Globally, over 300 million surgeries are performed each year, and more than 50% of surgeries involve patients aged 65 and older. Aging poses significant challenges to perioperative brain health, as the deterioration of brain structure and function increases susceptibility to postoperative neurological complications. Protecting perioperative brain health remains a worldwide clinical challenge. With senescence, the brain undergoes a progressive decline in homeostasis across various molecular, cellular, and regional functions. Anesthetics and surgical stimuli may accelerate the disruption of brain homeostasis and exacerbate age-related neurodegeneration. This review provides a framework for understanding how anesthesia and surgery can affect brain health in the aging population and contribute to postoperative neurological complications, with a particular focus on perioperative neurocognitive disorder.

OBJECTIVE: To explore the current status, evolution, hot topics, and future research trends in the field of burn-related sepsis research through a visual analysis of literature. METHODS: A bibliometric method was employed to retrieve articles related to burn-related sepsis from January 1, 1994, to May 16, 2024, in the China National Knowledge Infrastructure (CNKI) and the Web of Science database. The CiteSpace 6.3.R1 software was used to analyze the retrieved literature. The number of publications, authors, countries, and institutions in both Chinese and English literature was statistically analyzed. Co-occurrence analysis, clustering analysis, and co-citation analysis of keywords were performed. RESULTS: A total of 1 090 articles from the CNKI database and 1 143 articles from the Web of Science database were retrieved. Over the past 20 years, the volume of Chinese publications has remained stable, although there has been a slight decline in the past two years. In contrast, the number of English publications, after a period of growth, showed a sharp decline over the past three years. In Chinese literature, 1 457 authors published articles on burn-related sepsis as first authors, with 14 core authors publishing four or more articles. In English literature, 98 authors published articles on burn-related sepsis as first authors. Research on burn-related sepsis was conducted by 76 countries, with the United States having the most collaborations and publications. Globally, 1 349 institutions published articles on burn-related sepsis, with the top institutions being the First Affiliated Hospital of the PLA General Hospital (8 articles) for Chinese literature and the University of Texas Medical Branch (57 articles) for English literature. In the co-occurrence analysis, 208 Chinese keywords and 211 English keywords were included. Excluding keywords related to search terms, the top five most frequent keywords in Chinese literature were burn, sepsis, infection, severe burn, and procalcitonin; the top five most frequent keywords in English literature were sepsis, septic shock, mortality, injury, and burn injury. Chinese keyword analysis identified six clusters, with the largest being sepsis, followed by procalcitonin, infection, and severe burn. English keyword analysis identified seven clusters, with the largest being expression, followed by epidemiology, inhalation injury, and acute kidney injury. The persistent clusters in Chinese literature were procalcitonin, with recent emerging nodes being severe burn, inflammatory response, platelets, and predictive value. In English literature, the persistent clusters were inhalation injury and nitric oxide, with recent emerging nodes being continuous renal replacement therapy, hemorrhagic shock, and early enteral nutrition. The longest-lasting emergent keyword in Chinese literature was delayed resuscitation (2003-2010), with the highest emergent strength being severe burn. In English literature, the longest-lasting emergent keywords, each lasting five years, were nitric oxide (2007-2012), management (2019-2024), and impact (2019-2024), with the highest emergent strength being thermal injury. CONCLUSIONS Research on burn-related sepsis has shifted from focusing on early studies on pathogenesis and mortality to focus on prevention, treatment, and early diagnosis. Future research is expected to focus on early diagnosis and risk factors of burn-related sepsis.
Burns/complications* ; Sepsis/etiology* ; Humans ; Bibliometrics ; China

Reactive oxygen species (ROS)-mediated anticancer modalities, which disturb the redox balance of cancer cells through multi-pathway simulations, hold great promise for effective cancer management. Among these, cooperative physical and biochemical activation strategies have attracted increasing attention because of their spatiotemporal controllability, low toxicity, and high therapeutic efficacy. Herein, we demonstrate a nanogel complex as a multilevel ROS-producing system by integrating chloroperoxidase (CPO) into gold nanorod (AuNR)-based nanogels (ANGs) for cascade-amplifying photothermal-enzymatic synergistic tumor therapy. Benefiting from photothermal-induced hyperthermia upon near-infrared (NIR) laser exposure, the exogenous ROS (including H₂O₂) were boosted by the AuNR nanogel owing to the intercellular stress response. This ultimately promoted the efficient enzyme-catalyzed reaction of loaded CPO combined with the rich endogenous H₂O₂ in tumor cells to significantly elevate intracellular ROS levels above the threshold for improved therapeutic outcomes. Both in vitro and in vivo studies have verified the cascade-amplifying ROS-mediated antitumor effects, providing feasible multimodal synergistic tactics for tumor treatment.

Objective To investigate the expression of peripheral programmed death (PD)-1hiCXCR5-CD4+T cells and its clinical significance in systemic lupus erythematosus (SLE). Methods Peripheral blood PD-1hiCXCR5-CD4+ T cells from 21 SLE patients and 16 healthy controls were examined by flow cytometry. The levels of serum anti-double-stranded deoxyribonucleic acid (dsDNA) antibodies were determined using immunoradiometric as-say. Data were analyzed with t test and Pearson's correlation test. Results The per-centages of PD-1hiCXCR5- cells within CD4+ T cell were significantly higher in SLE patients [(2.1 ±2.0)％] compared to normal controls [(0.3±0.3)％] (t=2.959, P<0.01). The percentages of PD-1hiCXCR5-cells within CD4+T cells in moderate to severe active SLE patients (3.0 ±2.0)％ was significantly increased compared to patients with mild or inactive (1.0±1.4)％(t=2.574, P<0.05) and normal controls (0.3±0.3)％ (t=5.149, P<0.01). The percentages of PD-1hiCXCR5- cells within CD4+ T cells from SLE patients were positively related with systemic lupus erythematosus disease activity index (SLEDAI) (r=0.475, P=0.0297). SLE patients in serum anti-dsDNA antibodies positive group (2.7±2.1)％displayed a higher percentage of PD-1hiCXCR5-cells within CD4+T cells than patients in serum anti-dsDNA antibodies negative group (0.6 ±0.5)％ (t=2.303, P<0.05). The percentages of PD-1hiCXCR5-cells within CD4+T cells from SLE patients were positively correlated with anti-dsDNA antibody titers. Conclusion The percentages of PD-1hiCXCR5- cells within CD4+ T cells from SLE patients are increased and are positively correlated with SLEDAI and anti-dsDNA antibody levels. Increased percentage of PD-1hiCXCR5-cells within CD4+T cells might play an important role in the pathogenesis of SLE.

Objective To recapitulate the clinical traits of conjunctiva-corneal carcinoma in situ with microinvasion,and explore the early diagnosis and precise therapeutic methods.Methods The clinical features,diagnosis,surgical methods and follow-up results of a hospitalized patient with keratoconjunctival in situ carcinoma with microinvasion were retrospectively analyzed and related literature was consulted.Results Surgical resection of the tumor and 2 mm marginal tissue outside the edge of the tumor was performed.Fresh corneal lamellar grafts were used to treat the disease.After 2 years of follow-up,the operation was effective and no recurrence was found.Conclusion Early diagnosis plays an important role in improving the prognosis of keratoconjunctival carcinoma in situ with microinvasion and preventing recurrence.For patients with keratoconjunctival carcinoma in situ acompanied with microinvasion,we have to expand the surgical resection of the tumor (≥2 mm at the edge of the tumor),and follow-up at regular intervals,if necessary,supplemented with chemotherapy or anti-metabolic treatment.

Objective To study the clinical value and the safety of endoscopic retrograde cholangio-pancreatography(ERCP)for chronic pancreatitis in the pediatric population.Methods Clinical data,endo-scopic reports,and radiography of chronic pancreatic patients aged from 2 to 17 years old who underwent ERCP between Jan.1,2008 and Apr.30,2014 at Endoscopy Center of Ruijin Hospital were reviewed.These patients were divided into 3 groups,patients aged from 2 to 6 years old as children group(n =27),patients aged from 7 to 12 years old as juvenile group(n =35)and patients aged from 13 to 17 as adolescent group(n =25). Their clinical data and complications were analyzed by groups.Results A total of 170 ERCP procedures were performed in 87 patients,with the success rate of 99.4%(169 /170).All patients were diagnosed as having chronic pancreatitis by ERCP.Success rates of children group,juvenile group and adolescent group were 97.6%(40 /41),100.0%(72 /72)and 100.0%(57 /57)respectively.There was no statistically significance among the three groups(P =0.207).No serious complications like bleeding or perforation occurred.No proce-dure-related mortality occurred in this study either.The rate of post-ERCP adverse events in children group, juvenile group and adolescent group were 41.5%(17 /41),25.0%(18 /72)and 24.6%(14/57),respective-ly.Children group had more adverse events than the juvenile group(P =0.039)and adolescent group(P =0.045).Conclusion Pediatric ERCP is highly effective in the pediatric population with chronic pancreatitis. The incidence of post ERCP adverse events is higher among the youngest children.

PURPOSE: Several studies have compared the effects of coronary stenting and coronary-artery bypass grafting (CABG) on left main coronary artery (LMCA) disease. However, there are limited data on the long-term outcomes of these two interventions in diabetic patients. MATERIALS AND METHODS: We evaluated 56 patients with LMCA stenosis who underwent drug-eluting stent (DES) implantation and 116 patients who underwent CABG in a single hospital in China between January 2004 and December 2006. We compared long-term major adverse cardiac events (death; a "serious outcome" composite of death, myocardial infarction, or stroke; and target-vessel revascularization). RESULTS: In-hospital (30-day) mortality was 0% for the DES group and 3.4% for the CABG group (p=0.31). There was no difference between the two groups in terms of risk of death [hazard ratio for stenting group, 0.49; 95% confidence interval (CI), 0.13-1.63; p=0.55] or risk of serious outcome (hazard ratio for DES group, 1.11; 95% CI, 0.39-1.45; p=0.47). The target-vessel revascularization rate was higher in the DES group than in the CABG group (hazard ratio, 3.67; 95% CI, 1.24-11.06; p=0.018). CONCLUSION: In this cohort of diabetic patients with LMCA stenosis, there was no difference in composite endpoints between patients receiving DESs and those undergoing CABG. However, stenting was associated with higher rates of target-vessel revascularization than CABG. DES implantation in diabetic patients with LMCA disease was found to be at least as safe as CABG.
Angioplasty, Balloon, Coronary/*methods ; Coronary Stenosis/*therapy ; Diabetes Mellitus ; *Drug-Eluting Stents ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome

Objective To observe the clinical outcome of repair of the tissue defects of the tendon and skin with thigh anterolateral free flap with iliotibial tract. Methods The data was reviewed from June 2006 to June 2010, which the thigh anterolateral free flap with iliotibial tract were used to repair the defects of the tendon and skin of back of hand in 12 patients. The skin flap was 7 cm´10 cm~8 cm´12 cm in area. The iliotibial tract was 7~13 cm in length and 8~10 cm in width. Institute of Hand Surgery of Chinese Medical Association was to assess the effect. The fellow-up of the 12 patients was 6 months~4 years. Results All the flaps survived after the operation. The result showed excellent in 3 patients, good in 6 and fair in 3. Conclusion It is an effective surgical method to repair the tissue defects of the tendon and skin with thigh anterolateral free flap with iliotibial tract.

ObjectiveTo study the effect of tetramethylpyrazine cooperated with autogenous periosteum graft on fibrous scar formation in the epidural space after laminectomy. Methods48 SD rats were divided randomly into 4 groups. Laminectomy was performed in lumbar 2 segment, and the exposed duras were covered with saline solution (group A), tetramethylpyrazine (group B), autogenous periosteum (group C), and tetramethylpyrazine and autogenous periosteum (group D) respectively. 12 weeks postoperatively, they were evaluated with the gross and histopathological observation, biochemistry examination. ResultsThe assessment of Rydell-Balazs and Nussbaum's Criterion of group B, C, D were obviously better than that of group A (P<0.01), and that of group D was superior to group B and C (P<0.05), no significant difference between group B and C (P>0.05). ConclusionTetramethylpyrazine cooperated with autogenous periosteum graft has a better effect on prevention peridural adhesion after laminectomy.

OBJECTIVE:To observe the outcomes of umbilical cord blood mesenchymal stem call transplantation for treating neural function of multiple system atrophy (MSA) patients.METHODS:A total of 20 MSA patients were selected at the Beijing Wu Stem Cells Medical Center from January to October 2008.All patients received treatment of vessel distention,anti-free radical,trophic nerve and call membrane stabilization,as well as umbilical cord blood mesenchymal stem call transplantation via intrathecal injection.Patients at left-lateral position,and body bent at hips,knees and necks.Acupuncture was conducted at the space of lumbar vertebra 3 and 4.Following local anesthesia,No.9 needle was directly pricked into the subarachnoid cavity.2 mg dexamethasone was slowly infused,and 5 mL (5×106 stem cells) umbilical cord blood mesenchymal stern call injection was obtained and slowly infused into the subarachnoid cavity within 10 minutes,once per week,four times as a course,totally one course.We adopted Unified Multiple System Atrophy Rating Scale (UMSARS) to evaluate those MSA patients.The higher score represented a severe pathogenetic condition.RESULTS:Compared with pretransplantation,the UMSARS score was significantly decreased in 20 patients 4 weeks follwing transplantation (P ＜ 0.01).After the treatment,patient's clinical symptoms such as slow movement,balance disturbance,orthostatic hypotension,urinary and bowel disorders had full obvious improvement.Graft versus host disease was not found.CONCLUSION:It is indicated that mesenchymal stem call transplantation is effective,can partly improve MSA patients' clinical symptoms,and improve patients' life quality.