Research progress in the relationship between gut microbiota metabolite trimethylamine N-oxide and ischemic stroke. / è‚ é“èŒç¾¤ä»£è°¢äº§ç‰©æ°§åŒ–ä¸‰ç”²èƒºä¸Žç¼ºè¡€æ€§è„‘å’ä¸­å ³ç³»çš„ç ”ç©¶è¿›å±•.

Ischemic stroke (IS) is a severe cerebrovascular disease that seriously endangers human health. Gut microbiota plays a key role as an intermediate mediator in bidirectional regulation between the brain and the intestine. In recent years, trimethylamine N-oxide (TMAO) as a gut microbiota metabolite has received widespread attention in cardiovascular diseases. Elevated levels of TMAO may increase the risk of IS by affecting IS risk factors such as atherosclerosis, atrial fibrillation, hypertension, and type 2 diabetes. TMAO exacerbates neurological damage in IS patients, increases the risk of IS recurrence, and is an independent predictor of post-stroke cognitive impairment (PSCI) in patients. Current research suggests that the mechanisms of TMAO action include endothelial dysfunction, promoting of foam cell formation, influence on cholesterol metabolism, and enhancement of platelet reactivity. Lowering plasma TMAO levels through the rational use of traditional Chinese medicine, dietary management, vitamins, and probiotics can prevent and treat IS.

Virtual reality in preoperative preparation of children undergoing general anesthesia: a randomized controlled study.

BACKGROUND: Preoperative anxiety can cause hyperalgesia, postoperative delirium and other adverse events, and even long-term psychological disorders. The aim of this trial was to determine whether preoperative virtual reality (VR) preparation reduces anxiety prior to induction of anesthesia. METHODS: Data were analyzed for 99 children undergoing elective surgery. Participants were randomly assigned to a VR exposure intervention group or a control group. In the VR group, children watched a VR video showing a realistic interactive immersive virtual version of the perioperative process. The control group received conventional preoperative preparation. Preoperative anxiety using the modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF) during anesthesia induction was the main outcome. Secondary outcomes included induction compliance, emergence delirium, pain, and parental satisfaction. RESULTS: The VR group had lower mYPAS-SF scores when leaving the waiting area (27.1, interquartile range, IQR 22.9-33.3 vs. 33.3, IQR 27.1-39.6; P = 0.006), and during anesthesia induction (29.2, IQR 22.9-33.3 vs. 39.6, IQR 33.3-55.2; P = 9×10-6). The Induction Compliance Checklist (ICC) scores during anesthesia induction were lower in the VR group (0.0, IQR 0.0-0.0 vs. 1.0, IQR 0.0-1.0; P = 0.003) than the control group, while parental satisfaction in the VR group was higher. CONCLUSION: Virtual reality exposure as a preparation tool has a beneficial effect on anxiety, induction compliance and parental satisfaction in children undergoing elective surgery. CLINICAL TRIAL REGISTRATION: ChiCTR2000035417.