1.Pain, agitation, and delirium practices in Chinese intensive care units: A national multicenter survey study.
Xiaofeng OU ; Lijie WANG ; Jie YANG ; Pan TAO ; Cunzhen WANG ; Minying CHEN ; Xuan SONG ; Zhiyong LIU ; Zhenguo ZENG ; Man HUANG ; Xiaogan JIANG ; Shusheng LI ; Erzhen CHEN ; Lixia LIU ; Xuelian LIAO ; Yan KANG
Chinese Medical Journal 2025;138(22):3031-3033
2.Application effect of dexmedetomidine combined with ciprofol general anesthesia in laparoscopic radical resection of ovarian cancer
Jun WANG ; Tengna SHI ; Lijie WANG ; Lishuang ZHONG ; Linlin SONG
Journal of Chinese Physician 2025;27(10):1500-1503
Objective:To explore the application effect of dexmedetomidine combined with ciprofol general anesthesia in laparoscopic radical resection of ovarian cancer.Methods:A total of 120 patients who underwent laparoscopic radical resection of ovarian cancer at the Hengshui Second People′s Hospital, Hebei Province from January 2021 to January 2023 were selected as the research objects. They were divided into the control group and the observation group by random number table method, with 60 cases in each group. Both groups underwent surgery under general anesthesia: the control group was given ciprofol, while the observation group was given dexmedetomidine combined with ciprofol. Postoperative recovery, changes in hemodynamics and vital signs, levels of stress indicators, and the occurrence of adverse reactions were compared between the two groups.Results:Compared with the control group, the observation group had fewer presses on the analgesic pump, shorter first flatus time and awakening time, lower Visual Analogue Scale (VAS) score at 1 hour after surgery, and higher Ramsay sedation score (all P<0.05). There were no statistically significant differences in heart rate (HR), mean arterial pressure (MAP), and bispectral index (BIS) between the two groups before induction (T 0) (all P>0.05); MAP at skin incision (T 1), 30 minutes after skin incision (T 2), and after extubation (T 3) in both groups were higher than those at T 0, while HR were lower than those at T 0 (all P<0.05); HR and MAP at T 1, T 2, and T 3 in the observation group were significantly lower than those in the control group (all P<0.05), but there was no statistically significant difference in BIS between the two groups at each time point (all P>0.05). There were no statistically significant differences in serum cortisol (COR) and adrenocorticotropic hormone (ACTH) levels between the two groups at T 0 (all P>0.05); serum COR and ACTH levels at T 3 and 1 hour after surgery (T 4) in both groups were higher than those at T 0 (all P<0.05), and the levels of serum COR and ACTH at T 3 and T 4 in the observation group were lower than those in the control group (all P<0.05). In the control group, there were 3 cases of hypotension, 7 cases of nausea and vomiting, and 1 case of respiratory depression; in the observation group, there were 2 cases of hypotension and 3 cases of nausea and vomiting. No serious adverse reactions occurred in either group, and the total incidence of adverse reactions in the observation group was lower than that in the control group (χ 2=3.354, P<0.05). Conclusions:Dexmedetomidine combined with ciprofol general anesthesia can promote postoperative recovery of patients undergoing laparoscopic radical resection of ovarian cancer, effectively stabilize hemodynamics, and reduce stress response and adverse reactions.
3.Risk factors of anastomotic stenosis after esophageal cancer surgery
Wenrong YANG ; Aimin LI ; Lijie YANG ; Zhonghua LI ; Zheng SONG ; Wanchun YANG ; Jianyuan CHA
China Modern Doctor 2025;63(23):24-27
Objective To investigate the risk factors for postoperative anastomotic stenosis in esophageal cancer patients.Methods A total of 200 patients who underwent radical esophageal cancer resection at the First Affiliated Hospital of Dali University from July 2015 to June 2024 were selected as subjects.The patients were divided into stenosis group(n=100)and non-stenosis group(n=100)based on whether they had benign anastomotic stenosis.Comparative analyses were conducted regarding the first feeding time,surgical duration,use of non-linear anastomotic devices,and anastomotic leakage in both groups.The independent risk factors for benign postoperative anastomotic stenosis were systematically evaluated.Results Delayed initial postoperative feeding,non-linear anastomotic devices,anastomotic leakage,and persistent postoperative hypoxemia were identified as risk factors for anastomotic stenosis in esophageal cancer patients after neck anastomosis.Balloon dilation-induced bleeding and early postoperative feeding within 12h served as protective factors(P<0.05).Conclusion The development of anastomotic stenosis in esophageal cancer patients following neck anastomosis may be associated with delayed initial feeding,non-linear anastomotic devices,anastomotic leakage,and persistent hypoxemia.
4.Effects of dexmedetomidine combined with propofol or cyclopropofol on postoperative stress in laparoscopic ovarian cancer surgery
Tengna SHI ; Lijie WANG ; Jun WANG ; Lishuang ZHONG ; Linlin SONG
Journal of Chinese Physician 2025;27(6):841-846
Objective:To investigate the effects of dexmedetomidine (Dex) combined with propofol or cyclopropofol on postoperative stress in laparoscopic ovarian cancer surgery.Methods:A total of 120 ovarian cancer patients who underwent laparoscopic radical resection of ovarian cancer in the Second People′s Hospital of Hengshui from January 2022 to December 2023 were selected and divided into observation group and control group by random number table method, with 60 cases in each group. The control group was given Dex combined with propofol for compound anesthesia, and the observation group was given Dex combined with cyclopropofol for compound anesthesia. The perioperative indicators and intraoperative opioid dosage were compared between the two groups. The heart rate (HR) and mean arterial pressure (MAP) were compared at 3 min after entering the operating room (T 1), intubation (T 2), skin incision (T 3), extubation (T 4) and leaving the operating room (T 5). The Ramsay Sedation Scale (RSS) scores at T 1, T 2, T 3, T 4 and Prince-Henry scores at 2, 6, 12, 24 h after operation were compared. The serum levels of prostin E 2 (PGE 2) and cortisol (Cor) 1 day before operation and 12, 24, 48 h after operation, as well as the incidence of adverse events during treatment were compared between the two groups. Results:The anesthesia recovery time in the observation group was significantly shorter than that in the control group, and the intraoperative dosages of sufentanil and remifentanil were significantly less than those in the control group (all P<0.05). Compared with T 1, there were no significant differences in HR and MAP at T 2, T 3, T 4 in the observation group (all P>0.05); the HR and MAP at T 2, T 3, T 4 in the control group were significantly different from those at T 1 (all P<0.05), and the HR and MAP at T 2, T 3, T 4, T 5 in the observation group were lower than those in the control group (all P<0.05). The RSS scores at T 2, T 3 and T 4 in the observation group were significantly higher than those in the control group (all P<0.05). The Prince-Henry scores at 2, 6, 12, 24 h after operation in the observation group were significantly lower than those in the control group (all P<0.05). The serum PGE 2 and Cor levels at 12, 24 and 48 h after operation in the observation group were significantly lower than those in the control group (all P<0.05). The total incidence of postoperative adverse events in the observation group was 18.33%(11/60), lower than 23.33%(14/60) in the control group ( P<0.05). Conclusions:Compared with Dex combined with propofol, Dex combined with cyclopropofol for compound anesthesia can reduce postoperative stress response in laparoscopic ovarian cancer surgery, improve intraoperative sedation and postoperative analgesia, stabilize hemodynamics, and has good safety.
5.Effects of dexmedetomidine combined with propofol or cyclopropofol on postoperative stress in laparoscopic ovarian cancer surgery
Tengna SHI ; Lijie WANG ; Jun WANG ; Lishuang ZHONG ; Linlin SONG
Journal of Chinese Physician 2025;27(6):841-846
Objective:To investigate the effects of dexmedetomidine (Dex) combined with propofol or cyclopropofol on postoperative stress in laparoscopic ovarian cancer surgery.Methods:A total of 120 ovarian cancer patients who underwent laparoscopic radical resection of ovarian cancer in the Second People′s Hospital of Hengshui from January 2022 to December 2023 were selected and divided into observation group and control group by random number table method, with 60 cases in each group. The control group was given Dex combined with propofol for compound anesthesia, and the observation group was given Dex combined with cyclopropofol for compound anesthesia. The perioperative indicators and intraoperative opioid dosage were compared between the two groups. The heart rate (HR) and mean arterial pressure (MAP) were compared at 3 min after entering the operating room (T 1), intubation (T 2), skin incision (T 3), extubation (T 4) and leaving the operating room (T 5). The Ramsay Sedation Scale (RSS) scores at T 1, T 2, T 3, T 4 and Prince-Henry scores at 2, 6, 12, 24 h after operation were compared. The serum levels of prostin E 2 (PGE 2) and cortisol (Cor) 1 day before operation and 12, 24, 48 h after operation, as well as the incidence of adverse events during treatment were compared between the two groups. Results:The anesthesia recovery time in the observation group was significantly shorter than that in the control group, and the intraoperative dosages of sufentanil and remifentanil were significantly less than those in the control group (all P<0.05). Compared with T 1, there were no significant differences in HR and MAP at T 2, T 3, T 4 in the observation group (all P>0.05); the HR and MAP at T 2, T 3, T 4 in the control group were significantly different from those at T 1 (all P<0.05), and the HR and MAP at T 2, T 3, T 4, T 5 in the observation group were lower than those in the control group (all P<0.05). The RSS scores at T 2, T 3 and T 4 in the observation group were significantly higher than those in the control group (all P<0.05). The Prince-Henry scores at 2, 6, 12, 24 h after operation in the observation group were significantly lower than those in the control group (all P<0.05). The serum PGE 2 and Cor levels at 12, 24 and 48 h after operation in the observation group were significantly lower than those in the control group (all P<0.05). The total incidence of postoperative adverse events in the observation group was 18.33%(11/60), lower than 23.33%(14/60) in the control group ( P<0.05). Conclusions:Compared with Dex combined with propofol, Dex combined with cyclopropofol for compound anesthesia can reduce postoperative stress response in laparoscopic ovarian cancer surgery, improve intraoperative sedation and postoperative analgesia, stabilize hemodynamics, and has good safety.
6.Risk factors of anastomotic stenosis after esophageal cancer surgery
Wenrong YANG ; Aimin LI ; Lijie YANG ; Zhonghua LI ; Zheng SONG ; Wanchun YANG ; Jianyuan CHA
China Modern Doctor 2025;63(23):24-27
Objective To investigate the risk factors for postoperative anastomotic stenosis in esophageal cancer patients.Methods A total of 200 patients who underwent radical esophageal cancer resection at the First Affiliated Hospital of Dali University from July 2015 to June 2024 were selected as subjects.The patients were divided into stenosis group(n=100)and non-stenosis group(n=100)based on whether they had benign anastomotic stenosis.Comparative analyses were conducted regarding the first feeding time,surgical duration,use of non-linear anastomotic devices,and anastomotic leakage in both groups.The independent risk factors for benign postoperative anastomotic stenosis were systematically evaluated.Results Delayed initial postoperative feeding,non-linear anastomotic devices,anastomotic leakage,and persistent postoperative hypoxemia were identified as risk factors for anastomotic stenosis in esophageal cancer patients after neck anastomosis.Balloon dilation-induced bleeding and early postoperative feeding within 12h served as protective factors(P<0.05).Conclusion The development of anastomotic stenosis in esophageal cancer patients following neck anastomosis may be associated with delayed initial feeding,non-linear anastomotic devices,anastomotic leakage,and persistent hypoxemia.
7.Application effect of dexmedetomidine combined with ciprofol general anesthesia in laparoscopic radical resection of ovarian cancer
Jun WANG ; Tengna SHI ; Lijie WANG ; Lishuang ZHONG ; Linlin SONG
Journal of Chinese Physician 2025;27(10):1500-1503
Objective:To explore the application effect of dexmedetomidine combined with ciprofol general anesthesia in laparoscopic radical resection of ovarian cancer.Methods:A total of 120 patients who underwent laparoscopic radical resection of ovarian cancer at the Hengshui Second People′s Hospital, Hebei Province from January 2021 to January 2023 were selected as the research objects. They were divided into the control group and the observation group by random number table method, with 60 cases in each group. Both groups underwent surgery under general anesthesia: the control group was given ciprofol, while the observation group was given dexmedetomidine combined with ciprofol. Postoperative recovery, changes in hemodynamics and vital signs, levels of stress indicators, and the occurrence of adverse reactions were compared between the two groups.Results:Compared with the control group, the observation group had fewer presses on the analgesic pump, shorter first flatus time and awakening time, lower Visual Analogue Scale (VAS) score at 1 hour after surgery, and higher Ramsay sedation score (all P<0.05). There were no statistically significant differences in heart rate (HR), mean arterial pressure (MAP), and bispectral index (BIS) between the two groups before induction (T 0) (all P>0.05); MAP at skin incision (T 1), 30 minutes after skin incision (T 2), and after extubation (T 3) in both groups were higher than those at T 0, while HR were lower than those at T 0 (all P<0.05); HR and MAP at T 1, T 2, and T 3 in the observation group were significantly lower than those in the control group (all P<0.05), but there was no statistically significant difference in BIS between the two groups at each time point (all P>0.05). There were no statistically significant differences in serum cortisol (COR) and adrenocorticotropic hormone (ACTH) levels between the two groups at T 0 (all P>0.05); serum COR and ACTH levels at T 3 and 1 hour after surgery (T 4) in both groups were higher than those at T 0 (all P<0.05), and the levels of serum COR and ACTH at T 3 and T 4 in the observation group were lower than those in the control group (all P<0.05). In the control group, there were 3 cases of hypotension, 7 cases of nausea and vomiting, and 1 case of respiratory depression; in the observation group, there were 2 cases of hypotension and 3 cases of nausea and vomiting. No serious adverse reactions occurred in either group, and the total incidence of adverse reactions in the observation group was lower than that in the control group (χ 2=3.354, P<0.05). Conclusions:Dexmedetomidine combined with ciprofol general anesthesia can promote postoperative recovery of patients undergoing laparoscopic radical resection of ovarian cancer, effectively stabilize hemodynamics, and reduce stress response and adverse reactions.
8.Effect of ultrasound-guided iliopsoas plane block on quality of postoperative recovery in patients un-dergoing hip arthroplasty
Bowei JIANG ; Fengdan MA ; Jin HUANG ; Jiashuo ZHANG ; Yanan HAN ; Shengyu WANG ; Lijie SONG ; Jinning LIU ; Kefei ZHAO ; Chunguang WANG
The Journal of Clinical Anesthesiology 2024;40(2):133-138
Objective To observe the effect of ultrasound-guided iliopsoas plane block(IPB)on the quality of postoperative recovery in patients undergoing hip arthroplasty.Methods Sixty patients who underwent hip arthroplasty were selected,37 males and 23 females,aged 40-79 years,BMI 18-30 kg/m2,ASA physical status Ⅰ-Ⅲ.The patients were divided into two groups by random number table method:the iliopsoas plane block group(group IPB)and the femoral nerve block(FNB)group(group FNB),30 pa-tients in each group.Before anesthesia induction,IPB was performed with 0.5%ropivacaine 10 ml and lat-eral femoral cutaneous nerve block was performed with 0.5%ropivacaine 5 ml in group IPB.And FNB was performed with 0.5%ropivacaine 10 ml and lateral femoral cutaneous nerve block was performed with 0.5%ropivacaine 5 ml in group FNB.The dosages of propofol,remifentanil,and cis-atracurium during operation were recorded.The quality of recovery-15(QoR-15)scale was evaluated preoperatively and postoperatively 1 day,2 and 3 days.The max VAS(VASmax)pain score and manual muscle test(MMT)score of quadri-ceps muscle were recorded 12,24,and 48 hours after surgery.The time of getting out of bed for the first time,opioid dosage,and patient satisfaction were recorded.The incidence of nerve injury,vascular injury,puncture site infection,and local anesthetic poisoning were recorded.The postoperative complications of diz-ziness,nausea and vomiting,deep vein thromboses,and elirium were also recorded.Results There was no significant difference in the dosage of propofol,remifentanil,and cis-atracurium between the two groups.Compared with group FNB,the QoR-15 scale score in group IPB was significantly higher 1 day,2 and 3 days after operation(P<0.05).Compared with group FNB,the MMT scores of quadriceps muscle was sig-nificantly higher in group IPB 12 and 24 hours after surgery(P<0.05),and the first time of getting out of bed was shortened in group IPB(P<0.05).However,there were no significant differences in the VASmax pain score,MMT score of quadriceps muscle 48 hours after surgery,opioid dosage,and patient satisfaction between the two groups.No nerve block related complications were found in both groups.There were no sig-nificant differences in postoperative complications between the two groups.Conclusion The iliopsoas plane block can improve the quality of postoperative recovery and accelerate the recovery of patients with hip re-placement,and the effect is better than that of femoral nerve block.
9.The value of early VA-ECMO support in the perioperative period of emergency percutaneous coronary intervention
Haijia YU ; Jingchao LI ; Huihui SONG ; Luqian CUI ; Shujuan DONG ; Yingjie CHU ; Lijie QIN
Chinese Journal of Emergency Medicine 2024;33(7):946-954
Objective:To investigate the effect of different timing of arterial -venous extracorporeal membrane oxygenation (VA-ECMO) on the prognosis of patients with acute myocardial infarction complicated with cardiogenic shock (AMICS).Methods:This study was a prospective cohort study. AMICS patients received VA-ECMO support primary percutaneous coronary intervention in Henan Provincial People's Hospital from May 2017 to July 2023 were divided into early VA-ECMO group and late VA-ECMO group. 64 AMICS patients who met the indications for VA-ECMO implantation, but did not revive VA-ECMO were included as control group. Demographic characteristics, coronary interventional (PCI) information and complications after VA-ECMO implantation were collected. The primary end points was 1-year survival, minor end point were in-hospital and perioperative death. Multivariate Logistic and Cox regression models were used to evaluate the effect of timing of VA-ECMO on prognosis of AMICS patients. Kaplan-Meier survival curve was used to analyze the 1-year survival outcome of the 3 groups.Results:A total of 143 AMICS patients were included, and materials of 136 patients entered in the final analysis, including 42 in the early VA-ECMO group, 34 in the late VA-ECMO group, and 60 in the non-VA-ECMO group. Compared with the late VA-ECMO group, the early VA-ECMO group had a higher ratio of PPCI after VA-ECMO, a longer D-to-B time, a shorter VA-ECMO support time, a higher success rate of VA-ECMO withdrawal, and a lower complication rate (all P<0.05). Compared with the early VA-ECMO group, the perioperative, in-hospital and 1-year mortality were significantly higher in Non-ECMO support (all P<0.05). There was no difference in perioperative and in-hospital mortality between the early VA-ECMO group and the late VA-ECMO group, but the 1-year mortality in the late VA-ECMO group was significantly higher ( P<0.05). Perioperative, in-hospital and 1-year mortality rates were lower in the late VA-ECMO group than in the no-VA-ECMO group, but the differences were not statistically significant. Multivariate Logistic and Cox regression analysis showed that after adjusting interference factors, early VA-ECMO was still a protective factor for in-hospital ( OR=0.244, P=0.015) and one year ( HR=0.308, P=0.001)mortality. Kaplan-Merier survival curve showed that compared with the late VA-ECMO group and the group without VA-ECMO, the early VA-ECMO group had the highest 1-year survival rate. Conclusion:Patients with AMICS may benefit more from early VA-ECMO than from late VA-ECMO support for PPCI.
10.Analysis of the epidemic characteristics of reported pulmonary tuberculosis incidence in Kashgar Prefecture, Xinjiang Uygur Autonomous Region from 2015 to 2022 and establishment of SARIMA prediction
Chong TENG ; Fang XIE ; Bing ZHAO ; Lijie ZHANG ; Hui LI ; Yuanyuan SONG ; Yang ZHENG ; Yang ZHOU ; Jing WANG ; Fei HUANG ; Mingting CHEN ; Xichao OU
Chinese Journal of Preventive Medicine 2024;58(11):1665-1672
Objective:To analyze the epidemic characteristics of reported tuberculosis incidence in Kashgar from 2015 to 2022, and use the seasonal autoregressive integrated moving average (SARIMA) model to predict the incidence, providing references for the local control of pulmonary tuberculosis.Methods:The reported incidence data of tuberculosis in the Kashgar area of Xinjiang from January 2015 to August 2023 were collected through the"Infectious Disease Monitoring System", a subsystem of the "Chinese Disease Prevention and Control Information System". The epidemic characteristics of reported incidence in this area from 2015 to 2022 were analyzed. Two SARIMA models of monthly reported incidence number and rate were established. The prediction performance of the two models was evaluated using the reported incidence data of tuberculosis from January 2023 to August 2023. The χ2 test was used to analyze population characteristics, and the Cochran-Armitage trend test was used to analyze annual incidence. Results:From 2015 to 2022, 133 972 cases of pulmonary tuberculosis were reported in Kashgar, with a yearly reported incidence rate of 383.64/100 000, showing a rising trend ( TCA=77.03, P<0.001) and then a declining trend ( TCA=176.16, P<0.001). The proportion of pathogenic positive pulmonary tuberculosis had increased yearly ( TCA=132.66, P<0.001). The reported onset time was concentrated from January to June each year, with a peak in April. Yengisar County, Zepu County and Yopurga County had the highest reported incidence rate in Kashgar. The sex ratio of men to women was 1.03∶1, and the reported incidence rate of men was higher than that of women ( χ2=27.04, P<0.001). The reported incidence rate of the group aged 60 years and older was the highest. The patient′s occupation was mainly farmers (84.99%). The average relative errors of the SARIMA ( 1, 1, 2) ( 0, 1, 1) 12 model and SARIMA ( 0, 1, 1)( 0, 1, 1) 12 model in predicting the reported monthly incidence number and rate were 11.67% and -9.81%, respectively. Both models had good prediction accuracy (MAPE=33.55%, MAPE=38.22%). Conclusion:The average reported incidence rate of pulmonary tuberculosis in the Kashgar area shows a rising trend first and then a declining trend. The patients are mainly men and farmers, and attention should be paid to the prevention and control of tuberculosis among the elderly in winter and spring. The SARIMA ( 1, 1, 2) ( 0, 1, 1) 12 model and SARIMA ( 0, 1, 1)( 0, 1, 1) 12 model can fit the trend of reported tuberculosis incidence in the Kashgar area well and have good predictive performance.

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