Objective:To observe the effectiveness and safety of the application of Wei nasal jet tube(WNJT)in anesthesia induction for patients with extensive facial burns.Methods:A total of 60 patients who underwent multiple systemic scab removal and skin graft-ing surgery in our hospital from July 2021 to July 2023 were enrolled in this study.The patients were 18-60 years of age,with a body mass index of 18-29 kg/m2,ASA II or III,and Mallampati I-III.Using a random number table method,the patients were divided into WNJT ventilation group(W group)and mask ventilation group(M group),with 30 cases in each group.Before anesthesia induction,WNJT was inserted into one side of the nasal cavity for hand controlled normal frequency supraglottic jet ventilation in group W pa-tients,while oxygen ventilation was administered to group M patients through conventional two-hand clasped face masks.After 5 min,tracheal intubation was performed under a visual laryngoscope.The mean amplitude of diaphragm fluctuations,end expiratory carbon dioxide partial pressure(PETCO2),and blood oxygen saturation(SpO2)measured by ultrasound were recorded during spontaneous respi-ration at 5 min of oxygenation and nitrogen removal(T0),as well as at 1 min(T1),2 min(T2),3 min(T3),4 min(T4),and 5 min(T5,im-mediately before intubation)of anesthetic induction.Arterial blood gas(PaO2 and PaCO2)at T0 and T5 were measured.Heart rate(HR)and mean arterial pressure(MAP)were recorded at T0-T5 in both groups of patients.The occurrence of postoperative pharyngeal pain,facial or mandibular angle bleeding,gastrointestinal bloating,and nasal mucosal bleeding were recorded in both groups of pa-tients.Results:At T0,there were no statistically significant differences in mean amplitude of diaphragm fluctuations,HR,MAP,PaO2,PaCO2,PETCO2,and SpO2 between the two groups of patients.At T1-T5,the HR and MAP of patients in the W group were significantly lower than those in the M group(P<0.05).At T5,the PaO2 of patients in the W group was significantly higher than that in the M group,while the PaCO2 and PETCO2 were significantly lower than those in the M group(P<0.05).However,the difference in SpO2 was not sta-tistically significant.The W group had less facial or mandibular angle bleeding and postoperative gastrointestinal bloating than the M group,and the differences were statistically significant(P<0.05).There were no statistically significant differences between the two groups of patients in postoperative pharyngitis and nasal mucosal bleeding(P>0.05).Conclusion:During general anesthesia induction in patients with extensive facial burns,WNJT has the advantages of good ventilation effect,high safety,less complications such as gas-trointestinal bloating and facial or mandibular angle bleeding,and more stable hemodynamics.WNJT has good application prospects in clinical anesthesia.

Objective To observe the sedative and analgesic effect of remazolam combined with sufentanil during ultrasound-guided nerve block in patients undergoing orthopedic surgery.Methods A total of 80 patients who underwent orthopedic surgery in our hospital from January to June 2023 were selected.They were randomly assigned to two groups with 40 cases in each group.In anesthesia preparation room,one group was injected intravenously 10 ml remazolam(0.15 mg/kg)+ sufentanil 0.1 μg/kg(R group)and the other group was injected intravenously 10 ml normal saline +sufentanil 0.1 μg/kg(S group).Ultrasound-guided nerve block was performed 2 min later.The Visual Analogue Scale(VAS)of the two groups were observed during the process of postural position,nerve block puncture and drug injection.Whether there was any discomfort or body movement during the nerve block process were recorded.The mean arterial pressure(MAP),heart rate,and pulse oxygen saturation were measured at baseline,5 min after intravenous injection,nerve block injection,and 10 min after nerve block.Adverse reactions were noted.Results The VAS scores of the R group were 0 point at the time of postural position,nerve block puncture and drug injection,which were significantly lower than those of the S group(all P =0.000).The incidence of sore swelling,electrical sensation,and pain at the time of nerve block of the R group were lower than those of the S group(P<0.05).The incidence of transient glossoptosis of the R group was higher than that of the S group(6 cases vs.0 case,P =0.026).The MAP before and after nerve block in the S group remained at a high level(>95 mm Hg),and the highest MAP appeared at the time point of nerve block;while the MAP of the R group decreased and remained at 80-90 mm Hg after sedation.Conclusion Remazolam combined with sufentanil can provide safe,painless,fear free"comfort medical service"for nerve block sedation and analgesia in anesthesia preparation room,and does not increase the risk of nerve injury and local anesthetic poisoning.

Objective To investigate the effect of L4 transverse process erector spinae plane block(ESPB)before general anesthesia hip surgery in elderly patients on reducing perioperative pain and stress,thus reducing opioid consumption and improving postoperative recovery quality.Methods Sixty patients aged 65 years old and above who underwent unilateral hip surgery from January to December 2023 were randomly divided into two groups(n = 30)by using the random number table method.The ESPB group received ultrasound-guided ESPB at the L4 level with 0.3%ropivacaine(0.5 ml/kg)before induction of anesthesia,while the control group did not receive ESPB.Laryngeal mask anesthesia was administered in both groups.The induction and maintenance methods were consistent in both groups.The Numerical Rating Scale(NRS)was used to evaluate the degree of pain at 8 h and 24 h after surgery.The times of pressing analgesic pump within 24 h after surgery were recorded.The hemodynamic changes at each time point during the operation were observed.The time interval from the end of the operation to the complete recovery and to remove the laryngeal mask were recorded.Intraoperative and Postanesthesia Care Unit(PACU)opioid consumption were noted.The incidence of postoperative agitation,postoperative nausea and vomiting(PONV),dizziness,and the recovery quality score were compared.Results The NRS scores of rest pain and motion pain at 8 h and 24 h after surgery were significantly lower in the ESPB group than those in the control group,and the times of pressing the analgesic pump within 24 h after surgery in the ESPB group was significantly less than that in the control group(P<0.05).The mean arterial pressure(MAP)of the ESPB group at 20 min after peeling was lower than that of the control group[(87.2±15.5)mm Hg vs.(96.7±16.9)mm Hg,P = 0.026].The sufentanil consumption,remifentanil consumption,and the number of cases using urapidil in the ESPB group were significantly lower than those in the control group[12.5(10.0,14.0)μg vs.12.5(12.5,17.5)μg,P =0.041;270(100,400)μg vs.600(448,800)μg,P<0.001;1 case vs.11 cases,P =0.001].The Steward score at30 min after entering PACU was significantly higher in the ESPB group than in the control group[6(5,6)points vs.5(4,5)points,P<0.001].There was no statistical significance in incidence of postoperative agitation,PONV,and dizziness between the two groups(P>0.05).Conclusion Preoperative ESPB at the level of the L4 transverse process can reduce the pain score within 24 h after surgery,reduce the amount of opioid used during and after hip surgery,and improve the quality of postoperative recovery in the elderly.

Objective To compare the application effects of different anesthesia methods under preoper-ative optimization measures in elderly patients with hip fracture surgery.Methods A total of 120 elderly pa-tients (≥75 years old) with hip fracture surgery in this hospital from May 2022 to December 2023 were se-lected as the study subjects and divided into group A and group B,60 cases in each group.The two groups a-dopted the preoperative optimization measures.The group A performed "two single three low" (unilateral,once,low position,low concentration and low dose) lumbar anesthesia,while group B conducted the laryngeal mask artificial airway anesthesia.The hemodynamic changes at skin incision in operation beginning (T1),at 30 min after operation (T2),suture at operation end (T3),at the end of operation (T4) and at 30 min after opera-tion end (T5),postoperative recovery time and occurrence situation of complications such as nausea and vomi-ting,agitation,postoperative delirium (POD) were compared between the two groups.Results The systolic blood pressure and the heart rate at T1 in group B were lower than those in group A,and the differences were statistically significant (P<0.05).The systolic blood pressure and heart rate at T4 in group B were higher than those in group A,and the difference was statistically significant (P<0.05).The recovery time,agitation,nausea and vomiting and incidence rate of adverse reactions such as POD had no statistical difference between the two groups (P<0.05).Conclusion On the basis of preoperative optimization measures,selecting the "two single three low" lumbar anesthesia method in elderly patients with hip fracture surgery anesthesia has more stable hemodynamics,less complications and faster postoperative recovery.

Objective To investigate the effects of dexmedetomidine injection at the Neiguan acupoint before general anaesthesia on neurocognitive disorder and sleep quality after non-cardiac major surgery in eld-erly people.Methods Elderly patients undergoing elective thoracic and laparoscopic surgery in this hospital from February 2023 to March 2024 were selected and divided into the dexmedetomidine Neiguan acupoint in-jection group(A),saline Neiguan acupoint injection group(B)and dexmedetomidine intravenous injection group(C)by the randomised numerical table method,40 cases in each group.The postoperative neurocognitive function and sleep-related condition in the three groups were observed.Results The incidence rate of postop-erative delirium(POD)on postoperative 1 d in the group A and C was significantly decreased compared with the group B,and the difference was statistically significant(P＜0.05);the incidence rate of POD on postoper-ative 2 d in the group A was significantly decreased compared with the group B(P＜0.05);the incidence rate of postoperative cognitive dysfunction(POCD)on postoperative 1 d in the group A and C was significantly de-creased compared with the group B,moreover which in the group A was lower than that in the group C,and the differences were statistically significant(P＜0.05);the incidence rate of POCD on postoperative 3,5 d in the group A was lower than that in the group B(P＜0.05).The MMSE score on postoperative 1,3,5 d in the group B and C was significantly decreased compared with preoperative 1 d(P＜0.05).The MMSE score on postoperative 1,3,5 d in the group A and C was higher than that in the group B.and the difference was statis-tically significant(P＜0.05).The PSQI score on postoperative 1,3,5 d in the group A and C was increased compared with preoperative 1 d(P＜0.05);compared with the group B,the PSQI score on postoperative 1,3,5 d in the group A and C was decreased,moreover the group A was lower the group C,and the differences were statistically significant(P＜0.05).The incidence rate of bradycardia in the group A and C was signifi-cantly higher than that in the group B(P＜0.05).The incidence rate of postoperative nausea and vomiting(PONV)in the group A was significantly lower than that in the group B and C(P＜0.05),and the difference between the group B and C had no statistical significance(P＞0.05).Conclusion Dexmedetomidine injection at the Neiguan acupoint before anaesthesia for minimally invasive surgery can significantly reduce periopera-tive neurocognitive dysfunction(PND)and improve the quality of sleep in elderly patients,moreover simulta-neously has the effect for preventing PONV.

J Objective To investigate the efficacy of butorphanol intravenous analgesia combined with transversus abdominal plane block in postoperative analgesia after cesarean section.Methods A total of 120 cases of cesarean section performed in Jinjiang Hospital from August 2021 to January 2022 were selected for the study.The cases were divided into three groups,according to the different methods of maternal postopera-tive analgesia,the group A was treated with intravenous analgesia(100 mL normal saline containing 3 μg/kg butorphanol+25 mg dolasetron,2 mL/h,continuous analgesia for 48 h);the group B received intravenous analgesia(100 mL normal saline containing 3 pg/kg butorphanol+25 mg dolasetron,2 mL/h,continuous an-algesia for 48 h)combined with transverse abdominal plane block(0.5％ropivacaine given bilaterally on each side).2 μg/kg butorphanol+25 mg dolasetron,2 mL/h,continuous analgesia for 48 h)combined with trans-versus abdominis plane block(10 mL of 0.5％ropivacaine was given bilaterally),and intravenous analgesia in the group C(100 mL of saline containing 2 pg/kg butorphanol+25 mg dolasetron,2 mL/h,continuous anal-gesia for 48 h)combined with transversus abdominis plane block(0.5％ropivacaine 10 mL was given bilater-ally),and the three groups were compared in terms of the VAS scores of postoperative analgesia at 4,8,12,24 and 48 h,the occurrence of the incidence of adverse reactions,such as dizziness,drowsiness,nausea,and vomi-ting,and the satisfaction with the analgesia.satisfaction of analgesia.Results Comparison of analgesic effect between groups,the VAS of group B and group C were significantly lower than those of group A at 4,8 and 12 h after surgery(P＜0.05),but there was no significant difference between group B and group C in pain scores(P＞0.05),and postoperative 24,48 h pain scores of the three groups are not statistically different(P＞0.05).In terms of the incidence of adverse reactions such as dizziness,drowsiness,nausea and vomiting,there was no significant difference in the incidence of adverse reactions between the group A and the group B,and they were all higher than that of the group C.Satisfaction with analgesia at 4,8,12,24,48 h after surgery:group C＞group B＞group A.Conclusion The multi-mode analgesia program of butorphanol intravenous an-algesia combined with transversal abdominis plane block can be safely and effectively used for postoperative analgesia after cesarean section,and appropriate reduction of butorphanol dosage when combined can alleviate the adverse reactions brought by opioids,thus improving the satisfaction of patients with postoperative analge-sia.

Objective To investigate the application of intubation laryngeal mask in laparoscopic anesthesia for elderly patients with hypertension. Methods A total of 80 patients ( ASA Ⅱ -Ⅲ) over 70 years old undergoing laparoscopic gastrointestinal and gallbladder surgery from March 2014 to February 2015 were selected.They were randomly divided into the intubating laryngeal mask group ( ILMA group) or endotracheal tube group ( ET group) , with 40 patients in each group.After the intubation, the two groups were anesthetized with remifentanil by target-controlled infusion ( TCI ) and sevoflurane inhalation.The ILMA group was inserted matching laryngeal mask to control respiratory ventilation and deepened to the proper depth of anesthesia.An endotracheal tube were inserted through the mask 5 min later, and then the breath was controlled via transtracheal catheter to maintain anesthesia.The ET group was inserted tracheal intubation after induction, and then the breath was controlled until extubation after the recovery of the tracheal extubation after surgery.The heart rate (HR), blood pressure (SBP and DBP) and bispectral index (BIS) were recorded at time points of before induction (T0), laryngeal mask or endotracheal tube insertion (T1), after endotracheal tube insertion (T2), skin incision (T3), beginning tissue dissection or entry of laparoscope (T4), resection of organs or tissues (T5), and tracheal extubation ( T6 ) , respectively.In addition, the recovery time, the recovery of spontaneous breathing, complications during the recovery time, such as restlessness, nausea and vomiting, were observed and compared. Results There were significant differences in HR, SBP, DBP, BIS between the two groups and among different time points (P=0.000).At time points of before operation ( T0 -T2 ) and anesthesia maintaining stage ( T3 -T6 ) , the HR, SBP, DBP and BIS were stable in both groups.At the time points of after endotracheal intubation ( T2 ) and extubation ( T6 ) , the ET group had significantly increased HR, SBP, and DBP, which were higher than the ILMA group (P<0.05).At the time point of T6, the BIS values were significantly increased in the ET group than the ILMA group (P<0.05).On postoperative recovery quality, the time from anesthesia to spontaneous breathing recovery and from end of surgery to call to open eyes was significantly longer in the ET group than the LIMA group [(130.1 ±26.1) min vs. (96.4 ±24.5) min, t=5.94, P=0.000;(16.1 ±2.7) min vs.(5.5 ±2.2) min, t=19.07, P=0.000]. Conclusion For elderly patients with hypertension undergoing laparoscopic surgery, use of intubation laryngeal mask for anesthesia is more stable and has less adverse cardiovascular reactions, with good outcomes of anesthesia recovery.

OBJECTIVE: The optimal multiplicity of infection (MOI) of the recombinant adenovirus Ad-Rad50-GFP carrying a mutant Rad50 gene expression region on the cell growth of nasopharyngeal carcinoma and the viral amplification efficiency of CNE1 cell infected by this adenovirus were studied. METHOD: The biological titer of Ad-Rad50-GFP was measured by end point dilution method. The impact of recombinant adenoviral vector transfection on the growth of CNE1 cells was observed by cell growth curve. Transfection efficacy of recombinant adenoviral vector was observed and calculated through fluorescence microscope. The expression f mutant Rad50 in the Ad-Rad50-GFP transfected CNE1 cells with optimal MOI was detected by Western Blot after transfection. RESULT: The biological titer of Ad-Rad50-GFP was 1.26 x 10¹¹ pfu/ml. CNE1 cell growth was not influenced significantly as they were transfected by recombinant adenoviral vector with MOI less than 50. Transfection efficacy of recombinant adenoviral vector was most salient at 24 hours after transfection, with the high expression of mutant Rad50, and the efficiency still remained about 70% after 72 hours. CONCLUSION Recombinant adenoviral vector Ad-Rad50-GFP could transfect CNE1 cells as well as result in the expression of mutant Rad50 in CNE1 cells effectively. MOI = 50 was the optimal multiplicity of infection of CNE1 cells transfected by recombinant adenoviral vector Ad-Rad50-GFP.
Adenoviridae ; Carcinoma ; Cell Line, Tumor ; Genetic Vectors ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; Transfection

Objective To evaluate the effect of age on the median-effective target plasma concentration (EC50) of propofol inhibiting body movement evoked by gastroscopy in the patients.Methods Ninety adult patients of both sexes,of ASA physical status Ⅰ or Ⅱ,with body mass index 19-25 kg/m2,scheduled for elective gastroscopy,were divided into 3 groups according to age (n =30 each):18-39 yr group (Ⅰ group),40-64 yr group (Ⅱ group) and 65-85 yr group (Ⅲ group).In Ⅰ,Ⅱ,Ⅲ groups,propofol was given by target-controlled infusion with the initial target concentrations of 2.5,2.0 and 1.5 μg/ml,respectively,and gastroscopy was performed when the target concentration was achieved.Body movement was defined as the directional movement in head or four extremities during gastroscopy.The target plasma concentration of propofol was determined by up-and-down sequential trial.Each time the plasma concentration of propofol increased/decreased by 0.5 μg/ml in the next patient depending on whether or not body movement developed.The EC50 and 95 ％ confidence interval of propofol inhibiting gastroscopy-evoked body movement were determined using Probit analysis.Results The EC50 (95 ％ confidence interval) of propofol was 4.2(3.8-4.5),4.1(3.7-4.4) and 2.4(1.8-2.7) μg/ml in Ⅰ,Ⅱ and Ⅲ groups,respectively.There was no significant difference in the EC50 of propofol between group Ⅱ and group Ⅰ.The EC50 of propofol was significantly lower in group Ⅲ than in Ⅰ and Ⅱ groups.Conclusion Age affects propofol-induced analgesia in patients with visceral pain,and the potency of propofol inhibiting visceral pain during gastroscopy in the elderly patients is significantly enhanced as compared with that in the young and middle-aged patients.

Objective Replacement of dexmedetomidine with propofol for maintaining the anes-thesia in elderly patients undergoing laparoscopic cholecystectomy.Methods Ninety patients,over 70 years old,undergoing laparoscopic cholecystectomy were randomly divided into 2 groups,propofol combined with remifentanil (group A),dexmedetomidine combined with remifentanil (group B),45 patients in each group.Group A was not treated with any preoperative medication,while group B was treated with loading dose of 0.5 μg/kg dexmedetomidine intravenously completed within 10 minutes. Induction methods were same in both groups,3 # or 4 # laryngeal mask were inserted after induction in both groups.Maintenance of anesthesia in group A treated with propofol 2.0-3.0 μg/ml + 4.5-5.5 ng/ml TCI;Maintenance of anesthesia in group B treated with dexmedetomidine 0.25 μg·kg-1·h-1 +remifentanil 4.5-5.5 ng/ml (TCI).HR,SBP,DBP,BIS were recorded at inserting the LMA (T1 ), beginning of the surgery (T2 ),dissociate the cholecyst (T3 ),withdrawal of the laparoscope (T4 ), extubate the LMA (T5 ).Postoperative recovery time,Steward awakening score and modified OAA/S score at extubation time were recorded.Results No significant difference was found between BIS val-ue of two groups at different time point.Compared with group A,HR at T1-T5 in group B were sig-nificantly lower,SBP,DBP were significantly decreased (P <0.05).There was no significant differ-ence between Steward awakening score and modified OAA/S score at recovery and extubation time in two groups.Conclusion Dexmedetomidine replacing propofol can be safely used in laparoscopic chole-cystectomy with less hemodynamic changes during maintenance of anesthesia in elderly patients.