Objective To investigate the predictive value of preoperative plasma total cholesterol levels for postoperative delirium(POD)following esophagectomy and to analyze its associated risk factors.Methods The complete perioperative electronic medical records of 187 patients with POD who underwent esophagectomy at the 960 Hospital of the People's Liberation Army between January 2019 and December 2023 were retrospectively analyzed.According to the occurrence of POD within one week postoperatively,the patients were categorized into a delirium group and a non-delirium group.The preoperative plasma total cholesterol levels were used to construct a receiver operating characteristic(ROC)curve for predicting delirium after esophagectomy.The area under the curve(AUC)and its 95%confidence interval(CI)were calculated.Additionally,the plasma total cholesterol level corresponding to the maximum Youden index(sensitivity+specificity-1)was determined as the optimal critical value.Results POD occurred in 24 of 187 patients who underwent esophageal cancer resection,with an incidence rate of 12.83%.Compared to the non-delirium group,the delirium group exhibited older age,lower intraoperative blood pressure,lower plasma total cholesterol and low-density lipoprotein levels,longer anesthesia duration,and a higher preva-lence of coronary heart disease,which was identified as a risk factor for POD.Dexmedetomidine administration was associated with a reduced occurrence of POD.The AUC,95%CI,cut-off value,sensitivity,and specificity of preop-erative plasma total cholesterol level for predicting POD were 0.761,0.657～0.865,≤4.11 mmol/L,70.8%,and 77.3%,respectively.Conclusions Among non-hyperlipidemic patients,low preoperative plasma total cholesterol levels and intraoperative hypotension are identified as independent risk factors for POD following esophageal cancer resection.Preoperative plasma total cholesterol levels exhibit moderate predictive value for the occurrence of POD.

Objective To investigate the predictive value of preoperative plasma total cholesterol levels for postoperative delirium(POD)following esophagectomy and to analyze its associated risk factors.Methods The complete perioperative electronic medical records of 187 patients with POD who underwent esophagectomy at the 960 Hospital of the People's Liberation Army between January 2019 and December 2023 were retrospectively analyzed.According to the occurrence of POD within one week postoperatively,the patients were categorized into a delirium group and a non-delirium group.The preoperative plasma total cholesterol levels were used to construct a receiver operating characteristic(ROC)curve for predicting delirium after esophagectomy.The area under the curve(AUC)and its 95%confidence interval(CI)were calculated.Additionally,the plasma total cholesterol level corresponding to the maximum Youden index(sensitivity+specificity-1)was determined as the optimal critical value.Results POD occurred in 24 of 187 patients who underwent esophageal cancer resection,with an incidence rate of 12.83%.Compared to the non-delirium group,the delirium group exhibited older age,lower intraoperative blood pressure,lower plasma total cholesterol and low-density lipoprotein levels,longer anesthesia duration,and a higher preva-lence of coronary heart disease,which was identified as a risk factor for POD.Dexmedetomidine administration was associated with a reduced occurrence of POD.The AUC,95%CI,cut-off value,sensitivity,and specificity of preop-erative plasma total cholesterol level for predicting POD were 0.761,0.657～0.865,≤4.11 mmol/L,70.8%,and 77.3%,respectively.Conclusions Among non-hyperlipidemic patients,low preoperative plasma total cholesterol levels and intraoperative hypotension are identified as independent risk factors for POD following esophageal cancer resection.Preoperative plasma total cholesterol levels exhibit moderate predictive value for the occurrence of POD.

Objective To evaluated the role of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of mediastinal lesions around the trachea.MethodsThe study was retrospective, between September 2009 to July 2010, 34 consecutive patients with enlarged mediastinal lymph nodes or mediastinal masses of unknown origin underwent EBUS-TBNA.Patients in whom EBUS-TBNA was nondiagnostic subsequently underwent surgical biopsy or a minimum of 6 months clinical and radiologic follow-up.ResultsOf the 34 patients, EBUS-TBNA achieved definitive diagnosis in 28 patients (82.4％), 10 were diagnosed as malignancies, 18 were diagnosed as benign.The sensitivity, specificity,and accuracy of EBUS-TBNA in distinguishing benign from malignant mediastinal lesions were 90.9％, 100％, and 97.1％,respectively.EBUS was well tolerated by all of the patients with no complications.ConclusionEBUS-TBNA of mediastinal lesions around the trachea is a minimally invasive safe diagnostic technique with high yield.

Objective To determine the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for staging of lung cancer. Methods The study was retrospective, a total of 52 patients underwent EBUSTBNA for known or suspected lung cancer. All patients were detected enlarged mediastinal lymph nodes on CT scan ( ≥ 1.0cm). Results Of the 52 patients, 41 patients were found with N2 or N3 disease on EBUS-TBNA. 11 patients with negative EBUS-TBNA underwent thoracoscopy or thoracotomy for pulmonary resection and mediastinal lymph node dissection, 9 patients were confirmed N0 by pathology, whereas 2 patients had metastatic lymph node. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of EBUS-TBNA for the mediastinal staging of lung cancer were 95.3%, 100%, 96.2%, 100%, and 81.8%, respectively. The procedure was uneventful, and there were no postoperative complications. Conclusion EBUS-TBNA is an effective and safe technique for mediastinal staging in lung cancer patients.

OBJECTIVE:To study the production process of ceftizoxime sodium.METHODS:Ceftizoxime acid was prepared with 7-Amino-3-norcephem-4-carboxylic acid(7-ANCA)and AE-ester ceftizoxime acid as raw material;then ceftizoxime sodium was obtained through the reaction between ceftizoxime acid and sodium carbonate.The effects of parameters including reaction time,and amount and dripping velocity of ethanol,the amount of sodium carbonate,and pH of solution on quality of product were studied.RESULTS:The reaction process could be realized successfully.The optimal parameters for the synthesis of ceftizoxime sodium were as follows:reaction time=1.5h,the velocity of dripping ethanol=400mL? h-1,reaction temperature