Objective To compare the efficacy of dual channel (intravenous channel and puncture needle channel) and single channel (puncture needle channel) of thrombin injection in reducing bleeding during low-dose CT-guided percutaneous lung biopsy, identify the optimal method, and develop a protocol with improved safety and efficacy while minimizing radiation exposure to patients. Methods Patients who underwent CT-guided percutaneous lung biopsy at Linyi Central Hospital between May 2024 and January 2025 were selected and divided into a dual channel group (observation group) and a single channel group (control group) according to the methods of thrombin injection. The baseline characteristics (sex, age, underlying lung disease, lesion diameter, distribution, proportion of solid lesions, enhancement degree, puncture depth and time, and benign or malignant) and the differences in CT images after lung puncture (bleeding, blood diffusion distance, and blood diffusion volume) were compared between the two groups of patients. Results There were no significant differences in baseline characteristics and bleeding incidence between the two groups of patients (P > 0.05). The diffusion distance and volume of blood in the dual channel group were significantly lower than those in the single channel group (P < 0.05). Conclusion The use of dual channel thrombin injection under low-dose CT guidance cannot reduce the incidence of bleeding in lung biopsy, but it can reduce the amount of bleeding, blood diffusion to surrounding lung tissues, and intraoperative radiation exposure to patients.

Objective:To explore the effects of ilioinguinal composite tissue flaps in repairing skin and soft tissue defects on hand or foot and reconstructing the flexion and extension functions of wrist, finger, ankle, and toe.Methods:From February 2012 to March 2018, 4, 5, and 3 patients (11 males and 1 female, 23-62 years old) with skin and soft tissue defects on hand or foot were admitted to Traditional Chinese Medicine Hospital of Zhongmu County of Henan Province, Henan Armed Police Corps Hospital, and the Affiliated Jiangyin Hospital of Medical College of Southeast University, respectively. Five patients had hand defects, and 7 patients had foot defects. The areas of skin and soft tissue defects after debridement were 10 cm×8 cm-15 cm×10 cm. The ilioinguinal composite tissue flaps were designed and resected according to the wound area and the length of tendon defects, and the areas of flaps were 10 cm×8 cm-15 cm×12 cm. According to the specific condition of the recipient area, the superficial iliac circumflex artery in the tissue flap was reconstructed by end-to-side anastomosis in 2 patients and end-to-end anastomosis in 1 patient with ulnar artery, end-to-side anastomosis in 4 patients with the dorsal foot artery, end-to-side anastomosis in 2 patients with the posterior tibial artery, and end-to-end anastomosis in 1 patient with the external tarsal foot artery in the recipient area, and the superficial epigastric artery in the tissue flap was reconstructed by end-to-side anastomosis in 1 patient with the radial artery and end-to-end anastomosis in 1 patient with the ulnar artery in the recipient area. The donor sites were sutured directly or repaired with medium split-thickness skin grafts. The survival of tissue flap after the operation and the appearance, texture, and the two-point discrimination distance of the tissue flaps during follow-up were observed. The hand function and foot function were evaluated by the total active movement standard of hand and the Maryland foot score standard, respectively.Results:All the tissue flaps in 12 patients survived. During follow-up of 6-36 months after operation, the tissue flaps were slightly bloated, with linear scars at the junction site in the recipient area, and the two-point discrimination distances of the tissue flaps were 15-22 mm. The hand function was excellent in 3 cases, good in 1 case, and fair in 1 case, and the foot function was excellent in 4 cases, good in 2 cases, and fair in 1 case, and all the patients were satisfied with the function and appearance of hand or foot.Conclusions:The ilioinguinal composite tissue flaps can repair the hand and foot wounds and reconstruct the flexion and extension functions of wrist, finger, ankle, and toe at the same time, which is an effective method to repair this kind of defects.

Objective To analyze the risk factors of acute kidney injury after orthotropic liver transplantation for adult benign end-stage liver disease.Methods A retrospective analysis was conducted in 30 recipients (18 males,12 females,aged 23-68 years,ASA grade Ⅲ or Ⅳ) who underwent orthotropic liver transplantation for benign end-stage liver disease at Tongji Hospital from May,2014 to December,2014.Both demographic characteristics and perioperative parameters were collected,including general condition,surgery and anesthesia factors and intraoperative salvage autotransfusion or not.Perioperative laboratory findings related to renal function including urine volume,serum creatinine (Scr) and urea nitrogen (BUN) were collected,too.All variables tested in the univariate analysis with a P<0.10 were included in a multiple logistic regression analysis.Results There were less intraoperative salvage autotransfusion,more platelet transfusion and a higher using rate of vasopressors in the AKI group after surgery than those did not.Patients who received intraoperative salvage autotransfusion had 0.058 time odds (95%CI 0.005-0.649) of AKI than those did not;patients who required platelet transfusion had 10.706 times higher odds (95%CI 1.212-94.963) of AKI than those did not.Conclusion It is likely that intraoperative salvage autotransfusion was able to decrease the morbidity of AKI,while platelet transfusion and vasopressor administration to maintain blood pressure could increase the possibility of AKI.

Objective To investigate the effect of ketamine on the mitochondrial function of rat neurons subjected to anoxia. Methods Primarily cultured rat hippocampal neurons were seeded in culture dishes (35 mm in diameter) at the density of 5×105-1×106 cells∕ml, and divided into 3 groups (n=11 each) using a random number table: control group, anoxia group and ketamine group. The neurons were exposed to 90% N2 plus 10% CO2 50 ml∕min for 5 min in anoxia group. In ketamine group, ketamine was added to the culture medium with the final concentration of 20 μmol∕L at 1 h before anoxia, and then the neurons were exposed to 90% N2 plus 10% CO2 50 ml∕min for 5 min. After the end of treatment in each group, the dead neurons were detected using trypan blue staining, the ATP content was determined by ATP bioluminescence assay, and mitochondrial membrane potential was measured by rhodamine 123 staining. Results Compared with control group, the mortality rate of hippocampal neurons was significantly in?creased, and the ATP content and mitochondrial membrane potential were significantly decreased in anoxia group and ketamine group ( P<0.05) . Compared with anoxia group, the mortality rate of hippocampal neu?rons was significantly decreased, and the ATP content and mitochondrial membrane potential were signifi?cantly increased in ketamine group (P<0.05). Conclusion The mechanism by which ketamine amelio?rates anoxia?induced damage to rat neurons is related to improved mitochondrial function.

Objective To compare the effects of a single injection of palonosetron and tropise-tron to prevent postoperative nausea and vomiting (PONV ) in gynecological surgeries. Methods Sixty patients undergoing elective major gynecological surgeries with general anesthesia (Apfel score ≥ 3 ) were included and randomized to group P (palonosetron ) and group T (tropisetron),30 patients in each group.All patients received general anesthesia with tracheal intuba-tion,and palonosetron 0.25 mg or tropisetron 5 mg were injected before anesthesia respectively in two groups.Intravenous hydromorphine was delivered for postoperative analgesia in all patients. PONV were evaluated and followed up for 72 hours.The degree of PONV was recorded and the com-plete response rate (CR)and complete control rate (CC)were calculated.Results The degree of PONV in 0-24 h and 24-48 h was milder in group P than in group T (P <0.05),while in 48-72 h the degree of PONV was similar between the two groups.In group P,5 patients had vomiting postopera-tively with the failure period of treatment of (1 9.6±9.4)h,and no patients needed rescue treatments. While in group T,1 9 patients suffered from vomiting with the failure period of treatment of (20.6± 4.5)h,and rescue treatments were delivered 3 times in total.The CR and CC of preventing PONV in 0-24 h,24-48 h and 0-72 h were significantly higher in group P than in group T (P <0.05).The CR and CC of the two groups were comparable in 48-72 h postoperatively.Conclusion A preoperative single dose of palonosetron 0.25 mg is better than tropisetron 5 mg in preventing PONV within 48hours after gynecological surgery.

Objective To evaluate the effect of different intravenous analgesia methods on postoperative incisional and uterine contraction pain after cesarean section.Methods Four hundred parturients (ASA Ⅱ-Ⅱ) undergoing cesarean section were randomly allocated into 4 groups,including sufentanil group (group S,96 cases),sufentanil combined with flurbiprofen axetil group (group SK,99 cases),butorphanol group (group N,106 cases) and butorphanol combined with llurbiprofen axetil group (group NK,99 cases).All the parturients received the operation under epidural combined with spinal anesthesia,and received patient-controlled intravenous analgesia (PCIA) after cesarean section.Numerical rating scale (NRS) of postoperative rest and dynamic incisional pain and uterine contraction pain,Ramsay sedation scale (RSS),and PCIA-related adverse events were recorded for 24 h after operation.Results All the parturients were finished this study.The age,body weight,gestational weeks and operative time in 4 groups had no significant difference (P ＞ 0.05).The NRS score of rest incisional pain was equivalent among the 4 groups (P ＞ 0.05).The NRS score of dynamic incisional pain after operative 13 h in group S was significantly lower than that in group N[(3.6 + 1.3) scores vs.(5.4 + 1.2) scores](P＜ 0.05).The NRS score of uterine contraction pain after operative 4,13 h in group N and group SK was lower than that in group S [(1.3 ± 1.0),(1.1 ± 0.9) scores vs.(2.5 ± 1.1) scores and (1.6 ± 1.0),(1.4 ± 0.9) scores vs.(2.9 ± 1.1) scores] (P ＜ 0.05).The RSS scores and incidence rate of dizziness were significantly higher in group N than those in group S (P ＜0.05).No abnormality of new-horn infant was recorded in 4 groups.Conclusion Sufentanil combined with nonsteroidal antiinflammatory drugs can perform effective and safe analgesia on postoperative incisional and uterine contraction pain after cesarean section.

Objective To evaluate the role of ATP-sensitive potassium (KATP) channel in spinal dorsal horn neurons in hyperalgesia after thoracotomy in rats.Methods Twenty-eight Sprague-Dawley rats,aged 7-9 weeks,weighing 250-350 g,in which intrathecal catheters were successfully implanted without complications on 14th day after chronic post-thoracotomy pain was induced,were randomly divided into 4 groups (n =7 each):control group,the solvent dimethyl sulfoxide (DMSO) group,KATP channel opener pinacidil group (group P) and KATP channel blocker glibenclamide group (group G).10％ DMSO 10 μl,pinacidil 10 μg/10 μl and glibenclamide 50μg/10μ1 were injected intrathecally in groups DMSO,P and G at 5 day after the intrathecal catheter was implanted,respectively.Paw withdrawal threshold to von Frey filament stimulation was measured before intrathecal administration and at 10,30 and 60 min after intrathecal administration and the acetone test was performed.Coldinduced pain threshold was measured.Results There was no significant difference in paw withdrawal threshold to yon Frey filament stimulation at each time point among the four groups (P ＞ 0.05).Compared with C and DMSO groups,cold-induced pain threshold was significantly increased in group P and decreased in group G (P ＜ 0.05).There was no significant difference in cold-induced pain threshold between C and DMSO groups (P ＞ 0.05).Conclusion KATP channel in spinal dorsal horn neurons is involved in the maintenance of hyperalgesia after thoracotomy in rats.

ObjectiveTo observe the effect of penehyclidine hydrochloride (PHC) on serum interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α ) concentrations following tourniquet deflation in patients undergoing lower limb surgery.Methods Thirty adult patients,scheduled for unilateral lower limb surgery,ASA classification [ - Ⅱ grades,were divided into control group and research group by random number table,each group of 15 cases.Before anesthesia 30 min,PHC in intravenous infusion of 0.01-0.02 mg/kg in research group,the corresponding volume in intravenous infusion of 0.9% sodium chloride in control group.Peripheral venous blood samples were collected immediately before tourniquet inflation (T0,baseline),immediately before tourniquet deflation(T1),30 min (T2) and 60 min (T3) after tourniquet deflation.Serum IL-6 and TNF- α concentrations were measured by enzyme linked immunosorbentassay.ResaltsSerum TNF- α change at the same time point after tourniquet deflation was not statistically significant between two groups (P ＞ 0.05).Serum IL-6 concentration was decreased at each time point after tourniquet deflation compared with T0 in research group,while increased in control group.Serum IL-6concentration difference of T3 and T0 had statistically significant between research group and control group [ (-8.8 ± 5.6) ng/L vs.( 10.2 ± 6.7) ng/L,P＜ 0.05].ConclusionsPHC in advance can decrease serum IL-6 concentration after tourniquet deflation in patients undergoing lower limb surgery.

ObjectiveTo summarize and analyse the perioperative management especially theanesthesia of 20 kidney transplant recipients in non-transplant surgery. MethodThe anesthesia management of 20 kidney transplant recipients in non-transplant surgery was analyzed retrospectively. ResultsIn 20 cases, 1 case (5％) was performed under local anesthesia,4 cases (20％) were performed under intravertebral anesthesia and 15 cases (75％) were performed under general anesthesia. The operation time was 30-260 min, all cases were managed successfully. ConclusionIt is still a clinical challenge to deal with the surgical patients after kidney transplantation, and it needs fully understanding of the pathophysiological status of the patient and closely collaboration of transplant physicians, anesthesiologists and the surgeons.

ObjectiveTo investigate the effect of ketamine on nicotine-induced current in rat superior cervical ganglion neurons.MethodsNewborn Wistar rats were used in this study.Neurons were isolated enzymatically from superior cervical ganglia of newborn rats in an aseptic condition and cultured in 90％ DMEM/F12,10％ horse serum containing penicillin 100 μg/ml for 5-7 d.Nicotine-induced current was measured and recorded using whole-cell patch clamp technique.A mixture of nicotine 50 μmol/L and different concentrations of ketamine ( 10,25,50,100 μmol/L) was added to the isolated neurons.The effect of ketamine on nicotine-induced current was evaluated.ResultsNicotine-induced peak current was inhibited by ketamine in a concentration-dependent manner.The time constant of fast and slow desensitizing phase of the nicotine acetylcholine receptor was shortened after being exposed to the mixture of nicotine 50 μmol/L + 50 or 100 μmol/L ketamine as compared to nicotine 50 μmol/L-induced current.The median effective concentration of ketamine inhibiting nicotine-induced current was less than 20 μmol/L.ConclusionKetamine can decrease nicotine-induced current in rat superior cervical ganglion neurons in a concentration-dependent manner indicating that inhibition of sympathetic activity is involved in the mechanism of decrease in BP by ketamine in specific condition.