Objective To evaluate the physical dependence of Zhixieling capsule.Methods The physical dependence of Zhixieling capsule was observed by mouse jump test,rat precipitation test and rat natural withdrawal test.Results Zhixieling capsule showed no obvious withdrawal symptoms.Conclusion Zhixieling capsule has no physical dependence.

OBJECTIVE：To o bserve the e fficacy and safety of the application of etomidate combined with propofol in diagnosis and treatment of elderly patients with painless tracheoscope. METHODS ：A total of 124 elderly patients with first selective bronchoscopy under general anesthesia were collected from Anhui Chest Hospital during Oct. 2019-May 2020，and then divided into propofol group （group P ），etomidate and propofol group （group EP ）according to random number table ，with 62 cases in each group. At anesthesia induction ，Sufentanil citrate injection 5 µg was slowly injected into both groups. Based on this base，group P was given Propofol injectable emulsion 2 mg/kg intravenously ；after the eyelash reflex disappeared ，group P was given intravenous infusion of Propofol injectable emulsion 4 mg/（kg·h）to maintain sedation and Remifentanil hydrochloride for injection 0.1-0.2 µg/（kg·min）to maintain analgesia. Group EP was given slow intravenous injection of 0.5％ Propofol injectable emulsion 1 mg/kg+0.1％ Etomidate injectable emulsion 0.2 mg/kg；after the eyelash reflex disappeared ，group EP was given intravenous pump of 0.5％ Propofol injectable emulsion+ 0.1％ Etomidate injectable emulision mixture（1 ∶ 1，V/V）20 mL/h to maintain sedation and Remifentanil hydrochloride for injection to maintain analgesia （same usage and dosage as group P ）；at the same time ，2 groups were given intravenous injection of Cisatracurium besilate for injection 0.1 mg/kg，the laryngeal mask was inserted into the anesthesia machine for mechanical ventilation ，and then the laryngeal mask w as placed into the tracheoscope fordiagnosis and treatment. Heart rate （HR） and mean arterial pressure （MAP） were observed in 2 groups at the time of entering the room （T1）， at the time of eyelash reflex disappearing after anesthesia induction （T2），at the beginning of t racheal intubation examination （T3），10 min after the beginning of the exam ination（T4），at the time of anesthesia recovery （T5），and at the time of leaving the room （T6）；operation time，anesthesia recovery time ，the use of vasoactive drugs ，postoperative 4 h cognitive function and adverse reactions were also observed in 2 groups. RESULTS ：Two patients in each group were excluded. At T 1，there was no statistical significance in MAP and HR between 2 groups（P＞0.05）. There was no statistical significance in MAP of group EP among different time points （P＞ 0.05）. MAP and HR of group P at T 2，MAP of group P at T 4，HR of group EP at T 2 were significantly lower than same group at T1，and MAP of group P at T 2 and T 4 were significantly shorter or lower than those of group EP at the same time （P＜0.05）. The anesthesia recovery time ，the incidence of hypotension and the utilization rate of vasoactive drugs in group EP were significantly lower than group P ；memory ability ，calculation ability and orientation force pass rate of group EP were significantly higher than those of group P of 4 h after operation （P＜0.05）. There was no statistical significance in operation time ，the incidence of injection pain，muscle spasm ，nausea and vomiting ，focus ability ，language ability ，structure ability ，reasoning ability pass rate between 2 groups（P＞0.05）. CONCLUSIONS ：Etomidate combined with propofol shows good therapeutic efficacy and safety for elderly patients with painless tracheoscope.

Objective To analyze the incidence and risk factors of postoperative pulmonary complications(PPCs)in elderly patients undergoing video-assisted thoracoscopic surgery(VATS).Methods Elderly patients aged≥65 years who underwent VATS in Peking Union Medical College Hospital from January 2013 to December 2017,were reviewed retrospectively and divided into non-PPCs group and PPCs group.General information,past medi-cal history,and postoperative complications were recorded in a uniform case report form.The clinical factors with statistical significance in univariate analysis and important clinical significance according to experience were ana-lyzed with Logistic regression to evaluate the independent risk factors for PPCs.Results A total of 900 patients were included,and 48(5.3%)of them suffered PPCs.Multivariate logistic regression showed that pre-operative smoking history,history of stroke,chronic obstructive pulmonary disease(COPD)and pulmonary lobectomy were independent risk factors for PPCs in elderly patients after VATS.Conclusions Elderly patient is a high-risk group for PPCs after VATS.The risk factors include smoking history,stroke,COPD and scope of surgery.Therefore,perioperative management needs to optimize,and monitoring should be strengthened for these high-risk patients.