Objective To compare the anesthetic effect and safety of remimazolam and propofol on patients underwent video-assisted thoracoscopic surgery for lung cancer.Methods Clinical data of patients with lung cancer underwent video-assisted thoracoscopic surgery were retrospectively collected.Remimazolam group was anesthetized by remimazolam,and propofol group was anesthetized by propofol.The changes in mean arterial pressure(MAP)and heart rate(HR)were compared between the two groups of patients before anesthesia induction(T0),after 5 min of tracheal intubation(T1),after 1 h of surgery(T2),during thorax closure(T3)and at 5 min after extubation(T4).The sedation onset time,recovery time and extubation time in the two groups were recorded.Stress response indicators[adrenocorticotropic hormone(ACTH),cortisol(Cor)]were compared at T0 and T4.Ramsay sedation score(RSS)was used to assess the sedation degree at T4.Visual analogue score(VAS)was applied to evaluate the pain degree at 2,12 and 24 h after surgery,and the perioperative anaesthesia-related adverse events were observed.Results There were 58 cases in remimazolam group and 64 cases in propofol group.The MAP values at T1 in remimazolam group and propofol group were(85.03±4.37)and(78.24±4.48)mmHg;at T2 were(80.39±3.95)and(75.49±4.11)mmHg;at T3 were(84.43±4.02)and(79.59±3.97)mmHg;the HR values at T2 were(76.44±5.75)and(72.39±6.03)beat·min-1,the difference were all significant(all P＜0.05).The sedation onset times in remimazolam group and propofol group were(62.45±6.27)and(72.33±7.19)s;the recovery times were(7.22±1.23)and(8.24±1.48)min;the extubation times were(8.34±1.50)and(10.09±1.83)min;the RSS scores at T4 were(2.03±0.39)and(1.88±0.35)points,the difference were all significant(all P＜0.05).The total incidence rates of anesthesia-related adverse events in remimazolam group and propofol group were 6.90％and 21.88％,respectively(P＜0.05).Conclusion Both remimazolam and propofol can play a good sedative effect during lung cancer video-assisted thoracoscopic surgery anesthesia.Remimazolam anesthesia has more stable intraoperative hemodynamics,faster onset and elimination,and higher safety.

Objectives: To investigated the safety and efficacy of treating patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) and elevated levels of N-terminal pro-hormone B-type natriuretic peptide (NT-proBNP) with levosimendan within 24 hours of first medical contact (FMC). Methods: This multicenter, open-label, block-randomized controlled trial (NCT03189901) investigated the safety and efficacy of levosimendan as an early management strategy of acute heart failure (EMS-AHF) for patients with NSTEMI and high NT-proBNP levels. This study included 255 patients with NSTEMI and elevated NT-proBNP levels, including 142 males and 113 females with a median age of 65 (58-70) years, and were admitted in the emergency or outpatient departments at 14 medical centers in China between October 2017 and October 2021. The patients were randomly divided into a levosimendan group (n=129) and a control group (n=126). The primary outcome measure was NT-proBNP levels on day 3 of treatment and changes in the NT-proBNP levels from baseline on day 5 after randomization. The secondary outcome measures included the proportion of patients with more than 30% reduction in NT-proBNP levels from baseline, major adverse cardiovascular events (MACE) during hospitalization and at 6 months after hospitalization, safety during the treatment, and health economics indices. The measurement data parameters between groups were compared using the t-test or the non-parametric test. The count data parameters were compared between groups using the χ² test. Results: On day 3, the NT-proBNP levels in the levosimendan group were lower than the control group but were statistically insignificant [866 (455, 1 960) vs. 1 118 (459, 2 417) ng/L, Z=-1.25,P=0.21]. However, on day 5, changes in the NT-proBNP levels from baseline in the levosimendan group were significantly higher than the control group [67.6% (33.8%,82.5%)vs.54.8% (7.3%,77.9%), Z=-2.14, P=0.03]. There were no significant differences in the proportion of patients with more than 30% reduction in the NT-proBNP levels on day 5 between the levosimendan and the control groups [77.5% (100/129) vs. 69.0% (87/126), χ²=2.34, P=0.13]. Furthermore, incidences of MACE did not show any significant differences between the two groups during hospitalization [4.7% (6/129) vs. 7.1% (9/126), χ²=0.72, P=0.40] and at 6 months [14.7% (19/129) vs. 12.7% (16/126), χ²=0.22, P=0.64]. Four cardiac deaths were reported in the control group during hospitalization [0 (0/129) vs. 3.2% (4/126), P=0.06]. However, 6-month survival rates were comparable between the two groups (log-rank test, P=0.18). Moreover, adverse events or serious adverse events such as shock, ventricular fibrillation, and ventricular tachycardia were not reported in both the groups during levosimendan treatment (days 0-1). The total cost of hospitalization [34 591.00(15 527.46,59 324.80) vs. 37 144.65(16 066.90,63 919.00)yuan, Z=-0.26, P=0.80] and the total length of hospitalization [9 (8, 12) vs. 10 (7, 13) days, Z=0.72, P=0.72] were lower for patients in the levosimendan group compared to those in the control group, but did not show statistically significant differences. Conclusions: Early administration of levosimendan reduced NT-proBNP levels in NSTEMI patients with elevated NT-proBNP and did not increase the total cost and length of hospitalization, but did not significantly improve MACE during hospitalization or at 6 months.
Male ; Female ; Humans ; Aged ; Natriuretic Peptide, Brain ; Simendan/therapeutic use* ; Non-ST Elevated Myocardial Infarction ; Heart Failure/drug therapy* ; Peptide Fragments ; Arrhythmias, Cardiac ; Biomarkers ; Prognosis

Objective: The purpose is to investigate the validity of a surgical technique that utilizes autologous costal cartilage grafts in primary rhinoplasty for female patients. Methods: From July 2015 to July 2017, 137 cases received primary rhinoplasty with various types of grafts originated from autologous costal cartilage to correct the unpleasant nasal appearances including low dorsum, poorly defined nasal tip and wide alar base. Results: With 6 to 36 months follow-up, six patients(4.3%) exhibited noticeable changes in nasal contour due to graft warping. Revision surgeries were commenced to correct those minor deformities, resulting in satisfactory outcome.All other cases presented significant improvements of the nasal appearance. Conclusions Autologous costal cartilage is a good source for primary rhinoplasty cases.

Objective To investigate amethod of building supporting structure in nasal reconstruction with more stable effect and better aestheticresult .It was intended to highlight the key points during the process of nasal reconstruction .Methods A retrospective analyze was done to all the patients in our center from January 2010 to July 2015. Patients' characteristics, flaps, supporting framework, defect location by subunits were recorded .Results 233 patients were included ( 126 males and 97 females) in this study.The age ranged from 4 to 60 years old with an average of 25.4 ys.Defects most commonly involved were nasal ala and tip with the average defect location of 4.39 subunits. Reconstructionmethod was given priority to expanded forehead flapto cover the costal cartilage framework . Postoperative follow-up was from 6 to 36 months.All the patients reported increased nasal appearance and function evaluation .Conclusions The stable and strong supporting structure has become an important factor to achieve the final esthetical and functionalresult of nasal reconstruction , no matter which kind of the flaps was used in the process .Costal cartilage enjoyswide applications and reliable effect , so it is a recommendable material for supporting structure in nasal reconstruction .

Objective To investigate amethod of building supporting structure in nasal reconstruction with more stable effect and better aestheticresult .It was intended to highlight the key points during the process of nasal reconstruction .Methods A retrospective analyze was done to all the patients in our center from January 2010 to July 2015. Patients' characteristics, flaps, supporting framework, defect location by subunits were recorded .Results 233 patients were included ( 126 males and 97 females) in this study.The age ranged from 4 to 60 years old with an average of 25.4 ys.Defects most commonly involved were nasal ala and tip with the average defect location of 4.39 subunits. Reconstructionmethod was given priority to expanded forehead flapto cover the costal cartilage framework . Postoperative follow-up was from 6 to 36 months.All the patients reported increased nasal appearance and function evaluation .Conclusions The stable and strong supporting structure has become an important factor to achieve the final esthetical and functionalresult of nasal reconstruction , no matter which kind of the flaps was used in the process .Costal cartilage enjoyswide applications and reliable effect , so it is a recommendable material for supporting structure in nasal reconstruction .

BACKGROUNDDespite psycho-oncological concerns and studies having thrived these past decades, sparse reports illustrate to what extent Chinese cancer patients are involved and influenced by comorbid mental health problems. To investigate the mental health condition of cancer patient, as well as its possible impacts on prognosis, the first large-scale survey was performed in the west of China.

METHODSFor standardizing and facilitating the assessment of mental illness in inpatients with cancer, a multidisciplinary rating flow was designed and established. On the basis of this system, between May 1st and 31st 2009, 2279 cancer inpatients from nine medical centers received preliminarily screening executed by oncologists using screening scales Mental Health Screening Questionnaire (MHSQ), Zung self-rating depression scales (SDS), Zung self-rating anxiety scale (SAS), and posttraumatic stress disorder checklist-civilian version (PCL-C). Further analyses of the ones screened positively were conducted by psychiatrists applying corresponding symptom-rating scales (HAMA/HAMD/BPRS). We summarized the overall proportion of patients with impaired mental health based on the data acquired from preliminary screening, and then calculated occurrence rates of each clinical syndrome of mental disorder according to symptom conclusions. The impact of comorbid mental illness was evaluated through the follow-up scheduled 1 year later, by comparing the survival rate, progression of disease, and quality of life (QoL) between subgroup patients with or without clinical syndrome of mental disorder.

RESULTSIn preliminary screenings, 26.1% (595/2279) yielded positive results. Further symptom conclusions confirmed 15.8% (359/2279) with clinical syndrome of mental disorder. Regarding specific type of syndrome, the occurrence rates of depression, anxiety, psychotic symptoms, and stress-related disorders were 13.3%, 10.2%, 2.8%, and 1.4%, respectively. Follow-up assessments were successfully performed in 1918 subjects (84.2%). Further analyses indicated that although insignificant influence was observed in terms of 1-year survival rate and disease progression, cancer patients with a clinical syndrome of mental disorder obtained significantly lower levels (P < 0.05) in five domains of QoL (scored by QLQ-C30).

CONCLUSIONIn China, at least 26% of cancer patients experienced impaired mental health, of which 60% already had a detectable clinical syndrome of mental disorder, which could significantly undermine their QoL.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Comorbidity ; Female ; Follow-Up Studies ; Humans ; Male ; Mental Disorders ; epidemiology ; Mental Health ; Middle Aged ; Neoplasms ; psychology

Background Despite psycho-oncological concerns and studies having thrived these past decades,sparse reports illustrate to what extent Chinese cancer patients are involved and influenced by comorbid mental health problems.To investigate the mental health condition of cancer patient,as well as its possible impacts on prognosis,the first large-scale survey was performed in the west of China.Methods For standardizing and facilitating the assessment of mental illness in inpatients with cancer,a multidisciplinary rating flow was designed and established.On the basis of this system,between May 1st and 31st 2009,2279 cancer inpatients from nine medical centers received preliminarily screening executed by oncologists using screening scales Mental Health Screening Questionnaire (MHSQ),Zung self-rating depression scales (SDS),Zung self-rating anxiety scale (SAS),and posttraumatic stress disorder checklist-civilian version (PCL-C).Further analyses of the ones screened positively were conducted by psychiatrists applying corresponding symptom-rating scales (HAMA/HAMD/BPRS).We summarized the overall proportion of patients with impaired mental health based on the data acquired from preliminary screening,and then calculated occurrence rates of each clinical syndrome of mental disorder according to symptom conclusions.The impact of comorbid mental illness was evaluated through the follow-up scheduled 1 year later,by comparing the survival rate,progression of disease,and quality of life (QoL) between subgroup patients with or without clinical syndrome of mental disorder.Results In preliminary screenings,26.1％ (595/2279) yielded positive results.Further symptom conclusions confirmed 15.8％ (359/2279) with clinical syndrome of mental disorder.Regarding specific type of syndrome,the occurrence rates of depression,anxiety,psychotic symptoms,and stress-related disorders were 13.3％,10.2％,2.8％,and 1.4％,respectively.Follow-up assessments were successfully performed in 1918 subjects (84.2％).Further analyses indicated that although insignificant influence was observed in terms of 1-year survival rate and disease progression,cancer patients with a clinical syndrome of mental disorder obtained significantly lower levels (P ＜0.05) in five domains of QoL (scored by QLQ-C30).Conclusion In China,at least 26％ of cancer patients experienced impaired mental health,of which 60％ already had a detectable clinical syndrome of mental disorder,which could significantly undermine their QoL.

Objective To discuss the risk and strategy of dental implantation in patients with periodontal disease and type 2 diabetes.Methods Retrospective analysis was performed of dental implantation results in 248 patients with periodontal disease and type 2 diabetes from 2000 to 2008.The survival rate was evaluated and the data statistically analyzed.Results The Nobel implant system and CDIC implant system were used.The operation applied flapless and bone expanding techniques.A total of 1190 implants were inserted (333 Nobel Replace implants and 857 CDIC implants).0.5％ (6 implants) lost during the first 6 months healing stage.The l-year,5-year and 8-year survival rate were 98.4％ (1165/1184),95.3％(487/511)and 89.2％(91/102) respectively.Conclusions The patients with periodontal disease and type 2 diabetes are suitable for implant treatment with satisfactory results under the conditions that the indication and risk factors are evaluated and controlled strictly.

BACKGROUND AND OBJECTIVEThe incidence of lung cancer in non-smokers is increasing in recent years. The aim of this investigation is to explore main risk factors of non-smoking primary lung cancers in Sichuan province in order to provide more accurate data for clinical.

METHODSOne hundred and fourty-five non-smoking pairs of cases and 145 of controls were matched by age and sex. The patients were newly-diagnosed definitely as primary lung cancer at West China Hospital of Sichuan University from March to December 2009.

RESULTSSeventeen exposure factors were explored as epidemic agents for non-smoking lung cancer in Sichuan by using univariate analysis; mutivariate conditional Logistic regression analysis showed that passive smoking, moved into newly renovated homes over the past 10 years, family cancer history from second/ third-degree relatives, lack of emotion regulation, heavy work pressure and poor quality of sleep were main risk agents for the non-smoking lung cancer incidence with OR 2.267 (95% CI: 1.231-4.177), 5.080 (95% CI: 1.632-15.817), 7.937 (95% CI: 1.815-34.705), 2.491 (95% CI: 1.230-4.738), 5.769 (95% CI: 2.030-16.396), 2.538 (95% CI: 1.277-4.861), respectively. While higher body mass index, eating fruit and vegetable and regular participating in physical exercise might be protective factors with OR 0.419 (95% CI: 0.226-0.779), 0.344 (95% CI: 0.155-0.762), 0.507 (95% CI: 0.274-0.937), respectively.

CONCLUSIONThe occurrence of non-smoking primary lung cancer associated with a variety of exposure factors including passive smoking, history of exposure to harmful environmental, family cancer history, mental and psychological factors in Sichuan Province.

Adult ; Aged ; Case-Control Studies ; China ; Environmental Exposure ; Female ; Humans ; Logistic Models ; Lung Neoplasms ; etiology ; Male ; Middle Aged ; Odds Ratio ; Risk Factors ; Smoking

OBJECTIVETo study the predictive value of ALT, HBeAg and HBV DNA levels at baseline and HBV DNA levels at week 12 adefovir dipivoxil (ADV) treatment to the efficacy of it at week 52 in patients with HBeAg-positive chronic hepatitis B (CHB).

METHODSNinety-eight HBeAg-positive CHB patients with serum HBV DNA>or=1x10(6) copies/ml and ALT levels between 1.5 to 10 times of upper limits of normal (ULN) were enrolled in the study. Ten mg/d of ADV was administered for 52 weeks. Line serum samples were collected for measuring HBV DNA and HBV markers. The efficacy of the treatment at week 52 was evaluated in patients with different ALT, HBeAg and HBV DNA levels at baseline and HBV DNA levels at week 12 after treatment.

RESULTSAt week 52 of ADV treatment, the rates of HBV DNA<10(3) were 72.7%, 66.7% and 53.0% respectively in patients with ALT>5xULN, HBeAg350 s/co (30.2%, P<0.01) and HBV DNA>10(8) copies/ml (34.4%, P<0.05) at baseline. HBeAg seroconversion rates were 42.2% and 7.5% (P<0.01) in patients with HBeAg titer350 S/co at baseline. In patients with HBV DNA<10(3), 10(3)-10(5) and >10(5) copies/ml at week 12, the ratios of them with HBV DNA<10(3) less than 1000 copies/ml at week 52 were 82.6%, 57.1% and 17.5% and significant differences were found between these groups (P<0.05); HBeAg seroconversion rates were 52.2%, 25.7% and 5.0% (P<0.05); ALT normalization rates were 100%, 83% and 75%, significantly higher in patients with HBV DNA<10(3) copies/ml than those with HBV DNA>10(5) copies/ml (P<0.05) at week 12. HBV DNA and HBeAg seroconversion at week 52 correlated with HBV DNA levels at week 12 (r=0.6 and r=0.5 respectively, P<0.01).

CONCLUSIONSIn HBeAg-positive CHB patients treated with adefovir dipivoxil, HBV DNA levels at week 12 can be used to predict the efficacy at week 52. HBV DNA<10(3) copies/ml at week 12 predict a better treatment result at week 52.

Adenine ; analogs & derivatives ; therapeutic use ; Adult ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; blood ; drug therapy ; Humans ; Male ; Organophosphonates ; therapeutic use ; Predictive Value of Tests ; Treatment Outcome ; Young Adult