LightGBM is an Effective Predictive Model for Postoperative Complications in Gastric Cancer: A Study Integrating Radiomics with Ensemble Learning.

Postoperative complications of radical gastrectomy seriously affect postoperative recovery and require accurate risk prediction. Therefore, this study aimed to develop a prediction model specifically tailored to guide perioperative clinical decision-making for postoperative complications in patients with gastric cancer. A retrospective analysis was conducted on patients who underwent radical gastrectomy at the First Affiliated Hospital of Nanjing Medical University between April 2022 and June 2023. A total of 166 patients were enrolled. Patient demographic characteristics, laboratory examination results, and surgical pathological features were recorded. Preoperative abdominal CT scans were used to segment the visceral fat region of the patients through 3Dslicer, a 3D Convolutional Neural Network (3D-CNN) to extract image features and the LASSO regression model was employed for feature selection. Moreover, an ensemble learning strategy was adopted to train the features and predict postoperative complications of gastric cancer. The prediction performance of the LGBM (Light Gradient Boosting Machine), XGB (XGBoost), RF (Random Forest), and GBDT (Gradient Boosting Decision Tree) models was evaluated through fivefold cross-validation. This study successfully constructed a model for predicting early complications following radical gastrectomy based on the optimal algorithm, LGBM. The LGBM model yielded an AUC value of 0.9232 and an accuracy of 87.28% (95% CI, 75.61-98.95%), surpassing the performance of other models. Through ensemble learning and integration of perioperative clinical data and visceral fat radiomics, a predictive LGBM model was established. This model has the potential to facilitate individualized clinical decision-making and the early recovery of patients with gastric cancer post-surgery.

Electronic Tuning of Photoexcited Dynamics in Heteroleptic Cu(I) Complex Photosensitizers.

Photoexcited dynamics of heteroleptic Cu(I) complexes as noble-metal-free photosensitizers are closely intertwined with the nature of their ligands. By utilizing ultrafast optical and X-ray transient absorption spectroscopies, we characterized a new set of heteroleptic Cu(I) complexes [Cu(PPh3)2(BPyR)]+ (R = CH3, H, Br to COOCH3), with an increase in the electron-withdrawing ability of the functional group (R). We found that after the transient photooxidation of Cu(I) to Cu(II), the increasing electron-withdrawing ability of R barely affects the internal conversion (IC) (e.g., Jahn-taller (JT) distortion) between singlet MLCT states. However, it does accelerate the dynamics of intersystem crossing (ISC) between singlet and triplet MLCT states and the subsequent decay from the triplet MLCT state to the ground state. The associated lifetime constants are reduced by up to 300%. Our understanding of the photoexcited dynamics in heteroleptic Cu(I) complexes through ligand electronic tuning provides valuable insight into the rational design of efficient Cu(I) complex photosensitizers.

Myelin-associated oligodendrocytic basic protein-dependent myelin repair confers the long-lasting antidepressant effect of ketamine.

Ketamine exhibits rapid and sustained antidepressant effects. As decreased myelination has been linked to depression pathology, changes in myelination may be a pivotal mechanism underlying ketamine's long-lasting antidepressant effects. Although ketamine has a long-lasting facilitating effect on myelination, the precise roles of myelination in ketamine's sustained antidepressant effects remain unknown. In this study, we employed spatial transcriptomics (ST) to examine ketamine's lasting effects in the medial prefrontal cortex (mPFC) and hippocampus of mice subjected to chronic social defeat stress and identified several differentially expressed myelin-related genes. Ketamine's ability to restore impaired myelination in the brain by promoting the differentiation of oligodendrocyte precursor cells (OPCs) into mature oligodendrocytes was demonstrated. Moreover, we showed that inhibiting the expression of myelin-associated oligodendrocytic basic protein (Mobp) blocked ketamine's long-lasting antidepressant effects. We also illustrated that α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) signaling mediated ketamine's facilitation on myelination. In addition, we found that the (R)-stereoisomer of ketamine showed stronger effects on myelination than (S)-ketamine, which may explain its longer-lasting antidepressant effects. These findings reveal novel mechanisms underlying the sustained antidepressant effects of ketamine and the differences in antidepressant effects between (R)-ketamine and (S)-ketamine, providing new insights into the role of myelination in antidepressant mechanisms.

Mapping the Ultrafast Mechanistic Pathways of Co Photocatalysts in Pure Water through Time-Resolved X-ray Spectroscopy.

Nanosecond time-resolved X-ray (tr-XAS) and optical transient absorption spectroscopy (OTA) are applied to study 3 multimolecular photocatalytic systems with [Ru(bpy)3 ]2+ photoabsorber, ascorbic acid electron donor and Co catalysts with methylene (1), hydroxomethylene (2) and methyl (3) amine substituents in pure water. OTA and tr-XAS of 1 and 2 show that the favored catalytic pathway involves reductive quenching of the excited photosensitizer and electron transfer to the catalyst to form a CoII square pyramidal intermediate with a bonded aqua molecule followed by a CoI square planar derivative that decays within ≈8 µs. By contrast, a CoI square pyramidal intermediate with a longer decay lifetime of ≈35 µs is formed from an analogous CoII geometry for 3 in H2 O. These results highlight the protonation of CoI to form the elusive hydride species to be the rate limiting step and show that the catalytic rate can be enhanced through hydrogen containing pendant amines that act as H-H bond formation proton relays.

Role of GABAergic system in the comorbidity of pain and depression.

Patients with chronic pain often suffer with depressive symptoms, and these two conditions can be aggravated by each other over time, leading to an increase in symptom intensity and duration. The comorbidity of pain and depression poses a significant challenge to human health and quality of life, as it is often difficult to diagnose early and treat effectively. Therefore, exploring the molecular mechanisms underlying the comorbidity of chronic pain and depression is crucial to identifying new therapeutic targets for treatment. However, understanding the pathogenesis of comorbidity requires examining interactions among multiple factors, which calls for an integrative perspective. While several studies have explored the role of the GABAergic system in pain and depression, fewer have examined its interactions with other systems involved in their comorbidity. Here, we review the evidence that the role of GABAergic system in the comorbidity of chronic pain and depression, as well as the interactions between the GABAergic system and other secondary systems involved in pain and depression comorbidity, providing a comprehensive understanding of their intricate interplay.

Predictive value of NoSAS questionnaire combined with the modified Mallampati grade for hypoxemia during routine sedation for gastrointestinal endoscopy.

BACKGROUND: The incidence of hypoxemia during painless gastrointestinal endoscopy remains a matter of concem. To date, there is no recognized simple method to predict hypoxemia in digestive endoscopic anesthesia. The NoSAS (neck circumference, obesity, snoring, age, sex) questionnaire, an objective and simple assessment scale used to assess obstructive sleep apnea (OSA), combined with the modified Mallampati grade (MMP), may have certain screening value. This combination may allow anesthesiologists to anticipate, manage, and consequently decrease the occurrence of hypoxemia. METHODS: This study was a prospective observational trial. The primary endpoint was the incidence of hypoxaemia defined as pulse oxygen saturation (SpO2) < 95% for 10 s. A total of 2207 patients admitted to our hospital for painless gastrointestinal endoscopy were studied. All patients were measured for age, height, weight, body mass index, neck circumference, snoring, MMP, and other parameters. Patients were divided into hypoxemic and non-hypoxemic groups based on the SpO2. The ROC curve was plotted to evaluate the screening value of the NoSAS questionnaire separately and combined with MMP for hypoxemia. The total NoSAS score was evaluated at cut-off points of 8 and 9. RESULTS: With a NoSAS score ≥ 8 as the critical value for analysis, the sensitivity for hypoxemia was 58.3%, the specificity was 88.4%, and the area under the ROC was 0.734 (P < 0.001, 95% CI: 0.708-0.759). With a NoSAS score ≥ 9 as a critical value, the sensitivity for hypoxemia was 36.50%, the specificity rose to 96.16%, and the area under the ROC was 0.663 (P < 0.001, 95% CI: 0.639-0.688). With the NoSAS Score combined with MMP for analysis, the sensitivity was 78.4%, the specificity was 84%, and the area under the ROC was 0.859 (P < 0.001, 95%CI:0.834-0.883). CONCLUSIONS: As a new screening tool, the NoSAS questionnaire is simple, convenient, and useful for screening hypoxemia. This questionnaire, when paired withMMP, is likely to be helpful for the screening of hypoxemia.

The soluble epoxide hydrolase inhibitor TPPU improves comorbidity of chronic pain and depression via the AHR and TSPO signaling.

BACKGROUND: Patients suffering from chronic pain often also exhibit depression symptoms. Soluble epoxide hydrolase (sEH) inhibitors can decrease blood levels of inflammatory cytokines. However, whether inhibiting sEH signaling is beneficial for the comorbidity of pain and depression is unknown. METHODS: According to a sucrose preference test (SPT), spared nerve injury (SNI) mice were classified into pain with or without an anhedonia phenotype. Then, sEH protein expression and inflammatory cytokines were assessed in selected tissues. Furthermore, we used sEH inhibitor TPPU to determine the role of sEH in chronic pain and depression. Importantly, agonists and antagonists of aryl hydrocarbon receptor (AHR) and translocator protein (TSPO) were used to explore the pathogenesis of sEH signaling. RESULTS: In anhedonia-susceptible mice, the tissue levels of sEH were significantly increased in the medial prefrontal cortex (mPFC), hippocampus, spinal cord, liver, kidney, and gut. Importantly, serum CYP1A1 and inflammatory cytokines, such as interleukin 1ß (IL-1ß) and the tumor necrosis factor α (TNF-α), were increased simultaneously. TPPU improved the scores of mechanical withdrawal threshold (MWT) and SPT, and decreased the levels of serum CYP1A1 and inflammatory cytokines. AHR antagonist relieved the anhedonia behaviors but not the algesia behaviors in anhedonia-susceptible mice, whereas an AHR agonist abolished the antidepressant-like effect of TPPU. In addition, a TSPO agonist exerted a similar therapeutic effect to that of TPPU, whereas pretreatment with a TSPO antagonist abolished the antidepressant-like and analgesic effects of TPPU. CONCLUSIONS: sEH underlies the mechanisms of the comorbidity of chronic pain and depression and that TPPU exerts a beneficial effect on anhedonia behaviors in a pain model via AHR and TSPO signaling.

Lateral septum-lateral hypothalamus circuit dysfunction in comorbid pain and anxiety.

Pain and anxiety comorbidities are a common health problem, but the neural mechanisms underlying comorbidity remain unclear. We propose that comorbidity implies that similar brain regions and neural circuits, with the lateral septum (LS) as a major candidate, process pain and anxiety. From results of behavioral and neurophysiological experiments combined with selective LS manipulation in mice, we find that LS GABAergic neurons were critical for both pain and anxiety. Selective activation of LS GABAergic neurons induced hyperalgesia and anxiety-like behaviors. In contrast, selective inhibition of LS GABAergic neurons reduced nocifensive withdrawal responses and anxiety-like behaviors. This was found in two mouse models, one for chronic inflammatory pain (induced by complete Freund's adjuvant) and one for anxiety (induced by chronic restraint stress). Additionally, using TetTag chemogenetics to functionally mark LS neurons, we found that activation of LS neurons by acute pain stimulation could induce anxiety-like behaviors and vice versa. Furthermore, we show that LS GABAergic projection to the lateral hypothalamus (LH) plays an important role in the regulation of pain and anxiety comorbidities. Our study revealed that LS GABAergic neurons, and especially the LSGABAergic-LH circuit, are a critical to the modulation of pain and anxiety comorbidities.

Desulfovibrio confers resilience to the comorbidity of pain and anxiety in a mouse model of chronic inflammatory pain.

BACKGROUND: Patients with chronic pain frequently suffer from anxiety symptoms. It has been well established that gut microbiota is associated with the pathogenesis of pain and anxiety. However, it is unknown whether the gut microbiota, particularly the specific bacteria, play a role in the comorbidity of chronic pain and anxiety. METHODS: Chronic inflammatory pain was induced in mice by a single injection of complete Freund's adjuvant (CFA). Mice were then separated into anxiety-susceptible and anxiety-resilient phenotypes by hierarchical clustering analysis of behaviors. Fecal samples were collected to perform 16S rRNA gene sequencing. Chronic diazepam intervention served as a therapeutic strategy and its effect on the composition of gut microbiota was also determined. RESULTS: α-Diversity and ß-diversity both showed significant differences among the groups. A total of 12 gut bacteria were both altered after CFA injection and reversed by chronic diazepam treatment. More importantly, the pain hypersensitivity and anxiety-like behaviors were relieved by chronic diazepam treatment. Interestingly, we also found that Desulfovibrio was increased in anxiety-resilient group compared to control and anxiety-susceptible groups. CONCLUSION: Abnormal composition of gut microbiota plays an essential role in chronic pain as well as in anxiety. Besides, the increased level of Desulfovibrio in anxiety-resilient mice indicated its therapeutic effects on the comorbidity of pain and anxiety. Collectively, targeting gut microbiota, especially increasing the Desulfovibrio level, might be effective in the alleviation of chronic pain-anxiety comorbidity.

Etomidate elicits anti-tumor capacity by disrupting the JAK2/STAT3 signaling pathway in hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is a leading malignancy of the digestive system, especially in China. Although radiotherapy, chemotherapy, and transarterial chemoembolization have achieved tremendous success, surgical resection remains the primary treatment for HCC patients. Recent studies have shown that intravenous anesthetic drugs may affect the malignant behaviors of tumor cells, ultimately leading to differences in the postoperative prognosis of patients. Etomidate is one of the most widely used intravenous anesthetic drugs for the induction and maintenance of anesthesia in tumor patients undergoing surgery. However, the effects and underlying mechanisms of etomidate on HCC cells have not yet been characterized. Our study indicated that etomidate significantly impedes the malignant progression of HCC cells. Mechanistically, etomidate inhibits phosphorylation and, ultimately, the activity of Janus kinase 2 (JAK2) by competing with ATP for binding to the ATP-binding pocket of JAK2. Thus, it suppresses the JAK2/STAT3 signaling pathway in HCC cells to exert its anti-tumor efficacy. Herein, we provide preclinical evidence that etomidate is the optimal choice for surgical treatment of HCC patients.

Analysis of postoperative pulmonary complications after gastrectomy for gastric cancer: development and validation of a nomogram.

Background: Postoperative pulmonary complications (PPCs) are common in gastric cancer patients after gastrectomy. The aim of our study was to investigate the perioperative risk factors and to develop a nomogram to identify patients who are at significant risk of PPCs. Methods: The clinical data of gastric cancer patients who underwent elective gastrectomy in the First Affiliated Hospital of Nanjing Medical University from 2017 to 2021 were retrospectively collected. All patients were randomly divided into a training and a validation cohort at a ratio of 7:3. Univariate and multivariate analysis were applied to identify the independent risk factors that might predict PPCs, and a nomogram was constructed. Both discrimination and calibration abilities were estimated by the area under a receiver operating characteristic curve (AUC) and calibration curves. The clinical effectiveness of the nomogram was further quantified with the decision curve analysis (DCA). Results: Of 2,124 included patients, one hundred and fifty patients (7.1%) developed PPCs. Binary logistic analysis showed that age > 65 years, higher total cholesterol level, longer duration of surgery, total gastrectomy, and the dose of oxycodone > 5.5 mg were independent risk factors for the occurrence of PPCs, which were contained in the nomogram. The predictive nomogram showed good discrimination and calibration [an AUC of 0.735 (95% CI: 0.687-0.783) in a training cohort and 0.781 (95% CI: 0.715-0.847) in a validation cohort]. The calibration curve and decision curve analysis showed a good agreement between nomogram predictions and actual observations. Conclusion: We developed a nomogram model based on age, total cholesterol, extent of resection, duration of surgery, and the dose of oxycodone to predict the risk of PPCs in gastric cancer patients after elective gastrectomy.

A Bibliometric Analysis of Research on Perioperative Neurocognitive Disorder: A Systematic Review.

BACKGROUND: Perioperative neurocognitive disorder (PND) is a general term for cognitive impairment that negatively affects multiple domains, including memory, concentration, and physical functioning. Numerous articles have been published on PND; however, only a few quantitative analyses covering this disorder have been published. METHODS AND MATERIALS: To clarify PND's developmental history, research foci, and future directions, we conducted a bibliometric analysis using the bibliometric tools VOSviewer and CiteSpace. A total of 4704 publications were obtained from the Web of Science database, including annual publications and trends, keywords, institutions, journals, and collaboration between countries/regions and authors. RESULTS: In addition, we found that neuroinflammation is a hotspot in recent studies. CONCLUSIONS: This bibliometric analysis provides a broad overview of studies in the field of PND.

Photochemical and Photophysical Dynamics of the Aqueous Ferrate(VI) Ion.

Ferrate(VI) has the potential to play a key role in future water supplies. Its salts have been suggested as "green" alternatives to current advanced oxidation and disinfection methods in water treatment, especially when combined with ultraviolet light to stimulate generation of highly oxidizing Fe(V) and Fe(IV) species. However, the nature of these intermediates, the mechanisms by which they form, and their roles in downstream oxidation reactions remain unclear. Here, we use a combination of optical and X-ray transient absorption spectroscopies to study the formation, interconversion, and relaxation of several excited-state and metastable high-valent iron species following excitation of aqueous potassium ferrate(VI) by ultraviolet and visible light. Branching from the initially populated ligand-to-metal charge transfer state into independent photophysical and photochemical pathways occurs within tens of picoseconds, with the quantum yield for the generation of reactive Fe(V) species determined by relative rates of the competing intersystem crossing and reverse electron transfer processes. Relaxation of the metal-centered states then occurs within 4 ns, while the formation of metastable Fe(V) species occurs in several steps with time constants of 250 ps and 300 ns. Results here improve the mechanistic understanding of the formation and fate of Fe(V) and Fe(IV), which will accelerate the development of novel advanced oxidation processes for water treatment applications.

Efficacy and safety of remimazolam besylate in bronchoscopy for adults: A multicenter, randomized, double-blind, positive-controlled clinical study.

Background: With the development of fiberoptic bronchoscopy in the diagnosis and treatment of various pulmonary diseases, the anesthesia/sedation requirements are becoming more demanding, posing great challenges for patient safety while ensuring a smooth examination/surgery process. Remimazolam, a brand-new ultra-short-acting anesthetic, may compensate for the shortcomings of current anesthetic/sedation strategies in bronchoscopy. Methods: This study was a prospective, multicenter, randomized, double-blind, parallel positive controlled phase 3 clinical trial. Subjects were randomized to receive 0.2 mg/kg remimazolam besylate or 2 mg/kg propofol during bronchoscopy to evaluate the efficacy and safety of remimazolam. Results: A total of 154 subjects were successfully sedated in both the remimazolam group and the propofol group, with a success rate of 99.4% (95%CI of the adjusted difference -6.7 × 10%-6% to -5.1 × 10%-6%). The sedative effect of remimazolam was noninferior to that of propofol based on the prespecified noninferiority margin of -5%. Compared with the propofol group, the time of loss of consciousness in the remimazolam group (median 61 vs. 48s, p < 0.001), the time from the end of study drug administration to complete awakening (median 17.60 vs. 12.80 min, p < 0.001), the time from the end of bronchoscopy to complete awakening (median 11.00 vs. 7.00 min, p < 0.001), the time from the end of study drug administration to removal of monitoring (median 19.50 vs. 14.50 min, p < 0.001), and the time from the end of bronchoscopy to removal of monitoring (median 12.70 vs. 8.60 min, p < 0.001) were slightly longer. The incidence of Adverse Events in the remimazolam group and the propofol group (74.8% vs. 77.4%, p = 0.59) was not statistically significant, and none of them had Serious Adverse Events. The incidence of hypotension (13.5% vs. 29.7%, p < 0.001), hypotension requiring treatment (1.9% vs. 7.7%, p = 0.017), and injection pain (0.6% vs. 16.8%, p < 0.001) were significantly lower in the remimazolam group than in the propofol group. Conclusion: Moderate sedation with 0.2 mg/kg remimazolam besylate is effective and safe during bronchoscopy. The incidence of hypotension and injection pain was less than with propofol, but the time to loss of consciousness and recovery were slightly longer. Clinical Trial Registration: clinicaltrials.gov, ChiCTR2000039753.

A Bibliometric Analysis of Research on the Role of BDNF in Depression and Treatment.

Brain-derived neurotrophic factor (BDNF), as the most widely distributed and widely studied neurotrophic factor in the mammalian brain, plays a key role in depression and the mechanisms of action for antidepressants. Currently, there is a large number of studies on the role of BDNF in the pathogenesis and therapeutic mechanism of depression. The quantity and quality of these studies, however, are unknown. To give beginners a quicker introduction to this research topic, we therefore performed a bibliometric analysis. A total of 5300 publications were included. We obtained the publications on this topic from the Web of Science database, and a variety of bibliographic elements were collected, including annual publications, authors, countries/regions, institutions, journals, and keywords. Moreover, we found that oxidative stress and neuroinflammation are the hotspots in the field in very recent years. Collectively, this study provides a comprehensive summary and analysis on the role of BDNF in depression and its treatment and offers meaningful values for beginners on this topic.

Effect of differences in extubation timing on postoperative pneumonia following meningioma resection: a retrospective cohort study.

BACKGROUND: This study was designed to examine extubation time and to determine its association with postoperative pneumonia (POP) after meningioma resection. METHODS: We studied extubation time for 598 patients undergoing meningioma resection from January 2016 to December 2020. Extubation time was analysed as a categorical variable and patients were grouped into extubation within 21 minutes, 21-35 minutes and ≥ 35 minutes. Our primary outcome represented the incidence of POP. The association between extubation time and POP was assessed using multivariable logistic regression mixed-effects models which adjusted for confounders previously reported. Propensity score matching (PSM) was also performed at a ratio of 1:1 to minimize potential bias. RESULTS: Among 598 patients (mean age 56.1 ± 10.7 years, 75.8% female), the mean extubation time was 32.4 minutes. Extubation was performed within 21 minutes (32.4%), 21-35 minutes (31.2%) and ≥ 35 minutes (36.4%), respectively, after surgery. Older patients (mean age 57.8 years) were prone to delayed extubation (≥ 35 min) in the operating room, and more inclined to perioperative fluid infusion. When extubation time was analysed as a continuous variable, there was a U-shaped relation of extubation time with POP (P for nonlinearity = 0.044). After adjustment for confounders, extubation ≥35 minutes was associated with POP (odds ratio [OR], 2.73 95% confidence interval [CI], 1.36 ~ 5.47). Additionally, the results after PSM were consistent with those before matching. CONCLUSIONS: Delayed extubation after meningioma resection is associated with increased pneumonia incidence. Therefore, extubation should be performed as early as safely possible in the operation room.

Depression and antidepressant effects of ketamine and its metabolites: The pivotal role of gut microbiota.

The discovery of the robust antidepressant actions of ketamine is regarded as one of the greatest advancements in depression treatment in the past 60 years. Recent findings have provided strong evidence for the presence of bidirectional communication networks between the gastrointestinal tract and the brain in depression. Moreover, increasing evidence supports the antidepressant role of ketamine in regulating the gut microbiome and microbiota-derived molecules; however, the mechanisms underpinning such effects are still ambiguous. This review summarizes the current understanding of the anti-depressant mechanisms of ketamine and its metabolites regarding the bidirectional regulation by microbiota-gut-brain axis. We review the relationship between gut microbiota and the antidepressant mechanisms of ketamine, and discuss the role of stress response, brain-derived neurotrophic factor (BDNF)-mediated neurogenesis, anti-inflammatory effect and neurotransmitters.

Trace Analysis of Gases and Liquids with Spontaneous Raman Scattering Based on the Integrating Sphere Principle.

Spontaneous Raman scattering is an attractive optical technique for the analysis of gases and liquids; however, their low densities and notoriously weak scattering cross sections demand an enhancement of the spontaneous Raman scattering signal for detection. Here, we have developed a simple but highly effective and fast technique to enhance the signal of spontaneous Raman scattering from gases and liquids. The technique is developed based on the principle of an integrating sphere, which realizes the multiple pass actions of low-energy pump light and the collection of all Raman scattered light for a sample volume of 2 mL. By measuring the ambient air sample with an exposure time of 180 s, we found the experimental detection limit of our spontaneous Raman scattering setup can reach 3 ppm. CH4 (<2 ppm) in air can be also examined by increasing the exposure time to 300 s. The performance of our setup used for the analysis of trace gases is further illustrated by characterizing ethane, propane, butane, and pentane in methane as well as isotopes of carbon dioxide. The results reveal that the detection limit of our setup for liquids can be improved by nearly 4 orders of magnitude compared to that of confocal Raman scattering spectroscopy with the same experimental conditions.

A bibliometric analysis of research on (R)-ketamine from 2002 to 2021.

Anesthetic ketamine is a racemic mixture containing equal amount of (R)-ketamine and (S)-ketamine. Increasing preclinical data show that (R)-ketamine has a rapid-onset and sustained antidepressant without significant side effects. There are currently many studies on (R)-ketamine, however, the quantity and quality of these studies are unknown. Therefore, we conducted a bibliometric analysis of research on (R)-ketamine from January 2002 to December 2021. We obtained the publications on (R)-ketamine from the Web of Science database during the period. A variety of bibliographic elements were collected, including annual publications, authors, countries/regions, institutions, journals, and keywords. A total of 922 publications were included in this study. Professor Kenji Hashimoto of Chiba University in Japan was the most productively influential author in the field of (R)-ketamine and the authors from United States were the leader in this field. In addition, we found that the antidepressant effect of (R)-ketamine has been a hotspot in very recent years. This study provided a comprehensive analysis of research on (R)-ketamine and highlighted the growing interest in (R)-ketamine and its antidepressant effects.

PP2A-associated tau hyperphosphorylation was involved in sevoflurane induced neonatal neurotoxicity.

BACKGROUND: The effects of sevoflurane anesthesia on childhood neurodevelopment and adult brain function have attracted increasing scientific attentions. However, the exact mechanisms underlying hyperphosphorylation of tau protein in sevoflurane induced abnormalities in central nervous system (CNS) development, particularly in the hippocampus, have not been fully determined. METHODS: We utilized molecular biological and behavioral approaches to compare the changes in cognitive function in mice exposed to repeated sevoflurane during the neonatal stage, and to assess whether PP2A-associated tau hyperphosphorylation is involved in sevoflurane induced neonatal neurotoxicity. RESULTS: We reported that mice anesthetized with repeated sevoflurane during the neonatal period caused cognitive dysfunction during the adulthood. More importantly, we found that hyperphosphorylation of tau protein and decreased level of protein phosphatase 2A (PP2A) were detected in the hippocampus of mice after neonatal exposure of sevoflurane. Meanwhile, GSK-3ß activity was found to be increased with repeated sevoflurane exposure, but not for more than 2 weeks. CONCLUSION: Our results suggest that PP2A-associated hyperphosphorylation of tau protein might contribute to sevoflurane induced developmental neurotoxicity. These findings could provide a theoretical basis for the safely usage of sevoflurane in pediatric surgeries, and offer a valuable reference and potential therapeutic targets for the development of neuroprotective drugs.