Objective To investigate the clinical effects of different dose of remifentanil with double-tube type laryngeal mask airway (LMA) ventilation in the aged patients undergoing total hip-arthroplasty (THA).Methods Sixty ASA class Ⅰ-Ⅱ grade patients undergoing THA were enrolled in the study.The patients were divided into three groups according to remifentanil dose with 20 cases each,0.2 μ g/ (kg· min)group,0.3 μ g/(kg· min) group and 0.4 μ g/(kg· min) group.Heart rate and mean arterial pressure (MAP)were measured immediately before anesthesia induction,immediately after anesthesia induction,immediately after inserting LMA,the set of operation,15 min during operation and discontinuation of anesthetic.Results All patients were successfully operated without intraoperative awareness.In 0.2 μ g/(kg·min) group,the patients suffered from the heart rate and MAP fluctuations,the high incidence of body movement (45.0％,9/20),and the maximum amount of propofol [(82.4 ± 21.6) mg].In 0.3 μg/(kg· min) group,heart rate and MAP had the better fluctuation,and patients might wake up faster postoperatively.In 0.4 μ g/(kg· min) group,heart rate and MAP significantly decreased,the amount of efedrina [(5.2 ± 4.3) mg] was the largest in the three groups,the recovery time [(5.2 ± 1.3) min] was the longest Conclusion Remifentanil 0.3 μg/(kg·min) compound with propofol with double-tube type LMA can be used for total intravenous anesthesia in the elderly patients with THA,with hemodynamic stability,fewer complications,and reliable ventilation.

The 13 nm gold nanoparticles ( AuNPs ) were synthesized through the reduction of HAuCl4 by sodium citrate and the glutathione was assembled on the AuNPs. Under the experiment conditions, glutathione-modified AuNPs ( GSH-AuNPs ) with negative charge presented a wine red color owing to the electrostatic repulsion between nanoparticals. Upon the addition of neurogenin 3 ( ngn3 ) peptide, the aggregation of GSH-AuNPs was induced by ngn3 peptide under a certain concentration of salt. The color of AuNPs solution changed from red to blue as a function of the ngn3 peptide concentration. Thus, a rapid detection method for ngn3 peptide using GSH-AuNPs as colorimetric probe was established. The optimal experiment conditions were equilibrium time=10 min, pH=6. 0, CNaCl=100 mmol/L. Under the optimum conditions, the assay showed a linear response range of 20-300 μg/L for the peptide with a detection limit being 8 μg/L and exhibited excellent selectivity for ngn3 peptide.

Objective To explore the clinical value of combined treatment of sufentanil and propofol in children during anesthesia induction.Methods 72 children were selected,and they were randomly divided into three groups by full random allocation method:observation group A,observation group B and control group,24 cases in each group.The observation group A was given intravenous infusion of sufentanil(0.01g · kg-1 · min-1),the observation group B was given intravenous infusion of sufentanil (0.02g · kg-1 · min-1),the control group was given intravenous saline infusion,then given propofol target controlled infusion after 30min.The bispectral index (BIS),propofol effect chamber (EC),OAA/S score and time of induction of anesthesia (LOC) time were recorded in the three groups.Results There was a significant correlation between BIS and propofol EC and OAA/S scores in the three groups,and there was a negative correlation between BIS and propofol EC (r =-0.82,-0.79,-0.88,all P ＜ 0.01).BIS and OAA/S score was positively correlated (r =0.86,0.81,0.89,all P ＜ 0.01).Compared with the control group [(9.11 ± 1.04) min],the LOC time of the observation group A and B [(5.37 ± 0.89) min,(4.49 ± 0.63) min] was significantly shortened (t =13.39,18.61,all P ＜ 0.01).The propofol EC of control group was (2.44 ± 0.5) μg/mL,the propofol EC of the observation group A and B [(1.38 ± 0.35) μg/mL,(1.14 ± 0.27) μg/mL] decreased during anesthesia induction (t =8.40,11.04,all P ＜ 0.01),and the effect of the observation group B was better than that of the observation group A (t =3.95,2.67,all P ＜ 0.05).There was no statistically significant difference in BIS between the observation group A and control group [(70 ± 4) vs.(69 ± 7),t =0.61,P ＞ 0.05].The BIS of observation group B (78 ± 5) was significantly higher than that of the observation group A and control group (t =6.12,5.13,all P ＜ 0.01).Conclusion Sufentanil combined with propofol for anesthesia in children has a synergistic effect,which is beneficial to reduce the amount of propofol EC during anesthesia induction,shorten the time of LOC and enhance the sedative effect of propofol,and it is worthy of further clinical application.

Comfort medical treatment has aroused the attention of all walks of life.Perioperative analgesia will be one of the important components.The analgesic guidelines of American Society of Anesthesiologists (ASA) and anesthesiology are all advocating multi mode analgesia.Transversus abdominis plane (TAP) block is considered to be one of the effective methods of multimode analgesia in the perioperative period.It can provide analgesia for surgical perioperative period,reduce the dosage of opioid after operation and the incidence of adverse reactions.We review the relevant factors on patient selection,anesthetic seletion and clinical efficacy for TAP block by reviewed relative literatures,aiming to provide new methods and ideas for clinical practice.TAP block opens new ideas for perioperative analgesia,and it is a new direction of multimode analgesia during perioperative period.

Objective The literature on perioperative management of patients with spinal tuberculosis(STB)in China was analyzed.To provide ideas and directions for the perioperative management of patients with spinal tuberculosis.Methods The journal literature on"spinal tuberculosis"and"perioperative period"were retrieved from Chinese National Knowledge Infrastructure,VIP Chinese Journal Service Platform,China Biology Medicine Disc and Wanfang Data during the period from January 1,1990 to May 31,2023.The VOSviewer software was used to visually analyze the retrieved literature data.The analysis includes publication year,publication region,journal distribution,keywords and so on.Results A total of 1306 papers were included.The overall number of published papers showed a trend of first increasing and then decreasing.The journal with the largest number of publications was Chinese Journal of Tuberculosis,with 53 publications(4.06％).75 keywords with frequency≥8 times were analyzed to form a cluster graph,and a total of 6 clusters were found.The themes of clustering were operation mode and timing,elderly patients and children,perioperative nursing,recurrence risk factors,postoperative complications,rehabilitation and functional exercise.Conclusion Research on perioperative management of patients with STB in China showed an initial rise and then a slow decline.Future studies need to focus more on vulnerable populations.Combined with the concept of rapid rehabilitation,we can explore the effective management mode of patients with STB in perioperative period.Accelerate the postoperative rehabilitation of patients with STB.

Objective To explore the effects of vascular risk factors on cognitive function among the elderly in community. Methods A cross-sectional study was conducted in 1 269 elderly people ( aged 65 and over) who were randomly selected from three communities. Through face-to-face interview, cognitive function was assessed by mini-mental state examination(MMSE),and blood samples were collected for labo-ratory examination. Logistic regression analysis was used to analyze the vascular risk factors affecting cogni-tive function. Results Age (( 73. 1 ± 6. 6), ( 71. 3 ± 4. 9),t=4. 603,P<0. 05),education level ( χ2=12. 727,P<0. 05),hypertension (χ2=9. 106,P<0. 05) and LDL-C (χ2=5. 157,P<0. 05) were significantly different in the elderly with or without mild cognitive impairment(MCI). After controlling age,gender and ed-ucation,the logistic regression analysis showed that hypertension(β=0. 378,P=0. 006,OR(95%CI)=1. 44 (1. 10-1. 91)),systolic blood pressure ≥140 mmHg( β=0. 350,P=0. 011,OR( 95% CI)= 1. 42( 1. 08-1. 86),1 mmHg=0. 133 kPa),and high LDL-C( β=0. 355,P=0. 014,OR(95%CI)=1. 43( 1. 08-1. 89)) were the risk factors of MCI in the elderly in the community. Hypertension alone or high LDL-C (β=0. 365, P=0. 029,OR(95%CI)=1. 44(1. 04-2. 00)) alone was risk factor for mild cognitive impairment in the eld-erly in the community. The risk of mild cognitive impairment in the elderly with hypertension and high LDL- C was 2. 00 times higher than that in the healthy elderly ( β=0. 696,P<0. 05,OR( 95%CI)= 2. 00( 1. 36-2. 97)). Conclusion Mild cognitive impairment in the elderly is closely related to hypertension and elevat-ed LDL-C levels. Multiple vascular risk factors can further increase the risk of cognitive impairment.

Objective:To analyze the influence of lifestyle changes on body weight and metabolic parameters during the early stage of corona virus disease 2019 (COVID-19) epidemic and regular epidemic prevention period in physical examination population.Methods:A total of 801 subjects from Nanjing enterprises and institutions who underwent physical examination in the Department of Health Promotion Center, the First Affiliated Hospital of Nanjing Medical University in May of 2019 to 2021 were included in this study. The basic information and data of body mass index, fasting blood glucose, total cholesterol, low density lipoprotein cholesterol (LDL-C), triglyceride and uric acid were collected. Information about dietary and exercise habits was obtained through pre-examination questionnaires. The data of 2019 was set as baseline data, data of 2020 represented information during the early stage of COVID-19 epidemic and data of 2021 represented information in regular epidemic prevention period. The subjects were divided into underweight group, normal weight group, overweight group, and obese group according to the body mass index at baseline. The Friedman test was applied to compare changes in body mass index and metabolic parameters across the population. Chi-square test was used to compare changes in dietary and exercise habits. Multivariate logistic regression analysis was adopted to explore the influencing factors of body mass index changes.Results:During the early stage of COVID-19 epidemic, the proportion of weight gain was the highest in the underweight group (42.9%), the proportion of weight loss was the highest in the overweight group (24.2%), and the obese group has the most stable body weight (70.6%) ( P=0.004). Men ( OR=0.56, 95% CI: 0.36-0.87) were less likely to gain weight than women ( P=0.010). There was no significant differences in weight change among all groups in the regular epidemic prevention period ( P=0.380). During the early stage of COVID-19 epidemic, the levels of fasting blood glucose, total cholesterol and LDL-C were significantly lower than those of baseline [4.98 (4.66, 5.42) vs 5.23 (4.91, 5.66) mmol/L, 4.98 (4.36, 5.67) vs 5.11 (4.54, 5.77) mmol/L, 2.90 (2.45, 3.33) vs 3.23 (2.77, 3.74) mmol/L], and the uric acid level was higher [333.0 (275.5, 397.0) vs 311.0 (257.5, 368.0) μmol/L] (all P<0.001). In regular epidemic prevention period, the levels of body mass index, fasting blood glucose, total cholesterol and LDL-C were significantly higher than those in the early stage of the epidemic [24.0 (21.9, 26.3) vs 23.8 (21.7, 26.1) kg/m 2, 5.18 (4.85, 5.62) vs 4.98 (4.66, 5.42) mmol/L, 5.12 (4.42, 5.76) vs 4.98 (4.36, 5.67) mmol/L, 3.06 (2.59, 3.57) vs 2.90 (2.45, 3.33) mmol/L], while the uric acid was significantly lower [319.0 (265.0, 377.0) vs 333.0 (275.5, 397.0) μmol/L] (all P<0.001). During the early stage of the epidemic, the reduction proportion of unhealthy diet in the home group was significantly higher than that in the outing group (19.5% vs 11.4%), and the increment proportion of exercise in the outing group was significantly higher than that in the home group (5.1% vs 1.6%) (both P<0.05). In regular epidemic prevention period, the increase rate of unhealthy diet in the home group was significantly higher than that in the outing group (26.8% vs 13.0%) ( P<0.001), and there was no significant difference in exercise between the two groups ( P=0.325). During the early stage of COVID-19 epidemic and in the regular epidemic prevention period, unhealthy diet>3 times per week ( OR=3.85, 3.01, 95% CI: 1.74-8.51, 1.41-6.39) was positively correlated with weight gain, and regular exercise ( OR=4.35, 2.61, 95% CI: 2.05-9.23, 1.15-5.91) was positively correlated with weight loss (all P<0.05). Conclusions:During the early stage of COVID-19 epidemic and in the regular epidemic prevention period, the lifestyle in the physical examination population has an impact on body weight and metabolic indicators. In the early stage of the epidemic, unhealthy diet and exercise decreased, and metabolic indicators such as blood glucose and lipids decreased. People with low body weight tend to gain weight. In the regular epidemic prevention period, the subjects′ exercise increased but unhealthy diet also increased, and blood glucose, lipid and body weight elevated significantly.

Objective:To investigate the association between serum uric acid,pulmonary function and airflow obstruction in Chinese Taiwan healthy subjects.Methods:All the cross-sectional analysis was performed in the population over 40 years old using the physical examination data of Chinese Taiwan MJ Health Resource Center between 1996 and 2016 stratification by gender.The correlation analyses between serum uric acid were done and multivariate Logistic regression analysis was used to explore the effect of serum uric acid on airflow obstruction.Results:A total of 35 465 people were included in the study,in-cluding 16 411 men and 19 054 women.Among them,the serum uric acid concentration of men was higher than that of women,and the serum uric acid concentration of the people with airflow obstruction was higher than that of the people without airflow obstruction.There was a negative correlation between serum uric acid level and the forced expiratory volume in one second(FEV1)and the force vital capacity(FVC)in women(P＜0.05),but in men the correlation didn't exist(P＞0.05).After adjusting for age,education,smoking status,drinking status,work strength,body mass index,history of cough,his-tory of hypertension,history of diabetes,history of dyslipidemia,white blood cells and blood albumin,the airflow obstruction in women was more likely to exist with the serum uric acid elevated(OR=1.12,95％CI:1.02-1.22,P＜0.05).The results showed that women with hyperuricemia were more likely to have airflow obstruction than those without hyperuricemia(OR=1.36,95％CI:1.06-1.75,P＜0.05).There was no correlation between serum uric acid concentration and airflow obstruction in men(OR=1.04,95％CI:0.96-1.13,P＞0.05),also the hyperuricemia and airflow obstruction(OR=1.12,95％CI:0.89-1.39,P＞0.05).Conclusion:There is a negative correlation between serum uric acid and FEV1 and FVC in relatively healthy women,and there is an association between elevated serum uric acid and airflow obstruction in women,but not in men.Further prospective studies are needed to explore whether high serum uric acid level can increase the risk of airflow obstruction.

Objective: To explore the effects of vascular risk factors on cognitive function among the elderly in community. Methods: A cross-sectional study was conducted in 1 269 elderly people (aged 65 and over) who were randomly selected from three communities.Through face-to-face interview, cognitive function was assessed by mini-mental state examination(MMSE), and blood samples were collected for laboratory examination.Logistic regression analysis was used to analyze the vascular risk factors affecting cognitive function. Results: Age ((73.1±6.6), (71.3±4.9), t=4.603, P<0.05), education level (χ²=12.727, P<0.05), hypertension (χ²=9.106, P<0.05) and LDL-C (χ²=5.157, P<0.05) were significantly different in the elderly with or without mild cognitive impairment(MCI). After controlling age, gender and education, the logistic regression analysis showed that hypertension(β=0.378, P=0.006, OR(95%CI)=1.44(1.10-1.91)), systolic blood pressure ≥140 mmHg(β=0.350, P=0.011, OR(95%CI)=1.42(1.08-1.86), 1 mmHg=0.133 kPa), and high LDL-C(β=0.355, P=0.014, OR(95%CI)=1.43(1.08-1.89)) were the risk factors of MCI in the elderly in the community.Hypertension alone or high LDL-C (β=0.365, P=0.029, OR(95%CI)=1.44(1.04-2.00)) alone was risk factor for mild cognitive impairment in the elderly in the community.The risk of mild cognitive impairment in the elderly with hypertension and high LDL-C was 2.00 times higher than that in the healthy elderly (β=0.696, P<0.05, OR(95%CI)=2.00(1.36-2.97)). Conclusion Mild cognitive impairment in the elderly is closely related to hypertension and elevated LDL-C levels.Multiple vascular risk factors can further increase the risk of cognitive impairment.

Humans ; Non-alcoholic Fatty Liver Disease ; Prospective Studies ; Risk Factors ; Exercise ; Liver