Objective To explore the effect of dexmedetomidine combined with sufentanil on postoperative analgesia , early postoperative cognitive function and serum inflammatory factors in patients with laparoscopic gastrectomy of gastric cancer.Methods 80 cases of laparoscopic resection of gastric cancer were randomly assigned to treatment group and control group.The control group were treated by sufentanil 1.6μg/kg.The treatment group were given sufentanil 1.6μg/kg combined with dexmedetomidine 2 μg/kg.The analgesic effect, early cognitive function and serum levels of inflammatory factors were tested and compared after surgery.Results Compared with the control group, the VAS score in 4 h,8 h,24 h and 48 h after surgery were lower in the treatment group (P<0.05), the POCD(P<0.05), the IL-6,IL-10 and TNF-αlevel were lower in the treatment group(P<0.05). Conclusion Dexmedetomidine combined with sufentanil showes better postoperative analgesic effect and fast recovery of cognitive function, regulate the levels of serum inflammatory cytokines after laparoscopic resection of gastric cancer .

Objective To investigate the effect of dexmedetomidine hydrochloride on hemodynamics,immune function and inflammatory factors in patients with gynecological laparoscopic operation.Methods According to the random comparison table,86 elderly patients with gynecological laparoscopic operation were divided into observation group(43cases) and control group(43cases).The observation group received conventional general anesthesia,and intravenously pumped with dexmedetomidine hydrochloride.The the control group received conventional general anesthesia,and intravenously pumped with normal saline.The changes of hemodynamics,immune function and inflammatory factors were observed and compared in different periods in the two groups.Results Compared with before induction,the level of HR increased significantly at intubation(t=-3.257,-5.019,all P<0.05),the level of HR decreased significantly at 15 min and 30 min after pneumoperitoneum in the two groups(15 min after pneumoperitoneum:t=2.111,-5.019;15 min after pneumoperitoneum:t=3.078,3.926,all P<0.05),but the changes of the observation group variation were significant smaller(at intubation:t=-2.078;15 min after pneumoperitoneum:t=2.105;30 min after pneumoperitoneum:t=1.993,all P<0.05),the level of MAP had no significant difference at intubation in the observation group(t=1.893,P>0.05),the level of MAP increased significantly at intubation in control group(t=-2.122,P<0.05),and there was significant difference at intubation in the two groups(t=-3.477,P<0.05).Compared with before induction,the levels of HR and MAP recovered in the two groups,there were no statistically significant difference at 24 h after operation(HR:t=0.474,0.233;MAP:t=0.853,-0.273,all P>0.05);Compared with before induction,the levels of CRP and IL-6 increased significantly at after operation and 24 h after operation in the two groups(CRP:t=-9.974,-16.872;IL-6:t=-7.284,-11.449,all P<0.05),and the levels of CRP and IL-6 increased more significantly in the control group(CRP:t=-7.509;IL-6:t=-4.744,all P<0.05);Compared with before induction,the levels of CD+3,CD+4,CD+4/CD+8 and NK had no statistically significant differences at after operation and 24 h after operation in the observation group(t=0.154,1.204,1.546,-0.289,all P>0.05),the levels of CD+3,CD+4,CD+4/CD+8 and NK decreased significantly after operation in the control group(t=11.514,10.317,9.180,6.815,all P<0.05),there were statistically significant differences after operation in the two groups(t=10.232,10.298,7.728,4.900,all P<0.05),and the level of NK decreased significantly at 24h after operation in the control group(t=4.362,P<0.05).Conclusion Dexmedetomidine hydrochloride can keep hemodynamics stability,reduce immune function damage and inflammation.

Objective:To investigate the effect of nerve block anesthesia on hemodynamics in elderly patients undergoing unilateral lower limb trauma surgery.Methods:From February 2017 to June 2019, 100 elderly patients with unilateral lower extremity trauma admitted in our hospital were selected in this study.According to different anesthesia methods, the patients were divided into two groups, with 50 cases in each group.Group B was given light specific gravity subarachnoid anesthesia, while group A received nerve block anesthesia.The anesthesia effect, hemodynamic parameter changes, complications and incidence of adverse reactions between the two groups were compared.Results:The total effective rate of group A was 98.00%(49/50), which was significantly higher than that of group B[86.00%(31/50)], the difference between the two groups was statistically significant(χ 2=16.973, P<0.05). Before anesthesia, there were no statistically significant differences in diastolic blood pressure, heart rate and blood oxygen saturation between the two groups(all P>0.05). At 15 minutes after anesthesia, the diastolic blood pressure, heart rate and blood oxygen saturation in group A were (70.32±3.42)mmHg, (86.28±2.42)times/min, (139.03±2.63)%, respectively, which in group B were (70.26±1.66)mmHg, (86.73±1.63)times/min, (140.97±1.84)%, respectively.At 30 minutes after anesthesia, the diastolic blood pressure, heart rate and blood oxygen saturation in group A were (68.73±2.11)mmHg, (85.26±0.52)times/min, (136.18±3.89)%, respectively, which in group B were (70.98±1.92)mmHg, (87.24±2.31)times/min, (140.39±0.77)%, respectively.At 60 minutes after anesthesia, the diastolic blood pressure, heart rate, blood oxygen saturation in group A were (67.34±3.25)mmHg, (86.26±1.31)times/min, (134.89±2.37)%, respectively, which in group B were (71.01±3.12)mmHg, (87.39±1.32)times/min, (140.99±1.64)%, respectively.The differences between the two groups were statistically significant( t=11.315, 10.924, 10.599, t=13.411, 8.226, 9.779, t=9.057, 8.497, 10.131, all P<0.05). The incidence of complications and adverse reactions in group A was 2.00%(2/50), which was significantly lower than that in group B[18.00%(9/50)], the difference between the two groups was statistically significant(χ 2=16.913, P<0.05). Conclusion:Nerve block anesthesia is effective in elderly patients with unilateral lower limb trauma surgery, which can effectively stabilize the hemodynamics and reduce the incidence of complications and adverse reactions.

Background Excessive radon exposure is considered the second risk factor for lung cancer. Since the opening of the subway in a city of Zhejiang Province, the exposure level of radioactive gas radon in subway stations and its impact on occupational health have become one of the important issues of public concern. Objective To monitor the radon concentration of subways in a city in Zhejiang Province and explore the effect of radon exposure on chromosome aberration and micronuclei in the working population. Methods A total of 55 vehicle control rooms of 55 stations affiliated to two different subway lines in a city were measured for one year; the 110 ticket offices and 55 security checkpoints from the same 55 stations were measured from 16 March to 14 June. The radon concentrations were compared by job types, subway lines, and seasons referring to Measurement methods for determination of radon in environmental air (HJ 1212-2021). Peripheral blood lymphocyte chromosome aberration and micronucleus analyses were conducted in 165 subway workers from monitoring sites for three different job types, then the influencing factors were analyzed. The detection methods were adopted from the standards of Test and assessment of chromosomal aberrations on occupational health examinations for radiation workers (GBZ/T 248-2014) and Standard for the method of micronucleus detection in lymphocytes on occupational health examination for radiation workers and exposure dose estimation (GBZ/T 328-2023). Results The radon concentration range of the target subways in Zhejiang Province was 10-320 Bq·m⁻³, all lower than the national limit (≤400 Bq·m⁻³). The differences in radon radioactivity levels among different lines, job types, and time segments were statistically significant (P<0.05). The rates of chromosomal aberration and micronucleus formation among the 165 subjects were 0.224% and 0.024%, respectively. There were significant differences in the rates of chromosome aberration and micronuclei among different jobs (vehicle control room, ticket office, security checkpoint) (P<0.05), but the abnormal rates were lower than the limits of the corresponding national standard. No significant correlation was found between jobs and chromosomal aberrations or micronuclei (P>0.05). Chromosome aberration and micronuclei varied by age, subway station seniority, and smoking (P<0.05). No effect of the above factors on chromosome aberration and micronuclei was observed by logistic regression (P>0.05). Conclusion The radon concentration in the target subway system is at a normal level. The rates of chromosomal aberration and micronucleus formation vary by jobs, but both are lower than the corresponding national limits. Therefore, radon exposure has not yet caused outstanding health impact on the subway workers.