Sevoflurane is one of the most widely used anesthetics for the induction and maintenance of general anesthesia in surgical patients. Sevoflurane treatment may increase the incidence of postoperative cognitive dysfunction (POCD), and patients with POCD exhibit lower cognitive abilities than before the operation. POCD affects the lives of patients and places an additional burden on patients and their families. Understanding the mechanism of sevoflurane-induced POCD may improve prevention and treatment of POCD. In this paper, we review the diagnosis of POCD, introduce animal models of POCD in clinical research, analyze the possible mechanisms of sevoflurane-induced POCD, and summarize advances in treatment for this condition.

Spinal cord injury (SCI) is a severe traumatic disease of the central nervous system, with a global prevalence of 236–4187 per million people. This meta-analysis aimed to evaluate the safety and efficacy of mesenchymal stem cells (MSCs) in treating patients with SCI as well as the optimal source and transplantation method of MSCs. PubMed, OVID, Cochrane, Web of Science, and China Biomedical Database were searched up until April 01, 2021. The study was conducted for five endpoints: American Spinal Injury Association (ASIA) motor and sensory score, ASIA grade improvement, Barthel Index (BI), and adverse reactions. Standard meta-analysis and network meta-analysis were performed using Stata 14.0. Eighteen studies with a total of 949 patients, were included in the meta-analysis. Standard meta-analysis showed that MSCs significantly improved ASIA motor score (P < 0.001), sensory score (P < 0.001), ASIA grade (P < 0.001), and BI (P < 0.001) compared to rehabilitation. In addition, in the network meta-analysis, autologous MSCs significantly improved the ASIA motor [MD = 8.01, 95% CI (4.27, 11.76)], sensory score [MD = 17.98, 95% CI (10.04, 25.91)], and BI [MD = 7.69, 95% CI (2.10, 13.29)] compared to rehabilitation. Similarly, compared to rehabilitation, intrathecal injection (IT) of MSCs significantly improved the ASIA motor [MD = 7.97, 95% CI (4.40, 11.53)] and sensory score [MD = 19.60, 95% CI (9.74, 29.46)]. Compared to rehabilitation, however, only the IL of MSCs was associated with more adverse reactions [OR = 17.82, 95% CI (2.48, 128.22)]. According to the results of SUCRA, both autologous MSCs and IT transplantation approaches most improved the neurological function in SCI patients. Cell transplantation using MSCs is effective in patients with SCI and IT of autologous MSCs may be more beneficial.

Neuropeptide Y (NPY), one of the most abundant neuropeptides in the body, is widely expressed in the central and peripheral nervous systems and acts on the cardiovascular, digestive, endocrine, and nervous systems. NPY affects the nutritional and inflammatory microenvironments through its interaction with immune cells, brain-derived trophic factor (BDNF), and angiogenesis promotion to maintain body homeostasis. Additionally, NPY has great potential for therapeutic applications against various diseases, especially as an adjuvant therapy for stem cells. In this review, we discuss the research progress regarding NPY, as well as the current evidence for the regulation of NPY in each microenvironment, and provide prospects for further research on related diseases.

Abstract. This study aimed to investigate the expression levels of in different types of patients with cholangiocarcinoma (CCA) and its correlation with the prognosis. Serum samples were collected from different types of patients with CCA (I, II, III, IV) and normal cases, followed by detection of expression of miRNA-195 using quantitative polymerase chain reaction (qPCR). The serum samples of 204 patients with CCA, including 75 cases of type I, 68 cases of type II, 35 cases of type III and 26 cases of type IV and 200 healthy subjects were selected. The baseline clinicopathological data of patients with CCA were assessed and recorded, and patients were followed up constantly. The receiver operating characteristic (ROC) curve was established, and the area under the ROC curve (AUC) was calculated to evaluate the difference of miRNA-195 expression levels between patients with CCA and normal controls. Survival curves were set up for groups with high and low expression levels via the Kaplan-Meier method, and the log-rank test was used to evaluate the difference of survival curves between the two groups. The expression of miR-195 in patients with CCA was significantly lower than that in the normal control group, with a sensitivity of 0.78 and a specificity of 0.76, and it was positively correlated with the pathological grade of CCA. Additionally, the expression level of serum miRNA-195 was associated with lymph node metastasis (P=0.009) and tumor-node-metastasis (TNM) classification (P= 0.010). The survival analysis revealed that the prognosis in patients with CCA in types III and IV was poorer than that in those with types I and III who had a low expression of miRNA-195 (P=0.0026). The results show that miR-195 is an important marker that reflects the malignant degree of CCA, and it is expected to be a reference marker to determine the prognosis of CCA. IntroductionCholangiocarcinoma (CCA) is a highly aggressive tumor derived from bile duct epithelial cells. In recent decades, the incidence and mortality rate of CCA have been on the increase worldwide (1,2). The survival rate and prognosis of CCA patients are not ideal due to the early invasion and metastasis (3). Although radical surgery is the only therapy for CCA, the disease is difficult to be controlled and treated given that patients are diagnosed in the middle or late stage when the disease is identified (4). Thus, it is imperative to further understand the pathogenesis of CCA, in order to search for a new diagnostic and therapeutic method (5,6).MicroRNA (miRNA) is a type of endogenous, small, non-coding single-stranded RNA molecule that regulates the expression of target genes after its transcription, and it is involved in the regulation of multiple physiological and pathological functions (7). Previous findings have shown that the abnormal expression of miRNA-195 is associated with breast cancer (8), lung cancer (9) and many other tumors, but the role of miRNA-195 in CCA has not been reported yet. Therefore, this study aimed to investigate the expression le...

Postoperative cognitive dysfunction (POCD), especially in elderly patients, is a serious complication characterized by impairment of cognitive and sensory modalities after surgery. The pathogenesis of POCD mainly includes neuroinflammation, neuronal apoptosis, oxidative stress, accumulation of Aβ, and tau hyperphosphorylation; however, the exact mechanism remains unclear. Non-coding RNA (ncRNA) may play an important role in POCD. Some evidence suggests that microRNA, long ncRNA, and circular RNA can regulate POCD-related processes, making them promising biomarkers in POCD diagnosis, treatment, and prognosis. This article reviews the crosstalk between ncRNAs and POCD, and systematically discusses the role of ncRNAs in the pathogenesis and diagnosis of POCD. Additionally, we explored the possible mechanisms of ncRNA-associated POCD, providing new knowledge for developing ncRNA-based treatments for POCD.

This study was designed to investigate the expression of myoglobin (Mb), N-terminal pro-brain natriuretic peptide (NT-proBNP) in serum and the expression of nuclear factor-κB (NF-κB) in neutrophils in patients with multiple organ dysfunction syndrome (MODS) and the clinical significance. From July 2014 to December 2015, 314 patients with severe disease were selected during their stays at the emergency ward of the Third People's Provincial Hospital of Henan Province (Zhengzhou, China). Seventy patients with MODS were selected as MODS group, 108 patients with single organ or system injury were selected as the key prevention group, and 136 patients without obvious organ or systemic injury were selected as prevention group. Serum levels of Mb and NT-proBNP were measured by ELISA. Neutrophils were isolated by flow cytometry, and the activity of NF-κB in neutrophils of MODS patients was measured by electrophoretic mobility shift assay (EMSA). At 1, 7 and 14 days after treatment, the levels of Mb, NT-proBNP and NF-κB in the three groups were significantly reduced compared with pretreatment levels (p<0.05). Logistic regression analysis showed that serum Mb, NT-proBNP and NF-κB activity were positively correlated with the progression of the disease (r=0.809, 0.785 and 0.833, p=0.012, 0.025 and 0.004), and negatively correlated with the treatment time (r=−0.773, −0.734 and −0.815; p=0.033, 0.041 and 0.078). Mb, NT-proBNP and NF-κB may be involved in the pathogenesis and development of MODS, and may play an important role in the prevention and treatment of MODS.

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