ABSTRACT
Aging is a natural process accompanied with a progressive deterioration of cognitive functions. With an aging population, more and more elderly people are suffering from cognitive impairment. Previous studies have paid more attention to the impact of inflammation and oxidative stress on cognitive function during aging. Recently, it has been discovered that neurovascular coupling (NVC), a mechanism regulating cerebral blood flow, may play a significant role in aging-related cognitive impairment. NVC responses regulate the supply of energy substances and oxygen during brain activity, which in turn enhances cognitive function. However, as people grow older, NVC responses gradually weaken, which may be one of the mechanisms underlying aging-induced cognitive impairment. Given the important role of NVC responses in the brain, it is necessary to search for intervention methods that can improve NVC responses and promote cognitive function. Exercise is an effective means to delay aging and improve cognitive function. It also has a certain promoting effect on NVC responses. This article reviews the regulatory mechanisms of NVC responses, the relationship between NVC responses and cognitive function, and explores the effects of aging and exercise intervention on NVC responses, hoping to provide new research ideas for exercise intervention to improve NVC responses and promote cognitive function in the elderly.
Subject(s)
Humans , Aged , Neurovascular Coupling/physiology , Aging , Cerebrovascular Circulation/physiology , Cognition , BrainABSTRACT
Objective To evaluate the curative efficacy of endoscopic retrograde cholangiopancreatography (ERCP) on bile leaks after orthotopic liver transplantation (OLT). Methods Data of 12 cases, hospitalized in our hospital from March 2013 to February 2016, with bile leaks after OLT confirmed by magnetic resonance imaging of the pancreas (MRCP) or ERCP were retrospectively analyzed . The curative efficacy of ERCP was evaluated including clinical symptoms of bile leaks and complications, occurrence time and location, diagnosis and treatment process and efficacy. Results In this study, 12 cases were male patients, with the average age of 49.75 ± 8.55 (age from 35 to 62 years old). Among them 11 cases were successfully treated by endoscopic nasobiliary drainage (ENBD), and the success rate of endoscopical therapy was 91.7%, the curative rate of bile leaks was 91.7%(11/12). No ERCP related serious complications and death were found in patients. Nine cases combined with biliary strictures and/or biliary duct stone/bile plug were performed endoscopic sphinctrotomy (EST) during the first time of ERCP, and accepted further ERCP treatment after 2 weeks when the bile leaks were healed. All patients with ENBD were carried out well except one case. Conclusion ERCP is a safe and effective minimally invasive treatment method for different types of bile leaks after OLT.
ABSTRACT
ObjectiveTo evaluate the safety and feasibility of the standardized management model of anesthesia for painless digestive endoscopy.MethodsData of 17 100 patients who underwent painless endoscopy were reviewed for severe adverse reaction and complications.The model included anaesthetist-directed appointment,nurse assistance during operation,and postoperative nurse observation.Eight hundred cases (200 of gastric endoscopy,intestinal endoscopy,EUS and ERCP respectively) were randomly selected and analyzed for times of endoscopic diagnosis,anesthesia,wakening and discharge,and complications.ResultsOf the 17 100 cases,severe complications occurred in 10 (0.058％ ),including 3 apnea,one respiratory obstruction due to opisthognathism and glossoptosis,five larygneal spasm and 1 reflux inspiration.There was no anesthesia or endoscopy related death.Study of 800 cases showed intraoperative MAP,HR increase or decrease over 30％ of the baseline,the incidence of SpO2 ＜ 95％ were 6.0％ ～ 25.0％,3.0％ ～8.5％,≤2.0％,respectively.The rate of lethe,good quality of sleep were 99％ ～ 100％ and 98.0％ ～100.0％,respectively.The rates of cough,body movement and myoclonic were 0.5％ ～4.5％,5.5％ ～11.5％,and 1.5％ ～ 3.5％,respectively.Rates of nausea and vomiting,excitement,restlessness and dizziness were lower than 4％.ConclusionThe standardized management model,feasible,safe and effective,is able to facilitate anesthetic efficacy and reduce complications.