Hypervirulent fowl adenovirus serotype 4 elicits early innate immune response and promotes virus-induced cellular autophagy in the spleen.

The recent emergence of hepatitis-hydropericardium syndrome caused by highly pathogenic fowl adenovirus serotype 4 (FAdV-4) has resulted in significant economic losses to the poultry industry. However, the early innate immune response of immune organs within 24 hpi and the induction of autophagy in vivo after FAdV-4 infection have not been fully elucidated. In this study, 35-day-old specific pathogen-free (SPF) chickens were artificially infected with hypervirulent FAdV-4, which resulted in a mortality rate of up to 90%. The results showed that FAdV-4 infection rapidly triggered the innate immune response in vivo of chickens, with the spleen eliciting a stronger innate immune response than the thymus and bursa. During the early stage of viral infection within 24 hpi, the main receptors TLR3/7/21, MDA5, and cGAS were activated via the NF-κB and TBK1/IRF7-dependent signaling pathways, which up-regulated production of inflammatory cytokines and type I interferons. Additionally, the expression levels of the autophagy-related molecules LC3B, Beclin1, and ATG5 were significantly up-regulated at 24 hpi, while degradation of SQSTM1/p62 was observed, suggesting that FAdV-4 infection elicits a complete autophagy response in the spleen. Besides, the colocalization of Fiber2 and LC3B suggested that FAdV-4 infection induced autophagy which benefits FAdV-4 replication in vivo. This study provides new insights into the immunoregulation signal pathways of the early innate immunity in response to hypervirulent FAdV-4 infection in vivo within 24 hpi and the close relationship between viral replication and autophagy.

Difficult intubation in a patient with acute epiglottitis and abscess complicated with cervical necrotizing fasciitis: A case report.

INTRODUCTION: Acute epiglottitis is not uncommon and it can cause high mortality due to airway obstruction. Acute epiglottitis complicated with cervical necrotizing fasciitis has rarely been reported, and it is also a life-threatening disease with a fatality rate of 7% to 50%. PATIENT CONCERNS: A 64-year-old woman presented to our hospital with chief complaints of sore throat and cervical swelling, long with foreign body sensation and hoarseness. Endoscopic laryngoscopy showed erythematous and swollen epiglottis with purulent secretions on the surface. Computed tomography (CT) scan showed swollen epiglottis and swelling of the neck with air- and fluid-containing necrotizing tissue. DIAGNOSES: The diagnosis was acute epiglottitis and abscess complicated with cervical necrotizing fasciitis. INTERVENTIONS: With the patient in awake condition, airway access was established by performing intubation with adjunctive use of gum elastic bougie, followed by surgical debridement under general anesthesia; a flap was used for skin coverage and intravenous piperacillin-tazobactam was administered. OUTCOMES: The patient was discharged without complications. CONCLUSION: Gum elastic bougie is a usable tool in difficult intubation. Adequate pre-anesthesia evaluation, patient sedation, and gentle manipulation assured the intubation success in this case.

Rapid detection of pigeon adenovirus 2 using a TaqMan real-time PCR assay.

Pigeons infected with aviadenoviruses have been found worldwide. Recently, pigeon adenovirus 2 (PiAdV-2) has been widely distributed in racing pigeons in Germany. However, the epidemiology of this virus remains unclear due to the lack of a specific detection platform for PiAdV-2. In this study, we first detected PiAdV-2 positivity in racing pigeons (designated FJ21125 and FJ21128, which share 100% nucleotide identity with each other based on the fiber 2 gene) in Fujian, Southeast China. These genes shared 99.8% nucleotide identity with PiAdV-2 (GenBank No. NC_031501) but only 54.1% nucleotide identity with PiAdV-1 (GenBank No. NC024474). Then, the TaqMan-qPCR assay for the detection of PiAdV-2 was established based on fiber 2 gene characterization. The established assay had a correlation coefficient of 1.00, with an amplification efficiency of 99.0%. The minimum detection limit was 34.6 copies/µL. Only PiAdV-2 exhibited a positive fluorescent signal, and no signal was detected for other pathogens (including PiCV, FAdV-4, FAdV-8a, EDSV, PPMV-1, RVA and PiHV). The assay has good reproducibility, with a coefficient of variation less than 2.42% both intragroup and intergroup. The distributions of PiAdV-2 in fecal samples from YPDS (35 samples) and healthy (43 samples) racing pigeons from different geographical areas were investigated and were 37.14% (YPDS) and 20.93% (healthy), respectively. In summary, we developed a TaqMan-qPCR platform for the detection of PiAdV-2 infection with high sensitivity, specificity, and reproducibility. We confirmed the presence of PiAdV-2 in China, and our data suggested that there is no indication of a correlation between YPDS and PiAdV-2. This study provides more information on the pathogenesis mechanism and epidemiological surveillance of PiAdV-2.

Effect of High-quality Nursing Care Combined with Psychological Intervention on Stress Response in Surgery and Postoperative Negative Emotions of Patients Undergoing General Anesthesia.

Objective: This study investigated the effect of high-quality nursing care combined with psychological intervention on the stress response and postoperative negative emotions of patients undergoing general anesthesia for surgery. Methods: From January 2019 to January 2020, the researchers chose 90 patients who received general anesthesia at Liaocheng People's Hospital for this study. The patients were divided into control and study groups, each with 45 patients. There were no significant demographic differences between the 2 groups. The control group received standard care, while the study group received high-quality nursing care and psychological intervention. The researchers compared the clinical measures provided to both groups to assess their effectiveness. Results: After the intervention, the study group reported improved surgical stress indicators compared to the control group, with higher scores on the SF-36 health survey and higher satisfaction with nursing care. The study group had lower scores on anxiety and depression scales and showed better body temperature conditions during and after the operation. Discussion: The study found that comprehensive nursing care and psychological interventions effectively reduced postoperative stress indicators and improved social functioning, somatic health, role limitations, and cognitive abilities. Psychological support, including counseling, cognitive-behavioral techniques, relaxation strategies, and stress management, effectively decreased anxiety and depression levels. These interventions provided coping mechanisms and emotional support to enhance overall well-being. Effective interdisciplinary collaboration may have also contributed to the positive outcomes observed. However, the study's limitations include its specific population sample and observational design, which could introduce bias. Future studies should use randomized controlled trials with larger sample sizes for more reliable results. Conclusion: High-quality nursing care combined with psychological interventions for patients undergoing general anesthesia successfully enhanced nursing satisfaction and alleviated patient stress and negative emotions. The method is worthy of promotion and application.

Comparison of Monotherapies and Combination Therapy of Tamsulosin and Tadalafil for Treating Lower Urinary Tract Symptoms Caused by Benign Prostatic Hyperplasia with or without Erectile Dysfunction: A Meta-Analysis.

BACKGROUND: There is limited research into the efficacy and safety of tadalafil combined with tamsulosin for the treatment of lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH), with or without erectile dysfunction (ED). Therefore, we aimed to investigate the efficacy and safety of combination therapy compared to that of monotherapy. METHODS: We searched PubMed, Embase, Cochrane Library, Web of Science, SinoMed, CNKI, WanFang Data Service Platform, and ClinicalTrials.gov to identify eligible studies. A total of 639 articles were retrieved, of which 12 were randomized controlled trials (RCTs) published as of February 2023 and included in this meta-analysis. RESULTS: After screening 639 articles, 12 RCTs including 1,531 subjects were considered eligible for the meta-analysis. The results showed that the total International Prostate System Score (total IPSS), maximum flow rate (Qmax), and quality of life (QoL) in tadalafil combined with tamsulosin were significantly better than those in monotherapy. Compared with tadalafil monotherapy, combination therapy mainly improved IPSS voiding. As for postvoid residual urine (PVR), the combination therapy did not improve PVR compared to the tadalafil group, but significantly improved PVR compared to the tamsulosin group. For the International Index of Erectile Function (IIEF), the curative effect of the combined group was better than that of the tamsulosin group but not better than that of the tadalafil group. In terms of safety, the adverse reactions (AEs) in the combined treatment group were significantly higher than those in the monotherapy group. None of the 12 RCTs reported serious adverse events. CONCLUSIONS: Tadalafil combined with tamsulosin was more effective in the treatment of male LUTS/BPH, with or without ED, on the improvement of total IPSS, QoL, and Qmax. However, the benefits of combination therapy for ED remain unclear. However, combination therapy seemed to have a higher incidence of adverse reactions.

Top 100 cited classical articles in sentinel lymph nodes biopsy for breast cancer.

Background: The sentinel lymph node biopsy (SLNB) takes on a critical significance in breast cancer surgery since it is the gold standard for assessing axillary lymph node (ALN) metastasis and determining whether to perform axillary lymph node dissection (ALND). A bibliometric analysis is beneficial to visualize characteristics and hotspots in the field of sentinel lymph nodes (SLNs), and it is conducive to summarizing the important themes in the field to provide more insights into SLNs and facilitate the management of SLNs. Materials and methods: Search terms relating to SLNs were aggregated and searched in the Web of Science core collection database to identify the top 100 most cited articles. Bibliometric tools were employed to identify and analyze publications for annual article volume, authors, countries, institutions, keywords, as well as hotspot topics. Results: The period was from 1998 to 2018. The total number of citations ranged from 160 to 1925. LANCET ONCOLOGY and JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION were the top two journals in which the above articles were published. Giuliano, AE was the author with the highest number of articles in this field with 15. EUROPEAN INST ONCOL is the institution with the highest number of publications, with 35 articles. Hotspots include the following 4 topics, false-negative SLNs after neoadjuvant chemotherapy; prediction of metastatic SLNs; quality of life and postoperative complications; and lymphography of SLNs. Conclusion: This study applies bibliometric tools to analyze the most influential literature, the top 100 cited articles in the field of SLNB, to provide researchers and physicians with research priorities and hotspots.

Whole-genome analysis reveals possible sources of ALV-J infection in an anyi tile-like gray chicken flock.

Avian leukosis virus (ALV) induces multiple tumors in chicken and is still prevalent in a lot of local flocks in China. In this study, we analyzed the ALV infection status in an Anyi tile-like gray chicken flock by DF1-cells isolation, virus identification, and genome sequencing. Results showed a 29% (29/100) ALV positive rate in this flock. Homology analysis based on env genes illustrated that all these stains belong to subgroup J (92-100% identities) and can be further divided into 5 batches, suggesting a higher diversity of ALV-J within the same flock. The whole-genome analysis of representative stains from each batch confirmed the close relationship between these isolated strains with previously reported strains from different regions (Guangxi, Shandong, and Heilongjiang), revealing the enrichment of different strains in Anyi tile-like grey chickens. This study provides the epidemiological data of ALV-J in a special chicken flock and a reference for the further eradication of ALV in China.

General Anesthesia Maintained with Sevoflurane versus Propofol in Pediatric Surgery Shorter Than 1 Hour: A Randomized Single-Blind Study.

BACKGROUND Sevoflurane was compared with propofol for general anesthesia maintenance in pediatric operations lasting less than 1 hour in terms of anesthetic effect and postoperative recovery. MATERIAL AND METHODS Children scheduled for inguinal hernia repair or hydrocele testis repair were randomly assigned to receive general anesthesia maintained with either sevoflurane (n=43) or propofol (n=43). The ilioinguinal nerve was blocked with 1% lidocaine (7 mg/kg) after intravenous administration of ketamine (2 mg/kg). At the end of the surgery in patients receiving sevoflurane, sevoflurane was stopped and a bolus of propofol of 1 mg/kg was administered. RESULTS Sevoflurane was associated with significantly less use of ketamine (35.1±10.6 mg) than was propofol (59.0±28.0 mg; P<0.001). In addition, sevoflurane was associated with a significantly shorter time in the post-anesthesia care unit (52.1±9.0 min) than was propofol (68.8±15.3 min; P<0.001). Propofol was associated with a significantly higher incidence of intraoperative body movement (33.3%) than was sevoflurane (13.5%; P=0.045). However, the 2 groups showed no important differences in other adverse events such as hypoxia, emergence agitation, and additional use of propofol. CONCLUSIONS In pediatric surgery lasting less than 1 hour, anesthesia maintained with sevoflurane was associated with significantly less use of ketamine, shorter postoperative recovery time, and less intraoperative body movement than was propofol.

Development and application of a fiber2 protein-based indirect ELISA for detection of duck adenovirus 3.

Duck adenovirus 3 (DAdV-3) is a newly identified duck adenovirus that has recently emerged in China. The incidence of duck infection caused by this virus is very high, with very large economic losses to the poultry industry. Thus, there is an urgent need for a serological assay for the specific detection of DAdV-3. To this end, prokaryotic expression of the fiber2 protein of DAdV-3 was used as a coating antigen to establish an indirect enzyme linked immunosorbent assay (ELISA) method for the specific detection of antibodies against DAdV-3. The method was found to be specific, repeatable and more sensitive than the agarose gel precipitation test (AGP). This indirect ELISA method based on the recombinant fiber2 protein may be used for the clinical detection of DAdV-3 infection and for monitoring antibody levels after vaccine immunization and is of great significance for the effective prevention and control of the disease.

Isolation and characterization of duck adenovirus 3 circulating in China.

Recently, infectious disease outbreaks characterized by swelling and hemorrhagic liver and kidneys occurred in Muscovy ducklings in China. Four viruses were isolated and identified as adenoviruses by transmission electron microscopy (TEM) and polymerase chain reaction (PCR). Sequence analysis identified the new isolates as duck adenovirus 3 (DAdV-3), species Duck aviadenovirus B. The pathogenicity of the new isolate DAdV-3 FJGT01 was investigated using challenge experiments. The gross lesions in the animal experiment were similar to the clinical lesions observed in the diseased ducks. TEM examination of liver sample showed that virions accumulated and arranged in crystal lattice formations in the nuclei of hepatocytes. The present study provides new information about the epidemiology and characteristics of duck adenovirus associated with Muscovy ducklings.

Effects of neoadjuvant chemotherapy on the depth of total intravenous anesthesia in patients with breast cancer undergoing unilateral modified radical mastectomy: A prospective observational study.

Toxic effects of neoadjuvant chemotherapy (NC) on nervous, hepatorenal, and pulmonary systems might affect general anesthesia depth. This study aimed to evaluate the effects of NC on depth of total intravenous anesthesia.This prospective observational study enrolled 60 patients undergoing elective unilateral modified radical mastectomy during total intravenous anesthesia with propofol and remifentanil (January-June 2015; Liaocheng People's Hospital, China): the NC group (n = 30) received NC, while the control group (n = 30) did not. Propofol and remifentanil dosages were adjusted according to indexes of consciousness (IoC1: sedation; IoC2: analgesia) to control fluctuations of blood pressure and heart rate within 20% of baseline values. Parameters reflecting propofol/remifentanil dosages, intraoperative adverse events, and quality of anesthetic recovery were recorded.The duration of propofol infusion (1.3 ±â€Š0.4 vs 1.8 ±â€Š0.5 hours, P < .05), mean propofol dosage (8.0 ±â€Š1.0 vs 9.3 ±â€Š1.5 mg kg h, P < .05), and adjustment frequency of target-controlled remifentanil infusion (2.9 ±â€Š1.8 vs 4.4 ±â€Š2.6 times/surgery, P < .05) were significantly lower in the NC group than in the control group; adjustment frequency of target-controlled propofol infusion was also numerically lower (2.0 ±â€Š1.1 vs 2.7 ±â€Š1.5 times/surgery, P = .053). Duration of remifentanil infusion, mean remifentanil dosage, voluntary eye opening, extubation time, and recovery score were not significantly different between groups. The incidence of tachycardia was lower in the NC group than in the control group (7.1% vs 37.0%, P < .05), but there was no significant difference in the incidence of total adverse events between groups.NC can enhance the sensitivity of breast cancer patients to the anesthetic effect of propofol.

Development of a PCR assay for detection and differentiation of Muscovy duck and goose parvoviruses based on NS gene characterization.

Muscovy duck parvovirus (MDPV) and goose parvovirus (GPV) have both been found to cause high mortality and morbidity in Muscovy ducklings. Specific detection is often rife with false positives due to high identity at the genomic nucleotide level and antigenic similarity between MDPVs and GPVs. In this study, significantly variable regions were found, via non-structural (NS) comparison, between MDPV and GPV NS genes; however, NS genes were conserved within the MDPV and GPV groups. A polymerase chain reaction (PCR) assay for detecting and differentiating MDPVs and GPVs was developed with more specificity based on the NS gene characterization. The assay detected as low as 103 DNA copies of both the MDPV and GPV strains, along with 549 separate base pairs (bp). No bands of the same size from other duck pathogens, including duck circovirus, duck enteritis virus, egg drop syndrome virus, duck-origin goose hemorrhagic polyomavirus, Escherichia coli, Salmonella, Riemerella anatipestifer and Pasteurella multocida were amplified. This indicates that this method for performing PCR provides a useful and reliable alternative tool for more precise differentiation of MDPV and GPV infection in clinical samples.

Prediction of the Risk of Laparoscopy-Assisted Gastrectomy by Comparing Visceral Fat Area and Body Mass Index.

PROPOSE: The purpose of this study was to compare the accuracy of visceral fat area (VFA) and body mass index (BMI) in predicting the risk of laparoscopic-assisted gastrectomy. METHODS: Clinicopathological and imaging data of 133 patients who underwent laparoscopy-assisted gastrectomy were recorded, including 17 cases of conversion to open surgery. The remaining 116 patients were retrospectively analyzed after we excluded 17 patients who had been transferred to laparotomy. The patients were divided into two groups according to BMI (≤25 kg/m2: BMI-L group; >25 kg/m2: BMI-H group) and VFA (≤100 cm2: VFA-L group; >100 cm2: VFA-H group). Clinical outcomes were compared between the BMI and VFA subgroups. RESULTS: There were no differences in intraoperative blood loss and the number of harvested lymph nodes between low and high patients defined by BMI and VFA (p > 0.050). However, in the comparison of patients who underwent laparoscopic resection only, it was found that the operation time and intraoperative blood loss of the VFA-H group were more than those of the VFA-L group (p < 0.050). Compared to the VFA-L group, the VFA-H group had later first exhaust time (p = 0.018), more complications (p < 0.001), and longer hospital stays (p = 0.049). However, no similar conclusion was obtained in the BMI group (p > 0.050). CONCLUSION: This study demonstrates that VFA better evaluates the difficulty of laparoscopy-assisted gastrectomy and the risk of postoperative complications than BMI.

Genomic analysis of Sheldrake origin goose hemorrhagic polyomavirus, China.

Goose hemorrhagic polyomavirus (GHPV) is not a naturally occurring infection in geese in China; however, GHPV infection has been identified in Pekin ducks, a domestic duck species. Herein, we investigated the prevalence of GHPV in five domestic duck species (Liancheng white ducks, Putian black ducks, Shan Sheldrake, Shaoxing duck, and Jinyun Sheldrake) in China. We determined that the Jinyun Sheldrake duck species could be infected by GHPV with no clinical signs, whereas no infection was identified in the other four duck species. We sequenced the complete genome of the Jinyun Sheldrake origin GHPV. Genomic data comparison suggested that GHPVs share a conserved genomic structure, regardless of the host (duck or geese) or region (Asia or Europe). Jinyun Sheldrake origin GHPV genomic characterization and epidemiological studies will increase our understanding of potential heterologous reservoirs of GHPV.

Development of a TaqMan-based real-time PCR for detecting duck adenovirus 3.

Recently, a novel duck adenovirus (designated as duck adenovirus 3, DAdV-3) was discovered in Muscovy ducks, China. Here, we developed a TaqMan-based real-time PCR assay (qPCR) for the detection of DAdV-3 infection. After the optimization of the qPCR conditions, the lower limit of detection for DAdV-3 infection was 40.9 copies/µl. No cross-reactivity was observed with other duck-derived pathogens. Intra- and inter-assay variability was less than 2.30%. DAdV-3 was detected in embryos and newly hatched ducklings by qPCR assay, the findings provided evidence of possible vertical transmission of DAdV-3. The developed qPCR analysis showed high specificity, sensitivity, and reproducibility, thereby indicating that it can be used in future investigations on the pathogenesis and epidemiology of DAdV-3.

A TaqMan-based real-time PCR for detection and quantification of newly identified novel pigeon adenovirus.

Recently, a novel pigeon adenovirus (N-PiAd) was found circulating in China, with the virus epidemiology and pathology remaining unclear. A TaqMan-based real-time PCR for detection and quantification of this newly identified N-PiAd infection targeting the hexon gene was developed with a limit of detection (LOD) of 31.2 DNA copies/µl, which was 10 times more sensitive than conventional PCR. There were no cross-reactions with common pigeon-origin viruses. Viral genome distribution in different tissues showed that the liver had the highest number of copies compared to other tissues (spleen, lung, kidney, heart and brain). The method established in this study exhibited high specificity, sensitivity and reproducibility, which can be used as a powerful tool for N-PiAd detection and quantification in epidemiological and pathogenesis studies.

Rapid detection of goose hemorrhagic polyomavirus using TaqMan quantitative real-time PCR.

Due to low doses of infection, an efficient and sensitive virus detection method is necessary to detect low amounts of goose hemorrhagic polyomavirus (GHPV). In this study, we have developed a TaqMan real-time PCR (qPCR) specific assay for the detection of GHPV. Specificity assay showed no cross-reactions with other common waterfowl viruses. The standard curve had a linear correlation of 0.997 and efficiency of 99% between the cycle threshold value and the logarithm of the plasmids copy number. The possible lowest detectable concentration was 35.4 copies/µl; 100 times more sensitive than conventional PCR (detection limit, 3.54 × 103 copies/µl). Domestic Jinyun Sheldrakes ducks and their embryonated eggs were found positive of GHPV infection which provides evidence of possible vertical transmission of GHPV.

Detection of novel adenovirus in sick pigeons.

This study reports a novel adenovirus that was found circulating in pigeons in China. Nucleotide homology analysis of the hexon gene showed a nucleotide similarity of 79.0 and 70.9% with PiAd-2 variant A and PiAd-1, respectively. Phylogenetic analysis suggested that the identified virus, together with PiAd-2 variant, constitutes a monophyletic group (proposed as Pigeon Aviadenovirus B) in the genus Aviadenovirus. The present study contributes to the understanding of the epidemiology, ecology, and taxonomy of adenoviruses in pigeons.

Effect of dexmedetomidine-induced anesthesia on the postoperative cognitive function of elder patients after laparoscopic ovarian cystectomy.

OBJECTIVE: To investigate the effect of dexmedetomidine at maintenance dose on the postoperative function of elder patients after general anesthesia for laparoscopic ovarian cystectomy. METHODS: We enrolled a total of 96 elder patients who were admitted to this hospital for laparoscopic ovarian cystectomy under general anesthesia between March 2015 and March 2017, and divided them into two groups, Group A (n = 48) and B (n = 48). Patients in both groups received the same methods for anesthesia induction and maintenance drugs. At the beginning of operation, patients in Group A received the intravenous injection of dexmedetomidine (0.8 µg/kg) followed by maintenance dose [0.5 µg/(kg h)] to the end of operation, while those in Group B underwent intravenous injection of 0.9% normal saline at the same rate, during which blood pressure, heart rate, oxyhemoglobin saturation and dosage of anesthetics at T1 (5 min after being delivered into the operation room), T2 (immediately after anesthesia induction), T3 (immediately after intubation), T4 (immediately after operation), T5 (immediately after end of operation) and T6 (immediately after extubation). Then, the levels of NSE, IL-6, CRP and HMGB1 were compared between two groups at 24 h before the operation, at the end, 24 h, 3 d and 7 d after operation. Besides, we also compared the postoperative cognitive functions and incidence of adverse reactions at 1 d before, 1, 2, 3 and 7 d after operation through MOCA scales. RESULTS: At T3, T4 and T6, comparisons of the average arterial pressure and heart rate showed that the differences between the two groups had statistical significance (p < .05). At the end of operation, and at 24 h, 3 d and 7 d after operation, we found that the levels of IL-6 and CRP in patients of two groups were all significantly elevated when compared with those before operation; at the end of operation and at 24 h and 3 d after operation, the levels of IL-6 and CRP in the Group B were higher than those in the Group A, and the differences had statistical significance (p < .05). At the end of operation and at 24 h and 3 d after operation, the levels of NSE and HMGB1 in two group were higher than those before operation, and a more significant elevation was identified in Group B with statistically significant differences (p < .05); at 7 d after operation, a decreasing trend was found in the level of HMGB1, which, however, remained higher than the preoperative level, and the level in Group B was still higher than that in Group A with statistically significant differences (p < .05). At 2 d after operation, we found that the scores of MOCA in the Group B were remarkably decreased in comparison with the scores in Group A with a statistically significant difference (p < .05). Moreover, the incidence rate of postoperative cognitive dysfunction (POCD) in the Group A was significantly lower than that in the Group B, and the difference had statistical significance (p < .05). CONCLUSION: Dexmedetomidine can ameliorate the postoperative cognitive functions of elder patients who received the laparoscopic ovarian cystectomy under general anesthesia, and effectively decrease the incidence rate of POCD without any obvious or severe adverse reaction. Thus, it can serve as a kind of adjuvant drug for general anesthesia in clinical practice.

[Influence of visceral fat area on laparoscopic radical gastrectomy in patients with gastric carcinoma].

OBJECTIVE: To explore the influence of visceral fat area(VFA) on laparoscopic radical gastrectomy and short-term outcome in patients with gastric carcinoma. METHODS: Clinicopathological and imaging data of 202 patients with gastric cancer who were treated by laparoscopic radical gastrectomy in the Affiliated Hospital of Qingdao University from May 2011 to July 2014 were retrospectively analyzed. VFA of all the patients were measured by CT, of which more than 10 000 m(2) were found in 104 patients(VFA-L group), less than 10 000 m2 in other 98 patients (VFA-S group). Intraoperative and postoperative outcomes were compared between the two groups. RESULTS: There were no differences in operation time, intraoperative blood loss and number of harvested lymph node between the two groups(all P>0.05). As compared to VFA-S group, VFA-L group had a higher incidence of conversion to open surgery[9.6%(10/104) vs. 2.0%(2/98), P=0.023], higher complication rate [22.1%(23/104) vs. 10.2%(10/98), P=0.003], longer postoperative fever time [(3.0±1.3) d vs. (2.4±1.1) d, P=0.000], total length of hospital stay [(18.6±11.8) d vs. (15.8±6.0) d, P=0.039]. There were no significant differences in first flatus passage time and total hospitalization costs between the two groups. CONCLUSION: Elevated VFA can raise the difficulty of laparoscopic radical gastrectomy, increase the risk of postoperative complication and prolong the postoperative recovery.