We aimed to evaluate the effect of remimazolam-based general anesthesia on cellular immune function and postoperative recovery quality in patients undergoing laparoscopic radical colorectal cancer surgery. A total of 90 patients scheduled for elective laparoscopic colorectal cancer radical surgery were randomly divided into 2 groups: the remimazolam group (Group R) and the propofol group (Group P), with 45 patients in each group. Anesthesia induction in Group R involved intravenous remimazolam, and in Group P, intravenous propofol until the loss of consciousness (modified observer's assessment of alertness/sedation [MOAA/S] score 1-2). Both groups then received intravenous sufentanil and cisatracurium for intubation. Cellular immune function markers (CD3+, CD4+, CD8+ T and natural killer [NK] cells) were recorded at different time points. Quality of Recovery [QoR]-15 scale scores, hemodynamic parameters, sedation scores (Riker and Ramsay scales), recovery times and adverse events were also recorded. Compared to Group P, Group R had significantly higher NK, CD3+, and CD4+ cell levels immediately after surgery and at 24 hours postoperatively. Group R showed a significantly lower incidence of intraoperative hypotension, bradycardia, and vasopressor use. Additionally, QoR-15 scores at 24 and 72 hours were higher in Group R. There were no significant differences in Riker or Ramsay scores, extubation time, post-anesthesia care unit stay, or the incidence of postoperative nausea, vomiting, and drowsiness between the 2 groups. Compared with propofol, remimazolam anesthesia results in better perioperative immune function preservation, reduced intraoperative hypotension and bradycardia, and improved postoperative recovery quality in patients undergoing laparoscopic radical colorectal cancer surgery.

BACKGROUND:Delayed wound healing is a common clinical complication following gastric cancer radical surgery, adversely affecting patient prognosis. With advances in artificial intelligence, machine learning offers a promising approach for developing predictive models that can identify high-risk patients and support early clinical intervention. AIM:To construct machine learning-based risk prediction models for delayed wound healing after gastric cancer surgery to support clinical decision-making. METHODS:We reviewed a total of 514 patients who underwent gastric cancer radical surgery under general anesthesia from January 1, 2014 to December 30, 2023. Seventy percent of the dataset was selected as the training set and 30% as the validation set. Decision trees, support vector machines, and logistic regression were used to construct a risk prediction model. The performance of the model was evaluated using accuracy, recall, precision, F1 index, and area under the receiver operating characteristic curve and decision curve. RESULTS:This study included five variables: Sex, elderly, duration of abdominal drainage, preoperative white blood cell (WBC) count, and absolute value of neutrophils. These variables were selected based on their clinical relevance and statistical significance in predicting delayed wound healing. The results showed that the decision tree model outperformed the logistic regression and support vector machine models in both the training and validation sets. Specifically, the decision tree model achieved higher accuracy, F1 index, recall, and area under the curve (AUC) values. The support vector machine model also demonstrated better performance than logistic regression, with higher accuracy, recall, and F1 index, but a slightly lower AUC. The key variables of sex, elderly, duration of abdominal drainage, preoperative WBC count, and absolute value of neutrophils were found to be strong predictors of delayed wound healing. Patients with longer duration of abdominal drainage had a significantly higher risk of delayed wound healing, with a risk ratio of 1.579 compared to those with shorter duration of abdominal drainage. Similarly, preoperative WBC count, sex, elderly, and absolute value of neutrophils were associated with a higher risk of delayed wound healing, highlighting the importance of these variables in the model. CONCLUSION:The model is able to identify high-risk patients based on sex, elderly, duration of abdominal drainage, preoperative WBC count, and absolute value of neutrophils can provide valuable insights for clinical decision-making.

As one of the volatile anaesthetic drugs commonly used in clinical anaesthesia, sevoflurane is extensively used in general anaesthesia surgery because of its rapid induction, hemodynamic stability, and rapid metabolism. However, postoperative cognitive dysfunction (POCD) is the most prevalent complications of its clinical application. Neuroinflammation and neuronal apoptosis are currently believed to be the primary mechanisms responsible for the development of cognitive dysfunction. MicroRNAs (miRNAs) can negatively regulate the expression of target genes, thereby influencing neurological and cognitive processes. Therefore, the effects and potential mechanisms of miRNAs on cognitive function may provide new ideas for the prevention and treatment of sevoflurane-induced POCD, a topic of intense research interest at the moment. The mechanisms involved in sevoflurane-induced POCD, the regulation of miRNAs expression by sevoflurane, and the effects of miRNAs on target genes and downstream signalling pathways were reviewed in order to obtain a comprehensive understanding of the effects of miRNAs on cognitive function.

OBJECTIVES:Postoperative hypothermia is a common clinical complication with a high incidence rate, potentially adversely affecting postoperative recovery. Transurethral holmium laser enucleation of the prostate (HoLEP) is a minimally invasive procedure for benign prostatic hyperplasia (BPH). Offering advantages such as minimal bleeding, broad indications, and rapid postoperative recovery. However, research on risk factors for postoperative hypothermia following HoLEP remains limited, and predictive models for guiding clinical practice are lacking. This study aims to develop a predictive model for assessing the risk of postoperative hypothermia in HoLEP patients and to identify relevant risk factors. METHODS:Clinical data from patients who underwent HoLEP at affiliated Hospital of Shandong Second Medical University were retrospectively collected. Patients were categorized into a hypothermia group and a non-hypothermia group based on whether postoperative hypothermia occurred. Preoperative, intraoperative, and postoperative indicators were compared between the 2 groups. Least absolute shrinkage and selection operator (LASSO) regression combined with logistic regression analysis was used to analyze clinical data. A predictive model for assessing the risk of postoperative hypothermia after HoLEP was constructed and internally validated using bootstrap resampling. RESULTS:A total of 403 patients were included in the analysis, among whom 85 patients developed postoperative hypothermia, with an incidence rate of 21.1%. Logistic regression analysis identified operative duration (OR=1.009, 95% CI 1.003 to 1.015), underweight status (OR=9.881, 95% CI 4.038 to 24.910), and prostate weight (OR=1.021, 95% CI 1.012 to 1.030) as independent risk factors for postoperative hypothermia, and these variables were incorporated into the nomogram model. Internal validation showed strong discriminative ability of the nomogram, with an area under the receiver operating characteristic curve (AUC) of 0.755 (95% CI 0.686 to 0.820) and a C-index of 0.832 (95% CI 0.787 to 0.865). The calibration curve demonstrated good consistency between predicted and observed outcomes. Decision curve analysis showed that the nomogram provided greater clinical utility when the risk threshold for postoperative hypothermia was between 8% and 97%. CONCLUSIONS:This study developed a nomogram model for predicting the risk of postoperative hypothermia in HoLEP patients, providing clinicians with a simple and effective predictive tool for individualized risk assessment and preoperative decision-making.

The aim of this study is to develop a nomogram to assess the risk of surgical site infection in elderly patients undergoing open lumbar spine surgery and explore related risk factors. We reviewed the records of 578 elderly patients who had undergone open lumbar spine surgery. The clinical parameters were subjected to lasso regression and logistic regression analyses. Subsequently, a nomogram was constructed to predict the risk of postoperative surgical site infection and validated using bootstrap resampling. A total of 578 patients were included in the analysis, of which 17 were diagnosed as postoperative surgical site infection. Following the final logistic regression analysis, obesity, hypoalbuminemia and drinking history were identified as independent risk factors and subsequently incorporated into the nomogram. The nomogram demonstrated excellent discrimination, with an area under the receiver-operating characteristic curve of 0.879 (95% CI 0.769 ~ 0.989) after internal validation. The calibration curve exhibited a high level of consistency. Decision curve analysis revealed that this nomogram had greater clinical value when the risk threshold for surgical site infection occurrence was >1% and <89%. We had developed a nomogram for predicting the risk of postoperative surgical site infection in elderly patients who had undergone open lumbar spine surgery. Validation using bootstrap resampling demonstrated excellent discrimination and calibration, indicating that the nomogram may hold potential clinical utility as a simple predictive tool for healthcare professionals.

目的 探讨罗哌卡因(RVC)对膀胱癌细胞的生长和化疗效果的影响及其潜在作用机制.方法 在使用不同浓度的罗哌卡因(0、0.1、0.5、1.0和2.0 mmol/L)处理膀胱癌细胞J82和T24细胞系后,采用CCK-8、EDU染色和细胞克隆形成能力实验检测细胞增殖水平.借助细胞划痕实验和Transwell小室检测罗哌卡因对细胞迁移和侵袭的影响.采用TUNEL和蛋白质印迹法检测细胞凋亡水平以及凋亡相关蛋白的表达.采用CCK-8检测罗哌卡因对丝裂霉素C(MMC)或吡柔比星(THP)的化疗效果影响.采用蛋白质印迹实验检测细胞AKT/GSK-3β/β-catenin信号蛋白的表达.结果 在细胞增殖研究中,与对照组相比,随着罗哌卡因处理浓度的提高,膀胱癌J82(F=19.512,P＜0.001)和T24细胞(F=68.939,P＜0.001)增殖水平被显著抑制.随着罗哌卡因浓度升高,J82和T24细胞侵袭水平和迁移率均降低,F 值分别为 45.290、51.910、172.200 和 84.820,均 P＜0.001;J82(F=506.200,P＜0.001)和 T24 细胞(F=811.500,P＜0.001)凋亡率均升高;J82 细胞 Bcl-2(F=65.080,P＜0.001)表达水平降低,Bax(F=91.150,P＜0.001)和 cleaved caspase-3(F=148.500,P＜0.001)表达水平升高;T24 细胞 Bcl-2(F=96.320,P＜0.001)表达水平降低,Bax(F=150.800,P＜0.001)和cleaved caspase-3(F=91.660,P＜0.001)表达水平升高.应用MMC后,随着罗哌卡因浓度升高,J82(F=195.630,P＜0.001)和T24(F=108.390,P＜0.001)细胞增殖水平均降低;应用THP后呈现出相同的趋势,F值分别为289.068和156.865,均P＜0.001.随着罗哌卡因浓度升高,J82细胞p-AKT(F=41.770,P＜0.001)和p-GSK-3β(F=40.030,P＜0.001)表达水平均降低;T24 细胞 p-AKT(F=31.080,P＜0.001)和 p-GSK-3β(F=42.720,P＜0.001)表达水平降低.加入MMC或THP后,罗哌卡因可通过AKT/GSK-3β/β-catenin信号通路影响细胞凋亡、侵袭和迁移,均P＜0.001.结论 罗哌卡因通过AKT/GSK-3β/β-catenin信号抑制膀胱癌细胞的生长,增强化疗效果.

Objective:Diabetes mellitus (DM) implicates oxidative stress, apoptosis, and inflammation, all of which may contribute liver injury. Aerobic exercise is assured to positively regulate metabolism in the liver. This project was designed to investigate whether and how aerobic exercise improves DM-induced liver injury.Methods:Seven-week-old male db/db mice and age-matched m/m mice were randomly divided into a rest control group or a group that received 12 weeks of aerobic exercise by treadmill training (10 m/min). Haematoxylin and eosin (HE) staining, electron microscopy, Oil Red O staining and TUNEL assays were used to evaluate the histopathological changes in mouse liver. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglyceride (TRIG), cholesterol (CHOL) were analyzed by serum biochemical analysis. Interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α), and tissue levels of malondialdehyde (MDA) and superoxide dismutase (SOD) were analyzed via ELISA. Nuclear factor E2-associated factor-2 (Nrf2), nuclear factor κB (NF-κB) and JAK2/STAT3 pathway-related proteins were measured by immunofluorescence, Western blotting and q-PCR. F4/80 expression in liver tissues was assessed by immunohistochemistry.Results:In diabetic mice, exercise training significantly decreased the levels of serum TRIG, CHOL, IL-6, TNF-α, ALT and AST; prevented weight gain, hyperglycaemia, and impaired glucose and insulin tolerance. Morphologically, exercise mitigated the diabetes-induced increase in liver tissue microvesicles, inflammatory cells, F4/80 (macrophage marker) levels, and TUNEL-positive cells. In addition, exercise reduced the apoptosis index, which is consistent with the results for caspase-3 and Bax. Additionally, exercise significantly increased SOD activity, decreased MDA levels, activated Nrf2 and decreased the expression of NF-kB, phosphorylated JAK2 and STAT3 proteins in the livers of diabetic mice.Conclusion:This study demonstrated that aerobic exercise reversed liver dysfunction in db/db mice with T2DM by reducing oxidative stress, apoptosis and inflammation, possibly by enhancing Nrf2 expression and inhibiting the JAK2/STAT3 cascade response.

Primary dysmenorrhea is one of the common gynecological diseases of women of childbearing age, which can affect the work, study, and life of patients in severe cases. From the perspective of Western medicine, primary dysmenorrhea is caused by excessive secretion of prostaglandin and contraction of uterine smooth muscle, so the treatment focus of Western medicine is oral non-steroidal anti-inflammatory drugs or contraceptives, but its side effects cannot be ignored. From the perspective of Chinese medicine, primary dysmenorrhea is caused by qi-blood stagnation, so the focus of Chinese medication is dialectical treatment, which can improve qi-blood stagnation by acupuncture, decoction, moxibustion, etc., with fewer side effects and long-term clinical significance. The purpose of this paper is to analyze the relevant literature about the pathogenesis and treatment of primary dysmenorrhea in recent years, and to understand the research progress of primary dysmenorrhea in Western medicine and traditional Chinese medicine, so as to provide a reference for clinical treatment of primary dysmenorrhea.

Objective: To compare the efficacy of intrathecal injection, nerve ozone injection, ozone injection around gasserian ganglion and combined with C-arm guided pulsed radiofrequency（PRF） in the treatment of facial postherpetic neuralgia. Methods: Collected the information of patients who suffered from postherpetic neuralgia（PHN） pain in the head and face from June 2016 to 2022 March in department of Anesthesiology, Pain and Sleep Medicine, Aviation General Hospital, then divided into intrathecal injection group of 35 patients, nerve ozone injection group of 26 patients, ozone injection around gasserian ganglion group of 35 patients and PRF combined ozone injection group of 12 patients according to the procedure. The patients were followed up for three months and six months after procedure. Visual analogue scale（VAS）, Barrow neurological institute（BNI） pain score and Pittsburgh sleep quality index（PSQI） were used to evaluate pain and sleep quality, and side effects were observed.Tactile abnormalities were assessed by von Frey. Results: The VAS, BNI, and PSQI scores in the four groups were significantly lower than pre-treatment. Compared with the intrathecal injection, nerve ozone injection and ozone injection with gasserian ganglion groups, the VAS, BNI, and PSQI scores of C-arm guided radiofrequency group was lower at 6 months（P ＜ 0.05）. Conclusion: Intrathecal injection, nerve ozone injection, ozone injection around gasserian ganglion and combined with pulsed radiofrequency are effective therapies for the treatment of head and facial PHN which can significantly relief the pain and improve the quality of sleep, but the effect of PRF combined with ozone group was better after 6 months.

目的:探讨了艾司氯胺酮用于乳腺癌根治术术中维持对患者苏醒期镇痛与镇静评分的影响.方法:挑选择期乳腺癌根治手术患者60例(ASA)分级Ⅰ- Ⅱ级,体重指数(BMI)18-25kg/m2无艾司氯胺酮使用禁忌.采取随机的数字表法,将病人分为两组:全身麻醉复合艾司氯胺酮即实验组(n=30)和全身麻醉组即对照组(n=30).入室常规面罩吸氧,开放外周静脉,连接监护仪,常规监测心率、血压、脉搏血氧饱和度、BIS等项目.对照组:使用丙泊酚和瑞芬太尼进行术中麻醉维持,使用恒速输液泵输注与试验组干预药物等容量的生理盐水.维

Dexmedetomidine, extensively utilized as an intravenous anesthetic in anesthesia, intensive care units, and other related medical departments, exhibits significant anti-inflammatory effects while inducing sedation. Numerous studies have demonstrated its capability to regulate autophagy, thereby exerting potent anti-inflammatory effects and offering therapeutic benefits in the treatment of acute lung injury. This article comprehensively reviews the mechanisms underlying autophagy, the role of dexmedetomidine in autophagy regulation, and the protective effects it conders in the context of acute lung injury. By doing so, it contributes positively to the arsenal of strategies aimed at both preventing and treating acute lung injury.

Previous studies have demonstrated a close association between α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid receptors (AMPARs) and depressive disorders, and activation of AMPARs may represent a promising way to treat depression. However, the effects of AMPAR potentiators on depression and the underlying mechanism have not been comprehensively clarified. We used lipopolysaccharide (LPS) to establish a depressive mouse model and an in vitro damage model of SH-SY5Y cells, and the AMPAR potentiator LY450108 was introduced to the study. We found that LY450108 alleviated LPS-induced depressive behavior and abnormal phosphorylation of hippocampal AMPARs in mice. LY450108 also alleviated LPS-induced apoptosis and decreased the viability of SH-SY5Y cells. In addition, LY450108 protected SH-SY5Y cells from LPS-induced abnormal phosphorylation of AMPARs. In conclusion, our findings suggest that LY450108 has antidepressant effects against LPS-induced neuronal damage and depression.

目的 探讨盐酸右美托咪啶(DEX)预先给药对内毒素肺损伤大鼠模型中缺氧诱导因子-1α(HIF-1α)、活性氧(ROS)和炎症介质白细胞介素-6(IL-6)表达及氧化应激的影响,评价DEX预先给药对内毒素性肺损伤的保护机制.方法 成年雄性SD大鼠30只,质量250～300 g,3～4个月龄,随机数字法分为空白对照组(C组)、内毒素组(L组)和内毒素+DEX预先给药组(D组)3组,每组10只.酶联免疫吸附法(ELISA)检测血清HIF-1α、ROS和IL-6含量变化;取肺组织,测定湿重/干重比(W/D)、超氧化物歧化酶(SOD)、丙二醛(MDA)和还原性谷胱甘肽(GSH)含量变化;蛋白质印迹法检测HIF-1α和IL-6蛋白表达.结果 注射内毒素可成功建立大鼠急性呼吸窘迫综合征肺损伤模型.C、L和D组血清HIF-1α分别为(0.261±0.015)、(0.287±0.025)和(0.387±0.056)ng/L;血清ROS分别为(1010±68)、(2172±175)和(1893±172)U/mL;血清IL-6分别为(29.73±1.92)、(72.13±13.28)和(42.15±6.71)ng/L,3组测定指标均值间差异有统计学意义,FROS=441.794,FHIF-1α=123.434,FIL-6=157.193,均P<0.001.两两多重比较显示,与C组比较,各组ROS、HIF-1α和IL-6表达均上调,均P<0.001;与L组比较,D组ROS和IL-6表达下调,HIF-1α表达上调,均P<0.001.蛋白质印迹法检测显示,与C组相比,L组HIF-1α及IL-6表达上调,均P<0.001;与L组相比,D组IL-6表达下调,HIF-1α升高,均P<0.001.C、L和D组的肺组织W/D分别为5.679±0.212、8.739±0.207和6.761±0.363,均值差异有统计学意义,FW/D=329.189,P<0.001;与C组比较,L组肺组织W/D值升高,P=0.001;与L组比较,D组肺组织W/D值降低,P<0.001.C、L和D组肺组织SOD分别为(191.09±8.89)、(117.45±10.50)和(159.33±11.42)U/mg,MDA分别为(12.31±0.55)、(47.36±0.36)和(34.67±0.28)mol/mg,GSH分别为(829.73±31.72)、(272.13±43.28)和(412.15±37.21)μmol/g.与C组比较,各组SOD和GSH表达下调,MAD表达上调,均P<0.001;与L组比较,各组SOD和GSH表达上调,MAD表达下调,均P<0.001.结论 DEX预先给药可减轻内毒素血症大鼠急性肺损伤程度,其机制可能为DEX可改善线粒体功能,抑制细胞线粒体,减轻内毒素致氧化应激损伤和凋亡.

A liquid chromatography-mass spectrometry (LC-MS) method for the analysis of corticosteroids in equine urine was developed. Corticosteroid conjugates were hydrolysed with beta-glucuronidase; free and enzyme-released corticosteroids were then extracted from the samples with ethyl acetate followed by a base wash. The isolated corticosteroids were detected by LC-MS and confirmed by LC-MS-MS in the positive atmospheric pressure chemical ionisation mode. Twenty-three corticosteroids (comprising hydrocortisone, deoxycorticosterone and 21 synthetic corticosteroids), each at 5 ng/ml in urine, could easily be analysed in 10 min.

Objective Explore the promoting effect of Internet + practice teaching model on medical students’ post competency. Methods From June 2018 to June 2020,160 five-year clinical medicine undergraduates（voluntary registration） from the Affiliated Hospital of Weifang Medical University, the first affiliated hospital and the Affiliated Yidu Central Hospital were selected as the research objects. Superior disciplines and superior clinical teaching resources of the affiliated hospitals（teaching hospitals） were integrated. Resources were shared among all hospitals, the Internet + practice teaching model was developed, and the factor index evaluation of medical students’ competency and the self-evaluation results of medical students’ competency were compared before and after teaching. Results The competency evaluation of medical students after Internet + practice teaching was significantly higher than that before teaching, and the difference was statistically significant（P＜0.05）. After the teaching reform, the clinical basic ability, comprehensive ability and scientific research ability of the medical students in this group were significantly improved compared with before teaching, and the comparison difference was statistically significant（P＜0.05）. Conclusion The construction of teaching implementation, security and management system based on Internet +, promoting the reform of clinical teaching methods through information technology, breaking the mode of clinical classroom teaching and clinical probation and practice independently in each hospital, is conducive to improving the post competency of medical students and cultivating excellent physicians in line with the development of The Times.

目的:帮助麻醉专业本科学生构建一种新的知识体系,提高职业素养和临床综合能力.方法:随机选取2016级麻醉学专业学生100人,对照组和实验组各50 人,将SimMan&MicroSim医学模拟培训系统应用到麻醉学技能教学培训与考核中.结果:利用此系统可提高麻醉学专业学生的交流沟通能力、临床操作能力、临床思维能力、危机管理能力和团队协作能力.结论:SimMan&MicroSim医学模拟培训系统可以提高麻醉专业本科学生的综合素质.

The pathogenesis of sepsis-associated encephalopathy (SAE) involves many aspects, including intracellular peroxidative stress damage, mitochondrial dysfunction, and cell apoptosis. In this study, we mainly explored the influence of P2X7R on the cognitive function of SAE and its molecular mechanism. We established a sepsis model using lipopolysaccharide (LPS) stimulation, followed by an assessment of cognitive function using Morris water maze, and then Western Blot was used to analyze the expression of tight junction proteins ZO-1 and Occludin in the hippocampus of mice. TUNEL assay was used to analyze the apoptosis of brain cells in frozen brain slices of mice during sepsis. Human brain microvascular endothelial cells (HBMECs) were used to research the molecular mechanism of brain cell damage induced by P2X7R. The results showed that P2X7R inhibitors dramatically improved the survival rate of mice, relieved the cognitive dysfunction caused by LPS stimulation, and significantly reduced the brain cell apoptosis caused by LPS. In addition, the inhibition of P2X7R can also reduce the production and accumulation of reactive oxygen species (ROS) in HBMECs in vitro and inhibit the apoptosis signaling pathway associated with mitochondrial serine protease Omi/HtrA2 in HBMECs in vitro. These results suggest that P2X7R has strong value as a potential target for the treatment of SAE.

新型冠状病毒肺炎(COVID-19)仍在全球范围内传播,尚无特效药应用于临床.乌司他丁(ulinastatin)在抗炎方面发挥重要作用,临床上主要应用于急性胰腺炎、休克和弥散性血管内凝血等,其还具有抗氧化应激、抗凝、免疫调节作用,可能对于降低COVID-19的严重程度和死亡率有重要意义.主要结合乌司他丁的药理作用及其在治疗急性呼吸窘迫综合征、脓毒症肺损伤等COVID-19并发症中的临床应用,论述其应用于COVID-19的可行性,以期为该病的临床治疗及新药研发提供帮助.

Abstract Background Postoperative cognitive dysfunction induced by anesthetics commonly occurs in elderly patients. This study aimed to evaluate the protective role of trametenolic acid B (TAB) in sevoflurane-induced cognitive impairments, and explore the underlying mechanisms. Methods Animal and cell experiments were performed in rats, differentiated PC12 and HAPI cells by exposing to 2% sevoflurane for 5 h. Different concentration (20, 40 and 80 µg/mL) of TAB was administrated in rats and cells. The cognitive function of rats was evaluated using the Morris water maze test and fear conditioning test. The cell proliferation and apoptosis were investigated using a CCK-8 assay and the flow cytometry. Pro-inflammatory cytokines in microglia were measured using ELISA kits. A miRNA microarray assay was conducted to screen differentially expressed miRNAs by TAB in both PC12 and HAPI cells. The luciferase reporter assay and western blot assay were used to assess the E2F1/CCNA2 and NF-κB pathways. Results TAB significantly alleviated sevoflurane-induced cognitive impairments in rats, improved PC12 cell viability, and inhibited the neuroinflammation of HAPI cells. miR-329-3p was downregulated in PC12 cells but upregulated in HAPI cells by TAB treatment, which mediated the effects of TAB on neurotoxicity and neuroinflammation. E2F1 and NF-κB P65 were two targets of miR-329-3p, and the E2F1/CCNA2 and NF-κB pathways were inhibited by miR-329-3p in PC12 and HAPI cells, respectively. Conclusions All the results provide evidence for the protective role of TAB against sevoflurane-induced cognitive impairments, which was achieved by alleviating neurotoxicity and neuroinflammation through differentially regulating miR-329-3p in neurons and microglia.

Background: Non-large artery atherosclerosis (LAA) infarcts are relatively rare compared to LAA type infarcts. Hemorrhagic transformation (HT) is one of the complications of acute ischemic stroke (AIS), and we aim to investigate the risk factors for the development of HT in patients with non-LAA type AIS.Patients and methods：From January 2015 to January 2020, we included a total of 52 patients with non-LAA type AIS who met the criteria for the occurrence of HT, for which 136 patients without HT were matched. Patients were followed up every 3 months by phone or in the clinic, with a minimum of 1 year of follow-up per patient. The risk factors associated with prognosis were derived after univariate analysis and multifactorial logistic regression analysis, and a nomogram model was developed based on these risk factors. The accuracy of the model was evaluated by creating a calibration plot and the receiver operating characteristic curve (ROC).Results: Through univariate analysis and logistics regression analysis, we found that the patient's creatine kinase-MB (CK-MB), ejection fraction (EF) and platelets (PLT) were independently related to the HT in patients with non-LAA type AIS. We accordingly developed smoothing curves to predict the probability of HT and found that the HT rate increased with increasing CK-MB and decreased with increasing EF and PLT. The nomogram based on these three factors had an area under curve (AUC) of 0.875 for the development group and 0.889 for the external validation group. The calibration plot showed a good prediction accuracy.Conclusions: Patients with non-LAA type AIS are relatively uncommon and presenting with HT is even rarer. Our nomogram built on cardiogenic parameters and PLT can accurately predict the occurrence of HT in these non-LAA type AIS patients, which has good clinical significance.