6% vs. 33.9%, respectively) and all products (23.7% vs. 26.4%). A comparable decrease in daily cigarettes was also observed. 39.5% of the sample switched at least once (tobacco smokers 15.1%; dual users 83.3%). CONCLUSIONS After six years, no evidence of harm reduction was found among e-cig or dual users. The complete switch to e-cig might support tobacco quitters remain abstinent, but the use of e-cig in addition to tobacco did not improve smoking cessation or reduction.OBJECTIVE To explore the protective effect of remifentanil against myocardial ischemia-reperfusion injury (MIRI) in rats and its mechanism. MATERIALS AND METHODS The rat models of IRI were established and randomly divided into 1) sham-operation group (S group), 2) IRI rat model group (M group), 3) low-dose remifentanil group (R-L group), 4) moderate-dose remifentanil group (R-M group), and 5) high-dose remifentanil group (R-H group). The rats in R-L group, R-M group, and R-H group were administrated with remifentanil at 0.4 μg/kg/min, 2 μg/kg/min, and 10 μg/kg/min, respectively. The activity of creatine kinase-MB (CK-MB), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) in myocardial cells was detected using the automatic biochemical analyzer, and the apoptosis rate of myocardial cells was detected via terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay. Moreover, the messenger ribonucleic acid (mRNA) and protein levels of related cytokines in myocardial cells were determined through quantitative Polymerase Chain Reaction (qPCR) and Western blotting, and the content of interleukin-1β (IL-1Symbol ) and IL-18 in peripheral blood was detected via enzyme-linked immunosorbent assay (ELISA). RESULTS Remifentanil at different concentrations could protect myocardium from IRI, and remifentanil at 2 μg/kg/min and 10 μg/kg/min could significantly down-regulate the myocardial enzyme indexes in IRI myocardial cells (p less then 0.01). Besides, remifentanil reduced the mRNA expressions of IL-18, INF-γ, TNF-β, and IL-1β (p less then 0.01), significantly decreased the protein expression of IL-18, and raised the protein expression of IL-18BP, thereby improving myocardial pathological damage. CONCLUSIONS The protective mechanism of remifentanil on the myocardium of MIRI rats may be related to the inhibition on the IL-18 signaling pathway.OBJECTIVE To explore the specific mechanism of sevoflurane in alleviating cerebral ischemia-reperfusion injury (CIRI) in rats through the c-Jun N-terminal kinase (JNK) signaling pathway. MATERIALS AND METHODS A total of 60 male specific pathogen-free Sprague-Dawley rats were randomly divided into sham group (n=20), model group (n=20), and sevoflurane group (n=20). In the sevoflurane group, sevoflurane (2.5%) was inhaled for 60 min at 24 h before the blockage of cerebral blood supply. The CIRI model was established using the suture method in the model group and sevoflurane group, while the right common carotid artery and external carotid artery were separated and ligated only, without suture placement, in the sham group. At 24 h after reperfusion, the neurological deficit score in each group was calculated, the water content in brain tissues in each group was detected based on dry-wet weight ratio, the infarction volume of brain tissues in each group was detected via 2,3,5-triphenyltetrazolium chloride (TTC) srary is the case in the sevoflurane group compared with those in the model group (p less then 0.05, p less then 0.01). CONCLUSIONS Sevoflurane can regulate the protein and gene expressions of Bax and Bcl-2 and reduce apoptosis in CIRI by regulating the JNK signaling pathway, thereby exerting a protective effect on brain tissues and improving the symptoms of neurological deficit.OBJECTIVE To compare volumetric modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) for the treatment of Graves' ophthalmopathy (GO) based on the dosimetric data. PATIENTS AND METHODS 19 patients diagnosed with GO were recruited in this study. For each patient, a dual-partial-arc VMAT plans and a 7-fixed-field IMRT plans were replanned. Dosimetric parameters of the targets and organs at risk (OARs) originated from the two kinds of plans were compared and analyzed. RESULTS Homogeneity index (HI) was superior in IMRT plans compared with VMAT (p=0.0014) but there was no significant statistical difference in conformity index (CI) between them (p=0.0673). IMRT plans revealed advantage in the OARs protection especially for the left and right lenses, optic nerves and eyeballs (p less then 0.05). CONCLUSIONS VMAT and IMRT are both feasible techniques in radiotherapy in GO from the perspective of dosimetric parameters. Homogeneity and OAR protection were slightly superior in IMRT plans compared with VMAT plans.OBJECTIVE Total laparoscopic hysterectomy (TLH) is associated with significant postoperative pain that worsens outcomes and prolongs hospital stay.  https://www.selleckchem.com/products/enarodustat.html  Ultrasound guided erector spinae plane block (ESPB) is a new technique for thoracic analgesia. Few cases have been described for postoperative analgesia in laparoscopy. We describe the use of preoperatory bilateral ESPB at level T10 to provide postoperative analgesia following THL. PATIENTS AND METHODS We enrolled 10 ASA 1-2 patients scheduled for TLH. After written informed consent we performed bilateral ESPB at T10 level in sitting position, with a linear probe and in plane cranio-caudal approach and ropivacaine 0.5% 20 for each side. The sensitive block was tested by pinprick. Standard general anesthesia was administered. Patient controlled analgesia (PCA) with morphine 1 mg/ml was delivered. We measured postoperative pain by visual analogue scale (VAS). RESULTS Five patients (50%) underwent simple TLH, 5 women (50%) had TLH plus salpingo-oophorectomy. VAS scores was less then 4 in all cases but one, and PCA morphine consumption was 4.1 ± 3.5 mg (mean ± SD). Pinprick was positive bilaterally in 3 patients (30%). CONCLUSIONS ESPB was an effective and safe procedure for postoperative pain control after TLH. Future research should compare ESPB to other techniques to assess its role on perioperative management of THL.