Objective To explore the efficacy and safety of oxycodone and midazolam for endoscopic retrograde cholangio-pancreatography(ERCP)under awake sedation.Methods Patients scheduled for elective ERCP in the department of gastroenterology of Xuzhou Central Hospital from January 2021 to December 2022 were prospectively recruited and randomly divided into the control group(pethidine combined with diazepam)and the experimental group(oxycodone combined with midazolam).Visual Analogue Scale(VAS)score,Ramsay Sedation Scale(RSS)score,heart rate(HR),respiratory rate(RR),blood oxygen saturation(SpO2),mean arterial pressure(MAP)and postoperative C-reactive protein and blood amylase levels were observed and compared between the two groups of patients before the procedure(T0),at the time of entry(T1),at the time of the opening of the endoscope into the duodenal papilla(T2),at the time of exit(T3).Additionally,incidence of adverse events,patient and endoscopist satisfaction were compared between the two groups.Results A total of 60 patients were included,30 in each group.The difference in the trends of VAS and RSS scores over time between the two groups was statistically significant(Ptime×treatment＜0.05).Compared to the control group,the experimental group had lower VAS scores and higher RSS scores at T1,T2 and T3(P＜0.05).The differences in SpO2 and MAP changes over time between the two groups were statistically significant(Ptime×treatment＜0.05),with higher values observed in the experimental group at T1-T3(P＜0.05).The incidence of pain,coughing and agitation in the experimental group was lower during the procedure(P＜0.05).Both endoscopist and patient satisfaction were significantly higher in the experimental group(P＜0.05).Conclusion Compared with pethidine combined with diazepam,oxcyodone combined with midazolam as a preoperative medication for awake sedation in ERCP treatment is more effective and safer.

Objective To explore the efficacy and safety of oxycodone and midazolam for endoscopic retrograde cholangio-pancreatography(ERCP)under awake sedation.Methods Patients scheduled for elective ERCP in the department of gastroenterology of Xuzhou Central Hospital from January 2021 to December 2022 were prospectively recruited and randomly divided into the control group(pethidine combined with diazepam)and the experimental group(oxycodone combined with midazolam).Visual Analogue Scale(VAS)score,Ramsay Sedation Scale(RSS)score,heart rate(HR),respiratory rate(RR),blood oxygen saturation(SpO2),mean arterial pressure(MAP)and postoperative C-reactive protein and blood amylase levels were observed and compared between the two groups of patients before the procedure(T0),at the time of entry(T1),at the time of the opening of the endoscope into the duodenal papilla(T2),at the time of exit(T3).Additionally,incidence of adverse events,patient and endoscopist satisfaction were compared between the two groups.Results A total of 60 patients were included,30 in each group.The difference in the trends of VAS and RSS scores over time between the two groups was statistically significant(Ptime×treatment＜0.05).Compared to the control group,the experimental group had lower VAS scores and higher RSS scores at T1,T2 and T3(P＜0.05).The differences in SpO2 and MAP changes over time between the two groups were statistically significant(Ptime×treatment＜0.05),with higher values observed in the experimental group at T1-T3(P＜0.05).The incidence of pain,coughing and agitation in the experimental group was lower during the procedure(P＜0.05).Both endoscopist and patient satisfaction were significantly higher in the experimental group(P＜0.05).Conclusion Compared with pethidine combined with diazepam,oxcyodone combined with midazolam as a preoperative medication for awake sedation in ERCP treatment is more effective and safer.

Objective:To investigate the construction of containing CT imaging features Nomograms model of postoperative intraluminal thromus (ILT) formation in patients with aortic dissective aneurysm (ADA).Methods:One hundred and twenty patients with Stanford type B ADA treated with overlapping stent endoluminal repair and multilayer spiral CT (MSCT) examination in Affiliated Hospital of Jining Medical College from May 2020 to February 2022 were selected. The patients were divided into the modeling population (84 patients) and the validation population (36 patients) according to a 7∶3 ratio. The factors influencing postoperative ILT formation in ADA patients were analyzed by univariate and Logistic multifactor regression models, and the prediction model of postoperative ILT formation was constructed based on the influencing factors.Results:In the modeled population, the rate of ILT formation within 1 month after luminal repair with overlapping stents was 27.38%(23/84), including 5 cases in the aortic arch and 18 cases in the abdominal aorta. In the modeled population, the results of univariate analysis showed that the sex, age, body mass index(BMI), smoking, drinking, hypertension, hyperlipidemia, rupture diameter, rupture distance from left subclavicular artery, involvement of important branches, uneven thickening of aneurysm wall, low density on plain scan and operation timing between the ILT formation group and non-ILT formation group had no statistically significant ( P>0.05). The diabetes mellitus, irregular inner wall, calcified plaque, postoperative anticoagulant therapy, B-type brain natriuretic peptide (BNP), fibrinogen (Fib), D-dimer (D-D) and C-reactive protein (CRP) between the two groups had statistical differences: 43.48%(10/23) vs. 11.48%(7/61), 86.96%(20/23) vs. 57.38%(35/61), 91.30%(21/23) vs. 62.30%(38/61), 21.74%(5/23) vs. 57.38%(35/61), (523.60 ± 128.74) ng/L vs.(271.83 ± 109.65) ng/L, (3.82 ± 0.96) g/L vs. (2.85 ± 0.83) g/L, (601.37 ± 75.62) μg/L vs. (389.20 ± 68.79)μg/L, (0.63 ± 0.19) mg/L vs. (0.48 ± 0.15) mg/L, P<0.05. The results of Logistic multifactor regression analysis showed that diabetes mellitus, irregular inner wall, calcified plaque, postoperative anticoagulant therapy and BNP, Fib, D-D CRP levels were influential factors for postoperative ILT formation in Stanford type B ADA patients ( P<0.05). The C-index of the model was 0.903 and 0.894 for the modeled and validated populations, respectively, which had good discrimination and was good at predicting ILT formation after operation in Stanford type B ADA patients. The model had good clinical utility in predicting postoperative ILT formation in Stanford B ADA patients. Conclusions:The Nomograms model can help to screen and identify patients with high risk of ILT formation at an early clinical stage.

Biodegradable stents (BDSs) are the milestone in percutaneous coronary intervention(PCI). Biodegradable polymeric stents have received widespread attention due to their good biocompatibility, moderate degradation rate and degradation products without toxicity or side effects. However, due to the defects in mechanical properties of polymer materials, the clinical application of polymeric BDS has been affected. In this paper, the BDS geometric configuration design was analyzed to improve the radial strength, flexibility and reduce the shrinkage rate of biodegradable polymeric stents. And from the aspects of numerical simulation, in vitro experiment and animal experiment, the configuration design and mechanical properties of biodegradable polymeric stents were introduced in detail in order to provide further references for the development of biodegradable polymeric stents.
Absorbable Implants ; Animals ; Percutaneous Coronary Intervention ; Polymers ; Prosthesis Design ; Stents