Additional file 1 of Integrative proteomics and metabolomics data analysis exploring the mechanism of brain injury after cardiac surgery in chronic stress rats

Supplementary Material 1

Results of markers of kidney injury in the three groups.

<p>(A) serum creatinine; (B) serum BUN; (C) serum CysC; (D) urine NAG, urine N-acetyl-β-D-glucosaminidase. Data are presented as mean±SD, n = 6, *<i>P</i> <0.05 versus Group C, Ψ<i>P</i> <0.05 versus Group S. For graphs pooled estimates for pairwise comparisons derived from Analysis of Covariance with adjustment for baseline serum creatinine at 53.61±9.53μmmol/L, serum BUN 4.31±1.34μmmol/L, serum CysC 24.35±4.2μg/L, were as follows: <b>serum creatinine;</b> 5min post CPB(T2): Group C, 64.24±12.53μmmol/L, Group U, 62.33±11.73μmmol/L. Test for overall treatment effect <i>P</i> = 0.074. 120min post CPB(T3): Group C, 86.62±11.41μmmol/L, Group U, 71.72±12.55μmmol/L. Test for overall treatment effect <i>P</i> = 0.032. <b>serum BUN;</b> 5min post CPB(T2): Group C, 5.43±1.87μmmol/L, Group U, 5.41±1.72μmmol/L. Test for overall treatment effect <i>P</i> = 0.081. 120min post CPB(T3): Group C, 7.37±1.72μmmol/L, Group U, 6.13±1.69μmmol/L. Test for overall treatment effect <i>P</i> = 0.025. <b>serum CysC;</b> 5min post CPB(T2): Group C, 30.47±4.4μg/L, Group U, 26.66±5.7μg/L. Test for overall treatment effect <i>P</i> = 0.069. 120min post CPB(T3): Group C, 40.62±6.5μg/L, Group U, 30.72±6.2μg/L. Test for overall treatment effect <i>P</i> = 0.001.</p

Image_1_The Effect of General Anesthesia vs. Regional Anesthesia on Postoperative Delirium—A Systematic Review and Meta-Analysis.TIF

BackgroundPostoperative delirium (POD) commonly occurs in patients following major surgeries and is associated with adverse prognosis. The modes of anesthesia may be associated with POD occurrence. General anesthesia (GA) causes loss of consciousness in the patient by altering the levels of some neurotransmitters as well as signaling pathways. We conducted this meta-analysis to investigate the effect of GA vs. regional anesthesia (RA) on POD incidence in surgical patients.MethodsThe databases of Pubmed, Embase, and Cochrane Library were searched till October 22, 2021. The eligible criteria were participants aged 18 years or older, patients undergoing surgery under GA and RA, and articles reporting the effect of GA vs. RA on POD incidence. RevMan 5.3 was used to perform statistical analyses.ResultsA total of 21 relevant trials with a total of 1,702,151 patients were included. The pooled result using random-effects model with OR demonstrated significant difference in POD incidence between patients with GA and RA (OR = 1.15, 95% CI: [1.02, 1.31], I2 = 83%, p for effect = 0.02). We did not obtain the consistent pooled result after sensitivity analysis (OR = 0.95, 95% CI: [0.83, 1.08], I2 =13%, p for effect = 0.44) and excluded the articles without the information on preoperative cognitive or neuropsychological assessment (OR = 1.12, 95% CI: [1.00, 1.25], I2 =80%, p for effect = 0.05), respectively.ConclusionThis meta-analysis could not identify that GA was significantly associated with POD occurrence in surgical patients compared with RA.</p

Typical histological examination results in the three groups.

<p>A, Group S, Tubules and glomeruli appear normal (H&E×400); B, Group C, after 2h CPB, kidney histologic changes include tubular dilatation(*), vacuole formation(▲), and glomerular over-filling (arrow) appeared obvious (H&E×400); C, Group U, injury changes of kidney still exist as tubular dilatation(*), vacuole formation(▲), and glomerular over-filling (<i>arrow</i>) but were milder with intervention of ulinastatin(H&E×400).</p

Results of plasma markers of inflammation in the three groups.

<p>(A) serum IL-6, interleukin-6; (B) serum TNF-α, tumor necrosis factor-α. Data are presented as mean±SD, n = 6, *<i>P</i> <0.05 versus Group C. For graphs pooled estimates for pairwise comparisons derived from Analysis of Covariance with adjustment for baseline serum IL-6 at 0.94±0.13μg/L, serum TNF-α 0.32±0.05ng/L, were as follows: <b>IL-6;</b> 5min post CPB(T2): Group C, 1.37±0.16μg/L, Group U, 1.01±0.13μg/L. Test for overall treatment effect <i>p</i> = 0.021. 120min post CPB(T3): Group C, 1.38±0.28μg/L, Group U, 1.13±0.24μg/L. Test for overall treatment effect <i>P</i> = 0.001. <b>TNF-α</b>; 5min post CPB(T2): Group C, 0.37±0.19 ng/L, Group U, 0.33±0.19ng/L. Test for overall treatment effect <i>P</i> = 0.075. 120min post CPB(T3): Group C, 0.35±0.13 ng/L, Group U, 0.32±0.13 ng/L. Test for overall treatment effect <i>P</i> = 0.088.</p

Image_2_The Effect of General Anesthesia vs. Regional Anesthesia on Postoperative Delirium—A Systematic Review and Meta-Analysis.TIF

BackgroundPostoperative delirium (POD) commonly occurs in patients following major surgeries and is associated with adverse prognosis. The modes of anesthesia may be associated with POD occurrence. General anesthesia (GA) causes loss of consciousness in the patient by altering the levels of some neurotransmitters as well as signaling pathways. We conducted this meta-analysis to investigate the effect of GA vs. regional anesthesia (RA) on POD incidence in surgical patients.MethodsThe databases of Pubmed, Embase, and Cochrane Library were searched till October 22, 2021. The eligible criteria were participants aged 18 years or older, patients undergoing surgery under GA and RA, and articles reporting the effect of GA vs. RA on POD incidence. RevMan 5.3 was used to perform statistical analyses.ResultsA total of 21 relevant trials with a total of 1,702,151 patients were included. The pooled result using random-effects model with OR demonstrated significant difference in POD incidence between patients with GA and RA (OR = 1.15, 95% CI: [1.02, 1.31], I2 = 83%, p for effect = 0.02). We did not obtain the consistent pooled result after sensitivity analysis (OR = 0.95, 95% CI: [0.83, 1.08], I2 =13%, p for effect = 0.44) and excluded the articles without the information on preoperative cognitive or neuropsychological assessment (OR = 1.12, 95% CI: [1.00, 1.25], I2 =80%, p for effect = 0.05), respectively.ConclusionThis meta-analysis could not identify that GA was significantly associated with POD occurrence in surgical patients compared with RA.</p

Table_1_The Effect of General Anesthesia vs. Regional Anesthesia on Postoperative Delirium—A Systematic Review and Meta-Analysis.DOC

BackgroundPostoperative delirium (POD) commonly occurs in patients following major surgeries and is associated with adverse prognosis. The modes of anesthesia may be associated with POD occurrence. General anesthesia (GA) causes loss of consciousness in the patient by altering the levels of some neurotransmitters as well as signaling pathways. We conducted this meta-analysis to investigate the effect of GA vs. regional anesthesia (RA) on POD incidence in surgical patients.MethodsThe databases of Pubmed, Embase, and Cochrane Library were searched till October 22, 2021. The eligible criteria were participants aged 18 years or older, patients undergoing surgery under GA and RA, and articles reporting the effect of GA vs. RA on POD incidence. RevMan 5.3 was used to perform statistical analyses.ResultsA total of 21 relevant trials with a total of 1,702,151 patients were included. The pooled result using random-effects model with OR demonstrated significant difference in POD incidence between patients with GA and RA (OR = 1.15, 95% CI: [1.02, 1.31], I2 = 83%, p for effect = 0.02). We did not obtain the consistent pooled result after sensitivity analysis (OR = 0.95, 95% CI: [0.83, 1.08], I2 =13%, p for effect = 0.44) and excluded the articles without the information on preoperative cognitive or neuropsychological assessment (OR = 1.12, 95% CI: [1.00, 1.25], I2 =80%, p for effect = 0.05), respectively.ConclusionThis meta-analysis could not identify that GA was significantly associated with POD occurrence in surgical patients compared with RA.</p

Table_2_The Effect of General Anesthesia vs. Regional Anesthesia on Postoperative Delirium—A Systematic Review and Meta-Analysis.docx

BackgroundPostoperative delirium (POD) commonly occurs in patients following major surgeries and is associated with adverse prognosis. The modes of anesthesia may be associated with POD occurrence. General anesthesia (GA) causes loss of consciousness in the patient by altering the levels of some neurotransmitters as well as signaling pathways. We conducted this meta-analysis to investigate the effect of GA vs. regional anesthesia (RA) on POD incidence in surgical patients.MethodsThe databases of Pubmed, Embase, and Cochrane Library were searched till October 22, 2021. The eligible criteria were participants aged 18 years or older, patients undergoing surgery under GA and RA, and articles reporting the effect of GA vs. RA on POD incidence. RevMan 5.3 was used to perform statistical analyses.ResultsA total of 21 relevant trials with a total of 1,702,151 patients were included. The pooled result using random-effects model with OR demonstrated significant difference in POD incidence between patients with GA and RA (OR = 1.15, 95% CI: [1.02, 1.31], I2 = 83%, p for effect = 0.02). We did not obtain the consistent pooled result after sensitivity analysis (OR = 0.95, 95% CI: [0.83, 1.08], I2 =13%, p for effect = 0.44) and excluded the articles without the information on preoperative cognitive or neuropsychological assessment (OR = 1.12, 95% CI: [1.00, 1.25], I2 =80%, p for effect = 0.05), respectively.ConclusionThis meta-analysis could not identify that GA was significantly associated with POD occurrence in surgical patients compared with RA.</p

Additional file 1 of Low postoperative blood platelet count may be a risk factor for 3-year mortality in patients with acute type A aortic dissection

Additional file 1: Table 1. Diagnostic criteria for each postoperative complications. Table 2. The results of univariate Logistic regression

Table_3_Gender Differences and Postoperative Delirium in Adult Patients Undergoing Cardiac Valve Surgery.DOCX

Background: Postoperative delirium (POD) is common in patients following cardiac surgery. According to studies on non-cardiac surgery, males suffered from higher incidence of POD. However, there is no report about effect of gender differences on POD occurrence in cardiac surgery patients. The aim of this study was to investigate the effect of gender differences on POD occurrence in adult patients after cardiac valve surgery.Methods: This is a retrospective case-control study. We recorded the clinical data in adult patients who underwent elective cardiac valve surgery from May 2019 to October 2020. POD was assessed by the Confusion Assessment Method for Intensive Care Unit. Univariate analysis was used to screen the potential risk factors. Collinearity analysis was conducted to detect overlapping predictor variables on the outcomes. A multivariate logistic regression with odds ratio (OR) and 95% confidence interval (CI) was used to identify the independent risk factors. The Hosmer-Lemeshow test was performed to show the good calibration of the logistic regression model.Results: In total, we recorded the perioperative data in 431 adult patients, including 212 males and 219 females. Sixty patients suffered from POD, including 39 males and 21 females. Twenty-one perioperative variables were selected, and 11 were screened by univariate analysis. We did not detect the severe collinearity among the 11 variables. Male gender was identified as a significant risk factor in POD occurrence in patients undergoing cardiac surgery (Adjusted OR: 2.213, 95% CI: 1.049–4.670, P = 0.037). The Hosmer-Lemeshow test demonstrated good calibration of the logistic regression model (χ2 = 7.238, P = 0.511). Besides, compared with females, the relationship of male and delirium subtypes was as follows: (1) hyperactive: adjusted OR: 3.384, 95% CI: 1.335–8.580, P = 0.010; (2) hypoactive: adjusted OR: 0.509, 95% CI: 0.147–1.766, P = 0.287. A Stratification analysis by age demonstrated that the males showed higher POD incidence in patients aged younger than 60 years (adjusted OR: 4.384, 95% CI: 1.318–14.586, P = 0.016).Conclusions: Male gender is an important risk factor in POD occurrence in patients following cardiac surgery. Furthermore, the incidence of hyperactive delirium is higher in males. Besides, the male patients aged younger than 60 years are at high risk of POD. We should pay more attention to the male patients to prevent their POD occurrence.</p