Sufentanil (SUF) and dexmedetomidine (DEX) are used as bupivacaine in the spinal technique that providing stable hemodynamic conditions with least side effects. This study aimed to compare the change in saturation oxygen and hemodynamic responses after intrathecal DEX and SUF as adjuvants to bupivacaine in patients undergoing dynamic hip screw. This clinical trial was conducted with 80 patients referring to Valiasr Hospital, Arak, Iran, who were randomly assigned to two groups (n = 40): DEX group (8 mg bupivacaine with 5 μg DEX) and SUF group (8 mg bupivacaine with 2.5 μg SUF). The pain severity was lower in DEX group at different hours and the systolic pressure and diastolic blood pressure were lower in DEX group than in SUF group after surgery. Saturation oxygen was generally lower and more stable in DEX group but there was no significant difference between two groups. The incidence of sensory and motor block was lower in DEX group than in SUF group, but the duration of assessment of sensory block was lower in SUF group than in DEX group. DEX relieves pain up to 24 hours postoperatively. Nevertheless, Care should be taken to avoid the DEX induced shivering in patients. The study was approved by Ethical Committee of Arak University of Medical Sciences by IR.ARAKMU.REC.1395.32 code on April 25, 2016 and was registered in Iranian Registry of Clinical Trials by code number: IRCT2017050220258N45 on August 4, 2017.

Following standard treatments, the traditional model for enhancing anti-tumor immunity involves performing immune reconstitution (e.g., adoptive immune cell therapies or immunoenhancing drugs) to prevent recurrence. For patients with advanced non-small cell lung cancer, we report here on two objectives, the immunosenescence for advanced non-small cell lung cancer and hydrogen gas inhalation for immune reconstitution. From July 1^st to September 25^th, 2019, 20 non-small cell lung cancer patients were enrolled to evaluate the immunosenescence of peripheral blood lymphocyte subsets, including T cell, natural killer/natural killer T cell and gamma delta T cell. Two weeks of hydrogen inhalation was performed during the waiting period for treatment-related examination. All patients inhaled a mixture of hydrogen (66.7%) and oxygen (33.3%) with a gas flow rate of 3 L/min for 4 hours each day. None of the patients received any standard treatment during the hydrogen inhalation period. After pretreatment testing, major indexes of immunosenescence were observed. The abnormally higher indexes included exhausted cytotoxic T cells, senescent cytotoxic T cells, and killer Vδ1 cells. After 2 weeks of hydrogen therapy, the number of exhausted and senescent cytotoxic T cells decreased to within the normal range, and there was an increase in killer Vδ1 cells. The abnormally lower indexes included functional helper and cytotoxic T cells, Th1, total natural killer T cells, natural killer, and Vδ2 cells. After 2 weeks of hydrogen therapy, all six cell subsets increased to within the normal range. The current data indicate that the immunosenescence of advanced non-small cell lung cancer involves nearly all lymphocyte subsets, and 2 weeks of hydrogen treatment can significantly improve most of these indexes. The study was approved by the Ethics Committee of Fuda Cancer Hospital, Jinan University in China (approval No. Fuda20181207) on December 7^th, 2018, and was registered on ClinicalTrials.gov (ID: NCT03818347) on January 24^th, 2019.

Molecular hydrogen has been suggested to have a cytoprotective effect on the whole body and to enhance exercise performances. However, the effect of hydrogen-rich gas mixture (HG) inhalation on physiological responses has been poorly investigated. We examined the impact of acute HG inhalation on subsequent oxidative stress, muscle damage, and exercise performances during the recovery period after a strenuous exercise. This is a two-trial, double-blind, crossover, repeated measures study. Eight physically active male volunteers inhaled HG (estimated fraction of inspired oxygen and hydrogen were 21.57 and 4.08% at most, respectively) or normal gas (placebo, ambient air 400 m above sea level) during a 60-minute recovery phase after oxidative stress-inducing exercise) completion comprising 30-minute treadmill running at an intensity corresponding to 75% of maximal oxygen uptake and squat jumps (5 sets × 10 repetitions). Before oxidative stress-inducing exercise and 10 minutes after the post-exercise gas inhalation, blood and urine samples were obtained and exercise performances (jumping ability; pedaling power output; muscle strength) were evaluated. Post-exercise HG inhalation attenuated the increase in urinary 8-hydroxydeoxyguanosine excretion rate (P < 0.05), a DNA oxidation marker, and the reduction in the countermovement jump height (P < 0.05), compared with Placebo inhalation. Other exercise performances and blood oxidative stress and muscle damage markers did not differ between HG and Placebo inhalation. Moreover, the increase in urinary 8-hydroxydeoxyguanosine excretion rate was significantly associated with countermovement jump performance reduction (r = –0.78, P < 0.01). These findings suggested that HG inhalation during post-exercise recovery period might improve exercise performance via reducing systemic oxidative damage. The study was approved by the Human Research Ethics Committee of the University of Yamanashi (approval No. H29-006) on June 28, 2017.

The various beneficial effects of the intake of molecular hydrogen (H2) have been demonstrated in the field of sports science. Although supplementation of H2 has been reported to increase mitochondrial metabolism in animal studies, the effects of the administration of H2 on aerobic capacity during exercise in humans are still not clear. We investigated whether a single or 2-week continuous intake of H2-rich water (HW) enhanced the aerobic capacity during incremental exercise in healthy humans. In this randomized, single-blinded, placebo-controlled experimental study, the participants performed an incremental cycling exercise to measure peak oxygen uptake and peak load before and after a single (500 mL) or a 2-week supplementation (total 5 L) of HW. In the latter experiment, the participants drank the 500 mL of HW on all weekdays (i.e., 10 times). The single intake of HW did not significantly increase peak oxygen uptake and peak load, and did not significantly alter the responses in oxidative stress, antioxidant activity, and lactate levels. However, importantly, the 2-week continuous consumption of HW significantly augmented peak oxygen uptake and tended to increase the peak load without any significant changes in lactate levels, oxidative stress, and antioxidant responses. In conclusion, the continuous supplementation of HW potentially augments the aerobic capacity, implying that continuous supplementation of H2 might help improve aerobic exercise performance and physical health. This study protocol was approved by the Ethical Committee of Chubu University (approval No. 260086-2) on March 29, 2018.

Neck pain is one of the major pathologies responsible for loss of labor. Many conservative treatment methods for neck pain have been described. The purpose of this study was to obtain pain scores for patients undergoing paravertebral ozone-oxygen (O₃/O₂) injections for neck pain caused by cervical disc disease. Over the last 6 months of 2018, 72 patients who undergoing intramuscular O₃/O₂ injections to treat neck pain were examined retrospectively in this multicenter study. Patients were injected with 30 mL of 20 μg/mL O₃/O₂ gas (into the paravertebral space). Subjects were treated once a week for 6 weeks. The visual analog scale pain scores and Japanese Orthopedic Association scores were obtained before (pre-injection) and after treatment (i.e., at 2 and 6 months). Significant improvements were observed in visual analog scale and Japanese Orthopedic Association scores at both 2 and 6 months versus the pre-injection scores. There was no significant difference in the visual analog scale or Japanese Orthopedic Association scores between 2 and 6 months. Paravertebral O₃/O₂ injection is a reliable and effective treatment of neck pain caused by cervical disc disease. The study was approved by Umraniye Education and Research Hospital, University of Health Sciences, Turkey (Reference Number: 00102187854) on September 25, 2019.

World Health Organization has declared coronavirus disease-19 (COVID-19) as a pandemic. Although there are studies about this novel virus, our knowledge is still limited. There is limited information about its diagnosis, treatment and prognosis. We aimed to investigate the effect of methemoglobin and carboxyhemoglobin levels on the prognosis of COVID-19. In this observational study, patients who were diagnosed with COVID-19 during March 1–April 31, 2020 in a secondary-level state hospital in Turkey were included in the study. COVID-19 diagnosis was confirmed with reverse transcription polymerase chain reaction method, with nasal, oral or sputum specimens. During the period this study was performed, 3075 patients were tested for COVID-19 and 573 of them were hospitalized. Among the hospitalised patients, 23.2% (133) of them had a positive polymerase chain reaction result for COVID-19. A total of 125 patients, 66 (52.8%) males and 59 (47.2%) females, with an average age of 50.2 ± 19.8 years, were included in the study. The most common findings in chest radiogram were ground-glass areas and consolidations, while one-third of the patients had a normal chest radiogram. Computed thorax tomography was performed for 77.6% (97/125) of the patients. The 24.7% of computed tomographies (24/97) did not reveal any pathological findings, and the most common findings were ground-glass appearance and consolidation. Those who needed intensive care had statistically significantly lower platelet count (P = 0.011) and higher lactate dehydrogenase levels (P < 0.001). No statistically significant difference was found in carboxyhemoglobin (P = 0.395) and methemoglobin (P = 1.000) levels. We found that carboxyhemoglobin and methemoglobin levels had no effect on COVID-19 prognosis, but low platelet level played a role in predicting COVID-19 prognosis. This study was approved by the Ethical Committee of Harran University Faculty of Medicine on May 11, 2020 with approval No. 09.

Metastatic breast cancer cells carry adult and neonatal variants of NaV1.5 voltage-gated activated Na⁺ channels involved in cell invasion. We hypothesize that instilling lignocaine near the surgical field to anesthetize the pectoral nerves for analgesia will decrease angiogenesis by blocking voltage-gated activated Na⁺ channels. Twenty patients undergoing unilateral modified radical mastectomy were randomized in a single-blinded, parallel-arm group feasibility pilot study in two groups. In Group I a catheter was placed between the pectoralis major and minor muscle under direct vision before skin closure. Ten milliliters of 2% lignocaine was given as an initial bolus followed by 10 mL of 2% lignocaine every 8 hours up to 24 hours. Group II did not receive any regional block. Primary measure outcomes were pre and postoperative changes in levels of vascular endothelial growth factor. Secondary outcomes were postoperative pain scores and total rescue analgesia used. Nine patients in each group were analyzed. Baseline demographic data of all females were similar with respect to age, body mass, height and duration of anesthesia. Postoperative mean serum levels of vascular endothelial growth factor were decreased by 46.60% from baseline in Group I, while were increased by 84.27% as compared to preoperative values in Group II. Postoperative average pain scores were less in Group I. Postoperative rescue analgesia in 24 hours in Group I was lower than that in Group II. There was no postoperative adverse event related to catheter or lignocaine administration at given doses. Instilling lignocaine to block pectoral nerves provides better postoperative analgesia and decreases a marker of angiogenesis. The study protocol was approved by the Institutional Ethical Committee of the Tertiary Centre (All India Institute of Medical Sciences Rishikesh India) (No. AIIMS/IEC/19/1002) on August 9, 2019, and the larger expansion trial was prospectively registered on Clinical Trial Registry India (No. CTRI/2020/01/022784) on January 15, 2020.

Diabetic nephropathy is one of the most important comorbidities in the diabetic population. In China, more and more young patients are showing an increasing prevalence of diabetes. As a gas molecule, hydrogen sulfide (H₂ S) has some unique chemical and physiological functions. In recent years, it has been studied in various fields. These effects are manifested in the induction of renal vasodilation and anti-renal vascular fibrosis. The ball clearing function is improved. Therefore, increasing prospective studies have focused on how H₂ S protects diabetic nephropathy and how to obtain H₂ S by modern means to treat diabetic nephropathy.

Application of ozone in oral care comes as new and alternative treatment modality in dentistry. The impact of biological and digital information leads to use of ozone application by various means for numerous treatment options in oral cavity. Ozone is a form of oxygen, which has an effective role in management of oral diseases. This review mainly emphasizes on utility of ozone in oral health care management. Its therapeutic potential and its clinical application in oral pathologies, periodontology, endodontics, oral surgery, prosthodontics, orthodontics, restorative dentistry, wound healing, tooth mineralization as treatment choice are reviewed.

Recent development regarding mixture of H₂ (concentration of ~66%) with O₂ (concentration of ~34%) for medical purpose, such as treatment of coronavirus disease-19 (COVID-19) patients, is introduced. Furthermore, the design principles of a hydrogen inhaler which generates mixture of hydrogen (~66%) with oxygen (~34%) for medical purpose are proposed. With the installation of the liquid blocking module and flame arresters, the air pathway of the hydrogen inhaler is divided by multiple isolation zones to prevent any unexpected explosion propagating from one zone to the other. An integrated filtering/cycling module is utilized to purify the impurity, and cool down the temperature of the electrolytic module to reduce the risk of the explosion. Moreover, a nebulizer is provided to selectively atomize the water into vapor which is then mixed with the filtered hydrogen-oxygen mix gas, such that the static electricity of a substance hardly occurs to reduce the risk of the explosion. Furthermore, hydrogen concentration detector is installed to reduce the risk of hydrogen leakage. Result shows that the hydrogen inhaler implementing the aforesaid design rules could effectively inhibit the explosion, even ignition at the outset of the hydrogen inhaler which outputs hydrogen-oxygen gas (approximately 66% hydrogen: 34% oxygen).