Clinics最新文献

{"title":"Melittin inactivates YAP/HIF-1α pathway via up-regulation of LATS2 to inhibit hypoxia-induced proliferation, glycolysis and angiogenesis in NSCLC","authors":"Hao Li","doi":"10.1016/j.clinsp.2024.100407","DOIUrl":"10.1016/j.clinsp.2024.100407","url":null,"abstract":"<div><h3>Background</h3><p>NSCLC is one of the most common causes of death. The hypoxia microenvironment contributes to cancer progression. The purpose was to explore the effects and mechanism of melittin on NSCLC cells in the hypoxic microenvironment.</p></div><div><h3>Methods</h3><p>NSCLC cell lines (A549 and H1299) were cultured in normoxia or hypoxia conditions with or without melittin treatment. The viability of the cells was detected via MTT assay and the proliferation ability was evaluated by EdU assay. QRT-PCR was performed to evaluate GLUT1, LDHA, HK2, VEGF and LATS2 mRNA levels. Glucose transport was assessed by the 2-NBDG uptake assay. The angiogenesis was determined by the tubule formation assay. The protein expressions of GLUT1, LDHA, HK2, VEGF, LATS2, YAP, p-YAP and HIF-1α were detected via western blotting assay. The tumor formation assay was conducted to examine the roles of melittin and LATS2 <em>in vivo</em>.</p></div><div><h3>Results</h3><p>Melittin inhibited hypoxia-induced cell viability, proliferation, glycolysis and angiogenesis as well as suppressed YAP binding to HIF-1α in NSCLC. Melittin inactivated the YAP/HIF-1α pathway via up-regulation of LATS2, ultimately inhibiting cancer progression of NSCLC. Moreover, melittin suppressed tumor growth via up-regulation of LATS2 <em>in vivo</em>.</p></div><div><h3>Conclusion</h3><p>Melittin inactivated the YAP/HIF-1α pathway via up-regulation of LATS2 to contribute to the development of NSCLC. Therefore, melittin is expected to become a potential prognostic drug for the therapy of NSCLC.</p></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"79 ","pages":"Article 100407"},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S180759322400084X/pdfft?md5=3af4cd7e13811d82b575ae2cd2a47a03&pid=1-s2.0-S180759322400084X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141418126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of the Cunningham technique for shoulder dislocation reduction and its role in providing analgesia and muscle relaxation as an adjunctive method","authors":"Fatih Ugur ,&nbsp;Mehmet Albayrak","doi":"10.1016/j.clinsp.2024.100447","DOIUrl":"10.1016/j.clinsp.2024.100447","url":null,"abstract":"<div><h3>Background</h3><p>Shoulder dislocation, particularly anterior dislocation, is a common orthopedic injury often presenting in emergency care settings, characterized by significant pain and muscle spasms. Prompt reduction is essential to alleviate symptoms and restore function. The Cunningham technique employs gentle pulling and massage motions targeted at the muscles and has emerged as a promising method for reducing anterior shoulder dislocations. However, its reported success rates vary widely across studies, and questions remain regarding its efficacy, particularly in cases of failure. This study aims to evaluate the effectiveness of the Cunningham technique for reducing anterior shoulder dislocations and its potential role in providing analgesia and muscle relaxation as an adjunctive method.</p></div><div><h3>Methods</h3><p>A retrospective study was conducted on patients presenting with acute anterior shoulder dislocation at a single center. Reduction using the Cunningham technique was performed initially, followed by the external rotation technique if unsuccessful. Procedural sedation and analgesia were administered if the reduction was still not achieved, and shoulder dislocation reduction was performed again through the external rotation method. The patients’ VAS scores were recorded and evaluated the Cunningham technique's effectiveness in reduction and whether it increases the effectiveness of other techniques applied for reduction by lowering the VAS score, even in cases where it is not effective.</p></div><div><h3>Results</h3><p>A total of 61 patients were included in the study. The reduction was performed using the Cunningham technique in 34.4% (21/61) patients, the external rotation technique in 47.5% (29/61) patients, and the external rotation technique with PSA in 18% (11/61) patients. Significant differences were observed in the duration of hospital stay among the three techniques, with ER with PSA resulting in the longest stay. VAS scores showed significant improvements from initial presentation to post-reduction in all three groups. A significant decrease in pre-reduction VAS scores was observed during the transition from the Cunningham technique to other techniques.</p></div><div><h3>Conclusion</h3><p>The Cunningham technique showed effectiveness in reducing anterior shoulder dislocations, providing analgesia, and muscle relaxation. It demonstrated favorable outcomes as an initial reduction technique, with the external rotation technique used as a subsequent option. Further studies comparing the success rates and complications of the Cunningham technique with other reduction methods are warranted to establish its role in clinical practice.</p></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"79 ","pages":"Article 100447"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1807593224001248/pdfft?md5=032d1fa6134222fe398006aeb65cacba&pid=1-s2.0-S1807593224001248-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician leadership in private acquisitions: Styles for all situations","authors":"Max S. Mano,&nbsp;Fadil Çitaku","doi":"10.1016/j.clinsp.2024.100443","DOIUrl":"10.1016/j.clinsp.2024.100443","url":null,"abstract":"","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"79 ","pages":"Article 100443"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1807593224001200/pdfft?md5=923b0a72dd5ac59d9906870931f0b61b&pid=1-s2.0-S1807593224001200-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression and clinical significance of miR-141-5p as a biomarker in the serum of patients with early spontaneous abortion","authors":"XiaoQun Che ,&nbsp;Xiao Wang ,&nbsp;LiLian Wang ,&nbsp;LiHua Xu ,&nbsp;Lin Zou ,&nbsp;TianZhong Ma ,&nbsp;Bi Chen","doi":"10.1016/j.clinsp.2024.100327","DOIUrl":"10.1016/j.clinsp.2024.100327","url":null,"abstract":"<div><h3>Aim</h3><p>miR-141-5p expression in patients with Early Spontaneous Abortion (ESA) and its correlation with hormone levels during pregnancy were investigated.</p></div><div><h3>Methods</h3><p>A total of 70 pregnant women with ESA were selected as the research group, and 70 normal pregnant women who chose abortion for non-medical reasons were selected as the Con group. Serum β-HCG, Progesterone (P), and Estrogen (E2) were detected by enzyme-linked immunosorbent assay. Differentially expressed miRNAs were screened by miRNA microarray analysis. miR-141-5p expression was detected by RT-qPCR, and its correlation with serum β-HCG, P, and E2 levels was analyzed. The diagnostic value of miR-141-5p for ESA was evaluated by the ROC curve.</p></div><div><h3>Results</h3><p>Serum β-HCG, P, and E2 were decreased and serum miR-141-5p was increased in patients with ESA. Pearson correlation analysis showed that serum β-HCG, P, and E2 levels were negatively correlated with miR-141-5p expression levels. ROC curve showed that miR-141-5p had a diagnostic value for ESA.</p></div><div><h3>Conclusions</h3><p>miR-141-5p is related to hormone levels during pregnancy and is expected to become a new candidate diagnostic marker for ESA.</p></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"79 ","pages":"Article 100327"},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1807593224000048/pdfft?md5=1d3211418aaf461c0791cd4e5c6a1407&pid=1-s2.0-S1807593224000048-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139706238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tanshinone IIA alleviates IL-1β-induced chondrocyte apoptosis and inflammation by regulating FBXO11 expression","authors":"Jin Xu,&nbsp;XiaoCheng Zhi,&nbsp;YunHui Zhang,&nbsp;Ren Ding","doi":"10.1016/j.clinsp.2024.100365","DOIUrl":"https://doi.org/10.1016/j.clinsp.2024.100365","url":null,"abstract":"<div><h3>Objective</h3><p>This study explored the pharmacological mechanism of Tanshinone IIA (TAN IIA) in the treatment of Osteoarthritis (OA), which provided a certain reference for further research and clinical application of Tan IIA in OA.</p></div><div><h3>Methods</h3><p>CHON-001 cells were stimulated with 10 μg/mL IL-1β for 48 h and treated with 10 μM TAN IIA for 48 h. Cellular viability and apoptosis were evaluated by CCK-8 assay and flow cytometry, and Cleaved caspase-3 was measured by Immunoblot assay and RT-qPCR. TNF-α, IL-6, and iNOS in CHON-001 cells were determined by RT-qPCR and ELISA. To further verify the effect of TAN IIA on OA, a rat model of OA <em>in vivo</em> was established by right anterior cruciate ligament transection. TAN IIA was administered at 50 mg/kg or 150 mg/kg for 7 weeks. The degree of cartilage destruction in OA rats was observed by TUNEL and HE staining. Cleaved caspase-3 and FBXO11 were measured by immunohistochemical staining, RT-qPCR, and Immunoblot. TNF-α, IL-6, and iNOS in chondrocytes of OA rats were detected by ELISA.</p></div><div><h3>Results</h3><p>IL-1β stimulated CHON-001 cell apoptosis and inflammation, and TAN IIA had anti-apoptosis and anti-inflammatory effects on IL-1β-regulated CHON-001 cells. TAN IIA down-regulated FBXO11 and inhibited PI3K/AKT and NF-κB pathways, thereby alleviating apoptotic and inflammatory reactions in CHON-001 cells under IL-1β treatment. Moreover, TAN IIA treatment improved chondrocyte apoptosis and inflammations in OA rats.</p></div><div><h3>Conclusion</h3><p>TAN IIA inhibits PI3K/Akt and NF-κB pathways by down-regulating FBXO11 expression, alleviates chondrocyte apoptosis and inflammation, and delays the progression of OA.</p></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"79 ","pages":"Article 100365"},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1807593224000425/pdfft?md5=20eff9587dc4f92c5b58a03f6075f25f&pid=1-s2.0-S1807593224000425-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140645451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Apatinib combined with Temozolomide on levels of sPD-1 and sPD-L1 in patients with drug-resistant recurrent glioblastoma","authors":"Ren Zhao Kuang ,&nbsp;Jun Wang ,&nbsp;Yuan Chuan Wang ,&nbsp;Xiao Ping Tang","doi":"10.1016/j.clinsp.2024.100376","DOIUrl":"https://doi.org/10.1016/j.clinsp.2024.100376","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to explore the effects of Apatinib combined with Temozolomide (TMZ) on the levels of Soluble PD-1 (sPD-1) and Soluble Programmed Death-1 Ligand (sPD-L1) in patients with drug-resistant recurrent Glioblastoma (GB).</p></div><div><h3>Study design</h3><p>A total of 69 patients with recurrent GB from September 2020 to March 2022 were recruited and assigned to the control group (n = 34) and observation group (n = 35) according to different treatment options after tumor recurrence. The control group was treated with TMZ, and the observation group was treated with Apatinib combined with TMZ. Levels of sPD-1 and spd-l1, clinical efficacy, survival time and adverse reactions were observed and compared between the two groups.</p></div><div><h3>Results</h3><p>General data including gender, age, body mass index, and combined diseases indicated no statistical significance between groups (p &gt; 0.05). Before the intervention, sPD-1 and sPD-L1 levels were not significantly different in the two groups (p &gt; 0.05). After interventions, levels of PD-1 and sPD-L1 levels decreased significantly (p &lt; 0.05). The objective remission rate and clinical benefit rate of the observation group were higher and overall survival and progression-free survival were longer than those of the control group (p &lt; 0.05). No significant difference was observed in major adverse reactions among patients (p &gt; 0.05).</p></div><div><h3>Conclusions</h3><p>Apatinib combined with TMZ is safe and effective in the treatment of recurrent GB. The combined application of the two can reduce the levels of sPD-1 and sPD-L1, which has important clinical application value.</p></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"79 ","pages":"Article 100376"},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S180759322400053X/pdfft?md5=9572741e604f5cbecafa38de2589f9ea&pid=1-s2.0-S180759322400053X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140901675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of plasma clearance of [51Cr]CrEDTA based on three, two and single samples to measure the glomerular filtration rate in patients with solid tumors: a prospective cross-sectional analysis","authors":"Anne C. Gomes ,&nbsp;George B. Coura Filho ,&nbsp;Luiz A. Gil Junior ,&nbsp;Renato A. Caires ,&nbsp;Emmanuel A. Burdmann ,&nbsp;Carlos A. Buchpiguel ,&nbsp;Veronica T. Costa e Silva ,&nbsp;Marcelo T. Sapienza","doi":"10.1016/j.clinsp.2024.100427","DOIUrl":"10.1016/j.clinsp.2024.100427","url":null,"abstract":"<div><h3>Objectives</h3><p>[⁵¹Cr]CrEDTA is used to measure the Glomerular Filtration Rate (GFR) in different clinical conditions. However, there is no consensus on the ideal number of blood samples to be taken and at what time points to measure its clearance. This study aimed to compare Slope Intercept (SI) and Single-Sample (SS) methods for measuring GFR in patients with solid tumors, stratified by age, GFR, and Body Mass Index (BMI).</p></div><div><h3>Methods</h3><p>1,174 patients with cancer were enrolled in this prospective study. GFR was calculated by the SI method using blood samples drawn 2-, 4-, and 6-hours after [⁵¹Cr]CrEDTA injection (246-GFR). GFR was also measured using the SI method with samples at 2 and 4 hours (24-GFR) and at 4 and 6 hours (46-GFR), and SS methods according to Groth (4Gr-GFR) and Fleming (4Fl-GFR). Statistical analysis was performed to assess the accuracy, precision, and bias of the methods.</p></div><div><h3>Results</h3><p>Mean 246-GFR was 79.2 ± 21.9 mL/min/1.73 m². ANOVA indicated a significant difference between 4Gr-GFR and the reference 246-GFR. Bias was lower than 5 mL/min/1.73 m² for all methods, except for SS methods in subgroups BMI &gt; 40 kg/m²; GFR &gt; 105 or &lt; 45. Precision was adequate and accuracy of 30 % was above 98% for all methods, except for SS methods in subgroup GFR &lt; 45.</p></div><div><h3>Conclusion</h3><p>46-GFR and 246-GFR have high agreement and may be used to evaluate kidney function in patients with solid tumors. Single-sample methods can be adopted in specific situations, for non-obese patients with expected normal GFR.</p></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"79 ","pages":"Article 100427"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1807593224001042/pdfft?md5=b0dc14970dc906a28748994c3cd941e0&pid=1-s2.0-S1807593224001042-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of serum 25-hydroxyvitamin D with cardiovascular and all-cause mortality in patients with chronic kidney disease: NHANES 2007‒2018 results","authors":"Luohua Li ,&nbsp;Jinhan Zhao","doi":"10.1016/j.clinsp.2024.100437","DOIUrl":"10.1016/j.clinsp.2024.100437","url":null,"abstract":"<div><h3>Background</h3><p>Vitamin D insufficiency is a prevalent issue in patients suffering from CKD. The purpose of this study was to determine whether serum 25(OH)D levels are associated with all-cause and cardiovascular mortality in patients with CKD.</p></div><div><h3>Methods</h3><p>To examine the associations between 25(OH)D levels and cardiovascular mortality, this retrospective cohort study used the National Health and Nutrition Examination Survey (NHANES) and the National Death Index (NDI) 2007‒2018 database. A total of 2,668 eligible subjects were included in this study, with follow-up conducted until December 31, 2019. The associations were assessed using Cox proportional hazards regression, restricted cubic splines, Kaplan-Meier survival curves, and competing risks survival analysis. Furthermore, subgroup and sensitivity analyses were performed.</p></div><div><h3>Results</h3><p>During a median follow-up of 72 months in a weighted population of 11,715,452 eligible participants, there were 665 deaths from any cause, including 196 cardiovascular-related deaths. After adjusting for covariates, lower levels of 25(OH)D were significantly associated with increased risks for both all-cause mortality (HR= 0.85, 95 % CI 0.77∼0.94) and cardiovascular mortality (SHR= 0.80, 95 % CI 0.67∼0.94). Consistent results were also observed when analyzing 25(OH)D as a categorical variable (quartile). Compared to group Q1, both group Q3 (HR = 0.71, 95 % CI 0.54‒0.93) and group Q4 (HR = 0.72, 95 % CI 0.55‒0.94) exhibited a significantly reduced mortality risk. Weighted restricted cubic splines revealed an inverse J-shaped linear association between levels of 25(OH) D and all-cause mortality ((PNonliner &gt; 0.05). Subgroup analysis and sensitivity analysis yielded similar findings.</p></div><div><h3>Conclusions</h3><p>All-cause mortality and cardiovascular disease-related mortality were significantly increased by lower 25(OH)D levels, both as continuous and categorical variables. 25(OH)D has an inverse J-shaped linear association with all-cause and cardiovascular mortality.</p></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"79 ","pages":"Article 100437"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1807593224001145/pdfft?md5=3b8826425f49a2ce509edca4dc818acc&pid=1-s2.0-S1807593224001145-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141598826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of different anesthesia methods on labor process and postpartum serum estrogen and progesterone levels in primiparas with painless labor","authors":"JunYan Liu ,&nbsp;ChongLai Shi ,&nbsp;Dan Wang ,&nbsp;XiaoDong Cui ,&nbsp;LiLi Geng ,&nbsp;JingJing Cui ,&nbsp;DongMei Sun ,&nbsp;Zhuo Yin","doi":"10.1016/j.clinsp.2024.100442","DOIUrl":"10.1016/j.clinsp.2024.100442","url":null,"abstract":"<div><h3>Objective</h3><p>To look into the effects of different anesthesia methods on the labor process and the expression of serum estrogen and progesterone in primiparas with painless labor.</p></div><div><h3>Methods</h3><p>60 primiparas receiving painless labor were selected as the research objects, and they were divided into either a Spinal &amp; Continuous epidural anesthesia group (n = 30) or a continuous epidural anesthesia group (n = 30), anesthesia is administered using the corresponding anesthesia method. The authors compared serum estrogen and progesterone, inflammatory index expression, pain degree and neonatal health status in different periods.</p></div><div><h3>Results</h3><p>At T2 and T3, serum P, LH, FSH and E2 levels in the Spinal &amp; Continuous epidural anesthesia group were signally lower than those in the Spinal &amp; Continuous epidural anesthesia group (p &lt; 0.05). Spinal &amp; Continuous epidural anesthesia group harbored faster onset and longer duration of sensory block and motor block than the Continuous epidural anesthesia group (p &lt; 0.05). SAS and SDS scores of the Spinal &amp; Continuous epidural anesthesia group were clearly lower than those of the Continuous epidural anesthesia group (p &lt; 0.05). VAS score and serum TNF-α, IL-6 levels of pregnant women in the Spinal &amp; Continuous epidural anesthesia group were memorably lower than those in the Continuous epidural anesthesia group at T2 and T3 (p &lt; 0.05). The total incidence of postoperative complications in the Spinal &amp; Continuous epidural anesthesia group was distinctively lower than that in the Continuous epidural anesthesia group (p &lt; 0.05).</p></div><div><h3>Conclusion</h3><p>Spinal anesthesia combined with continuous epidural anesthesia has a better anesthesia effect in the painless labor of primiparas, which can effectually ameliorate the labor process and the expression of serum estrogen and progesterone.</p></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"79 ","pages":"Article 100442"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1807593224001194/pdfft?md5=f614b2607392df365351d8e2f7bbd377&pid=1-s2.0-S1807593224001194-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141598827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resource management strategies for prioritizing non-scheduled surgical procedures in a tertiary public hospital","authors":"Marcelo Cristiano Rocha ,&nbsp;Rafaela Alkmin da Costa ,&nbsp;Edivaldo Massazo Utiyama","doi":"10.1016/j.clinsp.2024.100482","DOIUrl":"10.1016/j.clinsp.2024.100482","url":null,"abstract":"","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"79 ","pages":"Article 100482"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1807593224001595/pdfft?md5=a3822d665fe323dad9780354684bbe16&pid=1-s2.0-S1807593224001595-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142097429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}