1.Fabrication and evaluation of an inositol hexaphosphate-zinc hydrogel with dual capabilities of self-mineralization and osteoinduction
LIU Mingyi ; MIAO Xiaoyu ; CAI Yunfan ; WANG Yan ; SUN Xiaotang ; KANG Jingrui ; ZHAO Yao ; NIU Lina
Journal of Prevention and Treatment for Stomatological Diseases 2026;34(1):29-40
Objective:
To fabricate a hydrogel loaded with inositol hexaphosphate-zinc and preliminarily evaluate its performance in self-mineralization and osteoinduction, thereby providing a theoretical basis for the development of bone regeneration materials.
Methods:
The hydrogel framework (designated DF0) was formed by copolymerizing methacryloyloxyethyltrimethylammonium chloride and four-armed poly(ethylene glycol) acrylate, followed by sequentially loading inositol hexaphosphate anions via electrostatic interaction and zinc ions via chelation. The hydrogel loaded only with inositol hexaphosphate anions was named DF1, while the co-loaded hydrogel was named DF2. The self-mineralization efficacy of the DF0 , DF1 and DF2 hydrogels was characterized using scanning electron microscopy, transmission electron microscopy (TEM), energy dispersive spectroscopy (EDS), and selected area electron diffraction (SAED). The biocompatibility was assessed via live/dead cell staining and a CCK-8 assay. The osteoinductive capacity of the DF0 , DF1 and DF2 hydrogels on MC3T3-E1 cells was assessed via alkaline phosphatase (ALP) and Alizarin Red S (ARS) staining. In the aforementioned cell experiments, cells cultured in standard medium served as the control group
Results:
The DF0, DF1, and DF2 hydrogels were successfully synthesized. Notably, DF1 and DF2 exhibited distinct self-mineralization within 6 days. Results from TEM, EDS, and SAED confirmed that the mineralization products were amorphous calcium phosphate in group DF1, and amorphous calciumzinc phosphate in group DF2. Biocompatibility tests revealed that none of the hydrogels (DF0, DF1, and DF2) adversely affected cell viability or proliferation. In osteogenic induction experiments, both ALP and ARS staining were intensified in the DF1 and DF2 groups, with the most profound staining observed in the DF2 group.
Conclusion
The developed inositol hexaphosphate-zinc hydrogel (DF2) demonstrates the dual capacity to generate calcium-phosphate compounds through self-mineralization while exhibiting excellent osteoinductive properties. This biocompatible, dual-promoting osteogenic hydrogel presents a novel strategy for bone regeneration.
2.Helicobacter pylori infection affecting the risk of colorectal adenomatous polyps in patients with type 2 diabetes mellitus
Lina CHEN ; Zhengjuan LIU ; Zhenli TANG
Journal of Public Health and Preventive Medicine 2026;37(1):130-133
Objective To analyze the influence of Helicobacter pylori (Hp) infection on the risk of colorectal adenomatous polyps in patients with type 2 diabetes mellitus (T2DM). Methods A total of 306 patients with T2DM who were treated in the hospital from April 2021 to April 2024 were enrolled as the study subjects. According to whether colorectal adenomatous polyps occurred, the enrolled patients were divided into adenomatous polyp group and non-adenomatous polyp group. The risk factors of colorectal adenomatous polyps in T2DM patients were discussed by univariate and Logistic multivariate regression analyses. The predictive value of Hp on the occurrence of colorectal adenomatous polyps was explored by receiver operating characteristic (ROC) curve. Results Among 306 T2DM patients, there were 142 cases of colorectal adenomatous polyps, with an incidence rate of 46.41%. After logistic analysis, it was found that Hp infection, concurrent gallbladder disease, fatty liver, alcohol drinking history and insulin use were independent influencing factors for colorectal adenomatous polyps (OR: 5.518, 95%CI: 2.806-10.850; OR: 2.782, 95%CI: 1.406-5.502; OR: 3.702, 95%CI: 1.684-8.141; OR: 2.125, 95%CI: 1.140-3.964; OR: 5.398, 95%CI: 2.528-11.525, P<0.05). ROR curve analysis indicated that the area under the curve (AUC), sensitivity and specificity of Hp infection in predicting colorectal adenomatous polyps were 0.611, 38.73% and 83.54%. Conclusion The occurrence of colorectal adenomatous polyps in patients with T2DM is affected by many factors among which Hp infection has obvious predictive value on its risk.
3.Influence of Antigen Type on the Establishment of an Induced Sjögren Syndrome Mouse Model
Wenshuang RONG ; Yuanfei NIU ; Meiting LIU ; Mengyuan YANG ; Shuang CUI ; Lina MA ; Yao FU ; Lianmei WANG ; Junling CAO
Laboratory Animal and Comparative Medicine 2026;46(2):178-190
ObjectiveThis study aims to compare the modeling effects of submaxillary gland antigen and salivary gland antigen in the establishment of Sjögren syndrome (SS) mouse models, and to characterize the phenotypic and immunological features of these models in comparison with spontaneous SS-prone non-obese diabetic (NOD)/LtJ mice. MethodsAdult C57BL/6J mice (equal numbers of males and females) were immunized with submaxillary gland antigen or salivary gland antigen, respectively, combined with Freund's adjuvant to induce SS models. Mice immunized with phosphate-buffered saline (PBS) combined with Freund's adjuvant served as the control group. Immunization was induced via multiple subcutaneous injections in the back with antigen combined with Freund's complete adjuvant (FCA) on Days 1 and 7. A booster immunization was administered via multiple subcutaneous injections in the back with antigen combined with Freund's incomplete adjuvant (FIA) on Day 14. Female NOD/LtJ mice were used as the spontaneous SS model group, with ICR mice as the corresponding control strain for comparative analysis. Body weight, water intake, and salivary flow rate of mice were dynamically monitored for 4 weeks. At the end of the experiment, tissue and serum samples were collected, the weights of submaxillary glands, thymus, and spleen were measured, and organ indices (organ-to-body weight ratios) were calculated. Pathological morphological analysis of the submaxillary gland and spleen was performed with hematoxylin and eosin (HE) staining. Serum interleukin-17 (IL-17) level was detected using enzyme-linked immunosorbent assay (ELISA). Real-time quantitative polymerase chain reaction was used to detect the mRNA expression levels of SS type A (SSA) and SS type B (SSB) in submaxillary gland tissues. ResultsFemale mice in the submaxillary gland antigen group exhibited significantly increased water intake (P<0.05) and reduced salivary flow rate (P<0.05) compared with the female control group. No statistically significant differences were observed in the submaxillary gland index, thymus index and spleen index (P>0.05). Focal lymphocytic infiltration was observed in the submaxillary glands, and the splenic marginal zone was enlarged. Serum IL-17 levels were significantly increased (P<0.05). There was no significant difference in submaxillary gland SSA/SSB expression levels (P>0.05). Compared with the female control group, female mice in the salivary gland antigen group showed no statistically significant differences in water intake, salivary flow rate, submaxillary gland index, and spleen index (P>0.05), whereas the thymus index was significantly reduced (P<0.01). Mild inflammatory cell infiltration and glandular atrophy were observed in the submaxillary glands, and the splenic white pulp and marginal zone were slightly enlarged. Serum IL-17 levels and submaxillary gland SSB mRNA expression levels were significantly increased (P<0.01), whereas no significant change was observed in submaxillary gland SSA expression levels (P>0.05). Compared with the male control group, mild submaxillary gland atrophy was observed in male mice in the submaxillary gland antigen group, whereas no obvious changes were found in other modeling-related indicators (P>0.05). Compared with the ICR control group, NOD/LtJ model mice exhibited elevated water intake (P<0.05), significantly reduced salivary flow rate (P<0.01), no significant differences in the submaxillary gland index or spleen index (P>0.05), but a significantly increased thymus index (P<0.05). Marked focal infiltration was observed in the submaxillary glands, the splenic marginal zone was obviously enlarged, and serum IL-17 concentrations as well as submaxillary gland SSA/SSB expression levels were significantly increased (P<0.05). ConclusionSubmaxillary gland antigen and salivary gland antigen can induce SS-related features in female C57BL/6J mice. The SS-related phenotype is more pronounced in the submaxillary gland antigen group than in the salivary gland antigen group, but weaker than that in spontaneously SS-prone female NOD/LtJ mice. Immunization of male C57BL/6J mice with submaxillary or salivary gland antigens fails to induce an obvious SS phenotype.
4.Spinal cord stimulation for spinal cord injury from 1999 to 2025: a bibliometric analysis
Yuanyuan QI ; Haifeng GAO ; Lina LIU ; Yujie XIE ; Jing XU ; Feng GAO ; Liang CHEN ; Degang YANG ; Jun LI
Chinese Journal of Rehabilitation Theory and Practice 2026;32(4):373-386
ObjectiveTo analyze the research hotspots and development trends in the field of spinal cord stimulation (SCS) for spinal cord injury (SCI). MethodsLiterature about SCS for SCI was retrieve from the Web of Science (WOS) Core Collection database, with a time range from January, 1999 to July, 2025. VOSviewer 1.6.20 and CiteSpace 6.4.R2 were used to analyze the annual publication volume, countries, authors, institutions, journals and keywords. ResultsA total of 636 literatures were included. From 1999 to 2025, the overall publication trend in this field showed an upward trajectory, with recent years fluctuating but tending to stabilize. The country with the most publications was the United States (429 papers), followed by Russia (98 papers) and China (70 papers). The institution with the highest number of publications was the University of California, Los Angeles (76 papers), the author with the most publications was V. Reggie Edgerton (70 papers), and the journal with the most publications was Journal of Clinical Medicine (31 papers). The most frequently cited study focused on exploring the combination of epidural spinal cord stimulation with task-specific training to restore motor function in patients with complete SCI. Keyword analysis showed that the research hotspots in this field were mainly focused on neuroregulation mechanisms, recovery of motor and autonomic nervous dysfunction, artificial intelligence, closed-loop stimulation and brain-computer interface technology innovations. In recent years, the research focus gradually shifted from basic mechanisms to personalized and precise multifunctional rehabilitation strategies. ConclusionThe field of SCS for SCI has undergone phases of basic mechanism exploration and clinical application expansion. Current research hotspots and future trends focus primarily on the development of new stimulation paradigms and combined innovative technologies.
5.Impact of hyperglycemia on liver fibrosis and end-stage liver disease in patients with comorbidities of chronic hepatitis B and steatotic liver disease
Xueli ZHANG ; Lina JIANG ; Meng LI ; Shuhong LIU ; Jingmin ZHAO
Journal of Clinical Hepatology 2026;42(4):831-839
ObjectiveTo analyze the clinicopathological features of patients with comorbidities of chronic hepatitis B (CHB) and steatotic liver disease (SLD), to investigate the impact of hyperglycemia on the risk of liver fibrosis and end-stage liver diseases (ESLD), and to provide a basis for the clinical management of such population. MethodsA total of 668 adult patients with CHB-SLD confirmed by liver biopsy in The Fifth Medical Center of Chinese PLA General Hospital from January 2011 to December 2019 were enrolled, and a retrospective cohort was established with the time of liver biopsy as the baseline and the onset of ESLD as the endpoint. All patients were followed up to March 31, 2024. Propensity score matching (PSM) was performed at a ratio of 1∶4 to balance baseline features between groups, resulting in 82 patients in the hyperglycemia group and 281 in the non-hyperglycemia group. The two groups were compared in terms of metabolic profiles, laboratory markers, and histopathological features. The Mann-Whitney U test was used for comparison of non-normally distributed quantitative data between two groups. The chi-square test or Fisher exact test was used for comparison of categorical data between two groups. A multivariate Logistic regression analysis was used to investigate the influencing factors for advanced fibrosis (AF), and the Kaplan-Meier survival analysis and the Cox proportional-hazards regression model were used to determine the influencing factors for the development of ESLD. ResultsCompared with the non-hyperglycemia group, the hyperglycemia group had a significantly higher number of factors for metabolic disorders, a significantly higher degree of hepatic steatosis, and a significantly higher detection rate of AF (all P<0.05). The multivariate Logistic regression analysis showed that hyperglycemia was a risk factor for AF (odds ratio = 1.753, 95% confidence interval [CI]: 1.017 — 3.023, P=0.043). The survival analysis showed that hyperglycemia increased the risk of ESLD (χ2=4.340, P=0.037). The multivariate Cox regression analysis confirmed that hyperglycemia was a significant metabolic risk factor for ESLD in patients with AF (adjusted hazard ratio=3.208, 95%CI: 1.201 — 8.568, P=0.020). ConclusionHyperglycemia can increase the risk of AF and ESLD in CHB-SLD patients. Clinical monitoring and active management should be strengthened for patients who have already developed AF and hyperglycemia.
6.Latent Profile Analysis of Sleep Patterns and Their Association with Gastrointestinal Heat Accumulation in 6878 Preschool Children in Beijing
Hanwen ZHANG ; Xiaohong GU ; Xueyan MA ; Xue LI ; Lina LIU ; Jiyu JIANG ; Shuxuan LI ; Qingpu MA ; Tiegang LIU
Journal of Traditional Chinese Medicine 2026;67(16):1759-1766
ObjectiveTo explore the latent profiles of sleep patterns and their association with gastrointestinal heat accumulation syndrome in preschool children in Beijing. MethodsA cross-sectional study design was adopted, and preschool children were recruited from 57 kindergartens in Beijing using convenience sampling. Sleep characteristics and gastrointestinal heat accumulation syndrome was assessed using the Chinese version of the Sleep Disturbance Scale for Children (SDSC) and Self-rating Diagnostic Scale for Gastrointestinal Heat Retention Syndrome in children (GHRS). Latent profile analysis (LPA) was applied to identify distinct sleep-related subgroups, and multivariate logistic regression was used to analyze the association between different sleep profiles and gastrointestinal heat accumulation syndrome. ResultsA total of 6878 preschool children were included in the study. Among them, 3.46% of the children (238/6878) had sleep disorders, while 54.42% (3743/6878) had gastrointestinal heat accumulation. Compared to children without gastrointestinal heat accumulation syndrome, those with this syndrome exhibited a higher prevalence of sleep disorders, higher SDSC scores, higher T-transformed total scores, and higher scores across all dimensions, including disorders of initiating sleep, disorders of maintaining sleep, sleep hyperhidrosis, sleep breathing disorders, parasomnias, nonrestorative sleep and excessive somnolence (P<0.01). Latent profile analysis identified four distinct sleep characteristic profiles, which were the mixed high-symptom group (32.39%, 2228/6878), sleep initiation and maintenance difficulty symptom group (49.07%, 3375/6878), low-symptom group (14.19%, 976/6878), and the group with no significant symptoms (4.35%, 299/6878). Multivariate logistic regression analysis demonstrated that the mixed high-symptom group, sleep initiation and maintenance difficulty symptom group, and low-symptom group were significantly associated with gastrointestinal heat accumulation syndrome. Among them, the mixed high-symptom group had the most significant association with gastrointestinal heat accumulation (OR=12.657, P<0.001), followed by the sleep initiation and maintenance difficulty symptom group (OR=4.964, P<0.001). ConclusionSleep characteristics in preschool children mainly present as composite patterns with different symptom combinations. Moreover, the sleep latent profiles of the mixed high-symptom group, the sleep initiation and maintenance difficulty symptom group, and the low-symptom group were significantly associated with gastrointestinal heat accumulation syndrome.
7.Application of Novel Environmentally Friendly Reagents in Pathological Section Preparation and Immunohistochemistry
Jieying LI ; Shujun LIANG ; Ying DING ; Shuying LIU ; Lina QIN ; Zhaoliang PAN ; Lianqiang FENG ; Huijie YUAN
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(3):509-517
ObjectiveTo explore the application effects of environmentally friendly reagents versus traditional reagents in tissue processing, paraffin sectioning, hematoxylin-eosin (HE) staining, special staining, and immunohistochemistry. MethodsPancreatic, renal, splenic, hepatic, pulmonary, skeletal muscle, and cardiac tissues were collected from mice and New Zealand rabbits, and randomly divided into a traditional group (Group A), an environmentally friendly reagent I group (Group B), and an environmentally friendly reagent Ⅱ group (Group C). The processed tissue sections from all three groups were subjected to paraffin sections, HE staining, phosphotungstic acid-hematoxylin staining, and Mallory trichrome staining. The pancreatic tissue sections were subjected to immunohistochemical detection of insulin protein. Evaluation criteria included tissue morphological integrity, embedding operability, section quality, and staining effects. ResultsNo significant differences were observed among the three groups of samples in terms of fixation efficacy, embedding operations, and section quality. After HE staining, all groups exhibited bright nuclear and cytoplasmic staining with clear contrast, with excellent-and-good rates of 98%, 99%, and 97% for Groups A, B, and C, respectively, showing no statistically significant differences (A vs. B, P=0.561; A vs. C, P=0.651). In phosphotungstic acid-hematoxylin staining, Groups A and C showed clear structural contrast and bright staining for striated muscle and collagen fibers, whereas Group B exhibited uneven staining. The excellent-and-good rates were 100%, 10%, and 95% for Groups A, B, and C, respectively, with significant differences between Group A and Group B (P<0.01) but no statistical difference between Group A and Group C (P=0.311). In Mallory trichrome staining, Groups A and B outperformed Group C. The excellent-and-good rates were 95%, 90%, and 15% for Groups A, B, and C, respectively, with significant differences between Group A and Group C (P<0.01), but no statistical difference between Group A and Group B (P=0.548). Immunohistochemical results showed that Group A had a clean background with no non-specific staining, while Groups B and C exhibited significant non-specific staining, with statistically significant differences in non-specific staining rates between the groups (A vs. B, 5% vs. 100%, P<0.01; A vs. C, 5% vs.100%, P<0.01). ConclusionIn HE staining, environmentally friendly reagents demonstrated effective tissue fixation and staining results comparable to traditional reagents, meeting the teaching requirements. For special staining, Group B and Group C performed better in Mallory trichrome staining and phosphotungstic acid-hematoxylin staining, respectively. However, environmentally friendly reagents exhibited non-specific staining issues in immunohistochemistry, where further optimization is required.
8.Clinical Observation Adjuvant Treatment with Modified Taohong Siwu Decoction (桃红四物汤) for Patients of Chronic Heart Failure Complicated with Lower Limb Deep Vein Thrombosis in the Chronic Stage of Blood Stasis Syndrome:A Randomize Controlled Clinical Trial
Xuelian LIU ; Lina MOU ; Shasha MA ; Jiandong XIAO ; Huijing ZHANG
Journal of Traditional Chinese Medicine 2025;66(12):1249-1256
ObjectiveTo observe the effectiveness and safety of modified Taohong Siwu Decoction (桃红四物汤) for patients of chronic heart failure with lower limb deep vein thrombosis in the chronic stage of blood stasis syndrome. MethodsA total of 120 patients of chronic heart failure with lower limb deep vein thrombosis in chronic stage of blood stasis syndrome were randomly divided into 60 cases each in control group and observation group. Both groups were given basic treatment of western medicine, and the observation group was additionally given modified Taohong Siwu Decoction (桃红四物汤) for oral administration, one dose per day. The treatment course for both groups lasted for 4 weeks. The total effective rate and the incidence of adverse reactions were compared between the two groups after treatment. Cardiac function indexes including left ventricular ejection fraction (LVEF), and left ventricular end-systolic internal diameter (LVESd), left ventricular end-diastolic internal diameter (LVEDd), serological indexes including N-terminal natriuretic natriuretic peptide precursor (NT-proBNP), high sensitivity C-reactive protein (hs-CRP) and vascular endothelial growth factor (VEGF), score of traditional Chinese medicine (TCM) symptom including chest pain, swelling of the affected limb, fixed tenderness, and bruising, haemodynamics indicators including high cut whole blood viscosity, low cut whole blood viscosity, and erythrocyte pressure, and coagulation indices including activated partial thromboplastin time (APTT), plasminogen time (PT), and fibrinogen (FIB) levels were compared before and after treatment. ResultsDuring the study, 3 cases were excluded and 2 cases lost follow-up in the observation group, while 2 cases were excluded and 3 cases lost follow-up in the control group. A total of 110 patients completed the trial, 55 cases in each of the two groups. The total effective rate in the observation group was 92.73% (51/55), which was significantly higher than that of the control group, 78.18% (43/55, P<0.05). Compared within group before treatment, LVEF, APTT and PT levels increased, LVESd, LVEDd, NT-proBNP, hs-CRP, VEGF, high cut whole blood viscosity, low cut whole blood viscosity, erythrocyte pressure volume and FIB levels decreased, chest pain, swelling of the affected limbs, stationary pressure pain and bruising score decreased in both groups after treatment, and the improvement of all above indexes was better in the observation group than that in control group (P<0.05 or P<0.01). The incidence of adverse reactions was 7.27% (4/55) in the observation group and 21.82% (12/55) in the control group, and the incidence of adverse reactions in the observation group was significantly lower than that in the control group (P<0.05). ConclusionModified Taohong Siwu Decoction (桃红四物汤) as adjuvant treatment for patients of chronic heart failure with lower limb deep vein thrombosis in the chronic stage of blood stasis syndrome showed better clinical effectiveness when compared with western basic treatment, which can improve the clinical symptoms, cardiac function, haemodynamics, and coagulation, with good safety.
9.Effect comparison of flat loop with double C-loop Toric intraocular lenses on astigmatism correction based on standard astigmatism vector analysis
Jintao XIA ; Jia LIU ; Mi HAO ; Ting MA ; Lina CHENG
International Eye Science 2025;25(4):632-637
AIM:To compare the effect of AT TORBI 709M and Tecnis ZMT intraocular lenses on astigmatism correction in patients with corneal astigmatism at 3 mo after operation based on the standard astigmatism vector analysis.METHODS: This was a retrospective case-control study. The clinical data of 69 patients(69 eyes)with corneal astigmatism who underwent phacoemulsification and implantation of toric intraocular lens(IOL)from June 2021 to December 2021 in Day Surgery Center of Xi'an No.1 Hospital was analyzed. The patients were divided into two groups. In group one, 38 cases(38 eyes)were implanted with AT TORBI 709M, and 31 patients(31 eyes)with Tecnis ZMT in group two. The axial length, preoperative astigmatism and axis, and the degree of intraocular lens were recorded. The uncorrected distance visual acuity(UCDVA), best corrected distance visual acuity(BCDVA), diopter, residual astigmatism and axis were recorded preoperatively and at 1 wk, 1 and 3 mo postoperatively. The postoperative surgical indicators, including spherical equivalent(SE), target induced astigmatism vector(TIA), surgically induced astigmatism vector(SIA), magnitude of error(ME), absolute value of angle of error(|AE|), absolute value of difference vector(|DV|), correction index(CI), and index of success(IOS)were evaluated by the standard astigmatism vector analysis.RESULTS:Postoperative UCDVA and BCDVA were significantly improved(all P<0.001), and there were statistically significant differences compared to preoperative UCDVA and BCDVA(all P<0.001). While, there was no significant difference in UCDVA and BCDVA between the two groups(P=0.275, 0.124). The standard astigmatism vector analysis showed that a good astigmatism correction was achieved in both AT TORBI 709M group and Tecnis ZMT group, and both |DV| and IOS were close to 0(P=0.329, 0.288). The CI of the AT TORBI 709M group was closer to 1, indicating a better astigmatism correction, while the CI of the Tecnis ZMT group was higher than 1, suggesting an overcorrection of astigmatism. However, the difference between the two groups was not statistically significant(P=0.193). The mean residual astigmatism at 3 mo postoperatively was -0.11±0.91 D in the AT TORBI 709M group and -0.46±0.76 D in the Tecnis ZMT group, respectively, showing no statistically significance difference(t=1.732, P=0.088).CONCLUSION:Both the flat loop AT TORBI 709M and the double C-loop Tecnis ZMT intraocular lenses can effectively improve postoperative visual acuity in patients with regular corneal astigmatism, showing good rotational stability and comparable correction abilities for both astigmatism with the rule and against-the-rule astigmatism.
10.Effect of mild hypercapnia during the recovery period on the emergence time from total intravenous anesthesia: a randomized controlled trial
Lan LIU ; Xiangde CHEN ; Qingjuan CHEN ; Xiuyi LU ; Lili FANG ; Jinxuan REN ; Yue MING ; Dawei SUN ; Pei CHEN ; Weidong WU ; Lina YU
Korean Journal of Anesthesiology 2025;78(3):215-223
Background:
Intraoperative hypercapnia reduces the time to emergence from volatile anesthetics, but few clinical studies have explored the effect of hypercapnia on the emergence time from intravenous (IV) anesthesia. We investigated the effect of inducing mild hypercapnia during the recovery period on the emergence time after total IV anesthesia (TIVA).
Methods:
Adult patients undergoing transurethral lithotripsy under TIVA were randomly allocated to normocapnia group (end-tidal carbon dioxide [ETCO2] 35–40 mmHg) or mild hypercapnia group (ETCO2 50-55 mmHg) during the recovery period. The primary outcome was the extubation time. The spontaneous breathing-onset time, voluntary eye-opening time, and hemodynamic data were collected. Changes in the cerebral blood flow velocity in the middle cerebral artery were assessed using transcranial Doppler ultrasound.
Results:
In total, 164 patients completed the study. The extubation time was significantly shorter in the mild hypercapnia (13.9 ± 5.9 min, P = 0.024) than in the normocapnia group (16.3 ± 7.6 min). A similar reduction was observed in spontaneous breathing-onset time (P = 0.021) and voluntary eye-opening time (P = 0.008). Multiple linear regression analysis revealed that the adjusted ETCO2 level was a negative predictor of extubation time. Middle cerebral artery blood flow velocity was significantly increased after ETCO2 adjustment for mild hypercapnia, which rapidly returned to baseline, without any adverse reactions, within 20 min after extubation.
Conclusions
Mild hypercapnia during the recovery period significantly reduces the extubation time after TIVA. Increased ETCO2 levels can potentially enhance rapid recovery from IV anesthesia.


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