Objective To evaluate the effects of edaravone on postoperative delirium in aged patients following total hip -re-placement surgery . Methods Two hundred and forty-six patients undergoing unilateral hip replacement surgery were randomly divided into edaravone group and control group .Patients in the edaravone group were intravenous injected with edaravone 30 mg before anesthesia induction, whereas patients in the control group received the same volume of saline solution .On preoperative day 1 and postoperative day 1, confusion assessment was applied to evaluate the consciousness of patients .The length of hospital stay , incidence of myocardial infarc-tion, stroke, pulmonary embolism, pneumonia and transfusion volume were also recorded .Also, the levels of plasma malondialdehyde ( MDA) superoxide dismutase ( SOD) , neuron-specific enolase ( NSE) and S100βprotein ( S100β) were measured on the preoperative and postoperative day 1. Results There was no difference in the length of hospital stay , the incidence of perioperative acute pulmonary embolism, myocardial infarction and stroke (P>0.05).POD was significantly lower in the edaravone group than the control group (P<0.05).Plasma levels of MDA, SOD, NSE and S100βwere comparable between the two groups (P>0.05).On the postoperative day 1, plasma levels of MDA and NSE were significantly lower in the edaravone group than the control group (P<0.05). Conclusion Edar-avone can reduce the incidence of POD in aged patients following total hip-replacement surgery .

Objective To evaluate the effects of different concentrations of hydroxyethyl starch (HES) 130/0.4 applied for different time periods on injury to human renal tubular epithelial cells.Methods Human renal kidney epithelial cells HK-2 at the logarithmic growth phase were seeded in 96-well plates at a density of 1 × 105 cells/ml (0.1 ml/well),in culture flasks (5 ml/flask) or in cluture dishes (5 ml/dish).HK-2 cells were randomly divided into 4 groups (n=49 each) using a random number table:control group (group C) and 0.3％,1.5％ and 3.0％ HES 130/0.4 groups (H1,H2 and H3 groups).In H1,H2 and H3 groups,HK-2 cells were incubated with 0.3％,1.5％ and 3.0％ HES 130/0.4,respectively.The equal volume of PBS was added to the culture medium in group C.At day 1,3,5 and 7 of incubation,the cell viability was measured.At day 3,5 and 7 of incubation,cell apoptosis was detected,and apoptosis rate was calculated.On day 7 of incubation,the cells were stained with toluidine blue for examination of intracellular HES deposition (under light microscope) and pathological changes (with transmission electron microscope).Results Compared with group C,the cell viability was significantly decreased on day 5 and 7 of incubation,and apoptosis rate was increased on day 3,5 and 7 of incubation in group H3,and no significant difference was detected in the parameters mentioned above in H1 and H2 groups.Microscopic examination showed that intracellular HES deposition was observed in H2 and H3 groups,and pathological changes were obvious,and apoptotic cells were also found in H3 group.Conclusion Application of high-concentration HES 130/0.4 for a long period can lead to injury to human renal tubular epithelial cells,however,application of high-or low-concentration HES 130/0.4 for a short period produces no influence on the cells.

Objective To observe the effects of mitochondrial protectant on hippocampal mito-chondrial function and synaptic plasticity in isoflurane-anesthesia aged mice.Methods Forty-eight fif-teen-month-old male C57BL/6 mice were equally divided into 4 groups (n=12):oxygen+normal sa-line (group CN),oxygen+SS-31 (group CS),isoflurane+normal saline (group IN),and isoflurane+SS-31 (group IS).SS-31(5 mg/kg)or normal saline was intraperitoneally administered with a vol-ume of 0.4 ml/kg 30 min before gas inhalation.After two hours gas inhalation,the hippocampus was removed to determine complex Ⅰ-Ⅳ activities,adenosine triphosphate (ATP)and mitochondrial membrane potential (MMP)levels from isolated mitochondria,and measure the content of synapsin-1,PSD-95,NMDAR2A,NMDAR2B,CaMKⅡα and CaMKⅡβ.Results Compared with the group IN,complex Ⅰ activity,ATP and MMP levels were increased,synapsin-1 and PSD-95 were up-regu-lated,whereas NMDAR2B,CaMK Ⅱα and CaMK Ⅱβ were down-regulated in the group IS (P <0.05).No significant difference was observed in the complex Ⅱ-Ⅳ activities and NMDAR2A expres-sion.Conclusion Mitochondrial protectant SS-31 attenuates isoflurane-induced mitochondrial dysfunc-tion and neuron synaptic plasticity impairments in aged mice.

Objective:In this paper, based on the 4D dose distribution of the treatment plan, the effects of respiratory movement on the dose distribution of three-dimensional conformal radiation therapy (3DCRT) and sliding window intensity-modulated radiation therapy (SW-IMRT) techniques were analyzed, and the dose errors caused by respiratory movement based on the 4D dose distribution were evaluated.Methods:In this study, the dynamic thoracic phantom (CIRS-008A) was used to simulate the patient with a 3 cm spherical insert as the tumor. Four motion patterns were simulated with cos 4( x) and sin ( x) wave forms of 10 mm and 5 mm amplitudes. The 4DCT scans with the phantom were performed in different breathing modes, and the maximum intensity projection (MIP), average intensity projection (AIP) and 10 separate 4DCT phase images were transferred to the Eclipse treatment planning system. The targets were contoured on MIP, with corresponding 3DCRT and SW-IMRT plans designed and dose calculated on AIP. By copying the plan designed on the AIP to each phase image of the 4DCT set, the MATLAB software package was employed to register and superimpose all the phase-specific doses onto one of the reference phase to create a 4D-accumulated dose distribution. Both films (EBT2) and optically stimulated luminescence (OSLD) detectors were inserted in and around the target area of the phantom to measure the delivered doses. The calculated 4D-accumulated doses were compared to the measured doses and their differences were evaluated using Gamma analysis. Results:Under different respiration modes, the average Gamma index (3%/3 mm) passing rates between the 4D-accumulated doses and EBT2-measured doses for 3DCRT and SW-IMRT plans were (98.8±0.78)% and (96.4±1.89)%, respectively. The absolute measurements of OSLDs both inside and outside of the target area well matched the 4D-accumulated doses.Conclusions:4DCT can be effectively applied to evaluate the treatment plan dose distribution through 4D dose accumulation, which can potentially avoid cold spots and target under-coverage. Under different respiration modes, both 3DCRT and SW-IMRT plans provide dose measurements consistent with those predicted by the 4D-accumulated dose of treatment plan.

BACKGROUND:Careful regulation of bone immune response during repair of bone scaffold is important for bone regeneration. OBJECTIVE:To review the influence of bone immune response on bone repair and the design of bone tissue engineering scaffold with regulating bone immune function and its application in bone repair. METHODS:Relevant articles published from 1973 to 2023 were retrieved from Science Direct,PubMed,Web of Science,and CNKI databases.English search terms were"osteoimmunology,macrophages,bone repair materials,bone scaffold,bone defects,bone regeneration".Chinese search terms were"bone immunity,macrophages,bone repair material,bone stent,bone defect,bone regeneration".Totally 80 articles of the latest research progress in this field were summarized and analyzed. RESULTS AND CONCLUSION:(1)A detailed review was conducted on the important time points in the origin and development process of bone immunity,and it was explained that macrophages,as important members of the bone immune regulatory system,can be divided into two phenotypes:M1(pro-inflammatory)and M2(anti-inflammatory),and play a key role in different stages of bone regeneration.During the inflammatory phase,M1 type macrophages can activate osteoclasts,initiate tissue repair processes,and participate in the reconstruction of bone microvascular networks.On the other hand,during the bone tissue regeneration process in the later stages of inflammation,sustained high expression of M1 type macrophages can hinder the formation of new bones.During the repair phase,M2 macrophages can secrete osteogenic cytokines,stimulate osteogenic differentiation and mineralization of bone marrow mesenchymal stem cells,and promote bone formation.On the other hand,long-term activation of M2 macrophages can increase the secretion of fibrogenic molecules,leading to excessive formation of scar tissue and delaying the healing process.Therefore,regulating macrophages to undergo phenotype transformation at appropriate stages and constructing an immune microenvironment beneficial for osteogenesis has great significance for bone regeneration.(2)In the process of designing bone scaffolds with bone immune regulation characteristics,the physical and chemical properties such as scaffold roughness,pore structure,stiffness,hydrophilicity,surface charge,and surface functional groups can be changed to affect non-specific protein and cell adhesion,thereby affecting the interaction between bone scaffolds and the immune system.By designing surface functional coatings of bioactive substances such as hydroxyapatite,bioactive glass,metal ions,extracellular matrix,drugs,cytokines,and exosomes,the immune microenvironment can be actively regulated by releasing bioactive substances after implantation into the body,affecting macrophage polarization and crosstalk between macrophages and bone cells,and promoting more M2 polarization of macrophages,so as to build a bone immune microenvironment that is conducive to bone regeneration.(3)Based on the research and development of bone tissue engineering scaffolds,in addition to focusing on the direct regulatory factors of stem cell osteogenic differentiation,this article also proposes that attention should be paid to the management of the immune microenvironment of stem cell differentiation.By regulating the appropriate bone immune microenvironment,more stem cell osteogenic differentiation can be induced;the osteogenic efficiency of the scaffold can be enhanced,and the concept of"bone immune regulatory characteristics"can be condensed;deeply elucidated the multi-directional regulatory role of the bone immune microenvironment and introduced the existing strategies for changing the physicochemical properties and surface functional coating of scaffolds to endow them with bone immune regulatory potential,providing new ideas for guiding the development of a new generation of bone tissue engineering scaffolds with bone immune regulatory characteristics.However,the bone immune microenvironment is a dynamic equilibrium state,and most of the existing regulatory strategies do not consider the dynamic matching of regulation.Therefore,the research and development of intelligent bone immune regulatory scaffolds with efficient and targeted regulation of the immune microenvironment will be a key focus of attention for scholars in future.