The Role of the Intestinal Flora and Its Derivatives in Neurocognitive Disorders: A Narrative Review from Surgical Perspective.

Perioperative neurocognitive dysfunction is a significant concern for population health, impacting postoperative recovery and increasing the financial burden on patients. With an increasing number of surgical procedures being performed, the prevention and management of perioperative neurocognitive dysfunction have garnered significant attention. While factors such as age, lifestyle, genetics, and education are known to influence the development of cognitive dysfunction, recent research has highlighted the role of the gut microbiota in neurological health. An increased abundance of pro-inflammatory gut microbiota can trigger and worsen neuroinflammation, neuronal cell damage, and impaired cellular autophagy. Moreover, the inflammation-promoting gut microbiota can disrupt immune function, impair neuroautophagy, and affect the production and circulation of extracellular vesicles and neurotransmitters. These factors collectively play a role in the onset and advancement of cognitive impairment. This narrative review delves into the molecular mechanisms through which gut microbiota and their derivatives contribute to cognitive impairment, focusing on the impact of anesthesia surgery, changes in gut microbial populations, and perioperative cognitive impairment associations. The study suggests that alterations in the abundance of various bacterial species and their metabolites pre- and post-surgery may be linked to postoperative cognitive impairment. Furthermore, the potential of probiotics or prebiotics in addressing cognitive impairment is discussed, offering a promising avenue for investigating the treatment of perioperative neurocognitive disorders.

Differentiation of three commercial tuna species through GC-Q-TOF and UPLC-Q/Orbitrap mass spectrometry-based metabolomics and chemometrics.

Food fraud is common in the tuna industry because of the economic benefits involved. Ensuring the authenticity of tuna species is crucial for protecting both consumers and tuna stocks. In this study, GC-Q-TOF and UPLC-Q/Orbitrap mass spectrometry-based metabolomics were used to investigate the metabolite profiles of three commercial tuna species (skipjack tuna, bigeye tuna and yellowfin tuna). A total of 22 and 77 metabolites were identified with high confidence using GC-Q-TOF and UPLC-Q/Orbitrap mass spectrometry, respectively. Further screening via chemometrics revealed that 38 metabolites could potentially serve as potential biomarkers. Hierarchical cluster analysis showed that the screened metabolite biomarkers successfully distinguished the three tested tuna species. Furthermore, a total of 27 metabolic pathways were identified through enrichment analysis based on the Kyoto Encyclopaedia of Genes and Genomes (KEGG) pathways.

MoS2/ReS2 Hollow Heterojunction for Enhanced Aqueous Zinc-Ion Storage Performance.

The research of cathode materials for water-based zinc ion batteries (ZIBs) is very hot because the current mainstream electrode makes it difficult to meet the requirements of high specific discharge capacity and maintain a stable structure in the electrochemical process. In this work, the cathode properties are adjusted by the modification idea of morphology regulation and heterojunction construction. The simple hydrothermal method is used to prepare the hollow bimetallic heterojunction nanospheres, and their electrochemical properties as cathode materials for ZIBs are studied for the first time. Herein, the optimized cathode delivers high-rate performance and long-term cycling stability (∼98.9% Coulombic efficiency at 0.1 A g-1 after 200 cycles). The results indicate that the hollow bimetallic heterojunction nanospheres can support the material structure and provide a wide Zn2+ migration channel. The excellent performance is because hollow heterojunction bimetallic sulfides can provide abundant catalytic active sites, improve the mobility of electrons, and enhance the battery performance fundamentally. Therefore, we firmly believe that the combination of the different modification ideas can coordinate to adjust the electrode performance of ZIBs, enriching the electrode types and expanding the energy system application range.

Super-Stretchable and High-Energy Micro-Pseudocapacitors Based on MXene Embedded Ag Nanoparticles.

The advancement of aqueous micro-supercapacitors offers an enticing prospect for a broad spectrum of applications, spanning from wearable electronics to micro-robotics and sensors. Unfortunately, conventional micro-supercapacitors are characterized by low capacity and slopy voltage profiles, limiting their energy density capabilities. To enhance the performance of these devices, the use of 2D MXene-based compounds has recently been proposed. Apart from their capacitive contributions, these structures can be loaded with redox-active nanowires which increase their energy density and stabilize their operation voltage. However, introducing rigid nanowires into MXene films typically leads to a significant decline in their mechanical properties, particularly in terms of flexibility. To overcome this issue, super stretchable micro-pseudocapacitor electrodes composed of MXene nanosheets and in situ reconstructed Ag nanoparticles (Ag-NP-MXene) are herein demonstrated, delivering high energy density, stable operation voltage of ≈1 V, and fast charging capabilities. Careful experimental analysis and theoretical simulations of the charging mechanism of the Ag-NP-MXene electrodes reveal a dual nature charge storage mechanism involving ad(de)sorption of ions and conversion reaction of Ag nanoparticles. The superior mechanical properties of synthesized films obtained through in situ construction of Ag-NP-MXene structure show an ultra stretchability, allowing the devices to provide stable voltage and energy output even at 100% elongation.

[Comparison of Clinical Characteristics of JAK2, CALR and Tri-Negative Driving Mutant Type in Patients with Essential Thrombocythemia].

OBJECTIVE: To investigate the relationship between mutated genes and clinical features in patients with essential thrombocythemia (ET). METHODS: The clinical data of 69 patients with ET from October 2018 to March 2022 were retrospectively analyzed. According to driver mutation type, patients were divided into JAK2 group, CALR group and triple-negative group. The sex, age, cardiovascular risk factors, thrombosis, splenomegaly, routine blood test and coagulation status of patients in three groups were analyzed. RESULTS: Among 69 ET patients, 46 cases were associated with JAK2 mutation, 14 cases with CALR mutation, 8 cases with triple-negative mutation, and one with MPL gene mutation. There were no significant differences in age and sex among the three groups (P >0.05). The highest thrombotic rate was 26.09% (12/46) in JAK2 group, then 12.5% (1/8) in triple-negative group, while no thrombotic events occurred in CALR group. The incidence of splenomegaly was the highest in JAK2 group (34.78%), while no splenomegaly occurred in triple-negative group. The white blood cell (WBC) count in JAK2 group was (9.00±4.86)×109/L, which was significantly higher than (6.03±2.32)×109/L in CALR group (P <0.05). The hemoglobin (Hb) and hematocrit (HCT) in JAK2 group were (148.42±18.79) g/L and (0.44±0.06)%, respectively, which were both significantly higher than (131.00±15.17) g/L and (0.39±0.05)% in triple-negative group (P <0.05). The platelet (PLT) in JAK2 group was (584.17±175.77)×109/L, which was significantly lower than (703.07±225.60)×109/L in CALR group (P <0.05). The fibrinogen (Fg) in JAK2 and triple-negative group were (2.64±0.69) g/L and (3.05±0.77) g/L, respectively, which were both significantly higher than (2.24±0.47) g/L in CALR group (P <0.05, P <0.01). The activated partial thromboplastin time (APTT) in triple-negative group was (28.61±1.99) s, which was significantly decreased compared with (31.45±3.35) s in CALR group (P <0.05). CONCLUSIONS: There are differences in blood cell count and coagulation status among ET patients with different driver gene mutations. Among ET patients, JAK2 mutation is most common. Compared with CALR group, the thrombotic rate, WBC and Fg significantly increase in JAK2 group, while PLT decrease. Compared with triple-negative group, the incidence of splenomegaly and HCT significantly increase. Compared with CALR group, Fg significantly increases but APTT decreases in triple-negative group.

Novel hollow MoS2@C@Cu2S heterostructures for high zinc storage performance.

Heterostructured materials have great potential as cathodes for zinc-ion batteries (ZIBs) because of their fast Zn2+ transport channels. Herein, hollow MoS2@C@Cu2S heterostructures are innovatively constructed using a template-engaged method. The carbon layer improves the electrical conductivity, provides a high in situ growth area, and effectively restricts volume expansion during the recycling process. MoS2 nanosheets are grown on the surfaces of hollow C@Cu2S nanocubes using the in situ template method, further expanding the specific surface area and exposing more active sites to enhance the electrical conductivity. As expected, an admirable reversible capacity of 197.2 mA h g-1 can be maintained after 1000 cycles with a coulombic efficiency of 91.1%. Therefore, we firmly believe that this work points the way forward for high-performance materials design and energy storage systems.

Evaluating the effects of graphene nanoparticles combined radio-frequency thawing on the physicochemical quality and protein conformation in hairtail (Trichiurus lepturus) dorsal muscle.

BACKGROUND: The thawing process is an essential step for a frozen marine fish. The present study aimed to investigate the effects of graphene magnetic nanoparticles combined radio-frequency thawing methods on frozen hairtail (Trichiurus lepturus) dorsal muscle. Seven thawing methods were used: air thawing, 4 °C cold storage thawing, water thawing, radio-frequency thawing (RT), radio frequency thawing combined with graphene nanoparticles (G-RT), radio frequency thawing combined with graphene oxide nanoparticles (GO-RT) and radio-frequency thawing combined with graphene magnetic nanoparticles (GM-RT). The thawing loss and centrifugal loss, electric conductivity, total volatile basic nitrogen, thiobarbituric acid reactive substances and color of thawed hairtail dorsal muscle were determined. The carbonyl content, total sulfhydryl groups, Ca2+ -ATPase activity, raman spectroscopy measurements and Fourier-transform infrared spectrometry measurements were determined using myofibrillar extracted from the dorsal muscle of hairtail. The water distribution was determined using low-field NMR techniques. RESULTS: The results demonstrated that the RT, G-RT, GO-RT and GM-RT could significantly shorten the thawing time. Moreover, GO-RT and GM-RT efficiently preserved the color of fish dorsal muscle and reduced the impact of thawing on fish quality by reducing lipid and protein oxidation. Meanwhile, the myofibrillar protein structure thawed by GO-RT and GM-RT were more stable and had a more stable secondary structure, which maintained strong systemic stability at the same time as slowing down protein oxidation. CONCLUSION: The results showed that GO-RT and GM-RT can significantly improve the thawing efficiency at the same time as effectively maintaining and improving the color and texture of thawed fish, slowing down the oxidation of proteins and lipids, and maintaining a good quality of thawed fish meat. © 2023 Society of Chemical Industry.

Optimizing the degradation of aflatoxin B1 in corn by Trametes versicolor and improving the nutritional composition of corn.

BACKGROUND: Corn, being an important grain, is prone to contamination by aflatoxin B1 (AFB1 ), and AFB1 -contaminated corn severely endangers the health of humans and livestock. Trametes versicolor, a fungus that can grow in corn, possesses the ability to directly degrade AFB1 through its laccase. This study aimed to optimize the fermentation conditions for T. versicolor to degrade AFB1 in corn and investigate the effect of T. versicolor fermentation on the nutritional composition of corn. AFB1 -contaminated corn was used as the culture substrate for T. versicolor. A combination of single-factor experiments and response surface methodology was employed to identify the optimal conditions of AFB1 degradation. RESULTS: The optimal conditions of AFB1 degradation were as follows: 9 days of fermentation, a fermentation temperature of 26.7 °C, a moisture content of 70.5% and an inoculation amount of 4.9 mL (containing 51.99 mg of T. versicolor mycelia). With the optimal conditions, the degradation rate of AFB1 in corn could reach 93.01%, and the dry basis content of protein and dietary fiber in the fermented corn was significantly increased. More importantly, the lysine content in the fermented corn was also significantly increased. CONCLUSION: This is the first report that direct fermentation of AFB1 -contaminated corn by T. versicolor not only efficiently degrades AFB1 but also improves the nutritional composition of corn. These findings suggest that the fermentation of corn by T. versicolor is a promising, environmentally friendly and efficient approach to degrade AFB1 and improve the nutritional value of corn. © 2023 Society of Chemical Industry.

Boosting the interfacial dynamics and thermodynamics in polyanion cathode by carbon dots for ultrafast-charging sodium ion batteries.

Ultrafast-charging is the focus of next-generation rechargeable batteries for widespread economic success by reducing the time cost. However, the poor ion diffusion rate, intrinsic electronic conductivity and structural stability of cathode materials seriously hinder the development of ultrafast-charging technology. To overcome these challenges, an interfacial dynamics and thermodynamics synergistic strategy is proposed to synchronously enhance the fast-charging capability and structural stability of polyanion cathode materials. As a case study, a Na3V2(PO4)3 composite (NVP/NSC) is successfully obtained by introducing an interface layer derived from N/S co-doped carbon dots. Density functional theory calculations validate that the interfacial bonding effect of V-N/S-C significantly reduces the Na+ transport energy barrier. D-band center theory analysis confirms the downward shift of the V d-band center enhances the strength of the V-O bond and considerably inhibits irreversible phase transformation. Benefitting from this interfacial synergistic strategy, NVP/NSC achieves a high capability and excellent cycling stability with a surprisingly low carbon content (2.23%) at an extremely high rate of 100C for 10 000 cycles (87.2 mA h g-1, 0.0028% capacity decay per cycle). Furthermore, a superior performance at 5C (115.3 mA h g-1, 92.1% capacity retention after 800 cycles) is exhibited by the NVP/NSC‖HC full cell. These findings provide timely new insights for the systematic design of ultrafast-charging cathode materials.

Combination of Biochar and Trichoderma harzianum Can Improve the Phytoremediation Efficiency of Brassica juncea and the Rhizosphere Micro-Ecology in Cadmium and Arsenic Contaminated Soil.

Phytoremediation is an environment-friendly method for toxic elements remediation. The aim of this study was to improve the phytoremediation efficiency of Brassica juncea and the rhizosphere soil micro-ecology in cadmium (Cd) and arsenic (As) contaminated soil. A field experiment was conducted with six treatments, including a control treatment (CK), two treatments with two contents of Trichoderma harzianum (T1: 4.5 g m-2; T2: 9 g m-2), one biochar treatment (B: 750 g m-2), and two combined treatments of T1B and T2B. The results showed Trichoderma harzianum promoted the total chlorophyll and translocation factor of Brassica juncea, while biochar promoted plant biomass compared to CK. T2B treatment showed the best results, which significantly increased Cd accumulation by 187.49-308.92%, and As accumulation by 125.74-221.43%. As a result, the soil's total Cd content was reduced by 19.04% to 49.64% and total As contents by 38.76% to 53.77%. The combined amendment increased the contents of soil available potassium, phosphorus, nitrogen, and organic matter. Meanwhile, both the activity of glutathione and peroxidase enzymes in plants, together with urease and sucrase enzymes in soil, were increased. Firmicutes (dominant bacterial phylum) and Ascomycota (dominant fungal phylum) showed positive and close correlation with soil nutrients and plant potentially toxic elements contents. This study demonstrated that phytoremediation assisted by biochar and Trichoderma harzianum is an effective method of soil remediation and provides a new strategy for enhancing plant remediation efficiency.

Smartphone-Assisted Flexible Electrochemical Sensor Platform by a Homology DNA Nanomanager Tailored for Multiple Cancer Markers Field Inspection.

In this work, an ingenious sensor technology was established by integrating the EBFCs on a flexible paper strip carrier (PE) that was used for simultaneous detection of tumor markers in complex samples. Adopting high performance ultrathin graphdiyne (U-GDY) as the substrate can increase the enzyme load, accelerate the electron transfer rate, and significantly enhance the detection sensitivity. A homologous DNA nanomanager strategy cleverly uses signal switches to recycle and amplify target miRNAs, while the smartphone receives real-time instantaneous current values to realize multivariate detection. Electrochemical data show that the detection limits (LODs) of miRNA-21 and miRNA-155 are 0.09 and 0.15 fM in the wide concentration range. The results confirm that the tailored sensor platform provides a strategy for the early cancer diagnosis and lays the foundation for the construction of a flexible wearable platform.

Cross-Sectional and Prospective Relationships Between Neuroticism and Depressive Symptoms Among College Students: The Mediating Role of Loneliness.

High levels of neuroticism are associated with an increased risk of depression. The mechanisms for this association are still unclear. This study investigated loneliness, a pervasive negative human emotion linked to depressive symptoms, as a potential mediator. Data were collected from 739 college students (71.6% females; mean age = 18.47, SD = .87) at two times points through 3 years. Self-report questionnaires were administered to assess neuroticism, loneliness, and depressive symptoms. Cross-sectional analyses of the baseline data suggested that loneliness mediates the association between neuroticism and depressive symptoms. Prospective analyses with two-wave data further prove that baseline neuroticism can predict the changes in depressive symptoms, and changes in loneliness sequentially mediated this association. These findings suggest a possibility of developing interventions for loneliness to interrupt the association between neuroticism and poorer mental health outcomes among college students.

Dyadic effects of cognitive function on depressive symptoms among middle-aged and older Chinese couples.

BACKGROUND: Although cognitive function and depressive symptoms have been suggested to be closely related, less attention has been paid to this association within married couples. This study explored the reciprocal dyadic relationship between cognitive function and depressive symptoms over time. METHODS: This study used four waves of data from the China Health and Retirement Longitudinal Study and analyses were restricted to middle-aged and older couples aged 45 or older. Actor-partner interdependence model adjusted for confounding factors was employed to examine the reciprocal association between cognitive function and depressive symptoms at both the individual and couple levels. Measures of cognitive function consisted of episodic memory and mental status. Depressive symptoms were measured by the Center for Epidemiological Studies Depression scale. RESULTS: For both husbands and wives, cognitive function was reciprocally associated with depressive symptoms at the individual level. Spouses' lower cognitive function was significantly linked to their partners' greater depressive symptoms. However, ones' depressive symptoms were not related to their partners' cognitive function. CONCLUSIONS: These findings expand our knowledge about the dyadic relationship between cognitive function and depressive symptoms in Chinese couples. Effects of interventions for depression in middle-aged and older adults may be enhanced by considering the marital context.

Xanthine Oxidase Inhibitory Peptides from Larimichthys polyactis: Characterization and In Vitro/In Silico Evidence.

Hyperuricemia is linked to a variety of disorders that can have serious consequences for human health. Peptides that inhibit xanthine oxidase (XO) are expected to be a safe and effective functional ingredient for the treatment or relief of hyperuricemia. The goal of this study was to discover whether papain small yellow croaker hydrolysates (SYCHs) have potent xanthine oxidase inhibitory (XOI) activity. The results showed that compared to the XOI activity of SYCHs (IC50 = 33.40 ± 0.26 mg/mL), peptides with a molecular weight (MW) of less than 3 kDa (UF-3) after ultrafiltration (UF) had stronger XOI activity, which was reduced to IC50 = 25.87 ± 0.16 mg/mL (p < 0.05). Two peptides were identified from UF-3 using nano-high-performance liquid chromatography-tandem mass spectrometry. These two peptides were chemically synthesized and tested for XOI activity in vitro. Trp-Asp-Asp-Met-Glu-Lys-Ile-Trp (WDDMEKIW) (p < 0.05) had the stronger XOI activity (IC50 = 3.16 ± 0.03 mM). The XOI activity IC50 of the other peptide, Ala-Pro-Pro-Glu-Arg-Lys-Tyr-Ser-Val-Trp (APPERKYSVW), was 5.86 ± 0.02 mM. According to amino acid sequence results, the peptides contained at least 50% hydrophobic amino acids, which might be responsible for reducing xanthine oxidase (XO) catalytic activity. Furthermore, the inhibition of the peptides (WDDMEKIW and APPERKYSVW) against XO may depend on their binding to the XO active site. According to molecular docking, certain peptides made from small yellow croaker proteins were able to bind to the XO active site through hydrogen bonds and hydrophobic interactions. The results of this work illuminate SYCHs as a promising functional candidate for the prevention of hyperuricemia.

Novel Peptide from the Hydrolysate of Hybrid Sturgeon (Acipenseridae) Spinal Cord: Isolation, Identification, and Anti-proliferative Effects in Human Cervix Cancer Cells.

Anti-proliferative peptides have recently attracted attention for their excellent bioactivity and biocompatibility. In this paper, five novel anti-proliferative peptides were identified from the hydrolysate of hybrid sturgeon spinal cord (HSSC). In addition, the structure-activity relationship of the novel anti-proliferative peptides was explored. In vitro experiments indicated that the peptide "VDSVLDVVRK" presented the highest inhibition of HeLa cell growth in all samples (IC50 = 2.5 µM). VDSVLDVVRK showed a random coil secondary structure and nanomicelles in the tumor microenvironment. Transmission electron microscopy results confirmed that nanomicelles disassemble as the concentration of VDSVLDVVRK decreases. Furthermore, VDSVLDVVRK could induce HeLa cell apoptosis by increasing the expression of Cyt-c (98.65 ± 1.85%, p < 0.01) and caspase-9 (39.85 ± 1.81%, p < 0.01). In this study, the anti-proliferative mechanism of the HSSC peptide was discussed, which provided a theoretical basis for the research and development of anti-proliferative functional food.

Flavor formation analysis based on sensory profiles and lipidomics of unrinsed mixed sturgeon surimi gels.

New insights revealing the flavor formation of unrinsed mixed sturgeon surimi with chicken breast were evaluated. Seventy-two volatile compounds were identified by gas chromatography-ion mobility spectrometry among the 11 surimi sample groups. The addition of 40% chicken breast caused changes in the concentrations of amino acids, 5'-nucleotides, and organic acids. Sensory attributes of balsamic, waxy, green, fresh, fatty, citrus, and aldehydic were marked when corelated with 125 volatiles identified by comprehensive two-dimensional gas chromatography-time-of-flight mass spectrometry. A total of 357 different lipids were identified through UPLC-Q-Orbitrap. Analysis of the correlations between flavor-active compounds and 16 different lipids revealed that various pathways, including the degradation of triglycerides, the biosynthesis of phosphatidylcholine, and the biosynthesis of lysine, serine, and methionine, were associated with flavor formation. This study provides a theoretical basis for the development of sturgeon processing industry and surimi products from the perspective of lipid changes.

Propofol inhibits glioma progression by regulating circMAPK4/miR-622/HOXA9 axis.

Propofol has a tumor-suppressive role in glioma, but the mechanism by which propofol is involved in glioma progression is largely unknown. This study aims to explore a potential circular RNAs (circRNAs)/microRNAs (miRNAs)/mRNA network in response to Propofol in glioma. Human glioma cell lines (U251 and LN229) were suffered from Propofol treatment (5 µg/mL for 24 h) and transfection. circRNA mitogen-activated protein kinase 4 (circMAPK4), miR-622, homeobox A9 (HOXA9) abundances were determined by quantitative reverse transcription polymerase chain reaction and western blot. Migration and invasion were analyzed via transwell analysis. Cell proliferation was evaluated using Cell Counting Kit-8 and colony formation analysis. Cell apoptosis and related protein expression were determined via flow cytometry and western blot. Target relationship was assessed via dual-luciferase reporter analysis, RNA pull-down and RNA immunoprecipitation. Propofol reduced circMAPK4 expression. Propofol inhibited cell proliferation, migration and invasion, while increased apoptosis via decreasing circMAPK4 in glioma cells. miR-622 was targeted via circMAPK4. circMAPK4 knockdown decreased glioma cell growth, migration and invasion by up-regulating miR-622. miR-622 knockdown reversed the effect of Propofol on glioma progression. HOXA9 was targeted by miR-622, and its expression was decreased by Propofol treatment. miR-622 overexpression restrained glioma progression via decreasing HOXA9. Propofol regulated circMAPK4/miR-622/HOXA9 axis in glioma cells. Propofol constrains glioma progression by regulating circMAPK4/miR-622/HOXA9 axis in vitro. Propofol restrains glioma cell growth, migration and invasion. circMAPK4 can regulate HOXA9 by sponging miR-622 in glioma cells. Propofol represses glioma progression via a circMAPK4/miR-622/HOXA9 axis.

Antiviral Therapy Favors a Lower Risk of Liver Cirrhosis in HBeAg-negative Chronic Hepatitis B with Normal Alanine Transaminase and HBV DNA Positivity.

Background and Aims: Direct evidence on the outcomes of hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) patients with normal alanine transaminase after long-term antiviral treatment is lacking. Methods: HBeAg-negative patients with normal ALT and positive HBV DNA (≥20 IU/mL) were retrospectively enrolled. The endpoints included virological response (HBV DNA<100 IU/mL), changes in aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 index (FIB-4), and the incidence of liver nodules, cirrhosis, and hepatocellular carcinoma (HCC). Results: This cohort (n=194) was divided into three subgroups, untreated (n=67), treatment-continued (n=87), and treatment-discontinued patients (n=40), with a median follow-up of 54 months. The treatment-continued group achieved 100% (95% CI: 94.7-100) virological response, and significantly reduced APRI and FIB-4 scores (both p<0.001). The risk of liver nodules and cirrhosis in that group was reduced by 76% (HR: 0.24, 95% CI: 0.11-0.54, p<0.001) and 89% (HR: 0.11, 95% CI: 0.14-0.91, p=0.041) vs. the untreated group and by 77% (HR: 0.23, 95% CI: 0.10-0.49, p<0.001) and 95% (HR: 0.05, 95% CI: 0.01-0.44, p=0.006) vs. the treatment-discontinued group. For patients with HBV DNA≥2,000 IU/mL, adherence to treatment lowered the risks of liver cirrhosis by 92% (95% CI: 0.01-0.67) and 93% (95% CI: 0.01-0.53) vs. the untreated and treatment-discontinued patients, respectively. No patient adhering to treatment developed HCC, but one in each of the remaining groups did. Conclusions: Continuous nucleos(t)ide analog (NA) treatment has a satisfactory effectiveness and helps to lower the risk of liver cirrhosis in HBeAg-negative CHB patients with normal alanine transaminase, especially in those with HBV DNA≥2,000 IU/mL.

TET2 Mutation May Be More Valuable in Predicting Thrombosis in ET Patients Compared to PV Patients: A Preliminary Report.

Thrombosis is a common complication of myeloproliferative neoplasm (MPN), and it is a major cause of disability and death. With the development of next-generation gene-sequencing technology, the relationship between non-driver mutations and thrombotic risk factors has also attracted considerable attention. To analyze the risk factors of thrombosis in patients with essential thrombocythemia (ET) and polycythemia vera (PV), we retrospectively analyzed the clinical data of 125 MPN patients (75 ET and 50 PV) and performed a multivariate analysis of the risk factors of thrombosis using a Cox proportional risk model. Among the 125 patients, 35 (28.0%) had thrombotic events, and the incidence of thrombotic events was 21.3% and 38.0% in ET and PV patients, respectively. In ET patients, the multivariate analysis showed that a TET2 mutation and history of remote thrombosis were independent risk factors for thrombosis in ET patients, with an HR of 4.1 (95% CI: 1.40-12.01; p = 0.01) for TET2 mutation and 6.89 (95% CI: 1.45-32.68; p = 0.015) for a history of remote thrombosis. In PV patients, the multivariate analysis presented the neutrophil-to-lymphocyte ratio (NLR) (HR: 4.77, 95% CI: 1.33-17.16; p = 0.017) and a history of remote thrombosis (HR: 1.67, 95% CI: 1.03-1.32; p = 0.014) as independent risk factors for thrombosis, with no significant change in the risk of thrombosis in patients with TET2 mutations. A further analysis of the clinical characteristics and coagulation occurring in ET patients with a TET2 mutation revealed that the values of age and D-dimer were significantly higher and antithrombin III was significantly lower in TET2-mutated ET patients compared to TET2-unmutated patients. In summary, TET2 mutation may be more valuable in predicting thrombosis in ET patients than in PV patients. ET patients with a TET2 mutation are older and present differences in coagulation compared to TET2-unmutated patients.

The impact of tubeless anesthesia versus intubated anesthesia on cerebral oxygen saturation and postoperative cognitive function in patients undergoing video-assisted thoracoscopic surgery: a randomized trial.

Background: In video-assisted thoracoscopic surgery (VATS), intubated anesthesia may affect cerebral oxygen balance and postoperative cognitive dysfunction (POCD). To avoid complications associated with intubated anesthesia, tubeless strategies have been proposed in recent years, but its effect on cerebral oxygen balance and POCD is still unclear. This prospective study compared the cerebral oxygen saturation and the incidence of POCD in patients undergoing VATS anesthetized with tubeless anesthesia vs. intubated anesthesia. Methods: A total of 60 patients with American Society of Anesthesiologists Standard (ASA) grade I-II who planned to undergo VATS at The First People's Hospital of Yunnan Province between May and October 2021 were selected and divided into non-intubated spontaneous ventilation group (SV group) or intubated mechanical ventilation group (MV group) by random number method. The primary outcome included the incidence of POCD and Mini-Mental State Examination (MMSE) on the 1st before operation and the 4th, 7th, 14th, and 30th day postoperatively, and cerebral oxygen saturation during surgery. Other outcomes of interest include respiratory and hemodynamic parameters, serum concentration of cognitive function related proteins [S100ß, interleukin (IL)-6, IL-1ß, and tumor necrosis factor α (TNF-α)], inflammatory cell counts, perioperative adverse events (arrhythmia, hypoxemia, asphyxia, etc.), postoperative pain scores, etc. Results: The incidence of hypercapnia in the SV group was significantly higher than in the MV group (P<0.001). Cerebral oxygen saturation at intraoperative was significantly higher than that in MV group (P<0.01). There was no significant difference in the incidence of POCD and the expression of cognitive function related proteins between the two groups (P>0.05). Leukocyte and neutrophil counts were significantly higher in the MV group after operation (P<0.05), whilst compared to the MV group, the SV group showed shorter postoperative recovery time, rest time before the first out of bed activity, chest tube duration, as well as less drainage volume of the chest tube and postoperative sore throat rarely occurred (P<0.05). Conclusions: Tubeless VATS can increase the incidence of hypercapnia and intraoperative cerebral oxygen saturation, but has no statistically significant difference in the incidence of POCD. In addition, tubeless anesthesia reduces systemic inflammatory, promotes the early postoperative mobilization, and accelerates the postoperative rehabilitation of patients. Trial Registration: Chinese Clinical Trial Registry ChiCTR2100042381.