Xiaobin Wang

Postoperative cognitive dysfunction (POCD) commonly affects elderly surgical patients and is associated with impairments in memory, attention, and executive function that can substantially reduce quality of life. The precise pathogenesis of POCD remains unclear, although trauma-induced epigenetic mechanisms have been implicated. Conventional sequencing methods are hindered by reverse-transcription arrest at modified RNAs, which may result in the underrepresentation or loss of small noncoding RNAs (sncRNAs) with important regulatory functions. Here, we applied panoramic RNA display by overcoming RNA modification-induced aborted sequencing (PANDORA-seq) to generate a comprehensive profile of highly modified sncRNAs in the hippocampus of mice with surgery-induced cognitive impairment. The dataset profiles the composition of hippocampal sncRNA classes—including miRNAs, tsRNAs, rsRNAs, and piRNAs—in control and surgery-exposed mice during the early postoperative period. We performed sequencing quality-control analyses and, as an orthogonal, assay-level check on selected sequencing signals, quantified selected tsRNAs by qRT-PCR. Structural mapping of these tsRNAs to their parental tRNAs was also performed. Overall, this resource provides a foundation for investigating neuroepigenetic changes associated with early postoperative cognitive impairment and for generating hypotheses regarding the molecular mechanisms of POCD.

Population aging and declining fertility have transformed family life courses, yet their long-term implications for women’s health remain insufficien

Although depressive symptoms have been associated with subsequent cognitive outcomes, it remains unclear whether different long-term symptom patterns are linked to specific cognitive domains such as episodic memory and orientation. We analyzed 7,211 participants from the China Health and Retirement Longitudinal Study (CHARLS). Based on a prespecified rule-based approach using CES-D-10 depressive symptom scores from 2011 to 2015, participants were categorized into four symptom pattern groups: never depressed, early-remission, late-onset, or persistent/recurrent. Linear regression was used to evaluate associations between these patterns and 2018 cognitive outcomes, adjusting for baseline cognition and potential confounders. Subgroup, sensitivity, and directional analyses were conducted to evaluate consistency and temporal direction. An exploratory pathway analysis examined whether grip strength and sleep disturbance might partly account for the association between the persistent/recurrent depressive symptom pattern and episodic memory. External validation was conducted using data from the Health and Retirement Study (HRS). Compared with the never depressed group, the late-onset and persistent/recurrent depressive symptom patterns were associated with lower 2018 episodic memory (adjusted coefficients: -0.932 [95% CI, - 1.227 to - 0.637] and - 0.842 [- 1.104 to - 0.580], respectively), whereas associations for the early-remission pattern were weaker. For orientation, significant associations were observed only for the late-onset and persistent/recurrent depressive symptom patterns. Associations were stronger among women and those with lower educational attainment. In an exploratory pathway analysis (n = 5,721), lower grip strength and greater sleep disturbance partly explained the association between the persistent/recurrent depressive symptom pattern and episodic memory (estimated indirect contribution: 16.9%). Directional analyses suggested potential bidirectionality between depressive symptoms and episodic memory. External validation in the HRS showed associations in the same direction. Persistent/recurrent and late-onset depressive symptom patterns were associated with poorer subsequent cognitive outcomes, particularly among women and individuals with lower educational attainment. Lower grip strength and more severe sleep disturbance may partly account for the association between the persistent/recurrent depressive symptom pattern and episodic memory. Directional analyses also indicated a bidirectional interplay between depressive symptoms and cognitive outcomes. Our findings suggest that long-term monitoring of depressive symptom patterns, together with attention to physical function and sleep health, may help identify individuals at elevated risk of cognitive decline.

Retrospective analyses have associated elevated mechanical power (MP) during one-lung ventilation (OLV) with reintubation rates and emergent non-invasive v

Background: As an intravenous general anaesthetic, esketamine has rapid and evident antidepressant effects and therefore helps prevent post-partum depression (PPD). This study aimed to observe the effect of intraoperative esketamine application on patients with PPD undergoing caesarean section and to explore whether this effect varies among patients with different personality types. Methods: A total of 280 patients who underwent elective caesarean section under spinal anaesthesia were randomly divided into esketamine and control groups. On the day before the surgery, each patient was assessed using the Edinburgh Post-partum Depression Scale (EPDS), Self-Rating Anxiety Scale(SAS), Self-Rating Depression Scale (SDS) and Eysenck Personality Questionnaire. Additionally, the pressure–pain threshold was measured. The esketamine group received a single intravenous injection of esketamine at a dose of 0.25 mg/kg (diluted to 5 mL and administered intravenously within 10 min after foetus removal). The control group received 5 mL of 0.9% normal saline. The primary outcome was PPD incidence, assessed using the EPDS on the 3rd post-operative day. The secondary outcomes included post-operative pain score and esketamine safety assessment. Results: Statistically significant differences in PPD incidence were observed among patients with different personality types (introverted unstable, 66.70%; extroverted unstable, 45.50%; extroverted stable, 19.40%; and introverted stable, 15.00%, p < 0.05). The patients with an extroverted-stable personality in the esketamine group had a lower PPD incidence than those in the control group (11.90% vs. 25.70%, p < 0.05). No statistical difference in total PPD incidence was observed between the two groups (35.7% vs. 29.3%, p > 0.05). Pain scores in the esketamine group were lower than those in the control group while at rest (4, 24 and 48 h) and during movement (4 and 8 h) after surgery (p < 0.05). The mean arterial pressure and heart rate in the esketamine group were higher than those in the control group during surgery (p < 0.05). Conclusion: A single intravenous administration of esketamine had no apparent effect on the overall PPD incidence among patients undergoing caesarean section. It may have a beneficial effect in reducing PPD incidence in patients with an extroverted-stable personality. Trial Registration: Chinese Clinical Trial Registry, ChiCTR2100050976, 09/09/2021, http://www.chictr.org.cn.

Remimazolam (Rema) is a novel anesthetic that is widely used in anesthesia and sedation in critically ill patients. Notably, Rema exerts effects in patients through activation of the γ‑aminobutyric acid (GABA) receptor. GABA may alleviate myocardial ischemia/reperfusion (I/R) injury; however, the impact of Rema and underlying molecular mechanism in myocardial I/R injury remain to be fully understood. Therefore, the present study aimed to investigate the effects of Rema on cardiac I/R injury and to determine the underlying mechanisms. An acute myocardial I/R model was established by ligating the left anterior descending artery in adult male C57BL/6 mice (8‑10 weeks). Cultured Raw264.7 cells treated with lipopolysaccharide (LPS) were also used to investigate the effect of Rema on macrophages. The results of the present study revealed that Rema improved I/R‑induced cardiac dysfunction by increasing the ejection fraction value and reducing the myocardial infarction area. In addition, Rema also alleviated I/R‑induced cardiac inflammatory cell infiltration based on H&E and immunofluorescence staining. Transmission electron microscopy and ROS measurements showed that Rema improved I/R‑induced mitochondrial structural disruption and oxidative stress in cardiomyocytes. Transcriptomics analysis and reverse transcription‑quantitative PCR revealed that Rema alleviated I/R‑induced release of inflammatory factors and cytokines by inhibiting the expression of IL‑1β, IL‑6, C‑C chemokine receptor 2 and C‑X‑C motif chemokine ligand 5. Rema also inhibited I/R‑induced CD68+ cell proliferation, IL‑1β release, and NOD‑like receptor thermal protein domain associated protein 3 (NLRP3) and IL‑1β expression. The results of in vitro assays revealed that Rema inhibited LPS‑induced increases in IL‑1β, IL‑6 and TNF‑α expression and release in cultured RAW264.7 macrophages. In conclusion, the present study revealed that Rema may alleviate I/R‑induced cardiac dysfunction and myocardial injury by inhibiting oxidative stress and inflammatory responses via the NLRP3/IL‑1β pathway.

Background: Numerous studies have shown that butorphanol exerts an inhibitory effect on visceral pain. The aim of this study was to observe the effects of a single epidural administration of butorphanol combined with patient-controlled intravenous analgesia on postpartum uterine contraction pain after cesarean section. Methods: We randomly allotted 121 women undergoing cesarean section surgery procedure to 3 groups: 31 cases were excluded; and 90 cases were divided into group S (blank control, n = 30), group I (intravenous butorphanol, n = 30), and group E (butorphanol administered into the epidural cavity, n = 30). We then observed changes in the indices of uterine contraction pain and intraoperative stretch pain for the 3 groups. Results: (1) In terms of the uterine contraction pain, the visual analog scale scores of group I were lower than those for group S at 10 minutes (P = .001), 20 minutes (P < .001), 30 minutes (P < .001), 1 hour (P < .001), 2 hours (P < .001), and 4 hours (P < .001) after the epidural administration. The visual analog scale scores of group E were lower than those of group I at 10 minutes (P < .001), 20 minutes (P < .001), 30 minutes (P < .001), 1 hour (P < .001), 2 hours (P < .001), 4 hours (P < .001), and 6 hours (P < .001) after the administration. (2) In terms of intraoperative traction reactions, sedation, and comfort during the operation, group E was superior to groups S and I at any time points (all P < .043). Conclusions: Butorphanol single epidural administration combined with intravenous patient-controlled analgesia can effectively reduce the pain of uterine contraction and intraoperative traction reaction and improve perioperative comfort of the parturient.

Patients with Postherpetic Neuralgia (PHN) often exhibit depressive-like symptoms, significantly impacting their quality of life. Esketamine, known for its analgesic properties, has also been recognized for its rapid antidepressant effects. However, its efficacy in the treatment of PHN requires further exploration. This study aims to evaluate the impact of intravenous patient-controlled analgesia(PICA) with esketamine on depressive mood in PHN patients. This retrospective study analyzed PHN patients hospitalized and treated at the affiliated hospital of Southwest Medical University from June 2021 to March 2023. Patients were divided into the esketamine group (E group) and the sufentanil group (S group) based on their treatment regimens. Primary outcomes included pain numerical rating scale(NRS), depression patient health questionaire-9(PHQ-9), and anxiety generalized anxiety disorder-7(GAD-7) scores measured before treatment, and at 3 days, 7 days, 1 month, 2 months, and 3 months post-treatment. A total of 83 patients were included in the analysis. Before treatment, there were no statistically significant differences in pain NRS, depression PHQ-9, and anxiety GAD-7 scores between the two groups (P > 0.05). Compared to before treatment, significant reductions in pain NRS scores were observed at all post-treatment time points in both groups (P < 0.05), with no differences between groups (P > 0.05). The E group exhibited significantly lower depression PHQ-9 scores than the S group at 3 days and 7 days post-treatment (P < 0.05), but no significant differences were observed at 1 month, 2 months, and 3 months (P > 0.05). Anxiety GAD-7 scores were significantly lower in the E group compared to the S group at 3 days, 7 days post-treatment (P < 0.05), with no statistical differences at 1 month, 2 months, and 3 months post-treatment (P > 0.05). Both PICA with esketamine and sufentanil alleviated pain equally in PHN patients. However, PICA with esketamine specifically improved early symptoms of anxiety and depression.