Objective To investigate the current status of postoperative analgesia practices among patients undergoing neurosurgical procedures in China to provide evidence-based support for formulating a standardized postoperative analgesia consensus and optimizing pain management strategies in the field of neurosurgery.Methods A questionnaire was designed with Wenjuanxing,covering 42 items in aspects including general information of participating medical institutions,current practices of neurosurgical postoperative analgesia,anesthesiologists'understanding and implementation of analgesic concepts,and the status of postoperative analgesic management.Distributed through the Chinese Association of Anesthesiologists,the questionnaire data were exported for descriptive statistical analysis after collection.Results A total of 116 medical institutions participated in this survey,with 178 valid questionnaires collected.Over 90%of respondents recognized the clinical necessity of postoperative analgesia for neurosurgical patients,while the actual implementation rate was only 53.9%.Although most hospitals adopted techniques such as local infiltration anesthesia,scalp nerve blocks,patient-controlled intravenous analgesia,and multimodal analgesia,their actual utilization rates remained low.Less than 50%of participating centers implemented preventive analgesia.Despite high awareness of chronic postoperative pain(96.9%),follow-up rates were relatively low.More than half of the institutions lacked acute pain service for neurosurgical analgesia management.Conclusion Postoperative analgesia in clinical neurosurgical practice in China currently remains suboptimal,with inadequate management.There is an urgent need to enhance public education,facilitate multidisciplinary collaboration,and formulate standardized guidelines for clinical practice.

Objective:To identify the risk factors for postoperative sleep disturbance (PSD) in patients undergoing spine surgery.Methods:In this case-control study, patients who underwent spine surgery from December 2023 to June 2024 at Beijing Tiantan Hospital of Capital Medical University, were selected as the subjects of the study. The quality of postoperative sleep was assessed using the Athens Insomnia Scale (AIS). The baseline characteristics and various perioperative indicators of the patients were collected. The patients were divided into PSD group and non-PSD group according to whether they had PSD. The variables with statistically significant differences from the univariate analysis were included in a multivariate logistic regression to identify the risk factors for PSD.Results:The results of the multivariate logistic regression analysis showed that preoperative sleep disturbance (odds ratio [ OR]=2.23, 95% confidence interval [ CI] 1.06-4.72, P=0.036), course of disease > 12 months ( OR=2.20, 95% CI 1.14-4.24, P=0.019) and AIS score > 2 on the night before surgery ( OR=2.06, 95% CI 1.02-4.16, P=0.045) were the independent risk factors for PSD in patients undergoing spine surgery. Conclusions:Preoperative sleep disturbance, course of disease > 12 months and AIS score > 2 on the night before surgery are independent risk factors for PSD in patients undergoing spine surgery.

Objective To explore the neurophysiological signatures of auditory event-related potentials(AERP)during propofol-induced graded sedation depths,and their correlations with sedation levels and behavioral responsiveness,and further to evaluate the feasibility of AERP components as potential biomarkers for quantifying consciousness states.Methods An auditory Oddball paradigm was used to evoke AERP responses in healthy volunteers under propofol-induced graded sedation.Linear mixed model was applied to explore the relationships between the mean amplitudes of AERP components[mismatch negativity(MMN);P300]and both sedation-induced conscious states[Modified Observer's Assessment of Alertness/sedation Scale(MOAA/S)scores]and behavioral performance(response accuracy).Results Twenty-two healthy volunteers were included.Data analysis revealed significant negative correlations between the mean amplitudes of MMN components[MMN-Dev:β=-0.62(-2.70--0.07),P=0.04;MMN-Nov:β=-0.15(-0.27--0.03),P=0.02]and MOAA/S scores during propofol sedation.Novel stimulus-evoked MMN amplitudes also correlated with response accuracy[MMN-Nov:β=-5.08(-7.78--2.37),P<0.01].There was a weak positive correlation between novel stimulus-evoked P300 amplitudes and MOAA/S scores[β=0.16(0.04-0.39),P=0.04],however,the correlation was no significant difference after adjusting for confounding factors including age,education level,and cognitive level.Conclusion The mean amplitude of MMN component elicited during auditory tasks was correlated with conscious states and behavioral accuracy under propofol-induced graded sedation.MMN holds promise as a potential neurophysiological indicator for quantifying conscious states or behavioral responsiveness during sedation.

Objective To explore the neurophysiological signatures of auditory event-related potentials(AERP)during propofol-induced graded sedation depths,and their correlations with sedation levels and behavioral responsiveness,and further to evaluate the feasibility of AERP components as potential biomarkers for quantifying consciousness states.Methods An auditory Oddball paradigm was used to evoke AERP responses in healthy volunteers under propofol-induced graded sedation.Linear mixed model was applied to explore the relationships between the mean amplitudes of AERP components[mismatch negativity(MMN);P300]and both sedation-induced conscious states[Modified Observer's Assessment of Alertness/sedation Scale(MOAA/S)scores]and behavioral performance(response accuracy).Results Twenty-two healthy volunteers were included.Data analysis revealed significant negative correlations between the mean amplitudes of MMN components[MMN-Dev:β=-0.62(-2.70--0.07),P=0.04;MMN-Nov:β=-0.15(-0.27--0.03),P=0.02]and MOAA/S scores during propofol sedation.Novel stimulus-evoked MMN amplitudes also correlated with response accuracy[MMN-Nov:β=-5.08(-7.78--2.37),P<0.01].There was a weak positive correlation between novel stimulus-evoked P300 amplitudes and MOAA/S scores[β=0.16(0.04-0.39),P=0.04],however,the correlation was no significant difference after adjusting for confounding factors including age,education level,and cognitive level.Conclusion The mean amplitude of MMN component elicited during auditory tasks was correlated with conscious states and behavioral accuracy under propofol-induced graded sedation.MMN holds promise as a potential neurophysiological indicator for quantifying conscious states or behavioral responsiveness during sedation.

Objective:To identify the risk factors for postoperative sleep disturbance (PSD) in patients undergoing spine surgery.Methods:In this case-control study, patients who underwent spine surgery from December 2023 to June 2024 at Beijing Tiantan Hospital of Capital Medical University, were selected as the subjects of the study. The quality of postoperative sleep was assessed using the Athens Insomnia Scale (AIS). The baseline characteristics and various perioperative indicators of the patients were collected. The patients were divided into PSD group and non-PSD group according to whether they had PSD. The variables with statistically significant differences from the univariate analysis were included in a multivariate logistic regression to identify the risk factors for PSD.Results:The results of the multivariate logistic regression analysis showed that preoperative sleep disturbance (odds ratio [ OR]=2.23, 95% confidence interval [ CI] 1.06-4.72, P=0.036), course of disease > 12 months ( OR=2.20, 95% CI 1.14-4.24, P=0.019) and AIS score > 2 on the night before surgery ( OR=2.06, 95% CI 1.02-4.16, P=0.045) were the independent risk factors for PSD in patients undergoing spine surgery. Conclusions:Preoperative sleep disturbance, course of disease > 12 months and AIS score > 2 on the night before surgery are independent risk factors for PSD in patients undergoing spine surgery.

Objective To investigate the current status of postoperative analgesia practices among patients undergoing neurosurgical procedures in China to provide evidence-based support for formulating a standardized postoperative analgesia consensus and optimizing pain management strategies in the field of neurosurgery.Methods A questionnaire was designed with Wenjuanxing,covering 42 items in aspects including general information of participating medical institutions,current practices of neurosurgical postoperative analgesia,anesthesiologists'understanding and implementation of analgesic concepts,and the status of postoperative analgesic management.Distributed through the Chinese Association of Anesthesiologists,the questionnaire data were exported for descriptive statistical analysis after collection.Results A total of 116 medical institutions participated in this survey,with 178 valid questionnaires collected.Over 90%of respondents recognized the clinical necessity of postoperative analgesia for neurosurgical patients,while the actual implementation rate was only 53.9%.Although most hospitals adopted techniques such as local infiltration anesthesia,scalp nerve blocks,patient-controlled intravenous analgesia,and multimodal analgesia,their actual utilization rates remained low.Less than 50%of participating centers implemented preventive analgesia.Despite high awareness of chronic postoperative pain(96.9%),follow-up rates were relatively low.More than half of the institutions lacked acute pain service for neurosurgical analgesia management.Conclusion Postoperative analgesia in clinical neurosurgical practice in China currently remains suboptimal,with inadequate management.There is an urgent need to enhance public education,facilitate multidisciplinary collaboration,and formulate standardized guidelines for clinical practice.

In comparison to conventional thoracotomy,video-assisted thoracoscopic surgery(VATS)is conducted in situations with a narrower surgical field and limited operational space.To successfully perform VATS,it is imperative to optimize the quality of lung isolation and collapse to the fullest extent.Delaying lung collapse might impede thoracic surgery.Various measures have been adopted clinically to enhance the speed and quality of lung collapse.This article provides a comprehensive review of the application and research of one-lung ventilation lung collapse technique in thoracic surgery.

Objective:To provide a basis for dealing with passengers′ health safety events by understanding the disease spectrum of passengers′ health safety events.Methods:Passengers who experienced health safety events in the cabin of an airline from 2021 to 2022 were select as the research objects, and the types and characteristics of diseases were analyzed.Results:A total of 1 226 health safety events among air passengers from 2021 to 2022, including 563 cases for man and 663 cases for woman, with a gender ratio of 0.85∶1, and the average age of all cases was (45.03±19.91) years old. The top 5 diseases were damage (30.67%), cardiovascular system disease (23.25%), digestive system disease (11.42%), respiratory disease (11.17%) and nervous system disease (10.03%). The luggage falling and burn caused injuries took high incidence in damage. Cardiovascular diseases mainly included angina pectoris and myocardial infarction. Digestive system diseases included symptoms such as abdominal discomfort, abdominal pain, diarrhea and vomiting caused by diet. Respiratory diseases mainly included asthma, bronchiectasis, lung tumor, and acute upper respiratory tract infections. Epilepsy ranked the first in nervous system diseases.Conclusions:Damage, cardiovascular system, digestive system, respiratory system, and nervous system diseases rank the top diseases in the disease spectrum of air passengers′ health safety events. Those provide the reference to passenger's safety management for making the countermeasure and emergency plan. The risk notification and reminder, as well as the publicity of traveling safety should be strengthened.

Objective:To provide a basis for dealing with passengers′ health safety events by understanding the disease spectrum of passengers′ health safety events.Methods:Passengers who experienced health safety events in the cabin of an airline from 2021 to 2022 were select as the research objects, and the types and characteristics of diseases were analyzed.Results:A total of 1 226 health safety events among air passengers from 2021 to 2022, including 563 cases for man and 663 cases for woman, with a gender ratio of 0.85∶1, and the average age of all cases was (45.03±19.91) years old. The top 5 diseases were damage (30.67%), cardiovascular system disease (23.25%), digestive system disease (11.42%), respiratory disease (11.17%) and nervous system disease (10.03%). The luggage falling and burn caused injuries took high incidence in damage. Cardiovascular diseases mainly included angina pectoris and myocardial infarction. Digestive system diseases included symptoms such as abdominal discomfort, abdominal pain, diarrhea and vomiting caused by diet. Respiratory diseases mainly included asthma, bronchiectasis, lung tumor, and acute upper respiratory tract infections. Epilepsy ranked the first in nervous system diseases.Conclusions:Damage, cardiovascular system, digestive system, respiratory system, and nervous system diseases rank the top diseases in the disease spectrum of air passengers′ health safety events. Those provide the reference to passenger's safety management for making the countermeasure and emergency plan. The risk notification and reminder, as well as the publicity of traveling safety should be strengthened.

OBJECTIVE: To investigate the association of the time of initial diagnosis with the severity of chronic obstructive pulmonary disease (COPD). METHODS: A total of 803 patients who were diagnosed to have COPD for the first time in our hospital between May 2015 to February 2018 were enrolled in this study.The diagnoses of COPD and asthma COPD overlap (ACO) were made according GOLD guidelines and european consensus definition.Lung function of the patients was graded according to the GOLD guidelines. RESULTS: The patients with COPD had a mean age of 61.8±9.9 years,including 726 male and 77 female patients.The course of the patients (defined as the time from symptom onset to the establishment of a diagnosis) was 3(0.5,8) years.Among these patients,85.2% had a moderate disease severity (FEV1%<80%),and 48.3% had severe or very severe conditions (FEV1%<50%);47.0% of them were positive for bronchial dilation test.In the overall patients,295(36.7%) were also diagnosed to have ACO,and the mean disease course of ACO[3(1,9) years]was similar to that of COPD[3(0.5,8) years](>0.05).A significant correlation was found between the disease course and the lung function of the patients.Multiple linear regression analysis showed that an older age and a longer disease course were associated with poorer lung functions and a greater disease severity. CONCLUSIONS The delay of the initial diagnosis is significantly related to the severity of COPD.
Age Factors ; Aged ; Asthma ; diagnosis ; Delayed Diagnosis ; adverse effects ; Disease Progression ; Female ; Humans ; Lung ; physiopathology ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; diagnosis ; physiopathology ; Severity of Illness Index ; Time Factors