Schizophrenia (SZ) stands as a severe psychiatric disorder. This study applied diffusion tensor imaging (DTI) data in conjunction with graph neural networks to distinguish SZ patients from normal controls (NCs) and showcases the superior performance of a graph neural network integrating combined fractional anisotropy and fiber number brain network features, achieving an accuracy of 73.79% in distinguishing SZ patients from NCs. Beyond mere discrimination, our study delved deeper into the advantages of utilizing white matter brain network features for identifying SZ patients through interpretable model analysis and gene expression analysis. These analyses uncovered intricate interrelationships between brain imaging markers and genetic biomarkers, providing novel insights into the neuropathological basis of SZ. In summary, our findings underscore the potential of graph neural networks applied to multimodal DTI data for enhancing SZ detection through an integrated analysis of neuroimaging and genetic features.
Humans ; Schizophrenia/pathology* ; Diffusion Tensor Imaging/methods* ; Male ; Female ; Adult ; Brain/metabolism* ; Young Adult ; Middle Aged ; White Matter/pathology* ; Gene Expression ; Nerve Net/diagnostic imaging* ; Graph Neural Networks

Objective:To evaluate the relationship between the mechanism of buprenorphine in attenuating neuroinflammation in microglia and the MAM domain-containing glycosylphosphatidylinositol anchor gene 1 ( MDGA1). Methods:The human microglial cell line HMC-3 was cultured in vitro and divided into 4 groups ( n=6 each) using a table of random numbers: control group (Con group), lipopolysaccharide(LPS)group, buprenorphine + LPS group (Bup+ LPS group) and buprenorphine + LPS + MDGA1 knockdown group (Bup+ LPS+ shMDGA1 group). LPS group was incubated with LPS at a final concentration of 1 μg/ml for 4 h. Bup+ LPS group was incubated with buprenorphine at a final concentration of 100 ng/ml for 1 h, followed by incubation with LPS at a final concentration of 1 μg/ml for 4 h. Bup+ LPS+ shMDGA1 group was transfected with MDGA1-specific shorthairpin RNA for knockdown, and the remaining treatment was similar to those previously described in Bup+ LPS group. The expression of MDGA1 in microglia was detected using real-time quantitative polymerase chain reaction, and the concentrations of interleukin (IL)-6, IL-1β, tumor necrosis factor-α (TNF-α), and inducible nitric oxide synthase (iNOS) in the supernatant were measured using enzyme-linked immunosorbent assay. Results:Compared with Con group, the concentrations of IL-6, IL-1β, TNF-α and iNOS in the supernatant were significantly increased, and the expression of MDGA1 in microglia was down-regulated in LPS group ( P<0.05). Compared with LPS group, the concentrations of IL-6, IL-1β, TNF-α and iNOS in the supernatant were significantly decreased, and the expression of MDGA1 in microglia was up-regulated in Bup+ LPS group ( P<0.05). Compared with Bup+ LPS group, the concentrations of IL-6, IL-1β, TNF-α and iNOS in the supernatant were significantly increased, and the expression of MDGA1 in microglia was down-regulated in Bup+ LPS+ sh MDGA1 group ( P<0.05). Conclusions:The mechanism by which buprenorphine alleviates neuroinflammation in microglia may be related to the up-regulation of the expression of MDGA1.

Objective To explore the impacts of remimazolam on intraoperative intracranial pressure(ICP)and cerebral oxygenation in patients undergoing laparoscopic lower abdominal and pelvic surgery under CO2 pneumoperitoneum combined with Trendelenburg position.Methods Eighty-eight patients scheduled to undergo laparoscopic lower abdominal and pelvic surgery were randomly assigned to the remimazolam group(n=44)and the sevoflurane group(n=44).In the remimazolam group,continuous infusion of remimazolam at a rate of 1 mg/(kg·h)was administered for anesthesia maintenance.In contrast,the sevoflurane group inhaled 2％sevoflurane.Heart rate(HR),mean arterial pressure(MAP),peak airway pressure(Peak),plateau airway pressure(Plat),end-tidal CO2(PETCO2),regional cerebral oxygen saturation(rSO2),and optic nerve sheath diameter(ONSD)of both eyes were measured and recorded at the following time points:prior to anesthesia induction(T0),5 minutes after induction(T1),10 minutes(T2),30 minutes(T3),and 60 minutes(T4)after the establishment of pneumo-peritoneum in Trendelenburg position,as well as 30 minutes after deflation in the supine position(T5).Results No significant intergroup differences were detected in HR,MAP,Peak,Plat,or PETCO2 at any time point(P>0.05).In both groups,Peak and Plat values were significantly higher at T2-T4 compared to T1(P<0.05).Regard-ing the ONSD)no intergroup differences were noted at T0 and T1(P>0.05).From T2 to T5,ONSD in both groups increased significantly relative to T0..It gradually rose with the prolongation of pneumoperitoneum and Trendelen-burg positioning and showed a slight decrease at T5(P<0.05).Specifically,at T3 and T4,the remimazolam group exhibited significantly smaller ONSD values than the sevoflurane group(P<0.05).Throughout the study,no inter-group differences in rSO2 were observed(P>0.05).Conclusion In laparoscopic lower abdominal and pelvic surgeries performed in the Trendelenburg position,intravenous anesthesia with remimazolam may be more effective in mitigating the elevation of intracranial pressure compared to sevoflurane inhalation.

Objective To explore the impacts of remimazolam on intraoperative intracranial pressure(ICP)and cerebral oxygenation in patients undergoing laparoscopic lower abdominal and pelvic surgery under CO2 pneumoperitoneum combined with Trendelenburg position.Methods Eighty-eight patients scheduled to undergo laparoscopic lower abdominal and pelvic surgery were randomly assigned to the remimazolam group(n=44)and the sevoflurane group(n=44).In the remimazolam group,continuous infusion of remimazolam at a rate of 1 mg/(kg·h)was administered for anesthesia maintenance.In contrast,the sevoflurane group inhaled 2％sevoflurane.Heart rate(HR),mean arterial pressure(MAP),peak airway pressure(Peak),plateau airway pressure(Plat),end-tidal CO2(PETCO2),regional cerebral oxygen saturation(rSO2),and optic nerve sheath diameter(ONSD)of both eyes were measured and recorded at the following time points:prior to anesthesia induction(T0),5 minutes after induction(T1),10 minutes(T2),30 minutes(T3),and 60 minutes(T4)after the establishment of pneumo-peritoneum in Trendelenburg position,as well as 30 minutes after deflation in the supine position(T5).Results No significant intergroup differences were detected in HR,MAP,Peak,Plat,or PETCO2 at any time point(P>0.05).In both groups,Peak and Plat values were significantly higher at T2-T4 compared to T1(P<0.05).Regard-ing the ONSD)no intergroup differences were noted at T0 and T1(P>0.05).From T2 to T5,ONSD in both groups increased significantly relative to T0..It gradually rose with the prolongation of pneumoperitoneum and Trendelen-burg positioning and showed a slight decrease at T5(P<0.05).Specifically,at T3 and T4,the remimazolam group exhibited significantly smaller ONSD values than the sevoflurane group(P<0.05).Throughout the study,no inter-group differences in rSO2 were observed(P>0.05).Conclusion In laparoscopic lower abdominal and pelvic surgeries performed in the Trendelenburg position,intravenous anesthesia with remimazolam may be more effective in mitigating the elevation of intracranial pressure compared to sevoflurane inhalation.

Objective:To evaluate the relationship between the mechanism of buprenorphine in attenuating neuroinflammation in microglia and the MAM domain-containing glycosylphosphatidylinositol anchor gene 1 ( MDGA1). Methods:The human microglial cell line HMC-3 was cultured in vitro and divided into 4 groups ( n=6 each) using a table of random numbers: control group (Con group), lipopolysaccharide(LPS)group, buprenorphine + LPS group (Bup+ LPS group) and buprenorphine + LPS + MDGA1 knockdown group (Bup+ LPS+ shMDGA1 group). LPS group was incubated with LPS at a final concentration of 1 μg/ml for 4 h. Bup+ LPS group was incubated with buprenorphine at a final concentration of 100 ng/ml for 1 h, followed by incubation with LPS at a final concentration of 1 μg/ml for 4 h. Bup+ LPS+ shMDGA1 group was transfected with MDGA1-specific shorthairpin RNA for knockdown, and the remaining treatment was similar to those previously described in Bup+ LPS group. The expression of MDGA1 in microglia was detected using real-time quantitative polymerase chain reaction, and the concentrations of interleukin (IL)-6, IL-1β, tumor necrosis factor-α (TNF-α), and inducible nitric oxide synthase (iNOS) in the supernatant were measured using enzyme-linked immunosorbent assay. Results:Compared with Con group, the concentrations of IL-6, IL-1β, TNF-α and iNOS in the supernatant were significantly increased, and the expression of MDGA1 in microglia was down-regulated in LPS group ( P<0.05). Compared with LPS group, the concentrations of IL-6, IL-1β, TNF-α and iNOS in the supernatant were significantly decreased, and the expression of MDGA1 in microglia was up-regulated in Bup+ LPS group ( P<0.05). Compared with Bup+ LPS group, the concentrations of IL-6, IL-1β, TNF-α and iNOS in the supernatant were significantly increased, and the expression of MDGA1 in microglia was down-regulated in Bup+ LPS+ sh MDGA1 group ( P<0.05). Conclusions:The mechanism by which buprenorphine alleviates neuroinflammation in microglia may be related to the up-regulation of the expression of MDGA1.

Objective:To evaluate the effect of obesity on the displacement of a left-sided double-lumen tube (DLT) during positional changes.Methods:This was a prospective cohort study. Six hundred and two patients who underwent elective chest surgery and required insertion of a left-sided DLT from February 2020 to November 2023 in our hospital were selected and divided into 2 groups based on the body mass index (BMI): obesity group (BMI≥28 kg/m 2,n=208) and non-obesity group (18.5 kg/m 2≤BMI<28 kg/m 2,n=394). General characteristics of patients, history of chest surgery, DLT model, depth of DLT placement in supine position, height/depth of placement (H/D) ratio, and distance of DLT displacement were recorded. DLT displacement was defined as a displacement distance of ≥15 mm. The logistic regression was used for analysis of the relationship between BMI and left DLT shift during positional changes. The receiver operating characteristic curve was used to evaluate the accuracy of BMI in predicting the left-sided DLT displacement during positional changes. Results:Compared with non-obese group, the depth of DLT placement was significantly reduced, the H/D ratio was increased, the distance of DLT displacement was increased, and the incidence of DLT displacement was increased in obese group ( P<0.05). The results of binary logistic regression analysis showed that a BMI≥28 kg/m 2 was an independent risk factor for DLT displacement ( OR value [95% confidence interval]=4.18 (2.36-7.38), P<0.001). The sensitivity of BMI in predicting the left-sided DLT displacement during positional changes was 77.4%, and the specificity was 69.6%, with an optimal cutoff value of 27.48 kg/m 2 and an area under the receiver operating characteristic curve of 0.757. Conclusions:Obesity can increase the probability of the left-sided DLT displacement during positional changes.

Objective:To compare the effects of left paratracheal pressure (LPP) and cricoid pressure (CP) during mask ventilation in obese patients.Methods:Sixty patients of either sex, aged 18-60 yr, with 28 kg/m 2≤body mass index<35 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, scheduled for general anesthesia, were divided into 2 groups ( n=30 each) using a random number table method: LPP group and CP group. In LPP group, pressure was applied beside the trachea, above the clavicle towards the vertebral direction, while in CP group, pressure was applied downwards to the cricoid cartilage, with a force of pressure between 25-35 N. The spatial relationship between the esophagus, trachea, and cricoid cartilage, the presence of air shadows in the gastric antrum during mask ventilation, and the cross-sectional area (CSA) of the gastric antrum before and after mask ventilation as well as the airway pressure during mask ventilation were observed. Results:In both groups, the esophagus was located in the left of the trachea in the supraclavicular region. There were no statistically significant differences in the airway pressure during mask ventilation and the CSA of the gastric antrum prior to mask ventilation between the two groups ( P>0.05). Compared to LPP group, the proportion of patients with air shadows in the gastric antrum during mask ventilation was significantly increased, and the CSA of the gastric antrum was increased after mask ventilation in CP group ( P<0.05). Conclusions:Compared to CP, LPP can decrease the development of air entering the stomach during mask ventilation and reduce the CSA of the gastric antrum after mask ventilation in obese patients.

Objective:To evaluate the efficacy of oliceridine for analgesia in the patients undergoing radical thyroidectomy for thyroid cancer.Methods:In this prospective, randomized, double-blind, single-center, positive-control study, 84 patients of either sex, aged 18-64 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, weighing 50-70 kg, with a body mass index of 18-28 kg/m 2, education years ≥ 6 yr, and expected surgery time>1 h, with thyroid cancer undergoing radical surgery under general anesthesia at the Affiliated Cancer Hospital of Zhengzhou University from August to October 2024, were divided into 2 groups using a random number table method: sufentanil group (S group, n=41) and oliceridine group (O group, n=43). During anesthesia induction: Group S received intravenous injection of sufentanil 15 μg, while group O received intravenous injection of oliceridine 3 mg; If the increase in mean arterial pressure or heart rate exceeded 20% of the baseline value within 3 min after tracheal intubation, an additional 5 μg of sufentanil (S group) or 1 mg of oliceridine (O group) was added. At 2 min before skin incision, sufentanil 15 μg was intravenously injected in group S, and oliceridine 3 mg was intravenously injected in group O. Effectiveness evaluation indicators: The visual analog scale scores were recorded at 5 min after tracheal extubation, immediately upon exiting the post-anesthesia care unit, and at 24 and 48 h postoperatively; Ramsay sedation scores were recorded at 5, 10, 20 and 30 min after tracheal extubation. The safety evaluation indicators: The use of vasoactive drugs during surgery and occurrence of adverse reactions within 48 h after surgery were recorded. Results:Compared with group S, no significant change was found in visual analog scale scores at different time points after surgery and Ramsay sedation scores at different time points after tracheal extubation ( P>0.05), and the usage rate of atropine during surgery and incidence of postoperative nausea and vomiting were significantly decreased in group O ( P<0.05). Conclusions:Oliceridine can produce postoperative analgesic efficacy comparable to sufentanil in the patients undergoing radical thyroidectomy for thyroid cancer, with smoother intraoperative hemodynamics and lower incidence of postoperative nausea and vomiting.

Objective:To evaluate the efficacy of oliceridine for postoperative analgesia in patients undergoing breast-conserving surgery for breast cancer.Methods:In this prospective, randomized, double-blind, single-center, positive-control clinical study, 123 patients with breast cancer, aged 18-64 yr, of American Society of Anesthesiologists Physical Status classification I or Ⅱ, with a body mass index of 18-28 kg/m 2, undergoing breast-conserving surgery under general anesthesia at the Affiliated Cancer Hospital of Zhengzhou University from May to August 2024, were divided into 2 groups using a random number table method: sufentanil group (group S, n=62) and oliceridine group (group O, n=61). During anesthesia induction, sufentanil 15 μg was intravenously injected in group S, and oliceridine 3 mg was intravenously injected in group O. At 2 min before skin incision, sufentanil 10 μg was intravenously injected in group S, and oliceridine 2 mg was intravenously injected in group O. Postoperative patient-controlled intravenous analgesia was performed, with group S receiving sufentanil 50 μg and group O receiving oliceridine 10 mg, each diluted with normal saline to 100 ml. The pain visual analog scale scores at rest and during activity were recorded at 6, 12, 24 and 48 h postoperatively. The time of the first pressing of the postoperative analgesic pump, effective pressing times of patient-controlled analgesia and requirement for rescue analgesia within 24 h after surgery were recorded. The Ramsay sedation scores were recorded at 5, 15 and 30 min after tracheal extubation. The postoperative recovery quality was measured using the 15-item quality of recovery questionnaire at 24 h before surgery and at 24 and 48 h after surgery. The adverse reactions were recorded within 48 h after surgery. Results:Compared with group S, no significant change was found in visual analog scale scores at rest and during activity at different time points, the time of the first pressing of the postoperative analgesic pump, effective pressing times of patient-controlled analgesia and requirement for rescue analgesia within 24 h after operation, or the Ramsay sedation scores at 5, 15 and 30 min after tracheal extubation ( P>0.05), and 15-item quality of recovery scores were significantly increased at 24 and 48 h after surgery, and the incidence of postoperative nausea and vomiting was decreased in group O ( P<0.05). Conclusions:Oliceridine produces postoperative analgesic effects comparable to sufentanil without affecting patient awakening and reduces postoperative nausea and vomiting, which is helpful for early postoperative recovery when used in the patients undergoing breast-conserving surgery for breast cancer.

Objective:To evaluate the efficacy of oliceridine for patient-controlled intravenous analgesia (PCIA) after bone tumor resection.Methods:In this prospective randomized controlled study, 72 patients of either sex, aged 18-64 yr, with a body mass index of 18-28 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ, who underwent elective bone tumor resection under general anesthesia, were selected and divided into 2 groups ( n=36 each) by the random number table method: sufentanil group (group S) and oliceridine group (group O). Combined intravenous-inhalational anesthesia was used in both groups. PCIA was performed from the end of surgery until 48 h after surgery. PCIA solution contained sufentanil 2 μg/kg in normal saline 100 ml in group S and oliceridine 0.4 mg/kg in normal saline 100 ml in group O. The background infusion rate was 2 ml/h, the bolus dose was 2 ml, the lockout interval was 15 min, and the maximum dose per hour was 10 ml in both groups. Flurbiprofen ester 50 mg was intravenously injected as rescue analgesic after operation when numerical rating scale score at rest≥4 or numerical rating scale score during activity≥7. The number of effective pressing times of patient-controlled analgesia (PCA), total pressing times of PCA, consumption of analgesics and requirement for rescue analgesia were recorded within 48 h after operation. Ramsay sedation scores were recorded at 2, 6, 12, 24 and 48 h after surgery. The occurrence of adverse reactions and requirement for rescue antiemetic within 48 h after surgery were recorded.The 15-item quality of recovery scale scores were assessed at 24 h before surgery and 24 and 48 h after surgery. The patient satisfaction score and satisfaction rate were recorded. Results:Compared with group S, the number of effective pressing times of PCA, total pressing times of PCA and consumption of analgesics were significantly reduced within 48 h after operation, the Ramsay sedation score was significantly increased at 12 h after surgery, the incidence of nausea and vomiting and rescue antiemetic rate were decreased, and the 15-item quality of recovery scale scores, satisfaction score and satisfaction rate were increased in group O ( P<0.05). There were no significant differences in the rate of rescue analgesia and incidence of respiratory depression, dizziness, pruritus and urinary retention within 48 h after operation ( P>0.05). Conclusions:Oliceridine has similar effect to sufentanil for postoperative PCIA, reduces the development of postoperative nausea and vomiting, improves satisfaction, and promotes early postoperative recovery when used in the patients undergoing bone tumor resection.