Many neurobehavioral processes, including psychomotor, cognitive, and affection are negatively impacted by sleep deprivation (SD), which may be harmful to a person's physical and mental health. Heat shock proteins (Hsps) have been demonstrated to play a protective role in a number of neurodegenerative diseases and are essential for maintaining intracellular protein homeostasis, but their roles in SD remain elusive. A mouse SD model was constructed using a modified multi-platform water environment method. The cognitive function was tested by novel object recognition test and Y-maze test, and anxiety-like behaviors were assessed by open field test (OFT). Protein expression was determined by Western blotting assay and ELISA assay. We found that SD could profoundly enhance anxiety levels and impair cognitive function in mice. SD also reduced the expression levels of p-cAMP-response element binding protein (CREB) and brain-derived neurotrophic factor (BDNF) and increased microglial activation and neuroinflammatory response in the hippocampus of mice. The intranasal injection of human recombinant Hsp70 protein could alleviate SD-induced anxiety and cognitive impairment, as well as restore pCREB and BDNF levels and reduce microglia-induced neuroinflammation in the hippocampus of SD mice. Hsp70 treatment might serve as a potential treatment for mitigating SD-related unfavorable symptoms.

The aim of this research was to explore the therapeutic capabilities of extracellular vesicles (EVs) derived from human umbilical cord mesenchymal stem cells (hUC-MSCs) that had been subjected to heat shock pretreatment, in treating psychiatric disorders induced by sleep deprivation in mice. The EVs were isolated and characterized, while western blotting was utilized to assess the expression of exosomal markers and heat shock protein 70 (HSP70). To evaluate the impact of EV treatment on anxiety-like behavior and cognitive impairment in sleep-deprived (SD) mice, the open field test, plus maze test, and Y-maze task were conducted. Heat shock pretreatment significantly increased the expression of HSP70 in EVs. Administration of EVs from heat shock-pretreated hUC-MSCs improved anxiety-like behavior and cognitive function in SD mice. Furthermore, EV treatment promoted synaptic protein expression, HSP70 expression and inhibited neuroinflammation in the hippocampus of SD mice. Western blotting analysis also revealed that EV treatment reduced the levels of TLR4 and p65 in the hippocampus. EVs from heat shock-pretreated hUC-MSCs have therapeutic potential for sleep deprivation-induced psychiatric disorders by regulating neuroinflammation and synaptic function in mice.

Objectives: This study aimed to identify the contributing factors, including systemic immune-inflammation index (SII), for pulmonary infections in elderly patients undergoing laparoscopic abdominal surgery with tracheal intubation under general anesthesia.Methods: A total of 356 eligible elderly patients were monitored post-surgery for pneumonia. Pathogens were identified from sputum samples, and factors like age, smoking, chronic obstructive pulmonary disease (COPD), intubation, anesthesia duration, and SII were analyzed for their influence on infection risk.Results: The pathogens were predominantly Gram-negative bacteria, with Klebsiella pneumoniae being the most common (26%). Significant risk factors for developing pneumonia included advanced age, smoking, COPD, prolonged intubation, and extended anesthesia. A higher preoperative SII was associated with an increased risk of pneumonia and correlated with infection severity and elevated levels of inflammatory markers. Multivariate analysis identified age over 70 (OR = 1.273, p = 0.021), age over 80 (OR = 2.085, p < 0.001), COPD (OR = 1.528, p = 0.009), prolonged intubation >2 h (OR = 2.187, p < 0.001), general anesthesia >4 h (OR = 1.846, p = 0.006), operative time > 2 h (OR = 1.415, p = 0.016), and preoperative SII >489.3 (OR = 1.403, p = 0.012) as independent risk factors for postoperative pulmonary infection.Conclusion: Our study highlighted critical risk factors for postoperative pulmonary infections in elderly patients undergoing laparoscopic abdominal surgery. Preoperative SII could be a novel predictor, offering potential for improved pre-surgical risk assessment.

Background: Single-lung ventilation (SLV) is a widely used procedure in thoracic surgery; however, it can lead to hypoxemia, which is attributed to intrapulmonary shunt and hypoxic pulmonary vasoconstriction. Stellate ganglion blockade (SGB) has shown protective effects during SLV in various pulmonary conditions. The objective of the study was to assess the clinical utility of ultrasound-guided SGB in patients undergoing thoracoscopic pulmonary lobectomy through a prospective clinical trial.Methods: This prospective randomized controlled double-blind trial included 116 patients who underwent SLV. After exclusion, 88 patients were randomly assigned to either the SGB group (n = 40) or control group (n = 39), with the latter receiving no SGB. Hemodynamics using oxygenation index (OI) and the pulmonary shunt fraction (Qs/Qt), respiratory mechanics using dynamic lung compliance (Cdyn) and mean airway pressure (P_mean), and levels of pro-inflammatory factors (IL-6 and IL-8) were assessed as clinical outcomes after surgery.Results: SLV induced upregulation of P_mean, Qs/Qt, and levels of IL-6 and IL-8 and downregulation of Cdyn and OI. Compared to the control group, the SGB group demonstrated significantly decreased P_mean, Qs/Qt, IL-6, and IL-8 and increased Cdyn and OI, suggesting the protective effects of SGB in patients who received SLV.Conclusions: Ultrasound-guided SGB improves respiratory mechanics, hemodynamics, and inflammatory responses during SLV. Our findings suggest a protective role of SGB in reducing complications associated with SLV.Clinical Trial Registration: The study was registered in the Chinese Clinical Trial Registry (#ChiCTR2200063210).

Chronic sleep deprivation impairs cognition and triggers neuroinflammation, but effective molecular therapies are lacking. Heat shock protein 70 (HSP70) offers neuroprotection, though its delivery across the blood–brain barrier remains a challenge. This study investigates exosomes as a vehicle to enhance brain delivery of HSP70 for treating chronic sleep deprivation. We engineered HEK293T cells to stably express HSP70 mRNA and the brain-targeting RVG-Lamp2b fusion protein, generating HSP70@Exo^RVG exosomes. These were characterized via transmission electron microscopy, nanoparticle tracking analysis, and Western blotting. In vitro uptake and HSP70 expression were assessed in neural progenitor cells (NPCs). In vivo efficacy was evaluated in a sleep-deprived mouse model using behavioral tests and molecular analyses of inflammatory and neurotrophic markers. HSP70@Exo^RVG exosomes efficiently delivered HSP70 mRNA to NPCs, increasing intracellular HSP70 protein. In vivo, systemic administration restored memory performance, reduced hippocampal TNF-α, IL-6, and IL-1β levels, and increased IL-10. Treatment also elevated brain-derived neurotrophic factor and phosphorylated CREB, indicating enhanced neurotrophic signaling. These effects surpassed those of non-targeted or empty exosomes. Engineered exosomes enabled effective brain-targeted HSP70 mRNA delivery, reversing cognitive and inflammatory consequences of sleep deprivation. To our knowledge, this is the first demonstration of RVG-modified exosomes successfully delivering mRNA (rather than siRNA or miRNA) for the treatment of sleep deprivation–induced deficits. HSP70@Exo^RVG offers a promising, noninvasive therapeutic strategy for sleep-related neurodegenerative conditions and highlights the potential of exosome-based mRNA delivery systems.

Ultrasound-guided transversus abdominis plane (TAP) block is widely used to provide effective postoperative analgesia and facilitate enhanced recovery after laparoscopic radical colectomy. However, the duration of TAP block is often limited by the pharmacokinetics of local anesthetics, and evidence regarding optimal adjuvant combinations to prolong its efficacy remains scarce. In this prospective, randomized controlled trial, 160 patients undergoing elective laparoscopic colectomy were randomly assigned to four groups (n = 40 each): Control (ropivacaine alone), Dexmedetomidine group (ropivacaine + dexmedetomidine), Dexamethasone group (ropivacaine + dexamethasone), and Combination group (ropivacaine + dexmedetomidine + dexamethasone). Primary outcomes included postoperative pain scores and sufentanil consumption. Secondary outcomes included Ramsay Sedation Scores, CD4+/CD8 + T cell ratios, and serum markers of stress response. Compared to ropivacaine alone, both dexmedetomidine and dexamethasone as single adjuvants significantly reduced postoperative pain scores and opioid requirements (p < 0.05). The combination group exhibited the most prolonged analgesic effect, with significantly lower sufentanil consumption and higher sedation scores at 6 and 24 h (p < 0.01). Moreover, both adjuvants attenuated the postoperative decline in CD4+/CD8 + T cell ratio, and the combination group demonstrated the greatest preservation of immune function and suppression of stress-induced immunosuppression. The combination of dexmedetomidine and dexamethasone as adjuvants to ropivacaine in TAP block provides superior and prolonged analgesia, reduces opioid consumption, and offers additional immunomodulatory benefits. This strategy represents a promising enhancement to multimodal analgesia protocols for patients undergoing laparoscopic colectomy. The study was registered in Chinese Clinical Trial Registry (ChiCTR2200065816, 2022-11-16).