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The objective of this study was to explore the potential causalities of fat mass, nonfat mass and height (henceforth, 'anthropometric measures') with sepsis risk and mortality. We conducted the Mendelian randomization (MR) investigation using genome-wide association study (GWAS) summary statistics of anthropometric measures, sepsis, and sepsis mortality. The GWAS summary data from the UK Biobank was used. Firstly, MR analysis was performed to estimate the causal effect of anthropometric measures on the risk of sepsis. The inverse-variance weighted (IVW) method was utilized as the primary analytical approach, together with weighted median-based method. Cochrane's Q test and MR-Egger intercept test were performed to assess heterogeneity and pleiotropy, respectively. Finally, we performed a series of sensitivity analyses to enhance the precision and veracity of our findings. The IVW method showed that genetically predicted weight-related measures were suggestively linked to an increased risk of sepsis. However, height displayed no causal association with sepsis risk and mortality. Furthermore, weight-related measures also displayed significant MR association with the sepsis mortality, except body nonfat mass and right leg nonfat mass. However, MVMR analysis indicated the observed effects for weight-related measures in the univariable MR analyses are more likely a bias caused by the interrelationship between anthropometric measures. According to the MR-Egger intercept assessment, our MR examination was not influenced by horizontal pleiotropy (all p>0.05). Moreover, the reliability of the estimated causal association was confirmed by the sensitivity analyses. In conclusion, these findings provided vital new knowledge on the role of anthropometric-related measures in the sepsis etiology. [ABSTRACT FROM AUTHOR]

Postoperative cognitive dysfunction (POCD) is a neurological complication associated with surgery and anesthesia that is commonly observed in older patients, and it can significantly affect patient prognosis and survival. Therefore, predicting and preventing POCD is important. Regional cerebral oxygen saturation (rSO2) reflects cerebral perfusion and oxygenation, and decreased intraoperative cerebral oxygen saturation has been reported to increase the risk of POCD. In this review, we elucidated the important relationship between the decline in rSO2 and risk of POCD in older patients. We also emphasized the importance of monitoring rSO2 during surgery to predict and prevent adverse perioperative cognitive outcomes. The findings reveal that incorporating intraoperative rSO2 monitoring into clinical practice has potential benefits, such as protecting cognitive function, reducing perioperative adverse outcomes, and ultimately improving the overall quality of life of older adults. [ABSTRACT FROM AUTHOR]

To investigate the protective effect of dexmedetomidine (Dex) on traumatic spinal cord injury (TSCI) and to evaluate the involvement of inhibition of endoplasmic reticulum (ER) stress response in the potential mechanism. Sprague–Dawley rats were randomly divided into five groups. The hind limb locomotor function of rats was evaluated at 1, 3 and 7 days after the operation. At 7 days after the operation, spinal cord specimens were obtained for hematoxylin and eosin (H&E), Nissl and TUNEL staining, as well as immunofluorescence and Western blot analyses to detect the level of apoptosis and the levels of proteins related to ER stress. 7 days after the operation, Dex treatment promoted the recovery and also inhibited apoptosis of neurons in the spinal cord. Additionally, Dexinhibited the expression of proteins related to ER stress response after spinal cord injury. Dex improves the neurological function of rats with TSCI and reduces apoptosis of spinal cord neurons. The potential mechanism is related to the inhibition of the ER stress response. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the molecular mechanism of quercetin in the treatment of sepsis using network pharmacological prediction and experimentation., Methods: Hub genes were identified by intersecting the differentially expressed genes (DEGs) of the GSE131761 and GSE9960 databases with genes from the hub modules of Weighted Gene Co-Expression Network Analysis (WGCNA), targets of quercetin, and ferroptosis. Subsequently, in order to determine the functional characteristics and molecular link of hub gene obtained above, we redetermined the hub-DEGs in GSE131761 according to high or low hub gene expression. Afterward, the main pathways of enrichment analysis were validated using these hub-DEGs. Finally, an experiment was conducted to validate the findings., Results: By intersecting 1415 DEGs in GSE131761, 543 DEGs in GSE9960, 5784 key modular genes, 470 ferroptosis-related genes, and 154 quercetin-related genes, we obtained one quercetin-related gene, Alox5 . Subsequently, 340 hub-DEGs were further validated according to high or low Alox5 expression. The results of the enrichment analysis revealed that hub-DEGs were mainly associated with inflammation and the immune response. Immune infiltration analysis showed that higher expression of Alox5 was related to macrophage infiltration and could be a predictor of diagnosis in patients with sepsis. The expression pattern of Alox5 was then depicted and the upregulation of Alox5 in the vital organs of septic mice was further demonstrated. In vitro and in vivo experiments showed that upregulation of Alox5 and inflammation-related cytokines induced by sepsis could be inhibited by quercetin ( p  < 0.05)., Conclusions: Alox5 may be involved in the occurrence and development of multi-organ functional disturbances in sepsis and is a reliable target of quercetin against sepsis.

Purpose: In order to classify different types of health data collected in clinical practice of hernia surgery more effectively and improve the classification performance of support vector machine (SVM). Methods: A prospective randomized study was conducted. Sixty patients undergoing hernia repair under general anesthesia were randomly divided into two groups, PLMA group ( n = 30) and ETT group ( n = 30), for airway management. Heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, respiratory parameters and the incidence of complications related to ProSeal laryngeal mask airway (PLMA) and endotracheal tube (ETT) were collected in clinical experiments in order to evaluate the operation condition. On the basis of this experiment, at first, expert credibility is introduced to process the index value; secondly, the classification weight of the index is objectively determined by the information entropy output of the index itself; finally, a comprehensive classification model of support vector machine based on key sample set is proposed and its advantages are evaluated. Result: After classifying the experimental data, we found that SVM can accurately judge the effect of surgery by data. In this experiment, PLMA method is better than ETT method in xenon repair operation. Discussion: SVM has great accuracy and practicability in judging the outcome of xenon repair operation. Conclusion: The proposed index classification weight model can deal with the uncertainties caused by uncertain information and give the confidence of the uncertain information. Compared with the traditional SVM method, the proposed method based on SVM and key sample set greatly reduces the number of samples that misjudge the effect of samples, and improves the practicability of SVM method. It is concluded that PLMA is superior to the ETT technique to hernia surgical. The idea of constructing classification model based on key sample set proposed in this paper can also be used for reference in other data mining methods.

Objective: To compare the diagnostic accuracy of stroke volume variation (SVV) and pulse pressure variation (PPV) in studies that examined both parameters in the same patient population., Methods: Literature search was conducted in PubMed, EMBASE, CINAHL, and Google Scholar. Receiver operator characteristic (ROC) curves were examined, and summary ROC curves were plotted., Results: The study was conducted from January to July 2013 in The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China. The meta-analysis of 19 studies published during the years 2005 and 2013 revealed a high degree of diagnostic accuracy of both SVV and PPV in predicting fluid responsiveness. The sensitivity and specificity of both the parameters were observed above 80% in a heterogeneous group of over 850 patients of which 55% responded to fluid challenge. The following values along with 95% confidence interval were noticed: SVV - sensitivity 82 (59-93%) and specificity 84 (62-95%), PPV - sensitivity 84 (62-95%) and specificity 83 (58-94%). Area under the curve values obtained in the pooled analysis were 0.84 (0.79-0.89) for SVV, and 0.88 (0.84-0.92) for PPV., Conclusion: Both SVV and PPV exhibit a high degree of diagnostic accuracy in predicting the success or failure of a fluid challenge in hemodynamically unstable critically ill patients under controlled mechanical ventilation.