Objective To compare the influence of propofol combined with sufentanil or remifentanil on the quality of wake-up during scoliosis surgery by wake-up test.Methods Fifty pa-tients undergoing scoliosis surgery were randomized into two groups.During the surgery,propofol combined with sufentanily 0.3-0.6 μg·kg-1·h-1 (group SF)or remifentanil 0.2-0.3 μg·kg-1·min-1 (group RF)were continuously infused to maintain anesthesia,and BIS was maintained at 40-60.In wake-up test,the infusion of sufentanyl in group SF was paused and,the infusion rate of remifentanil in group RF was adjusted to 0.05 μg·kg-1·min-1 until the patient completed the wake-up test under instruction.The time that spontaneous breathing occurred,body movement was detected and the capa-bility to follow instructions in both two groups were recorded.MAP,HR,PET CO2 were measured at the time 10 min after medication adjustment (T1 ),waking up(T2 )and 10 min after waking up (T3 ), respectively,in both two groups.Wake-up quality was also recorded.Results The time that sponta-neous breathing occurred,body movement was detected and the capability to follow instructions in group RF were significantly shorter than those in group SF (P <0.05).At T2 the incidence of agita-tion in group RF was significantly higher than that in group SF(P <0.05).And the hemodynamics of group SF were more stable than those of group RF (P <0.05).Conclusion Propofol combined with sufentanil can improve wake-up quality during scoliosis surgery,but the wake-up time is relatively lon-ger.

Objective: To examine the trend of the burden on chronic obstructive pulmonary diseases (COPD) and epidemiologic transition on related risk factors among the Chinese population from 1990 to 2019. Methods: Based on the data from the Global Burden of Disease 2019 Study, we used the indicator numbers such as disability-adjusted life year (DALY), years of life lost (YLD), years lived with disability (YLL), and prevalence rate to describe the changes of COPD burden stratified by different sex and age groups from 1990 to 2019. We applied population attribution faction (PAF) to analyze the burden attributed to risk factors and epidemiological transition. Results: In 2019, the age-standard rate for DALY, YLD, and YLL and prevalence rate for COPD were 1 102.77/100 000 population,862.37/100 000 population, 240.40/100 000 population, and 2 404.41/100 000. Both age-standardized DALY and YLL rates for COPD in males were higher than in females, except for the YLD rate in females. COPD's top five risk factors were particulate matter pollution, smoking, occupational particulate matter, gases, and fumes, low temperature, and secondhand smoke. Smoking surpassed environmental particulate pollution in 1994 and became the first factor causing the disease burden of COPD. Since then, the order of risk factors has not changed. The PAF of environmental particulate pollutants increased by 1.78% annually, from 15.22% in 1990 to 25.37%, and the PAF of household air pollution from solid fuels decreased by 5.59% annually, from 40.30% in 1990 to 7.59%. Conclusions: From 1990 to 2019, the per person health loss caused by COPD in China showed an overall downward trend. The PAF of relevant risk factors has also changed, the importance of environmental factors is relatively declined, and the status of smoking and other related risk behaviors has become increasingly prominent. The prevention and control of COPD can focus on screening high-risk groups (≥40 years old, smoking, heavy air pollution, having occupational exposure), smoking cessation, and environmental treatment.
Female ; Male ; Humans ; Adult ; Cost of Illness ; Pulmonary Disease, Chronic Obstructive/epidemiology* ; Air Pollution/adverse effects* ; Particulate Matter ; China/epidemiology* ; Dust ; Gases

ObjectiveTo evaluate the efficacy of three screening questionnaires for COPD in the community residents of Songjiang District， Shanghai， and to provide a basis for selecting COPD screening questionnaire and process that are more suitable. MethodsCommunity residents aged 40 years or over were randomly selected from the Shanghai Suburban Adult Cohort and Biobank for the study with screening questionnaires and spirometry. Questionnaires included the COPD screening questionnaire （COPD-SQ）， the COPD population screener （COPD-PS） and the revised COPD diagnostic questionnaire （revised-CDQ）. Evaluation of the efficacy of these questionnaires was based on the area under the receiver operating characteristic curve （AUC） of the subjects. DeLong test was used to compare the accuracy of different questionnaires； Z test was used to compare the accuracy of different cut-off values for the same questionnaire. ResultsAmong 3 184 community residents， a total of 259 （8.1%） COPD patients were screened by spirometry. AUC values of these 3 screening questionnaires were >0.7 indicating that they were reliable COPD screening tools. The sensitivity and specificity of the questionnaires at the recommended cut-off values were COPD-SQ （63.7% and 72.2%）， COPD-PS （12.0% and 96.1%）， and revised CDQ （78.8% and 52.7%）， with the COPD-SQ having the highest screening accuracy （AUC=0.754）. The optimal and recommended cut-off values for the three questionnaires differed in this population， but the difference in accuracy was statistically significant only for COPD-PS. The optimal cut-off values for the three questionnaires differed between male and female， and the sensitivity and accuracy of COPD-SQ and COPD-PS improved when lower cut-off values were used for women. The AUC was greater when two questionnaires were utilized simultaneously for screening， but the differences were not statistically significant. ConclusionThe COPD-SQ is recommended for primary COPD screening； a lower cut-off value for women should be considered. The COPD screening questionnaire needs to be further improved for the early diagnosis and treatment of COPD patients.