Background: Postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) are the most common central nervous system dysfunctions during the perioperative period.Melatonin protects nerve cells and impacts cognitive functioning in patients after surgery.Methods: A total of 120 patients undergoing elective non-cardiac surgery were evaluated with the confusion assessment method (CAM) for diagnosis of POD on the day before and the 1 st , 2 nd , 3 rd , and 7 th day after surgery.Also, a neuropsychological test for the diagnosis of POCD was performed on the day before and 1 week after surgery.Patients' urine was collected to examine the concentration of 6-sulfatoxymelatonin (6-SMT), the metabolite of melatonin, with the enzyme-linked immunosorbent assay method.Meanwhile, urine creatinine values were examined to calculate the 6-SMT/creatinine ratio (M/C).Results: The incidence rates of POD and POCD were 7% and 44%, respectively.There were no statistically differences for the M/C on the 1 st , 2 nd , 3 rd , and 7 th day after surgery between the POD and the non-POD groups (P>0.05).However, there were statistically significant differences (P<0.05) in the rates of M/C change [(preoperative value-postoperative value)/(postoperative value) ×100%] on the 1 st and 7 th day after surgery between both groups.Patients were divided into Group I 1 (≥100%) and Group II 1 (<100%) based on the M/C rate changes on the 1 st day, Group I 7 (≥200%) and Group II 7 (<200%) based on the M/C rate changes on the 7 th day, and Group I w (≥100%) and Group II w (<100%) based on the M/C rate changes during the 1 st week after surgery.The incidence rates of POD for Group I 1 and Group II 1 were 21.1% and 3.7%, respectively; for Group I 7 and Group II 7 were 50% and 1.1%, respectively; for Group I w and Group II w were 17.2% and 2.8%, respectively.For 7 patients with POD had POCD, the occurrence of POCD was related to POD (P<0.05).Conclusions: Increased melatonin after surgery may be a risk factor for POD.There may be no correlation between melatonin and POCD.POD may be a risk factor of POCD.
ABSTRACT The influenza virus neuraminidase H274Y substitution is a highly prevalent amino acid substitution associated with resistance to the most heavily used influenza drug, oseltamivir. Previous structural studies suggest that the group specific 252 residue (Y252 in group 1 and T252 in group 2) might be a key factor underlying H274Y resistance. However, H274Y has only been reported in N1 subtypes, which indicates that there must be additional key residues that determine H274Y resistance. Furthermore, we found that members of NA serotype N3 also possess Y252, raising the key question as to whether or not H274Y resistance may also be possible for some group 2 NAs. Here, we demonstrate that the H274Y substitution results in mild oseltamivir resistance for N3. Comparative structural analysis of N3, N1, and their 274Y variants indicates that the interaction of residue 296 (H in N1 and nonaromatic for other serotypes) with conserved W295 is another important determinant of oseltamivir resistance.
Abstract Dabie bandavirus (previously severe fever with thrombocytopenia syndrome virus; SFTSV), is an emerging tick-borne bunyavirus responsible for severe fever with thrombocytopenia syndrome (SFTS), a disease with high case fatality that is characterized by high fever, thrombocytopenia, and potentially lethal hemorrhagic manifestations. Currently, neither effective therapeutic strategies nor approved vaccines exist for SFTS. Therefore, there remains a pressing need to better understand the pathogenesis of the disease and to identify therapeutic strategies to ameliorate SFTS outcomes. Using a type I interferon (IFN)-deficient mouse model, we investigated the viral tropism, disease kinetics, and the role of the virulence factor nonstructural protein (NSs) in SFTS. Ly6C+ MHCII+ cells in the lymphatic tissues were identified as an important target cell for SFTSV. Advanced SFTS was characterized by significant migration of inflammatory leukocytes, notably neutrophils, into the lymph node and spleen, however, these cells were not required to orchestrate the disease phenotype. The development of SFTS was associated with significant upregulation of proinflammatory cytokines, including high levels of IFN-γ and IL-6 in the serum, lymph node, and spleen. Humoral immunity generated by inoculation with delNSs SFTSV was 100% protective. Importantly, NSs was critical to the inhibition of the host IFNɣ response or downstream IFN-stimulated gene production and allowed for the establishment of severe disease. Finally, therapeutic but not prophylactic use of anti-IL-6 antibodies significantly increased the survival of mice following SFTSV infection and, therefore, this treatment modality presents a novel therapeutic strategy for treating severe SFTS.
To study the protective effect of "Huang Lian Jie Du Tang" active fraction (HLJDTAF) on experimental cerebral ischemia.Middle cerebral artery occlusion (MCAO) in rats was used to observe the protective effect of HLJDTAF on ischemia stroke. Common carotid artery occlusion (CCAO) rat was used to analyse the effect of HLJDTAF on blood brain barrier (BBB) permeability. Common carotid artery occlusion and reperfusion repeatedly (CCAORR) in mice were used to test effect of HLJDTAF on gasp time, brain exponential and water content of brain.HLJDTAF could improve the abnormal behavior of MCAO rats and decrease the infarction area (P < 0. 05, P < 0. 01). HLJDTAF could also significantly prolong the shorten gasp time of CCAORR mice, reduce the brain exponential and decrease the water content in brain (P < 0. 05, P < 0. 01).HLJDTAF can protect the brain ischemia injury.
Abstract Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) Omicron and its subvariants (such as BQ.1, XBB and the latest variants, including XBB.1.16, EG.5, and BA.2.86), as the dominant variants, currently account for almost all new infections in the world due to their high transmissibility and immune escape ability. Omicron‐specific mRNA vaccines showed great potential to protect against Omicron infections. However, whether the vaccine could provide long‐term protection is unknown. Toward this goal, we evaluated the immunogenicity of a preclinical Omicron (BA.1)‐specific mRNA vaccine (S Omicron ‐6P) in different animal models. S Omicron ‐6P induced the highest levels of antibody titers at 1–2 weeks in different animals after the second dose. Even 9 months after the immunization, we observed modest neutralizing activity against Omicron subvariants in macaques. In addition, immunological memory cells can be rapidly reactivated upon stimulation. S Omicron ‐6P at concentrations higher than 10 μg effectively protected hamsters from BA.1 challenge 253 days after the first immunization, which could be attributed to the reactivation of immune systems. In addition, the toxicity tests conducted in rats revealed a highly favorable biosafety profile for S Omicron ‐6P, even at high dosages. Our data suggest that the Omicron‐specific mRNA vaccine is highly effective and safe in animal models and provides long‐term immunologic protection against SARS‐CoV‐2 Omicron infections.
Nasopharyngeal tuberculosis refers to the tuberculosis in the nasopharynx, which is mainly treated with systemic chemotherapy with anti-tuberculosis drugs. Here, we reported a case of nasopharyngeal tuberculosis treated by cryosurgery combined with local spraying of isoniazid on the basis of systemic chemotherapy with anti-tuberculosis drugs. By reviewing the case data and relevant literature, we understood the clinical manifestations, diagnosis and differential diagnosis of the disease, improved everyone's understanding of the disease, and proposed a new method of cryosurgery combined with local spraying of isoniazid for the treatment of nasopharyngeal tuberculosis for clinical discussion.
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