Objective To investigate the effect of different doses of dexmedetomidine combined with intercostal nerve block in regional adenomammectomy.Methods 112 patients receiving regional adenomammectomy and meeting criterions were selected from Oct.2013 to Oct.2016.And they were divided into control group and low,medium,and high dose group according to table of random number,with 28 cases in each group.Patients of the control group only received intercostal nerve block.Patients of low dose group received low dose of dexmedetomidine (0.7 μg/kg load dose and 0.25μg· kg-1·h-1 maintenance doses) combined with intercostal nerve block.Patients of medium dose group received medium dose of dexmedetomidine (0.7 μg/kg load dose and 0.5 μg·kg-1·h-1 maintenance doses) combined with intercostal nerve block.Patients of high dose group received high dose of dexmedetomidine (0.7 μg/kg load dose and 1 μg· kg-1·h-1 maintenance doses) combined with intercostal nerve block.Mean arterial pressure,heart rate,VAS score and sedation score of the four groups were detected and compared at T0,T1,T2,T3 and T4.Results The mean arterial pressure and heart rate of medium and high dose group were lower than those of the control group and low dose group at T1,T2,T3 (P＜0.05).The mean arterial pressure and heart rate of high dose group were lower than those in medium dose group at T1,T2,T3 (P＜0.05).VAS score of medium and high dose group were lower than those of the control group and low dose group (P＜0.05),while the difference was not statistically significant between medium and high dose group(P＞0.05).The sedation scores of low,medium and high dose groups were higher than those of the control group at T1,T2,T3 and T4 (P＜0.05),while the sedation score of high dose group were higher than those of low and medium dose groups at T1,T2,T3 and T4 (P＜0.05).Conclusion Medium and high dose of dexmedetomidine combined intercostal nerve block can effectively relieve pain for patients undergoing regional adenomammectomy,while high dose of dexmedetomidine is likely to cause bradycardia,hypotension and excessive sedation.Appropriate dosage should be chosen in clinical practice.

Melanoma is the skin malignancy with high potential of metastasis, and its morbidity rate is increasing every year. Melanoma patients exhibit a significantly elevated tumor mutational burden, with a higher prevalence of neoantigenic epitopes, leading to widespread activation of immune cells. Consequently, melanoma demonstrates a favorable response rate to immunotherapy. In this study, the infiltration landscape of common immune cells and their function in the melanoma microenvironment were depicted and analyzed. This study contributes to a better understanding among clinical practitioners of the role of the immune system in the development and progression of melanoma, and provides valuable guidance for the development of novel immunotherapeutic agents.

Melanoma is the skin malignancy with high potential of metastasis, and its morbidity rate is increasing every year. Melanoma patients exhibit a significantly elevated tumor mutational burden, with a higher prevalence of neoantigenic epitopes, leading to widespread activation of immune cells. Consequently, melanoma demonstrates a favorable response rate to immunotherapy. In this study, the infiltration landscape of common immune cells and their function in the melanoma microenvironment were depicted and analyzed. This study contributes to a better understanding among clinical practitioners of the role of the immune system in the development and progression of melanoma, and provides valuable guidance for the development of novel immunotherapeutic agents.

INTRODUCTIONKnowledge of stroke symptoms is associated with seeking medical attention early, and knowledge of risk factors is an essential factor in stroke prevention. In this study, we evaluated the level of stroke literacy in Singapore.

MATERIALS AND METHODSA cross-sectional study of Singapore citizens and permanent residents aged 21 years and above was conducted in a public housing estate. Participants were randomly sampled using multi-stage stratified sampling. Assessment of awareness of stroke symptoms and risk factors was performed using open-ended questions. In total, 687 respondents were recruited, with a response rate of 69.7%.

RESULTSOverall, 52.4% of respondents identified the brain as the source of pathology, and 47.6% could cite at least 1 of the 3 FAST symptoms (facial droop, arm weakness and speech difficulty), while 40% could name 2 or more of 7 established risk factors for stroke (high blood pressure, high cholesterol, cigarette smoking, diabetes mellitus, older age, previous heart attacks and stroke). Respondents at higher risk of stroke (older individuals and those with stroke risk factors) did not have greater awareness of stroke symptoms and risk factors. The majority of respondents reported they would seek immediate medical care if they experienced stroke symptoms. Only 59.4% knew the emergency ambulance service telephone number.

CONCLUSIONIn a sample of Singaporean adults residing in a public housing estate, we found evidence of poor stroke literacy, highlighting the need for comprehensive population-based education efforts. There is a role for opportunistic education among those at higher risk of stroke.

Adult ; Aged ; Cross-Sectional Studies ; Female ; Health Literacy ; Humans ; Male ; Middle Aged ; Public Housing ; Risk Factors ; Singapore ; Socioeconomic Factors ; Stroke ; Surveys and Questionnaires ; Young Adult