Mechanical damage is one of the predisposing factors of inflammation, and it runs through the entire inflammatory pathological process. Repeated or persistent damaging mechanical irritation leads to chronic inflammatory diseases. The mechanism of how mechanical forces induce inflammation is not fully understood. Piezo1 is a newly discovered mechanically sensitive ion channel. The Piezo1 channel opens in response to mechanical stimuli, transducing mechanical signals into an inflammatory cascade in the cell leading to tissue inflammation. A large amount of evidence shows that Piezo1 plays a vital role in the occurrence and progression of chronic inflammatory diseases. This mini-review briefly presents new evidence that Piezo1 responds to different mechanical stresses to trigger inflammation in various tissues. The discovery of Piezo1 provides new insights for the treatment of chronic inflammatory diseases related to mechanical stress. Inhibiting the transduction of damaging mechanical signals into inflammatory signals can inhibit inflammation and improve the outcome of inflammation at an early stage. The pharmacology of Piezo1 has shown bright prospects. The development of tissue-specific Piezo1 drugs for clinical use may be a new target for treating chronic inflammation.

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Piezo1 Channels as Force Sensors in Mechanical Force-Related Chronic Inflammation

Perioperative neurocognitive disorders (NCDs) refer to neurocognitive abnormalities detected during the perioperative periods, including preexisting cognitive impairment, preoperative delirium, delirium occurring up to 7 days after surgery, delayed neurocognitive recovery, and postoperative NCD. The Diagnostic and Statistical Manual of Mental Disorders‐5th edition (DSM‐5) is the golden standard for diagnosing perioperative NCDs. Given the impracticality of using the DSM‐5 by non‐psychiatric practitioners, many diagnostic tools have been developed and validated for different clinical scenarios. The etiology of perioperative NCDs is multifactorial and includes predisposing and precipitating factors. Identifying these risk factors is conducive to preoperative risk stratification and perioperative risk reduction. Prevention for perioperative NCDs should include avoiding possible contributors and implementing nonpharmacologic and pharmacological interventions. The former generally includes avoiding benzodiazepines, anticholinergics, prolonged liquid fasting, deep anesthesia, cerebral oxygen desaturation, and intraoperative hypothermia. Nonpharmacologic measures include preoperative cognitive prehabilitation, comprehensive geriatric assessment, implementing fast‐track surgery, combined use of regional block, and sleep promotion. Pharmacological measures including dexmedetomidine, nonsteroidal anti‐inflammatory drugs, and acetaminophen are found to have beneficial effects. Nonpharmacological treatments are the first‐line measures for established perioperative NCDs. Pharmacological treatments are still limited to severely agitated or distressed patients.

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/cns.13873

Perioperative neurocognitive disorders: A narrative review focusing on diagnosis, prevention, and treatment

Comparison of dexmedetomidine-propofol and ketamine-propofol administration during sedation-guided upper gastrointestinal system endoscopy.

The importance of trial sequential analysis in the evaluation of the results of a meta-analysis.

To assess whether intraoperative use of nitrous oxide (N2O) as an adjunct to general anesthesia is associated with a shorter length of stay in the postanesthesia care unit (PACU). We analyzed data from adult patients who underwent non-cardiothoracic surgery under general anesthesia between May 2008 and December 2018. We assessed the association between intraoperative low- and high-dose N2O and PACU length of stay. A total of 148,284 patients were included in the primary analysis. After adjusting for a priori defined confounders, a high dose of N2O significantly decreased PACU length of stay, with a calculated difference of −9.1 min (95% confidence interval [CI], −10.5 to −7.7; P 30 min difference) in patients who underwent complex surgical procedures and received intraoperative antiemetic therapy.

The association of nitrous oxide on length of stay in the postanesthesia care unit: a retrospective observational study

INTRODUCTION The Bispectral Index (BIS) provides an objective measure of the level of sedation and general anesthesia. We performed this meta-analysis and trial sequential analysis (TSA) of randomized clinical trials to clarify whether BIS monitoring is helpful in enhancing intraprocedual safety, shortening procedure duration or promoting recovery during sedation for endoscopic procedures. EVIDENCE ACQUISITION PubMed, EMBASE, CINAHL, the Cochrane Central Register of Controlled Trials [CENTRAL]) databases, reference lists of articles as well as relevant articles from "Google Scholar" were searched until May 31st, 2018. Randomized controlled trials (RCTs) comparing BIS with clinical signs for titration of sedation depth during endoscopy were screened and identified if they reported one of the following outcome measures: intraprocedual safety (hemodynamic stability and cardiorespiratory complications such as hypoxia, hypertension/hypotension, and bradycardia/tachycardia), procedure duration, recovery time and patient/endoscopist's satisfaction. EVIDENCE SYNTHESIS Twelve studies with 13 RCTs recruiting 1372 patients were identified with great inter-trial heterogeneity. Meta-analysis found that BIS monitoring of sedation depth was associated with lower incidences of intraprocedural hypoxia (P=0.009) compared with clinical signs which was not confirmed by TSA. Meta-analysis and TSA found that the endoscopic procedure duration (P=0.143), recovery time (P=0.083), satisfaction scores from both the cases (P=0.085) and endoscopists (P=0.125) and the incidences of hypertension/ hypotension (P=0.639) or heart rates (P=0.201) were similar between BIS and control group. CONCLUSIONS More high-quality large-sampled RCTs are needed to confirm whether BIS monitoring for endoscopy sedation helps reduce intraprocedural hypoxia. BIS monitoring fails to shorten procedure duration, promote recovery or boost satisfaction among patients and endoscopists.

Bispectral index monitoring of sedation depth during endoscopy: a meta-analysis with trial sequential analysis of randomized controlled trials.

Inhibition of Piezo1/Ca2+/calpain signaling in the rat basal forebrain reverses sleep deprivation-induced fear memory impairments.

Development and validation of a risk score for predicting postoperative delirium after major abdominal surgery by incorporating preoperative risk factors and surgical Apgar score.

Comparisons of the humoral and cellular immunity induced by live A16R attenuated spore and AVA-like anthrax vaccine in mice

Aiming at the uncertainty of traditional 3D video capturing including camera focal lengths, distance and angle parameters between two cameras, a red-blue 3D video fusion system based on DM642 hardware processing platform is designed with the parallel optical axis. In view of the brightness reduction of traditional 3D video, the brightness enhancement algorithm based on human visual characteristics is proposed and the luminance component processing method based on YCbCr color space is also proposed. The BIOS real-time operating system is used to improve the real-time performance. The video processing circuit with the core of DM642 enhances the brightness of the images, then converts the video signals of YCbCr to RGB and extracts the R component from one camera, so does the other video and G, B component are extracted synchronously, outputs 3D fusion images finally. The real-time adjustments such as translation and scaling of the two color components are realized through the serial communication between the VC software and BIOS. The system with the method of adding red-blue components reduces the lost of the chrominance components and makes the picture color saturation reduce to more than 95% of the original. Enhancement algorithm after optimization to reduce the amount of data fusion in the processing of video is used to reduce the fusion time and watching effect is improved. Experimental results show that the system can capture images in near distance, output red-blue 3D video and presents the nice experiences to the audience wearing red-blue glasses.

Hao Zhang

Papers

Bispectral index monitoring of sedation depth during endoscopy: a meta-analysis with trial sequential analysis of randomized controlled trials.

Inhibition of Piezo1/Ca2+/calpain signaling in the rat basal forebrain reverses sleep deprivation-induced fear memory impairments.

Development and validation of a risk score for predicting postoperative delirium after major abdominal surgery by incorporating preoperative risk factors and surgical Apgar score.

Comparisons of the humoral and cellular immunity induced by live A16R attenuated spore and AVA-like anthrax vaccine in mice

The design of red-blue 3D video fusion system based on DM642