Objective:To evaluate the effects of different doses of sufentanil on the pupillary dilation reflex (PDR) during induction of general anesthesia.Methods:In this randomized controlled study, 124 patients of either sex, aged 18-64 yr, with a body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, undergoing surgery with general anesthesia, were divided into 4 groups ( n=31 each) using a random number table method: control group (group C) and different doses of sufentanil groups (S1-S3 groups). Sufentanil 0.2, 0.4 and 0.6 μg/kg were intravenously injected in S1-S3 groups, respectively, and the equal volume of normal saline was injected instead in group C. Tetanic stimulation (50 mA, 50 Hz, 5 s) was applied at 5 min after injection of sufentanil. Pupil diameter was measured and the pupillary dilation value and dilation rate were calculated upon entering the operating room while awake, after loss of consciousness, 5 min after intravenous injection of sufentanil, and at maximal pupil diameter after tetanic stimulation. The presence or absence of PDR, PDR latency and PDR duration were also recorded. Results:The pupillary dilation values and dilation rates decreased progressively from group C through groups S1 to S3 ( P<0.05). Compared to group C, the disappearance rate of PDR was significantly increased, and the latency of PDR was prolonged in groups S2 and S3, and the duration of PDR was significantly shortened in groups S1-S3 ( P<0.05). Compared to group S1, the disappearance rate of PDR was significantly increased, and the latency of PDR was prolonged in S2 and S3 groups ( P<0.05). Conclusions:The inhibitory effect of sufentanil on the PDR during induction of general anesthesia is dose-dependent.

Objective To investigate the protective effect of valeric acid on Doxorubicin-induced myocardial injury in mice.Methods C57BL/6J mice and AC16 cells were randomly divided into control group,injury group,and low-,medium-,and high-dose valeric acid groups.Doxorubicin was used to treat mice and myocardial cells to establish myocardial injury models.Hematoxylin-eosin(HE)staining was used to analyze the pathological changes of myocardial tissue in mice,and enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of myocardial injury markers and inflammatory factors in mice from each group.Cell counting kit was used to detect the viability of myocardial cells in each group,and spectrophotometry was used to detect the levels of superoxide dismutase(SOD)and malondialdehyde(MDA)in the serum and myocardial cells in mice from each group.Reactive oxygen species(ROS)fluorescence probe was used to detect the levels of reactive oxygen species in each group,and flow cytometry was used to detect the apoptosis rate of each group.Western blot was used to detect the expression levels of nuclear factor erythroid 2-related factor 2(Nrf2)and heme oxygenase 1(HO-1)proteins in myocardial tissue and myocardial cells of mice from each group.Results Compared with the injury group,the myocardial injury in the low-,medium-,and high-dose valeric acid groups was ameliorated,the levels of myocardial injury markers gradually decreased,the levels of SOD in the body,and the expression levels of Nrf2 and HO-1 proteins gradually increased,and the levels of inflammatory factors,MDA,and apoptosis rate gradually decreased(P<0.05).Compared with myocardial cells in the injury group,the viability of myocardial cells,the levels of SOD,and the expression levels of Nrf2 and HO-1 proteins in the low-,medium-,and high-dose valeric acid groups gradually increased,while the levels of inflammatory factors,MDA,and apoptosis rate gradually decreased(P<0.05).Conclusion Valeric acid can inhibit inflammation and oxidative stress to improve Doxorubicin-induced myocardial injury,which may be related to the activation of Nrf2/HO-1 signaling pathway by valeric acid.

Objective:To evaluate the effects of different doses of sufentanil on the pupillary dilation reflex (PDR) during induction of general anesthesia.Methods:In this randomized controlled study, 124 patients of either sex, aged 18-64 yr, with a body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, undergoing surgery with general anesthesia, were divided into 4 groups ( n=31 each) using a random number table method: control group (group C) and different doses of sufentanil groups (S1-S3 groups). Sufentanil 0.2, 0.4 and 0.6 μg/kg were intravenously injected in S1-S3 groups, respectively, and the equal volume of normal saline was injected instead in group C. Tetanic stimulation (50 mA, 50 Hz, 5 s) was applied at 5 min after injection of sufentanil. Pupil diameter was measured and the pupillary dilation value and dilation rate were calculated upon entering the operating room while awake, after loss of consciousness, 5 min after intravenous injection of sufentanil, and at maximal pupil diameter after tetanic stimulation. The presence or absence of PDR, PDR latency and PDR duration were also recorded. Results:The pupillary dilation values and dilation rates decreased progressively from group C through groups S1 to S3 ( P<0.05). Compared to group C, the disappearance rate of PDR was significantly increased, and the latency of PDR was prolonged in groups S2 and S3, and the duration of PDR was significantly shortened in groups S1-S3 ( P<0.05). Compared to group S1, the disappearance rate of PDR was significantly increased, and the latency of PDR was prolonged in S2 and S3 groups ( P<0.05). Conclusions:The inhibitory effect of sufentanil on the PDR during induction of general anesthesia is dose-dependent.

Objective:To investigate the histopathological subtype and clinical characteristics of vascular malformations in the head and neck.Methods:All patients with head and neck vascular malformations referred to Henan Provincial People′s Hospital between January 2021 and December 2023 were collected, and the clinicopathological features were analyzed by SPSS 26.0 statistical software.Results:A total of 675 patients were included, there were 293 male and 382 female patients with a mean onset age of (26.2±21.8）years and a mean diagnosis age of (31.8±20.6）years. Most vascular malformations were located in oral and maxillofacial region (52.1%, 352/675), with an average diameter of (28.0±19.8）mm. Venous malformations were the most common (71.4%, 482/675). There were 230 patients presented with simultaneous phenomenon, and of them the thrombus was most commonly noted (66.5%, 153/230). Venous malformations more frequently occurred in patients who were older than 20 years, extracranial in site, and mostly involved female patients with complications. Combined vascular malformation more frequently occurred in patients who were under 20 years old, extracranial in site, and mostly involved female patients. Capillary malformations more frequently occurred in patients under 20 years old, extracranial in site, and no complications occurred. Lymphatic vessel malformation more frequently occurred in patients who were under 20 years old, extracranial in site, female and with no complications. Arteriovenous malformations were more common in the intracranial and most of them were without any complications. Two cases (2/21) were associated with PIK3CA gene mutation. There were 109 patients with recurrence after initial treatment.Conclusions:Vascular malformations in the head and neck are more commonly found in the extracranial and maxillofacial regions, and venous malformations are the most common type; while arteriovenous malformations are more common in the intracranial site. Appropriate diagnosis is the premise of appropriate treatment.

Objective To investigate the protective effect of valeric acid on Doxorubicin-induced myocardial injury in mice.Methods C57BL/6J mice and AC16 cells were randomly divided into control group,injury group,and low-,medium-,and high-dose valeric acid groups.Doxorubicin was used to treat mice and myocardial cells to establish myocardial injury models.Hematoxylin-eosin(HE)staining was used to analyze the pathological changes of myocardial tissue in mice,and enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of myocardial injury markers and inflammatory factors in mice from each group.Cell counting kit was used to detect the viability of myocardial cells in each group,and spectrophotometry was used to detect the levels of superoxide dismutase(SOD)and malondialdehyde(MDA)in the serum and myocardial cells in mice from each group.Reactive oxygen species(ROS)fluorescence probe was used to detect the levels of reactive oxygen species in each group,and flow cytometry was used to detect the apoptosis rate of each group.Western blot was used to detect the expression levels of nuclear factor erythroid 2-related factor 2(Nrf2)and heme oxygenase 1(HO-1)proteins in myocardial tissue and myocardial cells of mice from each group.Results Compared with the injury group,the myocardial injury in the low-,medium-,and high-dose valeric acid groups was ameliorated,the levels of myocardial injury markers gradually decreased,the levels of SOD in the body,and the expression levels of Nrf2 and HO-1 proteins gradually increased,and the levels of inflammatory factors,MDA,and apoptosis rate gradually decreased(P<0.05).Compared with myocardial cells in the injury group,the viability of myocardial cells,the levels of SOD,and the expression levels of Nrf2 and HO-1 proteins in the low-,medium-,and high-dose valeric acid groups gradually increased,while the levels of inflammatory factors,MDA,and apoptosis rate gradually decreased(P<0.05).Conclusion Valeric acid can inhibit inflammation and oxidative stress to improve Doxorubicin-induced myocardial injury,which may be related to the activation of Nrf2/HO-1 signaling pathway by valeric acid.

Objective:To investigate the histopathological subtype and clinical characteristics of vascular malformations in the head and neck.Methods:All patients with head and neck vascular malformations referred to Henan Provincial People′s Hospital between January 2021 and December 2023 were collected, and the clinicopathological features were analyzed by SPSS 26.0 statistical software.Results:A total of 675 patients were included, there were 293 male and 382 female patients with a mean onset age of (26.2±21.8）years and a mean diagnosis age of (31.8±20.6）years. Most vascular malformations were located in oral and maxillofacial region (52.1%, 352/675), with an average diameter of (28.0±19.8）mm. Venous malformations were the most common (71.4%, 482/675). There were 230 patients presented with simultaneous phenomenon, and of them the thrombus was most commonly noted (66.5%, 153/230). Venous malformations more frequently occurred in patients who were older than 20 years, extracranial in site, and mostly involved female patients with complications. Combined vascular malformation more frequently occurred in patients who were under 20 years old, extracranial in site, and mostly involved female patients. Capillary malformations more frequently occurred in patients under 20 years old, extracranial in site, and no complications occurred. Lymphatic vessel malformation more frequently occurred in patients who were under 20 years old, extracranial in site, female and with no complications. Arteriovenous malformations were more common in the intracranial and most of them were without any complications. Two cases (2/21) were associated with PIK3CA gene mutation. There were 109 patients with recurrence after initial treatment.Conclusions:Vascular malformations in the head and neck are more commonly found in the extracranial and maxillofacial regions, and venous malformations are the most common type; while arteriovenous malformations are more common in the intracranial site. Appropriate diagnosis is the premise of appropriate treatment.

Objective To investigate the diagnostic value and risk of gastrointestinal stromal tumors(GIST)by multislice spiral computed tomography(MSCT).Methods A total of 118 suspected GIST patients admitted to Huzhou Central Hospital from June 2021 to November 2022 were selected for MSCT examination and pathological examination.Taking pathological diagnosis as the gold standard,the efficacy of MSCT in diagnosing GIST was analyzed.Multifactor analysis was used to investigate the factors affecting the risk of GIST.Results Pathological diagnosis of GIST was confirmed in 103 of 118 suspected patients.The sensitivity,specificity and accuracy of MSCT diagnosis of GIST were 97.09%,86.67%and 95.76%,respectively.There were significant differences in maximum tumor diameter,tumor shape,tumor boundary,tumor density,cystic necrosis and fat space between high-risk group and low-risk group(P<0.05).The results of multifactor analysis showed that maximum tumor diameter,tumor shape,tumor density and fat space were all factors affecting the risk of GIST(P<0.05).Conclusion MSCT has a high accuracy in the diagnosis of GIST.The maximum tumor diameter,tumor shape,tumor density and fat space are all factors affecting the risk of GIST.

Objective:To investigate the effect of iron deficiency on the prognosis of elderly patients with ejection fraction preserved heart failure (HFpEF).Methods:The clinical data of old patients (>75 years) with HFpEF from November 2021 to May 2023 in General Hospital of Eastern Theater of the Chinese People′s Liberation Army were retrospectively analyzed. The patients were divided into iron deficiency group (65 cases) and non-iron deficiency group (90 cases) according to serum ferritin (SF) and transferrin saturation (TSAT) at admission. The first hematological indexes and echocardiogram examination results after admission were compared between two groups. The patients were followed up until November 2023, the poor prognosis was recorded. The correlation between iron deficiency, iron metabolism indexes and poor prognosis in elderly patients with HFpEF was analyzed by Spearman correlation analysis. The Kaplan-Meier survival curve was drawn to analyze the effect of iron deficiency on the cumulative survival in elderly patients with HFpEF.Results:There were no statistical difference in triglyceride, total cholesterol, low density lipoprotein cholesterol, C-reactive protein, hemoglobin and echocardiogram indexes between the two groups ( P>0.05). The N-terminal pro-brain natriuretic peptide (NT-proBNP), creatinine, procalcitonin (PCT) and interleukin-6 (IL-6) in iron deficiency group were significantly higher than those in non-iron deficiency group: 427.23 (281.00, 736.90) pmol/L vs. 313.50 (182.47, 363.25) pmol/L, (167.93 ± 51.22) μmol/L vs. (121.71 ± 11.99) μmol/L, 0.12 (0.05, 0.22) μg/L vs. 0.07 (0.04, 0.16) μg/L and 25.60 (8.38, 47.01) ng/L vs. 10.15 (4.75, 19.89) ng/L, the SF, serum iron (SI) and TSAT were significantly lower than those in non-iron deficiency group: 75.40 (42.30, 198.00) μg/L vs. 207.00 (281.00, 736.90) μg/L, (6.49 ± 2.66) μmol/L vs. (12.75 ± 4.24) μmol/L and (16.65 ± 6.26)% vs. (33.78 ± 11.16)%, and there were statistical differences ( P<0.01 or <0.05). The patients were followed up for (12.06 ± 7.58) months, the all-cause mortality, cardiovascular mortality, readmission rate and heart failure readmission rate in iron deficiency group were significantly higher than those in non-iron deficiency group: 40.0% (26/65) vs. 20.0% (18/90), 18.5% (12/65) vs. 4.4% (4/90), 90.8% (59/65) vs. 70.0% (63/90) and 66.2% (43/65) vs. 17.8% (16/90), and there were statistical differences ( P<0.01). Spearman correlation analysis result showed that the iron deficiency was positive correlation with all-cause death, cardiovascular death, readmission and heart failure readmission in elderly patients with HFpEF ( P<0.01); the SI and TSAT were negative correlation with all-cause death, cardiovascular death, readmission and heart failure readmission ( P<0.01 or <0.05); and the SF was not correlation with the indexes ( P>0.05). Kaplan-Meier survival analysis result showed that the risk of all-cause death was significantly increased in elderly HFpEF patients with iron deficiency, and the cumulative survival rate was significantly reduced (log-rank χ2 = 6.48, P<0.05). Conclusions:The elderly HFpEF patients with iron deficiency have poor prognosis with high mortality and readmission rate.

Objective:To investigate the relation between 25 hydroxyvitamin D3 level and global registry of acute coronary event (GRACE) score in elderly patients with acute coronary syndrome (ACS).Methods:The clinical data of 120 elderly male patients with ACS hospitalized in the General Hospital of Eastern Theater Command from January 2020 to June 2022 were retrospectively analyzed. Clinical characteristics of patients were collected and the 25 hydroxyvitamin D3 level was assessed with the chemiluminescent immunoassay method. According to GRACE score, the patients were divided into intermediate-risk group (109 to 140 scores, 46 cases) and high-risk group(>140 scores, 74 cases). The severity of coronary lesion was assessed according to the results of coronary angiography (CAG) and then they were divided into A, B, C group. The independent influential factors of GRACE score were analyzed by Logistic regression analysis.Results:The level of 25 hydroxyvitamin D3 in the high-risk group was lower than that in the intermediate-risk group: (13.84 ± 3.42) μg/L vs. (18.57 ± 5.17) μg/L, the usage rate of angiotensin-converting enzyme inhibitors (ACEI)/angiotonin receptor blocker (ARB) in the high-risk group was lower than that in the intermediate-risk group: 17.6%(13/71) vs. 41.3%(19/46), there were statistical differences ( P<0.05). Logistic regression analysis showed that 25 hydroxyvitamin D3 level was the risk factor for GRACE score ( OR = 0.745, 95% CI 0.657-0.844, P<0.05). The level of 25 hydroxyvitamin D3 had negative correlation with the severity of coronary lesion ( P<0.05). Conclusions:The level of 25 hydroxyvitamin D3 has correlation with GRACE score and the severity of coronary lesion in elderly patients with ACS.

Objective To establish a coronavirus(CoV)infection model using human nasal mucosa organoids for testing antiviral drugs and evaluate the feasibility of using human nasal mucosa organoids with viral infection as platforms for viral research and antiviral drug development.Methods Human nasal mucosa organoids were tested for susceptibility to SARS-CoV-2 and HCoV-OC43 pseudoviruses.In a P3 laboratory,nasal mucosa organoids were infected with the original strain of SARS-CoV-2 and 4 variant strains,and the infection conditions were optimized.The viral loads in the culture supernatants were measured at different time points using RT-qPCR,and immunofluorescence assay was employed to localize SARS-CoV-2 nucleocapsid protein to determine the type of the infected cells.In the optimized nasal mucosa viral infection model,the antiviral effects of camostat and bergamot extract(which were known to inhibit SARS-CoV-2)were tested and the underlying molecular mechanisms were explored.Results In the optimized nasal mucosa organoid models infected with SARS-CoV-2 and HCoV-OC43 pseudoviruses,the viral load in the culture supernatants increased significantly during the period of 2 to 24 h following the infection,which confirmed infection of the organoids by both of the pseudoviruses.The nasal mucosa organoids could be stably infected by the original SARS-CoV-2 strain and its 4 variant strains,validating successful establishment of the viral infection model,in which both camostat and bergamot extract exhibited dose-dependent antiviral effects.Conclusions Human nasal mucosa organoids with SARS-CoV-2 infection can serve as platforms for screening and testing antiviral drugs,particularly those intended for nasal administration.