Objective To observe the effect of ketamine preemptive analgesia on postoperative pain and recovery in laparoscopic cholecystectomy(LC). Methods Eighty LC patients under general anesthesia with propofol and remifentany were randomly divided into two groups of PR and PRK with 40 cases each. The patients in group PRK were given additional low-dose ketamine 0.3 mg/kg before skin incision. Recovery from anesthesia was evaluated at 30 min, 1 h and 12 h after surgery by SS and VRS scoring. Results There were no significant differences in the time for regaining spontaneous breathing,opening eyes and extubation between the two groups. But recovery of anesthesia was with less restlessness and VRS pain scores, better sedation in group PRK than those in group PR (P< 0.05). Conclusion Preemptive intravenous analgesia with low-dose ketamine has the advantage of quicker recovery from anesthesia with less incidence of restlessness and pain in LC patients.

Objective To evaluate the efficacy of puerarin for prevention of brain injury in the patients undergoing open heart surgery under cardiopulmonary bypass (CPB).Methods Thirty ASA physical status Ⅲ patients of both sexes,aged 50-64 yr,weighing 50-75 kg,scheduled for elective cardiac valve replacement under general anesthesia,were randomly divided into 2 groups (n =15 each) using a random number table:control group(group C) and puerarin group (group P).Puerarin 400 mg was infused intravenously over 30 min immediately at skin incision in group P and the equal volume of 5％ glucose-sodium chloride injection was given in group C.Before induction of anesthesia (T0),at 30 min of CPB (T1),immediately after aortic unclamping (T2),and at 6,12 and 24 h after termination of CPB (T3.5),blood samples were collected from the jugular venous bulb for determination of the plasma concentration of neuron-specific enolase (NSE) and S-100 β protein.P300 eventrelated potential latency and amplitude were determined and cognitive function was assessed by Mini-Mental State Examination (MMSE) score at 1 day before surgery and 7 days after surgery.The patients were diagnosed as having post-operative cognitive dysfunction when MMSE score before surgery-MMSE score after surgery ≥ 2,or when M MSE score≤ 24.Results Compared with group C,the concentrations of plasma NSE and S-100 β protein were significantly decreased at T15,and P300 event-related potential latency was shortened,P300 event-related potential amplitude was increased,and the incidence of postoperative cognitive dysfunction was decreased at 7 days after operation in group P.Conclusion Puerarin can prevent the brain injury in the patients undergoing open heart surgery under CPB.

Objective:To evaluate the efficacy of dexmedetomidine for patient-controlled sleep regulation in improving postoperative sleep disorders in patients with gastrointestinal tumors.Methods:One hundred and fifty American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ patients, regardless of gender, aged 40-80 yr, with a preoperative Pittsburgh Sleep Quality Index (PSQI) score of ≤7 and a PSQI score of >7 on the 1st day after surgery, undergoing elective laparoscopic resection of gastrointestinal tumors from May 2023 to December 2023 in the Affiliated Changzhou No. 2 People′s Hospital of Nanjing Medical University, were divided into 3 groups ( n=50 each) using a random number table method: normal saline group and dexmedetomidine via different routes of administration groups (DEX1 group, DEX2 group). After the routine use of 48 h postoperative analgesia, dexmedetomidine 400 μg and atropine 1 mg in 100 ml of normal saline were added to the analgesic pump in DEX1 and DEX2 groups, DEX1 group received a background infusion at a rate of 2.5 ml/h, and after an initial dose of 6 ml, the patient-controlled analgesia (PCA) pump was programmed to deliver 4 ml with a lockout interval of 10 min and background infusion at 0.5 ml/h in DEX2 group. In NS group, normal saline was added to the PCA pump, and the methed of petient-controlled administration was the same as those previously described in DEX2 group. PSQI scores were recorded at days 1, 3 and 7 and 1 month postoperatively, and visual analogue scale scores were recorded on postoperative days 1, 3 and 7. Personal Health Questionnaire Depression Scale scores were assessed and the polysomnogram was monitored on the preoperative day 1, and 15-item Quality of Recovery (QoR-15) scale scores were assessed on postoperative day 7. The duration of PACU stay, consumption of anesthetic drugs, the total pressing times of PCA within 48 h, consumption of analgesic drugs and lenth of hospital stay were recorded. Results:Compared with NS group, the sleep stage N1 ratio and arousal index were significantly decreased and the sleep stage N2 ratio and sleep efficiency were increased on postoperative days 3 and 7, PSQI scores at days 3 and 7 and 1 month after operation and VAS score at postoperative day 7 were decreased, the length of hospital stay was shortened in DEX1 and DEX2 groups, and QoR-15 scale scores were significantly increased in DEX2 group ( P<0.05). Compared with DEX1 group, the sleep stage N3 ratio was significantly increased, PSQI scores were decreased on postoperative days 3 and 7, and QoR-15 scale scores were increased in DEX2 group ( P<0.05). Multivariate logistic regression analysis showed that dexmedetomidine for patient-controlled sleep regulation was a protective factor against postoperative sleep disturbances ( P<0.05). Conclusions:For the patients with postoperative sleep disorders following surgery for gastrointestinal tumors, self-controlled administration of dexmedetomidine for 3 consecutive days after surgery improves the sleep structure, raises the subjective sleep quality and promotes the postoperative recovery.

Objective To evaluate the risk of 10?year risk of ischemic cardiovascular disease (ICVD) in patients with type 2 diabetes aged 35 years old and above in two cities of Jiangsu province. Methods From December 2013 to January 2014, a total of 15 624 patients with type 2 diabetes aged 35 years old and above, who received national basic public health service in Changshu county of Suzhou city, Huai′an and Qinghe districts of Huai′an city, Jiangsu province, were recruited by cluster sampling method. Face?to?face questionnaire survey, anthropometric and laboratory measurements were conducted to collect exposures to ICVD risk factors. Improved Ten Year Risk Assessment Table of ICVD in Chinese was used to assess the risk score and the absolute risk of developing ICVD. Results The participants were (62.2±9.7) years old, of which 6 137 were men (39.3%). Among the participants, the highest rate of exposure to ICVD risk factors was high systolic blood pressure (74.8%, n=11 685), followed by high total cholesterol (70.7%, n=11 051).The score of 10?year risk for ICVD was (10.4±3.3) and the median (P25-P75) value of absolute risk was 15.6% (6.8%-32.7%). 16.7% (n=2 602) participants were under extremely high risk of 10?year risk for ICVD, 23.8% (n=3 714) under high?risk and 24.0% (n=3 746) under middle?risk. Among the total risk score of ICVD, age (49.1%), hypertension (17.7%) and diabetes (15.5%) accounted for relatively high proportion, however, smoking (11.0%) was the most important risk factor except for age (47.4%) and systolic blood pressure (20.5%) in male participants. Conclusion Patients with type 2 diabetes aged 35 years old and above in two cities of Jiangsu Province have a high risk of developing ICVD for 10 years, especially in elderly, female, hypertension patients and male smokers.

Objective To investigate the effect of esketamine on perioperative pain and depression in patients with thoracoscopic pulmonary nodule resection.Methods A total of 120 patients with selec-tive thoracoscopic pulmonary nodule resection were randomly divided into low-dose esketamine group(group L),high-dose esketamine group(group H)and saline control group(group C),with 40 cases in each group.Before skin incisionafter anesthetic induction,0.25 mg/kgesketamine,0.50 mg/kg esketamine and the equivalent amount of saline were separately administered for patients in the three groups.Visual Analogue Scale(VAS)score for pain and the Self-rating Depression Scale(SDS)score were compared among the three groups at the time points of one day before surgery(T0),one day after surgery(T1),three days after surgery(T2),and the day of discharge(T3),and postopera-tive analgesia within 24 h and perioperative adverse reactions were also recorded.Results The VAS scores for rest and coughing at T1 were significantly lower in group L and group H than group C(P＜0.05);compared with group C,the total press number of analgesic pump with in 24 h and effec-tive press number were significantly decreased in group L and group H,and the dosage of sufentanil was also significantly decreased(P＜0.05).There were no significant differences in depression scores at different time points among the three groups(P＞0.05).There were no significant differences in the incidence rates of nausea,vomiting,dizziness,hallucinations,and nightmares among the three groups(P＞0.05).Conclusion Esketamine can effectively alleviate pain on the first day after oper-ation and reduce the dosage of opioid analgesics without increasing the incidence of adverse reactions in patients with thoracoscopic pulmonary nodule resection;compared with 0.25 mg/kg esketamine,0.50 mg/kg esketamine doesn't demonstrate better postoperative analgesia or improvement in periop-erative depression.

Objective To investigate the effect of esketamine on perioperative pain and depression in patients with thoracoscopic pulmonary nodule resection.Methods A total of 120 patients with selec-tive thoracoscopic pulmonary nodule resection were randomly divided into low-dose esketamine group(group L),high-dose esketamine group(group H)and saline control group(group C),with 40 cases in each group.Before skin incisionafter anesthetic induction,0.25 mg/kgesketamine,0.50 mg/kg esketamine and the equivalent amount of saline were separately administered for patients in the three groups.Visual Analogue Scale(VAS)score for pain and the Self-rating Depression Scale(SDS)score were compared among the three groups at the time points of one day before surgery(T0),one day after surgery(T1),three days after surgery(T2),and the day of discharge(T3),and postopera-tive analgesia within 24 h and perioperative adverse reactions were also recorded.Results The VAS scores for rest and coughing at T1 were significantly lower in group L and group H than group C(P＜0.05);compared with group C,the total press number of analgesic pump with in 24 h and effec-tive press number were significantly decreased in group L and group H,and the dosage of sufentanil was also significantly decreased(P＜0.05).There were no significant differences in depression scores at different time points among the three groups(P＞0.05).There were no significant differences in the incidence rates of nausea,vomiting,dizziness,hallucinations,and nightmares among the three groups(P＞0.05).Conclusion Esketamine can effectively alleviate pain on the first day after oper-ation and reduce the dosage of opioid analgesics without increasing the incidence of adverse reactions in patients with thoracoscopic pulmonary nodule resection;compared with 0.25 mg/kg esketamine,0.50 mg/kg esketamine doesn't demonstrate better postoperative analgesia or improvement in periop-erative depression.

Objective To evaluate the risk of 10?year risk of ischemic cardiovascular disease (ICVD) in patients with type 2 diabetes aged 35 years old and above in two cities of Jiangsu province. Methods From December 2013 to January 2014, a total of 15 624 patients with type 2 diabetes aged 35 years old and above, who received national basic public health service in Changshu county of Suzhou city, Huai′an and Qinghe districts of Huai′an city, Jiangsu province, were recruited by cluster sampling method. Face?to?face questionnaire survey, anthropometric and laboratory measurements were conducted to collect exposures to ICVD risk factors. Improved Ten Year Risk Assessment Table of ICVD in Chinese was used to assess the risk score and the absolute risk of developing ICVD. Results The participants were (62.2±9.7) years old, of which 6 137 were men (39.3%). Among the participants, the highest rate of exposure to ICVD risk factors was high systolic blood pressure (74.8%, n=11 685), followed by high total cholesterol (70.7%, n=11 051).The score of 10?year risk for ICVD was (10.4±3.3) and the median (P25-P75) value of absolute risk was 15.6% (6.8%-32.7%). 16.7% (n=2 602) participants were under extremely high risk of 10?year risk for ICVD, 23.8% (n=3 714) under high?risk and 24.0% (n=3 746) under middle?risk. Among the total risk score of ICVD, age (49.1%), hypertension (17.7%) and diabetes (15.5%) accounted for relatively high proportion, however, smoking (11.0%) was the most important risk factor except for age (47.4%) and systolic blood pressure (20.5%) in male participants. Conclusion Patients with type 2 diabetes aged 35 years old and above in two cities of Jiangsu Province have a high risk of developing ICVD for 10 years, especially in elderly, female, hypertension patients and male smokers.

Objective: To analyze the attributable burden of smoking on the deaths of cardio-cerebral vascular diseases (CCVD) in inhabitants aged 30 years and above in Jiangsu Province. Methods: Comparative risk assessment approach in Global Burden of Disease (GBD) was used with the data from Jiangsu Non-communicable Disease and Behavioral Risk Factor Surveillance System and Death Monitoring Surveillance System in 2013, and population attributable fraction (PAF), years of life lost (YLL), work of potential years of life lost, index of life lost and life loss attributed to smoking were calculated. Results: In 2013, there were 162 158 CCVD deaths aged 30 years and above in the surveillance areas of Jiangsu Province, of which 25 102 deaths were attributed to smoking (PAF: 15.48%, attributed mortality rate: 55.13/100 000). The YLL, work of potential years of life lost and index of life lost were 532 494 person years, 78 024 person years and 9.15 years respectively. The decline of life expectancy was 0.58 years. The PAF of CCVD attributed to smoking in male and female were 27.97% and 3.18%, respectively, and the mortality rate of cardio-cerebral diseases attributed to smoking in male and female were 100.13/100 000 and 11.27/100 000, respectively. The burden of ischemic heart disease and hemorrhagic stroke were most severe, with standardized YLL rate were 3.65‰ and 3.20‰, respectively. Conclusion Smoking caused a great burden of cardio-cerebral disease deaths in inhabitants in Jiangsu province.

Objective: To evaluate the risk of 10-year risk of ischemic cardiovascular disease (ICVD) in patients with type 2 diabetes aged 35 years old and above in two cities of Jiangsu province. Methods: From December 2013 to January 2014, a total of 15 624 patients with type 2 diabetes aged 35 years old and above, who received national basic public health service in Changshu county of Suzhou city, Huai′an and Qinghe districts of Huai′an city, Jiangsu province, were recruited by cluster sampling method. Face-to-face questionnaire survey, anthropometric and laboratory measurements were conducted to collect exposures to ICVD risk factors. Improved Ten Year Risk Assessment Table of ICVD in Chinese was used to assess the risk score and the absolute risk of developing ICVD. Results: The participants were (62.2±9.7) years old, of which 6 137 were men (39.3%). Among the participants, the highest rate of exposure to ICVD risk factors was high systolic blood pressure (74.8%, n=11 685), followed by high total cholesterol (70.7%, n= 11 051).The score of 10-year risk for ICVD was (10.4±3.3) and the median (P₂₅-P₇₅) value of absolute risk was 15.6% (6.8%-32.7%). 16.7% (n=2 602) participants were under extremely high risk of 10-year risk for ICVD, 23.8% (n=3 714) under high-risk and 24.0% (n=3 746) under middle-risk. Among the total risk score of ICVD, age (49.1%), hypertension (17.7%) and diabetes (15.5%) accounted for relatively high proportion, however, smoking (11.0%) was the most important risk factor except for age (47.4%) and systolic blood pressure (20.5%) in male participants. Conclusion Patients with type 2 diabetes aged 35 years old and above in two cities of Jiangsu Province have a high risk of developing ICVD for 10 years, especially in elderly, female, hypertension patients and male smokers.

Objective: To analyze the disease burden of stroke and its health loss attributable to passive smoking in people aged 60 years and over in Jiangsu province. Methods: Data were retrieved from the Chronic and Non-communicable Diseases and Risk Factors Surveillance in Jiangsu in 2013 and the death registry system in Jiangsu. Combined with the method in Global Burden of Disease Study 2016 (GBD2016), the indicators, such as population attributable fraction (PAF) and disability-adjusted life years (DALY) for stroke due to passive smoking were calculated. Results: In 2013, the mortality rate, age-standardized mortality rate, DALY and DALY rate of stroke in people aged 60 years and over in Jiangsu were 718.15/100 000, 439.28/100 000, 1 179 602 person years and 9 234.99/100 000, respectively. Year of life lost (YLL) accounted for 87.00% of the total DALY. The DALY and corresponding rate of stroke increased rapidly with age, and were higher in women (612 084 person years and 9 319.71/100 000, respectively) than those in men (567 518 person years and 9 145.33/100 000, respectively). The prevalence of passive smoking was 34.04% in people aged 60 years and over in Jiangsu. The PAF, attributable DALY, attributable DALY rate and its age- standardized rate of stroke due to passive smoking in people aged 60 years and over in Jiangsu were 3.88%, 45 769 person years, 358.12/100 000 and 920.64/100 000, respectively; and were also higher for men (4.35%, 24 687 person years, 397.82/100 000 and 515.30/100 000, respectively) than those for women (3.44%, 21 056 person years, 320.60/100 000, 405.34/100 000, respectively). Conclusions The disease burden of stroke was heavy in the elderly in Jiangsu, and passive smoking might have great influence on the disease burden of stroke. Prevention and control of stroke and passive smoking exposure should be taken actively to improve health for the elderly.