Objective To explore the effect of lidocaine combined with ropivacaine in penile dorsal nerve block for pediatric circumcision.Methods 130 children with pediatric circumcision surgery were divided into observation group and control group by the digital meter method,65 cases in each group.The control group was taken inhaled sevoflurane composite static note ketamine surgery,the observation group was given ropivacaine combined with intravenous infusion of ketamine for penile dorsal nerve block anesthesia.The anesthesia effects of the two groups were recorded.Results In the observation group,10 min after surgery,the rhythm of the heart was (98.47±10.88)times/min,central arterial pressure was (65.13±7.78)mmHg.In the control group,10min after surgery,the rhythm of the heart was (121.78±15.23)times/min,central arterial pressure was (85.27±12.31)mmHg,the differences between the two groups were statistically significant(t=10.040,11.150,all P＜0.05).In the observation group,the used ketamine,waking up time,pain score,incidence rate of pain and irritability were (41.38±11.28)mg,(5.54 ±1.03)min,(2.11±1.13)points,7.69％,respectively,which in the control group were (71.47±16.82)mg,(13.67±2.57)min,(3.89±1.79)points,26.15％,respectively,the differences between the two groups were statistically significant(t=11.978,23.673,6.779,χ2=7.878,all P＜0.05).Conclusion The anesthesia effect of lidocaine combined with ropivacaine in penile dorsal nerve block for pediatric circumcision is stable,safe and reliable,it is worthy of popularization and application in clinic.

Objective: To understand the level and trend of health literacy among residents in Zhoushan City, Zhejiang Province from 2015 to 2023, so as to provide the reference for developing promotion strategies and interventions of health literacy. Methods: Permanent residents aged 15 to 69 years in Zhoushan City were selected as the survey subjects using a multi-stage stratified random sampling combined with population-size proportional sampling method. The residents' health literacy was investigated using the Questionnaire on the Health Literacy among Chinese Residents, and standardized by Zhoushan City population data captured from the national population census in China. The absolute increase and growth rate of health literacy level from 2015 to 2023 were calculated to investigate the changing trends in health literacy levels. Results: A total of 19 296 residents were monitored from 2015 to 2023, including 8 006 men (41.49%) and 11 290 women (58.51%), and had a mean age of (50.06±12.67) years. The health literacy levels among residents in Zhoushan City from 2015 to 2023 were 13.10%, 18.33%, 20.35%, 23.71%, 27.58%, 30.75%, 34.36%, 37.03% and 39.47%, respectively, showing an upward trend (P<0.05), with an average annual growth rate of 2.93%. The 9-year absolute increase rates of 26.37%, and the growth rate reached 201.30%. The health literacy levels of basic knowledge and concept, healthy lifestyle and behaviors and basic skills all appeared increasing trends (all P<0.05), and the 9-year absolute increase and growth rate of the basic skills were the smallest (7.64% and 34.60%). The health literacy levels of six categories of health issues all showed upward trends (all P<0.05). The health literacy levels of residents in different regions and genders showed upward trends (both P<0.05). Except for the age of 65 to 69 years, the health literacy levels among all the other age groups showed upward trends (all P<0.05). There was no significant changing trend in the health literacy level among illiterate/semi-literate residents (P>0.05), the health literacy level among residents with primary school education showed a downward trend (P<0.05), while the health literacy levels of residents with other educational levels all showed upward trends (all P<0.05). There was no significant changing trend in the health literacy level among farmers (P>0.05), while the health literacy levels among residents with other occupations showed upward trends (all P<0.05). Conclusions The health literacy level among residents in Zhoushan City steadily increased from 2015 to 2023. Health education and promotion efforts have been targeted at key populations of the elderly aged over 65 years, residents with a primary school education or below and farmers.

Objective:To compare the perioperative outcomes between robotic pancreaticoduodenectomy(RPD)and laparoscopic pancreaticoduode-nectomy(LPD)in patients aged ≥65 years. Methods:The clinical data of 130 patients aged ≥65 years who received minimally invasive pancreaticoduodenectomy(MIPD)at Department of Gastrointestinal and Pancreatic Surgery,Zhejiang Provincial People's Hospital from January 2019 to December 2022 were retrospectively analyzed.The patients were divided into the RPD group(n=66)and the LPD group(n=64)according to the operation method,and the perioperative clinical data were compared between the 2 groups. Results:Compared with the LPD group,the average age of patients in the RPD group was higher than that of the LPD group[(71.95±4.73)years vs(70.39±3.9)years,P＜0.05];the RPD group had more patients with diabetes(39.4％vs 18.8％,P＜0.05)and cardiopulmonary diseases(37.9％vs 17.2％,P＜0.05);the RPD group had shorter operation time[(272.91± 68.38)min vs(362.81±78.24)min,P＜0.05]and less intraoperative blood loss[median(range):1 00 mL(50-200 mL)vs 1 50 mL(1 00-200 mL),P＜0.05)];the RPD group had higher incidence of chylous fistula(1 2.1％vs 1.6％,P＜0.05)but lower incidence of surgical morbidity(37.9％vs 46.9％),serious complications(19.7％vs 34.4％),postoperative pancreatic fistula(12.1％vs 17.2％),biliary fistula(3.0％vs 3.1％),abdominal infection(10.6％vs 14.1％),postoperative bleeding(4.5％vs 4.5％),and postoperative cardiopulmonary complications(1 2.1％vs 20.3％)with no statistically significant difference(P＞0.05);the RPD group waited shorter time before restarting diet[(3.97±1.59)d vs(5.34±2.56)d,P＜0.05]. Conclusion:MIPD is safe and feasible in patients aged ≥65 years.The incidence of perioperative complications is similar between the 2 groups.Compared with LPD,RPD has shorter operation time,less intraoperative blood loss,and shorter duration before restarting diet after operation,which has certain clinical advantages.