Preoperative Salivary Cortisol AM/PM Ratio Predicts Early Postoperative Cognitive Dysfunction After Noncardiac Surgery in Elderly Patients.

BACKGROUND: The diagnosis of postoperative cognitive dysfunction (POCD) requires complicated neuropsychological testing and is often delayed. Possible biomarkers for early detection or prediction are essential for the prevention and treatment of POCD. Preoperative screening of salivary cortisol levels may help to identify patients at elevated risk for POCD. METHODS: One hundred twenty patients >60 years of age and undergoing major noncardiac surgery underwent neuropsychological testing 1 day before and 1 week after surgery. Saliva samples were collected in the morning and the evening 1 day before surgery. POCD was defined as a Z-score of ≤-1.96 on at least 2 different tests. The primary outcome was the presence of POCD. The primary objective of this study was to assess the relationship between the ratio of AM (morning) to PM (evening) salivary cortisol levels and the presence of POCD. The secondary objective was to assess the relationship between POCD and salivary cortisol absolute values in the morning or in the evening. RESULTS: POCD was observed in 17.02% (16 of 94; 95% confidence interval [CI], 9.28%-24.76%) of patients 1 week after the operation. A higher preoperative AM/PM salivary cortisol ratio predicted early POCD onset (odds ratio [OR], 1.56; 95% CI, 1.20-2.02; P = .001), even after adjusting for the Mini-Mental Sate Examination score (odds ratio, 1.55; 95% CI, 1.19-2.02; P = .001). The area under the receiver operating characteristic curve for the salivary cortisol AM/PM ratio in individuals with POCD was 0.72 (95% CI, 0.56-0.88; P = .006). The optimal cutoff value was 5.69, with a sensitivity of 50% and specificity of 91%. CONCLUSIONS: The preoperative salivary cortisol AM/PM ratio was significantly associated with the presence of early POCD. This biomarker may have potential utility for screening patients for an increased risk and also for further elucidating the etiology of POCD.

Injectable thermosensitive chitosan/ß-glycerophosphate/collagen hydrogel maintains the plasticity of skeletal muscle satellite cells and supports their in vivo viability.

A cell carrier plays an important role in the maintenance, growth and engraftment of specific cells aimed for defined therapeutic uses in many tissue engineering strategies. A suitable microenvironment for the cells allows for the maximum efficacy of the hybrid device. We have prepared an injectable thermosensitive chitosan/ß-glycerophosphate/collagen (C/GP/Co) gel and investigated its potential application as a support for the culture of skeletal muscle satellite cells (SMSCs). A cell viability assay was used to evaluate the in vitro cytocompatibility of the gel. Cell growth was assessed by scanning electron microscopy (SEM), confocal laser scanning microscopy (CLSM) and histological analysis. The influence of the C/GP/Co gel on the plasticity of SMSCs seeded at the surface of the gel was assessed by induction of the myogenic, osteogenic and adipogenic differentiation. C/GP/Co gel provided the appropriate environment for the culture of SMSCs in vitro. In addition, the C/GP/Co gel supported SMSC plasticity. In vivo testing of the SMSC-seeded gel was investigated by subcutaneous injection into the dorsum of nude mice. Cell viability was assessed both by in vivo imaging and histological examination of the explants. In conclusion, C/GP/Co hydrogel is a cytocompatible carrier for the in vivo delivery of SMSCs and supportive for SMSC plasticity. Thus, this gel has potential applications in tissue engineering and regenerative medicine.

[Effects of injectable chitosan/ß-glycerol phosphate disodium/collagen scaffold on the growth and differentiation of myoblasts].

OBJECTIVE: To prepare injectable chitosan/ß-glycerol phosphate disodium/collagen scaffold and observe its effects upon the growth and differentiation of myoblasts. METHODS: After the preparations, 2 wt% chitosan (C) solution, 50 wt% ß-glycerol phosphate disodium (GP) solution and 2 mg/ml collagen (Co) solution were mixed on ice according to a volume ratio of 5:1:6 to yield a thermosensitive injectable scaffold. To assess the cytotoxicity of scaffold, the extraction fluids of different concentrations were added into the myoblast culture. Then relative growth rate (RGR) was calculated. The growth and differentiation state of myoblasts in routine culture or gel-coated plates were compared. Myoblasts were encapsulated in C/GP/Co solution before gelation to perform a 3-dimensional culture and then observed dynamically. RESULTS: No cytotoxicity was demonstrated. No significant difference of proliferation index was demonstrated (P > 0.05) but fusion index and size of myotube increased significantly (P < 0.05). Thriving viability and proliferation were verified by the observations of laser confocal scanning microscope and scanning electron microscope. CONCLUSION: C/GP/Co scaffold is a promising carrier for the culture and transplantation of myoblasts.

Surface-biofunctionalized multicore/shell CdTe@SiO(2) composite particles for immunofluorescence assay.

Strongly fluorescent multicore/shell structured CdTe@SiO(2) composite particles of ∼ 50 nm were synthesized via the reverse microemulsion method by using CdTe quantum dots co-stabilized by thioglycolic acid and thioglycerol. The optical stability of the CdTe@SiO(2) composite particles in a wide pH range, under prolonged UV irradiation in pure water, or in different types of physiological buffers was systematically investigated. Towards immunofluorescence assay, both poly(ethylene glycol) (PEG) and carboxyl residues were simultaneously grafted on the surface of the silanol-terminated CdTe@SiO(2) composite particles upon further reactions with silane reagents bearing a PEG segment and carboxyl group, respectively, in order to suppress the nonspecific interactions of the silica particles with proteins and meanwhile introduce reactive moieties to the fluorescent particles. Agarose gel electrophoresis, dynamic light scattering and conventional optical spectroscopy were combined to investigate the effectiveness of the surface modifications. Via the surface carboxyl residue, various antibodies were covalently conjugated to the fluorescent particles and the resultant fluorescent probes were used in detecting cancer cells through both direct fluorescent antibody and indirect fluorescent antibody assays, respectively.

Percutaneous sclerotherapy with polidocanol under the guidance of ultrasound for venous malformations in children - A retrospective cohort study from a single tertiary medical center.

This study reports our experience, the therapeutic outcomes and complications of percutaneous sclerotherapy (PS) with polidocanol to treat venous malformations (VMs) in children.A retrospective analysis was conducted of pediatric patients with VMs who underwent PS using polidocanol under continuous ultrasound (US) guidance between January 2015 and January 2018 at our department. Medical records were reviewed to record demographic information, lesion characteristics, treatment sessions, therapeutic outcomes and complications. χ analysis was employed to evaluate the effects of these characteristics on outcomes.Hundred treatment sessions were performed for lesions in 47 patients. The mean age of the patients was 4.1 ±â€Š3.6 years (mean ±â€ŠSD). The female to male ratio was almost 2:1 (female 32, male 15). The location of the VMs included the head and neck in 16 cases (34.0%), upper extremity in 11 cases (23.4%), lower extremity in 10 cases (21.3%), and trunk and perineum in 10 cases (21.3%). The majority of the lesions were focal in 36 cases (76.6%), while 11 (23.4%) were diffuse. Seventeen patients (36.2%) underwent single PS session, 14 patients (29.8%) underwent 2 sessions, 10 patients (21.3%) underwent 3 sessions and 6 patients (12.7%) underwent ≧4 sessions. The mean PS session per patient was 2.1 ±â€Š1.1. The mean follow-up duration was 11.4 ±â€Š7.6 months. After the last PS session, 8 patients (17.0%) had excellent outcomes, 27 (57.4%) had good outcomes, 10 (21.3%) had fair outcomes, and 2 (4.3%) had poor outcomes. Focal lesions were more likely to have good or excellent outcomes than diffuse lesions (χ = 4.522, P = .033). No other lesion characteristic significantly affected the outcomes (good or excellent outcomes), including lesion location (χ = 2.011, P = .570) or lesion size (χ = 1.045, P = .307). After the PS procedure, temporary local swelling occurred in 81 sessions (81.0%), local pain occurred in 15 sessions (15.0%), fever occurred in 27 (27.0%) sessions, and transient local numbness occurred in four sessions (4.0%).PS with polidocanol under the guidance of US appears to be safe and effective for the treatment of VMs in children, especially for focal lesions.

Dendritic star polymers for efficient DNA binding and stimulus-dependent DNA release.

Water-soluble core-shell star polymers consisting of a dendritic polyphenylene core and an outer shell containing a defined number of amino groups have been synthesized via atom transfer radical polymerization (ATRP). All macromolecules efficiently interacted with a diverse set of DNA fragments, and stable complexes were formed and visualized by atomic force microscopy. The observed tight binding of DNA, which was found in the sub-nanomolar range, was mainly attributed to strong electrostatic interactions. Complex stoichiometries between the polyelectrolytes were controlled via the number of amino groups of the star polymers, and well-defined nanoscopic architectures were formed. DNA was released from the complexes after treatment with high concentrations of sodium chloride in aqueous solution. Such star polymers, which allow the binding and release of DNA, represent attractive candidates for the development of novel anion-exchange resins for DNA purification or as nonviral vector systems for gene delivery.

Aqueous synthesis of PEGylated copper sulfide nanoparticles for photoacoustic imaging of tumors.

By integrating high imaging sensitivity and high resolution in a single modality, photoacoustic (PA) imaging emerges as a promising diagnostic tool for clinical applications. Benefiting from the absorption in the near-infrared region (NIR), copper sulfide nanoparticles (NPs) as a contrast agent are potentially useful for increasing the sensitivity of PA imaging. However, the aqueous synthesis of size-tunable, biocompatible and colloidally stable copper sulfide NPs remains challenging due to the intrinsic dipole-dipole interactions among particles. In this work, aqueous synthesis of PEGylated copper sulfide NPs with controllable size between 3 and 7 nm was developed. The particle size-dependent contrast enhancement effect of the copper sulfide NPs for PA imaging was carefully studied both in vitro and in vivo. Although the contrast enhancement effect of the copper sulfide NPs is proportional to particle size, the in vivo studies revealed that copper sulfide NPs smaller than 5 nm presented higher tumor imaging performance, especially at the tumor boundary site, which was further discussed in combination with the pharmacokinetic behaviors of differently sized particles.