Triglyceride-glucose index predicts postoperative delirium in elderly patients with type 2 diabetes mellitus: a retrospective cohort study.

BACKGROUND: Postoperative delirium (POD) is more prevalent among elderly patients with type 2 diabetes mellitus (T2DM). Insulin resistance (IR) can be assessed using the triglyceride-glucose (TyG) index, a novel biomarker. This study aims to investigate the predictive potential of the TyG index for POD in elderly patients with T2DM. MATERIALS AND METHODS: Elderly patients (≥ 65) with T2DM who underwent non-neurosurgery and non-cardiac surgery were enrolled. Univariate and multivariate logistic regression analyses were conducted to assess the association between the TyG index and POD. Additionally, subgroup analyses were performed to compare the sex-specific differences in the predictive ability of the TyG index for POD. RESULTS: A total of 4566 patients were included in this retrospective cohort. The receiver operating characteristic (ROC) curve analysis determined the optimal cut-off value for the TyG index to be 8.678. In the univariate model, a TyG index > 8.678 exhibited an odds ratio (OR) of 1.668 (95% CI: 1.210-2.324, P = 0.002) for predicting POD. In the multivariate regression models, the ORs were 1.590 (95% CI: 1.133-2.252, P < 0.008), 1.661 (95% CI: 1.199-2.325, P < 0.003), and 1.603 (95% CI: 1.137-2.283, P = 0.008) for different models. Subgroup analyses demonstrated that the predictive ability of the TyG index was more pronounced in females compared to males. CONCLUSION: The TyG index shows promise as a novel biomarker for predicting the occurrence of POD in elderly surgical patients with T2DM.

TET1 is a Diagnostic and Prognostic Biomarker Associated with Immune Infiltration in Papillary Thyroid Cancer.

To investigate the function of ten-eleven translocation 1 (TET1) and its underlying mechanism in papillary thyroid cancer (PTC). Using the RNA-Seq data based on GDC TCGA, we analyzed the gene expression pattern of TET1 in PTC. Immunohistochemistry was carried out to assess the TET1 protein level. Then, its diagnostic and prognostic functions were determined by various bioinformatics approaches. Enrichment analysis was performed to explore the potential pathways in which TET1 is mainly involved. Finally, the immune cell infiltration analysis was conducted and the association of TET1 mRNA expression with the expression levels of immune checkpoints, tumor mutation burden (TMB) score, microsatellite instability (MSI) score, and cancer stem cells (CSC) score was examined. TET1 expression was lower in PTC tissues compared with that in normal tissues (P < 0.01). Besides, TET1 had a certain value in diagnosing PTC, and low-TET1 mRNA expression led to favorable disease-specific survival (DSS) (P < 0.01). The enrichment analysis revealed autoimmune thyroid disease and cytokine-cytokine receptor interaction were the consistent pathways in which TET1 participated. TET1 was negatively correlated with the Stromal score and Immune score. The different proportions of immune cell subtypes were observed between high- and low-TET1 expression groups. Interestingly, TET1 mRNA expression was inversely related to the expression levels of immune checkpoints, and TMB, MSI, and CSC scores. TET1 might be a robust diagnostic and prognostic biomarker for PTC. TET1 affected the DSS of PTC patients possibly through the regulation of immune-related pathways and tumor immunity.

Association of sleep quality on the night of operative day with postoperative delirium in elderly patients: A prospective cohort study.

BACKGROUND: Sleep disturbances in the peri-operative period have been associated with adverse outcomes, including postoperative delirium (POD). However, research on sleep quality during the immediate postoperative period is limited. OBJECTIVES: This study aimed to investigate the association between sleep quality on the night of the operative day assessed using the Sleep Quality Numeric Rating Scale (SQ-NRS), and the incidence of POD in a large cohort of surgical patients. DESIGN: A prospective cohort study. SETTING: A tertiary hospital in China. PATIENTS: This study enrolled patients aged 65 years or older undergoing elective surgery under general anaesthesia. The participants were categorised into the sleep disturbance and no sleep disturbance groups according to their operative night SQ-NRS. MAIN OUTCOME MEASURES: The primary outcome was delirium incidence, whereas the secondary outcomes included acute kidney injury, stroke, pulmonary infection, cardiovascular complications and all-cause mortality within 1 year postoperatively. RESULTS: In total, 3072 patients were included in the analysis of this study. Among them, 791 (25.72%) experienced sleep disturbances on the night of operative day. Patients in the sleep disturbance group had a significantly higher risk of developing POD (adjusted OR 1.43, 95% CI 1.11 to 1.82, P  = 0.005). Subgroup analysis revealed that age 65-75 years; male sex; ASA III and IV; haemoglobin more than 12 g l -1 ; intra-operative hypotension; surgical duration more than 120 min; and education 9 years or less were significantly associated with POD. No interaction was observed between the subgroups. No significant differences were observed in the secondary outcomes, such as acute kidney injury, stroke, pulmonary infection, cardiovascular complications and all-cause mortality within 1 year postoperatively. CONCLUSIONS: The poor subjective sleep quality on the night of operative day was independently associated with increased POD risk, especially in certain subpopulations. Optimising peri-operative sleep may reduce POD. Further research should investigate potential mechanisms and causal relationships. TRIAL REGISTRY: chictr.org.cn: ChiCTR1900028545.

Individualised positive end-expiratory pressure titrated intra-operatively by electrical impedance tomography optimises pulmonary mechanics and reduces postoperative atelectasis: A randomised controlled trial.

BACKGROUND: A protective intra-operative lung ventilation strategy has been widely recommended for laparoscopic surgery. However, there is no consensus regarding the optimal level of positive end-expiratory pressure (PEEP) and its effects during pneumoperitoneum. Electrical impedance tomography (EIT) has recently been introduced as a bedside tool to monitor lung ventilation in real-time. OBJECTIVE: We hypothesised that individually titrated EIT-PEEP adjusted to the surgical intervention would improve respiratory mechanics during and after surgery. DESIGN: Randomised controlled trial. SETTING: First Medical Centre of Chinese PLA General Hospital, Beijing. PATIENTS: Seventy-five patients undergoing robotic-assisted laparoscopic hepatobiliary and pancreatic surgery under general anaesthesia. INTERVENTIONS: Patients were randomly assigned 2 : 1 to individualised EIT-titrated PEEP (PEEPEIT; n = 50) or traditional PEEP 5 cmH2O (PEEP5 cmH2O; n = 25). The PEEPEIT group received individually titrated EIT-PEEP during pneumoperitoneum. The PEEP5 cmH2O group received PEEP of 5 cmH2O during pneumoperitoneum. MAIN OUTCOME MEASURES: The primary outcome was respiratory system compliance during laparoscopic surgery. Secondary outcomes were individualised PEEP levels, oxygenation, respiratory and haemodynamic status, and occurrence of postoperative pulmonary complications (PPCs) within 7 days. RESULTS: Compared with PEEP5 cmH2O, patients who received PEEPEIT had higher respiratory system compliance (mean values during surgery of 44.3 ±â€Š11.3 vs. 31.9 ±â€Š6.6, ml cmH2O-1; P < 0.001), lower driving pressure (11.5 ±â€Š2.1 vs. 14.0 ±â€Š2.4 cmH2O; P < 0.001), better oxygenation (mean PaO2/FiO2 427.5 ±â€Š28.6 vs. 366.8 ±â€Š36.4; P = 0.003), and less postoperative atelectasis (19.4 ±â€Š1.6 vs. 46.3 ±â€Š14.8 g of lung tissue mass; P = 0.003). Haemodynamic values did not differ significantly between the groups. No adverse effects were observed during surgery. CONCLUSION: Individualised PEEP by EIT may improve intra-operative pulmonary mechanics and oxygenation without impairing haemodynamic stability, and decrease postoperative atelectasis. TRIAL REGISTRATION: Chinese Clinical Trial Registry (www.chictr.org.cn) identifier: ChiCTR2100045166.

Analysis of synonymous codon usage pattern of genes in unique non-blood-sucking leech Whitmania pigra.

Whitmania pigra is a unique, fluid-sucking ectoparasite and an anticoagulant medical leech. The codon usage bias (CUB) is the nonuniform usage of synonymous codons in which some codons are more preferred than others. Here, we performed a comprehensive analysis of CUB of genes in W. pigra, analyzing 140 780 transcripts, 59 553 unigenes, and 20 304 qualified coding sequences (CDSs) from the transcriptomic data of W. pigra. The effective number of codons values suggested that the CUB was low in these genes. We recognized profoundly favored codons in W. pigra that have a G/C-ending. Parity rule two-bias plots suggested that both mutation pressure and natural selection might have influenced the CUB. However, neutrality plots revealed that natural selection might have played a major role while mutation pressure might have played a minor role in shaping the CUB. We applied principal component analysis to relative synonymous codon usage values for divided CDSs based on GC content and codon-ending bases. Codon usage in W. pigra had a general inclination toward C-ending codons and natural selection rather than mutation pressure is the dominant force in the genetic evolution of W. pigra. To our knowledge, this is the first study to describe a complete codon usage analysis of W. pigra; this will increase the understanding of CUB and evolution in W. pigra. The analysis of codon usage patterns in W. pigra aids in understanding its evolution and genetic architecture.

Analysis of codon usage patterns in Hirudinaria manillensis reveals a preference for GC-ending codons caused by dominant selection constraints.

BACKGROUND: Hirudinaria manillensis is an ephemeral, blood-sucking ectoparasite, possessing anticoagulant capacities with potential medical applications. Analysis of codon usage patterns would contribute to our understanding of the evolutionary mechanisms and genetic architecture of H. manillensis, which in turn would provide insight into the characteristics of other leeches. We analysed codon usage and related indices using 18,000 coding sequences (CDSs) retrieved from H. manillensis RNA-Seq data. RESULTS: We identified four highly preferred codons in H. manillensis that have G/C-endings. Points generated in an effective number of codons (ENC) plot distributed below the standard curve and the slope of a neutrality plot was less than 1. Highly expressed CDSs had lower ENC content and higher GC content than weakly expressed CDSs. Principal component analysis conducted on relative synonymous codon usage (RSCU) values divided CDSs according to GC content and divided codons according to ending bases. Moreover, by determining codon usage, we found that the majority of blood-diet related genes have undergone less adaptive evolution in H. manillensis, except for those with homologous sequences in the host species. CONCLUSIONS: Codon usage in H. manillensis had an overall preference toward C-endings and indicated that codon usage patterns are mediated by differential expression, GC content, and biological function. Although mutation pressure effects were also notable, the majority of genetic evolution in H. manillensis was driven by natural selection.

A trophic cascade induced by predatory ants in a fig-fig wasp mutualism.

A trophic cascade occurs when predators directly decrease the densities, or change the behaviour, of herbivores and thus indirectly increase plant productivity. The predator-herbivore-plant context is well known, but some predators attack species beneficial to plants (e.g. pollinators) and/or enemies of herbivores (e.g. parasites), and their role in the dynamics of mutualisms remains largely unexplored. We surveyed the predatory ant species and studied predation by the dominant ant species, the weaver ant Oecophylla smaragdina, associated with the fig tree Ficus racemosa in southwest China. We then tested the effects of weaver ants on the oviposition behaviour of pollinating and non-pollinating fig wasps in an ant-exclusion experiment. The effects of weaver ants on fig wasp community structure and fig seed production were then compared between trees with and without O. smaragdina. Oecophylla smaragdina captured more non-pollinating wasps (Platyneura mayri) than pollinators as the insects arrived to lay eggs. When ants were excluded, more non-pollinators laid eggs into figs and fewer pollinators entered figs. Furthermore, trees with O. smaragdina produced more pollinator offspring and fewer non-pollinator offspring, shifting the community structure significantly. In addition, F. racemosa produced significantly more seeds on trees inhabited by weaver ants. Oecophylla smaragdina predation reverses the dominance of the two commonest wasp species at the egg-laying stage and favours the pollinators. This behavioural pattern is mirrored by wasp offspring production, with pollinators' offspring dominating figs produced by trees inhabited by weaver ants, and offspring of the non-pollinator P. mayri most abundant in figs on trees inhabited by other ants. Overall, our results suggest that predation by weaver ants limits the success of the non-pollinating P. mayri and therefore indirectly benefits the mutualism by increasing the reproductive success of both the pollinators and the plant. Predation is thus a key functional factor that can shape the community structure of a pollinator-plant mutualistic system.

A Chromosome-Level Genome Assembly and Annotation for the Oecanthus rufescens (Orthoptera: Oecanthidae).

Oecanthus is a genus of cricket known for its distinctive chirping and distributed across major zoogeographical regions worldwide. This study focuses on Oecanthus rufescens, and conducts a comprehensive examination of its genome through genome sequencing technologies and bioinformatic analysis. A high-quality chromosome-level genome of O. rufescens was successfully obtained, revealing significant features of its genome structure. The genome size is 877.9 Mb, comprising 10 pseudo-chromosomes and 70 other sequences, with a GC content of 41.38% and an N50 value of 157,110,771 bp, indicating a high level of continuity. BUSCO assessment results demonstrate the genome's integrity and quality are high (of which 96.8% are single-copy and 1.6% are duplicated). Comprehensive genome annotation was also performed, identifying approximately 310 Mb of repetitive sequences, accounting for 35.3% of the total genome sequence, and discovering 15,481 tRNA genes, 4,082 rRNA genes, and 1,212 other non-coding genes. Furthermore, 15,031 protein-coding genes were identified, with BUSCO assessment results showing that 98.4% (of which 96.3% are single-copy and 1.6% are duplicated) of the genes were annotated.

Progress in research on ablation of thyroid nodules.

The incidence of thyroid nodules is rising annually. Surgical treatment is effective, but often results in significant trauma, recurrent laryngeal nerve injury, hypoparathyroidism, and other complications. Recent years have seen significant breakthroughs in thyroid nodule ablation for treating thyroid diseases, although its application remains controversial. The objective was to review the development history and current research status of thyroid nodule ablation to provide a reference for future studies. The literature on thyroid nodule ablation was reviewed, analysing its advantages and disadvantages. The therapeutic effect of thyroid nodule ablation in treating benign thyroid lesions is noteworthy, but issues such as lax treatment indications and excessive medical treatment persist. Initial success has been achieved in treating thyroid malignant lesions, particularly papillary thyroid microcarcinoma (PTMC). However, the curative effect requires further follow-up verification.

Risk factors prediction of 6-month mortality after noncardiac surgery of older patients in China: a multicentre retrospective cohort study.

BACKGROUND: Identifying the risk factors associated with perioperative mortality is crucial, particularly in older patients. Predicting 6-month mortality risk in older patients based on large datasets can assist patients and surgeons in perioperative clinical decision-making. This study aimed to develop a risk prediction model of mortality within 6 months after noncardiac surgery using the clinical data from 11 894 older patients in China. MATERIALS AND METHODS: A multicentre, retrospective cohort study was conducted in 20 tertiary hospitals. The authors retrospectively included 11 894 patients (aged ≥65 years) who underwent noncardiac surgery between April 2020 and April 2022. The least absolute shrinkage and selection operator model based on linear regression was used to analyse and select risk factors, and various machine learning methods were used to build predictive models of 6-month mortality. RESULTS: The authors predicted 12 preoperative risk factors associated with 6-month mortality in older patients after noncardiac surgery. Including laboratory-associated risk factors such as mononuclear cell ratio and total blood cholesterol level, etc. Also including medical history associated risk factors such as stroke, history of chronic diseases, etc. By using a random forest model, the authors constructed a predictive model with a satisfactory accuracy (area under the receiver operating characteristic curve=0.97). CONCLUSION: The authors identified 12 preoperative risk factors associated with 6-month mortality in noncardiac surgery older patients. These preoperative risk factors may provide evidence for a comprehensive preoperative anaesthesia assessment as well as necessary information for clinical decision-making by anaesthesiologists.

Polionemobius gyirongensis sp. nov. from Tibet, China, and the identification of the species Polionemobius ebony Wu & Ma, 2022 and its close relative (Orthoptera: Trigonidiidae; Nemobiinae).

A new species, Polionemobius gyirongensis Ma & Wang, sp. nov., is reported from Tibet, China. Its appearance is similar to that of Polionemobius yunnanus Liu & Shi, 2014, with a small-sized body and oval notch on both sides of the pronotum. Description and illustrations for the new species are provided here. At the same time, we compared Polionemobius ebony Wu & Ma, 2022 and Pteronemobius nigriscens (Shiraki, 1911) and determined that they are different species.

Redescription of two species of Capillogryllus Xie, Zheng & Liang, 2003, with a new species from China (Orthoptera: Gryllidae; Gryllinae).

The species with a strongly pubescent body with the genus name Capillogryllus by Xie, Zheng, and Liang in 2003 are reviewed. Capillogryllus has presently two species, Capillogryllus exilipalpis Xie & Zheng, 2003 (type specimen is a female), and Capillogryllus dolabripalpis Xie & Zheng, 2003 (type species), both of which are only known from China at this time. In Gyirong County, Tibet, we discovered a new species of this genus that is distinct from the two species mentioned above. Here, three species of Capillogryllus are described and illustrated.

Redescription of two species and a new distribution record for China of the genus MelanogryllusChopard, 1961 and a report of one new species of the genus Velarifictorus Randell, 1964 (Orthoptera: Gryllidae; Gryllinae).

Dark body color is very common among crickets, and this article discusses four species of black field crickets with distinct distributions. There are three species of the genus Melanogryllus Chopard, 1961 and one species of the genus Velarifictorus Randell, 1964. Of them, Melanogryllus chopardi Bey-Bienko, 1968 was discovered in Southwest Xizang, on the border between China and Nepal; Melanogryllus desertus (Pallas, 1771) was primarily found in arid regions of northwestern China; Melanogryllus bilineatus Yang & Yang, 1994 was often collected from the Southeast China coastal region; and the last species, Velarifictorus yuanilandrevus sp. nov., is a new species that was collected in Yunnan, a province in Southwest China. In addition, the new species could be distinguished from the others by its black body coloration and the absence of yellow stripes on the head. Here, we describe these species in detail, with photographs of the genitalia, and provide a distribution map for them and keys for Chinese Melanogryllus species.

Ultrastructural observation of digestive tract and the adaptative characteristics of dietary habits for ground-dwelling and omnivorous insects.

The digestive tract of insects from mouth to anus is the crop, proventriculus, gastric caecum, midgut, ileum, colon and rectum, and the Malpighian tubules attached to the ileum belong to the excretory organs. As the main organs for digesting food and absorbing nutrients, the structure of the insect digestive tract is inevitably adapted to feeding habits. Among the Orthoptera, the digestive tracts of phytophagous locusts and carnivorous katydids have been studied for their adaptations to their food habits, while the adaptations of the digestive tracts of omnivorous insects have been less studied. In order to systematically study the adaptations of the digestive tracts of ground-nesting omnivorous insects to their feeding habits, this study was carried out with Loxoblemmus taicoun Saussure, 1877, Teleogryllus emma (Ohmachi & Matsuura, 1951), and Velarifictorus micado (Saussure, 1877). Through the use of a scanning electron microscope (SEM) and a VHX digital microscope, the digestive tract structures of these three most widespread and common omnivorous crickets in China were examined in order to better understand how omnivorous insects digestive tract structures differ from those of specialists. When we compared the morphological features of these crickets digestive tracts to those of phytophagous and carnivorous insects, we discovered six adaptive traits of omnivorous insects, including: (1) they have a shorter foregut and longer midgut and hindgut; (2) they have a well-developed muscular intestinal wall; (3) the spines in the inner wall of their crop are uniformly arranged and less chitinized; (4) the proventriculus is sclerotized and spherical, and the inner wall is accompanied by ossified large teeth; (5) they have well-developed cilia at the base of the crop and at the base of the ossified denticles; (6) they have only two lobulated gastric caeca. The study summarizes six characteristics of the digestive tract of omnivorous crickets that are compatible with their food habits, providing evidence and clues for further research on the relationship between the digestive tract and food habits in Orthoptera.

A new genus and a new species of Trigonidiidae (Orthoptera: Grylloidea) from north Myanmar amber.

We present the description of a new genus and new species of Trigonidiidae, Qiongqi crinalis gen. et sp. nov., found in amber deposits at Noije Bum, near Tanai in the Hukawng Valley of northern Myanmar. Its lateralized eyes, short clypeus, exposed mandible, and extremely dense setae entirely covering the body, provides us with new knowledge on the morphology of Trigonidiidae. Additionally, a key to species of fossil Trigonidiidae in amber was provided.

A morphological study of the ovipositor of the genus Capillogryllus Xie, Zheng & Liang, 2003 with a new species of the genus from China (Orthoptera: Gryllidae; Gryllinae).

The genus Capillogryllus includes three species, Capillogryllus dolabripalpis Xie & Zheng, 2003, Capillogryllus exilipalpis Xie & Zheng, 2003, Capillogryllus spinae Wu & Ma, 2023. Recently, we found a new species of this genus in Yadong County, Xizang Autonomous Region, and described it here. In addition, we found that the ovipositor varies greatly within this taxon, so we compare and characterize their ovipositor and discuss the feasibility of using the ovipositor alone to identify them. We also provide two keys based on the genitalia of males and females.

Ornebius exserolimbus Wang & Ma, sp. nov., a new species of Ornebius (Orthoptera: Mogoplistidae; Mogoplistinae) from China.

The Mogoplistidae genus Ornebius contains eight species groups and 124 species worldwide, with 14 species recorded from China. Here, we find a new species belonging to the species group alii Bhowmik, 1970 from Yunnan Province, China. The new species, Ornebius exserolimbus sp. nov., is distinct by bearing a protrusion on the anterior margin of the pronotum. This feature was first discovered in scale crickets and it might be related to some special locomotion function of crickets. Besides describing and illustrating the new species, we provide keys for Chinese Ornebius species in this article.

Redescription of both Goniogryllus bistriatus Wu & Wang, 1992 and Callogryllus yunnanus Wu & Zheng, 1992 (Orthoptera: Gryllidae, Gryllinae).

Goniogryllus bistriatus Wu & Wang, 1992 was described at the end of the last century, based on the female holotype, and there have been no further studies or reports related to this species since then. Callogryllus yunnanus Wu & Zheng, 1992 also has a similar situation. Although the holotype is a male, its external genitalia have been lost. These issues pose obstacles to subsequent taxonomic research. Recently, we have successively discovered these two species in Huize County, Yunnan Province, China. To address the aforementioned taxonomic problems, this article describes the male specimens of the G. bistriatus and redescribes the female; meanwhile, since the original description of C. yunnanus lacked male genital characteristics, and we have also conducted a complete redescription of this species based on the new specimen.