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Background: Hyperbilirubinemia (HB) is a common occurrence after cardiopulmonary bypass and often results in increased rates of complications. Methods: We conducted a study on 411 patients who underwent cardiac surgery with extracorporeal circulation and divided them into a training set and a validation set. Least absolute shrinkage and selection operator (LASSO) regression was employed to screen out variables. Multivariate logistic regression was subsequently applied to establish prediction models, which were then evaluated using receiver operating characteristic (ROC) curves and calibration plots. Finally, restricted cubic splines (RCSs) curve pairs were used to calculate the adjusted ORs for each independent risk factor. Results: A clinical prediction model based on preoperative bilirubin elevation, aortic clamp time and intraoperative red blood cell (RBC) transfusion was successfully developed. The model presented an ROC of 0.855 (0.808, 0.901) in the training set. The validation set demonstrated a promising ROC of 0.839 (0.761, 0.917), and the calibration curve closely approximated the true incidence. The risk of postoperative HB was increased when the aortic clamp time was greater than 133 min, when the red blood transfusion volume was greater than 275 ml or when the preoperative total bilirubin concentration was greater than 16.65 mol/L. Conclusion: In this study, the aortic clamp time was identified as a crucial factor for postoperative HB during cardiac surgery. A three-factor prediction model that includes the aortic clamp time for the prediction of HB after cardiac surgery was successfully established. Furthermore, patients with hyperbilirubinemia post-surgery had a worse short-term prognosis. [ABSTRACT FROM AUTHOR]

Patients with Parkinson's disease (PD) often require surgery, and therefore may receive inhalation anesthesia. However, it is currently unknown whether inhalation anesthetics affect the prognosis of the disease. Leucine‑rich repeat kinase 2 (LRRK2) genetic mutations are the most common cause of familial PD, contributing to ~39% of all cases in certain populations. The aim of the present study was to determine the effects of inhaled anesthetics on PD, by observing the influence of sevoflurane on a LRRK2‑associated Drosophila model of PD. PD transgenic Drosophila overexpressing LRRK2 were generated by crossing flies expressing an LRRK2 upstream activation sequence, with tyrosine hydroxylase (TH)‑Gal4 flies. Western blot analysis successfully verified that the transgenic Drosophila overexpressed LRRK2. Three days prior to eclosion, three genotypes of Drosophila were divided into four groups, and were exposed to air, 1, 2, or 3% sevoflurane, for 5 hours. Twenty‑four hours after the exposure, the electrophysiological activities of the projection neurons (PN) in the brains of the Drosophila were recorded using a patch clamp. The locomotor activities were tested on days 5, 10, 15, 20, 25, 30, 35 and 40 following eclosion. The frequency of miniature excitatory synaptic currents (mEPSCs) obtained from the PNs of the TH‑wild type LRRK2 (TH‑WT) Drosophila brain, following exposure to air (1.60±0.05 Hz), was lower as compared with the wild type LRRK2 (WT) (2.51±0.07 Hz) and W1118 (2.41±0.10 Hz) Drosophila. After exposure to 1, 2 and 3% sevoflurane, the frequency of mEPSCs in the brains of the TH‑WT group decreased to 0.82±0.04 Hz, 0.63±0.16 Hz and 0.55±0.04 Hz, respectively. The percentage decrease of the frequency of mEPSCs, from exposure to air to 1% sevoflurane, of the TH‑WT group (48.32%±3.08%) was significantly higher, as compared with the WT (39.17%±1.42%) and W1118 (35.10%±2.66%) groups, and there was no statistical difference between the WT and W1118 groups. The transgenic TH‑WT Drosophila presented an early decrease in locomotor ability, as compared with the WT and W1118 groups. Following a 5 hour exposure to sevoflurane, the percentage decrease of the climbing abilities of the TH‑WT group, from exposure to air to 1% sevoflurane, were significantly lower, as compared with the WT and W1118 groups. In conclusion, sevoflurane had negative effects on the control W1118 flies, and also severely aggravated the prognosis of PD in the LRRK2‑associated Drosophila model, through synaptic cholinergic deficits and impairment on locomotor abilities.