13) underwent non-cardiac surgery were divided into three groups depend on anesthesia choice. Epidural anesthesia (group E n=26), General anesthesia (group G n=19), Combinative anesthesia means epidural anesthesia plus general anesthesia(group C n=25).Three anesthesia manner were analysed to hemodynamic effects. Results Mean Glodman score: group C was 16?3.8, group G was 18?7.0 , group E was 17?3.3. Cases of using vasoactive drug in group E (69.23%) were more than group C (56%) and group G (47.36%.).Conclusions It is important for patients with severe cardiac disease to maintain organs oxygen supply during non-cardiac surgery. Steady hemodynamic might be gainned by using vasoactive drugs carefully.

Objective To investigate the effect of ketamine on learning and memory function of adult rats after injection of ketamine at early development stage. Methods Twelve rats born in a week were randomly divided into ketamine anesthesia group(Ket group)and normal saline control group(Ns group).Rats in Ket group were intraperitoneally injected with 50 mg/kg ketamine,and those in Ns group were administrated with same amount of normal saline.After eight weeks,Morris water maze test was adopted to explore the latency in place navigation and spatial probe ability.The sections of hippocampus were obtained,and immunohistochemical staining was employed to detect the expression of Bax and Bcl-2.Results In Morris water maze test,the latency in place navigation of Ket group Was significantly longer than that of Ns group(P<0.05),and the spatial probe ability significantly decreased(P<0.05).It Was revealed by immunohistochemical staining that the expression of Bax in Ket group was significantly higher than that in Ns group,while there was no significant difference in the expression of Bcl-2 between these two groups. Conclusion Application of ketamine in neonatal rats may result in learning and memory impairment in adulthood,and the underlying mechanism may correlate to the apoptosis of neuron in hippocampus region.

Hypertonic saline solutions have received more attention as effective agents for the treatment of brain damage. Studies indicated the beneficial action of hypertonic saline solutions in intracranial pressure, cerebral blood flow and neurologic outcome. This article reviews the available evidence on hypertonic saline solutions as they relate to traumatic brain injury.

Objective To investigate the effect and safety of administering magnesium sulphate as a technique of controlled hypotension during functional endoscopic sinus surgery. Methods Seventy-five patients arranged for selective functional endoscopic sinus surgery under general anesthesia, were randomly assigned into three groups: control group, magnesium sulphate group and nitroglycerin group(n=25). The patients of magnesium sulphate group received 10% magnesium sulphate 40 mg/kg before the induction of anaesthesia, and then 15 mg·kg~(-1)·h~(-1) by continuous infusion during the operation. The same volume of 5% glucose was administered to the patients in control group. Constant infusion of nitroglycerin beginning with 1 μg·kg~(-1)·min~(-1) was administered to the patients in nitroglycerin group. The hemodynamic indexes, amount of bleeding, fluid intake, operation time, recovery time, quality of surgery field, muscle relaxation and adverse reaction were recorded. Concentration of Mg~(2+) in magnesium sulphate group were compared before and after surgery.Results The patients in the magnesium sulphate group maintained balanced heart rates during the operation, while the heart rates of patients in control group and nitroglycerin group increased significantly (P<0.01). The patients of magnesium sulphate group had lower amount of bleeding and shorter operation time compared with control group (P<0.01). The quality of surgery field in magnesium sulphate group was significantly better than that in control group (P<0.01). Time for 75% recovery of myokymia and recovery index in magnesium sulphate group was higher than those in control group and nitroglycerin group(P<0.01). No adverse reaction was observed in all groups. Conclusion Magnesium sulphate can be effective and safe for controlled hypotension during functional endoscopic sinus surgery.

AIM: To explore the effect of intestinal flora disturbance on postoperative cognitive dysfunction in patients with inhalation anesthesia by using propensity score matching method. METHODS: Patients received inhalation anesthesia of patients between January 2018 and December 2021 in our hospital were included in the study. 91 cases of postoperative cognitive dysfunction patients as cognitive impairment group, 85 cases of postoperative cognitive dysfunction patients as control group. Propensity score matching method was used to compare the clinical data and bacterial DNA, which was extracted from the stool samples of the two groups before surgery. And 16S rRNA sequencing was performed to analyze the differences of intestinal flora between the two groups. RESULTS: A total of 20 pairs of patients were successfully matched between the two groups. There was no significant difference in age, gender and other general information between the two groups (P>0.05). PCoA analysis showed that although there was some overlap in the PCoA plot of stool samples from the two groups, the PCoA scatter plot showed significant differences between the two groups. LEfse multistage species difference discriminant analysis showed that at the genus level, the abundance of 6 bacteria genera was higher in the cognitive impairment group. The intestinal bacillus genus, MAO spirillum, thick wall bacteria door, clostridium, neisseria bacterium, neisseria bacteria genera abundance increased in the cognitive impairment group, majorly the klebsiella bacillus clostridium, platts bacteria and enterobacteriaceae, mesh, wool spirillum, addicted to bile bacteria genera, door deformation, clostridium, enterobacteriaceae bacteria enriched, etc. CONCLUSION: Cognitive dysfunction in patients with inhalation anesthesia is related to intestinal flora disorder, which is mainly manifested by the enrichment of Bacteria such as Leiborella and Prevotella.

Background and objective As computed tomography (CT) screening for lung cancer becomes more common in China, so too does detection of pulmonary ground-glass nodules (GGNs). Although anumber of national or international guidelines about pulmonary GGNs have been published,most of these guidelines are produced by respiratory, oncology or radiology physicians, who might not fully understand the progress of modern minimal invasive thoracic surgery, and these current guidelines may overlook or underestimate the value of thoracic surgery in the management of pulmonary GGNs. In addition, the management for pre-invasive adenocarcinoma is still controversial. Based onthe available literature and experience from Shanghai Pulmonary Hospital, we composed this consensus about diagnosis and treatment of pulmonary GGNs. For lesions which are considered as adenocarcinoma in situ, chest thin layer CT scan follow-up is recommended and resection can only be adopt in some specific cases and excision should not exceed single segment resection. For lesions which are considered as minimal invasive adenocarcinoma, limited pulmonary resection or lobectomy is recommended. For lesions which are considered as early stage invasive adenocarcinoma, pulmonary resection is recommend and optimal surgical methods depend on whether ground glass component exist, location, volume and number of the lesions and physical status of patients. Principle of management of multiple pulmonary nodules is that primary lesions should be handled with priority, with secondary lesions taking into account.
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Adenocarcinoma ; diagnosis ; diagnostic imaging ; surgery ; Adenocarcinoma of Lung ; China ; Consensus ; Hospitals ; Humans ; Lung Neoplasms ; diagnosis ; diagnostic imaging ; surgery ; Physicians ; psychology ; Positron Emission Tomography Computed Tomography ; Practice Guidelines as Topic ; Retrospective Studies ; Solitary Pulmonary Nodule ; diagnosis ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed