Post-Operative Cognitive Dysfunction: An exploration of the inflammatory hypothesis and novel therapies.

The aging population is burgeoning globally and this trend presents great challenges to the current healthcare system as the growing number of aged individuals receives procedures of surgery and anesthesia. Postoperative cognitive dysfunction (POCD) is a severe postoperative neurological sequela. Advanced age is considered as an independent risk factor of POCD. Mounting evidence have shown that neuroinflammation plays an essential role in POCD. However, it remains debatable why this complication occurs highly in the aged individuals. As known, aging itself is the major common high-risk factor for age-associated disorders including diabetes, cardiovascular disease, cancer, and neurodegenerative diseases. Chronic low-grade neuroinflammation (dubbed neuroinflammaging in the present paper) is a hallmark alternation and contributes to age-related cognitive decline in the normal aging. Interestingly, several lines of findings show that the neuroinflammatory pathogenesis of POCD is age-dependent. It suggests that age-related changes, especially the neuroinflammaging, are possibly associated with the postoperative cognitive impairment. Understanding the role of neuroinflammaging in POCD is crucial to elucidate the mechanism of POCD and develop strategies to prevent or treat POCD. Here the focus of this review is on the potential role of neuroinflammaging in the mechanism of POCD. Lastly, we briefly review promising interventions for this neurological sequela.

Postoperative cognitive dysfunction in the aged: the collision of neuroinflammaging with perioperative neuroinflammation.

An Overview on the Mechanisms of Neuroprotection and Neurotoxicity of Isoflurane and Sevoflurane in Experimental Studies

Postoperative cognitive dysfunction (POCD) is a neurological sequela of surgery and anesthesia. It occurs with high incidence in the aged population. Neuroinflammation is considered one of the least controversial culprits contributing to this postsurgical cognitive impairment, although it is a matter of debate as to why this complication occurs frequently in geriatric individuals. It is unclear how neuroinflammation is activated in aged populations following exposure to anesthesia and surgical procedures. In this study, we investigated the role of sirtuin 1 (SIRT1) in neuroinflammatory priming and cognitive deficits in aged rats after anesthesia and surgery. Our findings demonstrated that the hippocampal expression of SIRT1 decreased with age. The trend of declining SIRT1 expression further deteriorated in aged rats after exposure to anesthesia and surgery. Furthermore, we found that decreased SIRT1 was associated with downregulated expression of DNA methyltransferase 1 (DNMT1) and upregulated acetylated-nuclear factor kappa B (ac-NF-κB) expression, resulting in microglial activation and increased proinflammatory cytokines in the hippocampus of aged rats. Interestingly, our results showed that pretreatment with resveratrol, a SIRT1 agonist, mitigated the neuroinflammatory response and microglial activation and improved cognitive performance in the context fear-conditioning test and Morris water maze. Taken together, our findings suggest that anesthesia and surgery-induced inhibition of hippocampal SIRT1 expression is involved in the activation of neuroinflammation and cognitive impairment in aged rats and that activating SIRT1 might paved a promising path to preventing this postsurgical sequela.

The role of SIRT1 in neuroinflammation and cognitive dysfunction in aged rats after anesthesia and surgery.

Activation of the canonical nuclear factor-κB pathway is involved in isoflurane-induced hippocampal interleukin-1β elevation and the resultant cognitive deficits in aged rats.

Minocycline mitigates isoflurane-induced cognitive impairment in aged rats

A zero-waste strategy to synthesize geopolymer from iron-recovered Bayer red mud combined with fly ash: Roles of Fe, Al and Si

Enhanced bromine fixation and tar lightweighting in co-pyrolysis of non-metallic fractions of waste printed circuit boards with Bayer red mud.

The global industrial solid waste (ISW) generation reaches billions of tons yearly. However, it is difficult to directly utilize ISW on a large scale due to its low recycling efficiency and accompanying environmental pollution. Meanwhile, the improper disposal of ISW in many developing countries leads to serious pollution to the air, water, and soil environment. In the present study, a systematic review on the status quo of the recycling and pollution control of the major ISW has been conducted. Based on the fundamental central paradigm of materials science and engineering, a bi-tetrahedron model has been newly proposed to promote the sound management of ISW. The tetrahedral model of the central paradigm for guiding ISW recycling has been rationally designed by comprising compositions, processing, structure, and properties as apexes with logic relations. Meanwhile, another coupled tetrahedral model was proposed to illustrate the logical relations between pollutant species, transfer and transformation, speciation in structure, and solidification/stabilization. This paralleled tetrahedral model can provide a hierarchy classification of environmental risk control for ISW management. In addition, the proposed bi-tetrahedron model was demonstrated in the geopolymer scenarios of ISW recycling. 

Environmentally sound management of industrial solid waste: A paradigm of proposed bi-tetrahedron

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Minocycline mitigates isoflurane-induced cognitive impairment in aged rats

A zero-waste strategy to synthesize geopolymer from iron-recovered Bayer red mud combined with fly ash: Roles of Fe, Al and Si

Enhanced bromine fixation and tar lightweighting in co-pyrolysis of non-metallic fractions of waste printed circuit boards with Bayer red mud.

Environmentally sound management of industrial solid waste: A paradigm of proposed bi-tetrahedron