Short-term perioperative cognitive therapy combined with rehabilitation exercise reduces the incidence of neurocognitive disorder in elderly patients: a randomized controlled trial.

BACKGROUND: To investigate whether short-term perioperative cognitive therapy combined with rehabilitation exercise decreases the incidence of neurocognitive disorder (NCD) in elderly patients who have undergone hip joint replacement surgery. This was a randomized, parallel controlled trial on elderly patients who underwent unilateral total hip joint replacement surgery at the Third Xiangya Hospital of Central South University. METHODS: Patients in the perioperative cognitive therapy combined with rehabilitation exercise group underwent preoperative cognitive training and postoperative cognitive training, rehabilitation exercise, and standardized health care services; the control group received only postoperative standardized health care service. Patients with NCD were defined as those with two or more abnormalities on 11 neuropsychological tests. Of the 607 individuals that we screened, 86 (exercise, 50; control, 36) who completed the study were included. RESULTS: The baseline characteristics were similar for the two groups. The incidence of NCD in the exercise group (10%, 5/50) was significantly lower than that in the control group (27.8%, 10/36) (P=0.032). The HVLT-R, HVLT-R delayed recall test, and HVLT-R recognition discriminating index were significantly improved in the exercise group compared with the control group (all P<0.05). Our findings highlight the clinical significance of perioperative cognitive exercise combined with rehabilitation exercise in preventing NCD among patients after surgery and anesthesia. CONCLUSIONS: Our study indicates that perioperative cognitive therapy combined with rehabilitation exercise can effectively reduce the incidence of NCD in elderly patients after total hip joint replacement surgery.

Metabolism and Regulation of Ascorbic Acid in Fruits.

Ascorbic acid, also known as vitamin C, is a vital antioxidant widely found in plants. Plant fruits are rich in ascorbic acid and are the primary source of human intake of ascorbic acid. Ascorbic acid affects fruit ripening and stress resistance and plays an essential regulatory role in fruit development and postharvest storage. The ascorbic acid metabolic pathway in plants has been extensively studied. Ascorbic acid accumulation in fruits can be effectively regulated by genetic engineering technology. The accumulation of ascorbic acid in fruits is regulated by transcription factors, protein interactions, phytohormones, and environmental factors, but the research on the regulatory mechanism is still relatively weak. This paper systematically reviews the regulation mechanism of ascorbic acid metabolism in fruits in recent decades. It provides a rich theoretical basis for an in-depth study of the critical role of ascorbic acid in fruits and the cultivation of fruits rich in ascorbic acid.

The serum uric acid and related cardiovascular risk factors in south Taiwan.

Hyperuricemia has been shown to be related to cardiovascular morbidity and mortality. Uric acid is a metabolic product synthesized from nucleic acids, amino acids and the Krebs cycle, reflecting a multiple metabolic associations in humans. The relation between uric acid and various cardiovascular metabolic parameters in Asians has rarely been reported on. In this study, we report the relationship between uric acid and various cardiovascular risk factors in 1,027 healthy Taiwanese adults living in Alien, an agricultural town in subtropical South Taiwan. Serum uric acid levels increased in proportion to age in women, but not in men. There were age and gender-specific correlations between uric acid and various cardiovascular metabolic parameters. Triglycerides and creatinine levels were two independent factors predicting serum uric acid levels in men, while only creatinine predicted uric acid levels in women of all age groups. Processes that influence the metabolism of uric acid and its association with other metabolic parameters differs by gender and age.

Age of rats seriously affects the degree of retinal damage induced by acute high intraocular pressure.

PURPOSE: To investigate whether retinal impairment was affected by age of rats in acute glaucoma model. METHODS: Young adult and aged rats were randomly divided into normal control, 45 mmHg, 60 mmHg and 90 mmHg groups. Intraocular pressures (IOP) of rats were acutely elevated to 45 mmHg, 60 mmHg and 90 mmHg, respectively. Neuron loss in ganglion cell layer (GCL) and activation of retinal macrolgia and microglia 3 days after high IOP treatment were detected by immunofluorescence and further quantitatively analyzed. RESULTS: Compared with normal control, significant loss of neurons at GCL of young adult retina wasn't detected until IOP treatment of 90 mmHg. In contrast, obvious loss of neurons at GCL of aged retina was detected at IOP of 45 mmHg (p = 0.002 for central; p = 0.001 for peripheral). The loss level of neurons of aged retina was significantly higher than that of young adult retina at different IOP treatments. Compared with the young adult retina, high IOP induced more significant increase at area percentage of microglia and microglia number in inner part of aged retina. Activation of microglia and macroglia was either in parallel to or earlier than neuron loss of GCL of aged and young adult retina. CONCLUSION: Our data suggest there exists an age-related susceptibility of rat retina to the increased IOP. Therefore, the effect of ages should be considered at glaucoma study of rat models.

Aging differentially affects the loss of neuronal dendritic spine, neuroinflammation and memory impairment at rats after surgery.

It is known that age is an important factor for postoperative cognitive dysfunction (POCD) and the patients with POCD suffer from the impairment of multiple brain regions and multiple brain functions. However currently animal studies of POCD mainly focus on hippocampus region, therefore in this study we performed partial hepatectomy in young adult and aged rats to test the questions (1) whether POCD in animals involves other brain areas besides hippocampus; (2) how age influences POCD of young adult and aged animals. We found that (1) in young adult rats, the memory was not significantly affected (P>0.05) 1d, 3d and 7d after partial hepatectomy, but was significantly impaired (p<0.001) in aged rats 1d and 3d post-surgery; (2) in young adult rats, the surgery did not significantly affect the densities of dendritic spines of neurons at CA1, dentate gyrus (DG) and cingulate cortex (P>0.05, respectively) 1d and 3d post-surgery, but the spine densities at CA1 and DG of aged rats were significant reduced 1d and 3d post-surgery (p<0.001, respectively), however this didn't happen at cingulate cortex (P>0.05); (3) In young adult rats, surgery didn't affect the activation of microglia and levels of TNF-α and IL-1ß at hippocampus (P>0.05), but significantly activated microglia and increased levels of TNF-α and IL-1ß at hippocampus of aged rats (P<0.05). Our data suggest that (1) partial hepatectomy-induced POCD mainly involves hippocampus impairments, and (2) differential loss of neuronal dendritic spines and neuroinflammation at hippocampus are most likely the mechanism for the formation of POCD in aged rats.