Objective:To evaluate the efficacy of liposomal bupivacaine transversus abdominis plane block (TAPB) in combination with general anesthesia for elderly patients undergoing laparoscopic radical resection of colorectal cancer.Methods:In this randomized controlled trial, 70 American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ patients, aged 60-80 yr, with body mass index of 18-28 kg/m 2, scheduled for elective laparoscopic radical resection of colorectal cancer at the General Hospital of Ningxia Medical University from September 2023 to June 2024, were divided into 2 groups ( n=35 each) using a table of random numbers: liposomal bupivacaine group (LB group) and hydrochloride bupi-vacaine group (HB group). After anesthesia induction, bilateral TAPB was performed under ultrasound guidance. In LB group, 0.44% liposomal bupivacaine 30 ml was injected on each side. In HB group, 0.25% hydrochloride bupivacaine 30 ml was injected on each side. Total intravenous anesthesia was adopted for both groups. Patient-controlled intravenous analgesia (PCIA) with sufentanil was carried out after surgery. When the visual analogue scale (VAS) score at rest was ≥ 4 within 72 h after surgery, hydromorphone 0.5 mg was intravenously injected for rescue analgesia. The area under the curve of VAS scores at rest and during activity was calculated within 12-72 h after surgery. The first pressing time of patient-controlled analgesia (PCA) and the effective pressing numbers of PCA, requirement for rescue analgesia, and score for satisfaction with analgesia were recorded. The sleep quality on 1 day before surgery and 1, 2 and 3 days after surgery was evaluated using the Richards-Campbell Sleep Questionnaire. The occurrence of adverse reactions, duration of post-anesthesia care unit stay, time to first ambulation, time to first flatus, and time to first oral intake, and postoperative length of hospital stay were recorded within 72 h after surgery. Results:Compared with HB group, the area under the curve of VAS scores at rest and during activity was significantly reduced at 12-72 h after operation, the first pressing time of PCA was prolonged, and the effective pressing numbers of PCA was reduced, the rate of rescue analgesia was decreased, the score for satisfaction with analgesia was increased, the Richards-Campbell Sleep Questionnaire scores were increased on the 2nd and 3rd days after surgery, the duration of post-anesthesia care unit stay and postoperative length of hospital stay were shortened, and the incidence of postoperative nausea was decreased in LB group ( P<0.05). Conclusions:The efficacy of liposomal bupivacaine TAPB combined with general anesthesia is superior to that of hydrochloride bupivacaine TAPB combined with general anesthesia in elderly patients undergoing laparoscopic colorectal cancer radical resection.

Aim Ischemic stroke(IS)is caused by acute ischemia of cerebral blood vessels,leading to brain tissue damage and neuronal apoptosis.The pathogenesis is complex,involving multiple cell death modes such as pyropto-sis,ferroptosis and disulfide death.Disulfide death is a newly discovered form of death that helps to explore the patholog-ical mechanisms of various diseases from a new perspective.The aim of this study is to discover and validate the differen-tial expression of disulfide death-related genes in blood samples of ischemic patients and their association with immune regu-lation.Methods The relevant datasets of clinical patients(GSE16561 and GSE37587)were obtained through online big data.Differentially expressed genes related to disulfide death were identified,and gene enrichment analysis was con-ducted to further explore the potential mechanisms.Subsequently,immune cell infiltration was analyzed to investigate the dysregulation of immune cells in the context of IS.Finally,the accuracy of key genes was verified through ROC curves,column charts,calibration curves,and decision curves,and a disease prediction model was constructed to predict the risk of stroke.Results Based on this dataset,significant differential expression of 9 genes related to disulfide death was identified.Independent external validation was conducted using the microarray dataset GSE58294.Single item compari-sons were performed on these differentially expressed genes in blood samples from 69 IS patients and 23 normal individuals.The results showed that the trends of LRPPRC,MYH9,NDUFA11,PRDX1 and RPN1,the 5 differentially expressed genes,were consistent.Immune infiltration analysis found that differentially expressed genes such as TLN1,MYH9,PRDX1,LRPPRC,NDUFA11 were also strongly correlated with CD8+T cells,activated NK cells,macrophages,and neu-trophils in IS patients.Functional enrichment analysis emphasized the important role of pathways such as focal adhesion,platelet aggregation,and activation in the occurrence and development of diseases.By using a column chart model for risk prediction,it was shown that the accuracy of these differentially expressed genes was good,and the ROC curve AUC value of the optimized combination of disulfide death-related genes could reach 0.844.Further validation through an external dataset(GSE58294)revealed that the ROC curve AUC value optimized for disulfide death-related genes reached 0.989,which had good clinical guidance significance for the risk of IS.Conclusions This study confirmed the existence of 5 disulfide death-related genes in IS patients through a dataset,including upregulation of MYH9 and downregulation of LRP-PRC,NDUFA11,PRDX1 and RPN1.These gene alterations are suggested to influence IS disease progression and prog-nosis through immune inflammation and bleeding risk.

Objective:To evaluate the efficacy of liposomal bupivacaine transversus abdominis plane block (TAPB) in combination with general anesthesia for elderly patients undergoing laparoscopic radical resection of colorectal cancer.Methods:In this randomized controlled trial, 70 American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ patients, aged 60-80 yr, with body mass index of 18-28 kg/m 2, scheduled for elective laparoscopic radical resection of colorectal cancer at the General Hospital of Ningxia Medical University from September 2023 to June 2024, were divided into 2 groups ( n=35 each) using a table of random numbers: liposomal bupivacaine group (LB group) and hydrochloride bupi-vacaine group (HB group). After anesthesia induction, bilateral TAPB was performed under ultrasound guidance. In LB group, 0.44% liposomal bupivacaine 30 ml was injected on each side. In HB group, 0.25% hydrochloride bupivacaine 30 ml was injected on each side. Total intravenous anesthesia was adopted for both groups. Patient-controlled intravenous analgesia (PCIA) with sufentanil was carried out after surgery. When the visual analogue scale (VAS) score at rest was ≥ 4 within 72 h after surgery, hydromorphone 0.5 mg was intravenously injected for rescue analgesia. The area under the curve of VAS scores at rest and during activity was calculated within 12-72 h after surgery. The first pressing time of patient-controlled analgesia (PCA) and the effective pressing numbers of PCA, requirement for rescue analgesia, and score for satisfaction with analgesia were recorded. The sleep quality on 1 day before surgery and 1, 2 and 3 days after surgery was evaluated using the Richards-Campbell Sleep Questionnaire. The occurrence of adverse reactions, duration of post-anesthesia care unit stay, time to first ambulation, time to first flatus, and time to first oral intake, and postoperative length of hospital stay were recorded within 72 h after surgery. Results:Compared with HB group, the area under the curve of VAS scores at rest and during activity was significantly reduced at 12-72 h after operation, the first pressing time of PCA was prolonged, and the effective pressing numbers of PCA was reduced, the rate of rescue analgesia was decreased, the score for satisfaction with analgesia was increased, the Richards-Campbell Sleep Questionnaire scores were increased on the 2nd and 3rd days after surgery, the duration of post-anesthesia care unit stay and postoperative length of hospital stay were shortened, and the incidence of postoperative nausea was decreased in LB group ( P<0.05). Conclusions:The efficacy of liposomal bupivacaine TAPB combined with general anesthesia is superior to that of hydrochloride bupivacaine TAPB combined with general anesthesia in elderly patients undergoing laparoscopic colorectal cancer radical resection.

Aim Ischemic stroke(IS)is caused by acute ischemia of cerebral blood vessels,leading to brain tissue damage and neuronal apoptosis.The pathogenesis is complex,involving multiple cell death modes such as pyropto-sis,ferroptosis and disulfide death.Disulfide death is a newly discovered form of death that helps to explore the patholog-ical mechanisms of various diseases from a new perspective.The aim of this study is to discover and validate the differen-tial expression of disulfide death-related genes in blood samples of ischemic patients and their association with immune regu-lation.Methods The relevant datasets of clinical patients(GSE16561 and GSE37587)were obtained through online big data.Differentially expressed genes related to disulfide death were identified,and gene enrichment analysis was con-ducted to further explore the potential mechanisms.Subsequently,immune cell infiltration was analyzed to investigate the dysregulation of immune cells in the context of IS.Finally,the accuracy of key genes was verified through ROC curves,column charts,calibration curves,and decision curves,and a disease prediction model was constructed to predict the risk of stroke.Results Based on this dataset,significant differential expression of 9 genes related to disulfide death was identified.Independent external validation was conducted using the microarray dataset GSE58294.Single item compari-sons were performed on these differentially expressed genes in blood samples from 69 IS patients and 23 normal individuals.The results showed that the trends of LRPPRC,MYH9,NDUFA11,PRDX1 and RPN1,the 5 differentially expressed genes,were consistent.Immune infiltration analysis found that differentially expressed genes such as TLN1,MYH9,PRDX1,LRPPRC,NDUFA11 were also strongly correlated with CD8+T cells,activated NK cells,macrophages,and neu-trophils in IS patients.Functional enrichment analysis emphasized the important role of pathways such as focal adhesion,platelet aggregation,and activation in the occurrence and development of diseases.By using a column chart model for risk prediction,it was shown that the accuracy of these differentially expressed genes was good,and the ROC curve AUC value of the optimized combination of disulfide death-related genes could reach 0.844.Further validation through an external dataset(GSE58294)revealed that the ROC curve AUC value optimized for disulfide death-related genes reached 0.989,which had good clinical guidance significance for the risk of IS.Conclusions This study confirmed the existence of 5 disulfide death-related genes in IS patients through a dataset,including upregulation of MYH9 and downregulation of LRP-PRC,NDUFA11,PRDX1 and RPN1.These gene alterations are suggested to influence IS disease progression and prog-nosis through immune inflammation and bleeding risk.

Abdomen/diagnostic imaging* ; Artificial Intelligence ; Body Composition ; Magnetic Resonance Imaging ; Practice Guidelines as Topic

Malaria still threatens global health seriously today. While the current discoveries of antimalarials are almost totally focused on single mode-of-action inhibitors, multi-targeting inhibitors are highly desired to overcome the increasingly serious drug resistance. Here, we performed a structure-based drug design on mitochondrial respiratory chain of

Objective: To study the threshold values of lactic acid (Lac)and buffuer excess (BE) when neonatal umbilical arterial blood gas is at pH <7.20. Methods: A total of 2 518 pregnant women admitted in Beijing New Century Women and Children′s Hospital from January 2017 to February 2019 were enrolled.The general conditions in perinatal period and labor methods were counted.Umbilical cord arterial blood was immediately collected before the first cry of newborn and was detected on the Abbott I-STAT automatic blood gas analyzer from the United States, and then the umbilical arterial blood gas was measured.We analyzed the perinatal factors affecting umbilical arterial blood gas.We studied the threshold values of Lac and BE for neonal asphyxia by receiver operating characteristic curve. Results: (1)Maternal anemia, Streptococcus agalactiae infection, precipitate labour, placenta abnormalities had no significant impact on neonatal umbilical artery blood gas.The Lac value in blood gas was higher in the group of premature rupture of fetal membranes and fetal intrauterine distress.The value of BE was lower in the group with premature rupture of fetal membranes and fetal distress (P<0.05). The Lac value in cesarean section group was the lowest[(1.79±1.25) mmol/L], while that in midwifery group was the highest[(4.45±1.58) mmol/L]. pH value was the lowest (7.25±0.07) in the midwifery group and the highest (7.31±0.06) in the cesarean section group.The value of BE was the lowest in the midwifery group[-(5.66±2.52) mmol/L], and the highest in the cesarean section group[-(2.99±2.28) mmol/L], with statistically significant differences among the three groups (P<0.05). (2) Multiple linear regression analysis showed that fetal delivery mode, fetal intrauterine distress, premature rupture of membranes, and gestational diabetes were the factors affecting Lac level in umbilical artery blood gas of newborns.Methods of delivery, intrauterine distress, premature rupture of membranes and placental abnormalities were the factors that affected the BE value of umbilical artery blood gas in newborns.(3) A total of 199 cases with pH value <7.2 were diagnosed as asphyxia, and the receiver operating characteristic curve of Lac and BE values of neonatal umbilical artery blood gas for the diagnosis of asphyxia was drawn.When Lac was >3.97 mmol/L, the sensitivity and specificity of the diagnosis of asphyxia were 0.864 and 0.791, respectively.When BE was ≤-6 mmol/L, the diagnostic sensitivity and specificity of asphyxia were 0.613 and 0.756, respectively. Conclusion Neonatal umbilical arterial blood gas is affected by many factors.The effect of accouche on umbilical arterial blood gas is large.When there is asphyxia with pH <7.2, the cut points of Lac and BE are >3.97 mmol/L and ≤-6 mmol/L, respectively.

Here,we reported a case of term infant with unilateral congenital microphthalmia (CM).Physical examination conducted on 2 d after birth showed that the left eye was barely open and the eye socket was deeper than the right.Meanwhile,the cornea of the left eye was not completely exposed and the light reflex could not be elicited.Ophthalmology consultation,ultrasound and CT scan were conducted,and CM was finally diagnosed since the infant was found to have a small eyeball and shortened axial length,accompanying by pathological changes in the lens,vitreous body and retina.This case suggested that detailed physical examination should be carried out,especially for the eyes,including orbit and eyelid,presence or absence of secretion or concealed eyeball,together with medical imaging techniques technology,to ensure an early detection and diagnosis of CM in neonates.

Objective To evaluate the effect of self-management education based on nurse-leading on the quality of life in patients with chronic heart failure (CHF).Methods Eighty patients with CHF in a tertiary hospital were enrolled in this study,and were divided into the intervention group and the control group randomly,with 40 cases in each group. Patients in the control group received conventional health education, while patients in the intervention group received the self-management education based on nurse-leading. The score of self-management behavior and the quality of life in two groups were evaluated and compared after six months.Results After six months,the score of self-management in the intervention group was (70.83±12.02), and was significantly higher than that in the control group (55.58±6.46) (t=9.675,P<0.05). The score of total quality of life and self-management in the intervention group was significantly higher than that in the control group (P<0.05).Conclusions Self-management education based on nurse-leading can improve the self-management and the quality of life of patients with CHF.

Objective To address the correlation between self-efficacy and quality of life in patients after coronary artery bypass graft. Methods A total of 88 patients in our hospital were investigated by using general data questionnaire, Barnason self-efficacy scale and concise health questionnaire ( MOS-SF 36 ) at 2 weeks, 6 weeks and 3 months after coronary artery bypass graft. Results The self-efficacy scores were (42. 8 ± 5. 4) at 2 weeks after operation, (44. 5 ± 4. 2) at 6 weeks after operation and (47. 6 ± 5. 6) at 3 months after operation, and the scores of quality of life were (73. 7 ± 11. 4) at 2 weeks after operation, (85. 9 ± 10. 6) at 6 weeks afteroperationand(93.9±16.2)at3monthsafteroperation(F=3.452,P<0.05). Afteroperation,theself-efficacy increase gradually, and the difference was statistically significant. The scores of quality of life were (73. 7 ± 11. 4) at 2 weeks, (85. 9 ± 10. 6) at 6 weeks, and (93. 9 ± 16. 2) at 3 months after operation, and there was a positive correlation between self-efficacy and quality of life ( r=0. 411, 0. 447, 0. 307,respectively;P<0. 01). Conclusions The quality of life and self-efficacy of patients after coronary artery bypass surgery are improved, and the two are positively correlated. Nursing staff should be based on principles of self-efficacy theory to strengthen the nursing work which may improve the patient′s self-efficacy and the quality of life.