Objective To assess the anesthesia efficacy of remifentanil-propofol or remifentanil-desflurance in patients undergoing video-assisted thoracoscopic surgery(VATS).Methods Forty ASA Ⅰ-Ⅱpatients. undergoing VATS were randomly divided into remifentanil-propofol group(group P,n=20)and remifentanil-desflurance group (group D,n=20).MAP and HR were monitered during the entire procedures. Conscious recovery, spontaneous breathing recovery, the endotracheal extubation time and OAAS score were recorded and compared between two groups. Results During the operation, MAP was decreased significantly in group D (P＜0.05).There was no significant difference in conscious recovery, spontaneous breathing recovery, the endotracheal extubation time and OAAS score between two groups. Conclusions The anesthesia efficacy of remifentanil-propofol or remifentanil-desflurance in patients undergoing VATS were both with quick recovery, but the fronter has more stable hemodynamics.

Objective To investigate use of sedative and hypnotics agents in urban community residents aged 60 years and over in Shanghai. Methods A cross-sectional study on use of sedative and hypnotics agents was conducted in 2248 residents aged 60 years and over in Jing' an community of Shanghai during July to October 2005 with questionnaire. Results Overall prevalence of use of sedative and hypnotics agents was 15.8% (355/2248), 7.3% (165/2248) for consecutive use and 6.2% (140/2248) for long-term consecutive use, respectively, which increased with age (P < 0.05). Prevalence of use of sedative and hypnotics agents, whatever consecutive use or long-term consecutive use was significantly higher in women than that in men [18.7 % (224/1303) vs. 11.7% (111/945), P<0.01; 8.3 % (108/1303) vs. 6.0% (57/945), P < 0.05 ; or 7. 3% (95/1303) vs. 4. 8% (45/945), P < 0.05]. Use of benzodiazepinos accounted for 90. 0 % (126/140) in those with long-term consecutive use. About 93.8 % (333/355) of sedative and hypnotic agents were prescribed by medical doctors. Conclusiong In general, prevalence of sedative and hypnotics agents use in the aged residents of community is higher, mainly with benzodiazepines. There are a few problems about their unreasonable use in women and attention should be paid to it.

Objective To observe glomerular mesangial cells (GMCs) proliferation induced by IgA1 and the association with the expression of apoptosis-related proteins-B cell lymphoma-2 (Bcl-2),cysteine aspartic acid protease-3 (Caspase-3),cysteine aspartic acid protease-9 (Caspase-9) and with mitofusin 2 (Mfn2) in rat GMCs,to study the possible mechanism of valsartan inhibiting rat GMCs proliferation,and to provide a new direction for the mechanism of GMCs proliferation and intervention research in IgA nephrology (IgAN).Methods GMCs stimulated with IgA1 were cultured in vitro to detect cellproliferation with the cell counting kit-8 cell activity assay (CCK8).GMCs were divided into three groups:CG,TG and VG.The GMCs proliferation level was detected by the CCK8,using real-time PCR to detect Mfn2 expression and Western blotting to detect protein levels of Mfn2,Bcl-2,Caspase-3,and Caspase-9.Results Rat GMCs proliferated significantly after stimulation with IgA1,and IgA1 could obviously stimulate high expression of Bcl-2 in GMCs and down regulate the expression of Mfn2,Caspase-3,and Caspase-9.Valsartan could inhibit the proliferation of GMCs induced by IgA1 significantly,downregulate the expression of Bcl-2,and upregulate the expression of Mfn2,Caspase-3,and Caspase-9.Conclusions These results showed that the mechanism of action of valsartan in the treatment of lgAN is inhibiting the proliferation of GMCs.This mechanism may be associated with the regulation of apoptosis-related proteins,such as Mfn2,Bcl-2,Caspase-3,and Caspase-9.These findings may provide a new direction for the mechanism of GMCs proliferation and intervention research in IgAN.

OBJECTIVETo observe the effect of Shenmai injection on the value of vascular endothelial active factors nitric oxide (NO), endothelin-1 (ET-1) of patients undergoing heart valve rveplacement and cardiac pulmonary bypass (CPB).

METHODThirty patients of cardiac valve replacement undergoing open heart surgery under cardiopulmonary bypass (CPB) were randomized single-blind method divided into Shenmai injection group (SM) and control group (C) with 15 cases each. Shenmai injection group (SM) were injected Shenmai injection 0.6 mL x kg(-1) added to physiological saline 250 mL after anaesthesia before CPB, the control control group were injected only physiological saline 250 mL at the same time. Blood samples were taken before induction of anesthesia and at 0.5, 2, 6, 24 hours after terminating CPB. To calculate P(A-a) DO2 and respiratory indexs (RI) by blood gas analysis, nitric oxide (NO) and endothelin-1 (ET-1) ET-1 were measured. At the same time, the time of CPB and artery blockage were recorded.

RESULTThere was no statistical significance before operation between 2 groups to every blood index. After CPB, P(A-a) DO2 , RI and ET-1 was higher than pre-operation after CPB (P < 0.05). But P(A-a) DO2, RI and ET-I of Shenmai group were lower than control group evidently at every point after CPB (P < 0.05 or P < 0.01). The concentrations of NO were reduced obveiously after CPB (P < 0.05), but in shenmai group, the range of descent was lower than control group (P < 0.01 or P < 0.05).

CONCLUSIONThe concentrations of NO and ET-1 is connected with the lung injury after CPB. Through rise the level of NO and reduce the level of ET-1, Shenmai injection can alleviate the lung injury in some degree after CPB and improve pulmonary oxygenation function.

Adult ; Blood Gas Analysis ; Cardiopulmonary Bypass ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; Endothelial Cells ; drug effects ; metabolism ; Endothelin-1 ; blood ; Female ; Heart Valve Prosthesis ; Humans ; Injections ; Male ; Middle Aged ; Nitric Oxide ; blood

Objective To understand the current status and analyze the factors affecting the work engagement of wound therapists,and to provide references for promoting their work engagement.Methods From September 2022 to March 2023,wound therapists who were certificated by European Wound Management Association for more than 3 months were selected as subjects by convenient sampling method.The data was collected by the General Information Questionnaire,Hospitals and Wound Clinics Questionnaire,Areas of Worklife Scale and Specialty Nurse Work Engagement Scale,and the factors influencing the work engagement of wound therapists were analyzed by univariate and multiple liner regression.Results A total of 219 wound therapists were included.The total mean score of areas of worklife was(99.37±13.70);the average score of items was(3.55±0.49);the total mean score of the specialty nurse work engagement was(140.01±16.00);the average score of items was(4.38±0.50).The results of multiple linear regression analysis showed that reward,community,fairness,and values were factors influencing the work engagement of wound therapists(P＜0.05).Conclusion The higher average score of each dimension of areas of worklife could predict the higher level of work engagement for wound therapists.Nursing managers should pay more attention to the job-matching degree of specialty nurses and adopt scientific and effective management methods to improve the job-matching,which will help improve the specialty nurses'work engagement and satisfaction and reduce job burnout.

Objective:To investigate the status quo of burnout and influencing factors of burnout of wound therapists in China, so as to provide support for the growth and development of wound therapist.Methods:From September 2022 to March 2023, a total of 235 specialist nurses certified as wound therapists in China were selected as research objects by the convenient sampling method. General information questionnaire of wound therapists, Areas of Worklife Scale (AWS), Specialty Nurse Work Engagement Scale (SNWES) and Maslach Burnout Inventory-Human Service Survey (MBI-HSS) were used to investigate the wound therapists. Binomial Logistic regression analysis was used to explore the influencing factors of wound therapist burnout.Results:A total of 235 questionnaires were sent out in this study, and 219 were effectively collected, with an effective recovery rate of 93.2%. Among 219 wound therapists, 125 (57.1%) were positive for burnout. The results of binomial Logistic regression analysis showed that job title, work load, team atmosphere and work value were the influencing factors of wound therapist burnout ( P<0.05) . Conclusions:The detection rate of occupational burnout among wound therapists is relatively high, and professional titles, workload, team atmosphere and work value affect their job burnout, suggesting that nursing managers should adopt corresponding measures to improve the occupational environment of wound therapists and reduce their job burnout.

Objective: To establish a quantitative three-dimensional method based on intraoral scan to evaluate the changes of soft tissue, and to evaluate the changes of supracrestal gingival thickness (SGT) in skeletal class Ⅲ patients induced by periodontal regenerative and corticotomy surgery (PRCS). Methods: Twenty-two systematically and periodontally healthy skeletal class Ⅲ patients (4 males and 18 females, aged between 19 and 35 years), who were in need of combined orthodontic-orthognathic treatment and referred to the Department of Periodontology from the Department of Orthodontics and the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from January, 2018 to March, 2019, were collected in the study. The teeth involved were 112 anterior teeth (46 maxillary anterior teeth and 66 mandibular anterior teeth). PRCS in anterior tooth area was conducted before orthodontic decompensation. Probing depth (PD), bleeding index (BI) and keratinized gingiva width (KGW) were recorded before surgery and 6 months post-surgery. The intraoral digital impressions of maxillary and mandibular anterior teeth were obtained by 3-shape intraoral scanner before surgery and 6 months after surgery. The Standard Tessellation Language (STL) files were processed using Geomagic qualify 12.2 software to establish the soft tissue morphological measurement model, and to quantitatively analyze the changes of gingival thickness situated 1 to 2 mm apical to the free gingival margin on the median sagittal measurement plane. Results: Probing depth and bleeding index had no significant difference before and 6 months after operation (P>0.05). KGW in 6-month post-operation group [(5.18±2.32) mm] was significantly higher than that in pre-operation group [(4.22±1.43) mm] (P<0.05). Supracrestal gingival thickness situated 1 to 2 mm apical to the free gingival margin also significantly increased 6 months after surgery (P<0.05). The changes of gingival thickness situated 1 to 2 mm apical to the free gingival margin in the upper anterior area were (0.68±0.56) and (1.00±0.69) mm, respectively. The changes in the lower anterior area were (0.38±0.42) and (0.58±0.45) mm, respectively. The gingival changes of the upper anterior teeth were also significantly higher than those of the lower anterior teeth (P<0.01). Conclusions The described quantitative measurement based on intraoral scan could be an effective method for quantitative evaluation of the changes of soft tissue. PRCS could safely increase the supracrestal gingival thickness as well as KGW in skeletal class Ⅲ patients who were in need of combined orthodontic-orthognathic treatment.