Spatiotemporal distribution characteristics of syphilis in Gansu province in 2005 - 2021 / 公共卫生与预防医学

Objective To analyze the spatiotemporal distribution characteristics of the syphilis epidemic in Gansu Province from 2005 to 2021, and to provide a reference for the prevention and control of the syphilis epidemic in Gansu Province. Methods ArcGIS 10.7 was used to map the annual incidence of syphilis in Gansu Province from 2005 to 2021, spatial autocorrelation analysis and local autocorrelation analysis were performed, and SaTScan 10.0.2 software was used for spatiotemporal scanning analysis. Results The global autocorrelation results showed that the annual incidence of syphilis in 2005-2021 was >0, Z＞1.96, and the P< 0.0001, showing a spatial clustering distribution, and the local autocorrelation results showed that there was one spatially similar high-high aggregation area and two spatially similar low-low aggregation areas in Gansu Province, and the hot spot analysis showed that there were 9 negative hotspot areas and 2 positive hotspot areas in the syphilis epidemic in Gansu Province. Spatiotemporal scanning analysis detected two high concentration areas, mainly concentrated in Gannan Tibetan Autonomous Prefecture. Conclusion Syphilis in Gansu Province has regional differences in space, and high-high accumulation areas in Gannan Tibetan Autonomous Prefecture persist, and targeted prevention and control strategies should be specified according to temporal and spatial characteristics.

Creep mechanical tests and shear rheological model of the anchorage rock mass under water‒rock coupling.

The development of deep geotechnical engineering is restricted by the complex geological conditions of deep rock masses and the unknown creep mechanism of rock in water-rich environments. To study the shear creep deformation law of the anchoring rock mass under different water content conditions, marble was used as the bedrock to make anchoring specimens, and shear creep tests of the anchoring rock mass under different water contents were carried out. The influence of water content on rock rheological characteristics is explored by analysing the related mechanical properties of the anchorage rock mass. The coupling model of the anchorage rock mass can be obtained by connecting the nonlinear rheological element and the coupling model of the anchorage rock mass in series. Related studies show that (1) shear creep curves of anchorage rock masses under different water contents have typical creep characteristics, including decay, stability and acceleration stages. The creep deformation of the specimens can be improved with increasing moisture content. (2) The long-term strength of the anchorage rock mass shows an opposite change law with increasing water content. The creep rate of the curve increases gradually with increasing water content. The creep rate curve shows a U-shaped change under high stress. (3) The nonlinear rheological element can explain the creep deformation law of rock in the acceleration stage. By connecting the nonlinear rheological element with the coupled model of anchoring rock mass in series, the coupled model of water‒rock under water cut conditions can be obtained. The model can be used to study and analyse the whole process of shear creep of an anchored rock mass under different water contents. This study can provide theoretical support for the stability analysis of anchor support tunnel engineering under water cut conditions.

The rhizospheric transformation and bioavailability of mercury in pepper plants are influenced by selected Chinese soil types.

Understanding and prediction of mercury (Hg) phytoavailability in vegetable-soil systems is essential for controlling food chain contamination and safe vegetable production as Hg-contaminated soils pose a serious threat to human health. In this study, four typical Chinese soils (Heilongjiang, Chongqing, Yunnan, and Jilin) with varied physicochemical properties were spiked with HgCl2 to grow sweet pepper (Capsicum annuum L.) in a pot experiment under greenhouse condition. The chemical fractionation revealed a significant decrease in exchangeable Hg, while an increase in organically bound Hg in the rhizosphere soil (RS) compared to bulk soil (BS). This observation strongly highlights the vital role of organic matter on the rhizospheric Hg transformation irrespective of contamination levels and soil properties. Stepwise multiple linear regression (SMLR) analysis between Hg concentration in plants, Hg fractions in RS and BS, and soil properties showed that Hg in plant parts was significantly influenced by soil total Hg (THg) (R2 = 0.90), soil clay (R2 = 0.99), amorphous manganese oxides (amorphous Mn) (R2 = 0.97), amorphous iron oxides (amorphous Fe) (R2 = 0.70), and available Hg (R2 = 0.97) in BS. Nevertheless, in the case of RS, Hg accumulation in plants was affected by soil THg (R2 = 0.99), amorphous Mn (R2 = 0.97), amorphous Fe oxides (R2 = 0.66), soil pH, and organically bound Hg fraction (R2 = 0.96). Among all the evaluated soils (n = 04), metal (mercury) concentration in terms of plant uptake was reported highest in the Jilin soil. Based on SMLR analysis, the results suggested that the phytoavailability of Hg was mainly determined by THg and metal oxides regardless of the rhizospheric effect. These findings facilitate the estimation of Hg phytoavailability and ecological risk that may exist from Hg-contaminated areas where pepper is the dominant vegetable.

Development of elevated body temperature during surgery under different general anesthesias in pediatric patients with congenital ptosis / 中华麻醉学杂志

Objective:To observe the development of elevated body temperature during surgical correction under different general anesthesias in the pediatric patients with congenital ptosis.Methods:Sixty American Society of Anesthesiologists Physical Status classification Ⅰ pediatric patients with blepharoptosis of both sexes, aged 2-10 yr, undergoing elective surgery for blepharoptosis correction, were divided into total intravenous anesthesia group(TIVA group) and combined intravenous-inhalational anesthesia group(CIIA group) using a random number table method, with 30 cases in each group. Anesthesia was induced with intravenous propofol 1-2 mg/kg, cisatracurium 0.15-0.25 mg/kg and fentanyl 2-3 μg/kg in both groups, and then the patients were endotracheally intubated. Anesthesia was maintained with intravenous infusion of propofol 50-200 μg·kg -1·min -1 and remifentanil 0.2-0.05 μg·kg -1·min -1 in TIVA group and with intravenous infusion of propofol 25-75 μg·kg -1·min -1 and remifentanil 0.2-0.5 μg·kg -1·min -1 and inhalation of 1%-1.5% sevoflurane in CIIA group. After completion of anesthesia induction, the nasopharyngeal temperature was continuously monitored until the end of surgery, and the occurrence of elevation in intraoperative body temperature (≥37.5 ℃) was recorded. Results:The incidence of elevated body temperature was 20% and 40% in TIVA group and CIIA group, respectively. Body temperature ≥39.0 ℃ did not occur in two groups. There was no significant difference in the incidence of elevated body temperature and constituent ratio of degree of elevation in body temperature between the two groups ( P>0.05). Conclusions:When total intravenous anesthesia and combined intravenous-inhalational anesthesia are used in the surgery for blepharoptosis correction in the pediatric patients with congenital ptosis, concurrent mild hypothermia is a non-small probability event, but it is safe to evaluate it in terms of the occurrence of malignant hyperthermia.

Precise ultrasound-guided stellate ganglion block combined with ozonated autohemotherapy in the treatment of sudden hearing loss / 临床麻醉学杂志

Objective To investigate the efficacy of precise ultrasound-guided stellate ganglion block(UG-SGB)combined with ozonated autohemotherapy in the treatment of sudden hearing loss.Methods Fifty-seven patients with sudden hearing loss,27 males and 30 females,aged 19-82 years,BMI 20-29 kg/m2,ASA physical status Ⅰ or Ⅱ,were randomly divided into drugs combined with UG-SGB and ozonated autohemotherapy treatment group(group U,n=29)and drugs group(group D,n=28)accord-ing to the random number table.All patients were given drug therapy.In addition to the treatment above,pa-tients in group U also received precise ultrasound-guided stellate ganglion block once on affected side com-bined with ozonated autohemotherapy once daily for 10 consecutive days.Patients in group D received drug therapy only.The average hearing threshold of the two groups was compared before treatment(T0),at dis-charge(T1),1 month(T2),3 months(T3),and 6 months after discharge(T4).The hearing improve-ment of the two groups was also compared at T1-T4 on the basis of T0.Moreover,tinnitus rate of the two groups was recorded T0-T4.In addition,adverse reactions such as toxicosis of local anaesthetics,pneumo-thorax were recorded.Results Compared with T0,the average hearing threshold was reduced significantly in both groups at T1-T4(P＜0.05),the incidence of tinnitus was reduced significantly at T1-T4 in both groups(P＜0.05).Compared with T,,the average hearing threshold was reduced significantly in group U at T2-T4(P＜0.05).The average hearing threshold of group U was lower than that in group D at T1-T4(P＜0.05).The hearing improvement in group U was better than that in group D at T2-T4(P＜0.05).The proportion of complete hearing recovery in group U was increased significantly than that in group D at T2-T4(P＜0.05)The proportion of effective hearing improvement in group U was decreased than that in group D at T3-T4(P＜0.05).No obvious adverse reaction was recorded,such as toxicosis of local anaesthetics,pneumothorax.Conclusion Precise ultrasound-guided stellate ganglion block combined with ozonated auto-hemotherapy based on drug treatment significantly improves the average hearing threshold of patients with sudden hearing loss in acute stage and improve their hearing.

Effect of different anesthesia onset time on postoperative circadian rhythm in patients undergoing robot-assisted radical prostatectomy / 临床麻醉学杂志

Objective To analyze the effect of different anesthesia induction time on postoperative circadian rhythm in patients undergoing robot-assisted radical prostatectomy.Methods A total of 103 pa-tients,aged 50-85 years,BMI 18-30 kg/m2,ASA physical status Ⅰ-Ⅲ,undergoing robot-assisted radi-cal prostatectomy from January 2022 to October 2022 were recruited.The patients were grouped according to the induction time:the morning 8:00-11:59 group(group M,n=53)and the afternoon 12:00-18:00 group(group A,n=50).D'Amico risk grade,duration of anesthesia,number of effective com-pressions of analgesic pump(D1)and actual compressions(D2)were recorded,D1/D2 were calculated.HR,MAP,SpO2 were recorded at 5 minutes after entrying the operation room(T0),5 minutes after anes-thesia induction(T,),5 minutes after the surgery start(T2),60 minutes after the surgery start(T3),at the end of surgery(T4)and 5 minutes after extubation(T5).BIS at T1-T4 were recorded.Sleeping status was assessed by the Athens insomnia scale(AIS)1 day before surgery,1 day and 3 days after surgery,and pain level was assessed 1 and 3 days after surgery using the digital rating scale(NRS).According to the re-sults of the morningness-eveningness questionnaire of sleep-wake assessment(MEQ-SA)1 day before surgery and 3 days after surgery,the patients'circadian rhythm was determined.Results There were no statistically significant differences in D'Amico risk grade,duration of anesthesia,D1/D2,HR,MAP,SpO2 and BIS at different time point,AIS scores 1 day before surgery,1 day and 3 days after surgery,and NRS scores 1 day and 3 days after surgery between the two groups.In group M,there were 11 cases(21％)of circadian rhythm changes,of which 5 people's circadian rhythm changed to"later"and 6 people's circadian rhythm changed to"earlier".In group A,there were 3 cases(6％)of circadian rhythm changes,of which 1 person's circadian rhythm changed to"later"and 2 people's circadian rhythm changed to"earlier".The rate of circadian rhythm change in group M was significantly higher than that in group A(P＜0.05).Conclusion The incidence of perioperative circadian rhythm alteration is significantly higher in patients undergoing robot-assisted radical prostatectomy who starts anesthesia in the morning than those in the after-noon.

Efficacy and safety of ciprofol in combined intravenous and inhalation anesthesia in elderly patients undergoing thoracoscopic surgery / 临床麻醉学杂志

Objective To research the efficacy and safety of ciprofol in combined intravenous and inhalation anesthesia in elderly patients undergoing thoracoscopic surgery.Methods A retrospective analysis was conducted on 806 elderly patients who underwent thoracoscopic surgery from January 2021 to July 2022,416 males and 390 females,aged 65-85 years,BMI 16-30 kg/m2,ASA physical status Ⅰ-Ⅲ.Patients were divided into two groups according to different intravenous anesthesia drugs during the sur-gery:ciprofol group(group C,n=229)and propofol group(group P,n=577).The preoperative and intraoperative indexes of the two groups were balanced by 1∶1 propensity score matching(PSM).Multiva-riate logistic regression was used to analyze the correlation between intravenous anesthetics and the incidence of adverse reactions(hypotension,bradycardia,hypoxemia during recovery,and postoperative nausea and vomiting).Multivariate linear regression was used to analyze the correlation between intravenous anesthetics and short-term recovery indicators after anesthesia(extubation time,postanesthesia care unit residence time,and length of postoperative hospitalization).Results Compared with group P,the total dosage of va-soactive drugs in group C were significantly reduced(P＜0.05),extubation time and PACU residence time were significantly shortened(P＜0.05).Multivariate logistic regression analysis showed that the use of cip-rofol was associated with a reduced incidence of intraoperative hypotension(OR=0.378,95％CI 0.236-0.603,P＜0.001)and hypoxemia during recovery(OR=0.542,95％CI 0.336-0.874,P=0.012).Multivariate linear regression analysis showed that the use of ciprofol was associated with the reduction of ex-tubation time and PACU residence time(P＜0.001).Conclusion Compared with propofol,combined in-travenous and inhalation anesthesia with ciprofol can significantly reduce the incidence of anesthetic adverse reactions in elderly patients,and is conducive to short-term recovery after anesthesia.

Effect of gender factor on efficacy of remimazolam combined with alfentanil in patients undergoing gastrointestinal endoscopy / 中华麻醉学杂志

Objective:To evaluate the effect of gender factor on efficacy of remimazolam combined with alfentanil in the patients undergoing gastrointestinal endoscopy.Methods:Two hundred patients, aged 18-64 yr, with body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists Physical Status classificationⅠor Ⅱ, scheduled for elective gastrointestinal endoscopy, were divided into 2 groups ( n=100 each) according to gender: male group (group M) and female group (group F). Remimazolam 0.2-0.3 mg/kg and alfentanil 5-7 μg/kg were intravenously injected, remimazolam 0.5-0.7 mg·kg -1·h -1 was continuously infused during operation to maintain the modified observer′s assessment of alert/sedation score<3 points, and alfentanil 2 μg/kg was administered when necessary. The consumption of remimazolam and alfentanil, examination time, recovery time and time of post-anesthesia care unit stay were recorded. The satisfaction scores of examination physicians and patients were recorded. The occurrence of adverse reactions such as injection pain, intraoperative body movement, respiratory depression, hypotension, bradycardia and hiccups and postoperative dizziness, nausea, vomiting, fatigue, abdominal pain and abdominal distension were recorded. Results:There was no significant difference in the consumption of remimazolam and alfentanil, examination time, recovery time, satisfaction scores of examination physicians and patients between the two groups ( P>0.05). There was no significant difference in the incidence of respiratory depression, hypotension, bradycardia, injection pain, body movement, hiccups, abdominal pain, abdominal distension, and fatigue between the two groups ( P>0.05). Compared with group M, the time of post-anesthesia care unit stay was significantly prolonged, and the incidence of postoperative dizziness, nausea and vomiting was increased in group F ( P<0.05). Conclusions:Remimazolam combined with alfentanil provides better efficacy in male patients than in female patients undergoing gastrointestinal endoscopy.

Relationship between mechanism underlying antidepressant effect of S-ketamine and hippocampal GABA BR in mice / 中华麻醉学杂志

Objective:To evaluate the relationship between the mechanism underlying the antidepressant effect of S-ketamine and hippocampal gamma-aminobutyric acid B receptor (GABA BR) in mice. Methods:A total of 54 male C57BL/6(B6) mice, aged 8 weeks, weighing 25-30 g, were used in this study. Forty mice were selected to develop the depression model by chronic social defeat stress. Twenty-six depression-susceptible mice were screened out by social avoidance test at day 11 after developing the model and divided into 2 groups ( n=13 each) by a random number table method: depression-susceptible group (Sus group) and depression-susceptible + S-ketamine group (Sus + S-ket group). The remaining 14 mice served as control group (C group). Starting from day 12 after developing the model, S-ketamine 10 mg/kg was intraperitoneally injected every day for 3 consecutive days in Sus+ S-ket group, while the equal volume of normal saline was given instead in C group and Sus group. The open field test was performed at 1 h after the last administration, and the total distance of movement was recorded. The forced swimming test was performed at 1 day after the open field test, and the immobile time was recorded. The sucrose preference test was performed to calculate the proportion of sucrose consumption at 1 day after the forced swimming test. One hour after the end of behavioral test, mice were sacrificed, and the hippocampal tissues were removed. Western blot was used to detect the expression of GABA BR1, GABA BR2, mammalian target of rapamycin (mTOR), phosphorylated mTOR (p-mTOR), brain-derived neurotrophic factor (BDNF), tyrosine kinase receptor B (TrkB), phosphorylated TrkB (p-TrkB), glutamate receptor 1 (GluR1) and postsynaptic dense protein 95 (PSD95). The p-mTOR/mTOR ratio and p-TrkB/TrkB ratio were calculated. The fluorescence intensity of BDNF in hippocampal CA1 region was detected by immunofluorescence. The number of dendritic spines in hippocampal CA1 region was measured by Golgi staining. Results:In the open field test, no statistically significant difference in the total distance was detected among the three groups ( P>0.05). Compared with C group, the immobile time in the forced swimming test was significantly prolonged, the proportion of sucrose consumption was decreased, the expression of hippocampal GABA BR1, GABA BR2, BDNF, GluR1 and PSD95 was down-regulated, and the ratios of p-mTOR/mTOR and p-TrkB/TrkB were decreased, the fluorescence intensity of BDNF and total number of dendritic spines in the hippocampal CA1 region were decreased in Sus group ( P<0.05), and no significant change was found in the parameters mentioned above in Sus+ S-ket group ( P>0.05). Compared with Sus group, the immobile time in the forced swimming test was significantly shortened, the proportion of sucrose consumption was increased, the expression of hippocampal GABA BR1, GABA BR2, BDNF, GluR1 and PSD95 was up-regulated, the ratios of p-mTOR/mTOR and p-TrkB/TrkB were increased, and the fluorescence intensity of BDNF and total number of dendritic spines in the hippocampal CA1 region were increased in Sus+ S-ket group ( P<0.05). Conclusions:The mechanism underlying the antidepressant effect of S-ketamine may be related to up-regulation of hippocampal GABA BR expression, activation of mTOR-BDNF signaling pathway, and improvement in synaptic plasticity in mice.

Prevalence survey of position management of anesthesia specialist nurses in tertiary hospitals in China / 中华麻醉学杂志

Objective:To evaluate the status of position management of anesthesia specialist nurses in China.Methods:From January 2022 to March 2022, a cross-sectional survey was conducted using a self-made questionnaire through convenience sampling to assess the current situation of position management of anesthesia specialist nurses in tertiary hospitals in mainland China.Results:A total of 154 questionnaires were distributed, 137 of which were recovered, the response rate was 89%, and 36 questionnaires were excluded. The survey involved 101 tertiary hospitals in 25 provincial administrative regions in China, and 90% of hospitals were general hospitals. Eighty-three percent of hospitals had separate anesthesia care units, anesthesia specialist nurses accounted for ≥ 10% of nurse anesthetists in 53% of hospitals. Ninety-four percent of hospitals had the position management system of specialist nurses, more than 50% of hospitals had position responsibility and hierarchical management systems and showed difference in position benefits. Less than 50% of hospitals had employed and full-time anesthesia specialist nurses. Fifty percent of hospitals conformed to the advocacy scope of anesthesia specialist nurse service. Fifty-five percent of hospitals carried out the qualification certification of anesthesia specialist nurses, and 37% of hospitals were the training bases for anesthesia specialist nurses. Ninety-six percent of hospitals formulated the development plan of anesthesia specialist nurses.Conclusions:The position management of anesthesia specialist nurses has begun to take shape in tertiary hospitals in China at present, but the institutional system of position management and specialized management need to be strengthened.

Recent advance in pathogenesis and treatment of depression related hyperalgesia / 中华神经医学杂志

Depression is one of the major types of psychiatric disorders, and often accompanies hyperalgesia except for mood alteration. At present, the mechanism of depression related hyperalgesia is mainly focused on monoamines, inflammatory cytokines, brain-derived neurotrophic factors and related neural circuits. At present, there is still a lack of specific treatment drugs for depression related hyperalgesia; and psychological therapy and traditional Chinese medicine therapy can play active auxiliary roles. In this review, the latest research progress of the above contents are noted to provide references for research and prevention of this disease.

Recent advance in pathogenesis and treatment of depression related hyperalgesia / 中华神经医学杂志

Depression is one of the major types of psychiatric disorders, and often accompanies hyperalgesia except for mood alteration. At present, the mechanism of depression related hyperalgesia is mainly focused on monoamines, inflammatory cytokines, brain-derived neurotrophic factors and related neural circuits. At present, there is still a lack of specific treatment drugs for depression related hyperalgesia; and psychological therapy and traditional Chinese medicine therapy can play active auxiliary roles. In this review, the latest research progress of the above contents are noted to provide references for research and prevention of this disease.

Effect of propofol on proliferation, invasion and migration of human melanoma cells and role of COX-2/PGE2/MMP signaling pathway / 中华麻醉学杂志

Objective:To evaluate the effect of propofol on proliferation, invasion and migration of human melanoma cells and role of cyclooxygenase-2 (COX-2)/prostaglandin E2 (PGE2)/matrix metalloproteinase (MMP) signaling pathway.Methods:SKMEL-5 cells were cultured in vitro and divided into 4 groups ( n=36 each) using the random number table method: control group (group C), propofol group (group P), COX-2 overexpression group (group COX-2), and COX-2 overexpression plus propofol group (group COX-2+ P). Propofol at the final concentration of 60 μmol/L was added in group P. The COX-2 overexpression plasmid pcDNA3.1-COX-2 was transfected into SKMEL-5 cells in group COX-2 and group COX-2+ P, and propofol at the final concentration of 60 μmol/L was added in group COX-2+ P.After incubation for 48 h, the cell proliferation rate was determined by CCK-8 method, the cell invasion and migration ability was determined by Transwell assay, the expression of COX-2 in cells was detected by Western blot, the expression of COX-2 mRNA in cells was detected by quantitative real-time polymerase chain reaction, and the concentrations of serum PGE2, MMP-2 and MMP-9 were determined by enzyme-linked immunosorbent assay. Results:Compared with group C, the cell proliferation rate was significantly decreased, the number of cell invasion and migration was decreased, the expression of COX-2 protein and mRNA was down-regulated, and the concentrations of PGE2, MMP-2 and MMP-9 in the supernatant were decreased in group P, and the cell proliferation rate was significantly increased, and the number of cell invasion and migration was increased, the expression of COX-2 protein and mRNA was up-regulated, and the concentrations of PGE2, MMP-2 and MMP-9 in the supernatant were increased in group COX-2 ( P<0.05). Compared with group P, the cell proliferation rate was significantly increased, and the number of cell invasion and migration was increased, the expression of COX-2 protein and mRNA was up-regulated, and the concentrations of PGE2, MMP-2 and MMP-9 in the supernatant were increased in group COX-2+ P ( P<0.05). Conclusions:Propofol can inhibit the proliferation, invasion and migration of human melanoma cells, and the mechanism may be related to inhibition of the COX-2/PGE2/MMP signaling pathway.

Efficacy of S-ketamine mixed with hydromorphone for improving patient-controlled intravenous analgesia after lumbar spinal surgery / 中华麻醉学杂志

Objective:To evaluate the efficacy of S-ketamine mixed with hydromorphone for improving patient-controlled intravenous analgesia (PCIA) after lumbar spinal surgery.Methods:Ninety-six American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 18-64 yr, with body mass index of 18.5-29.9 kg/m 2, scheduled for elective lumbar fusion surgery under general anesthesia, were divided into 2 groups ( n=48 each) using a random number table method: hydromorphone for PCIA group (group H) and S-ketamine mixed with hydromorphone for PCIA group (group S+ H). PCIA was performed at the end of operation.PCIA solution contained hydromorphone 0.05 mg/ml mixed with S-ketamine 0.25 mg/ml in group S+ H and hydromorphone 0.05 mg/ml in group H. The PCIA pump was set up to deliver a 2 ml bolus dose with a 10-min lockout interval, background infusion at 2 ml/h and total volume of 200 ml.When the numerical rating scale score ≥4 and analgesia was ineffective by pressing the PCA pump for 3 consecutive times, hydromorphone 0.2 mg was intravenously injected as rescue analgesic.The cumulative consumption of hydromorphone (consumption for analgesic pump and consumption for rescue analgesia) and occurrence of adverse reactions such as pruritus, respiratory depression, nausea, vomiting, drowsiness, dizziness, headache, hallucinations and nightmares within 48 h after operation were recorded.The patients′ satisfaction with analgesia was recorded at 48 h after operation.The time to first flatus after operation and quality of recovery (QoR-15 scale) at 24 and 48 h after operation were recorded. Results:Compared with group H, the cumulative consumption of hydromorphone within 48 h after surgery were significantly reduced, the patients′ satisfaction with analgesia was increased, the time to first flatus after operation was shortened, QoR-15 scores were increased at 24 and 48 h after operation ( P<0.05), and no significant change was found in the requirement for rescue analgesia and incidence of adverse reactions within 48 h after surgery in group S+ H ( P>0.05). Conclusions:Compared with PCIA with hydromorphone, S-ketamine mixed with hydromorphone can reduce postoperative consumption of hydromorphone, increase satisfaction with analgesia, and promote early postoperative recovery after lumbar spinal surgery.

Efficacy of remimazolam combined with alfentanil for gastroscopy in frail elderly patients / 中华麻醉学杂志

Objective:To evaluate the efficacy of remimazolam combined with alfentanil for gastroscopy in frail elderly patients.Methods:Sixty American Society of Anesthesiologists physical status Ⅱ or Ⅲ elderly patients, aged 65-85 yr, with body mass index of 18-30 kg/m 2, of Clinical Frailty Scale score≥5, scheduled for elective painless gastroscopy, were divided into 2 groups ( n=30 each) using a random number table method: remimazolam combined with alfentanil group (group R) and propofol combined with remifentanil group (group P). A combination of alfentanil 10 μg/kg and remimazolam 0.2 mg/kg was intravenously injected until loss of consciousness in group R. Remifentanil 0.5 μg/kg combined with propofol 1.0-2.0 mg/kg was intravenously injected until loss of consciousness in group P. According to the intraoperative conditions, 1/4 of the initial dose of remimazolam was intravenously injected in group R, and 1/4 of the initial dose of propofol was intravenously injected in group P. The time for gastroscopy, requirement for additional remimazolam or propofol, onset time of anesthesia, emergence time and time of post-anesthesia care unit stay were recorded.Physician′s satisfaction scores, patient′s satisfaction scores and Verbal Pain Scale scores were recorded.The occurrence of injection pain, respiratory depression, bradycardia, hypotension and nausea and vomit was recorded. Results:There was no significant difference in the requirement for additional remimazolam or propofol, onset time of anesthesia, time for gastroscopy, physician′s satisfaction scores, and patient′s satisfaction scores, Verbal Pain Scale scores and incidence of nausea and vomit between two groups ( P>0.05). Compared with P group, the emergence time and time of post-anesthesia care unit stay were significantly shortened, and the incidence of injection pain (0 vs.33%), respiratory depression (0 vs.20%), hypotension (3% vs.23%) and bradycardia (3% vs.23%) was decreased in R group ( P<0.05). Conclusions:Remimazolam combined with alfentanil is safe and effective, with rapid recovery from anesthesia, and provides better efficacy than the combination of propofol and remifentanil when used for gastroscopy in frail elderly patients.

Effects of sugammadex on quality of recovery after laparoscopic bariatric surgery in severely obese patients / 中华麻醉学杂志

Objective:To evaluate the effects of sugammadex on the quality of recovery after laparoscopic bariatric surgery in severely obese patients.Methods:One hundred and eighty patients, aged 18-65 yr, with body mass index ≥ 40 kg/m 2, undergoing elective laparoscopic bariatric surgery, of American Society of Anesthesiologists physical status Ⅲ, were enrolled and divided into 2 groups ( n=90 each) by the random number table method: sugammadex group (S group) and neostigmine group (N group). Before anesthesia, bilateral T 6 and T 9 paravertebral nerve blocks were performed, and 0.33% ropivacaine 15 ml was injected on each side.When the reappearance of T 2 was monitored under train-of-four (TOF) stimulation after the end of surgery, and sugammadex 2 mg/kg was intravenously injected in S group, and neostigmine 0.04 mg/kg and atropine 0.02 mg/kg were intravenously injected in N group.After the patient was transferred to the general ward, flurbiprofen axetil 50 mg was injected intravenously every 12 h, and oxycodone and flurbiprofen axetil were used for patient-controlled intravenous analgesia at the same time.When the numerical rating scale (NRS) score ≥4 and the analgesic pump was ineffective, bilateral T 7 paravertebral nerve block was performed for rescue analgesia, and 0.33% ropivacaine 15 ml was injected on each side.The postoperative quality of recovery was assessed by the 15-item Quality-of-Recovery scale before operation and at 24 h after operation.The TOF ratio ≥ 0.9 and extubation time were recorded.The SpO 2 at the time of transfer to post-anesthesia care unit (PACU), the lowest SpO 2 and occurrence of SpO 2 < 92% during PACU were recorded.The occurrence of residual muscle relaxation and Ramsay sedation score were recorded at 30 min after entering PACU.The time of PACU stay, time to the first off-bed activity and length of hospital stay were recorded.The cumulative consumption of oxycodone, requirement for rescue analgesia, dizziness, nausea and vomiting, hypoxemia, and pulmonary complications were recorded within 48 h after operation. Results:There were no significant differences in the total score of 15-item Quality-of-Recovery scale before surgery and at 24 h after surgery, cumulative consumption of oxycodone within 48 h after surgery, rate of rescue analgesia, and incidence of dizziness, nausea and vomiting, hypoxemia and pulmonary complications between the two groups ( P>0.05). Compared with N group, the scores of the three recovery indicators (feel energized with enough rest, engagement in work or family activities, and tension and anxiety) were significanatly increased, time to TOF ratio ≥ 0.9, extubation time, time of PACU stay, time to the first off-bed activity and length of hospital stay were shortened, and the incidence of residual muscle relaxation was decreased in S group ( P<0.05). Conclusions:Antagonizing residual muscle relaxation with sugammadex is helpful for the recovery of severely obese patients after laparoscopic bariatric surgery.

Study on the screening of active constituents of Taohong Siwu Decoction and the protective effect of ferulic acid on myocardial injury / 中国临床药理学与治疗学

AIM: To screen the active constituents in Taohong Siwu Decoction(THSWD) by Systems Pharmacology and to study its protective effect on myocardial injury through cell experiments. METHODS: The TCMSP database and Pharmmaper database were used to retrieve the constituents and active constituent targets of THSWD. The Genecards database was used to retrieve the myocardial injury related targets gene. Then construct and analyze the constituents-disease intersection target network and the contribution value of constituents, and screen out the main active constituents of THSWD acting on the myocardium. Furthermore, CoCl

Application of Chinese version of SF-36 scale and its reliability and validity in patients with chronic Keshan disease / 中华地方病学杂志

Objective:To evaluate the reliability and validity of the Chinese version of concise health status questionnaire (SF-36 scale) in evaluating the quality of life of patients with chronic Keshan disease, and to provide a scientific basis for studying the quality of life and the evaluation of treatment and rehabilitation of this population.Methods:In the August 2017, using cluster random sampling method, 175 patients with chronic Keshan disease treated by self-management of family beds in Pingliang City, Gansu Province in 2017 were selected as survey subjects, and demographic and disease data were collected. The Chinese version of SF-36 scale was used to investigate the quality of life. Split-half reliability and Cronbach's α coefficient were used to evaluate the reliability of the SF-36 scale; the factor analysis, correlation and differences between groups were used to evaluate the validity of the SF-36 scale.Results:The split-half reliability value of SF-36 scale was 0.916, and the Cronbach's α coefficient was 0.869. Factor analysis extracted 3 common factors from 8 dimensions of SF-36 scale, and the cumulative contribution rate of the 3 common factors to the total variance was 72.08%. In addition to the correlation coefficient ( r) between Role-Emotional and Bodily Pain dimension, the r value between total score and the scores of each dimension, and the scores of each dimension of SF-36 scale were 0.140 - 0.769. Except for the Bodily Pain dimension, there were statistically significant differences in the scores of Physiological Functioning, Role-Physical, General Health, Vitality, Social Functioning, Role-Emotional, and Mental Health dimension of the quality of life of patients with different grades of cardiac function ( F = 4.66, 10.73, 6.77, 14.61, 5.58, 9.57, 7.10, P < 0.05). Conclusion:The Chinese version of SF-36 scale has good reliability and validity in evaluating the quality of life of patients with chronic Keshan disease, and can be used to evaluate the quality of life of the patients.

Optimization strategy of anesthesia for modified electroconvulsive therapy in patients with major depressive disorder: low-dose esketamine combined with propofol / 中华麻醉学杂志

Objective:To evaluate the optimization efficacy of low-dose esketamine combined with propofol in the patients with major depressive disorder undergoing modified electroconvulsive therapy (MECT).Methods:Fifty-six American Society of Anesthesiologists physical statusⅠor Ⅱ patients, aged 18-64 yr, scheduled for MECT for the first time, were assigned into esketamine plus propofol group (group EP, n=28) and propofol group (group P, n=28) according to a ratio of 1∶1 by the random number table method.Esketamine 0.25 mg/kg was intravenously injected before anesthesia induction in group EP, while the equal volume of normal saline was given instead in group P. Propofol and succinylcholine were then intravenously injected to perform MECT in two groups.The primary outcomes were the remission rate and response rate, and the secondary outcomes included the number of MECT required for response and remission, the seizure duration, energy inhibition index and consumption of propofol for each MECT, and the occurrence of therapy-related adverse reactions and relapse. Results:Compared with group P, the remission rate and response rate were significantly increased, and the number of MECT required for response and remission was decreased, the seizure duration was prolonged, and energy inhibition index was increased, the consumption of propofol was reduced ( P<0.05), and no significant change was found in the incidence of therapy-related adverse reactions and relapse in group EP ( P>0.05). Conclusions:Low-dose esketamine combined with propofol can enhance the efficacy of MECT and shorten the course of therapy without increasing therapy-related adverse reactions in the patients with major depression.

Comparison of efficacy of mivacurium versus cisatracurium in patients undergoing painless fiberoptic bronchoscopy / 中华麻醉学杂志

Objective:To compare the efficacy of mivacurium versus cisatracurium in patients undergoing painless fiberoptic bronchoscopy.Methods:A total of 100 patients of both sexes, aged 18-64 yr, of American Society of Anesthesiology physical status I or Ⅱ, scheduled for elective fiberoptic bronchoscopy were divided into 2 groups ( n=50 each) using a random number table method: mivacurium group (M group) and cisatracurium group (C group). Mivacurium 0.15 mg/kg was injected intravenously in group M, and cisatracurium 0.1 mg/kg was injected intravenously in group C. The onset time of neuromuscular block (ThD95), the duration of neuromuscular block (TOFR25), recovery index (RI), recovery time of autonomous respiration, extubation time and time of discharge from postanesthesia care unit (PACU) were recorded.The occurrence of intraoperative and postoperative adverse reactions and complications were recorded.The mean arterial pressure (MAP), heart rate (HR) and SpO 2 at restlessness at 10 min after entering the operating room (T 1), at loss of consciousness (T 2), when laryngeal mask airway was inserted (T 3), at the end of surgery (T 4), when laryngel mask airway was removed (T 5), and when the patients left the operating room (T 6). Results:Compared with group C, TOFR25, RI, recovery time of autonomous respiration, extubation time and time of discharge from PACU were significantly shortened, the total incidence of adverse reactions was decreased ( P<0.05), and no significant change was found in ThD95 in group M ( P>0.05). There was no significant difference in MAP, HR and SpO 2 at each time point between the 2 groups ( P>0.05). Conclusion:Mivacurium provides better efficacy than cisatracurium when used for painless fiberoptic bronchoscopy.