Objective To compare the effect of target controlled infusion (TCI) and man controlled infusion (MCI) of propofol in pain-free endoscopic ultrasonography.Methods Sixty patients undergoing pain-free endoscopic ultrasonography were divided into TCI group and MCI group by random digits table method,each group 30 patients.Operation time,dose of propofol,time to loss consciousness and recovery time were recorded.The level of mean artery pressure (MAP) and heart rate (HR) were recorded before induction (T0),before operation (T1),5 min afteroperafion (T2) and 5 min afterawake (T3).Cases with bucking,aspiration,laryngeal spasm,pulse oxygen saturation (SpO2) lower than 0.90,MAP lower than 50 mmHg (1 mmHg =0.133 kPa) and HR lower than 50 bpm were recorded.Results Dose of propofol was higher in MCI group than that in TCI group,time to loss consciousness was shorter in MCI group than that in TCI group,recovery time was shorter in TCI group than that in MCI group,there was significant difference (P ＜ 0.01).The level of MAP and HR on T1 were significantly lower than those on T0 between two groups (P ＜ 0.05).The level of MAP and HR on T1 in TCI group were signifcantly higher than those in MCI group (P ＜ 0.05).The rate of bucking between two groups had no significant difference (x2 =0.37,P ＞ 0.05).The rate of anoxemia in TCI group was 10.0％ (3/30),in MCI group was 66.7％ (20/30),there was significant difference (x2 =20.38,P ＜ 0.01).The rate ofMAP lower than 50 mmHg in TCI group was 6.7％ (2/30),in MCI group was 30.0％ (9/30),there was significant difference (x2 =5.46,P ＜ 0.05).The rate of HR lower than 50 bpm between two groups had no significant difference (x2 =3.35,P ＞ 0.05).Conclusion Compared with MCI,patients induced by TCI mode are more stable in blood pressure,and more safe.

Objective To evaluate the effects of penehyclidine hydroehloride as an atropine alternative on angioearpy and glandular secretions when premedieated in ketamine complex total intravenous anesthesia(TIVA)in children.Methods Forty patients aged 3-10 years undergoing ketamine and propofol complex TIVA were randomly divided into two groups.Penehyclidine hydrochloride(group P,n=20)or atropine(group A,n=20)was premedicated intramuscularly 30 min before anesthesia.Heart rate(HR),mean arterial pressure(MAP),breath rate(R)and the amount of saliva secretion(SS)were recorded before premedication(0 min),10 min,20 min,30 min,60 min and 150 min after.Results (1)SS reduced significantly 20 min,30 min and 60 min after premedication in both groups(P＜0.01),and in 150 min,it was still in a significantly reduced level in group P(P＜0.01),which was significantly lower than that in group A(P＜0.01).(2)MAP,HR and R in group P showed no significant differences before and after premedication(P＞0.05).But in group A,HR increased significantly at 20 min,30 min and 60 min after premedication(P＜0.05 or＜0.01),MAP increased significantly at 30 min and 60 min after premedication(P＜0.01),and meanwhile of them were also significantly higher than those in group P(P＜0.05 or＜0.01).Conclusions Penehychdine hydrochloride can effectively reduce respiratory glandular secretion with longer persistence,and nearly has no influence on HR and blood pressure,which suggests it could be a superior to atropine alternative as an anesthesia premedication in children.

Mechanical ventilation with lung protective ventilation strategy not only results in decreased mortality and reduced postoperative pulmonary complications in patients with acute lung injury/acute respiratory disease syndrome,but also is beneficial to healthy patients.Factors influencing the prognosis of lung protective ventilation strategy is detailed in this article.

Objective    To investigate the effect of pulmonary ultrasound on pulmonary complications in ultra-fast-track anesthesia for congenital heart disease surgery. Methods    In 2019, 60 patients with congenital heart diseases underwent ultra-fast-track anesthesia in Shenzhen Children's Hospital, including 34 males and 26 females with the age ranging from 1 month to 6 years. They were randomly divided into a normal group (group N, n=30) and a lung ultrasound optimization group (group L, n=30). Both groups were used the same anesthesia method and anesthetic compatibility. The group N was anesthetized by ultra-fast-track, the tracheal tube was removed after operation and then the patients were sent to the cardiac intensive care unit (CCU). After operation in the group L, according to the contrast of pre- and post-operational lung ultrasonic examination results, for the patients with fusion of B line, atelectasis and pulmonary bronchus inflating sign which caused the increase of lung ultrasound score (LUS), targeted optimization treatment was performed, including sputum suction in the tracheal tube, bronchoscopy alveolar lavage, manual lung inflation suction, ultrasound-guided lung recruitment and other optimization treatments, and then the patients were extubated after lung ultrasound assessment and sent to CCU. The occurrence of pulmonary complications, LUS, oxygenation index (OI), extubation time, etc were compared between the two groups. Results    Compared with the induction of anesthesia and 1 hour after extubation of the two groups, the incidence of pulmonary complications in the group L (18 patients, 60.0%) was lower than that in the group N (26 patients, 86.7%, χ2= 4.17, P=0.040) and the rate of patients with LUS score reduction was higher in the group L (15 patients, 50.0%) than that in the group N (7 patients, 23.3%, χ2=4.59, P=0.032). The correlation analysis between the LUS and OI value of all patients at each time point showed a good negative correlation (P<0.05). Extubation time in the group L was longer than that in the group N (18.70±5.42 min vs. 13.47±4.73 min, P=0.001). Conclusion    Ultra-fast-track anesthesia for congenital heart disease can be optimized by pulmonary ultrasound examination before extubation, which can significantly reduce postoperative pulmonary complications, improve postoperative lung imaging performance, and help patients recover after surgery, and has clinical application value.

【Objective】 To compare the ability of body mass index （BMI）， body fat percentage （BFP）， waist circumference （WC）， waist-to-height ratio （WHtR）， visceral fat index （VFI） and the combinations of two kinds of obesity indices to predict the risk of hypertension. 【Methods】 Data collected in the baseline survey of “Gansu Province’s Urban and Rural Natural Population Cohort Establishment and Tumor Follow-up Study” were analyzed. Area under the curve （AUC） of ROC curve with covariates was used to analyze and compare the effects of individual obesity evaluation index and the combination of two kinds of obesity indices in predicting the risk of hypertension. 【Results】 Analyses of data of 20，079 adults showed that the AUC of BMI， WC， WHtR， BFP and VFI was 0.636， 0.604， 0.615， 0.614 and 0.619， respectively. AUC of the combination of BMI and WC （0.643） was higher than that of BMI （0.636）； however， the change rate of AUC was only 1.09%. AUC of the combinations of WC， WHtR and VFI， the three central obesity evaluation indices， and BFP， a general obesity evaluation index， were lower than that of BMI. The optimal cutoff value for BMI was 24.2 kg/m². 【Conclusion】 The effect of BMI in predicting the risk of hypertension is better than that of BFP， WC， WHtR and VFI. The effects of the combinations of the two kinds of obesity evaluation indices are not better than that of BMI. To prevent and control hypertension， adults should keep their BMI under overweight.

【Objective】 To estimate the prevalence, associated factors and patterns of multimorbidity of non-communicable diseases among adults in Shaanxi Province so as to provide evidence for the prevention and control of non-communicable diseases. 【Methods】 We used the data of adults aged 18 years and older collected in the baseline survey of Shaanxi Project in the Regional Ethnic Cohort Study in Northwest China. Multinomial logistic regression was used to explore the associated factors for multimorbidity. Exploratory factor analysis was used to extract patterns of multimorbidity. 【Results】 The prevalence of multimorbidity was 10.7% among the 44 442 participants. Age increase, being males, urban residence, and being overweight or obesity were positively associated with multimorbidity. Compared with women, men had a higher risk of multimorbidity. The OR and 95% CI was 1.25 (1.12-1.39). The risk of multimorbidity increased with age among adults. Compared with participants aged 18.0-34.9 years, the ORs and 95% CIs of those aged 35.0-44.9, 45.0-54.9, 55.0-64.9, and ≥65.0 years were 4.73 (3.47-6.46), 15.61 (11.60-21.00), 41.39 (30.76-55.70) and 90.04 (66.58-121.77), respectively. The primary multimorbidity patterns among adults in Shaanxi were cardiovascular-metabolic multimorbidity (5.4%), viscero-articular multimorbidity (1.0%), and respiratory multimorbidity (0.3%). 【Conclusion】 More than one in ten adults in Shaanxi Province had multimorbidity, and the predominant pattern of multimorbidity was cardiovascular-metabolic multimorbidity. The prevention and control of non-communicable diseases should be reinforced in middle-aged and older people, males, people living in the urban, and overweight or obese people. More attention should be paid to the prevention and control of cardiovascular-metabolic diseases.

【Objective】 To evaluate the dietary quality with the dietary balance index (DBI_16) and the association between dietary quality and bone mass among middle-aged and elderly people in Gansu Province so as to provide evidence for improving dietary quality and bone health status of Gansu population. 【Methods】 Based on the information of the type and quantity of food intake and the bone mass of middle-aged and elderly people aged 35 years and above collected by the Gansu Project in the Regional Ethnic Cohort Study in Northwest China, DBI_16 was used to evaluate the intake level of cereals, vegetables, fruits, milk, beans, fish and shrimp, eggs and other foods, and the degree of inadequate, excessive and unbalanced dietary intake of the participants. Multiple linear regression was used to evaluate the associations of three component indexes of DBI_16, high bound score (DBI_HBS), low bound score (DBI_LBS), diet quality distance (DBI_DQD), and seven single indexes of DBI_16 with bone mass. 【Results】 Analyses of the dietary and bone mass data of 11,840 participants showed that 44.8% of participants consumed excessive amounts of cereals compared to the dietary recommendation. 96.3%, 90.6%, 90.1%, 71.9%, 95.1% and 60.3% of participants’ intake of vegetables, fruits, milk, soybeans, fish and shrimp, and eggs, respectively, were inadequate. 47.7% participants consumed less than 10 types of food. 2.3% participants’ DBI_LBS levels were appropriate. 54.7% participants’ DBI_HBS levels were appropriate. Only 1.2% participants’ DBI_DQD reached a balanced level. The bone mass level in the study population was (2.5±0.6) kg [(2.8±0.5) kg for men and (2.3±0.5) kg for women]. After adjusting for sociodemographic characteristics, lifestyle, total dietary energy intake and body mass index, DBI_LBS and DBI_DQD were negatively associated with bone mass [β and 95% CI was -0.002 01 (-0.003 62--0.000 40) and -0.001 76 (-0.003 09--0.000 43), respectively]. 【Conclusion】 Dietary intake imbalance is common among middle-aged and elderly people in Gansu Province, and the more severe the dietary intake imbalance, the lower the bone mass level.