Association of preoperative coronavirus disease 2019 with mortality, respiratory morbidity and extrapulmonary complications after elective, noncardiac surgery: An observational cohort study.

STUDY OBJECTIVE: To assess the impact of preoperative infection with the contemporary strain of severe acute respiratory coronavirus 2 (SARS-CoV-2) on postoperative mortality, respiratory morbidity and extrapulmonary complications after elective, noncardiac surgery. DESIGN: An ambidirectional observational cohort study. SETTING: A tertiary and teaching hospital in Shanghai, China. PATIENTS: All adult patients (≥ 18 years of age) who underwent elective, noncardiac surgery under general anesthesia at Huashan Hospital of Fudan University from January until March 2023 were screened for eligibility. A total of 2907 patients were included. EXPOSURE: Preoperative coronavirus disease 2019 (COVID-19) positivity. MEASUREMENTS: The primary outcome was 30-day postoperative mortality. The secondary outcomes included postoperative pulmonary complications (PPCs), myocardial injury after noncardiac surgery (MINS), acute kidney injury (AKI), postoperative delirium (POD) and postoperative sleep quality. Multivariable logistic regression was used to assess the risk of postoperative mortality and morbidity imposed by preoperative COVID-19. MAIN RESULTS: The risk of 30-day postoperative mortality was not associated with preoperative COVID-19 [adjusted odds ratio (aOR), 95% confidence interval (CI): 0.40, 0.13-1.28, P = 0.123] or operation timing relative to diagnosis. Preoperative COVID-19 did not increase the risk of PPCs (aOR, 95% CI: 0.99, 0.71-1.38, P = 0.944), MINS (aOR, 95% CI: 0.54, 0.22-1.30; P = 0.168), or AKI (aOR, 95% CI: 0.34, 0.10-1.09; P = 0.070) or affect postoperative sleep quality. Patients who underwent surgery within 7 weeks after COVID-19 had increased odds of developing delirium (aOR, 95% CI: 2.26, 1.05-4.86, P = 0.036). CONCLUSIONS: Preoperative COVID-19 or timing of surgery relative to diagnosis did not confer any added risk of 30-day postoperative mortality, PPCs, MINS or AKI. However, recent COVID-19 increased the risk of POD. Perioperative brain health should be considered during preoperative risk assessment for COVID-19 survivors.

A Case of Coenurosis in a Wild Rabbit (Lepus sinensis) Caused by Taenia serialis Metacestode in Qinghai Tibetan Plateau Area, China.

Six cystic metacestodes were found in the abdominal muscles of a wild rabbit, Lepus sinensis, in China. The coenurus contained one or more scolices armed with hooklets. Mitochondrial cox1 (1,623 bp) confirmed 98% homology with cox1 of Taenia serialis. This is the first report of T. serialis infection in an intermediate host in the Qinghai Tibetan Plateau Area, China.

Lasiopodomys fuscus as an important intermediate host for Echinococcus multilocularis: isolation and phylogenetic identification of the parasite.

BACKGROUND: Echinococcus multilocularis causes alveolar echinococcosis (AE) and is widely prevalent in Qinghai Province, China, where a number of different species have been identified as hosts. However, limited information is available on the Qinghai vole (Lasiopodomys fuscus), which is hyper endemic to Qinghai Province and may represent a potential intermediate host of E. multilocularis. Thus, L. fuscus could contribute to the endemicity of AE in the area. METHODS: Fifty Qinghai voles were captured from Jigzhi County in Qinghai Province for the clinical identification of E. multilocularis infection via anatomical examination. Hydatid fluid was collected from vesicles of the livers in suspected voles and subjected to a microscopic examination and PCR assay based on the barcoding gene of cox 1. PCR-amplified segments were sequenced for a phylogenetic analysis. E. multilocularis-infected Qinghai voles were morphologically identified and subjected to a phylogenetic analysis to confirm their identities. RESULTS: Seventeen of the 50 Qinghai voles had E. multilocularis-infection-like vesicles in their livers. Eleven out of the 17 Qinghai voles presented E. multilocularis infection, which was detected by PCR and sequencing. The phylogenetic analysis showed that all 11 positive samples belonged to the E. multilocularis Asian genotype. A morphological identification and phylogenetic analysis of the E. multilocularis-infected Qinghai voles confirmed that all captured animals were L. fuscus. CONCLUSIONS: L. fuscus can be infected with E. multilocularis and plays a potential role in the life cycle and epidemiology of E. multilocularis in the Qinghai-Tibetan Plateau of China.

Pre-treatment with a Xingnaojing preparation ameliorates sevoflurane-induced neuroapoptosis in the infant rat striatum.

Xingnaojing (XNJ), is a standardized Chinese herbal medicine product derived from An Gong Niu Huang Pill. It may be involved in neuroprotection in a number of neurological disorders. Exposure to anesthetic agents during the brain growth spurt may trigger widespread neuroapoptosis in the developing brain. Thus the present study aimed to identify whether there was a neuroprotective effect of XNJ on anesthesia­induced neuroapoptosis. Seven­day­old rats received treatment with 2.1% sevoflurane for 6 h. Rat pups were injected intraperitoneally with 1 or 10 ml/kg XNJ at 0.2, 24 and 48 h prior to sevoflurane exposure. The striata of neonatal rats were collected following administration of anesthesia. Western blotting and immunohistochemistry were used to analyze the expression of activated caspase 3, Bax and phosphorylated protein kinase B (p­AKT) in the striatum. It was found that activated caspase 3 and Bax expression were upregulated in the striatum following sevoflurane treatment. Preconditioning with XNJ attenuated the neuronal apoptosis induced by sevoflurane in a dose­dependent manner. Anesthesia reduced the expression of p­AKT (phosphorylated at sites Thr308 and Ser473) and phosphorylated extracellular­regulated protein kinase (p­ERK) in the striatum. Pre­treatment with XNJ reversed the reduction in p­AKT, but not p­ERK expression. These data suggest that XNJ has an antiapoptotic effect against sevoflurane­induced cell loss in the striatum. It thus holds promise as a safe and effective neuroprotective agent. The action of XNJ on p­AKT may make a significant contribution to its neuroprotective effect.

Chronic constriction injury induced long-term changes in spontaneous membrane-potential oscillations in anterior cingulate cortical neurons in vivo.

BACKGROUND: Neuropathic pain induction by nerve injury has been shown by in vitro studies to be accompanied by synaptic strengthening in the anterior cingulate cortex (ACC) and has been shown by pharmacological studies in vivo to be prevented by blocking N-methyl-D-aspartate (NMDA) receptor-dependent ACC plasticity. These findings indicate that ACC neurons undergo nerve injury-induced synaptic modifications and further raise a new question about neuropathic pain-associated changes in neuronal activity in the ACC in vivo, particularly spontaneous neuronal oscillations - a process believed to be fundamental for many forms of brain function. OBJECTIVE: In this study, we examined the change of spontaneous membrane-potential (MP) oscillations in the ACC in vivo in a neuropathic pain animal model of chronic constriction injury (CCI), which may account for neuropathic pain development, as well as pain hypersensitivity and spontaneous pain. STUDY DESIGN: Experimental trial in rats. METHODS: Neuropathic pain rats were produced by CCI surgery on the common sciatic nerve. Neuropathic pain-related behaviors were accessed by evoked responses to both mechanical and thermal stimuli, as well as spontaneous pain indicated by spontaneous foot lifting. In vivo whole-cell recording was performed in both control and neuropathic pain rats under anaesthesia. MP and action-potential (AP) changes of layer II/III ACC pyramidal cells were measured in current-clamp mode. The level of anaesthesia was evaluated by monitoring respiratory and heart rates in some experiments. RESULTS: Within 7 to 14 days after CCI surgery, the frequency of MP oscillations of ACC neurons was found to be significantly higher than that in control rats. Such an increase in oscillation frequency after surgery was not due to periphery transmission via the sciatic nerve subjected to CCI surgery and was indicated to be accounted for by neuronal modifications in the central nervous system. Furthermore, this increase was found to result in a higher overall level of MP excitation as well as an increase in spontaneous AP firing. LIMITATIONS: Our findings in MP and AP changes were obtained in anaesthetized brains; this issue remains to be further examined by using whole-cell recording in awake behaving animals. CONCLUSIONS: Neuropathic pain is accompanied by the increase in rates of spontaneous oscillations of ACC neurons. This change may be critical for neuropathic pain development, as well as pain hypersensitivity and spontaneous pain in neuropathic pain animals.

Helicobacter pylori promotes invasion and metastasis of gastric cancer cells through activation of AP-1 and up-regulation of CACUL1.

Infection with Helicobacter pylori is important in the development and progression of gastric cancer. However, the mechanisms that regulate this activation in gastric tumors remain elusive. CACUL1 has been cloned and identified as a novel gene that is expressed in many types of cancer and is involved in cell cycle regulation and tumor growth. The current study aimed to examine the expression of CACUL1 in gastric cancer samples and analyze its correlation with H. pylori infection. We found that CACUL1 was highly expressed in gastric cancer tissues and negatively correlated with gastric cancer differentiation and TNM stage. In addition, CACUL1 expression was high in H. pylori-infected tissues compared with H. pylori non-infected tissue. We found that H. pylori could up-regulate CACUL1 expression through activating protein 1. The up-regulation of CACUL1 expression could promote matrix metalloproteinase 9 and Slug expression to increase invasion and metastasis of tumor cells. These results suggested that H. pylori-triggered CACUL1 production occurred in an activating protein 1-dependent manner and regulated matrix metalloproteinase 9 and Slug expression to affect the invasion and metastasis of tumor cells. Therefore, CACUL1 is a potential therapeutic target for the treatment of aggressive gastric cancer.

Chemical composition and sensory evaluation of fermented tea with medicinal mushrooms.

In commercial tea production, plenty of tea leaf waste is generated, which may not only exert pollution risk to environment, but also a huge waste of bioactive ingredients in tea. In this study, the 4th to 7th leaves of tea bush were collected and used as substrate for mycelial culture of two renown medicinal mushrooms Grifola frondosa and Tianzhi (new variants of Ganoderma lucidum) to obtain a new type of solid-state fermented tea. Result showed that the polysaccharides of Grifola frondosa and Tianzhi fermented tea were 1.52 and 4.14 %, tea polyphenols were 1.51 and 1.85 %, the free amino acids were 1.52 and 0.94 %, caffeine were 1.16 and 1.70 %, polyphenols/amid acids ratio were 1.0 and 1.98, water extractions were 35.53 and 32.86 %, protein contents were 17.63 and 6.13 mg/g, respectively. The volatile components were mainly composed of alcohols, esters, aldehydes and ketones. The contents of major flavor compositions of fermented tea had changed and their relation tended to be harmonious, and the variety of amino acids significantly increased. Therefore, the sensory flavor and therapeutic qualities of fermented tea were significantly improved.