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To establish pathological features of skeletal muscle post-stroke and to provide a background for promising interventions. Adult male SD rats were selected and randomly divided into a control group, a sham group, and a middle cerebral artery occlusion (MCAO) group. The tolerance and capability of exercise were separately collected on days 1, 3, 5, and 7 after the MCAO operation. The neurological deficits, brain infarct volume, soleus histopathology, mRNA-seq analysis, flow cytometry, immunofluorescence, and protein expression analysis were performed on the seventh day. Rats in the MCAO group showed that soleus tissue weight, pulling force, exercise capacity, endurance, and muscle structure were significantly decreased. Moreover, the RNA sequencing array revealed that mitochondrial-mediated autophagy was the critical pathological process, and the result of transcriptomic findings was confirmed at the translational level. The mitochondrial membrane potential and the mfn2 and p62 protein expression were decreased, and the Beclin-1, ATG5, Parkin, PINK1, LC3B, and Drp1 expression were upregulated; these results were consistent with immunohistochemistry. This is the first report on the pathological features of limbic symptoms on day 7 after MCAO surgery in rats. In addition, we further confirmed that autophagy is one of the main causative mechanisms of reduced muscle function after stroke.

Background Total knee arthroplasty (TKA) has long been associated with significant blood loss, hence postoperative hemoglobin (Hb) and hematocrit (Hct) determination remains necessary for evaluating blood loss and guiding transfusions. The aim of the study was to depict the changing patterns of perioperative Hb and Hct levels and to identify an optimal timing of determination in patients receiving TKA surgeries. Methods This was a prospective observational study by recruiting a total of 302 consecutive patients who received TKA surgeryfor final analysisfrom January 2017 until December 2018. Patients were kept in hospital for a full week postoperatively to detect a preoperative, postoperative day1 through to day7 Hb and Hct concentrations, postoperative 1-month, 3-months and 6-monthsvalues were followed up in the clinic visiting. Results Hb and Hct levels decreased in the first few days and reached a nadir on postoperative day4 and day3 respectively while recovered in the following days and approached to preoperative values at postoperative 3-months. The mean maximum drop of Hb and Hct concentrations was detected as 4.0g/dL and 11.5%separately. Significant differences were detected on Hb and Hct concentrations between the timing neighbors on preoperative vs. day1, day1 vs. day2, day2 vs. day3, day7 vs. 1 month, 1-monthvs. 3-months and Hct values at 3-months vs. 6-months. A total of 21 patients received blood transfusion perioperatively, among whom 4 patients were at postoperative day3and 5 patients were at day4. Conclusion Hb and Hct concentrations dramatically decreased during the first few days following TKA surgery whilegradually recovered from postoperative day4 and approached to the preoperative values at 3-months postoperatively. The changing patterns indicated an optimal timing of blood determination on postoperative day3 or day4 to accurately reflect ongoing hidden blood loss for better guiding blood transfusions.