Objective To explore the factors related with prolonged anesthesia recovery (PAR) in patients with cerebral palsy after gener-al anesthesia. Methods 293 patients with cerebral palsy who received lower limbs orthopedics (LLO) under general anesthesia during July, 2009 to August, 2014 were retrospected and the factors related to PAR were analyzed. Results 37 patients (12.6%) suffered from PAR. There was significant difference in factors including body-weight, grade of physical status for anesthesia according to American Association of Anesthesiologists (ASA), the style to set a venous channel, blood loss, general anesthesia combined with epidural anesthesia (GAEA), in-tra-operative inhalation anesthetics, and serious adverse events (SAE) between patients with or without PAR, according to single factor anal-ysis with chi-square test. It was significant that the factors of ASA grade (B=1.490), SAE (B=2.159) and GAEA (B=-1.487) according to non-conditional logistic analysis. Conclusion PAR is related to several factors and GAEA combined with general anesthesia contributes to the recovery of patients with cerebral palsy.

Objective To observe the application of multimodal analgesia (MA) in lower extremity orthopedic surgery (LEOS) for patients with cerebral palsy (CP). Methods 100 CP patients following spasm undergoing LEOS under combined general anesthesia were randomly assigned into group C (n=50) and group M (n=50). In group M, the methods including a small dose of intravenous ketamine (0.25 mg/ kg) 15 minutes before skin incision, 0.25% ropivacaine hydrochloride in surgical area with infiltration anesthesia just before skin incision, and an intravenous infusion of sufentanil (0.05 μg/kg/h) combined with remifentanil (0.2 μg/kg/min) were performed. In group C, the methods mentioned above were not performed. The intravenous analgesia pump for single-use was prescribed for the patients in both groups. The postoperative analgesic effect (PAE) and side effects were observed. Results 4 dropped in group C. PAE in group M was significantly superior to that in group C (P<0.05), and the doctors as well as the caretakers for the patients were more satisfactory with the outcome (P<0.001). There was no significantly difference in the side effects between two groups (P>0.05). Conclusion MA could increase PAE in LEOS for CP patients following spasm and the safety was not influenced.

Objective:To summarize the characteristics of the participants (P), interventions (I), control measures (C), outcomes (O) and study design (S) of the clinical study of chronic back pain (CBP) in recent years; To further systematically organize the outcomes of the clinical study of CBP and their corresponding measurement tools.Methods:Clinical studies of CBP were retrieved from various databases including CNKI, Wanfang Database, VIP, SinoMed, Cochrane Library, Pubmed, Embase, Web of Science, etc. The search period was from January 1, 2015 to December 31, 2019. The retrieved literature was extracted and analyzed.The retrieved literatures will be extracted and analyzed. The retrieved literature was subjected to data extraction and analysis, and the quality of outcome indicators was evaluated according to 6 items. The Newcastle-Ottawa Scale ( NOS ) was used to evaluate the quality of cohort studies and case-control studies. Analyze the relationship between outcome indicators and interventions.Results:A total of 3 028 articles were finally included after examination and screening. The top 7 diagnoses of CBP were low back pain, lumbar disc protrusion, lumbar vertebral stenosis, lumbar vertebral slip, lumbar disc degression, non-specific chronic low back pain and post-operative pain syndrome. The top 7 intervention measures in clinical studies of CBP were surgery, acupuncture, physiotherapy, Tuina, exercise therapy, Western medicine painkillers and oral Chinese patent medicines. A total of 47 outcomes and 348 outcome measurement tools were reported in the literature included.Conclusion:In the clinical study of CBP in the recent years, there are problems such as incomplete and low quality of reporting, a wide variety of outcome measurement tools and lack of uniform reporting standards. The characteristics of patients determine the common characteristics of outcomes selection and it is also necessary to consider the specific outcomes related to interventions.

BackgroundMental illness during pregnancy has become a major public health problem in China over the recent years， and depression is the most common psychological symptom during pregnancy. Current research efforts are directed towards the therapy on prenatal depression， whereas the construction of prediction model for prenatal depression risk has been little studied. ObjectiveTo construct a simple model for predicting the risk of prenatal depression， thus providing a valuable reference for the prevention of maternal depression during pregnancy. MethodsA total of 803 pregnant women attending three hospitals in Nanchong city were consecutively recruited from May 2021 to February 2022. A self-administered questionnaire was developed for the assessment of social demographic variables， obstetrical and general medical indexes and psychological status of all participants， and Self-rating Depression Scale （SDS） was utilized to screen for the presence of maternal depression. Subjects were randomly assigned into modelling group （n=635） and validation group （n=168） at the ratio of 8∶2 under simple random sampling with replacement. The candidate risk factors of maternal depression during pregnancy were screened using binary Logistic regression analysis， and the predictive model was constructed. Then the performance of the predictive model was validated using receiver operating characteristics （ROC） curve. Results① Lack of companionship （β=-0.692， OR=0.501， 95% CI： 0.289~0.868）， low mood during the last menstrual period （β=-1.510， OR=0.221， 95% CI： 0.074~0.656）， emotional stress during the last menstrual period （β=-1.082， OR=0.339， 95% CI： 0.135~0.853）， unsatisfactory relationship between mother-in-law and daughter-in-law （β=-1.228， OR=0.293， 95% CI： 0.141~0.609）， and indifferent generally relationship between mother-in-law and daughter-in-law （β=-0.831， OR=0.436， 95% CI： 0.260~0.730） were risk factors for prenatal depression in pregnant women （P<0.05 or 0.01）. ② Model for predicting the prenatal depression risk yielded an area under curve （AUC） of 0.698 （95% CI： 0.646~0.749）， the maximum Youden index was 0.357 in modelling group with the sensitivity and specificity was 0.606 and 0.751， and an AUC of 0.672 （95% CI： 0.576~0.767） and maximum Youden index of 0.263 in validation group with the sensitivity and specificity of 0.556 and 0.707. ConclusionThe simple model constructed in this study has good discriminant validity in predicting of the risk of prenatal depression. ［Funded by Nanchong Social Science Research Project of the 14th Five-Year Plan （number， NC21B165）］