Investigation of the biocontrol mechanism of a novel Pseudomonas species against phytopathogenic Fusarium graminearum revealed by multi-omics integration analysis.

Phytopathogenic Fusarium graminearum poses significant threats to crop health and soil quality. Although our laboratory-cultivated Pseudomonas sp. P13 exhibited potential biocontrol capacities, its effectiveness against F. graminearum and underlying antifungal mechanisms are still unclear. In light of this, our study investigated a significant inhibitory effect of P13 on F. graminearum T1, both in vitro and in a soil environment. Conducting genomic, metabolomic, and transcriptomic analyses of P13, we sought to identify evidence supporting its antagonistic effects on T1. The results revealed the potential of P13, a novel Pseudomonas species, to produce active antifungal components, including phenazine-1-carboxylate (PCA), hydrogen cyanide (HCN), and siderophores [pyoverdine (Pvd) and histicorrugatin (Hcs)], as well as the dynamic adaptive changes in the metabolic pathways of P13 related to these active ingredients. During the logarithmic growth stage, T1-exposed P13 strategically upregulated PCA and HCN biosynthesis, along with transient inhibition of the tricarboxylic acid (TCA) cycle. However, with growth stabilization, upregulation of PCA and HCN synthesis ceased, whereas the TCA cycle was enhanced, increasing siderophores secretion (Pvd and Hcs), suggesting that this mechanism might have caused continuous inhibition of T1. These findings improved our comprehension of the biocontrol mechanisms of P13 and provided the foundation for potential application of Pseudomonas strains in the biocontrol of phytopathogenic F. graminearum. IMPORTANCE: Pseudomonas spp. produces various antifungal substances, making it an effective natural biocontrol agent against pathogenic fungi. However, the inhibitory effects and the associated antagonistic mechanisms of Pseudomonas spp. against Fusarium spp. are unclear. Multi-omics integration analyses of the in vitro antifungal effects of novel Pseudomonas species, P13, against F. graminearum T1 revealed the ability of P13 to produce antifungal components (PCA, HCN, Pvd, and Hcs), strategically upregulate PCA and HCN biosynthesis during logarithmic growth phase, and enhance the TCA cycle during stationary growth phase. These findings improved our understanding of the biocontrol mechanisms of P13 and its potential application against pathogenic fungi.

[Systematic review and Meta-analysis of efficacy and safety of Shumian Capsules in treatment of insomnia].

This study aims to assess the safety and efficacy of Shumian Capsules in the treatment of insomnia. Randomized controlled trial(RCT) about Shumian Capsules for insomnia were retrieved from databases. RevMan 5.4 was used for statistical analysis. A total of 23 articles were included, involving 2 621 patients. Meta-analysis showed that Shumian Capsules had advantages in the treatment of insomnia(RR=1.07, 95%CI[1.03, 1.10], P=0.000 2) and insomnia with depression(RR=1.13, 95%CI[1.02, 1.25], P=0.02) in terms of total response rate. Shumian Capsules had advantages in the treatment of insomnia(MD=-0.75, 95%CI[-1.33,-0.17], P=0.01) and insomnia with depression(MD=-2.51, 95%CI[-2.96,-2.06], P<0.000 01) in terms of PSQI score. The incidence of adverse events in the Shumian Capsules(RR=0.33, 95%CI[0.24, 0.46], P<0.000 01) and Shumian Capsules + conventional western medicine(RR=0.71, 95%CI[0.54, 0.95], P=0.02) was lower than that in the conventional wes-tern medicine alone. In addition, Shumian Capsules had an advantage in treating insomnia complicated with depression in terms of HAMD score(P<0.000 1) and reducing the serum levels of 5-HT, TSH, T3, and T4 in insomnia patients(P<0.05). The quality of evidence was mostly medium or low. The studies demonstrate that Shumian Capsules is effective and safe for treating insomnia, which may be related to the mechanism of lowering the levels of 5-HT, TSH, T3, and T4 in the serum. In view of the quality of evidence, the application of Shumian Capsules should be considered after comprehensive evaluation in clinical practice.

Diverse long-term potentiation and depression based on multilevel LiSiOxmemristor for neuromorphic computing.

Memristor-based neuromorphic computing is expected to overcome the bottleneck of von Neumann architecture. An artificial synaptic device with continuous conductance variation is essential for implementing bioinspired neuromorphic systems. In this work, a memristor based on Pt/LiSiOx/TiN structure is developed to emulate an artificial synapse, which shows non-volatile multilevel resistance state memory behavior. Moreover, the high nonlinearity caused by abrupt changes in the set process is optimized by adjusting the initial resistance. 100 levels of continuously modulated conductance states are achieved and the nonlinearity factors are reduced to 1.31. The significant improvement is attributed to the decrease in the Schottky barrier height and the evolution of the conductive filaments. Finally, due to the improved linearity of the long-term potentiation/long-term depression behaviors in LiSiOxmemristor, a robust recognition rate (∼94.58%) is achieved for pattern recognition with the modified National Institute of Standards and Technology handwriting database. The Pt/LiSiOx/TiN memristor shows significant potential in high-performance multilevel data storage and neuromorphic computing systems.

An integrated multimedia fate modeling framework for identifying mitigation strategy of antibiotic ecological risks: A case study in a peri-urban river.

Antibiotics have been heavily used over the past decades, resulting in their frequent detections in rivers and increasing ecological risks. Recognizing characteristics of antibiotic ecological risks (AERs) and making effective strategies to mitigate the AERs are essential to ensure the safety of aquatic ecosystem and public health. In this study, an integrated technological framework has been proposed toward identifying management options for reducing AERs by jointly utilizing multimedia fugacity modelling and ecotoxicological risk assessment, and applied to characterize the AERs in a peri-urban river in Beijing. Specifically, a level III fugacity model has been successfully established to simulate the fate of antibiotics in the environment, and the manageable parameters have been screened out via sensitivity analysis of the model. Then the validated fugacity model has been used for scenario modellings to optimize mitigation strategies of AERs. Results show most of the antibiotics considered are frequently detected in the river, and pose medium or high risks to aquatic organisms. Relatively, the macrolides and fluoroquinolones present higher ecotoxicological risks than sulfonamides and tetracyclines. Furthermore, the mixture risk quotient and predictive equation of concentration addition suggest joint and synergistic/antagonistic effects of AERs for multiple or binary antibiotics in the environment. Largely, the concentrations of antibiotics in the river are determined by the source emissions into water and soil. Scenario modellings show the improvement of antibiotic removal rates would be considered preferentially to mitigate the AERs. Also, controlling human consumption is conducive to reducing the risks posed by tetracyclines, macrolides and trimethoprim, while controlling animal consumption would benefit the reduction for sulfonamides. Overall, the joint strategy presents the greatest reduction of AERs by reducing antibiotic consumption and together improving sewage treatment rate and antibiotic removal rate. The study provides us a useful guideline to make ecological risk-based mitigation strategy for reducing AERs in environment.

Bicarbonate ringer's solution could improve the intraoperative acid-base equilibrium and reduce hepatocellular enzyme levels after deceased donor liver transplantation: a randomized controlled study.

BACKGROUND: Bicarbonate Ringer's (BR) solution is a direct liver and kidney metabolism-independent HCO3- buffering system. We hypothesized that BR solution would be more effective in improving acid-base equilibrium and more conducive to better liver function than Acetate Ringer's (AR) solution in conventional orthotopic liver transplantation (OLT) patients. METHODS: Sixty-nine adult patients underwent OLT. Patients in the bicarbonate and acetate groups received BR solution or AR solution as infused crystalloids and graft washing solution, respectively. The primary outcome was the effect on pH and base excess (BE) levels. The secondary outcome measures were the incidence and volume of intraoperative 5% sodium bicarbonate infusion and laboratory indicates of liver and kidney function. RESULTS: The pH and absolute BE values changed significantly during the anhepatic phase and immediately after transplanted liver reperfusion in the bicarbonate group compared with the acetate group (all P < 0.05). The incidence and volume of 5% sodium bicarbonate infusion were lower in the bicarbonate group than in the acetate group (all P < 0.05). The aspartate transaminase (AST) level at 7 postoperative days and the creatine level at 30 postoperative days were significantly higher in the acetate group than in the bicarbonate group (all P < 0.05). CONCLUSION: Compared with AR solution, BR solution was associated with improved intraoperative acid-base balance and potentially protected early postoperative liver graft function and reduced late-postoperative renal injury.

Low CP Overhead Waveform Design for Multi-Path Channels with Timing Synchronization Error.

In classical orthogonal frequency division multiplexing (OFDM) systems, inserting the cyclic prefix (CP) is necessary before each symbol to overcome the multi-path effect, which, however, occupies numerous time-frequency radio resources, resulting in hampered spectrum efficiency. To address this issue, in this paper, symbol repetition aware OFDM (SR-OFDM) is developed to lower the overhead of CP. In the proposed SR-OFDM, multiple symbols share the same CP with which we examine that the multi-path channels can also be overcome by a simple single-tap equalization without causing any interference. Moreover, after the discrete Fourier transform at the receiver, different symbols are proved to be separated in the time domain, which is beneficial for lowering the demodulation complexity. Furthermore, it is revealed that the above conclusions still hold even under timing synchronization errors, which makes the proposed SR-OFDM favorable in real systems. Extensive simulations validate the efficacy of our proposed SR-OFDM system under the multi-path channels with or without timing synchronization errors.

[Effect of Mailuo Shutong Pills in treatment of ischemic stroke based on network pharmacological analysis and experimental verification].

The present study aimed to explore the targets and mechanism of Mailuo Shutong Pills(MSP) in the treatment of ischemic stroke by network pharmacology, and verify the key targets through molecular docking and animal experiment, so as to provide a theoretical basis for the clinical application of MSP. The main chemical ingredients of MSP were obtained by searching against the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP) and relevant literature. The potential targets of the ingredients of MSP in treating ischemic stroke were obtained from SwissTargetPrediction and DisGeNET. Protein-protein interaction(PPI) network was analyzed in STRING and plotted in Cytoscape. Gene Ontology(GO) annotation and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analysis were carried out with DAVID. Molecular docking was simulated to determine the binding activity of active ingredients to key targets in AutoDock Vina. The mouse model of ischemic stroke was established. The mice were classified into a sham group, a model group, and an MSP group. After the administration, cerebral infarction volume was detected by 2,3,5-triphenyltetrazoliumchloride(TTC) staining, and Western blot was performed to determine the levels of phosphatidylinositol 3-kinase(PI3 K), protein kinase B(AKT), nuclear factor-κB(NF-κB) and their phosphorylated proteins. A total of 222 ingredients of MSP were screened out, including beta-sitosterol, quercetin, licochalcone B, and lupiwighteone, which acted on 701 targets. Totally 1 079 targets associated with ischemic stroke were retrieved, among which 192 common targets were shared by MSP and ischemic stroke. The key targets included AKT1, phosphatidylinositol 3-kinase catalytic subunit alpha(PIK3 CA), phosphatidylinositol 3-kinase regulatory subunit 1(PIK3 R1), and nuclear factor-κB p65 subunit(RELA), which were mainly involved in PI3 K/AKT, tumor necrosis factor(TNF), and NF-κB signaling pathways. The results of molecular docking revealed that PI3 K, AKT1, and RELA had good binding ability to the active ingredients of MSP. The animal experiment results showed that compared with the model group, MSP decreased cerebral infarction volume, down-regulated the expression of p-NF-κB, and up-regulated the expression of p-PI3 K and p-AKT in mouse brain. In summary, the active ingredients in MSP may treat cerebral injury by activating PI3 K/AKT signaling pathway and inhibiting NF-κB signaling pathway.

Asymmetric hologram with a single-size nanostructured metasurface.

Geometric metasurfaces, governed by PB phase, have shown their strong polarization sensitivity and can generate opposite phase delay when the handedness of incident circularly-polarized (CP) light is opposite. Here, we show this interesting characteristic can be employed to generate asymmetric forward and backward propagation with the same incident left- or right-handed CP light, which is hard to achieve with conventional optical elements and devices. Specifically, with the modified holographic design algorithm to consider both forward and backward CP light, an asymmetric meta-hologram is designed, which can project two different holographic images in the forward and backward directions, respectively. We demonstrate this concept by fabricating an asymmetric hologram with a single-size nanostructured metasurface, and the experimentally obtained holographic images in both directions have shown their advantages of high fidelity, broadband response and low crosstalk. The proposed asymmetric metasurface can play an important role in data storages, anti-counterfeitings, optical communications, displays and many other related fields.

Multiplexing meta-hologram with separate control of amplitude and phase.

Metasurfaces have shown their unique capabilities to manipulate the phase and/or amplitude properties of incident light at the subwavelength scale, which provides an effective approach for constructing amplitude-only, phase-only or even complexed amplitude meta-devices with high resolution. Most of meta-devices control the amplitude and/or phase of the incident light with the same polarization state; however, separately controlling of amplitude and phase of the incident light with different polarization states can provide a new degree of freedom for improving the information capacity of metasurfaces and designing multifunctional meta-devices. Herein, we combine the amplitude manipulation and geometric phase manipulation by only reconfiguring the orientation angle of the nanostructure and present a single-sized design strategy for a multiplexing meta-hologram which plays the dual roles: a continuous amplitude-only meta-device and a two-step phase-only meta-device. Two different modulation types can be readily switched merely by polarization controls. Our approach opens up the possibilities for separately and independently controlling of amplitude and phase of light to construct a multiplexing meta-hologram with a single-sized metasurface, which can contribute to the advanced research and applications in multi-folded optical anti-counterfeiting, optical information hiding and optical information encoding.

Metasurfaces with single-sized antennas for reconstructing full-color holographic images without cross talk.

Designing a color hologram with conventional metasurfaces usually resorts to a supercell strategy or single-sized approach with different incident angles. However, these designs still have their own drawbacks that need to be further solved. Herein, we show a new, to the best of our knowledge, single-sized strategy to design full-color geometric meta-holograms by utilizing the conjugation property of two circularly polarized lights with opposite handedness and diffraction dispersion. The experimentally captured holographic color images are reconstructed with high quality and without cross talk, which agrees well with our theoretical prediction. Moreover, only with an appropriate combination of wavelength and polarization state can color images be observed accurately. Our strategy provides a simple and effective approach for full-color meta-holography and offers significant potential in image display, information storage, etc.

Transparent HfO x -based memristor with robust flexibility and synapse characteristics by interfacial control of oxygen vacancies movement.

Hafnium oxides (HfO x ) based flexible memristors were fabricated on polyethylene naphtholate (PEN) substrates to simulate a variety of bio-synapse functions. By optimizing the manufacturing conditions of electrode and active films, it is proved that the TiN/HfO x /W/ITO/PEN bilayer device has robust flexibility and can still be modulated after 2000 times of bending. The memristor device exhibits better symmetrical and linear characteristics with excellent uniformity at lower programming power consumption (∼38 µW). In addition, the essential synaptic behaviors have further been achieved in the devices, including the transition from short-term plasticity to long-term plasticity and spike time-dependent plasticity. Through the analysis of I-V curves and XPS data, a switching mechanism based on HfO x /W interface boundary drift is constructed. It is revealed that the redox reaction caused by W intercalation can effectively regulate the content of oxygen vacancy in HfO x . At the same time, bias-induced interfacial reactions will regulate the movement of oxygen vacancies, which emulates bio-synapse functions and improves the electrical properties of the device.

Silicon-on-insulator based multifunctional metasurface with simultaneous polarization and geometric phase controls.

Enabled with both magnetic resonance and geometric phase, dielectric nanobrick based metasurfaces have shown their unusual abilities to produce high-definition and high-efficiency holographic images. Herein, we further show that such a metasurface can not only project a holographic image in far field but also record a grayscale image right at the metasurface plane simultaneously, merely with a single-celled nanostructure design approach. Specifically, each nanobrick in a unit-cell of the metasurface acts as a half-wave plate and it can continuously rotate the polarization direction of incident linearly polarized light. Governed by Malus law, light intensity modulation is available with the help of a bulk-optic analyzer and a continuous grayscale image appears right at the metasurface plane. At the same time, the concept of orientation degeneracy of nanostructures can be utilized to generate a 4-step geometric phase, with which a holographic image is reconstructed in far field. We experimentally demonstrate this multifunctional meta-device by employing the widely used silicon-on-insulator (SOI) material and all results agree well with our theoretical prediction. With the novel features of easiness in design, high efficiency, broadband spectrum response, strong robustness, high security and high information density, the proposed SOI-based metasurfaces will have extensive applications in optical information security and multiplexing.

Continuous amplitude-modulated meta-fork gratings with zero-order extinction.

Metasurfaces, acting as arrays of perfect nano-polarizers, provide a promising approach to manipulate the amplitude of an incident light at the sub-wavelength scale. In this Letter, we design and demonstrate continuous amplitude-modulated meta-fork gratings to generate optical vortex beams. More importantly, benefiting from the unique negative amplitude modulation, the unavoidable zero-order light that conventional amplitude-only elements always suffer disappears by carefully adjusting the orientation of each nanobrick. The dramatically dropped zero-order light with only 3% leakage energy verifies our design. With the advantages of continuous amplitude modulation, zero-order extinction, and super-high resolution, the proposed meta-fork grating will have a widespread application in integrated optical vortex manipulation and promote the emergence of many other amplitude-modulated nano-optical devices.

Low consumption two-terminal artificial synapse based on transfer-free single-crystal MoS2 memristor.

Both synaptic emulators and brain-like calculation demand an energy-efficient and bio-realistic device where two-dimensional materials have been proven as a promising competitor. Lateral memristors based on transfer-free single-crystal MoS2 with single layer grown by chemical vapor deposition (CVD) were fabricated. Here the MoS2 memristor successfully emulates typical biological synaptic behaviors including excitatory/inhibitory post-synaptic current (EPSC/IPSC), spike timing-dependent plasticity (STDP), spike rate-dependent plasticity (SRDP) and long-term plasticity (LTP). Moreover, an interesting multi-state LTP and a low consumption of 1.8 pJ after LTP process are achieved which is attributed to the high resistance of transfer-free single-crystal monolayer MoS2, representing a low value among previous MoS2 devices. The migration of Sulfur vacancies lead the conductance modulation by changing the Schottky barrier instead of forming a filament. Our work demonstrates that MoS2 memristors can more flexibly satisfy the demands of complex artificial synaptic/neuron applications.

[Recent developments in enhancing the efficiency of CRISPR/Cas9- mediated knock-in in animals].

Gene-editing technology can artificially modify genetic material of targeted loci by precise insertion, deletion, or replacement in the genomic DNA. In recent years, with the developments of zinc-finger endonuclease (ZFN), transcription activator-like effector nuclease (TALEN), clustered regularly interspaced short palindromic repeats/CRISPR- associated protein 9 (CRISPR/Cas9) technologies, such precise modifications of the animal genomes have become possible. Although gene-editing tools, such as CRISPR/Cas9, can efficiently generate double-strand breaks (DSBs) in mammalian cells, the homology-directed repair (HDR) mediated knock-in (KI) efficiency is extremely low. In this review, we briefly describe the current development of gene-editing tools and summarize the recent strategies to enhance the CRISPR/Cas9- mediated KI efficiency, which will provide a reference for the generation of human disease models, research on gene therapy and livestock genetic improvement.

Is Sensorineural Hearing Loss Related to Chronic Rhinosinusitis Caused by Outer Hair Cell Injury?

BACKGROUND Sensorineural hearing loss is caused by defects in the inner ear. In the present study, associations between chronic rhinosinusitis, outer hair cell injury, and sensorineural hearing loss were investigated. MATERIAL AND METHODS A total of 103 patients who met the inclusion criteria were recruited and allocated into a chronic rhinosinusitis group (n=82) and a simple deviated nasal septum group (n=21). Degree and type of hearing loss, including distortion product otoacoustic emissions, were used to assess the status of cochlear outer hair cells. RESULTS The rate of hearing loss in the simple deviated nasal septum group was significantly lower than in the chronic rhinosinusitis group (4.76%, 1/21 vs. 24.39%, 20/82, P<0.05), among which 15 chronic rhinosinusitis patients (75%, 15/20) had hearing loss in the high frequency range. Acoustic stapedial reflexes were elicited in all patients of the 2 groups, while positive Metz was found in 3 chronic rhinosinusitis patients (15%, 3/20). The pass rate of distortion product otoacoustic emissions (DPOAEs) for chronic rhinosinusitis patients was significantly lower than in simple deviated nasal septum patients (88.10% vs. 70.73%, P<0.05). Moreover, the signal-to-noise ratio of DPOAE test results at 704 Hz, 3991 Hz, and 5649 Hz in the chronic rhinosinusitis group were significantly lower than in the simple deviated nasal septum group (P<0.05). Logistic regression analysis revealed a correlation between severity of chronic rhinosinusitis and sensorineural hearing loss (OR=1.39, P<0.05). CONCLUSIONS Outer hair cell injury and sensorineural hearing loss may have a common cause in chronic rhinosinusitis patients.

A Lane Detection Method Based on a Ridge Detector and Regional G-RANSAC.

Lane detection plays an important role in improving autopilot's safety. In this paper, a novel lane-division-lines detection method is proposed, which exhibits good performances in abnormal illumination and lane occlusion. It includes three major components: First, the captured image is converted to aerial view to make full use of parallel lanes' characteristics. Second, a ridge detector is proposed to extract each lane's feature points and remove noise points with an adaptable neural network (ANN). Last, the lane-division-lines are accurately fitted by an improved random sample consensus (RANSAC), termed the (regional) gaussian distribution random sample consensus (G-RANSAC). To test the performances of this novel lane detection method, we proposed a new index named the lane departure index (LDI) describing the departure degree between true lane and predicted lane. Experimental results verified the superior performances of the proposed method over others in different testing scenarios, respectively achieving 99.02%, 96.92%, 96.65% and 91.61% true-positive rates (TPR); and 66.16, 54.85, 55.98 and 52.61 LDIs in four different types of testing scenarios.

Anti-Depressive Effectiveness of Baicalin In Vitro and In Vivo.

Baicalin (BA), a major polyphenol compound isolated from the extracts of Scutellaria radix, has been previously reported to ameliorate depressive-like behaviors in mice with chronic unpredictable mild stress (CUMS). However, its underlying antidepressant mechanisms remain unclear. This study was designed to confirm the antidepressant-like effects of BA on CUMS induced behavioral abnormalities in mice, and sought to explore the pharmacological mechanisms in vivo and in vitro. The CUMS procedure was carried out to induce depression in mice. Afterwards, the tail suspension test (TST), forced swim test (FST), and open field test (OFT) were performed within 24 h, then sucrose preference test (SPT) was conducted. Additionally, PC12 cells were pretreated with BA for 2 h, then further stimulated with corticosterone for 24 h. The levels of Interleukin-1ß (IL-1ß), IL-6 and Tumor Necrosis Factor-α (TNF-α) in serum, hippocampus homogenate and cell culture medium were determined using the enzyme-linked immunosorbent assay (ELISA) method. The protein expressions of inhibition of high mobility group box 1 protein (HMGB1)/Toll-like receptor 4 (TLR4)/nuclear factor kappa B (NF-κB) pathways in hippocampus and PC12 cells were detected. Our results showed that CUMS-treated mice presented notable depressive-like symptoms, such as decreased sucrose consumption, increased FST and TST immobility time. While BA (25, 50 mg/kg) significantly attenuated these changes. Besides, BA treatment considerably inhibited inflammatory cytokinesl (IL-1ß, IL-6, TNF-α) levels in serum, hippocampus homogenate and cell culture medium. Western blot analysis indicated that BA inhibited the expressions of HMGB1, TLR4, and p-NF-κBp65 both in vivo and in vitro. In conclusion, the present study confirmed that BA possessed efficient antidepressant effects on depression, which was possibly related to the inhibition of HMGB1/TLR4/NF-κB pathways.

Molecular diversity and hypoglycemic polypeptide-P content of Momordica charantia in different accessions and different seasons.

BACKGROUND: Momordica charantia (MC) has been used for treating diabetes mellitus from ancient times in Asia, Africa and South America. There are many MC accessions in local markets. Polypeptide-P as a main hypoglycemic component in MC was first studied in this experiment to illustrate the different contents in MC of different accessions and different harvesting times. RESULTS: Nineteen MC accessions collected from different regions were clustered into three groups using random amplified polymorphic DNA (RAPD) and inter-simple sequence repeat (ISSR) molecular markers. Content of polypeptide-P in the tested MC accessions was detected by western blot (WB) method. The WB results revealed that polypeptide-P was detected in MC accessions harvested in June and July but not in September and October. Furthermore, Polypeptide-P content corresponded well with the MC accessions. CONCLUSION: Our results suggest that the MC accessions and the harvesting times or the weather during harvest play significant roles in high content of polypeptide-P.

[Effect of ulinastatin on postoperative cognitive function in the elderly with fracture].

OBJECTIVE: To observe the vary of postoperation cognitive function and inflammatory mediators CRP in elderly patients with fracture after using ulinastatin. METHODS: Forty-eight patients over 65 years old patients with hip fracture were randomly divided into two groups: ulinastatin group (n = 21) and control group (n = 27). All patients underwent combined spinal-epidural anesthesia. The patients in ulinastatin group received intravenous injection of ulinastatin with a dose of 5 000 U/kg before skin incision and at the moment of the end of operation. Cognitive function was assessed by Mini-Mental State Examination (MMSE) at the day of the operation (T0), 1 (T1), 3 (T2) and 7 (T3) days after opreation. The incidence of POCD was calculated. Blood samples were taken at the day of the operation and 3 days after operation for determination of CRP. RESULTS: Compared with control group (23.8 ± 0.8, 24.3 ± 0.7), the MMSE scores were significantly increased at T1, T2in ulinastatin group (26.0 ± 0.7, 26.6 ± 0.6) (t1= 2.161, t2= 2.431, P < 0.05). There were no differences at T00, T3(t0 = 0.472, t3 = 1.585, P > 0.05). The respectively incidence of POCD of ulinastatin group and control group were 40.7% and 4.8%, and that of ulinastatin group was significantly lower than control group (χ² = 8.155, P < 0.01). Serum CRP concentration of ulinastatin group after operation was (64.46 ± 9.86) mg/L, significantly lower than control group (123.63 ± 7.17) mg/L (t = -4.974, P < 0.05). CONCLUSION: Ulinastatin can reduce the incidence of POCD in the elderly patients with fracture, which may be related to the anti-inflammatory effect of ulinastatin.