Objective:To investigate the effects of dexmedetomidine on short-term prognosis in elderly patients with gastric cancer after laparoscopic radical gastrectomy.Methods:A total of 60 elderly patients with gastric cancer admitted to Shanxi Provincial Cancer Hospital from June 2018 to September 2019 were selected as the research objects. The patients were randomly divided into the observation group and the control group according to random number method, 30 cases in each group. All patients underwent laparoscopic radical gastrectomy. The patients in the control group received routine intravenous anesthesia, and the patients in the observation group were assisted with intravenous infusion of dexmedetomidine on the basis of anesthesia in the control group. The general situation during and after surgery, hemodynamics and postoperative delirium of patients in the two groups were observed and compared.Results:The anal exhaust time and hospitalization time in the observation group was shorter than that in the control group [(72±10) h vs. (79±13) h, t = 8.384, P = 0.031; (11.0±1.7) d vs. (12.9±1.9) d, t = 7.404, P = 0.022]. While the time of abdominal drainage was (8.4±2.8) d and (8.6±1.6) d, respectively in the observation group and the control group, and the difference was not statistically significant ( t = 0.958, P = 1.092); the volume of abdominal drainage was (534±50) ml and (545± 55) ml, respectively, and the difference was not statistically significant ( t = 0.847, P = 1.202). Compared with the preoperative baseline, the mean arterial pressure (MAP) in the two groups was stable during the operation. At extubation, the MAP in the control group [(104±5) mmHg, 1 mmHg = 0.133 kPa] was higher than that in the observation group [(92±7) mmHg] ( t = 7.383, P < 0.01); in the control group, the MAP at extubation was also higher compared with the preoperative MAP [(92±9) mmHg] ( P < 0.05). The heart rate in the observation group was lower than that before surgery and the same period in the control group.The incidence rate of delirium and suspicious delirium was 3% (1/30) and 7% (2/30) in the observation group, 10% (3/30) and 13% (4/30) in the control group within 7 d after surgery, and there were statistically significant differences in delirium and suspicious delirium between the two groups ( χ2 = 9.394, 7.485, all P < 0.05). Conclusion:Dexmedetomidine can reduce the incidence of delirium in elderly patients with gastric cancer after laparoscopic radical gastrectomy, and make the hemodynamics more stable and recovery faster.

Objective To compare the effects of different methods of honey sunburn on the contents of calycosin and formononetin in Hedysari Radix; To provide the basis for the establishment of the optimum processing technology. Methods By frying (traditional method), baking, and microwave methods put Hedysari Radix under honey sunburn. Agilent HC-C18 column (4.6 mm × 250 mm, 5 μm) was used; the mobile phase was acetonitrile-0.01% phosphoric acid solution, gradient elution (0–12 min, 30%–33% acetonitrile; 12–13 min, 31%–40% acetonitrile; 13–25 min, 40% acetonitrile) with velocity of 1.0 mL/min; detection wavelength was 248 nm;the column temperature was 30 ℃; sample volume was 10 μL. Results There was statistical significance in the contents of calycosin and formononetin of different methods of honey sunburn for Hedysari Radix. Among them, the contents of calycosin and formononetin in Hedysari Radix processed by honey roast were the highest, 7.9116 and 49.6996 μg/g, respectively; the contents of calycosin and formononetin in Hedysari Radix processed by traditional method were the lowest, 4.7767 and 37.2910 μg/g, respectively; the contents of calycosin and formononetin in raw Hedysari Radix and Hedysari Radix by honey microwave method were the same, 5.0802, 42.7989 μg/g, and 3.9839, 42.3145 μg/g, respectively. Conclusion Different honey sunburn methods for the contents of calycosin and formononetin in Hedysari Radix have certain effects, and honey roast method is the optimum method.

Objective To observe the effects of a decoction of buzhong yiqi in conjunction with rehabilitation training in relieving post-stroke fatigue.Methods A group of 115 stroke patients was enrolled and randomly divided into a simple rehabilitation group and a combination therapy group.Both groups received conventional rehabilitation treatment and appropriate treatment of any primary diseases.In addition,those in the combination therapy group were given a decoction of buzhong yiqi twice daily for a total of 4 weeks.EMG signals,subjective evaluations of fatigue severity,active rehabilitation exercise duration,motor function and ability in the activities of daily living (ADL) were assessed before treatment and after 4 weeks of treatment.The slope of the surface electromyogram's mean power frequency (KMPF) and median frequency (KMF) were used to quantify fatigue.Subjective fatigue severity was estimated using a fatigue severity scale (FSS).The active rehabilitation exercise lasted,on average,90 minutes daily.The Fugl-Meyer assessment (FMA) was used to evaluate motor function and the modified Barthel index (MBI) ADL ability.Results There were no statistically significant differences between the groups before treatment.After 4 weeks of treatment all the outcomes in both groups had improved (except the FSS scores of the simple rehabilitation group).The KMPF,KMF,FSS,exercise duration,FMA scores and MBI scores in the combination therapy group were all significantly better than those in the simple rehabilitation group.Conclusion Taking buzhong yiqi can significantly improve the clinical effects of conventional rehabilitation training on post-stroke fatigue.It helps relieve fatigue,improve active participation in rehabilitation exercise,and also improve motor function and ADL ability.

The abuse of opioids in the perioperative period has made the side effects of opioids increasingly prominent. So many anesthesiologists have proposed the concept of opioid-free anesthesia. Immunomodulation is an important field of modern medical research. With the introduction of the concept of enhanced recovery after surgery, the immunomodulatory effects of opioids have received increasing attention. Currently, the fentanyl family is commonly used opioid analgesics in clinical practice. This article reviews the research progress of the fentanyl family and immunomodulation, in order to provide guidance for clinicians to choose analgesic drugs.

Objective:To analyze the anesthesia effect of closed-loop target-controlled infusion system in esophageal cancer surgery.Methods:A total of 78 patients with esophageal cancer who underwent surgery in Shanxi Provincial Cancer Hospital from February to October 2019 were selected and divided into observation group and control group by random number table method, with 39 cases in each group. The patients in the observation group were anesthetized by closed-loop target-controlled infusion of propofol, while the propofol target-controlled infusion concentration of patients in the control group was manually controlled by anesthesiologists. The dosage of propofol, the time from drug discontinuation to recovery, the time of stay in post-anesthesia care unit (PACU), the incidence of hypoxemia after entering PACU and the incidence of anesthesia related complications were analyzed and compared between the two groups.Results:The dosage of propofol in the observation group was lower than that in the control group [(978±163) mg vs. (1 307±278) mg], and the difference was statistically significant ( t = 9.234, P = 0.028). The time from drug discontinuation to recovery in the observation group was shorter than that in the control group [(9.7±1.2) min vs. (13.2±2.6) min], and the difference was statistically significant ( t = 9.895, P = 0.025). The time of stay in PACU in the observation group was shorter than that in the control group [(15.6±2.4) min vs. (19.5±3.0) min], and the difference was statistically significant ( t = 9.536, P = 0.026). The incidence of hypoxemia after entering the PACU in the observation group was lower than that in the control group [7.69% (3/39) vs. 23.08% (9/39)], and the difference was statistically significant ( χ2 = 10.271, P = 0.016). The total incidence of postoperative anesthesia-related complications in the observation group was lower than that in the control group [10.26% (4/39) vs. 23.08% (9/39)], and the difference was statistically significant ( χ2 = 8.353, P = 0.021). Conclusion:The application of closed-loop target-controlled infusion system can effectively reduce the dosage of propofol, shorten the recovery time of patients and the time of stay in PACU, reduce the incidence of hypoxemia after entering PACU and the incidence of postoperative anesthesia related complications, which is worthy of clinical application.

Objective To investigate the application of non-invasive positive pressure ventilation in emergency department in China.Methods A questionnaire survey was carried out in the emergency department in China,then the results were analyzed.Results Out of the 317 hospitals,non-invasive ventilators were available in the emergency department in 150 clinics (47.3％).Among them,144 clinics were the tertiary hospitals,and 6 clinics were the secondary hospitals.The leading five causes for NPPV were as follows:acute exacerbation of chronic obstructive pulmonary diseases (AECOPD) (29.7％),acute cardiogenic pulmonary edema (23.2％),ventilator weaning (11.2％),acute respiratory distress syndrome (ARDS) (9.0％),and extubation failure (8.7％).The bi-level positive airway pressure (BiPAP) S/T was the most commonly used ventilation mode (51.8％),followed by the continuous positive airway pressure (CPAP)(30.3％) and BiPAP (S)(12.5％).The oronasal mask (73.7％) and the nasal mask (24.2％) were the most favorable interfaces for NPPV.The reasons for NPPV underusing mainly included insufficient training (36.8％),lacking of related knowledge (22.9％),medical teaching staff shortage (21.1％) and poor compliance of patients (11.0％).The main causes of the failure of NPPV were as follows:poor tolerance (31.5％),irrational parameters setting (25.6％),unfitness of interface (17.8％),airway secretions (14.7％),and disorders of consciousness (10.4％).Conclusions In China,the types of patients most commonly treated with NPPV in the emergency department are those with AECOPD and acute cardiogenic pulmonary edema.Barriers to popularize the use of NPPV in the emergency department include availability of equipment,physician with familiarity in operating the NPPV,and human resources required for NPPV.

Objective To investigate the readmission of male schizophrenia patients in a hospital of Zhoushan and its influencing factors,and to build a nomogram model.Methods A total of 183 male schizophrenics patients admitted to the Second People's Hospital of Zhoushan from January to December 2022 were analyzed retrospectively.Patients were divided into readmission group (hospitalization frequency ≥ 2 times) and non-readmission group (hospitalization was once) based on the number of hospitalization.Perform univariate analysis on the data of two groups of patients using t test or x2 test.Multivariate Logistic regression model was used to investigate the influencing factors of readmission in schizophrenia patients within one year,and a nomogram prediction model was established.Results The rate of readmission was 49.18％ in 183 schizophrenic patients.Course of disease,duration of first hospitalization,and history of tobacco and alcohol consumption were independent risk factors for readmission (P<0.05).The area under the curve (AUC) of the receiver operating characteristic curve in the column chart model is 76.53.Conclusion The readmission rate of male schizophrenia patients in the Second People's Hospital of Zhoushan is high,and the course of disease,duration of first hospitalization,and history of tobacco and alcohol consumption are independent risk factors for the readmission of schizophrenia patients within one year.The establishment of the nomogram prediction model is expected to evaluate the high risk factors for the readmission of schizophrenia patients and implement targeted interventions to improve the quality of life of patients.

Objective To optimize the processing technology of honey baked Hedysari Radix, so as to provide the experimental basis for the quality control of Hedysari Radix processed products and standardization of the processing.Methods L9 (34) orthogonal design method was used, and the mean content of calycosin and formononetin which were detected by HPLC with gradient elution were taken as the comprehensive evaluation indexes, the processing technology was optimized.Results The optimum processing technology of honey baked Hedysari Radix was thickness of 3 cm at the temperature of 70 ℃ for 2.5 h.Conclusion Hedysari Radix baking processed products produced by the optimum technology met with the requirement of Chinese Pharmacopoeia (2015 Edition), which was simple, feasible, and repeatable.The method would provide evidence for further research on optimum processing technology and for standardiztion of industrial production.

Objective To establish the fingerprint map and method of multi-component content determination of ginger and its processed products,and to evaluate their quality. Methods High performance liquid chromatography (HPLC) was used to establish the fingerprint of ginger and its processed products (dried ginger,baked ginger,ginger charcoal) and the method for the simultaneous determination of content of five components. The data were analyzed by similarity evaluation and chemical pattern recognition. Results The fingerprint of ginger and its processed products was established. The similarity was ranged from 0.931 to 0.996. A total of 15 common peaks were confirmed. Five components (6-ginger phenol,8-ginger phenol,10-ginger phenol,6-ginger enol,zingiberone) were identified when compared with the standard. The content of 6-ginger phenol,8-ginger phenol and 10-ginger phenol in ginger and its processed products(dried ginger,baked ginger,ginger charcoal),which were determined by HPLC,met the standard of Chinese Pharmacopoeia(2020 edition). The content of 6-ginger enol and zingiberone in fresh ginger was very low,but their content increased significantly after processing into dried ginger and baked ginger. Ginger and its processed products can be divided into different category in cluster analysis. Five components with VIP greater than one were selected by orthogonal partial least squares discriminant analysis. Conclusion The HPLC fingerprint and assay method established in this study are specific,simple and feasible,stable and reliable. With the help of chemical pattern recognition method,it can provide reference for the quality evaluation of ginger and its processed products.