The ideal perioperative fluid resuscitation for patients with ruptured abdominal aortic aneurysms (rAAAs) is unknown. It has been shown in trauma studies that a higher ratio of plasma and platelets to packed red blood cells confers a mortality benefit. Controversy remains whether this is true also in the rAAA population. The objective of the present study was to investigate the benefit of a greater ratio of plasma/packed red blood cells in patients with rAAAs.

A health sciences librarian searched four electronic databases, including PubMed, Embase, Cochrane, and ClinicalTrials.gov, using concepts for the terms „fluid resuscitation,” „survival,” and „ruptured abdominal aortic aneurysm.” Two reviewers independently screened the studies that were identified through the search strategy and read in full any study that was potentially relevant. Studies were included if they had compared the mortality of patients with rAAAs who had received a greater ratio of plasma to other component therapy with that of patienlar to the amount of packed red blood cells. However, the included studies reported very low-quality evidence based solely on highly heterogeneous observational studies, and further research is warranted.

Overall, the findings from the available studies would suggest that for patients who have undergone open surgery for a rAAA, mortality tends to be decreased when the amount of plasma transfused perioperatively is similar to the amount of packed red blood cells. However, the included studies reported very low-quality evidence based solely on highly heterogeneous observational studies, and further research is warranted.

The aim of the present study was to review the clinical outcomes of a staged approach using total arch replacement (TAR) with an elephant trunk or a frozen elephant trunk, followed by fenestrated-branched endovascular aortic repair (F-BEVAR) for patients with mega aortic syndrome.

We reviewed the clinical data and outcomes of 11 consecutive patients (8 men; mean age, 71± 7years) treated by staged TAR and F-BEVAR from January 2014 to December 2018. The F-BEVAR procedures were performed under a prospective, nonrandomized, physician-sponsored investigational device exemption protocol. All patients had had mega aortic syndrome, defined by an ascending aorta, arch, and extent I-II thoracoabdominal aortic aneurysm. The endpoints were 30-day mortality, major adverse events (MAE), patient survival, freedom from reintervention, and freedom from target vessel instability.

Of the 11 patients, 6 had developed chronic postdissection aneurysms after previous Stanford A (three A

, two A

, one A

) dissection repair the follow-up period. Four patients had required reintervention, all performed using an endovascular approach.

A staged approach to treatment of mega aortic syndrome using TAR and F-BEVAR is a feasible alternative for selected high-risk patients. Larger clinical experience and longer follow-up are needed.

A staged approach to treatment of mega aortic syndrome using TAR and F-BEVAR is a feasible alternative for selected high-risk patients. Larger clinical experience and longer follow-up are needed.A honey bee can dip nectar of viscosity across two orders of magnitude, by viscous lapping technique using a segmental tongue covered with erectable hairs. The drinking technique suffers risks of leakage occurring between tongue hairs, and the amount of leakage is related to hair spacing as well as nectar viscosity. When lapping, tongue segments are elongated, which enlarges the hair spacing in longitudinal direction. Experimental observations show that the hair spacing of tongue increases with respect to sucrose solution concentration until it reaches the maximum extension when sucrose solution concentration is above 35%. Considering leakage occurring in the hairy tongue, we hypothesize that the dynamical extension of hair spacing may help honey bees minimize the effects of leakage to reach maximal nectar intake rate. A mathematical model is developed for determining the optimal hair spacing that can meet the demands of both augmenting the nectar intake rate and reducing the risk of leakage. Theoretical prediction and experimental measurements demonstrate honey bees are able to adjust the tongue to meet the optimal hair spacing when dipping nectar of concentration more dilute than 35% and maintain a maximum extension to improve the nectar intake rate when concentration is greater than 35%. We then give the prediction of concentration preferences of three bee species, and discuss effects of dipping frequency and gravity on the leakiness between tongue hairs. This work may not only gain insights into adaptive feeding strategy in insects, but inspire the design of adaptive microfluidic transport devices with dynamic brushy surfaces.One of the most notable effects of ageing is an accelerated decline of skeletal muscle mass and function, resulting in various undesirable outcomes such as falls, frailty, and all-cause mortality. The loss of muscle mass directly leads to functional deficits and can be explained by the combined effects of individual fibre atrophy and fibre loss. The gradual degradation of fibre atrophy is attributed to impaired muscle protein homeostasis, while muscle fibre loss is a result of denervation and motor unit (MU) remodelling. Neuromuscular electrical stimulation (NMES), a substitute for voluntary contractions, has been applied to reduce muscle mass and functional declines. However, the measurement of the effectiveness of NMES in terms of its mechanism of action on the peripheral motor nervous system and neuromuscular junction, and multiple molecular adaptations at the single fibre level is not well described. NMES mediates neuroplasticity and upregulates a number of neurotropic factors, manifested by increased axonal sprouting and newly formed neuromuscular junctions. Repeated involuntary contractions increase the activity levels of oxidative enzymes, increase fibre capillarisation and can influence fibre type conversion. Additionally, following NMES muscle protein synthesis is increased as well as functional capacity. This review will detail the neural, molecular, metabolic and functional adaptations to NMES in human and animal studies.Bone repair using BMP-2 is a promising therapeutic approach in clinical practices, however, high dosages required to be effective pose issues of cost and safety. The present study explores the potential of low dose BMP-2 treatment via tissue engineering approach, which amalgamates 3-D macro/microporous-nanofibrous bacterial cellulose (mNBC) scaffolds and low dose BMP-2 primed murine mesenchymal stem cells (C3H10T1/2 cells). Initial studies on cell-scaffold interaction using unprimed C3H10T1/2 cells confirmed that scaffolds provided a propitious environment for cell adhesion, growth, and infiltration, owing to its ECM-mimicking nano-micro-macro architecture. Osteogenic studies were conducted by preconditioning the cells with 50 ng/mL BMP-2 for 15 min, followed by culturing on mNBC scaffolds for up to three weeks. The results showed an early onset and significantly enhanced bone matrix secretion and maturation in the scaffolds seeded with BMP-2 primed cells compared to the unprimed ones. Moreover, mNBC scaffolds alone were able to facilitate the mineralization of cells to some extent. These findings suggest that, with the aid of 'osteoinduction’ from low dose BMP-2 priming of stem cells and 'osteoconduction’ from nano-macro/micro topography of mNBC scaffolds, a cost-effective bone tissue engineering strategy can be designed for quick and excellent in vivo osseointegration.Carboxylesterase 2 (CES 2), plays a pivotal role in endobiotic homeostasis and xenobiotic metabolism. Protostanes, the major constituents of the genus Alisma, display a series of pharmacological activities. Despite the extensive studies of pharmacological activities, the investigation on inhibitory effects of protostanes against CES 2 is rarely reported. In this study, the inhibitory activities of a library of protostanes (1-25) against human CES 2 were investigated for the first time, using 6,8-dichloro-9,9-dimethyl-7-oxo-7,9-dihydroacridin-2-yl benzoate (DDAB) as the specific fluorescent probe for human CES 2. Compounds 1, 2, 7, 8, 12, 13, 18, 19, and 25 showed strong inhibitory effects towards CES 2. For the most potent compounds 1, 7, 13, and 25, the inhibition kinetics were further investigated, and these four protostanes were all uncompetitive inhibitors against human CES 2 with the inhibition constant (Ki) values ranging from 0.89 μM to 2.83 μM. In addition, molecular docking and molecular dynamics stimulation were employed to analyze the potential interactions between these protostanes and CES 2, and amino acid residue Gln422 was identified to play a crucial role in the strong inhibition of protostanes towards CES 2.Bone related-bacterial diseases including wound infections and osteomyelitis (OM) remain a serious problem accompanied with amputation in most severe cases. In this work, we report an exceptional effective antibacterial alginate aerogel, which consists of tigecycline (TGC) and octahedral Cu crystal as an organo-inorganic synergy platform for antibacterial and local infection therapy applications. The alginate aerogel could greatly prolong the release of copper ions and maintain effective antibacterial concentration over 18 days. The result of in-vitro experiments demonstrated that the alginate aerogel has an exceptional effective function on antibacterial activity. Cytotoxicity tests indicated that the alginate aerogel has low biological toxicity (average cell viability >75%). These remarkable results suggested that the alginate aerogel exhibits great potential for the treatment of OM, and has a prosperous future of application in bone tissue engineering.The relationship between the water holding (WH) and gel properties of protein-based hydrogels is important for designing and regulating the texture and sensory properties of foods. Herein, the relation among WH and heat-set gel properties of ovalbumin (OVA)-carboxymethylcellulose (CMC) electrostatic complexes was explored. The results showed that the gels exhibited homogeneous and dense structure and good WH compared with pure OVA at pH 4.6, while Young’s modulus decreased significantly (P less then 0.05). This was closely related to the inhibition of the electrostatic interaction on the formation of large protein aggregates during heat treatment (90 °C, 30 min). Specially, the CMC1.2 (the degree of substitution was 1.2) with higher charge density showed stronger interference than CMC0.7 (the degree of substitution was 0.7) for the gel network structure and properties. Moreover, the addition of salt ions could enhance the gel strength. Meanwhile, the coarseness and microstructure pore size were also increased with enhancing of ionic strength, resulting in a significant decrease in the WH. The effective permeability coefficient (k1) and water flux coefficient (k2) of gels have a significant positive correlation with their network pore size, indicated that the regulation of WH of hydrogel mainly depended on controlling the pore size of its microstructure.