• Anesthesia
• Dementia
• Hippocampus
• Irisin
• Microglia
• Neuroinflammation
• Postoperative cognitive dysfunction (POCD)
• Surgery

• Animals
• Microglia/metabolism
• Mice
• Fibronectins/metabolism
• Cognitive Dysfunction/metabolism
• Cognitive Dysfunction/prevention & control
• Male
• STAT6 Transcription Factor/metabolism
• Postoperative Cognitive Complications/metabolism
• Postoperative Cognitive Complications/prevention & control
• Mice, Inbred C57BL
• Humans
• Aged
• Disease Models, Animal
• Neuroinflammatory Diseases/metabolism
• Blood-Brain Barrier/metabolism
• Blood-Brain Barrier/drug effects
• Female

• eletroacupuncture
• ferroptosis
• postoperative cognitive dysfunction
• tibial fractures

• 4-octyl itaconate
• Gut microbiota
• Itaconate
• Neurogenesis
• Neuroinflammation
• Nrf2
• Postoperative cognitive dysfunction

• Animals
• NF-E2-Related Factor 2/metabolism
• Male
• Mice
• Mice, Inbred C57BL
• Neurogenesis/drug effects
• Gastrointestinal Microbiome/drug effects
• Postoperative Cognitive Complications/metabolism
• Neuroinflammatory Diseases/metabolism
• Succinates/pharmacology
• Succinates/therapeutic use
• Brain/drug effects
• Brain/metabolism
• Cognitive Dysfunction/metabolism
• Cognitive Dysfunction/drug therapy
• Anesthesia

• 82101255 National Natural Science Foundation of China
• ZR2020QH291 Natural Science Foundation of Shandong Province
• ZR2020MH126 Natural Science Foundation of Shandong Province
• 2023 Qingdao Outstanding Health Professional Development Fund

• Anesthesiologists
• China
• Cross-sectional study
• Knowledge, attitudes, and practice
• Postoperative cognitive dysfunction

• Humans
• Male
• Adult
• Female
• Cross-Sectional Studies
• Health Knowledge, Attitudes, Practice
• Anesthesiologists
• Postoperative Cognitive Complications
• Surveys and Questionnaires
• China/epidemiology

• TEMPOL pretreatment
• aged rats
• cognitive function
• inflammatory response
• oxidative stress
• sevoflurane anesthesia

• Rats
• Male
• Animals
• Sevoflurane/pharmacology
• Oxidative Stress
• Cognition
• Anesthesia
• Superoxide Dismutase/metabolism
• Superoxide Dismutase/pharmacology

• glucocorticoids
• meta-analysis
• perioperative neurocognitive disorders
• postoperative cognitive dysfunction
• postoperative delirium

• Humans
• Adult
• Adolescent
• Glucocorticoids
• Randomized Controlled Trials as Topic
• Administration, Intravenous
• Hip Fractures
• Neurocognitive Disorders

• Corticotropin-releasing hormone (CRH)
• Immune cells
• Mast cells (MCs)
• Neuroinflammation
• Peripheral surgery

• Humans
• Mast Cells
• Neuroinflammatory Diseases
• Endothelial Cells
• Hypothalamo-Hypophyseal System
• Pituitary-Adrenal System
• Inflammation
• Histamine

• Humans
• Postoperative Cognitive Complications/diagnosis
• Apolipoprotein E4/genetics
• Delirium/diagnosis
• Retrospective Studies
• Alleles
• Prospective Studies
• Cognitive Dysfunction/genetics
• Postoperative Complications/prevention & control

• Mineralocorticoid receptor
• neural stem cell proliferation
• postoperative cognitive dysfunction

• cerebrospinal fluid
• mental status and dementia tests
• postoperative cognitive complications
• urinary tract

• Aged
• Analgesia, Epidural
• Biomarkers
• Humans
• Male
• Proteome
• Proteomics/methods
• Transurethral Resection of Prostate

Evidence indicates that inhalative anesthetics enhance the β-site amyloid precursor protein (APP)-cleaving enzyme (BACE) activity, increase amyloid beta 1-42 (Aβ_1–42) aggregation, and modulate dendritic spine dynamics. However, the mechanisms of inhalative anesthetics on hippocampal dendritic spine plasticity and BACE-dependent APP processing remain unclear. In this study, hippocampal slices were incubated with equipotent isoflurane (iso), sevoflurane (sevo), or xenon (Xe) with/without pretreatment of the BACE inhibitor LY2886721 (LY). Thereafter, CA1 dendritic spine density, APP processing-related molecule expressions, nectin-3 levels, and long-term potentiation (LTP) were tested. The nectin-3 downregulation on LTP and dendritic spines were evaluated. Sevo treatment increased hippocampal mouse Aβ_1–42 (mAβ_1–42), abolished CA1-LTP, and decreased spine density and nectin-3 expressions in the CA1 region. Furthermore, CA1-nectin-3 knockdown blocked LTP and reduced spine density. Iso treatment decreased spine density and attenuated LTP. Although Xe blocked LTP, it did not affect spine density, mAβ_1–42, or nectin-3. Finally, antagonizing BACE activity partly restored sevo-induced deficits. Taken together, our study suggests that sevo partly elevates BACE activity and interferes with synaptic remodeling, whereas iso mildly modulates synaptic changes in the CA1 region of the hippocampus. On the other hand, Xe does not alternate dendritic spine remodeling.

• dendritic spines
• isoflurane
• sevoflurane
• synaptic plasticity
• xenon
• β-site amyloid precursor protein-cleaving enzyme

• NOD-like receptor protein 3 inflammasome
• SET domain–containing (lysine methyltransferase) 7
• neuroinflammation
• postoperative cognitive dysfunction
• pyroptosis

Neuroscience research using laboratory animals has increased over the years for a number of reasons. Some of these studies require the use of anesthetics for surgical procedures. However, the use of anesthetics promotes several physiological changes that may interfere with experimental results. Although the anesthetics and methods of delivery used to vary, one of the most common is ketamine associated with another compound such as xylazine. We aimed to evaluate the effect of ketamine and xylazine (KX) on corticosterone levels and on the degree of phosphorylation of p44/42 (ERK1/2), Src kinases and calcium/calmodulin-dependent kinase II (CAMKII). We also compared the effects of KX on sleep deprivation, which is known to affect the hormonal profile including corticosterone.

We found that the use of KX can increase corticosterone levels and alter the degree of phosphorylation of signaling proteins.

The online version contains supplementary material available at 10.1186/s13104-021-05763-w.

• Corticosterone
• Ketamine
• Signaling molecules
• Sleep deprivation
• Xylazine

• CD200-CD200R1
• Hippocampus
• Inflammatory factors
• Neuroinflammation
• Postoperative neurocognitive disorder (PND)

Postoperative cognitive dysfunction (POCD) refers to the complications of the central nervous system before and after surgery in patients without mental disorders. Many studies have shown that surgical anesthesia may cause POCD, especially in elderly patients. This article aims to study the relationship between artificial intelligence-based general anesthetics and postoperative cognitive dysfunction. This article first describes and classifies artificial intelligence, introduces its realization method, machine learning algorithms, and briefly introduces the basic principles of regression and classification methods in machine learning; then, the principles and techniques of general anesthetics are proposed. The pathogenesis of postoperative cognitive dysfunction (POCD) is explained in detail. Finally, the effect of anesthetics on postoperative cognitive dysfunction is obtained from both inhaled anesthetics and intravenous anesthetics. The impact on postoperative cognitive function is explained. The experimental results in this article show that there is no statistically significant difference in the two groups of patients' age, gender ratio, body mass index, education level, preoperative comorbidities, and other general indicators. Through the use of EEG bispectral index monitors to monitor the depth of anesthesia and postoperative cognitive dysfunction, first, there was no obvious relationship between the occurrence of postoperative cognitive dysfunction at 1, 5, 10, and 50 days and discharge time. The comprehensive monitoring group can reduce the clinical dose of preventive medication and cis-atracurium and shorten the patient's recovery time, extubation time, and recovery time. In addition, it can also reduce the increase of serum protein S100β in elderly patients and reduce the incidence of early postoperative cognitive dysfunction.

• Cholinergic anti-inflammatory pathway
• Inflammation
• Postoperative cognitive dysfunction
• Sevoflurane
• Specificity protein 1

Dexmedetomidine (DEX) was widely used in clinical work. However, the effectiveness of DEX on postoperative cognitive dysfunction (POCD) was still need to be confirmed. The aim of this meta-analysis was to explore whether DEX can reduce the incidence of POCD on the first day and seventh postoperative day. The results showed that lower incidence of POCD associated with DEX treatment on the first (odds ratio [OR]: 0.41; 95% confidence interval [CI]: 0.31-0.54) or seventh postoperative day (OR: 0.53; 95% CI: 0.36-0.77). Mini-Mental State Examination scores on the first (mean difference [MD]: 4.67; 95% CI: 1.72-7.63) and seventh postoperative days (MD: 3.71; 95% CI: 2.51-4.90) were higher in DEX use group than that in physiological saline group. Meanwhile, neuron-specific enolase (NSE; MD: −3.99; 95% CI: −6.20 to −1.78) and interleukin 6 (IL-6) levels (MD: −17.53; 95% CI: −21.51 to −13.54) on the first postoperative day in DEX group were lower than that in the physiological saline group. This meta-analysis suggested that DEX use could reduce the risk of POCD and the reduction in levels of NSE and IL-6 can improve long-term cognitive dysfunction and anti-inflammation.

• cognition disorders
• dexmedetomidine
• inflammation
• postoperative

This essay aims to make investigation on the mechanism of glucose metabolism disorder and Lipopolysaccharide administration-induced cognitive function impairment in adult rats with surgery. Methods: Divide the objects, 40 male Sprague-Dawley rats at the age of 9 months, into 4 groups. Provide unilateral nephrectomy surgery and/or lipopolysaccharide intraperitoneal injection. Postoperative cognitive function evaluation would be tested by the Morris water maze. Rats with Postoperative Cognitive Dysfunction (POCD) were scanned to analyze the brain glucose metabolism by means of 18F-FDG PET/CT. Phosphatidylinositol 3-Kinase (PI3K), Protein Kinase β (AKT), Insulin Substrates Receptor-2 (IRS-2) and Glucose Transporter 4 (GLUT4) were detected as well. Data will be captured through gene expression in POCD rats via Quantitative Real-Time PCR (QRT-PCR). On the other side, Western Blot was used to measure the expression levels of IRS-2, p-IRS-2, p-PI3K, PI3K, p-AKT, AKT, GLUT4, and p-GLUT4. Results: During the Morris water maze test, the staging time (latency) of rats in each group was becoming short gradually as the training progressed. The incubation time of Day 5 of each group was shorter than that of Day 1 (P < 0.05). On the Day 3 after the surgery, the average target quadrant residence time of Group S+L (100 μg/Kg) was shorter, compared with Group C, L and S. Of which, the average number of perforation was reduced greater than that of Group C (P < 0.05). The average swimming speed of the groups is of no distinct difference (P > 0.05). After the operation, there was no great difference shown among the subjects (P > 0.05) in the average residence time of the target quadrant, the mean number of passages, and the mean swimming speed. On Day 3, the average latency of Group S+L (100 μg/Kg) was longer than Group C (P < 0.05) in the working memory test after the operation. The average latency of rats in Group L and S was showed longer than that in Group C, with tiny difference (P > 0.05). In the 7-Day working memory test, the average latency of the rats in Group L, S and S+L (100 μg/Kg) was obviously longer than that in Group C. Comparing to preoperative rats, POCD rats of Group S+L (100 μg/Kg) were scanned by 18F-FDG PET/CT three days later after the operation. Its SUVmax of the frontal and temporal lobe areas were decreased significantly (P < 0.05). However, difference degree was not significantly shown in the SUVmax between Group C and the preoperative rats (P > 0.05). In comparison with the gene expression of of Group C, the PI3K, IRS-2, AKT and GLUT4 mRNA genes are the key genes in the insulin signaling pathways of the hippocampus of the POCD rats. The expression level was reduced. The expression level of all protein of PI3K, IRS-2, GLUT4 and AKT in the POCD rats was of no great contrast with that in Group C. But for IRS-2 protein, the phosphorylation level has increased, and meanwhile decreased for AKT, PI3K and GLUT4 proteins (P < 0.05). Conclusions: Adult SD rats cognitive dysfunction model treated with unilateral nephrectomy combined and 100 μg/kg LPS intraperitoneal injection were led to abnormal both brain glucose metabolism and insulin expression. The proved phenomenal results signal pathway-related proteins PI3K, IRS-2, AKT and GLUT4. It reached the conclusion that surgical trauma, rather than anesthesia, leads to impaired cognitive function. PI3K, IRS-2, AKT, and GLUT4pathway of brain can be partial explanations of the pathogenesis of POCD.

• 18F-FDG PET/CT
• AGE, Advanced Glycation End products
• FDG, Fluorodeoxyglucose
• GLUT4, Glucose Transporter 4
• Glucose metabolism
• IRS-2, Insulin Substrate Receptor-2
• LPS, Lipopolysaccharide
• MAPK, Mitogen-Activated Protein Kinase
• OSEM, Ordered Subsets Expectation Maximization
• PI3K, IRS-2, AKT, and GLUT4 pathway
• PI3K, Phosphatidylinositol 3-Kinase
• POCD, Postoperative Cognitive Dysfunction
• Postoperative cognitive dysfunction
• QRT-PCR, Quantitative Real-Time PCR
• ROS, Reactive Oxygen Species
• SUV, Standard Uptake Value
• Surgical trauma
• TLR4, Toll-like Receptor 4

Post-operative cognitive dysfunction (POCD) is a complication of the central nervous system characterized by mental disorders, anxiety, personality changes and impaired memory. POCD occurs frequently after coronary artery bypass grafting (CABG) and can severely affect quality of life for patients. To date, the development of POCD biomarkers remains a challenge. Alterations in the expression of non-coding RNAs from brain tissue and peripheral blood have been linked to POCD. The present study aimed to detect the differential circular RNAs (circRNAs) in plasma exosomes of patients with POCD after CABG. The relative expression levels of circRNAs were analyzed using circRNA microarray analysis in the plasma exosomes of patients with POCD. Differentially altered circRNAs (P<0.05, fold change >1.5) were validated by reverse transcription-quantitative PCR in the plasma exosomes of patients with POCD. The target genes of the microRNAs were predicted using bioinformatics analysis. The functions and signaling pathways of these target genes were investigated by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes analyses. The microarray results indicated that the levels of nine circRNAs in patients with POCD were higher than those in the control subjects; and six circRNAs were at a lower level than those in control subjects. The RT-qPCR results from patients with POCD showed that only circRNA_089763 of the 15 circRNAs identified was significantly increased compared with control subjects. circRNA target gene prediction and functional annotation analysis showed significant enrichment in several GO terms and pathways associated with POCD. The present study provides evidence for the abnormal expression of POCD-induced circRNA_089763 in human plasma exosomes, as well as the involvement of POCD.

To investigate the effects of electroacupuncture in regulating astrocytes and oxidative stress in a rat model of postoperative cognitive dysfunction (POCD).

Male aged Sprague-Dawley rats were randomized to undergo left hepatic lobe resection to induce POCD, followed by either electroacupuncture or no treatment; or similar surgery without left lobe resection or electroacupuncture (sham). Postsurgical cognitive function, hippocampal astrocyte number and oxidative stress indicators were measured.

At days 1, 3 and 7 following surgery, escape latency was significantly shorter and platform crossing frequency was increased with electroacupuncture versus other groups. At postoperative day 1, the electroacupuncture group showed significantly fewer glial fibrillary acidic protein (GFAP)-positive hippocampal astrocytes versus the POCD model group. In POCD rats, electroacupuncture significantly decreased serum S100 calcium binding protein B and neuron-specific enolase levels, and increased brain-derived neurotrophic factor and glial cell-derived neurotrophic factor levels, at days 1, 3 and 7. Electroacupuncture significantly attenuated the hippocampal POCD-induced increase in malondialdehyde and decreased superoxide dismutase levels at day 1 following surgery.

Electroacupuncture may improve cognitive function in rats with POCD by reducing hippocampal GFAP-positive astrocyte number and suppressing oxidative stress.

• Postoperative cognitive dysfunction (POCD)
• astrocyte
• electroacupuncture (EA)
• oxidative stress
• partial hepatectomy

• AMPKα1
• autophagy
• postoperative cognitive dysfunction

Delirium is the most frequent manifestation of acute brain dysfunction in intensive care unit (ICU). Although antipsychotics are widely used to treat this serious complication, recent evidence has emphasized that these agents did not reduce ICU delirium (ICU-D) prevalence and did not improve survival, length of ICU or hospital stay after its occurrence. Of note, no pharmacological strategy to prevent or treat delirium has been identified, so far. In this scenario, new scientific evidences are urgently needed. Investigations on specific ICU-D subgroups, or focused on different clinical settings, and studies on medications other than antipsychotics, such as dexmedetomidine or melatonin, may represent interesting fields of research. In the meantime, because there is some evidence that ICU-D can be effectively prevented, the literature suggests strengthening all the strategies aimed at prevention through no-pharmacological approaches mostly focused on the correction of risk factors. The more appropriate strategy useful to treat established delirium remains the use of antipsychotics managed by choosing the right doses after a careful case-by-case analysis. While the evidence regarding the use of dexmedetomidine is still conflicting and sparse, this drug offers interesting perspectives for both ICU-D prevention and treatment. This paper aims to provide an overview of current pharmacological approaches of evidence-based medicine practice. The state of the art of the on-going clinical research on the topic and perspectives for future research are also addressed.

• Delirium
• Intensive care
• Haloperidol
• Antipsychotic agents
• Major tranquilizers
• Cognitive decline
• Dexmedetomidine

The α5 subunit-containing gamma-amino butyric acid type A receptors (α5 GABAARs) are a distinct subpopulation that are specifically distributed in the mammalian hippocampus and also mediate tonic inhibitory currents in hippocampal neurons. These tonic currents can be enhanced by low-dose isoflurane, which is associated with learning and memory impairment. Inverse agonists of α5 GABAARs, such as L-655,708, are able to reverse the short-term memory deficit caused by low-dose isoflurane in young animals. However, whether these negative allosteric modulators have the same effects on aged rats remains unclear. In the present study, we mainly investigated the effects of L-655,708 on low-dose (1.3%) isoflurane-induced learning and memory impairment in elderly rats. Young (3-month-old) and aged (24-month-old) Wistar rats were randomly assigned to receive L-655,708 0.5 hour before or 23.5 hours after 1.3% isoflurane anesthesia. The Morris Water Maze tests demonstrated that L-655,708 injected before or after anesthesia could reverse the memory deficit in young rats. But in aged rats, application of L-655,708 only before anesthesia showed similar effects. Reverse transcription-polymerase chain reaction showed that low-dose isoflurane decreased the mRNA expression of α5 GABAARs in aging hippocampal neurons but increased that in young animals. These findings indicate that L-655,708 prevented but could not reverse 1.3% isoflurane-induced spatial learning and memory impairment in aged Wistar rats. All experimental procedures and protocols were approved by the Experimental Animal Ethics Committee of Academy of Military Medical Science of China (approval No. NBCDSER-IACUC-2015128) in December 2015.

• M2 type microglia
• Wnt/Frizzled signaling pathway
• early brain injury
• inflammatory cytokines
• nerve regeneration
• neural regeneration
• nuclear factor-κB
• peroxisome proliferator-activated receptor-γ
• subarachnoid hemorrhage

Bispectral index (BIS) monitoring can reduce the duration of anesthesia. This study aimed to evaluate the effects of BIS monitoring during surgery for resection of colon carcinoma in elderly patients using the Attention Network Test (ANT) to study alerting, orienting, and executive functions, and the Confusion Assessment Method (CAM).

Eighty-one patients (65–75 years) underwent radical surgery for colon carcinoma with general intravenous anesthesia, propofol (6–8 mg/kg/h), vecuronium (0.03–0.05 mg/kg/min), and remifentanil (0.1–0.2 μg/kg/min). The BIS group (n=41) underwent adjustment of anesthesia to maintain a BIS value between 40–60; the non-BIS group (N=40) underwent standard intraoperative hemodynamic monitoring. Primary endpoints were alerting, orienting, and executive functions assessed pre-operatively and on postoperative days 1 and 5 using the ANT; the secondary endpoint was delirium during the first five postoperative days, assessed using the CAM.

Propofol and remifentanil doses were significantly lower in the BIS group compared with the non-BIS group (P<0.001). Alerting, orienting, and executive functions showed no differences between the two groups pre-operatively but were impaired in both groups on postoperative day 1 compared with pre-operative levels (P<0.001). On postoperative day 5, alerting (P=0.607) and orienting (P=0.851) functions recovered in the BIS group but remained impaired in the non-BIS group (P<0.001). Delirium was significantly lower in the BIS group compared with the non-BIS group (17.5% vs. 27.5%) (P<0.001).

BIS-guided anesthesia was associated with reduced anesthetic exposure, early postoperative recovery of alerting and orienting functions, and reduced postoperative delirium.

• Aged Rats
• Ginseng
• Monkshood
• Postoperative Cognitive Dysfunction
• Radix Ophiopogonis
• Shenfu Injection
• Shenmai Injection