Objective:To summarize the key points of perioperative anesthesia management of infants undergoing endoscopic endonasal resection of craniopharyngioma.Methods:The medical records of infants, aged 1-3 yr, undergoing endoscopic endonasal resection of craniopharyngioma at Beijing Tiantan Hospital affiliated to Capital Medical University from January 1, 2023 to December 31, 2023, were retrospectively analyzed. The demographic and perioperative information was collected.Results:Six pediatric patients were included, with 5 males and 1 female, with height of (103±6) cm and weight of (16±3) kg. Five cases had abnormal anterior pituitary hormones before surgery. All the children with abnormal hormone levels were given hormone supplementation during surgery, except for those with elevated free thyroxine. None of the 6 children showed significant electrolyte abnormalities or diabetes insipidus. Five children received blood transfusion treatment, with an allogeneic red blood cell volume of (114±79) ml. Among them, 4 children received allogeneic plasma transfusion, with a volume of (75±69) ml. All the 6 pediatric patients were conscious with tracheal tubes removed after surgery. Three pediatric patients had hyponatremia, and 2 pediatric patients still had hypothyroidism. All the pediatric patients did not experience postoperative diabetes insipidus, cerebrospinal fluid rhinorrhea or epileptic seizures.Conclusions:Adequate preoperative assessments should be conducted, and detection of anterior pituitary hormone levels should be improved, with hormone replacement therapy administered when necessary in the perioperative anesthesia management for endoscopic endonasal resection of craniopharyngioma in infants. Vital signs should be closely monitored, and prompt treatment should be administered when diabetes insipidus and electrolyte disorders are found during surgery. Attention should be given to airway management to avoid airway spasms after surgery.

Objective:To observe the incidence of early blood eosinophils (Eos) elevation in patients with peritoneal dialysis (PD), analyze its related factors, and its relationship with early-onset peritonitis in PD patients.Methods:This study was a retrospective observational cohort study. Patients who underwent PD catheterization in Peking University People's Hospital from January 2012 to December 2022 were included. After surgery, PD treatment was started immediately and followed up regularly ≥12 months. The general information and laboratory indexes collected 1 week before catheterization, and at 1, 3, 6 and 12 months after catheterization were recorded. The occurrence of elevated blood Eos (≥0.5×10 9/L) during the early stage of PD, the related factors of Eos elevation (≥0.5×10 9/L) and the relationship with early-onset peritonitis (within 12 months after PD initiation) were analyzed. Results:(1) A total of 235 patients were enrolled, with an age of (57.9.±13.9) years, including 136 males (57.9%). The primary diseases were predominantly chronic glomerulonephritis (111/235, 42.7%) and diabetic nephropathy (83/235, 35.3%). During the 12-month follow-up period, 73 patients had elevated blood Eos (31.1%), of which 37 cases (50.7%) occurred within 1 month after PD catheterization, 21 cases (28.7%) occurred 2-3 months after PD catheterization, 12 cases (16.4%) occurred 4-6 months after PD catheterization, and 3 cases (4.1%) occurred 7-12 months after PD catheterization. In 73 patients with elevated Eos, 69 cases (94.5%) were mildly elevated, 4 cases (5.5%) were moderately elevated. As for the duration of elevated blood Eos, 28 cases (38.4%) lasted less than 1 month, 27 cases (37.0%) lasted 1-3 months, and 18 cases (24.7%) lasted more than 3 months. (2) In patients with elevated blood Eos, the proportion of male patients (71.4% vs. 52.1%, χ 2=7.515, P=0.006), the proportion of diabetes mellitus (55.7% vs. 41.2%, χ 2=4.168, P=0.046), and the proportion of combined vascular disease (32.9% vs. 18.2%, χ 2=6.060, P=0.017) were significantly higher than those patients in normal blood Eos group. (3) Multivariate Logistic regression analysis showed that male was an independent related factor for elevated blood Eos (≥0.5×10 9/L) in the early stages of PD ( OR=2.044, 95% CI 1.101- 3.794, P=0.023). (4) Diabetes mellitus ( OR=3.363, 95% CI 1.087-10.405, P=0.035), lower baseline hemoglobin level ( OR=0.941, 95% CI 0.903-0.980, P=0.004) and elevated blood Eos (with serum Eos<0.5×10 9/L as reference, OR=2.917, 95% CI 1.022-8.326, P=0.045) were the independent related factors of early-onset peritonitis. Conclusion:Blood Eos elevations are common in early stage of PD patients , mainly occuring within 6 months after PD catheterization, and most of them are slightly increased and last less than 3 months. Male sex is an independent related factor for the elevation of blood Eos in the early stage of PD. Elevated blood Eos is an independent related factor for early-onset peritonitis.

Multi-rehabilitation treatment and early nutritional support are closely related to the recovery of critical ill patients.At present,a number of nutritional and rehabilitation interventions have been applied to critically ill patients to aid in their treatment and improve their nutritional status and motor dysfunction..In recent years,certain progress has been made in related research.This paper aims to summarize the latest literature on the application of multidisciplinary rehabilitation therapy in patients with CI under early nutritional support,provide comprehensive,systematic and practically valuable reference for clinical medical staff when formulating comprehensive treatment plans for CI patients under early nutritional support,and improve the treatment effect and quality of life of CI patients.

A method was developed for determination of dilauryl thiodipropionate(DLTDP)in fried foods by coupling solid-phase extraction(SPE)pretreatment with reverse-phase liquid chromatography-tandem mass spectrometry(RPLC-MS/MS)detection.Samples were extracted with n-hexane as the solvent,purified using a neutral alumina SPE cartridge,and finally analyzed by RPLC-MS/MS.Quantitative analysis was performed using matrix-matched calibration curves combined with an external standard method under optimal experimental conditions.The results showed that DLTDP exhibited good linearity in the range of 2.0-50.0 μg/L,with a correlation coefficient(R2)≥0.999.The limit of detection(LOD)and the limit of quantification(LOQ)of the method were 0.15 mg/kg and 0.5 mg/kg,respectively.The mean recoveries at three fortification levels(0.5,1.0,and 200 mg/kg)in different samples ranged from 84.8%to 96.8%,with the relative standard deviations(RSDs)all less than 8.0%.The developed method was highly sensitive,accurate and reliable,and easy to operate,making it well suited for the routine quantitative analysis of DLTDP in fried foods.

Objective To compare the application effects of bronchial blocker(BB)and double-lumen endotracheal tube(DLT)in pediatric thoracoscopic lobectomy.Methods A total of 80 pediatric patients who underwent thoracoscopic lobectomy at Xuzhou Children's Hospital from February 2020 to February 2023 were randomly divided into the DLT group(n=40)and the BB group(n=40)by envelope drawing.The DLT group received treatment with double-lumen endotracheal tubes,while the BB group was treated with bronchial blockers.Perioperative indicators,mean arterial pressure(MAP),heart rate(HR)at different times,airway pressure,pre-and post-operative recovery quality scores(QoR-15),intraoperative lung collapse(LCS)scores,modified Aldrete recovery scores,and adverse reactions were compared between the two groups.Results The comparison of single-lung ventilation time,intubation positioning time,and anesthesia time between the two groups showed no statistically significant differences(P＞0.05);however,the operation time of the BB group was(68.37±6.28)minutes and the hospital stay was(4.56±0.35)days,while those of the DLT group were(76.87±8.34)minutes and(5.97±0.70)days,respectively.There was a statistically significant difference between the two groups(P＜0.05).There were no significant differences in the mean arterial pressure(MAP)and heart rate(HR)before induction(T0)between the two groups(P＞0.05).The MAP of the BB group immediately after intubation(T1),2 minutes after intubation(T2),immediately after extubation(T3),and 2 minutes after extubation(T4)was(91.53±8.28)mmHg,(89.58±8.72)mmHg,(89.33±8.97)mmHg,and(95.40±9.86)mmHg,respectively.The HRS were(72.74±6.35)times/minute,(72.83±6.82)times/minute,(71.19±6.57)times/minute,and(73.63±7.46)times/minute respectively.The MAP in the DLT group was(83.88±7.29)mmHg,(83.40±7.66)mmHg,(85.17±7.91)mmHg,and(89.42±9.15)mmHg,respectively.HR was(66.68±6.17)times/minute,(64.27±6.19)times/minute,(65.97±6.28)times/minute,and(68.80±6.27)times/minute,respectively.There was a statistically significant difference between the two groups(P＜0.05).The airway pressures of the BB group at 5 minutes of bilateral lung ventilation(T5),5 minutes of unilateral lung ventilation(T6),and 5 minutes of recovery of bilateral lung ventilation(T7)were(14.36±2.46)cmH2O,(17.34±2.75)cmH2O,and(15.30±2.32)emH2O,respectively.The values in the DLT group were(17.77±2.85)cmH2O,(21.35±3.17)cmH2O,and(18.49±2.99)cmH2O,respectively.There was a statistically significant difference between the two groups(P＜0.05).There was no statistically significant difference in QOR-15 score and modified Aldrete recovery score one day before the operation between the two groups(P＞0.05).One day after surgery,the QOR-15 score of the BB group was(119.33±12.20)points,and the intraoperative LCS score was(7.70±0.61)points,while those of the DLT group were(107.60±10.10)and(6.31±0.57)points,respectively.There was a statistically significant difference between the two groups(P＜0.05).The incidence of adverse reactions was 10.0％in the BB group and 27.5％in the DLT group.There was a statistically significant difference between the two groups(P＜0.05).Conclusion The application of bronchial blockers in pediatric thoracoscopic lobectomy shows better results compared to double-lumen endotracheal tubes.

Objective To establish an HPLC method to determine the concentration of inositol nicotinate（IN） in rat skin, and study the pharmacokinetic characteristics of IN after transdermal administration of heparin sodium inositol nicotinate cream in rats. Methods HPLC method was used to establish a simple and rapid analytical method for the determination of IN concentration in the skin of rats at different time points after administration. The established method was used to study the pharmacokinetics of IN after transdermal administration of heparin sodium inositol nicotinate cream in rats, and the pharmacokinetic parameters were fitted with DAS software. Results The linearity of the analytical method was good in the concentration range of 0.25-20 μg/ml, the quantitative limit was 0.25 μg/ml, and the average recovery rate was 96.18%. The pharmacokinetic parameters of IN after transdermal administration of heparin sodium inositol nicotinate cream in rats were as follows: t_1/2 was （4.555±2.054） h, T_max was （6±0）h, C_max was （16.929±2.153）mg/L, AUC_0−t was （150.665±16.568） mg·h /L ,AUC_0−∞ was （161.074±23.917） mg·h /L, MRT_（0−t） was （9.044±0.618）h, MRT_{（0−∞）} was （10.444±1.91） h, CLz/F was （0.19±0.03） L/（h·kg）, and Vz/F was （1.19±0.437） L/（h·kg）. Conclusion IN could quickly penetrate the skin and accumulate in the skin for a long time, which was beneficial to the pharmacological action of drugs on the lesion site for a long time. The method is simple, rapid, specific and reproducible, which could be successfully applied to the pharmacokinetic study of IN after transdermal administration in rats.

Object To study the efficacy and potential mechanism of Tongbianling capsule in constipation. Methods The effects of Tongbianling capsule on intestinal motility in normal mice and carbon powder propulsion rate in small intestine of constipation model mice after were observed administration. The potential targets and key pathways of Tongbianling capsule in treating constipation were identified through network pharmacology. To verify the mechanism, the expression of p-PI3K/PI3K, p-AKT/AKT and CASP3 proteins in mouse colon tissue was detected by the western blot. Results The time for mice to excrete the first black stool was shortened and the number of fecal particles was increased in Tongbianling capsule administration group, and the carbon powder propulsion rate of mice in each Tongbianling capsule administration group was increased. The results of network pharmacology showed that treatment of constipation by Tongbianling capsule may be related to signaling pathways such as PI3K-Akt signaling pathway and 5-HT. The protein expression of p-PI3K/PI3K, p-AKT/AKT, and CASP3 in mouse colon tissue could be significantly downregulated in administration group. Conclusion Tongbianling capsule could effectively promote intestinal peristalsis in mice, increase the frequency of defecation, and effectively treat constipation. The mechanism of its action may be related to the direct or indirect regulation of intestinal motility by the PI3K-Akt signaling pathway.

This paper focuses on extreme environments and systematically analyzes sleep disorders caused by multiple pathogenesis,including circadian rhythm disorder,yin-yang imbalance and qi-blood disorder under weightlessness,emotional depression due to environmental changes,abnormal diet and excretion,and six excesses pathogenic factors,in accordance with the theory of correspondence between nature and human.It proposes harmonizing yin and yang as the core therapeutic principle and guiding framework,with specific methods including calming rebellious qi-blood,regulating qi movement,harmonizing heart and kidney,and dredging and regulating blood vessels,thus forming the"one guiding principle and four specific methods"treatment strategy.Additionally,by integrating the modified application of classic formulas,a diagnostic and therapeutic approach targeting multi-dimensional pathogenesis is established.This study aims to promote the in-depth integration of Traditional Chinese Medicine(TCM)in extreme environmental medicine through TCM theories and innovative application of prescriptions,provide TCM-characterized solutions for health management of workers in extreme environments,and facilitate the transformation of extreme environmental medicine toward the modern medical model of"prevention-treatment integration".

This review aimed to provide a comprehensive analysis of the etiology, epidemiology, pathology, and conventional treatment of heterotopic ossification (HO), especially emerging potential therapies. HO is the process of ectopic bone formation at non-skeletal sites. HO can be subdivided into two major forms, acquired and hereditary, with acquired HO predominating. Hereditary HO is a rare and life-threatening genetic disorder, but both acquired and hereditary form can cause severe complications, such as peripheral nerve entrapment, pressure ulcers, and disability if joint ankylosis develops, which heavily contributes to a reduced quality of life. Modalities have been proposed to treat HO, but none have emerged as the gold standard. Surgical excision remains the only effective modality; however, the optimal timing is controversial and may cause HO recurrence. Recently, potential therapeutic strategies have emerged that focus on the signaling pathways involved in HO, and small molecule inhibitors have been shown to be promising. Moreover, additional specific targets, such as small interfering RNAs (siRNAs) and non-coding RNAs, could be used to effectively block HO or develop combinatorial therapies for HO.
Humans ; Ossification, Heterotopic/genetics*