation content and outcome measures BACKGROUND Although prehabilitation programmes for patients undergoing major intra-abdominal cancer surgery have been shown to improve pre-operative physical fitness, the conclusions regarding any postoperative benefits are inconsistent. OBJECTIVES The aim of this study was to evaluate the content of and the outcome measures used in studies of prehabilitation programmes for these patients. It was hypothesised that the content of prehabilitation programmes is often therapeutically invalid, and that the postoperative outcomes assessed are inadequate to evaluate the impact of complications. DESIGN A systematic review of randomised controlled trials. DATA SOURCES Studies published between January 2009 and January 2019 were retrieved from PubMed, Embase and PEDro. ELIGIBILITY CRITERIA Studies were included when they investigated the effects of prehabilitation in patients undergoing intra-abdominal surgery for cancer, reported pre-operative and/or postoperative outcome measures and were conducted as a randomised controlled trial. Studies for which the full text was not available were excluded, as were studies of patients undergoing nonabdominal cancer surgery. RESULTS Eight studies (565 patients) were included. Therapeutic validity was low in five studies. Most studies included low-risk surgical patients and considerable variation was observed between prehabilitation programmes in terms of supervision, training context, frequency, intensity, duration and training type. Objective monitoring of training progression was typically not performed, and most trials did not include nutritional or psychological support. Postoperative complications were reported in seven studies, but no study reported the impact of postoperative complications, nor on long-term postoperative outcomes. CONCLUSION The content of prehabilitation programmes was heterogeneous. Studies with a high therapeutic validity found unequivocal evidence that prehabilitation had beneficial effects on postoperative outcomes. Future research should focus on adequate selection and inclusion of high-risk surgical patients and provide personalised and probably multimodal (partly) supervised prehabilitation, with objective monitoring of progress. Measuring the incidence and impact of postoperative complications may contribute to demonstrating the clinical value of prehabilitation. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 Correspondence to Bart C. Bongers, PhD, Maastricht University, Department of Nutrition and Movement Sciences, P.O. Box 616, 6200 MD Maastricht, The Netherlands Tel: +0031433882236; e-mail: bart.bongers@maastrichtuniversity.nl Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.ejanaesthesiology.com). © 2019 European Society of Anaesthesiology

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