Myocardial ischemia is common in aging population. This study investigates the protective effect of Sevoflurane on myocardial ischemia reperfusion injury (MIRI) and its underlying mechanism. A total of 87 patients with a history of myocardial ischemia who underwent abdominal surgery with Sevoflurane general anesthesia were recruited in the study. The clinical data, blood pressure, heart rate, pressure-rate quotient (PRQ) and rate-pressure product (RPP) were recorded. Serum samples were collected and heart-type fatty acid binding protein (H-FABP), ischemia modified albumin (IMA), interleukin-1β (IL-1β), and interleukin-18 (IL-18) were measured to observe whether Sevoflurane anesthesia had protective effect on myocardium. In addition, MIRI rats and hypoxia/reoxygenation (H/R) injury cell model was established using neonatal rat ventricular myocytes (NRVM). Rats or NRVM were pretreated with sevoflurane for 45min before hypoxia. The mRNA expression of purinergic receptor-7 (P2X7) and NLR family pyrin domain containing 3(NLRP3) were examined. The protein expression of P2X7, NLRP3, apoptosis-associated speck-like protein (ASC), cysteine aspartic acid specific protease-1(Caspase-1), Gasdermin-D (GSDMD), Bcl-2 Associated X Protein (Bax), B-cell lymphoma-2 (Bcl-2) in myocardial tissue and cells were evaluated. The serum contents of IL-1β, IL-18, Malondialdehyde (MDA), Superoxide dismutase (SOD), Lactate dehydrogenase (LDH), Creatine kinase (CK), and Creatine kinase isoenzymes (CK-MB) were measured. The cellular localization and fluorescence intensity of NLRP3 and ASC in cells were detected. It was found that the secretion of IL-1β and IL-18 decreased in the patients. After I45 min/R3h in SD rats and H3h/R1h in NRVM, the protein expressions of P2X7, NLRP3, ASC, Caspase-1 and GSDMD were increased, the release of IL-1β, IL-18, CK, CK-MB, LDH and MDA were increased, and SOD activity was decreased. Sevoflurane treatment inhibited the high expression of P2X7, NLRP3, ASC, Caspase-1 and GSDMD, inhibited the release of LDH, CK,CK-MB and MDA in cells, and improved the activity of SOD, indicating that Sevoflurane alleviated the damage of MIRI of rats and H/R of NRVM, and had myocardial protective effect. Taken together, our study suggests that Sevoflurane inhibited the expression of IL-1β, IL-18 and GSDMD by inhibiting the P2X7-NLRP3 signaling pathway. It reduced the H/R injury of cardiomyocytes and protected the cardiac function by regulating inflammatory reaction and pyroptosis.

The aim of the present study was to compare the effect of different surgical methods on postoperative cognitive function in patients undergoing abdominal surgery, determine the risk factors of postoperative cognitive dysfunction (POCD) by logistic regression, and investigate these risk factors through different surgical methods. A total of 70 patients undergoing selective abdominal surgery were selected into this study. The age of these patients ranged within 32 to 85 years. The cognitive function of these patients was assessed by the mini-mental state examination at one day before the operation, and at the first and seventh day after the operation. The temperature of the tympanic membrane, PETCO2 values, visual analogue scale scores, educational level, and operation time were recorded. Logistic regression analysis was used to analyze related factors of POCD. The incidence rate of perioperative hypothermia in groups O and L were 31.2 and 10.5 per cent, respectively; and the difference was statistically significant (P < 0.05). The difference in visual analogue scale scores at the first and seventh day after the operation between these two groups were statistically significant (P < 0.01). The incidence of POCD in group O was significantly higher than that in group L at the first and seventh day after the operation (P < 0.05). According to logistic regression results, it was found that age, perioperative hypothermia, and postoperative pain were risk factors of POCD. The difference in POCD for the patients undergoing abdominal surgery through different surgical methods was statistically significant, and this was closely correlated to perioperative hypothermia and postoperative pain.

ObjectiveTo investigate the impact of anesthesia on the change of olfactory function and cognitive function in elderly patients who undergo abdominal surgery.MethodsA total of 30 elderly patients who underwent abdominal surgery were recruited as the research subjects. The Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test was used to test the olfactory function and the Mini-mental State Examination (MMSE), Hopkins Verbal Learning Test – Revised (HVLT-R), Trail Making Test (TMT), Stroop Color Word Test (SCWT), Digit-Symbol Coding Test (DSCT), and Verbal Fluency Test (VFT) were used to assess their cognitive function before general anesthesia, and on the 3rd and 7th day post-anesthesia. The serum level of IL-1β, IL-6, and TNF-α were measured before anesthesia and at 0, 12, and 24 h post-anesthesia. In total, 30 healthy volunteers who did not undergo anesthesia were used as the control group. The test results of all subjects were recorded and their correlations were analyzed.ResultsOn the 3rd and 7th day post-anesthesia, the olfactory recognition threshold of patients in the surgical group was lower than that of control group with significant difference (P &lt; 0.05). On the 3rd and 7th postoperative day, the patient’s short-term memory and delayed memory, attention and processing speed were decreased (P &lt; 0.05). On the 7th day post-anesthesia, delayed memory and processing ability were still decreased (P &lt; 0.05). In the surgical group, Spearman correlation analysis showed that the difference of olfactory recognition score on the 3rd and 7th day post-anesthesia was positively correlated with short-term memory and delayed memory of cognitive function. Compared with pre-anesthesia, the serum levels of IL-1β, IL-6, and TNF-α in the surgical group were significantly increased at each time point after anesthesia.ConclusionAbdominal surgery with general anesthesia in elderly patients may increase the level of serum inflammatory factors, induce olfactory impairment, particularly the decline of olfactory identification threshold and cause cognitive dysfunction with declined short-term memory, delayed memory and attention. There was a positive correlation between olfactory impairment and cognitive dysfunction after general anesthesia. Therefore, olfactory impairment could be an early indicator to guide early intervention for postoperative cognitive dysfunction.

Cognitive dysfunction is a common disease in aging population. This study aims to compare the influence of different degrees of anemia on the cognitive function of patients undergo hysteromyoma surgery. Sixty-one patients aged 18–60 years who underwent uterine fibroid surgery in the Second Affiliated Hospital of Shantou University Medical College from March 2019 to December 2020 were selected for this study. Patients were divided into three groups: group normal (Group N, patients have no anemia), group of mild anemia (Group Mi, patients have mild anemia) and group of moderate anemia (Group Mo, patients had moderate anemia). Combined spinal and epidural anesthesia were administered. Cognitive function tests were performed 1 day before the surgery and repeated at the 5th and 30th days after surgery. Peripheral venous blood samples from patients were collected before the surgery, right after surgery and at the 24th and 72nd hours after surgery. The contents of S-100β, IL-6, TNF-α and IL-1β in serum samples were determined by ELISA. It was found that there were no significant differences in general characteristics of patients among Group N, Group Mi and Group Mo (p &gt; 0.05). Nine patients developed postoperative cognitive dysfunction after surgery, and the incidence was 14.75% (9/61). The incidence of postoperative cognitive dysfunction (POCD) was 40% in Group Mo, which was higher than that in Group N and Group Mi. The difference was statistically significant (p &lt; 0.05). Inflammatory factors in patients with POCD were higher in post-surgery than before-surgery (p &lt; 0.05), while there was no statistical significance in the difference of inflammatory factors of patients without POCD before and after surgery (p &gt; 0.05). Taken together, this study suggested that moderate anemia could be a risk factor of POCD in patients undergoing hysteromyoma surgeries. This study will help surgeons developing measures for preventing the occurrence of POCD.

There is an error in the Funding statement. The correct number for "the National Natural Science Foundation of China" is " 81473215 and 81870276".Additionally, in the original article, there was a mistake in "Figures 2-4" as published. The problem was caused by the incomplete uploading of some figures in the process of uploading revised manuscripts and figures before publication. We did not carefully check it, which led to the error when publishing the article. The correct figures appear below:Publisher's Note: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.