Journal of Investigative Surgery最新文献

{"title":"Antrum Preservation Versus Antrum Resection in Laparoscopic Sleeve Gastrectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Chao Niu, Bo Li, Hongwei Wan, Wendi Jin, Zhiping Zhang, Wanfu Zhang, Xiaogang Li","doi":"10.1080/08941939.2025.2477099","DOIUrl":"https://doi.org/10.1080/08941939.2025.2477099","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the effects of laparoscopic sleeve gastrectomy (LSG) with antrum preservation (AP) and antrum resection (AR) on weight loss and postoperative complications.</p><p><strong>Methods: </strong>A meta-analysis of randomized controlled trials (RCTs) followed PRISMA guidelines. The databases searched included PubMed, Web of Science, Embase Medline, and the Cochrane Library up to October 2022. Extracted data included operation time, hospital stay, excess weight loss, total weight loss, body mass index (BMI), weight, and complications.</p><p><strong>Results: </strong>Eleven RCTs were included with 843 patients: 422 with AR and 421 with AP. The AR group exhibited higher total weight loss at 3 months (<i>p</i> = 0.02), 6 months (<i>p</i> < 0.001), and 1 year (<i>p</i> < 0.001) postoperatively. They also showed greater excess weight loss at 6 months (<i>p</i> < 0.001), 1 year (<i>p</i> < 0.001), and 2 years (<i>p</i> = 0.03). BMI reduction was more significant in the AR group at 3 (<i>p</i> = 0.007) and 6 months (<i>p</i> < 0.001). The AR group lost weight more rapidly at 3 months (<i>p</i> = 0.05), 6 months (<i>p</i> = 0.04), and 1 year (<i>p</i> < 0.001). No significant differences were found in operation time, hospital stay, bleeding, staple line disruption, Clavien-Dindo complications, or remission rates of diabetes, hypertension, arthritis/back pain, hyperlipidemia, or gastroesophageal reflux disease (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>LSG with AR offers better short-term weight loss than AP without increasing surgical complications, but the long-term effects and complications need further investigation in larger RCTs.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2477099"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radical Resection of Differentiated Thyroid Cancer in Elderly Patients: Evaluation of the Efficacy of the Immunocolloidal Gold Strip Method Combined with Nanocarbon Negative Imaging Tracing Technology for Parathyroid Gland Imaging.","authors":"YanBin Liu, LiJuan Zuo, YunChao Xin, YaChao Liu, ZeDong Tian, XiaoLing Shang","doi":"10.1080/08941939.2024.2447850","DOIUrl":"https://doi.org/10.1080/08941939.2024.2447850","url":null,"abstract":"<p><strong>Objective: </strong>Extant imaging methods used for the proper identification of the parathyroid glands to prevent post-operative hypothyroidism associated with the resection of differentiated thyroid cancer (DTC) are limited by factors such as low specificity, high cost, and technical complexity. This study, therefore, sought to investigate the efficacy of the immunocolloidal gold strip method combined with nanocarbon negative imaging tracing technology for parathyroid gland imaging during radical resection of DTC in elderly patients.</p><p><strong>Methods: </strong>A total of 100 elderly patients with DTC were enrolled and randomly divided into two groups: the control group and the observation group. The control group underwent conventional radical thyroidectomy with bilateral cervical lymph node dissection, while the observation group received the immunocolloidal gold strip method combined with nanocarbon negative imaging tracing technology for parathyroid gland imaging during the surgery. The baseline characteristics, intraoperative findings, postoperative parathyroid hormone (PTH), and serum calcium levels, as well as postoperative complications, were compared between the two groups.</p><p><strong>Results: </strong>There were no significant differences in age, gender, body mass index, comorbidities, or smoking history between the two groups. The observation group had a significantly higher number of parathyroid glands identified during surgery compared with the control group. The postoperative PTH and serum calcium levels at postoperative days 1 and 3 and at 6 months were significantly higher in the observation group than those in the control group. The incidence of postoperative hypoparathyroidism was significantly lower in the observation group.</p><p><strong>Conclusion: </strong>The immunocolloidal gold strip method combined with nanocarbon negative imaging tracing technology is effective in identifying and preserving parathyroid glands during radical resection of DTC in elderly patients.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2447850"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Prior Bariatric Surgery on the Outcomes of Joint Arthroplasty: A Systematic Review and Meta-Analysis.","authors":"Zhou Zhang, Xiang Shi, Wei Liu, Jianwei Wang, Qingfeng Shen, Guozhu Xu, Jiakuan Bao, Yupeng Dong","doi":"10.1080/08941939.2024.2446579","DOIUrl":"10.1080/08941939.2024.2446579","url":null,"abstract":"<p><strong>Objective: </strong>Obesity is a risk factor for joint arthroplasty complications. With this systematic review and meta-analysis, we assessed whether a positive history of bariatric surgery influences postoperative outcomes in patients undergoing various types of joint arthroplasty.</p><p><strong>Methods: </strong>We conducted a comprehensive search database such as Scopus, PubMed, Medline Ovid, CNKI, and CENTRAL for studies comparing outcomes between patients undergoing arthroplasty with and without a history of bariatric surgery. We extracted data on short-term medical complications, venous thromboembolism (VTE), periprosthetic infections, superficial wound infections, hospital stay length, and operative time. We used the data to conduct meta-analyses using random-effects models and subgroup analyses based on the type of arthroplasty.</p><p><strong>Results: </strong>Overall, 15 studies with nearly 150,000 participants were included. The analysis showed that prior bariatric surgery did not significantly affect overall medical complications post-arthroplasty, with OR of 0.968 (95%CI, 0.706-1.327). For VTE, the results similarly indicated no substantial difference, with an OR of 0.912 (95%CI, 0.644-1.291). In assessing periprosthetic infections, the OR was 0.754 (95%CI, 0.535-1.064), showing comparable rates between patients with and without a history of bariatric surgery.Regarding superficial wound infections, the analysis produced an OR of 2.390 (95%CI, 0.723-7.897), indicating variability but not statistical significance. Hospital stay length was reduced in patients with a history of bariatric surgery, reflected by SMD of -0.113 (95%CI, -0.221 to -0.005). Lastly, operative time also showed a significant reduction, with an SMD of -0.462 (95%CI, -0.865 to -0.059).</p><p><strong>Conclusions: </strong>Prior bariatric surgery does not reduce the risk of short-term complications post-arthroplasty, but it seems to reduce the hospital stay length and operative time. The effects vary significantly across different types of joint arthroplasty, suggesting a need for tailored preoperative assessments and care protocols.</p><p><strong>Protocol registration: </strong>This systematic review and meta-analysis was registered at PROSPERO, with the number: CRD42024539052.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2446579"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Co-Administration of Midazolam and Dexmedetomidine on Haemodynamics and Stress Response in Elderly Patients with Non-Small Cell Lung Cancer.","authors":"Yanjun Zhao, Dongjiao An, Liang Bi","doi":"10.1080/08941939.2024.2445587","DOIUrl":"https://doi.org/10.1080/08941939.2024.2445587","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to evaluate the effect of co-administration of midazolam and dexmedetomidine on hemodynamics and stress response in elderly patients with non-small cell lung cancer (NSCLC).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this prospective, randomized controlled trial, 154 elderly NSCLC patients scheduled for lobectomy in our oncology department from January 2019 to December 2021 were recruited. Patients were randomized 1:1 to receive either dexmedetomidine (control group) or dexmedetomidine plus midazolam (study group) for anesthesia during lobectomy &lt;i&gt;via&lt;/i&gt; the random number table method, with 77 patients in each group. Perioperative indicators, hemodynamics, and stress reactions of the patients were recorded and compared between the two groups to investigate the efficacy of the two different anesthetic protocols.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;No significant differences were observed between the two groups in terms of operative time, anesthesia time, and intraoperative bleeding volume (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). Preoperative pain, pain at anesthesia recovery, and pain levels 7 days postoperatively were also comparable between the two groups. In the study group, the awakening time was 15 ± 2 min significantly shorter compared to the control group (25 ± 3 min). Cooperation within the first hour was significantly faster by 8.5 ± 0.5 min compared to 6.0 ± 1.0 min in the control group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). The cost of materials used was significantly higher in the study group, with an average of 300 ± 25 USD, compared to 200 ± 20 USD in the control group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Additionally, the two groups showed no significant difference in the need for experience and surveillance (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). Significantly lower visual analog scale (VAS) scores were found one day after the surgery in patients given dexmedetomidine plus midazolam than those anesthetized administered with dexmedetomidine only, suggesting an enhanced pain mitigation effect after incorporating midazolam for anesthetic induction. Patients treated with dexmedetomidine plus midazolam presented with a more stable hemodynamic status than those treated with dexmedetomidine only, as evidenced by the significantly lower variability of mean arterial pressure (MAP), oxygen saturation (SpO2), and heart rate (HR). Co-administration of dexmedetomidine plus midazolam for lobectomy anesthesia resulted in significantly lower serum cortisol (Cor) and norepinephrine (NE) concentrations in patients at anesthesia recovery than dexmedetomidine alone. However, this difference was not observed one day postoperatively. There was no statistically significant difference in the incidence of adverse reactions between the two groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The combination of midazolam with dexmedetomidine anesthesia in lobectomy improves the intraoperative hemodynamic status of elderly patients with NSCLC and mitigates their stress response. However, further research is req","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2445587"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of miR-143-3p in the Development of Hemorrhoids and Postoperative Wound Healing.","authors":"Qing Liu, Wei Han, Ling Wang, Weifang Shang, Xinyu Cao","doi":"10.1080/08941939.2025.2480799","DOIUrl":"https://doi.org/10.1080/08941939.2025.2480799","url":null,"abstract":"<p><strong>Background: </strong>Hemorrhoids refer to a common anorectal disorder that is usually associated with vascular proliferation. The present study investigated the role of miR-143-3p in the development of hemorrhoids and postoperative wound healing, aiming to provide novel ideas for the study of the pathogenesis of hemorrhoids and their clinical treatment.</p><p><strong>Methods: </strong>Hemorrhoid tissues and normal perianal tissues were collected from 42 patients who underwent hemorrhoid surgery. The expressions of miR-143-3p, vascular endothelial markers (CD31, vWF, and VEGFR2), and inflammatory factors (TNF-α, IL-1β, and IL-6) in these tissues were determined using RT-qPCR. The correlation of miR-143-3p with CD31, vWF, and VEGFR2 was analyzed using Pearson's method. The proliferation of HUVEC and HaCaT cells was detected using the CCK-8 assay. The migration of HUVEC and HaCaT cells was detected using Transwell assay. The apoptosis of HUVEC cells was detected using flow cytometry.</p><p><strong>Results: </strong>Reduced expression of miR-143-3p in hemorrhoid tissues was negatively correlated to the mRNA levels of CD31, vWF, and VEGFR2. The mRNA levels of CD31, vWF, and VEGFR2 in the HUVEC cells were reduced after miR-143-3p overexpression. Overexpression of miR-143-3p inhibited the proliferation and migration of HUVEC cells while promoting apoptosis in these cells. Upregulation of miR-143-3p decreased the mRNA levels of TNF-α, IL-1β, and IL-6 in HaCaT cells while promoting cell proliferation and migration in these cells.</p><p><strong>Conclusions: </strong>Downregulation of miR-143-3p was noted in hemorrhoids, which could be linked to the regulation of angiogenesis. MiR-143-3p might have an anti-inflammatory role in postoperative wound healing.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2480799"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Hsa-miR-4741/LILRB2 on Senescence of Nucleus Pulposus Cells and Their Prognostic Values in Lumbar Disc Herniation.","authors":"Zhendong He, Nan Zheng, Xiu-Quan Guo, Gang-Gang Wang, Mingjian Lin","doi":"10.1080/08941939.2025.2458180","DOIUrl":"https://doi.org/10.1080/08941939.2025.2458180","url":null,"abstract":"<p><strong>Background: </strong>The incidence of lumbar disk herniation (LDH) is usually caused by lumbar disk degeneration. Surgery is a common treatment strategy for LDH, but it can recur, resulting in recurrent disk herniation (RDH).</p><p><strong>Purpose: </strong>To explore the predictive value of hsa-miR-4741 and LILRB2 in the prognosis of LDH surgery and the mechanism of nucleus pulposus senescence.</p><p><strong>Method: </strong>The ROC curves of RDH based on hsa-miR-4741 and LILRB2 were constructed to evaluate their predictive values in the prognosis of LDH surgery. Human nucleus pulposus cells (NPC) was treated by TNF-α to construct a cell senescence model, studying the senescence mechanism. Oxidative stress and senescence markers were detected after overexpression of hsa-miR-4741 and LILRB2 to evaluate their effects on the senescence of NPC. Dual luciferase assay and the transfection of hsa-miR-4741 mimics or inhibitor were used to investigate the targeted regulation of it to LILRB2.</p><p><strong>Results: </strong>The combination of hsa-miR-4741 and LILRB2 showed higher accuracy in predicting the outcome of RDH (AUC = 0.9367), compared with a single molecule. Overexpression of hsa-miR-4741 enhanced TNF-α-induced oxidative stress and senescence, while LILRB2 overexpression had the opposite effect. Hsa-miR-4741 mimics attenuated the luciferase activity of NPC transfected with wt-LILRB2 vector and significantly down-regulated LILRB2 expression. In addition, the antioxidant NAC reversed the promotion of hsa-miR-4741 on NPC senescence.</p><p><strong>Conclusion: </strong>The combination of hsa-miR-4741 and LILRB2 was a good predictor of LDH prognosis. Hsa-miR-4741 promoted oxidative stress-induced NPC senescence by negatively regulating LILRB2.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2458180"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the Diagnosis-to-Treatment Interval on the Survival of Patients with Papillary Thyroid Cancer.","authors":"Tingting Wei, Hongbo Huang, Aijie Zhang, Heng Zhang, Lingquan Kong, Yunhai Li, Fan Li","doi":"10.1080/08941939.2025.2456463","DOIUrl":"https://doi.org/10.1080/08941939.2025.2456463","url":null,"abstract":"<p><strong>Background: </strong>For papillary thyroid cancer (PTC) patients, no consensus has been reached for the impact of diagnosis-to-treatment interval (DTI) on patient survival outcomes. We evaluated the impact of DTI on prognosis among patients with PTC.</p><p><strong>Methods: </strong>Patients diagnosed as PTC were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2019. The initial treatment strategies include surgery, radiation therapy, chemotherapy, hormone, immunotherapy, and/or active surveillance according to the SEER. Patients were grouped as follows: (I) DTI 0 (interval < 1 month or immediate treatment), (II) DTI 1-3 months, (III) DTI 4-5 months, and (IV) DTI ≥6 months.</p><p><strong>Results: </strong>A total of 168,969 patients with PTC were included in this cohort study. Median follow-up time was 84.0 months. No significant overall survival (OS) difference was observed between patients with immediate treatment and DTI 1-3 months. However, DTI 4-5 months and ≥6 months were associated with poorer OS compared to patients with immediate treatment. Although Kaplan-Meier analysis suggested slight TCSS differences between the delayed and immediate treatment groups, these disappeared after adjusting for tumor characteristics and treatment factors.</p><p><strong>Conclusions: </strong>A short-term delay (1-3 months) had no significant impact on OS, whereas more than 3 months of DTI resulted in poorer OS. Notably, delayed treatment had no impact on TCSS. These findings suggest that short-term delays are unlikely to affect survival, supporting decision-making flexibility for patients with low-risk PTC within three months of diagnosis.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2456463"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Simulation and Three-Dimensional Model for the Operative Treatment of Tibiofibular Diaphyseal Fracture: A Randomized Controlled Clinical Trial.","authors":"Yin Zhang, Qing Bi, Li Zhang, Danjie Zhu","doi":"10.1080/08941939.2025.2463351","DOIUrl":"https://doi.org/10.1080/08941939.2025.2463351","url":null,"abstract":"<p><strong>Background: </strong>In order to ascertain the safety and therapeutic efficacy of preoperative simulation in conjunction with three-dimensional (3D) printing modalities for the surgical management of tibiofibular diaphyseal fractures. We postulate that preoperative simulation and three-dimensional (3D) printing techniques have a significant impact on reducing the mean operative time, diminishing intraoperative blood loss, and decreasing the frequency of fluoroscopic.</p><p><strong>Material and methods: </strong>Sixty patients with tibiofibular diaphyseal fracture were divided into the conventional surgery group (<i>n</i> = 30) and the 3D printing group (<i>n</i> = 30). In the 3D printing group, preoperative equal-ratio fracture models prepared using the 3D printing technique were used to perform preoperative simulation, guide the real surgical operation, examine implant reduction and placement as well as preoperative plate/screw size. The operation time, intraoperative bleeding, frequency of fluoroscopies, Visual Analog Scale (VAS), and Johner-Wruhs Scale were recorded.</p><p><strong>Results: </strong>The operation time, blood loss, and the frequency of fluoroscopy during operation in the group with preoperative simulation and 3D printing were less than that in the conventional surgery group (<i>p</i> < 0.001). Meanwhile, the Visual Analog Scale (VAS) and Johner-Wruhs Scale were also improved in both groups.</p><p><strong>Conclusion: </strong>The findings indicated that preoperative simulation and three-dimensional (3D) printing may facilitate the treatment of tibiofibular diaphyseal fractures, potentially enhancing preoperative planning and contributing to the precision and personalization of the surgical procedure. Thus, the application of this technology possesses considerable promise for future utilization in clinical practice.</p><p><strong>Trial registry: </strong>Name of the registry: This study was registered in the Chinese Clinical Trial Registry; Trial registration number: ChiCTR2100052379.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2463351"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Norepinephrine Infusion and the Central Venous Waveform in a Porcine Model of Endotoxemic Hypotension with Resuscitation: A Large Animal Study.","authors":"Zachary R Bergman, Roy K Kiberenge, Richard W Bianco, Gregory J Beilman, Colleen M Brophy, Kyle M Hocking, Bret D Alvis, Eric S Wise","doi":"10.1080/08941939.2024.2445603","DOIUrl":"https://doi.org/10.1080/08941939.2024.2445603","url":null,"abstract":"<p><strong>Background: </strong>Venous waveform analysis is an emerging technique to estimate intravascular fluid status by fast Fourier transform deconvolution. Fluid status has been shown proportional to <i>f</i>₀, the amplitude of the fundamental frequency of the waveform's cardiac wave upon deconvolution. Using a porcine model of distributive shock and fluid resuscitation, we sought to determine the influence of norepinephrine on <i>f</i>₀ of the central venous waveform.</p><p><strong>Methods: </strong>Eight pigs were anesthetized, catheterized and treated with norepinephrine after precipitation of endotoxemic hypotension, and subsequent fluid resuscitation to mimic sepsis physiology. Hemodynamic parameters and central venous waveforms were continually transduced throughout the protocol for post-hoc analysis. Central venous waveform <i>f</i>₀ before, during and after norepinephrine administration were determined using Fourier analysis.</p><p><strong>Results: </strong>Heart rate increased, while central venous pressure, pulmonary capillary wedge pressure and stroke volume decreased throughout norepinephrine administration (<i>p</i> < 0.05). Mean <i>f</i>₀ at pre-norepinephrine, and doses 0.05, 0.10, 0.15, 0.20 and 0.25 mcg/kg/min, were 2.5, 1.4, 1.7, 1.7, 1.6 and 1.4 mmHg², respectively (repeated measures ANOVA; <i>p</i> < 0.001). On post-hoc comparison to pre-norepinephrine, <i>f</i>₀ at 0.05 mcg/kg/min was decreased (<i>p</i> = 0.04).</p><p><strong>Conclusions: </strong>As the performance of f₀ was previously characterized during fluid administration, these data offer novel insight into the performance of f₀ during vasopressor delivery. Central venous waveform <i>f</i>₀ is a decreased with norepinephrine, in concordance with pulmonary capillary wedge pressure. This allows contextualization of the novel, venous-derived signal f₀ during vasopressor administration, a finding that must be understood prior to clinical translation.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2445603"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11709120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950211","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":"Study on the Prognostic Factors Related to Endovascular Treatment of Acute Basilar Artery Occlusion Within 24 Hours of Onset.","authors":"Changchun Jiang, Yu Fan, Yuechun Li, Wei Ma","doi":"10.1080/08941939.2024.2442382","DOIUrl":"https://doi.org/10.1080/08941939.2024.2442382","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the prognostic effect of endovascular treatment (EVT) in patients with acute base artery occlusion (ABAO) within 24 h of onset, and analyze the factors related to prognosis.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on all ABAO patients who received EVT within 24 h of onset in the neurology department of Baotou Central Hospital in Inner Mongolia from May 2016 to October 2022. Good prognosis was defined as a Modified Rankin Scale (mRS) score of 0-3 and poor prognosis mRS score of 4-6 at 90 day follow-up, and factors related to prognosis were analyzed.</p><p><strong>Results: </strong>Among the 77 patients included in the analysis, 68 patients (88.3%) achieved recanalization (modified thrombolysis in cerebral infarction, mTICI 2b/3 grade). Thirty eight patients (49.4%) achieved an overall good prognosis. In univariate analysis, age, baseline Glasgow Coma Scale (GCS), baseline National Institutes of Health Stroke Scale (NIHSS), posterior circulation Acute Stroke Prognostic Early CT score (pc ASPECTS), preoperative intravenous thrombolysis, and mTICI2b-3 were factors affecting good prognosis. Multivariate analysis showed that shorter onset to puncture time (OR 0.069; 95% CI, 0.009-0.519; <i>p</i> = 0.009), lower NIHSS (OR 1.179; 95% CI, 1.019-1.364; <i>p</i> = 0.027), and higher pc ASPECTS (OR 0.489, 95% CI, 0.250-0.959, <i>p</i> = 0.037) were factors influencing good prognosis in this study.</p><p><strong>Conclusions: </strong>In summary, endovascular treatment for patients with acute basilar artery occlusion is safe and effective, but EVT may achieve better prognosis within 6 h of onset. The shorter time from onset to puncture at admission, lower baseline NIHSS score, and higher baseline pc-ASPECTS are factors affecting the good prognosis of patients at 90 days.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2442382"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}