Objective To compare anesthetic effect and safety of general anesthesia and combined spinal and epidural anesthesia used in autonomic nervous hyperresponsive surgery for patients with paraplegia.Methods 26 paraplegic patients were randomly divided into two groups-control group and treatment group from February 2011 to November,2015,each with 13 cases.The control group used general anesthesia,while the treatment group used combined spinal and epidural anesthesia,to observe onset time,duration,intraoperative hemodynamic changes and complications,Complications,length of stay and cost,Days and costs of hospitalization,satisfaction of patients and their families,of anesthesia in two groups.Results The dosage of narcotics and the onset time of the treatment group were better than that of the control group.The difference between the two groups was significant,and had statistical significance (P＜0.05) Two groups of patients after surgery,diastolic blood pressure,systolic blood pressure and heart rate were lower in the treatment group than in the control group,and had statistically significant difference (P＜0.05);The postoperative complications of the treatment group were significantly better than those of the control group,and had statistically significant difference (P＜0.05);There were statistically significant differences in postoperative pain degree between the two groups (P＜0.05);Two groups of patients in hospital days,hospital costs,satisfaction rate had statistically significant difference,Have statistical significance (P＜0.05).Conclusion In autonomic nervous hyperresponsive surgery for patients with paraplegia,anesthetic effect and safety of combined spinal and epidural anesthesia is significantly better than that of general anesthesia,featured by the rapid onset of action,long duration,fewer complications,strong safety and patients' great satisfaction.It is worth generalizing and applying clinically.

Objective To evaluate the quality of postoperative recovery of patients undergoing cardiac great vessels surgery by 15-item Recovery Quality Score Scale(QoR-15),to retrospectively analyze the influence of perioperative multi-factors on postoperative recovery quality,and to establish the predictive model.Methods Clinical data of patients who underwent cardiac great vascularsur-gery from March 2020 to September 2022 were collected through electronic medical record system and the postoperative QoR-15 score were evaluated.The data including gender,age,postoperative follow-up time,American Society of Anesthesiologists(ASA)classification,preoperative lactate level,co-morbidities,emergency or not,extracorporeal circulation or not,etc.were collected.The modified frailty index(mFI)was also calculated.Surgical patterns,operation time,extracorporeal circulation time,aortic block time,type of heart recurrence,perioperative fluid therapy,extracorporeal circulation temperature,and other postoperative data as well as postoperative data including ICU retention time after surgery,total length of stay and QoR-15 score were recorded.The univariate and multivariate Logistic regression analysis were then applied to construct a prediction model,and its accuracy was validated.Results A total of 213 patients were included,in which 15 patients were excluded,and 198 postoperative QoR-15 score sheets were received.Gender,ASA classification,preoperative lac-tate level,postoperative follow-up time,and mFI were significant influencing factors on the quality of rehabilitation of patients undergoing cardiac or great vascular surgery.The prediction model of ln(p/1-p)=-5.571+0.862 × gender+3.844 × ASA classification+3.143 × preoperative lactate level+2.001 × postoperative follow-up time+3.712 × mFI,which had good predictive and classifi-cation effects.Conclusion Gender,ASA classification,preoperative lactate level,postoperative follow-up time and mFI are influencing factors on the recovery quality of patients after cardiac great vascular surgery.

Objective To evaluate the quality of postoperative recovery of patients undergoing cardiac great vessels surgery by 15-item Recovery Quality Score Scale(QoR-15),to retrospectively analyze the influence of perioperative multi-factors on postoperative recovery quality,and to establish the predictive model.Methods Clinical data of patients who underwent cardiac great vascularsur-gery from March 2020 to September 2022 were collected through electronic medical record system and the postoperative QoR-15 score were evaluated.The data including gender,age,postoperative follow-up time,American Society of Anesthesiologists(ASA)classification,preoperative lactate level,co-morbidities,emergency or not,extracorporeal circulation or not,etc.were collected.The modified frailty index(mFI)was also calculated.Surgical patterns,operation time,extracorporeal circulation time,aortic block time,type of heart recurrence,perioperative fluid therapy,extracorporeal circulation temperature,and other postoperative data as well as postoperative data including ICU retention time after surgery,total length of stay and QoR-15 score were recorded.The univariate and multivariate Logistic regression analysis were then applied to construct a prediction model,and its accuracy was validated.Results A total of 213 patients were included,in which 15 patients were excluded,and 198 postoperative QoR-15 score sheets were received.Gender,ASA classification,preoperative lac-tate level,postoperative follow-up time,and mFI were significant influencing factors on the quality of rehabilitation of patients undergoing cardiac or great vascular surgery.The prediction model of ln(p/1-p)=-5.571+0.862 × gender+3.844 × ASA classification+3.143 × preoperative lactate level+2.001 × postoperative follow-up time+3.712 × mFI,which had good predictive and classifi-cation effects.Conclusion Gender,ASA classification,preoperative lactate level,postoperative follow-up time and mFI are influencing factors on the recovery quality of patients after cardiac great vascular surgery.

ObjectiveTo explore the antidepressant effect of Sophora flavescens seed extract and its molecular mechanism. MethodA mouse depression model was established by intraperitoneal injection of lipopolysaccharide（LPS）， and normal group， model group， fluoxetine group（2.5 mg·kg^-1）， and S. flavescens seed low， medium and high dose groups（200， 400， 800 mg·kg^-1） were set up for 7 d of consecutive gavage. Then the antidepressant effect of S. flavescens seed extract was evaluated by using open field test， elevated plus maze test and forced swimming test. Pathological morphological changes in the hippocampal tissue was observed by hematoxylin-eosin（HE） staining. Protein expression levels of G₁/S-specific cyclin D₁（Cyclin D₁）， Wnt1， β-catenin and phosphorylated glycogen synthase kinase-3β（p-GSK-3β） in mouse brain tissues were detected by Western blot. Hippocampal cell apoptosis was detected by terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate（dUTP） nick end labeling（TUNEL）. ResultThe results of mouse behavioral experiments showed that compared with the normal group， the speed of movement in the open field and the distance of movement in the central area of the open field， and the time spent on the open arms of the elevated plus maze were significantly reduced in the model group（P<0.01）， while immobility time in the forced swimming test was significantly increased（P<0.05）. Compared with the model group， the S. flavescens seed medium and high dose groups had increased speed of movement in the open field test and time spent on the open arms of the elevated plus maze test（P<0.05， P<0.01）， and decreased immobility time in the forced swimming test（P<0.05）， the distance of movement in the central area of the open field test increased in the high dose group（P<0.05）. HE staining results showed that compared with the normal group， the hippocampal neuron structure of mice in the model group was damaged. Compared with the model group， after treatment of S. flavescens seed extract， the pathological state of the mouse hippocampal neuron structure was alleviated， and the neurons increased， were neatly arranged， and the cytoplasm was clear. Western blot results showed that the protein expression levels of Wnt1 and β-catenin in mouse brain tissue were significantly decreased（P<0.01）， while the protein expression levels of Cyclin D₁ and p-GSK-3β were significantly increased（P<0.01） after LPS injection. Compared with the model group， protein expression levels of Wnt1 and β-catenin in brain tissue of S. flavescens seed medium and high dose groups were significantly increased（P<0.01）， while the protein expression levels of Cyclin D₁ and p-GSK-3β were significantly decreased（P<0.01）. TUNEL staining results showed that the hippocampal cell apoptosis rate in the model group was significantly increased compared with that of the normal group（P<0.01）， while the hippocampal cell apoptosis rate in the S. flavescens seed medium and high dose groups was significantly decreased compared with that of the model group（P<0.01）. ConclusionS. flavescens seed extract can effectively improve the severity of depression in LPS-induced depressed mice， and its molecular mechanism is related to the regulation of neuroinflammation and hippocampal neuronal apoptosis mediated by Wnt/β-catenin signaling pathway.