Objective:To investigate the effect of ultrasound-guided lumbar quadratus muscle plane block combined with general anesthesia on the analgesic effect during and after laparoscopic colon cancer radical surgery in elderly patients.Methods:A prospective study was conducted on 61 elderly patients who underwent radical colon cancer surgery at the Changsha Central Hospital Affiliated to South China University from May 2022 to February 2023, with American Society of Anesthesiologist (ASA) grades Ⅱ to Ⅲ. They were randomly divided into SA and GA groups using a random number table method, with 31 patients in the SA group and 30 patients in the GA group. The SA group received ultrasound-guided plane block of the upper lumbar quadratus muscle in the arcuate ligament combined with general anesthesia, while the GA group received simple general anesthesia. Record the mean artery pressure (MAP) and heart rate (HR) of two groups of patients at the time of entering the operating room (T 0), 5 minutes before skin incision (T 1), at skin incision (T 2), 30 minutes after surgery (T 3), at surgery end (T 4), and during anesthesia resuscitation and extubation (T 5); The Visual Analogue Scale (VAS) of two groups of patients at T 5, upon returning to the ward (T 6), 6 hours (T 7), 12 hours (T 8), 24 hours (T 9), and 48 hours (T 10) after surgery were recorded; The dosage of sufentanil, remifentanil, and propofol used during surgery, anesthesia recovery time, total number of analgesic pump presses within 48 hours after surgery, Lovett muscle strength score, early postoperative recovery, and adverse reactions within 48 hours after surgery were also recorded. Resultsl:The MAP and HR of the SA group were lower than those of the GA group at T 1-5 (all P<0.05); The VAS score of the SA group was lower than that of the GA group at T 5-10 (all P<0.05); The intraoperative dosage of propofol, remifentanil, and sufentanil in the SA group was lower than that in the GA group (all P<0.05); The anesthesia recovery time and first time out of bed in the SA group were earlier than those in the GA group (all P<0.05); The total number of times the analgesic pump was pressed within 48 hours after surgery was less than that of the GA group ( P<0.05); The incidence of nausea and vomiting within 48 hours after surgery in the SA group was lower than that in the GA group ( P<0.05). There was no statistically significant difference in postoperative Lovett muscle strength score, hospital stay, and dizziness incidence between the two groups of patients (all P>0.05). Conclusions:Ultrasound-guided lumbar quadratus muscle plane block on the arcuate ligament can significantly reduce the dosage of intraoperative general anesthesia drugs and postoperative analgesics in elderly patients undergoing laparoscopic colon cancer surgery, reduce postoperative pain scores, effectively alleviate postoperative pain, and thus advance the patient′s first time out of bed activity, reduce postoperative complications, and promote rapid recovery.

The setting and adjustment of ventilator parameters need to rely on a large amount of clinical data and rich experience. This paper explored the problem of difficult decision-making of ventilator parameters due to the time-varying and sudden changes of clinical patient's state, and proposed an expert knowledge-based strategies for ventilator parameter setting and stepless adaptive adjustment based on fuzzy control rule and neural network. Based on the method and the real-time physiological state of clinical patients, we generated a mechanical ventilation decision-making solution set with continuity and smoothness, and automatically provided explicit parameter adjustment suggestions to medical personnel. This method can solve the problems of low control precision and poor dynamic quality of the ventilator's stepwise adjustment, handle multi-input control decision problems more rationally, and improve ventilation comfort for patients.
Humans ; Ventilators, Mechanical ; Respiration, Artificial ; Neural Networks, Computer

Day surgery, as a new perioperative management model that is safe, efficient, and consumes a small amount of medical resources, has been widely recognized in recent years. With the requirements of China's new healthcare system reform and the promotion of national policies, there is a significant increase in hospitals carrying out day surgery, and they are about to enter a new stage of rapid development. Adequate preoperative evaluation of patients undergoing day surgery is an important link in improving perioperative care during day surgery. This article reviews the importance, location and personnel, methods, timing and content of day surgery preoperative evaluation, and current situation of day evaluation in China, in order to provide reference for clinical workers related to day surgery.

Objective: To investigate the epidemiological characteristics of pulmonary tuberculosis ( PTB ) incidence and mortality in Zhejiang Province from 2016 to 2020, so as to provide the evidence for formulating the PTB control strategy. Methods: The data regarding the PTB patients in Zhejiang Province from 2016 to 2020 were collected from the Tuberculosis Management Information System of the Chinese Disease Control and Prevention Information System. The reported cases and deaths of PTB cases were descriptively analyzed by time, population and regions. Results: A total of 129 985 PTB cases were reported in Zhejiang Province from 2016 to 2020, and the overall reported incidence rate of PTB was 45.81/105, with a tendency toward a decline in the reported incidence ( χ2trend=298.899, P<0.001 ) and an annual decline rate of 3.72%. The prevalence rates of rifampicin resistance, positive etiological tests, negative etiological tests and no etiological results were 1.51%, 47.17%, 46.67% and 4.65%, respectively. A total of 546 PTB deaths occurred in Zhejiang Province from 2016 to 2020, and the reported mortality of PTB was 0.19/105, with a tendency towards a decline ( χ2trend=10.818, P<0.001) and an annual decline rate of 11.99%.The prevalence rates of rifampicin resistance, positive etiological tests, negative etiological tests and no etiological results were 1.83%, 82.97%, 13.37% and 1.83%, respectively. The highest reported incidence ( 92.18/105 ) and mortality ( 1.19/105 ) of PTB was found in patients aged 65 years and older, and farmer was the predominant occupation of PTB cases (60 774 cases, 46.75%) and dead PTB cases ( 345 cases, 63.19% ). In addition, the top three cities with the highest incidence of PTB included Quzhou City ( 66.43/105 ), Jinhua City ( 64.24/105 ) and Lishui City ( 53.91/105 ), and the top three cities with the highest mortality of PTB included Quzhou City ( 0.67/105 ), Lishui City ( 0.27/105 ) and Jiaxing City ( 0.26/105 ). Conclusions Both the reported incidence and mortality of PTB appeared a tendency towards a decline in Zhejiang Province from 2016 to 2020; however, the proportion of positive etiological tests increased. Higher attention should be paid to the elderly aged 65 years and older and and farmers, and active screening and health education are recommended; in addition, PTB control requires to be intensified in highly prevalent regions, including Quzhou City, Jinhua City and Lishui City.

Objective: To analyze the epidemiological characteristics of pulmonary tuberculosis cases at ages of 60 years and older in Quzhou City, Zhejiang Province, so as to provide the evidence for formulating the pulmonary tuberculosis control strategy among the elderly. Methods: The data pertaining to pulmonary tuberculosis cases at ages of 60 years and older in Quzhou City from 2010 to 2020 were collected through the Tuberculosis Management Information System of the China Disease Prevention and Control Information System. The trends for incidence, population distribution, diagnosis and treatment of pulmonary tuberculosis cases aged 60 years and older were analyzed using a descriptive epidemiological method. Results: Totally 8 754 pulmonary tuberculosis cases aged 60 years and older were reported in Quzhou City from 2010 to 2020, accounting for 47.65% of all pulmonary tuberculosis cases, and the number of pulmonary tuberculosis appeared a tendency towards a rise ( χ2trend=173.320, P<0.001 ), while the incidence of pulmonary tuberculosis showed a tendency towards a decline ( χ2trend=389.820, P<0.001 ), with an annual decline rate of 177.11/105. There were 4 307 smear-positive pulmonary tuberculosis cases, accounting for 58.71% of all smear-positive cases, and the number of smear-positive pulmonary tuberculosis cases showed a tendency towards a rise ( χ2trend=126.320, P<0.001 ), while the proportion of smear-positive cases showed a tendency towards a decline ( χ2trend=21.680, P<0.001 ), with an annual smear-positive rate of 87.14/105. The incidence of pulmonary tuberculosis was 256.94/105 among males and 91.43/105 among females at ages of 60 years and older ( χ2=20.903, P<0.001 ). The highest incidence of pulmonary tuberculosis was seen in patients aged 80 to 84 years ( 235.17/105 ), and farmers were the predominant occupation ( 7 171 cases, 81.92% ), while the highest number of cases was reported in Quzhou City (8 676 cases, 99.11%). There were 7 752 treatment-naïve cases ( 88.55% ), while 5 830 cases with delay in seeking healthcare services, and the proportion of delay in seeking healthcare services showed a tendency towards a rise from 2010 to 2020 ( χ2trend=4.853, P=0.028 ), with an annual mean delay rate of was 66.60%. Conclusion The incidence of pulmonary tuberculosis appeared a tendency towards a decline among patients aged 60 years and older in Quzhou City from 2010 to 2020, and the elderly aged 80 years and older and farmers should be paid more attention.

Objective:To investigate the analgesic effect of ultrasound-guided pericapsular nerve group (PENG) block combined with laryngeal mask general anesthesia and internal fixation of proximal femoral nail antirotation (PFNA) under ERAS concept in elderly patients.Methods:A total of 50 elderly patients with femoral trochanteric fractures treated with PFNA internal fixation who were admitted to Changsha Central Hospital from January 2021 to March 2022 were selected and according to the random number table method, they were divided into groups P and F, with 26 cases in group P (ultrasound-guided PENG block combined with laryngeal mask general anesthesia group) and 24 cases in group F [ultrasound-guided fascia iliaca compartment block (FICB)] combined with laryngeal mask general anesthesia group]. The bispectral index (BIS) of the two groups of patients was maintained within the range of 40-60, and the dosage of cyclopofol and remifentanil was adjusted according to the BIS and hemodynamic changes. Postoperative oxycodone was used for patient controlled intravenous analgesia (PCIA). When the Visual Analogue Scale (VAS) score ≥4, 1 mg intravenous oxycodone was administered as rescue analgesia. The VAS score was observed and recorded before nerve block (T 0), 10 minutes after nerve block (T 1), 20 minutes after nerve block (T 2), when the patients were placed in body position after bed (T 3), after laryngeal mask removal (T 4), 12 h after operation (T 5), 24 h after operation (T 6) and 48 h after operation (T 7). The mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO 2) at each time point from T 0 to T 4 were observed and recorded; the intraoperative dose of remifentanil, the rescue dose of oxycodone at postoperative T 6 and T 7, Lovett muscle strength score, anesthesia operation time, anesthesia recovery time and postoperative anesthesia-related complications were recorded. Results:There was no significant difference between the two groups in VAS scores at T 0, T 4, T 5 and T 6, MAP, HR and SpO 2 at T 0, T 1, T 2 and T 4, the dosage of remifentanil during operation, the remedial dosage of oxycodone at T 6 after operation, anesthesia operation time and anesthesia recovery time (all P>0.05). Compared with group F, the VAS scores of group P at T 1, T 2, T 3 and T 7 were lower than those of group F (all P<0.05); At T 3, there was no significant difference in SpO 2 between the two groups ( P>0.05), but the MAP and HR in group P was lower than that in group F (all P<0.05); The remedial dose of oxycodone at T 7 in group P was lower than that in group F ( P<0.05), and the analgesic effect was longer; Lovett muscle strength score at T 6 and T 7 in group P was better than that in group F (all P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups ( P>0.05). Conclusions:Compared with FICB, ultrasound-guided PENG block used in PFNA internal fixation in elderly patients has faster effect, lower dosage of opioid analgesics, longer duration of analgesia, and less impact on postoperative lower limb muscle strength.

Objective To explore the characteristics of short-term static balance of obese children by comparing the excursion of center of pressure (COP) in obese and non-obese children under six kinds of standing circumstances. Methods By using the Footscan balance plate system, parameters of COP excursion for 47 obese children and 50 non-obese children standing on both feet or single foot with eyes open or eyes closed for 10 seconds were obtained, respectively. Results The maximum COP displacement in anterior-posterior direction of obese children was significantly greater than that of non-obese children during standing on both feet with eyes closed. During standing on left foot with eyes open, the sway velocity of obese boys was significantly lower than that of non-obese boys; the maximum COP displacement in medial-lateral direction of obese boys was significantly lower than that of non-obese boys and the maximum displacement of COP in medial-lateral direction of obese girls was significantly greater than that of non-obese girls. The sway velocity of boys was significantly greater than that of girls during standing on left foot with eyes closed. Conclusions In short period of time, the static balance of obese children in anterior-posterior direction was worse than that of non-obese children during standing on both feet with eyes closed. Obesity had different impacts on static balance of different genders. The performance of static balance for obese boys was better than that of non-obese boys, while the performance of static balance for obese girls was worse than that of non-obese girls during standing on left foot with eyes open. Girls had a better static balance performance than boys during standing on left foot with eyes closed. There were no significant differences in static balance performance between boys and girls under the other circumstances. As static balance of children is affected by obesity and gender, it is suggested that different methods of losing weight should be considered for obese children of different genders.

Objective To investigate the clinical manifestations and genetic features of children with papillorenal syndrome caused by PAX2 gene mutation.Methods Clinical manifestations,imaging changes and sequencing data were collected and analyzed from a family with papillorenal syndrome who were diagnosed in Wuhan Children's Hospital in February 2018."PAX2","papillorenal syndrome" and "renal coloboma syndrome" were used as key words to search in China National Knowledge Infrastructure,Wangfang Data Knowledge Service Platform,PubMed and Human Gene Mutation Database up to April 2018.Results A ten years old girl was admitted due to "edema and urine output decreased for one week".Lab showed BUN 25.30 mmol/L,Scr 766.5 μmol/L,Urine protein 3.6 g/24 h.Imaging examination showed bilateral vesical and ureter reflux combined with left duplex kidney and duplication of ureter.Developmental dysplasia of the left hip was also found.The father of the patient had been diagnosed with chronic kidney disease for 10 years and on hemodialysis for 6 years.Next generation sequencing revealed that both the father and daughter carried a heterozygous nonsense mutation in the exon3 c.219C ＞ G(p.Y73X) of PAX2.No Chinese literature ever was reported about papillorenal syndrome.Ninety-four articles in English were retrieved and 177 patients with papillorenal syndrome were confirmed by gene analysis with a total of 92 PAX2 variants.Ten nonsense mutations had been reported.Developmental dysplasia of the hip (DDH) never be reported before.Conclusion Papillorenal syndrome caused by PAX2 mutation can mainly manifest as abnormal development of both kidney and optic nerve,which may be accompanied by other systemic abnormalities,it is rarely reported in China.DDH may be a new phenotype of papillorenal syndrome.

Objective Based on health economics,the influencing factors on prevalence rate of drinking-water-borne dental fluorosis were studied.Methods Collect panel data on the prevalence and influencing factors of dental fluorosis in drinking water-type endemic fluorosis (referred to as fluorosis) in 26 provinces (municipalities and autonomous regions) from 2005 to 2015.The theoretical hypothesis model of influencing factors on the prevalence of drinking-water-borne dental fluorosis was constructed from six aspects:economic operation status (electricity consumption),urbanization status (urban population ratio),natural environmental protection (per capita public green space area),urban water supply capacity (urban water population),health expenditure,and fixed assets investment of health institutions.And then Eviews 7.2 was used for panel data regression analysis.Results From 2005 to 2015,the prevalence rate of drinking-water-borne dental fluorosis in China showed a downward trend (r =-0.881,P ＜0.05).The electricity consumption,urban population ratio,per capita public green space area,urban water population and health expenditure had significant impacts on the prevalence rate of drinking-water-borne dental fluorosis (P ＜ 0.05).In this model,per capita public green space area and urban population ratio had the greatest impacts on the prevalence of drinking-water-borne dental fluorosis (absolute value of the standard coefficient ＞ 1).Then,the absolute value of standard coefficient on urban water population was 0.750,and that of electricity consumption and health expenditure were the lowest (absolute value of the standard coefficient =0.266).Conclusion Favorable natural environment,urbanization,construction of urban water supply facilities,reasonable increase of health expenditure and sustainable development of regional economy are powerful impetus to reduce the prevalence rate of drinking-water-borne dental fluorosis and to promote public health development.

Cordycepin exerts neuroprotective effects against excitotoxic neuronal death. However, its direct electrophysiological evidence in Alzheimer's disease (AD) remains unclear. This study aimed to explore the electrophysiological mechanisms underlying the protective effect of cordycepin against the excitotoxic neuronal insult in AD using whole-cell patch clamp techniques. β-Amyloid (Aβ) and ibotenic acid (IBO)-induced injury model in cultured hippocampal neurons was used for the purpose. The results revealed that cordycepin significantly delayed Aβ + IBO-induced excessive neuronal membrane depolarization. It increased the onset time/latency, extended the duration, and reduced the slope in both slow and rapid depolarization. Additionally, cordycepin reversed the neuronal hyperactivity in Aβ + IBO-induced evoked action potential (AP) firing, including increase in repetitive firing frequency, shortening of evoked AP latency, decrease in the amplitude of fast afterhyperpolarization, and increase in membrane depolarization. Further, the suppressive effect of cordycepin against Aβ + IBO-induced excessive neuronal membrane depolarization and neuronal hyperactivity was blocked by DPCPX (8-cyclopentyl-1,3-dipropylxanthine, an adenosine A₁ receptor-specific blocker). Collectively, these results revealed the suppressive effect of cordycepin against the Aβ + IBO-induced excitotoxic neuronal insult by attenuating excessive neuronal activity and membrane depolarization, and the mechanism through the activation of A₁R is strongly recommended, thus highlighting the therapeutic potential of cordycepin in AD.
Action Potentials ; Adenosine ; Alzheimer Disease ; Fires ; Ibotenic Acid ; Membranes ; Neurons ; Neuroprotection ; Neuroprotective Agents ; Patch-Clamp Techniques ; Pyramidal Cells