Objective To analyze the influencing factors of delirium after endovascular aortic repair, and to provide a basis for clinical nursing and prevention of this condition. Methods Patients who underwent endovascular aortic repair at Fuwai Hospital, Chinese Academy of Medical Sciences from 2018 to 2019 were selected. The Chinese version of the Nursing Delirium Screening Scale (Nu-DESC) was used to assess whether postoperative delirium occurred. Patients with a Nu-DESC score≥ 3 were assigned to the delirium group. Non-delirium patients who had the same surgeon and adjacent surgical order were selected at a 1 : 4 ratio to form the non-delirium group. Univariate analysis was performed on the clinical data of the two groups. Factors with P<0.1 in the univariate analysis and those considered clinically significant were included in a multivariate logistic regression analysis to identify the influencing factors of postoperative delirium. Stratified analysis was conducted based on thoracic endovascular aortic repair (TEVAR) and endovascular abdominal aortic repair (EVAR). Results A total of 213 patients were included, comprising 46 in the delirium group and 167 in the non-delirium group. The overall mean age was (60.3±12.0) years, and 183 (85.9%) were male. Univariate analysis showed that emergency admission, preoperative neutrophil percentage, aortic dissection, surgical duration, intubation time, and ICU stay may be associated with postoperative delirium. Multivariate analysis revealed that longer operative and intubation times were associated with a higher likelihood of delirium. In the stratified analysis, the results for the TEVAR group were consistent with the overall findings, whereas no significant differences were observed in the EVAR group. Conclusion Longer surgical and intubation times are associated with an increased risk of delirium in patients undergoing TEVAR. No significant factors influencing delirium are identified in patients undergoing EVAR.

Objective To investigate the regulatory effect of calcitonin gene-related peptide (CGRP) on the mRNA and protein expression of neuronal nitric oxide synthase (NOS), as well as the release of nitric oxide (NO) in cultured human keratinocyte line HaCaT. Methods NO level in the supernatant of cell culture medium was detected with an enzymatic NO detecting kit, the mRNA expression of neuronal NOS was studied with reverse transcription polymerase chain reaction(RT-PCR), and the protein expression of neuronal NOS was studied with immunochemical technique(SP). Results Compared with that in normal culture condition, the mRNA and protein expression of neuronal NOS and the release of NO was significantly upregulated by CGRP in HaCaT cells. Whereas, the expression of neuronal NOS and the release of NO in HaCaT cells induced by CGRP was inhibited by CGRP-8-37, an inhibitor of CGRP receptor. Conclusion The expression of neuronal NOS in keratinocytes and the release of NO from keratinocytes could be upregulated by CGRP.