Objective:To evaluate the role of autophagy in reduction of high glucose and hypoxia-reoxygenation (HG+ H/R) injury to isolated cardiomyocytes by dexmedetomidine in rats.Methods:The normally cultured rat H9c2 cardiomyocytes at the logarithmic growth phase were seeded in 6-well plates at a density of 1×10 6 cells/ml and divided into 4 groups ( n=15 each) using a random number table method: control group (group C), group HG+ H/R, dexmedetomidine group (group DEX) and dexmedetomidine+ autophagy inhibitor 3-methylpurine group (group 3-MA). The cells were incubated in culture medium with 1% fetal bovine serum + 1% double antibody for 24 h when the cell density reached 50%.To establish HG+ H/R injury model, the cardiomyocytes were cultured in high-glucose culture medium (glucose concentration of 33 mmol/L) for 24 h, and then incubated in a 37 ℃ incubator (95% N 2+ 5%CO 2) for 4 h followed by reoxygenation (90%O 2+ 10%CO 2) for 2 h. Dexmedetomidine was added until the final concentration reached 5 μmol/L at 1 h before hypoxia in DEX and 3-MA groups, and 3-MA was added until the final concentration reached 5 μmol/L at 1 h of incubation with dexmedetomidine.At 2 h after reoxygenation, the cell viability was recorded by the cell counting kit-8 assay, lactate dehydrogenase (LDH) activity was detected by LDH kit, the expression of autophagy-related protein LC3, P62 and Beclin-1 was detected by Western Blot, the ratio of LC3Ⅱ/LC3Ⅰwas calculated, and the expression of P62 and Beclin-1 mRNA was detected by real-time polymerase chain reaction. Results:Compared with group C, the cell viability was significantly decreased in HG+ H/R, DEX and 3-MA groups, LDH activity in the supernatant was increased and expression of P62 was decreased in HG+ H/R and 3-MA groups, ratio of LC3Ⅱ/LC3Ⅰwas decreased in group 3-MA, and the expression of Beclin-1 was down-regulated in group HG+ H/R ( P<0.05). Compared with HG+ H/R group, LDH activity in the supernatant was significantly decreased, expression of Beclin-1, P62 and its mRNA was up-regulated, and ratio of LC3Ⅱ/LC3Ⅰwas increased in DEX group, and LDH activity in the supernatant was increased in group 3-MA ( P<0.05). Compared with DEX group, cell viability were decreased, LDH activity in the supernatant was increased, Beclin-1, P62 and its mRNA was down-regulated, and ratio of LC3Ⅱ/ LC3Ⅰwas decreased in group 3-MA ( P<0.05). Conclusion:Autophagy is involved in the reduction of HG+ H/R injury to isolated cardiomyocytes by dexmedetomidine in rats.

Objective:To construct a dual-track clinical nursing path based on fast and slow channels in Post Anesthesia Care Unit (PACU) to provide references for the implementation of standardized nursing for patients in the anesthesia recovery period.Methods:On the basis of literature review, evidence-based methods were used to construct the classification management of patients in anesthesia recovery period based on the theoretical framework of fast and slow channels. The research team initially drafted the clinical nursing path table in the PACU from May 2019 to June 2019 and conducted two rounds of Delphi expert letter inquiries from July to October 2019 to further revise and improve the path table.Results:The recovery rates of the two rounds of expert consultation were 90.91% and 100.00%. The expert authority coefficient was 0.89, the variation coefficient of the path table was 0.06, and the Kendall harmony coefficient was 0.25. Finally, the flow chart and three levels of anesthesia recovery based on fast and slow channels were formed.Conclusions:The established clinical nursing path in the PACU has reliable results. Based on the fast and slow channels to assess the risk degree of patients in the anesthesia recovery period, the classified management of patients can be implemented in the PACU, providing a reference for clinical nursing practice.

Objectives:To investigate the effect of polyester filament fiber surgical drape in neurosurgery.Methods:A total of 181 neurosurgical surgeries were selected from April to July 2019 in a first-class general hospital. They were randomly divided into 2 groups, cotton group (92 cases) were covered with cotton drape, polyester filament fiber group (89 cases) were covered with polyester filament fiber. The anti-permeation performance, incidence of intraoperative hypothermia, and incidence of postoperative surgical site infection (SSI) between the two groups were compared.Results:At the end of the operation, the wetting rate of the cotton draped was 58.7% (54/92) and that in polyester filament fiber was 15.7% (14/89), with statistically significant differences ( χ2 value was 35.605, P<0.05);The incidence of intraoperative hypothermia was 22.8% (21/92) in the cotton group and 11.2% (10/89) in the polyester filament fiber group, with statistically significant differences ( χ2 value was 4.281, P<0.05). The incidence of SSI in the cotton group was 16.3% (15/92) , while that in the polyester filament fiber group was 6.7% (6/89) , with statistically significant differences ( χ2 value was 4.034, P<0.05). Conclusions:In neurosurgical operations with a long operation time and a large amount of irrigation fluid during the operation, using the polyester filament fiber drape can prevent the irrigation fluid from wetting the surgical drape, protect the surgical incision better, reduce the incidence of SSI and intraoperative hypothermia to some extent.

The surgical drape system is a sterile barrier to prevent skin bacteria from entering the incision. The surgical drape system is used to maintain the sterile state of the surgical area, which can reduce the risk of SSI. Therefore, it is the basic measure to prevent SSI. This review summarizes the importance, development, current situation and prospect of surgical drape system, in order to provide reference for clinicians.