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.

The identification and diagnosis of coronavirus disease 2019 (COVID-19) is of great significance in the treatment of COVID-19. Based on Diagnosis and Treatment Protocol for COVID-19 (Trial Version 5) issued on February 8, 2020 by the National Health Commission, there is no fungal pneumonia among the disease listed in the identification and diagnosis item. Thus, we reported a case of patient with AIDS associated with pneumocystis carinii severe pneumonia admitted to Shanghai Fourth People′s Hospital affiliated to Tongji University School of Medicine in January, 2020, which was helpful in improving the identification and diagnosis of COVID-19.

During the epidemic of coronavirus disease 2019 (COVID-19), the infection of the elderly population will bring great challenges to clinical diagnosis and treatment, outcome and management.Combined with the characteristics of anesthesia and the pathophysiological characteristics of COVID-19 on lung function impairment in elderly patients, Chinese Society of Anesthesiology formulated the " Recommendations for anesthesia management and infection control in elderly patients with COVID-19″. This recommendation expounds preoperative visit and infection control, anesthesia management protocol, anesthesia monitoring, anesthesia induction/endotracheal intubation, anesthesia maintenance and infection control, intraoperative lung protection strategy, anti-stress and anti-inflammatory management, hemodynamic optimization, infection control during emergence from anesthesia, and postoperative analgesia in elderly patients with COVID-19, and provides the reference for the safe and effective implementation of anesthesia management in elderly patients during the prevention and control of COVID-19 epidemic.

PURPOSE: Colorectal cancer (CRC) is the third most common cancer in China and poses high morbidity and mortality. In recent years, increasing evidence has indicated that microRNAs played important functions in the occurrence and development of tumors. The purpose of this study was to identify the biological mechanisms of miR-362 in CRC. MATERIALS AND METHODS: Quantitative real-time PCR was carried out to assess the expression of miR-362 and SIX1. The Kaplan-Meier method was employed to evaluate the 5-year overall survival of CRC patients. The proliferative and invasive abilities of CRC cells were assessed by MTT and transwell assays. RESULTS: miR-362 was significantly decreased in CRC tissues and cell lines, compared to the normal tissues and normal cells. A significant connection was confirmed between the overall survival of 53 CRC patients and low expression of miR-362. Downregulation of miR-362 inhibited the proliferation and invasion through binding to the 3′-UTR of SIX1 mRNA in CRC. Additionally, we discovered that SIX1 was a direct target gene of miR-362 and that the expression of miR-362 had a negative connection with SIX1 expression in CRC. SIX1 could reverse partial functions in the proliferation and invasion in CRC cells. CONCLUSION: miR-362 may be a prognostic marker in CRC and suppress CRC cell proliferation and invasion in part through targeting the 3′-UTR of SIX1 mRNA. The newly identified miR-362/SIX1 axis provides insight into the progression of CRC.
Cell Line ; Cell Proliferation ; China ; Colorectal Neoplasms ; Down-Regulation ; Humans ; Methods ; MicroRNAs ; Mortality ; Real-Time Polymerase Chain Reaction ; RNA, Messenger

Along with changes of medical model, hospitals need to provide best outcome with lowest cost and best patient′s experience rather than merely medical treatments. It is the cultivation of lean awareness to the doctors that could acquire such outcome. The healthcare lean awareness can be summarized as responsibility awareness, digitalized awareness, detail awareness, and outstanding awareness. Through the cultivation of lean awareness, humanism can immerse into the doctors′practice, which is conducive to train for the great masters of the medicine.

Objective To investigate the effect of ginsenoside Rd on oxidative stress induced by H2O2 in microglia cells and the changes of biological function of microglia cells.Methods The microglia cell lines N9 were divided into control group,ginsenoside Rd group,H2O2 group,ginsenoside Rd 10 μmol/L+H2O2 group and ginsenoside Rd 20 μmol/L+H2O2 group.In the control group,the N9 cells were incubated in the CO2 incubator for 24 h;in the ginsenoside Rd group,the N9 cells were treated with 20 μmol/L ginsenoside Rd for 24 h;in the H2O2 group,the N9 cells were treated with 700 μmol/L H2O2 for 24 h;the cells in ginsenoside Rd 10 μmol/L+H2O2 group and ginsenoside Rd 20 μmol/L+ H2O2 group were pretreated with 10 μmol/L or 20 μmol/L ginsenoside Rd for 24 h,respectively,and then,700 μmol/L H2O2 was added to the medium and co-cultured for another 24 h.After the treatment,the cell viability was measured by MTT assay,the intracellular reactive oxygen species (ROS) level was determined by 2',7'-dichlorofluorescein diacetate (DCFH-DA) and mitochondrial membrane potential (MMP) was measured by tetramethylrhodamine methyl ester (TMRE).Western blotting was used to detect the expression of brain derived neurotrophic factor (BDNF) in N9 cells.Results As compared with those in the control group and ginsenoside Rd group,the cell survival rate was significantly decreased,ROS level was significantly increased and MMP was significantly decreased in H2O2 group (P＜0.05);as compared with the control group,the BDNF expression in ginsenoside Rd group was higher,and the difference was statistically significant (P＜0.05);as compared with H2O2 group,the cell survival rate,BDNF expression and MMP level increased significantly,ROS was significantly decreased in ginsenoside Rd 10 μmol/L+H2O2 group and ginsenoside Rd 20 μmol/L+H2O2 group (P＜0.05).Conclusion Ginsenoside Rd could protect microglia cells from oxidative stress damage induced by H2O2,and could increase the secretion of BDNF,which has a significant protective effect on microglia cells.

Objective To establish a method for determinning quetiapine in human hair by HPLC.Methods A reverse phase HPLC system was performed on Inertsil ODS-C18 column (4.6 mm ×150 mm,5μm)with the mobile phase consisted of 0.01 mol/Lammonioum-methanol(32︰68).The flow rate was 1.0 mL/min,column temperature was 40℃,the detection wavelength was 254 nm.N-hexane was used as extracting solvent.Results The calibration curve was linear in the range of 5-200 ng/mg.for quetiapine.The recovery of extraction >75.0%, the recovery of method was between 95.0% and 105.0%, the intra-day and inter-day precision were all no more than 10.0%.This method met the requirements of biological samples. Conclusion A HPLC method of concentration of quetiapine in human hair is established, which is simple,sensitive,accurate and has a certain value.

Objective To investigate the mechanism of kuiyusan on recovering intestinal mucosa of patients with active ulcerative colitis(UC). Methods Forty-eight patients with active UC were selected as our subjects. They were applied kuiyusan to retention enema for1 time per day for 15 days as a treatment course. Next treatment course were started interval 7 days and all patients were received 3 treatment courses. Changes of pathological signs were observed before and after the treatment with kuiyusan. Results The rate of intestinal mucosal focal small hemorrhages after treatment was 37. 5 %(18 / 48),significantly lower than that at pre-treatment(87. 5%(42 / 48);χ2 = 25. 60,P < 0. 001). The UC mucosal epithelial regeneration rate,disappear rate of intestinal mucosal epithelial goblet cells and Paneth cells regeneration rate at pre-treatment were 18. 8%(9 / 48),31. 2%(15 / 48),6. 3%(3 / 48),significantly different from that after treatment(50. 0%(24 / 48), 6. 3%( 3 / 48 ),20. 8%( 10 / 48 );χ2 = 10. 39,9. 85,4. 36;P < 0. 01 ). The incidence rate of intestinal lymphocyte hyperplasia and infiltration of eosinophils at pre-treatment were 95. 8%(46 / 48)and 100%(48 /48),higher than that after treatment( 72. 9%( 35 / 48 ) and 56. 2%( 27 / 48 )) and the differences were significant(χ2 = 9. 56,26. 88;P < 0. 01). Crypt abscess incidence were decreased from 56%(27 / 48)at pre-treatment to 25%(12 / 48)at after treatment( χ2 = 9. 72,P < 0. 01). Conclusion Kuiyusan can obviously improve small vascular lesions and crypt abscess of the mucous membrane on active UC,reduce neutrophil, eosinophil infiltration,maintain the intestinal epithelial tight junction,improve mucosal barrier,as well as promote healing of mucosal inflammation.