Objective To explore the effects of three different patient-controlled analgesia protocols on sedation and analgesia in patients undergoing thoracoscopic surgery for lung cancer.Methods Ninety-three patients undergoing thoracoscopic surgery for lung cancer in our hospital from November 2022 to April 2023 were selected,and randomly assigned into three groups according to different postoperative analgesic protocols.Group P(n=30)was given patient-controlled intravenous analgesia,group T(n=31)received patient-controlled intravenous analgesia combined with thoracic paravertebral block,while group S(n=32)received patient-controlled intravenous analgesia combined with serratus intercostal plane block.Then the Visual Analogue Scale(VAS)score,Ramsay sedation scores,the press times of analgesic pump,the use of sedative drugs and adverse effects were compared among all three groups,and the sensory block plane,performance time,onset time and duration of the block were compared between group T and S.Results VAS scores in the resting state at postoperative 2 h,24 h and 48 h were(3.09±0.69),(2.83±0.59)and(2.07±0.51)in group P,which were higher than group T[(1.22±0.33),(2.51±0.54)and(1.57±0.45)]and group S[(1.01±0.30),(2.23±0.51)and(1.22±0.25)],group T was higher than group S.VAS scores in the coughing state at postoperative 2 h,24 h and 48 h were(3.63±0.55),(3.24±0.67)and(2.61±0.51)in group P,which were higher than the group T[(1.45±0.29),(2.71±0.56)and(2.33±0.53)]and group S[(1.14±0.28),(2.40±0.57)and(2.03±0.52)],group T was higher than group S.VAS scores in the resting and coughing states at postoperative 2 h,24 h and 48 h yielded statistical difference among three groups(all P＜0.05).Ramsay sedation scores at postoperative 2 h,24 h and 48 h were(2.21±0.51),(2.34±0.56)and(2.31±0.55)in group P,(2.23±0.53),(2.35±0.55)and(2.33±0.54)in group T and(2.22±0.52),(2.36±0.57)and(2.32±0.55)in group S,with no statistical difference(all P＞0.05).The press times of analgesic pump at postoperative 24 h and 48 h were(10.18±2.42)and(14.51±3.20)in group P,which were higher than the group T[(3.32±0.79)and(6.84±1.62)]and group S[(1.17±0.28)and(2.63±0.62)],group T was higher than group S,with statistical difference(all P＜0.05).The additional dose of sufentanil and the total amount of sufentanil used in postoperative period were(8.05±1.99)μg and(71.53±6.91)μg in group P,which were more than the group T[(3.77±0.93)pg and(65.82±5.77)μg]and the group S[(2.23±0.55)μg and(47.54±4.56)μg],group T was higher than group S,with statistical difference(all P＜0.05).Group S had shorter performance time[(5.32±1.77)min]and longer block duration time[(12.51±2.14)h]than those of group T[(12.41±3.42)min and(10.31±2.01)h],with statistical difference(all P＜0.05).The incidence of adverse reactions was 6.25％in group S,which was lower than the group P(30.00％,P＜0.05),and no statistical difference was reported among three groups in the occurrence rate of comparisons(all P＞0.05).Conclusion The sedation effects of the three different patient-controlled analgesia protocols are comparable,but patient-controlled intravenous analgesia combined with serratus intercostal plane block provides better postoperative analgesia for patients undergoing thoracoscopic surgery for lung cancer,which has less analgesic pump presses and lower dose of postoperative analgesic drugs used,and fewer adverse effects.

Objective: To explore the linear associations between social support, coping strategies, depression, anxiety, and cognitive function among people with type 2 diabetes mellitus (T2DM) using a path-analytic method. Methods: This cross-sectional study enrolled 496 individuals hospitalized due to T2DM. Well-trained investigators conducted face-to-face interviews with the participants using the Social Support Rating Scale, the Chinese version of Medical Coping Modes Questionnaire, the Hospital Anxiety and Depression scale, and the Mini Mental State Examination to measure social support (including objective support, subjective support, and support utilization), coping strategies (including confrontation, avoidance, and acceptance-resignation), depression/anxiety, and cognitive function, respectively. A path analysis was used to elucidate the linear associations between social support, coping strategies, depression, anxiety, and cognitive function. Results: In the final path model with satisfactory model fit, objective support was found to be associated with cognitive function not only directly but also indirectly through confrontation coping and depression, and acceptance-resignation coping and depression/anxiety. Further, subjective support was found to be associated with cognitive function indirectly through depression/anxiety, as well as serially through acceptance-resignation coping and depression/anxiety. Support utilization was found to be associated with cognitive function indirectly through confrontation coping and depression, as well as through acceptance-resignation coping and depression/anxiety. Conclusion Social support, coping strategies, depression, and anxiety were associated with cognitive function among people with T2DM, and these associations were best explained by a serial mediation model from social support, coping strategies, and depression and anxiety to cognitive function.

Objective: To explore the linear associations between social support, coping strategies, depression, anxiety, and cognitive function among people with type 2 diabetes mellitus (T2DM) using a path-analytic method. Methods: This cross-sectional study enrolled 496 individuals hospitalized due to T2DM. Well-trained investigators conducted face-to-face interviews with the participants using the Social Support Rating Scale, the Chinese version of Medical Coping Modes Questionnaire, the Hospital Anxiety and Depression scale, and the Mini Mental State Examination to measure social support (including objective support, subjective support, and support utilization), coping strategies (including confrontation, avoidance, and acceptance-resignation), depression/anxiety, and cognitive function, respectively. A path analysis was used to elucidate the linear associations between social support, coping strategies, depression, anxiety, and cognitive function. Results: In the final path model with satisfactory model fit, objective support was found to be associated with cognitive function not only directly but also indirectly through confrontation coping and depression, and acceptance-resignation coping and depression/anxiety. Further, subjective support was found to be associated with cognitive function indirectly through depression/anxiety, as well as serially through acceptance-resignation coping and depression/anxiety. Support utilization was found to be associated with cognitive function indirectly through confrontation coping and depression, as well as through acceptance-resignation coping and depression/anxiety. Conclusion Social support, coping strategies, depression, and anxiety were associated with cognitive function among people with T2DM, and these associations were best explained by a serial mediation model from social support, coping strategies, and depression and anxiety to cognitive function.

Objective: To explore the linear associations between social support, coping strategies, depression, anxiety, and cognitive function among people with type 2 diabetes mellitus (T2DM) using a path-analytic method. Methods: This cross-sectional study enrolled 496 individuals hospitalized due to T2DM. Well-trained investigators conducted face-to-face interviews with the participants using the Social Support Rating Scale, the Chinese version of Medical Coping Modes Questionnaire, the Hospital Anxiety and Depression scale, and the Mini Mental State Examination to measure social support (including objective support, subjective support, and support utilization), coping strategies (including confrontation, avoidance, and acceptance-resignation), depression/anxiety, and cognitive function, respectively. A path analysis was used to elucidate the linear associations between social support, coping strategies, depression, anxiety, and cognitive function. Results: In the final path model with satisfactory model fit, objective support was found to be associated with cognitive function not only directly but also indirectly through confrontation coping and depression, and acceptance-resignation coping and depression/anxiety. Further, subjective support was found to be associated with cognitive function indirectly through depression/anxiety, as well as serially through acceptance-resignation coping and depression/anxiety. Support utilization was found to be associated with cognitive function indirectly through confrontation coping and depression, as well as through acceptance-resignation coping and depression/anxiety. Conclusion Social support, coping strategies, depression, and anxiety were associated with cognitive function among people with T2DM, and these associations were best explained by a serial mediation model from social support, coping strategies, and depression and anxiety to cognitive function.

Objective: To explore the linear associations between social support, coping strategies, depression, anxiety, and cognitive function among people with type 2 diabetes mellitus (T2DM) using a path-analytic method. Methods: This cross-sectional study enrolled 496 individuals hospitalized due to T2DM. Well-trained investigators conducted face-to-face interviews with the participants using the Social Support Rating Scale, the Chinese version of Medical Coping Modes Questionnaire, the Hospital Anxiety and Depression scale, and the Mini Mental State Examination to measure social support (including objective support, subjective support, and support utilization), coping strategies (including confrontation, avoidance, and acceptance-resignation), depression/anxiety, and cognitive function, respectively. A path analysis was used to elucidate the linear associations between social support, coping strategies, depression, anxiety, and cognitive function. Results: In the final path model with satisfactory model fit, objective support was found to be associated with cognitive function not only directly but also indirectly through confrontation coping and depression, and acceptance-resignation coping and depression/anxiety. Further, subjective support was found to be associated with cognitive function indirectly through depression/anxiety, as well as serially through acceptance-resignation coping and depression/anxiety. Support utilization was found to be associated with cognitive function indirectly through confrontation coping and depression, as well as through acceptance-resignation coping and depression/anxiety. Conclusion Social support, coping strategies, depression, and anxiety were associated with cognitive function among people with T2DM, and these associations were best explained by a serial mediation model from social support, coping strategies, and depression and anxiety to cognitive function.

Objective To explore the effect of intraoperative mild hyperventilation on postoperative shoulder pain(PLSP)in patients undergoing gynecological laparoscopic surgery.Methods Eighty-two pa-tients,aged 18-64 years,BMI 18.5-32.0 kg/m2,ASA physical status Ⅰ or Ⅱ,who underwent gyneco-logical laparoscopic surgery from January to September 2023 were selected.According to the random number table method,the patients were divided into two groups:observation group and control group,41 patients in each group.The observation group was given mild hyperventilation during the operation to maintain PETCO230-33 mmHg,and the control group was treated with conventional mechanical ventilation to maintain PETCO2 35-40 mmHg.The incidence of PLSP and VAS pain score of PLSP were recorded 12,24,48,72 hours,and 1 week after operation.The results of arterial blood gas analysis were recorded before anesthesia induction,15 minutes after pneumoperitoneum,at the end of operation,and 24 hours after operation.The intraoperative consumption of propofol and remifentanil,extubation time,bradycardia(HR＜50 beats/mi-nute),and intraoperative hypotension(SBP＜90 mmHg)were recorded.The occurrence of adverse reac-tions such as nausea and vomiting within 72 hours after operation and the requirement for rescue analgesia within 1 week after operation were recorded.Results Compared with the control group,the incidence of PLSP and VAS pain scores 12,24,48,72 hours,and 1 week after operation in the observation group were significantly reduced(P＜0.05),and PaCO2 15 minutes after pneumoperitoneum and at the end of opera-tion were significantly reduced(P＜0.05).There were no significant differences between the two groups in intraoperative consumption of propofol and remifentanil,extubation time,incidence of intraoperative brady-cardia and hypotension,incidence of nausea and vomiting within 72 hours after surgery,and requirement for rescue analgesia within 1 week after surgery.Conclusion Mild hyperventilation in gynecological laparo-scopic surgery can effectively reduce the incidence of PLSP and the degree of pain within 1 week after sur-gery,and does not increase the related adverse reactions within 72 hours after surgery.

Objective To investigate the effect of esketamine on postoperative analgesia,stress response and serum tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)levels in children undergoing tonsillectomy(TE)combined with endoscopic-assisted transoral adenoidectomy(ETA).Methods 98 children with tonsil and adenoid hypertrophy from January 2023 to August 2023.They were divided into two groups randomly,with 49 cases in each group.Children in both groups received the same TE plus ETA treatment,and were given the same anesthesia induction and maintenance.The observation group was given 0.5 mg/kg of esketamine injection intravenously 20 min before the operation ended,while the control group same dose of normal saline intravenously.The operation and anesthesia recovery were observed in the two groups.The scores of the face,legs,activity,cry,consolability behavioral tool(FLACC)and pediatric anesthesia emergence delirium scale(PAED)were compared between the two groups immediately after extubation(T1),10 min after extubation(T2),20 min after extubation(T3),30 min after extubation(T4)and 60 min after extubation(T5).The stress response indicators and inflammatory reaction mediators were tested at the time entering the operating room(T0)and T5 time points.And the two groups were also compared in terms of adverse reactions.Results There were no significant differences in surgical duration,extubation time,wake-up time and length of postanesthesia care unit(PACU)stay between the two groups(P＞0.05).The FLACC and PAED scores at T1,T2,T3,T4 and T5 time points in observation group were lower than those of the control group,the differences were statistically significant(P＜0.05).The serum cortisol(Cor),angiotensin Ⅱ(Ang Ⅱ),tumor necrosis factor-α(TNF-α)and interleukin-iβ(IL-1β)levels of the two groups at T5 time point were higher than those at T0 time point,the differences were statistically significant(P＜0.05).At T5 time point,the levels of serum Cor,Ang Ⅱ,TNF-α and IL-1β in observation group were lower than those of the control group,the differences were statistically significant(P＜0.05).The incidence of adverse reactions in observation group was significantly lower than that in control group,the difference was statistically significant(8.16％and 24.49％,P＜0.05).Conclusion Application of esketamine in the operation of TE combined with ETA in children can achieve exert good sedative and analgesic outcomes,and effectively reduce the stress response and inflammatory reaction caused by surgical trauma in children.