Risk factors for early postoperative cognitive dysfunction after colorectal surgery.

BACKGROUND: It has been reported that postoperative cognitive dysfunction (POCD) is correlated with the degeneration of the central nervous system, oxidative stress, inflammation, and endocrine and immune dysfunction. Increased age, predisposed comorbidity, long surgery time, and prolonged stay in the intensive care unit have been reported to be risk factors for developing POCD for cardiac surgery. In the present study, the risk factors of early POCD after colorectal surgery were investigated. METHODS: Eighty patients, who provided informed consents for their participation in this study, were enrolled and received colorectal surgery under general anesthesia. Neuropsychological tests were performed preoperatively and on postoperative day seven. The risk factors for POCD were analyzed using a multivariate logistic regression model. RESULTS: Nineteen patients were diagnosed with POCD (24.7%). Diabetes history (OR = 8.391 [2.208-31.882], P = 0.012), fasting over 3 days after surgery (OR = 5.236 [1.998-13.721], P = 0.001) and an SIRS score of > 3 on the second day after surgery (OR = 6.995 [1.948-25.111], P = 0.003) were risk factors for early POCD in colorectal cancer patients. CONCLUSION: The risk factors for early POCD after colorectal surgery included diabetes history, fasting over 3 days, and an SIRS score of > 3 on the second day.

Safety and effectiveness assessment of endovascular recanalization for non-acute middle cerebral artery occlusion.

BACKGROUND: Endovascular treatment for patients with symptomatic nonacute middle cerebral artery occlusion remains clinically challenging, and proof of a beneficial effect on functional outcome is lacking. We aim to evaluate the effectiveness and safety of endovascular recanalization for patients with symptomatic nonacute middle cerebral artery occlusion. METHODS: Ninety-eight patients with symptomatic atherosclerotic nonacute middle cerebral artery occlusion were divided into drug treatment groups (42) and endovascular treatment groups (56). The rate of recanalization, peri-procedural complications, and follow-up results were evaluated. RESULTS: Among the 56 patients who received endovascular treatment, 53 (94.6%) achieved successful recanalization. The rate of peri-procedural complications was 7.1% (4/56), and the death rate was 1.8% (1/56). Any stroke within 90 days was 7.1% (4/56). Among the 42 patients in drug treatment group, any stroke within 90 days was 19.0% (8/42), death rate was 0. CONCLUSION: Among patients with symptomatic nonacute middle cerebral artery occlusion with a short length of occlusion and a moderate-to-good collateral circulation, endovascular treatment seems to be safe. And endovascular treatment could reduce the recurrence rate of stroke.

Spatial and temporal evaluations of estrogenic activity in tap water served by a water plant in Wuhan, China.

This study aimed to evaluate the spatial and temporal characteristics of estrogenic activities in tap water served by a water plant in Wuhan, China. Tap water samples were monthly collected from the three sampling sites with different distances of distribution network from the plant during April 2010-March 2011: Min (less than 0.1km), Mid (approximately 4km) and Max (approximately 8km). Estrogenic activities of solid phase-extracted tap waters were measured by using recombinant yeast assay incorporated with and without exogenous metabolic activation system (rat liver S9 fractions) and expressed as 17ß-estradiol equivalents (EEQ). Pro-estrogenic and estrogenic activity in tap water ranged from 151.4 to 1395.6pg EEQ/L and 35.2 to 1511pg EEQ/L, respectively. Average pro-estrogenic activity (680.3pg EEQ/L) was significantly higher than estrogenic activity (412.8pg EEQ/L) throughout the whole year. The pro-estrogenic activity significantly increased with the extending of distribution network, and was also statistically correlated with water temperature and pH. However, pro-estrogenic and estrogenic activity was not altered across four seasons. Our results suggest that the pro-estrogenic and estrogenic chemicals are present in tap water served by the water plant.

Effect of aquaporin-4 deficiency on intravenous anaesthetic induced hypnotic effects in mice.

The deficiency of aquaporin-4 (AQP4) has been reported to alter release of neurotransmitters in the mouse brain. However, the functional relevance of AQP4 in mediating essential components of the general anaesthetic state is unknown. The aim of the present study was to investigate the role of AQP4 in general anaesthesia in mice lacking AQP4. The hypnotic effects of propofol, ketamine, and pentobarbital in AQP4 knockout (KO) and CD1 control mice were evaluated using the behavioural endpoint of loss of righting reflex (LORR). The effects of propofol on extracellular levels of amino acids in prefrontal cortex of freely moving mice were investigated using microdialysis coupled to high performance liquid chromatography with fluorescent detection. The result showed that, after receiving ketamine or pentobarbital, LORR occurred at earlier time in KO mice than that in control animals. Intraperitoneal injection of ketamine or pentobarbital increased the duration of LORR. After the administration of propofol, the duration of LORR was significantly reduced in KO mice compared with that in controls. Propofol increased the extracellular levels of aspartate, glutamate, and GABA, but not taurine, in prefrontal cortex. There were significant differences of increase patterns of the three kinds of neurotransmitters between KO and WT mice. Notably, the duration of GABA level increase correlated with the duration of LORR in two genotypes of mice. These results provide in vivo evidence of different responses in time-dependent release of excitatory and inhibitory neurotransmitters in prefrontal cortex of the two genotypes of mice. It is suggested that changes in anaesthetic reactions in mice with AQP4 loss may be related to neurotransmitter regulation, and that normal functioning of AQP4 plays an important role in the maintenance of anaesthetic hypnosis.

Optimization of Douchi fibrinolytic enzyme production by statistical experimental methods.

Thrombus disease, one of the common cardiovascular diseases, has attracted worldwide attention for its rising mortality and morbidity. Due to the distinct shortages of current fibrinolytic drugs, new fibrinolytic agents warrant investigation. In this study, 8 fibrinolytic enzyme-producing strains were isolated from Douchi-a traditional Chinese food, and strain XY-1 which produced the largest amount of the enzyme was chosen for the following experiments. The enzyme produced by strain XY-1 was named Douchi fibrinolytic enzyme (DFE). We optimized the liquid culture medium of strain XY-1 for enzyme production using Plackett-Burman and Box-Behnken design. The predicted maximal DFE yield was 19.78 FU/mL with 11.4 g/L peptone, 0.5 g/L magnesium sulfate and 1 g/L sodium chloride. However, we acquired maximal production of 21.33 FU/mL in actual experiments, equal to 107.84% of the theoretical value, and the yield had been increased by 79.55% as compared to the yield of un-optimized culture. It was demonstrated that the combined use of Plackett-Burman design and response surface methodology in fermentation optimization can effectively and rapidly increase DFE production.

Low-dose intravenous tirofiban infusion after endovascular recanalization for non-acute middle cerebral artery occlusion.

Background and purpose: Endovascular recanalization for patients with symptomatic non-acute middle cerebral artery occlusion still remines challenging. Postoperative treatment is still controversial. This study aims to investigate the safety and effectiveness of tirofiban after elective angioplasty in patients with non-acute middle cerebral artery occlusion related ischemic stroke. Methods: Our study is a retrospective case series study of 48 stroke patients who received elective endovascular recanalization for middle cerebral artery occlusion. Patients who received EVT without hemorrhage were divided into 2 groups: those who did not receive intravenous tirofiban treatment (control group, n = 25); those who received continuous intravenous infusion of 0.2-0.3 mg/h tirofiban for 48 h after endovascular recanalization (intravenous tirofiban group, n = 23). Early reocclusion of treated arteries, symptomatic hemorrhage, and 90-day functional outcome of the 2 groups were compared. Results: The 90-day mRS score and NIHSS score after endovascular recanalization showed no significantly different between the two groups. However, the rate of mRS score reverse (≥1) was significantly higher in the intravenous tirofiban group than the control (73.9% versus 24.0%, P = 0.001), and the rate of NIHSS score reverse (≥3) in the intravenous tirofiban group was also higher (43.5% verse 16.0%, P = 0.037). The rate of early reocclusion, symptomatic hemorrhage (4.3% versw 4%, P = 0.734), showed no difference between the two groups. Conclusions: Low-dose intravenous tirofiban infusion (0.2-0.3 mg/h for 48 h) after endovascular treatment seems to be safe and potentially effective for non-acute middle cerebral artery occlusion patients.

A clinical research of 11cases of human umbilical cord mesenchymal stem cells for curing senile vascular dementia.

BACKGROUND: Patients affected by senile vascular dementia (VaD) suffer from a gradual deterioration in their cognitive expressions as well as the ability of taking care for themselves. This study aimed to investigate the clinical efficacy and safety of improving cognitive function and daily life activities of patients with VaD by transplanting human umbilical cord mesenchymal stem cells (HUCMSCs). METHODS: A total number of 11 patients with senile VaD, who were admitted through outpatient treatment and hospitalized between February 2013 and February 2016, were selected. The diagnosis was based on CT and MRI examinations. The cultivated HUCMSCs (106 /kg) were injected by intravenous (i.v.) infusion on three occasions. Patients were evaluated for the Mini-Mental State Examination (MMSE) with 25-30 as normal, 21-24 as mild dementia, 10-20 as moderate dementia, and 0-9 as severe dementia. In addition, the Barthel index (BI) was used for a standardized activities of daily living (ADLs) with 0-20 as total dependence, 21-60 as severe dependence, 61-90 as moderate dependence, and 91-95 slight dependence. The t-test was performed to compare statistical significance. RESULTS: The study included 11 subjects, one of whom fell out due to an event unrelated to the study. The results show descriptive statistics at different time points. No matter MMSE score or Barthel index, the difference between before treatment and after treatment or follow-up was statistically significant (P < 0.001).Result interpretation: this intervention method has a significant therapeutic effect, and in the 3-month follow-up period, the intervention effect is still significant compared with that before treatment. CONCLUSIONS: Our preliminary clinical observations suggest that the i.v. infusion of HUCMSCs significantly improved the cognitive function (MMSE) and daily life activities (BI) of patients with senile VaD. This approach may prove to be safe and relatively simple method to be applied for the treatment of senile VaD.

α-lipoic acid attenuates spatial learning and memory impairment induced by hepatectomy.

The aim of the present study was to compare the effects of α-lipoic acid (ALA) on postoperative cognitive dysfunction (POCD) between wild type (WT) and leptin receptor-deficient (db/db) mice and to elucidate the underlying mechanism of treatment with ALA. The present study compared the effects of ALA on spatial learning and memory of WT and db/db mice using a Morris water maze following hepatectomy. The expression levels of proteins, including cyclin-dependent kinase 5 (Cdk5), tau, phosphorylated tau and amyloid ß (Aß) were measured in the hippocampus. Surgery impaired postoperative cognitive function in both WT and db/db mice. Furthermore, the expression levels of Cdk5 and Aß, and the phosphorylation of tau in the hippocampus increased after the surgery in both WT and db/db mice. The ultrastructure of hippocampal neurons and synapses was analyzed by transmission electron microscopy and the results revealed that surgery damaged the structure of neurons and synapses in both WT and db/db mice. Treatment with ALA protected the postoperative cognitive function and the structure of hippocampal neurons and synapses, and prevented the increase in protein expression levels of Cdk5 and Aß, and the phosphorylation of tau in the hippocampus of WT but not db/db mice. The results of the present study suggest that ALA may be used for the treatment of POCD. The molecular mechanisms underlying the activity of ALA require further investigation.

Removal of nitrogen, phosphorus, and organic pollutants from water using seeding type immobilized microorganisms.

OBJECTIVE: To study the possibility of removing nitrogen, phosphorus, and organic pollutants using seeding type immobilized microorganisms. METHODS: Lakes P and M in Wuhan were chosen as the objects to study the removal of nitrogen, phosphorus, and organic pollutants with the seeding type immobilized microorganisms. Correlations between the quantity of heterotrophic bacteria and the total nitrogen (TN), total phosphorus (TP), and total organic carbon (TOC) in the two lakes were studied. The dominant bacteria were detected, inoculated to the sludge and acclimated by increasing nitrogen, phosphorus and decreasing carbon source in an intermittent, time-controlled and fixed-quantity way. The bacteria were then used to prepare the seeding type immobilized microorganisms, selecting diatomite as the adsorbent carrier. The ability and influence factors of removing nitrogen, phosphorus, and organic pollutant from water samples by the seeding type immobilized microorganisms were studied. RESULTS: The coefficients of the heterotrophic bacterial quantity correlated with TOC, TP, and TN were 0.9143, 0.8229, 0.7954 in Lake P and 0.9168, 0.7187, 0.6022 in Lake M. Ten strains of dominant heterotrophic bacteria belonging to Pseudomonas, Coccus, Aeromonas, Bacillus, and Enterobateriaceae, separately, were isolated. The appropriate conditions for the seeding type immobilized microorgansims in purifying the water sample were exposure time=24 h, pH=7.0-8.0, and quantity of the immobilized microorganisms=0.75-1 g/50 mL. The removal rates of TOC, TP, and TN under the above conditions were 80.2%, 81.6%, and 86.8%, respectively. CONCLUSION: The amount of heterotrophic bacteria in the two lakes was correlated with TOC, TP, and TN. These bacteria could be acclimatized and prepared for the immobilized microorganisms which could effectively remove nitrogen, phosphorus, and mixed organic pollutants in the water sample.

[A correlative study on heterotrophic bacteria and the main pollutant in city lakes' water].

OBJECTIVE: To provide scientific basis for bioremediation of city lake, the distribution of heterotrophic bacteria and its correlation with major pollutions condition were studied. METHODS: Puping Lake and Moshui Lake of Wu Han City were choosen as the objects of our study. COD(cr) TOC, TP and TN were determined in sampled freshwater and sediment via the standard methods. At the same time the bacteria was cultivated. RESULTS: The average value of COD(cr), TOC, TP and TN were 8. 934 mg/L, 5.125 mg/L, 0.089 mg/L, 4.739 mg/L in Puping Lake and 86.296 mg/L,13.255 mg/ L, 1.796 mg/L, 7.325 mg/L in Moshui Lake. Ten strains of heterotrophic bacteria were isolated from the sample and they are Pseudomonas, Bacillus, Enterobateriaceae, Aeromonas and Coccus. The dominant strain in water was Pseudomonas. The proportion of Bacillus in sediment was relatively higher. In the two lakes, the average bacteria counts were 1.90 x 10(3) CFU and 5.53 x 10(4) CFU per mL in water, 3.12 x 10(5) CFU and 5.06 x 10(5) CFU per g in sediment. CONCLUSION: Puping Lake and Moshui Lake were polluted seriously according to the standard; Gram negative rods were the main types in water, and the dominant type was Pseudomonas, the Gram positive bacteria was Bacillus; The type and quantity of bacteria in Moshui Lake were higher than those in Puping Lake, and there were correlations between the quantity of bacteria and the pollutants.

Extensive variability in vasoactive agent therapy: a nationwide survey in Chinese intensive care units.

BACKGROUND: Inconsistencies in the use of the vasoactive agent therapy to treat shock are found in previous studies. A descriptive study was proposed to investigate current use of vasoactive agents for patients with shock in Chinese intensive care settings. METHODS: A nationwide survey of physicians was conducted from August 17 to December 30, 2012. Physicians were asked to complete a questionnaire which focused on the selection of vasoactive agents, management in the use of vasopressor/inotropic therapy, monitoring protocols when using these agents, and demographic characteristics. RESULTS: The response rate was 65.1% with physicians returning 586 valid questionnaires. Norepinephrine was the first choice of a vasopressor used to treat septic shock by 70.8% of respondents; 73.4% of respondents favored dopamine for hypovolemic shock; and 68.3% of respondents preferred dopamine for cardiogenic shock. Dobutamine was selected by 84.1%, 64.5%, and 60.6% of respondents for septic, hypovolemic, and cardiogenic shock, respectively. Vasodilator agents were prescribed by physicians in the management of cardiogenic shock (67.1%) rather than for septic (32.3%) and hypovolemic shock (6.5%). A significant number of physicians working in teaching hospitals were using vasoactive agents in an appropriate manner when compared to physicians in nonteaching hospitals. CONCLUSIONS: Vasoactive agent use for treatment of shock is inconsistent according to self-report by Chinese intensive care physicians; however, the variation in use depends upon the form of shock being treated and the type of hospital; thus, corresponding educational programs about vasoactive agent use for shock management should be considered.

Evaluation of genotoxic effects caused by extracts of chlorinated drinking water using a combination of three different bioassays.

Potential genotoxic effects of chlorinated drinking water now are of a great concern. In this study, raw water, finished water, and tap water from a water plant in Wuhan, China were collected in two different sampling times of the year (January and July). Genotoxic effects of water extracts were evaluated using a combination of three different bioassays: SOS/umu test, HGPRT gene mutation assay, and micronucleus assay, which were separately used to detect DNA damage, gene mutation, and chromosome aberration. The results of three different bioassays showed that all water samples in January and July induced at least one types of genotoxic effects, of which the DNA-damage effects were all detectable. The levels of DNA-damage effects and gene-mutation effects of finished water and tap water in January were higher than those in July. Chlorination could increase the DNA-damage effects of drinking water in January and the gene-mutation effects of drinking water in both January and July, but did not increase the chromosome-aberration effects of drinking water in both January and July. Our results highlighted the importance of using a combination of different bioassays to evaluate the genotoxicity of water samples in different seasons.

Human remains from the Pleistocene-Holocene transition of southwest China suggest a complex evolutionary history for East Asians.

BACKGROUND: Later Pleistocene human evolution in East Asia remains poorly understood owing to a scarcity of well described, reliably classified and accurately dated fossils. Southwest China has been identified from genetic research as a hotspot of human diversity, containing ancient mtDNA and Y-DNA lineages, and has yielded a number of human remains thought to derive from Pleistocene deposits. We have prepared, reconstructed, described and dated a new partial skull from a consolidated sediment block collected in 1979 from the site of Longlin Cave (Guangxi Province). We also undertook new excavations at Maludong (Yunnan Province) to clarify the stratigraphy and dating of a large sample of mostly undescribed human remains from the site. METHODOLOGY/PRINCIPAL FINDINGS: We undertook a detailed comparison of cranial, including a virtual endocast for the Maludong calotte, mandibular and dental remains from these two localities. Both samples probably derive from the same population, exhibiting an unusual mixture of modern human traits, characters probably plesiomorphic for later Homo, and some unusual features. We dated charcoal with AMS radiocarbon dating and speleothem with the Uranium-series technique and the results show both samples to be from the Pleistocene-Holocene transition: ∼14.3-11.5 ka. CONCLUSIONS/SIGNIFICANCE: Our analysis suggests two plausible explanations for the morphology sampled at Longlin Cave and Maludong. First, it may represent a late-surviving archaic population, perhaps paralleling the situation seen in North Africa as indicated by remains from Dar-es-Soltane and Temara, and maybe also in southern China at Zhirendong. Alternatively, East Asia may have been colonised during multiple waves during the Pleistocene, with the Longlin-Maludong morphology possibly reflecting deep population substructure in Africa prior to modern humans dispersing into Eurasia.

[The impact of diabetes mellitus and insulin interference on cortical SCF/KIT of mice].

OBJECTIVE: To investigate the expression of cortical SCF/KIT system at different blood glucose level in mice. METHODS: 27 male C57 mice were randomly divided into control group, diabetes group, and diabetes plus insulin group. The diabetic mice were induced by streptozotocin. Western-blot and double-immunofluorescence histochemistry were used to detect the expression of SCF and KIT. RESULTS: Both methods indicate that the level of S-SCF and M-SCF were decreased significantly in the diabetes group, and this trend can be reversed effectively when the insulin was utilized. CONCLUSION: The decline of SCF might be one of underlying mechanisms of diabetic encephalopathy.

Development and validation of UPLC method for quality control of Curcuma longa Linn.: Fast simultaneous quantitation of three curcuminoids.

A new reversed phase ultra performance liquid chromatography (UPLC) method was developed for the rapid quantification of three curcuminoids (curcumin (C), desmethoxycurcumin (DMC) and bisdesmethoxycurcumin (BDMC)) in Curcuma longa Linn. (C. longa) using a Waters BEH Shield RP C(18), 2.1 mm x 100 mm, 1.7 microm column. The runtime was 2 min. The influence of column temperature and mobile phase on resolution was investigated. The method was validated according to the ICH guideline for validation of analytical procedures with respect to precision, accuracy, and linearity. The limits of detection were 40.66, 49.38 and 29.28 pg for C, DMC and BDMC, respectively. Limits of quantitation for C, DMC and BDMC, were 134.18, 164.44 and 97.50 pg, respectively. Linear range was from 3.28 to 46.08 microg/ml. The mean+/-SD percent recoveries of curcuminoids were 99.47+/-1.66, 99.50+/-1.99 and 97.77+/-2.37 of C, DMC and BDMC, respectively. Comparison of system performance with conventional HPLC was made with respect to analysis time, efficiency and sensitivity. The proposed method was found to be reproducible and convenient for quantitative analysis of three curcuminoids in C. longa. This work provided some references for quality control of C. longa.