Objective To observe the anaesthetic effect of sulfentanil combined with bupivacaine for subarachnoid block on cesarean section patients and the influence on the patient and fetus.Methods Eighty patients who were scheduled for elective cesarean section under subarachnoid block,were distributed into two groups:bupivacaine with no sulfenlanil(group B)and bupivacaine with sulfentanil(group BS).Detected SBP,DBP,MAP,HR,SpO2 before and after anesthesia.The time of drug onset,motor recovery and pain recovery were recorded,the effect of muscle relaxation was evaluated,and the drag reaction,neonatal Apgar score and anesthesia complication were recorded.Results There was no significant difference in the time of drug onset and motor recovery,muscle relaxation,neonatal Apgar score between the two groups.MAP was lower after 3-10 min of anesthesia than before anesthesia,but there was no significant difference after 30-120 min of anesthesia in the two groups.The rate of drag reaction was 27.5% in group B,but no case in group BS.The time of pain recovery was longer in group BS than that in group B(P＜0.01).The rate of temporary itch of skin after operation was 17.5% in group BS.Conclusion The addition of sulfentanil to hyperbaric bupivacaine provides adequate anesthesia for cesarean section and good postoperative analgesia.

Objective To compare the effects of isoflurane and pentobarbital on the establishment of subarachnoid block model in rats.Methods 60 SD rats aged 4 months were randomly divided into Group A (n =30) and Group B (n=30).Rats in Group A received intraperitoncal injection of 10 g/L pentobarbital sodium solution 30 mg/kg and 1/4 of the initial dosage was added according to the operation effect.The induction and maintenance of anesthesia were achieved by isoflurane inhalation in Group B during operation.We recorded the time of anesthesia induction,quality of anesthesia,time of anesthesia,time of operation,and recovery time.The heart rate,respiration frequency,temperature,and saturation of blood oxygen were recorded during operation.We compared death from anesthesia and success of modeling in the two groups.Results There was no significant difference between the groups with regard to age,weight,body temperature or saturation of blood oxygen (P＞ 0.05).Compared to Group B,heart rate decreased 1-60 minutes after anesthesia and respiration frequency decreased 5 minutes after anesthesia in Group A (P＜0.05).The time of anesthesia induction,time of anesthesia,time of operation,and recovery time were shorter in Group B (P＜0.05).The quality of anesthesia was better in Group B (P＜0.05).The success rate of modeling was higher but mortality rate of anesthesia was lower in Group B than in Group A (P＜0.05).Conclusion Compared with intraperitoneal injection of pentobarbital sodium,isoflurane inhalation can provide a better anesthetic effect during the operation to establish a rat model of subarachnoid block.

Objective To evaluate the effects of the laryngeal mask airway for spontaneous breath-ing in short pediatric operation under Sevoflurane inhalation anesthesia.Methods Eighty children undergo-ing hernia surgery, of whom ASA Ⅰ or Ⅱ, in accordance with the random number table, were randomly divided into two groups( each 40 cases):the laryngeal mask airway for spontaneous breathing with Sevoflu-rane inhalation anesthesia in group A,and tracheal intubation for controlled ventilation with Sevoflurane inha-lationa nesthesia in group B.Children in the two groups were fasting for 6 hours and without drinking for 4 hours before anesthse ia.Anestheis a was induced with Sevoflurane inhalation fro all patients.The laryngela mask airway was insertde soon afet r induction of anesthesia with Sevoflurane inhalation,and anse thesia main-tained with Sevoflurane in halta ion in gor up A.P atients in gruo p B wereg iven cisatracurium 0.15 mg/kg intravenous injectio n before tracheal intubation, and anesthesia maintained with Sevoflurane inhalation, 40 minutes before the end of the surgeryt o sot p using muscle relaxant.Ten minutes before the end of the operation to stop Sevoflurane inhalation,in two groups.The end-tidal carbon dioxide partial pressure(PETCO2 ), mean blood pressure,heart rate,respiratory rate,pulse oxygen saturation and end-tidal sevoflurane partial pres-sure(PETSev) were recorded one minute before the induction of anesthesia,15 min,30 min,45 min,and 60 min after the induction of anesthesia.Both the time to regain consciousness and the time to remove laryngeal mask airway or tracheal catheter were recorded in two groups.Results The mean blood pressure, heart rate decreased in two groups after the induction of anesthesia(P<0.05).The value of PaCO2 increased and that of base excess decreased in 30 min after the induction of anesthesia in group A(P<0.05).The value of PETCO2 increased, and that of pH decreased in 45 min after the induction of anesthesia in group A (P<0.05).The movements of the limbs and head induced by operative stimulation in group A were more than those in group B(P<0.05),but the incidences of cough and laryngospasm induced by removing the laryngeal mask airw ay or tracheal catheter in group B were higher than those in group A(P<0.05).Both the time to regain consciousness and the time to remove laryngeal mask airway or tracheal catheter were shorter in group A than those in group B ( P<0.05 ) .Conclusion It is safe that the laryngeal mask airway for spontaneous breathing with Sevoflurane inhalation anesthesia in short pediatric operation.The time of anesthe-sia is beyond half an hour during operation and the artificial respiration sholu d be implemented.

Objective:To compare 3D-printing-assisted surgery and conventional surgery in the treatment of Schazker type Ⅵ tibial plateau fractures.Methods:A retrospective study was conducted to analyze the clinical data of 50 patients with type Ⅵ tibial plateau fracture who had been treated from January 2019 to December 2021 at the 5 Departments of Orthopedics in The First Affiliated Hospital of Nanchang University, The First People's Hospital of Jiujiang, Pingkuang General Hospital, Ganzhou People's Hospital, and Nanchang Hongdu Hospital of Traditional Chinese Medicine. The patients were divided into 2 groups according to their different treatment methods. In the 3D printing group of 25 cases treated by 3D-printing-assisted surgery, there were 14 males and 11 females, with an age of (42.5±9.1) years; in the conventional group of 25 cases treated by conventional surgery, there were 13 males and 12 females with an age of (42.2±9.3) years. The 2 groups were compared in terms of operation time, intraoperative blood loss, intraoperative fluoroscopy frequency, fracture healing time, postoperative complications, the Rasmussen radiological scores and the American Hospital for Special Surgery (HSS) knee function scores at 6 and 12 months after operation.Results:There was no significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). The operation time [(125.4±10.6) min], intraoperative blood loss [(206.2±16.3) mL], intraoperative fluoroscopy frequency [(9.2±2.7) times] and fracture healing time [(3.0±0.7) months] in the 3D printing group were all significantly less than those in the conventional group [(168.2±14.1) min, (303.2±20.4) mL, (15.5±3.5) times and (4.1±0.8) months] while the Rasmussen radiological scores (17.6±1.2 and 17.9±0.6) and HSS knee scores (90.8±6.4 and 91.5±5.6) at 6 and 12 months after operation in the 3D printing group were all significantly higher than those in the conventional group (16.2±2.6 and 16.7±2.2; 84.5±9.2 and 87.6±8.0) (all P<0.05). In the 3D printing group, there were 1 case of wound infection and 1 case of wound dehiscence after operation. In the conventional group, there were 2 cases of wound skin necrosis, 3 cases of wound dehiscence, 1 case of traumatic arthritis, 2 cases of wound infection, and 1 case of screw loosening. The incidence of complications in the 3D printing group (8.0%, 2/28) was significantly lower than that in the conventional group (36.0%, 9/25) ( P<0.05). Conclusion:In the treatment of Schatzker type VI tibial plateau fractures, compared with conventional surgery, 3D-printing-assisted surgery can lead to better curative outcomes, because it is conducive to lowering surgical difficulty, reducing postoperative complications, and promoting fracture union and functional recovery of the knee.

Objective:To investigate the relationship between vaccination doses and the duration of positive nucleic acid or antigen tests in Corona Virus Disease 2019 (COVID-19) patients during omicron epidemic.Methods:A cross-sectional study was conducted from December 26 to December 31, 2022 among COVID-19 patients from all community health service centers in 16 districts of Beijing municipality selected by multi-stage stratified cluster quota sampling method. A questionnaire was used to collect the basic information, vaccination doses, results of nucleic acid or antigen tests of all subjects. The subjects were divided into 5 groups according to the doses of COVID-19 vaccination: the non-vaccination group, the 1, 2, 3 and 4 doses vaccination group. The relationship between vaccination doses and the duration of positive nucleic acid or antigen tests was analyzed by univariate and multivariate logistic regression models.Results:A total of 10 506 COVID-19 cases were included in the study with the age of (43.3±13.7) years. The duration of positive nucleic acid or antigen tests was longer than 7 days in 59.4%(276/465), 51.5%(67/130), 50.6%(355/701), 46.1% (3 464/7 520) and 39.2%(662/1 690) of non-vaccination, and 1, 2, 3, 4 dose vaccination groups, respectively ( P<0.001). Multivariate logistic regression analysis showed that compared with non-vaccination patients, the vaccination dose was an independent protective factor for duration of positive nucleic acid or antigen tests>7 days, and the OR values were 0.7 (95% CI 0.5-0.9, P=0.015), 0.6 (95% CI 0.5-0.8, P<0.001) and 0.5 (95% CI 0.4-0.6, P<0.001) for 2, 3 and 4 doses of vaccination, respectively. Conclusion:The vaccination doses are independently related to the duration of positive nucleic acid or antigen tests in COVID-19 patients and the risk is gradually decreases with the increasing vaccination doses.

Objective To find out the differences in regional characteristics of heat vulnerability between people living in urban centers and urban-fringe areas of Jinan city so as to provide basis for the development of adaptation measures to heat. Methods A cross-sectional survey on heat vulnerability was conducted in urban center and urban-fringe areas of Jinan city,using a self-designed questionnaire among 801 residents at the age of 16 years or older in August 2013. Data of 23 indicators related to heat vulnerability were collected and aggregated to 7 dimensions:health and medical insurance,social networks,heat perception and adaptive behavior,economic status,resources, living environment and working environment. An index score was calculated using a balanced weighted average approach for each dimension,ranging from 0 to 1,with the closer to 1 as greater vulnerability. Results The scores on heat perception and adaptive behavior,economic status, resources and working environment dimensions for urban-fringe areas were 0.42,0.63,0.55 and 0.62, statistically significantly higher than the urban center area of 0.41,0.51,0.26 and 0.41. Scores of living environment,social networks and health/medical insurance dimensions for urban center area were 0.57,0.49 and 0.31,which were all higher than the urban-fringe areas of 0.50,0.46 and 0.25, with differences statistically significant. Conclusion Residents living in the urban center might be more vulnerable to heat in terms of living environment,health/medical insurance and social networks while residents living in the urban-fringe areas might more be vulnerable in terms of heat perception and adaptive behavior,economic status,life resources and working environment. These facts indicated that heat vulnerability among residents could be quite different,even at a fine geographic sale. We would thus suggest that intervention strategies on protecting people from heat,should be more targeted.

OBJECTIVETo find out the differences in regional characteristics of heat vulnerability between people living in urban centers and urban-fringe areas of Jinan city so as to provide basis for the development of adaptation measures to heat.

METHODSA cross-sectional survey on heat vulnerability was conducted in urban center and urban-fringe areas of Jinan city, using a self-designed questionnaire among 801 residents at the age of 16 years or older in August 2013. Data of 23 indicators related to heat vulnerability were collected and aggregated to 7 dimensions:health and medical insurance, social networks, heat perception and adaptive behavior, economic status, resources, living environment and working environment. An index score was calculated using a balanced weighted average approach for each dimension, ranging from 0 to 1, with the closer to 1 as greater vulnerability.

RESULTSThe scores on heat perception and adaptive behavior, economic status, resources and working environment dimensions for urban-fringe areas were 0.42,0.63,0.55 and 0.62, statistically significantly higher than the urban center area of 0.41,0.51,0.26 and 0.41. Scores of living environment, social networks and health/medical insurance dimensions for urban center area were 0.57,0.49 and 0.31, which were all higher than the urban-fringe areas of 0.50,0.46 and 0.25, with differences statistically significant.

CONCLUSIONResidents living in the urban center might be more vulnerable to heat in terms of living environment, health/medical insurance and social networks while residents living in the urban-fringe areas might more be vulnerable in terms of heat perception and adaptive behavior, economic status, life resources and working environment. These facts indicated that heat vulnerability among residents could be quite different, even at a fine geographic sale. We would thus suggest that intervention strategies on protecting people from heat, should be more targeted.

Adolescent ; Adult ; Aged ; China ; Cross-Sectional Studies ; Female ; Health Status ; Hot Temperature ; Humans ; Male ; Middle Aged ; Surveys and Questionnaires ; Urban Population ; statistics & numerical data ; Young Adult

BACKGROUND: Suicidal behaviors are seriously social issues among adolescents in the world. Exposed to smoking and being bullied are risk factors of suicidal behaviors. The present study was aimed to examine the interaction of smoking and being bullied on suicidal behaviors among Chinese adolescents. METHODS: A total of 18,900 students were involved in the questionnaire study, in four cities of China from November 2017 to January 2018. Suicidal behaviors, smoking, and being bullied were measured by self-reported validated instruments. Chi-square tests and logistic regression were used to analyze the associations of suicidal ideation (SI)/suicidal plan (SP)/suicidal attempt (SA), smoking, and being bullied. RESULTS: The prevalence of smoking, being bullied, SI/SP/SA, were 3.1%, 20.6%, 26.4%, 13.2%, and 5.2% respectively. Interaction analysis indicated that being bullied was associated with a greater increase in the likelihood of suicidal behaviors for adolescents with smoking than for those without smoking. CONCLUSIONS These finding suggest that smoking exacerbates the association between being bullied and suicidal behaviors. Future research should explore how and why smoking appears to more bully-victims than for those without smoking and how to mitigate it.
Adolescent ; Adolescent Behavior/psychology* ; Bullying/psychology* ; Child ; China/epidemiology* ; Cross-Sectional Studies ; Humans ; Prevalence ; Smoking/psychology* ; Students/statistics & numerical data* ; Suicidal Ideation