The research progress of perioperative non-pharmacological interventions on postoperative cognitive dysfunction: a narrative review

Postoperative cognitive dysfunction (POCD) is a common neurological complication in elderly patients after surgery and general anesthesia. The occurrence of POCD seriously affects the postoperative recovery of patients, and leads to prolonged hospital stay, reduced quality of life, increased medical costs, and even higher mortality. There is no definite and effective drug treatment for POCD. More evidence shows that perioperative non-pharmacological intervention can improve postoperative cognitive function and reduce the incidence of POCD. Therefore, our studies summarize the current non-pharmacological interventions of POCD from the aspects of cognitive training, physical activity, transcutaneous electrical acupoint stimulation, noninvasive brain stimulation, non-pharmacological sleep improvement, music therapy, environment, and multimodal combination Interventions, to provide more data for clinical application and research

Process Mineralogy and Beneficiation-Metallurgy Test of Geertuo Gold Deposit, West Qinling

Through detailed field geological survey, using high-precision mineral phase microscope, image analyzer, X-ray diffraction analyzer, scanning electron microscope and other testing methods, the research on the mineralogical characteristics of the Geertuo gold deposit, the results show that the metallic minerals are mainly hematite and limonite, and the non-metallic minerals are mainly calcite and quartz. Gold mainly exists in the form of natural gold, the content is more than 99%, and the particle size is between 3 μm and 20 μm, which belongs to microscopic gold. The intercalation relationship between gold and carrier minerals mainly includes fractured gold, intergranular gold and encapsulated gold. According to the characteristics of ore and minerals, the comparison test of beneficiation and smelting shows that the all-slime cyanide leaching scheme is a better beneficiation and smelting process for this type of mine

Comparative Study of Coal Sample Stress Sensitivity Characterized by Different Methods

The stress sensitivity of pores and fractures in four groups of coal samples was measured and analyzed comprehensively by overburden nuclear magnetic resonance(NMR) and permeability. The results show that the compression coefficient based on the overburden permeability increases with the increase of fracture development, the corresponding T2 spectral area of pore and fracture decreases exponentially with the increase of stress, in the same sample, the stress sensitivity of fracture is greater than that of seepage pore, and the adsorption pore is the lowest; compared with the pore developed samples, the compression coefficient of the fissure developed adsorption pore did not change significantly with the stress; in the same pressure range, the compressibility obtained by permeability is obviously greater than that obtained by NMR

A comb-brushing-type green soybean pod harvesting equipment: Design and experiment.

To solve the problem of low efficiency of manual harvesting of green soybeans and lack of adaptable harvesters, in this study, a brushing-type green soybean harvester was designed. The comb-brushing type green soybean pod harvesting equipment is composed of a front-mounted separation drum, a full-width material delivery mechanism, a negative pressure cleaning system, and a stalk-pod separation system. Based on the operation requirements of the front-mounted brushing-type detachment drum, the drum parameters, parameters of comb arrangement, and structural parameters of the comb, the force analysis in detachment was performed. By taking the pod detachment rate and damage rate as the response indexes, the rotational speed of the drum, the travel speed of the device, and teeth distance as influencing factors, a three-factor five-level orthogonal rotary combination test was carried out by the software Design-Expert. By establishing mathematical regression models for various influencing factors and evaluation indicators, conducting variance analysis and significance analysis on the response indicators of each factor, the optimal parameters were obtained at a rotational speed of teeth of 397.36 rpm/min, minimum axial teeth distance of 4.8 mm and travel speed of the device of 0.5 m/s. Field test results showed that, under the optimal parameter combination, the pod detachment rate was 94%, the damage rate was 3.04%, the harvesting efficiency was greater than 0.187 hm2/h, and impurity content was less than 7.8%, all of which met the design and usage requirements. The research results can provide a reference for the design of soybean harvesters

Minimal alveolar concentration of sevoflurane in combination with remimazolam in adults during laryngeal mask insertion: an up-down sequential allocation study

Abstract Background Remimazolam is a novel ultrashort-acting intravenous benzodiazepine sedative-hypnotic. The combination of remimazolam and sevoflurane does not increase respiratory sensitivity, produce bronchospasm, or cause other adverse conditions. We aimed to observe the effects of different remimazolam doses on the minimum alveolar concentration (MAC) of sevoflurane at end-expiration during laryngeal mask insertion and evaluate the effect of sex on the efficacy of the combination of remimazolam on the suppression of laryngeal mask insertion in adult patients. Methods We included 240 patients undergoing laparoscopic surgery under general anesthesia with elective placement of a laryngeal mask (120 males and 120 females). The patients were randomly divided into four groups according to sex: a control group (randomization for female patients, RF0; randomization for male patients, RM0) and three remimazolam groups (RF1, RM1 / RM2, RF2 / RM3, RF3), with 30 patients in each group. Induction was established by vital capacity rapid inhalation induction (VCRII), using 8% sevoflurane and 100% oxygen (6 L/min) in all patients. The (RF1, RM1), (RM2, RF2), and (RM3, RF3) groups were continuously injected with remimazolam at doses of 1, 1.5, and 2.0 mg/kg/h, respectively, while the (RM0, RF0) group was injected with an equal volume of normal saline. The end-expiratory concentration of sevoflurane was adjusted to a preset value after the patient’s eyelash reflex disappeared. After the end-expiratory concentration of sevoflurane was kept stable for at least 15 min, the laryngeal mask was placed, and the patient’s physical response to the mask placement was observed immediately and within 30 s of placement. The MAC of sevoflurane was measured using the up-and-down sequential method of Dixon. Results The calculated MAC of end-expiratory sevoflurane during laryngeal mask insertion in adult females was (2.94 ± 0.18)%, (2.69 ± 0.16)%, (2.32 ± 0.16)% and (1.83 ± 0.15)% in groups RF0, RF1, RF2 and RF3; (2.98 ± 0.18)%, (2.80 ± 0.19)%, (2.54 ± 0.15)% and (2.15 ± 0.15)% in male groups RM0, RM1, RM2 and RM3, respectively. The MAC values were significantly lower in the (RF1-RF3, RM1-RM3) group when compared to the (RF0, RM0) group. There was no significant difference between (RF0, RF1) and (RM0, RM1), but the MAC value of the RF2-RF3 group was significantly lower than that of the RM2-RM3 group. Conclusions Remimazolam can effectively reduce end-expiratory sevoflurane MAC values during laryngeal mask placement in adults. When remimazolam was measured above 1.5 mg/kg/h, the effect of inhibiting laryngeal mask implantation in female patients was stronger than that in male patients. Remimazolam at a dose of 1–2 mg/kg/h combined with sevoflurane induction can be safely and effectively used in these patients

Methodological quality for systematic reviews of adverse events with surgical interventions: a cross-sectional survey.

An increasing number of systematic reviews assessed the safety of surgical interventions over time. How well these systematic reviews were designed and conducted determines the reliability of evidence. In this study, we aimed to assess the methodological quality of systematic reviews on the safety of surgical interventions. We searched PubMed for systematic reviews of surgical interventions with safety as the exclusive outcome from 1st-Jan, 2015 to 1st-Jan, 2020. The methodological quality of eligible systematic reviews was evaluated according to the AMSTAR 2.0 instrument. The primary outcomes were the number of methodological weaknesses and the global methodological quality. The proportion of each methodological weakness among eligible systematic reviews was compared by three pre-defined stratification variables. The absolute difference of the proportion (PD) was used as the effect estimator, with the two-tailed z-test for the significance. We identified 127 systematic reviews from 18,636 records. None (n = 0, 0.00%) of them could be rated as "high" in terms of the global methodological quality; in contrast, they were either rated as "low" (n = 18, 14.17%) or as "critically low" (n = 109, 85.83%). The median number of methodological weaknesses of these systematic reviews was 8 (interquartile range, IQR: 6 to 9), in which 4 (IQR: 2 to 4) were critical weaknesses. Systematic reviews that used any reporting guideline (e.g., domain 13, PD = -0.22, 95% CI: - 0.39, - 0.06; p = 0.01) and developed a protocol in advance (e.g., domain 6, PD = -0.20, 95% CI: - 0.39, - 0.01; p = 0.04) were less likely to have methodological weakness in some domains but not for the rest (e.g., domain 8, PD = 0.04, 95% CI: - 0.14, 0.21; p = 0.68; with protocol vs. without). The methodological quality of current systematic reviews of adverse events with surgical interventions was poor. Further efforts, for example, encouraging researchers to develop a protocol in advance, are needed to enhance the methodological quality of these systematic reviews

DataSheet1_Silver-promoted solid-phase guanidinylation enables the first synthesis of arginine glycosylated Samoamide A cyclopeptide analogue.PDF

Cyclization and glycosylation serve as effective approaches for enhancing the drug properties of peptides. Distinct from typical glycosylation, atypical arginine N-glycosylation has drawn increasing attention due to its fundamental role in various cellular procedures and signaling pathways. We previously developed a robust strategy for constructing arginine N-glycosylated peptides characterized by silver-promoted solid-phase guanidinylation. Modeled after cyclic octapeptide Samoamide A, an antitumor peptide composed of eight hydrophobic amino acids extracted from cyanobacteria, herein we first performed arginine scanning to determine an optimal position for replacement with arginine. Consequently, the first synthesis of arginine glycosylated Samoamide A cyclopeptide analogue was described combining solid-phase glycosylation with solution-phase cyclization. The resultant SA-HH-TT displayed enhanced water solubility compared with the non-glycosylated SA-HH-TT. Notably, our method provides a universal strategy for synthesizing arginine N-glycosylated cyclopeptides.</p

Data_Sheet_1_Effect of thoracic paravertebral nerve block on delirium in patients after video-assisted thoracoscopic surgery: a systematic review and meta-analysis of randomized controlled trials.docx

BackgroundNerve blocks are widely used in various surgeries to alleviate postoperative pain and promote recovery. However, the impact of nerve block on delirium remains contentious. This study aims to systematically evaluate the influence of Thoracic Paravertebral Nerve Block (TPVB) on the incidence of delirium in patients post Video-Assisted Thoracoscopic Surgery (VATS).MethodsWe conducted a systematic search of PubMed, Embase, Web of Science, Cochrane Library, and Scopus databases in June 2023. The search strategy combined free-text and Medical Subject Headings (MeSH) terms, including perioperative cognitive dysfunction, delirium, postoperative cognitive dysfunction, paravertebral nerve block, thoracic surgery, lung surgery, pulmonary surgery, and esophageal/esophagus surgery. We utilized a random effects model for the analysis and synthesis of effect sizes.ResultsWe included a total of 9 RCTs involving 1,123 participants in our study. In VATS, TPVB significantly reduced the incidence of delirium on postoperative day three (log(OR): −0.62, 95% CI [−1.05, −0.18], p = 0.01, I2 = 0.00%) and postoperative day seven (log(OR): −0.94, 95% CI [−1.39, −0.49], p 2 = 0.00%). Additionally, our study indicates the effectiveness of TPVB in postoperative pain relief (g: −0.82, 95% CI [−1.15, −0.49], p 2 = 72.60%).ConclusionThe comprehensive results suggest that in patients undergoing VATS, TPVB significantly reduces the incidence of delirium and notably diminishes pain scores.Systematic review registrationCRD42023435528. https://www.crd.york.ac.uk/PROSPERO.</p