Association between perioperative self-reported sleep disturbances and delirium risk in elderly patients following total joint arthroplasty: a cohort study.

Perioperative sleep disturbance may increase delirium risk. However, the role of perioperative sleep disturbance in delirium following total joint arthroplasty remains unclear. This prospective cohort study aimed to observe the delirium risk in patients with sleep disturbances. After excluding pre-existing sleep disturbances, older patients scheduled for total joint arthroplasty from July 17, 2022, to January 12, 2023, were recruited. Preoperative sleep disturbance or postoperative sleep disturbance was defined as a Chinese version of the Richards-Campbell Sleep Questionnaire (RCSQ) score of <50 during hospitalisation. A cut-off score of 25 was used to classify the severity of sleep disturbance. The primary outcome was the incidence of postoperative delirium. In all, 11.6% of cohort patients (34/294) developed delirium. After multivariate analysis, a preoperative Day 1 RCSQ score of ≤25 (odds ratio [OR] 3.62, 95% confidence interval [CI] 1.19-10.92; p = 0.02), occurrence of sleep disturbances (OR 2.76, 95% CI 1.19-6.38; p = 0.02) and RCSQ score of ≤25(OR 2.91, 95% CI 1.33-6.37; p = 0.007) postoperatively were strong independent predictors of delirium. After sensitivity analysis for daily delirium, a postoperative Day 1 RCSQ score of ≤25 (OR 9.27, 95% CI 2.72-36.15; p < 0.001) was associated with a greater risk of delirium on postoperative Day 1, with a reasonable discriminative area under the curve of 0.730. We concluded that postoperative but not preoperative sleep disturbances may be an independent factor for delirium risk. Sleep disturbance on the first night after surgery was a good predictor of subsequent delirium, no matter the nature of self-reported sleep disturbance.

Melatonin protects against ovarian damage by inhibiting autophagy in granulosa cells in rats.

OBJECTIVES: This study sought to further verify the protective mechanism of Melatonin (MT) against ovarian damage through animal model experiments and to lay a theoretical and experimental foundation for exploring new approaches for ovarian damage treatment. METHOD: The wet weight and ovarian index of rat ovaries were weighted, and the morphology of ovarian tissues and the number of follicles in the pathological sections of collected ovarian tissues were recorded. And the serum sex hormone levels, the key proteins of the autophagy pathway (PI3K, AKT, mTOR, LC3II, LC3I, and Agt5) in rat ovarian tissues, as well as the viability and mortality of ovarian granulosa cells in each group were measured by ELISA, western blotting, CCK8 kit and LDH kit, respectively. RESULTS: The results showed that MT increased ovarian weight and improved the ovarian index in ovarian damage rats. Also, MT could improve autophagy-induced ovarian tissue injury, increase the number of primordial follicles, primary follicles, and sinus follicles, and decrease the number of atretic follicles. Furthermore, MT upregulated serum AMH, INH-B, and E2 levels downregulated serum FSH and LH levels in ovarian damage rats and activated the PI3K/AKT/mTOR signaling pathway. Besides, MT inhibited autophagic apoptosis of ovarian granulosa cells and repressed the expression of key proteins in the autophagic pathway and reduced the expression levels of Agt5 and LC3II/I. CONCLUSIONS: MT inhibits granulosa cell autophagy by activating the PI3K/Akt/mTOR signaling pathway, thereby exerting a protective effect against ovarian damage.

Melatonin protects against ovarian damage by inhibiting autophagy in granulosa cells in rats

Abstract Objectives: This study sought to further verify the protective mechanism of Melatonin (MT) against ovarian damage through animal model experiments and to lay a theoretical and experimental foundation for exploring new approaches for ovarian damage treatment. Method: The wet weight and ovarian index of rat ovaries were weighted, and the morphology of ovarian tissues and the number of follicles in the pathological sections of collected ovarian tissues were recorded. And the serum sex hormone levels, the key proteins of the autophagy pathway (PI3K, AKT, mTOR, LC3II, LC3I, and Agt5) in rat ovarian tissues, as well as the viability and mortality of ovarian granulosa cells in each group were measured by ELISA, western blotting, CCK8 kit and LDH kit, respectively. Results: The results showed that MT increased ovarian weight and improved the ovarian index in ovarian damage rats. Also, MT could improve autophagy-induced ovarian tissue injury, increase the number of primordial follicles, primary follicles, and sinus follicles, and decrease the number of atretic follicles. Furthermore, MT upregulated serum AMH, INH-B, and E2 levels downregulated serum FSH and LH levels in ovarian damage rats and activated the PI3K/AKT/mTOR signaling pathway. Besides, MT inhibited autophagic apoptosis of ovarian granulosa cells and repressed the expression of key proteins in the autophagic pathway and reduced the expression levels of Agt5 and LC3II/I. Conclusions: MT inhibits granulosa cell autophagy by activating the PI3K/Akt/mTOR signaling pathway, thereby exerting a protective effect against ovarian damage.

Values of serum sFlt-1, PLGF levels, and sFlt-1/PLGF ratio in diagnosis and prognosis evaluation of preeclamptic patients.

PURPOSE: To explore the values of serum sFlt-1, PLGF levels and sFlt-1/PLGF ratio in the diagnosis and prognosis evaluation of preeclamptic patients. METHODS: From March 2017 to October 2018, 60 cases of early onset preeclampsia (E-PE), 116 cases of late onset preeclampsia (L-PE) and 50 cases of gestational hypertension (GH) were selected. Fifty women who had vaginal bleeding or abdominal distention before 34 gestational weeks were selected as an early control group, and 50 pregnant women awaiting delivery were selected as a late control group. Serum sFlt-1 and PLGF levels were measured, and changes of sFlt-1/PLGF ratio were analyzed. Their correlations with neonatal birth weight were analyzed, and ROC curves were plotted for E-PE diagnosis. RESULTS: The sFlt-1/PLGF ratio of patients with E-PE was significantly higher than those of other groups, and negatively correlated with neonatal birth weight. When the ratio was used as a diagnostic index, AUC was 0.975. The ratio of patients with severe L-PE exceeded that of cases with mild L-PE. In all preeclamptic patients, the ratio was elevated with increasing maternal and neonatal complications. CONCLUSION: sFlt-1/PLGF ratio is valuable for assessing the severity of preeclampsia and diagnosing E-PE, and can be used to predict neonatal birth weight.

Enhancement of Solar-Driven Photocatalytic Activity of BiOI Nanosheets through Predominant Exposed High Energy Facets and Vacancy Engineering.

The increasing application of exposed high energy facet is an effective strategy to improve the photocatalytic performance of photocatalysts because the vacancies are beneficial to photocatalytic reaction. Vacancy dominates numerous distinct properties of semiconductor materials and thus plays a conclusive role in the photocatalysis applications. In this work, two kinds of BiOI nanomaterials with different vacancies are synthesized via a facile solvothermal method. The positron annihilation analysis shows that the thinner BiOI nanosheets possess larger-sized vacancy than BiOI nanoplates. Thus, BiOI nanosheets show the enhanced separation efficiency of electron-hole pairs and adsorption ability for contaminants under visible light. The results are also validated with the first-principle computation. Therefore, higher photocatalytic activity to the photodegradation of tetracycline is observed from the nanosheets than that obtained from BiOI nanoplates. This work not only arouses attention to vacancies, but also opens up an avenue for precision design of vacancies to prepare novel photocatalytic materials driven under solar light.

Improving Photocatalytic Water Treatment through Nanocrystal Engineering: Mesoporous Nanosheet-Assembled 3D BiOCl Hierarchical Nanostructures That Induce Unprecedented Large Vacancies.

Vacancy control can significantly enhance the performance of photocatalytic semiconductors for water purification. However, little is known about the mechanisms and approaches that could generate stable large vacancies. Here, we report a new mechanism to induce vacancy formation on nanocrystals for enhanced photocatalytic activity: the introduction of mesopores. We synthesized two nanosheet-assembled hierarchical 3D BiOCl mesoporous nanostructures with similar morphology and exposed facets but different nanosheet thickness. Positron annihilation analysis detected unprecedentedly large VBi‴ VO•• VBi‴ VO•• VBi‴ vacancy associates (as well as VBi‴ VO•• VBi‴) on BiOCl assembled from 3-6 nm nanosheets but only VBi‴ VO•• VBi‴ vacancy associates on BiOCl assembled from thicker (10-20 nm) nanosheets. Comparison of vacancy properties with 2D ultrathin 2.7 nm nanosheets (with VBi‴ VO•• VBi‴ and VBi‴) indicates that nanosheet thinness alone cannot explain the formation of such large atom vacancies. On the basis of density functional theory computations of formation energy of isolated Bi vacancy, we show that mesopores facilitate the formation of large vacancies to counterbalance thermodynamic instability caused by incompletely coordinated Bi and O atoms along the mesopore perimeters. We corroborate that the extraordinarily large VBi‴ VO•• VBi‴ VO•• VBi‴ vacancy associates facilitate photoexcitation of electrons and prevent the recombination of electron-hole pairs, which significantly enhances photocatalytic activity. This is demonstrated by the rapid mineralization of bisphenol A (10-5 M) with low photocatalyst loading (1 g L-1), as well as enhanced bacterial disinfection. Improved electron-hole separation is also corroborated by enhanced photocatalytic reduction of nitrate.

Synthesis of a novel adamantyl nitroxide derivative with potent anti-hepatoma activity in vitro and in vivo.

In this study, a novel adamantyl nitroxide derivative was synthesized and its antitumor activities in vitro and in vivo were investigated. The adamantyl nitroxide derivative 4 displayed a potent anticancer activity against all the tested human hepatoma cells, especially with IC50 of 68.1 µM in Bel-7404 cells, compared to the positive control 5-FU (IC50=607.7 µM). The significant inhibition of cell growth was also observed in xenograft mouse model, with low toxicity. Compound 4 suppressed the cell migration and invasion, induced the G2/M phase arrest. Further mechanistic studies revealed that compound 4 induced cell death, which was accompanied with damaging mitochondria, increasing the generation of intracellular reactive oxygen species, cleavages of caspase-9 and caspase-3, as well as activations of Bax and Bcl-2. These results confirmed that adamantyl nitroxide derivative exhibited selective antitumor activities via mitochondrial apoptosis pathway in Bel-7404 cells, and would be a potential anticancer agent for liver cancer.

DRUGS System Improving the Effects of Clinical Pathways: A Systematic Study.

The aim of the study is to assess the feasibility of Drugs Rational Usage Guideline System (DRUGS)-supported clinical pathway (CP) for breast carcinoma, cataract, inguinal hernia and 2-diabetes mellitus whether the application of such a system could improve work efficiency, medical safety, and decrease hospital cost. Four kinds of diseases which included 1773 cases (where 901 cases using paper-based clinical pathways and 872 cases using DRUGS-supported clinical pathways) were selected and their demographic and clinical data were collected. The evaluation criteria were length of stay, preoperative length of stay, hospital cost, antibiotics prescribed during hospitalization, unscheduled surgery, complications and prognosis. The median total LOS was 1 to 3 days shorter in the DRUGS-supported CP group as compared to the Paper-based CP group for all types (p < 0.05). Totel hospital cost decreased significantly in the DRUGS-supported CP group than that in Paper-based CP group. About antibiotics prescribed during hospitalization, there were no statistically differences in the time of initial dose of antibiotic and the duration of administration except the choice of antibiotic categories. The proportion of DRUGS-supported clinical pathway conditions where a broad-spectrum antibiotic was prescribed decreased from 63.6 to 34.5 % (p < 0.01) in the Paper-based group. While after the intervention, the differences were statistically not significant in unscheduled surgery, complications and prognosis. In this study, DRUGS-supported clinical pathway for breast carcinoma, cataract, inguinal hernia, 2-diabetes mellitus was smoothly shifted from a paper-based to an electronic system, and confer benefits at the hospital level.

Reduced graphene oxide-supported TiO2 fiber bundles with mesostructures as anode materials for lithium-ion batteries.

Although the synthesis of mesoporous materials is well established, the preparation of TiO2 fiber bundles with mesostructures, highly crystalline walls, and good thermal stability on the RGO nanosheets remains a challenge. Herein, a low-cost and environmentally friendly hydrothermal route for the synthesis of RGO nanosheet-supported anatase TiO2 fiber bundles with dense mesostructures is used. These mesostructured TiO2 -RGO materials are used for investigation of Li-ion insertion properties, which show a reversible capacity of 235 mA h g(-1) at 200 mA g(-1) and 150 mA h g(-1) at 1000 mA g(-1) after 1000 cycles. The higher specific surface area of the new mesostructures and high conductive substrate (RGO nanosheets) result in excellent lithium storage performance, high-rate performance, and strong cycling stability of the TiO2 -RGO composites.

Expression of markers of endoplasmic reticulum stress-induced apoptosis in the placenta of women with early and late onset severe pre-eclampsia.

OBJECTIVES: Endoplasmic reticulum (ER) stress-induced apoptosis has been implicated in severe pre-eclampsia (SPE) and is characterized by the activation of three signaling pathways: PKR-like endoplasmic reticulum kinase (PERK), activating transcription factor 6 (ATF6), and inositol-requiring 1 (Ire1). This study was designed to investigate the role of ER stress in the pathogenesis of SPE. MATERIALS AND METHODS: Placental tissues were collected from 32 women with normal pregnancies and two cohorts of women with early (n = 32) or late onset (n = 32) SPE. The expression of glucose-regulated protein 78 (GRP78), PERK, eukaryotic initiation factor 2 subunit a (eIF2α), activating transcription factor 6 (ATF4), ATF6, Ire1, CHOP (ClEBP homologus protein), and caspase 12 mRNA and protein in the placentas was analyzed using real-time reverse transcription-polymerase chain reaction and Western blotting, respectively. RESULTS: The levels of GRP78, PERK, eIF2α, CHOP, ATF6, and caspase 12 mRNA and protein expression were significantly higher in the placentas of women with early and late SPE than in the control women, whereas there were no differences in ATF6 and Ire1 mRNA and protein. CONCLUSION: ER stress-induced apoptosis was important in the development of SPE, especially in early onset SPE and was probably due to the activation of the PERK signaling pathway.

Protective effects of Lycium barbarum polysaccharide on 6-OHDA-induced apoptosis in PC12 cells through the ROS-NO pathway.

Oxidative stress plays an important role in Parkinson's disease and other neurodegenerative disorders. Lycium barbarum polysaccharides (LBP), the main active ingredients extracted from the fruits of Lycium barbarum L., have been shown to be a potent antioxidant. In the present study, we investigated the protective effects, and the possible mechanism of action of LBP against 6-hydroxydopamine (6-OHDA)-induced apoptosis in PC12 cells. Our data demonstrated that LBP significantly reversed the 6-OHDA-induced decrease in cell viability, prevented 6-OHDA-induced changes in condensed nuclei and decreased the percentage of apoptotic cells in a dose-dependent manner. Furthermore, LBP also slowed the accumulation of reactive oxygen species (ROS) and nitric oxide (NO), decreased the level of protein-bound 3-nitrotyrosine (3-NT) and intracellular free Ca2+, and inhibiting the overexpression of nuclear factor κB (NF-κB), neuronal nitric oxide synthase (nNOS) and inducible nitric oxide synthase (iNOS). These results demonstrate that LBP prevents 6-OHDA-induced apoptosis in PC12 cells, at least in part through the ROS-NO pathway.

High performance liquid chromatographic method for the determination of cinepazide maleate and its application to a pharmacokinetic study in rats.

A simple and reliable high performance liquid chromatographic (HPLC) method has been developed and validated to quantify cinepazide maleate, a calcium blocker, in rat plasma. Cinepazide maleate and Tinidazole (internal standard) have been extracted by a simple liquid-liquid extraction before injection into chromatographic system. Chromatographic separation was achieved on a reversed phase C18 column with a mobile phase consisted of a water mixture of 10mM potassium dihydrogen phosphate (pH=4.5):methanol (40:60, v/v), pumped at flow rate of 1.0mL/min, and detected at 303nm. The method exhibited a linear range of 0.12-120µg/mL in blank rat plasma, with the lower detection limit of 0.06µg/mL. The method was statistically validated for linearity, accuracy, precision, selectivity and stability following FDA guidelines. The intra- and inter-assay coefficients of variation did not exceed ±15% from the nominal concentration. The accuracy of cinepazide maleate was within ±15% of the theoretical value. The assay has been applied successfully in a pharmacokinetic study of cinepazide maleate after a single intravenous at three doses in rat. And cinepazide maleate injection can improve the bioavailability of cinepazide maleate greatly, and has a dose-dependence profile in rats.

A highly selective colorimetric chemodosimeter for fast and quantitative detection of hydrogen sulfide.

Based on the fact that hydrogen sulfide (H(2)S) possesses the smallest steric hindrance among thiols and the SH(-) group adds faster to an electron-poor C=C double bond, we designed and synthesized a tricyanoethylene-derived colorimetric chemodosimeter 1 for the fast and highly selective assay of H(2)S. Chemodosimeter 1 exhibited excellent water-solubility due to the introduction of two hydrophilic hydroxyl groups. Upon the addition of Na(2)S, chemodosimeter 1 showed a fast (complete within 400 s) and robust decrease of the absorption intensity (>97%), accompanied by a color change from red to colorless. Additionally, a linear relationship between absorption intensity and the added Na(2)S concentrations (0-130 µM) was observed in aqueous buffer solution (pH 7.4, 20 mM PBS). Importantly, the proposed paradigm in this paper, adoption of the tricyanoethylene derivative as a recognition receptor to distinguish H(2)S from other thiols and analytes, provides a promising methodology for the design of colorimetric and fluorescent chemodosimeters for fast determination of H(2)S.

The influence of gravity on the precise measurement of solute diffusion coefficients in dilute liquid metals and metalloids.

It is now well known that the diffusion coefficient (D) measured in a laboratory in low earth orbit (LEO) is less than the corresponding value measured in a terrestrial laboratory. However, all LEO laboratories are subject to transient accelerations (g-jitter) superimposed on the steady reduced gravity environment of the space platform. In measurements of the diffusion coefficients for dilute binary alloys of Pb-(Ag, Au,Sb), Sb-(Ga,In), Bi-(Ag,Au,Sb), Sn-(Au,Sb), Al-(Fe, Ni,Si), and In-Sb in which g-jitter was suppressed, it was found that D proportional to T (temperature) if g-jitter was suppressed, rather than D proportional to T(2) as observed by earlier workers with g-jitter present. Furthermore, when a forced g-jitter was applied to a diffusion couple, the value measured for D increased. The significance of these results is reviewed in the light of recent work in which ab initio molecular dynamics simulations predicted a D proportional to T relationship.