Objective To explore the value of serum ischemia modified albumin (IMA) level in assessment of disease severity for patients with chronic obstructive pulmonary disease (COPD).Methods A total of 81 cases of patients with COPD treated in our hospital from September 2015 to March 2016 were selected (COPD group),including 51 cases of patients with acute exacerbation of COPD and 30 cases of patients with stable of COPD.Meanwhile,30 volunteers without COPD were collected as control group.Serum levels of IMA were detected and compared among different groups.Correlations between serum level of IMA and serum level of myoglobin (MYO),troponin T (TNT) and C reactive protein (CRP),and white blood cell (WBC) count were analyzed respectively.A receiver operating characteristic (ROC) curve was also plotted to investigate the diagnostic value of serum IMA level for diagnosing COPD.Results Serum level of IMA in the COPD group was higher than that in the control group [84.1 (79.1,88.5) U/L vs.73.1 (70.2,75.1)U/L],serum level of IMA in patients with acute exacerbation of COPD was higher than that of patients with stable of COPD [85.5 (82.3,89.4)U/L vs.78.1 (75.9,83.0)U/L],serum levels of IMA in patients with acute exacerbation and stable of COPD both were higher than that in the control group,there were statistically significant differences (P＜0.05).The serum level of IMA was positively related with serum level of MYO in patients with COPD (r=0.554,P =0.00).ROC curve indicated when the cutoff value was set as 76.55 U/L,the sensitivity and specificity of serum level of IMA for diagnosing COPD was 88.5％ and 80.0％ respectively,and area under the ROC curve was 0.88.Conclusion Serum level of IMA could be a valuable indicator for clinically assessing disease severity of patients with COPD,which deserves further study through expanding samples size.

Objective To compare the sedative and analgesic effects of remifentanil combined with propofol administered by target-controlled infusion(TCI)and intravenous infusion during local anesthesia.Methods Sixty ASA Ⅰ or Ⅱ patients,aged 18-55 yr,with body mass index ＜ 30 kg/m2,scheduled for plastic surgery under local anesthesia,were equally and randomly divided into TCI group(group T)and intravenous infusion group (group V).Remifentanil(the initial target plasma concentration 1.0 ng/ml)and propofol(the initial target plasma concentration 1.0 ng/ml)were given by TCI before local anesthesia in group T.Remifentanil was infused at a rate of 0.05 μg·kg-1 ·min-1 after a loading dose of 0.25 μg/kg and propofol was infused at a rate of 3 mg·kg-1 ·h-1 after a loading dose of 0.5 mg/kg in group V.The target plasma concentration or infusion rate was adjusted to maintain the modified OAA/S score of 2 or 3.Hypoxemia,bradypnea and/or apnea were recorded during operation.The total amount of remifentanil and propofol consumed was calculated.Results Compared with group V,the incidence of hypoxemia,bradypnea and/or apnea were significantly decreased during operation,and the total amount of remifentanil and propofol consumed was significantly reduced in group T(P ＜ 0.05).Conclusion The sedative and analgesic effects of remifentanil combined with propofol given by TCI are superior to those given by intravenous infusion during local anesthesia,with better safety.

Quintessential course is a kind of demonstration course,therefore,various colleges paid great attention to the construction and utilization of quintessential courses.In order to promote educational reform,improve teaching quality of medicine and reflect the value of quintessential courses,we should adopt a variety of measures to ensure the smooth undergoing of the whole process in teaching and research section of neurology including information resource sharing,video recording of class teaching,network platform constructing,teaching team constructing as well as individuation and diversification.

Objective To compare remifentanil?propofol target?controlled infusion ( TCI ) with sufentanil?propofol TCI for sedation and analgesia in the patients undergoing local anesthesia. Methods Sixty patients, aged 17?54 yr, with body mass index <30 kg∕m2, scheduled for elective plastic surgery underlocal anesthesia, were equally and randomly divided into remifentanil group (group R) and sufentanil group(group S) by using a random number table. Remifentanil (the initial target plasma concentration 1?? 0ng∕ml) and propofol (the initial target plasma concentration 1?? 0 μg∕ml) were given by TCI in group R.Sufentanil (the initial target plasma concentration 0?? 10 ng∕ml) and propofol (the initial target plasma con?centration 1?? 0 μg∕ml) were given by TCI in group S. The target plasma concentration was adjusted to main?tain the modified Observer′s Assessment of Alertness∕Sedation Scale score of 2 or 3. The occurrence of painresponses, hypoxemia, bradypnea and∕or apnea was recorded during operation. The total amount of propofolconsumed was calculated. Results There was no significant difference in the incidence of pain response,hypoxemia, bradypnea and∕or apnea, and total amount of propofol consumed between the two groups (P >0?? 05). Conclusion Remifentanil?propofol TCI provides similar sedative and analgesic efficacy to that a?chieved by sufentanil?propofol TCI in the patients undergoing local anesthesia.

Objective To evaluate and compare the efficacy and safety of sedative and analgesic anesthesia in surgical patients with supine and prone position .Methods Sixty female patients, American Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged from 18 -53 years, scheduled for elective plastic operations under sedative and analgesic anesthesia combined with local anesthesia were divided into two groups according to their surgical positions: supine group ( n=30 ) and prone group ( n=30 ) .All patients received Ⅳ dexmedetomidine ( DEX) 1 μg/kg over 15 min followed by 0.4 -0.7 μg/kg/h infusion. Both groups were administered Ⅳ midazolam 0.04 mg/kg and a continuous infusion of remifentanil of 0.1 μg/kg/min at the beginning of anesthesia .Heart rate ( HR) , mean arterial pressure (MAP), pulse oximetry (SpO2), respiratory rate (RR), bispectral index (BIS) and Ramsay sedation scores ( RSS) were recorded at the following time points: before anesthesia ( T0 ) , 5 min after induction with midazolam ( T1 ) , 10 min after induction of midazolam ( T2 ) , immediately after induction with DEX( T3 ) , the beginning of local anesthesia ( T4 ) , the beginning of surgery ( T5 ) , 30 min after anesthesia induction ( T6 ) , 60 min after anesthesia induction ( T7 ) , immediately after turning off DEX infusion (T8), the end of surgery (T9).Incidences of respiratory depression, incidences of apnea, oxygen supplementation by facial mask and jaw-thrust, frequencies of body movements and additional rescue medication were also recorded .After surgery , recall of events during surgery , the visual analogue scales (VAS) for pain in PACU, the satisfaction levels of patients and surgeons were also assessed .Results No significant differences were found in MAP , SpO2 , RR, BIS, RSS scores at any time point between two groups (all P >0.05).There were no significant differences in incidences of respiratory depression , frequencies of body movements and additional rescue medication during surgery between groups ( all P>0. 05).Neither were recall of events during surgery , the visual analogue scales (VAS) for pain and the satisfaction levels of patients and surgeons after surgery (all P>0.05).The HR at time points of T0, T1, T2 in prone group were significantly higher than those in supine group (all P<0.05).Compared with the supine group , the incidences of apnea , oxygen supplementation by facial mask and jaw-thrust in prone group were significantly lower .Conclusions Sedative and analgesic anesthesia is effective and safe for patients with prone surgical position and has a lower incidence of upper airway obstruction during surgery than patients in supine surgical position .

Objective To evaluate and compare the efficacy and safety of sedative and analgesic anesthesia in surgical patients with supine and prone position .Methods Sixty female patients, American Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged from 18 -53 years, scheduled for elective plastic operations under sedative and analgesic anesthesia combined with local anesthesia were divided into two groups according to their surgical positions: supine group ( n=30 ) and prone group ( n=30 ) .All patients received Ⅳ dexmedetomidine ( DEX) 1 μg/kg over 15 min followed by 0.4 -0.7 μg/kg/h infusion. Both groups were administered Ⅳ midazolam 0.04 mg/kg and a continuous infusion of remifentanil of 0.1 μg/kg/min at the beginning of anesthesia .Heart rate ( HR) , mean arterial pressure (MAP), pulse oximetry (SpO2), respiratory rate (RR), bispectral index (BIS) and Ramsay sedation scores ( RSS) were recorded at the following time points: before anesthesia ( T0 ) , 5 min after induction with midazolam ( T1 ) , 10 min after induction of midazolam ( T2 ) , immediately after induction with DEX( T3 ) , the beginning of local anesthesia ( T4 ) , the beginning of surgery ( T5 ) , 30 min after anesthesia induction ( T6 ) , 60 min after anesthesia induction ( T7 ) , immediately after turning off DEX infusion (T8), the end of surgery (T9).Incidences of respiratory depression, incidences of apnea, oxygen supplementation by facial mask and jaw-thrust, frequencies of body movements and additional rescue medication were also recorded .After surgery , recall of events during surgery , the visual analogue scales (VAS) for pain in PACU, the satisfaction levels of patients and surgeons were also assessed .Results No significant differences were found in MAP , SpO2 , RR, BIS, RSS scores at any time point between two groups (all P >0.05).There were no significant differences in incidences of respiratory depression , frequencies of body movements and additional rescue medication during surgery between groups ( all P>0. 05).Neither were recall of events during surgery , the visual analogue scales (VAS) for pain and the satisfaction levels of patients and surgeons after surgery (all P>0.05).The HR at time points of T0, T1, T2 in prone group were significantly higher than those in supine group (all P<0.05).Compared with the supine group , the incidences of apnea , oxygen supplementation by facial mask and jaw-thrust in prone group were significantly lower .Conclusions Sedative and analgesic anesthesia is effective and safe for patients with prone surgical position and has a lower incidence of upper airway obstruction during surgery than patients in supine surgical position .

Abstract OBJECTIVE To analyze and summarize the research history, development status, trends and hotspots of Codonopsis Radix by bibliometrics. METHODS Search and screen the related literatures of Codonopsis Radix from the CNKI database and the Web of Science core collection database from Januar 1, 1992 to June 30, 2022. VOSviewer and CiteSpace softwares were used for visual analysis of the number of publications, authors, institutions, countries, funding funds, published journals, literature citation frequency, keywords, clustering and emergent word, and a visual graph was drew. RESULTS A total of 594 effective literature, 484 in Chinese and 110 in English were included. GAO Jianping and ZOU Yuanfeng were the scholars with the largest amount of Chinese and English literature. China was the country with the most published researches on Codonopsis Radix. The School of Pharmaceutical Science of Shanxi Medical University and the Chinese Academy of Sciences were the institutions with the largest number of Chinese and English literature publications respectively. The National Science Foundation of China was the largest fund to support the research of Codonopsis Radix. The journal that received the most Chinese and English literature were Journal of Chinese Medicinal Materials and International Journal of Biological Macromolecules respectively. The most frequently cited Chinese literature was a summary of the chemical constituents and pharmacological effects of Codonopsis Radix. The most frequently cited English literature was a study on the structure identification and pharmacological effects of Codonopsis Radix polysaccharides. The map of key words, clustering and emergent words in Chinese literature showed that the main research directions of Codonopsis Radix were compatibility formula, resource planting, pharmacological action and quality control. The map of key words, clustering and emergent words in English literature indicated that the study of Codonopsis Radix always focused on the material basis and mechanism of its active ingredients. CONCLUSION The annual publications on of Codonopsis Radix show an increasing trend, and the main research institutions are distributed in many universities and research institutes in China. Both Chinese and English literature have their own research directions, and the pharmacological effects of active ingredients are the common trend hotspots.