Objective To explore the influence of dexmedetomidine on blood gas and inflammation cytokines in patients with one-lung ventilation (OLV).Methods Sixty-two patients undergoing radical resection of pulmonary carcinoma were divided into observation group and control group in sequence,31 cases in each group.All patients treated with intravenous sufentanil 0.3-0.5 μg/kg,propofol 1.5-2.5 mg/kg,midazolam 0.5 mg/kg and rocuronium 0.9 mg/kg for induction of anesthesia;intravenous infusion of propofol 6-8 mg·kg-1 ·h-1 and remifentanil 0.1-0.5 μg·kg-1 ·min-1,intermittent intravenous injection of cisatracurium for anesthesia maintenance.The patients in the observation group were given 1μg/kg loading dose dexmedetomidine 10 min before anesthesia induction (infusion in 10 min),maintaining at 0.5 μg·kg-1 ·h-1 until 30 min before the end of surgery.The patients in the control group were given the same amount of saline as a control.The blood gas analysis index,pH,partial oxygen pressure (PaO2),CO2 partial pressure (PaCO2) and such inflammation cytokines as tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) at OLV (T0),after OLVlh (T1),the end of OLV (T2) were respectively tested,the dosage of propofol in the two groups were recorded.Results The dosage of propofol in observation group was significantly lower than that in the control group (P＜0.05);pH declined in the two groups (P＜0.05),but the difference had no statistical significance;PaO2 was rising then declined in the two groups (P＜0.05),but it was significantly higher in the observation group than in the control group(P＜0.05);PaCO2 in the two groups increased gradually(P＜0.05),it was significantly lower in the observation group than in the control group (P＜0.05);The serum TNF-α,IL-6 in the two groups showed a trend of increasing (P＜0.05),it was significantly lower in the observation group than in the control group (P＜0.05).Conclusion Dexmedetomidine can maintain blood gas stability and reduce inflammation caused by single lung ventilation.

Objective To explore the effects of different anesthesia methods on postoperative TLR4 expression and the level of serum S100β protein in children.Methods Totally 122 children with elective surgery were randomly divided into two groups.The control group was treated with ketamine intravenous anesthesia,while the observation group was treated with inhalation anesthesia with sevoflurane.Expression of TLR4,the level of serum S100β protein and the adverse reactions of anesthesia were observed.Results During the period of anesthesia,the incidence rates of physical and mental symptoms in the observation group were significantly lower than the control group (P ＜ 0.05).The levels of serun S100β protein at 2 h and 24 h after operation in the observation group were significantly lower than those in the control group (P ＜ 0.05).Compared with those before operation,there was no significant difference in the expression of TLR4 at the time of skin incision,2 h and 24 h after operation (P ＞ 0.05).The expressions of TLR4 at the time points of after skin incision,2 h and 24 h after operation in the control group were significantly lower than those before operation and the observation group (P ＜ 0.05).Conclusion The sevoflurane inhalation anesthesia can reduce the adverse reactions of anesthesia in children with surgery.

Objective To explore the effects of different anesthesia methods on postoperative TLR4 expression and the level of serum S100β protein in children.Methods Totally 122 children with elective surgery were randomly divided into two groups.The control group was treated with ketamine intravenous anesthesia,while the observation group was treated with inhalation anesthesia with sevoflurane.Expression of TLR4,the level of serum S100β protein and the adverse reactions of anesthesia were observed.Results During the period of anesthesia,the incidence rates of physical and mental symptoms in the observation group were significantly lower than the control group (P ＜ 0.05).The levels of serun S100β protein at 2 h and 24 h after operation in the observation group were significantly lower than those in the control group (P ＜ 0.05).Compared with those before operation,there was no significant difference in the expression of TLR4 at the time of skin incision,2 h and 24 h after operation (P ＞ 0.05).The expressions of TLR4 at the time points of after skin incision,2 h and 24 h after operation in the control group were significantly lower than those before operation and the observation group (P ＜ 0.05).Conclusion The sevoflurane inhalation anesthesia can reduce the adverse reactions of anesthesia in children with surgery.

Background::Few evidence is available in the early prediction models of behavioral and psychological symptoms of dementia (BPSD) in Alzheimer’s disease (AD). This study aimed to develop and validate a novel genetic-clinical-radiological nomogram for evaluating BPSD in patients with AD and explore its underlying nutritional mechanism.Methods::This retrospective study included 165 patients with AD from the Chinese Imaging, Biomarkers, and Lifestyle (CIBL) cohort between June 1, 2021, and March 31, 2022. Data on demographics, neuropsychological assessments, single-nucleotide polymorphisms of AD risk genes, and regional brain volumes were collected. A multivariate logistic regression model identified BPSD-associated factors, for subsequently constructing a diagnostic nomogram. This nomogram was internally validated through 1000-bootstrap resampling and externally validated using a time-series split based on the CIBL cohort data between June 1, 2022, and February 1, 2023. Area under receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were used to assess the discrimination, calibration, and clinical applicability of the nomogram.Results::Factors independently associated with BPSD were: CETP rs1800775 (odds ratio [OR] = 4.137, 95% confidence interval [CI]: 1.276-13.415, P = 0.018), decreased Mini Nutritional Assessment score (OR = 0.187, 95% CI: 0.086-0.405, P <0.001), increased caregiver burden inventory score (OR = 8.993, 95% CI: 3.830-21.119, P <0.001), and decreased brain stem volume (OR = 0.006, 95% CI: 0.001-0.191, P = 0.004). These variables were incorporated into the nomogram. The area under the ROC curve was 0.925 (95% CI: 0.884-0.967, P <0.001) in the internal validation and 0.791 (95% CI: 0.686-0.895, P <0.001) in the external validation. The calibration plots showed favorable consistency between the prediction of nomogram and actual observations, and the DCA showed that the model was clinically useful in both validations. Conclusion::A novel nomogram was established and validated based on lipid metabolism-related genes, nutritional status, and brain stem volumes, which may allow patients with AD to benefit from early triage and more intensive monitoring of BPSD.Registration::Chictr.org.cn, ChiCTR2100049131.

Objective:To investigate the feasibility and clinical diagnostic value of rapid arterial spin labeling (ASL) imaging in brain glioma.Methods:Patients with glioma admitted to Beijing Tiantan Hospital, Capital Medical University from May 2021 to December 2022 were prospectively enrolled. All patients received MR rapid ASL (scan time: 1 min) and conventional ASL (scan time: 4 min 30 s), where the cerebral blood flow (CBF) perfusion maps were obtained. The qualitative analysis of CBF signal intensity and quantitative analysis of average CBF values from both tumor solid and edema regions were conducted by two radiologists independently. Kappa test and intraclass correlation coefficient ( ICC) were used to analyze the consistency of qualitative and quantitative results, respectively. Results:A total of 30 patients with brain glioma were included. The 2 physicians used rapid ASL to determine low perfusion, isoperfusion, and hyperperfusion in the tumor area in 1, 6, 23 cases and 0, 5, and 25 cases, respectively; and used conventional ASL to determine low perfusion, isoperfusion, and hyperperfusion in the tumor area in 0, 9, and 21 cases, respectively. The results of qualitative analysis of rapid ASL and conventional ASL were highly consistent within and between groups ( Kappa was 0.830 and 0.850 respectively). The results of quantitative analysis of rapid ASL and conventional ASL were highly consistent within and between groups ( ICC 0.940—0.994). Conclusion:Rapid ASL with shorter scanning time could be applied in assessing tissue perfusion in brain glioma and contribute to the clinical diagnosis of gliomas.