1.Study on CTRP3-mediated UCHL1 enhancing SeVGMT reprogramming of CFs to protect cardiac function in MI mice
Yanbi Song ; Yunqing Zhang ; Huiyu Liu ; Junmin Chen
Acta Universitatis Medicinalis Anhui 2025;60(10):1896-1907
Objective:
To investigate the effects of C1q tumor necrosis factor⁃related protein 3 (CTRP3) ⁃enhanced Sendai virus (SeV) vector⁃overexpressing Gata4 , Mef2c , and Tbx5 (SeVGMT) in the treatment of myocardial in⁃farction (MI) mice and to analyze whether ubiquitin carboxyl⁃terminal hydrolase L1 (UCHL1) mediates this thera⁃peutic pathway.
Methods:
The mice were divided into 7 groups ( n = 12) : Sham group , MI group , SeVGMT group , CTRP3⁃Lv group , UCHL1 ⁃sh group , SeVGMT + CTRP3⁃Lv group , and SeVGMT + CTRP3⁃Lv + UCHL1 ⁃sh group. In the Sham group , only the skin was incised without ligation , while the coronary artery was ligated 2 - 3 mm below the left atrial appendage in mice in other groups. PBS was injected at three points in the myocardial infarction boundary in the Sham and MI groups 30 minutes after ligation. Mice in other groups were injected with SeVGMT , CTRP3-Lv , or UCHL1-sh according to their grouping. Four weeks after treatment , fractional shortening (FS) , ejection fraction (EF) , left ventricular end-diastolic diameter (LVIDd) , left ventricular end-systolic diameter (LVIDs) , heart rate (HR) , mean arterial pressure (MAP) , serum creatine kinase isoenzyme MB (CK-MB) , myocardial troponin I ( cTnI) and lactate dehydrogenase ( LDH) levels , and myocardial tumor necrosis factor-α (TNF-α ) , interleukin-1β (IL-1β) and interleukin-6 (IL-6) levels in mice were detected. The pathological changes of myocardial tissue were detected by 2 , 3 , 5-triphenyltetrazolium chloride ( TTC) , hematoxylin-eosin ( HE) , Masson trichrome and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining. The mRNA expressions of CTRP3 and UCHL1 were detected by qRT-PCR. The protein expressions of CTRP3 , UCHL1 , collagen Ⅰ , collagen Ⅲ , Bcl-2-associated X (Bax) and B-cell lymphoma/leukemia-2 (Bcl-2) in myocardial tissue were detected by Western blot or immunohistochemical staining.
Results:
Compared with SeVGMT group and CTRP3-Lv group , the levels of EF , FS , HR and MAP in SeVGMT + CTRP3-Lv group increased (P < 0. 05) . The levels of LVIDd , LVIDs , CK-MB , cTnI , LDH , TNF-α , IL-1β and IL-6 decreased (P < 0. 05) . MI area , fibrosis area and TUNEL positive rate decreased (P < 0. 05) , the protein levels collagen Ⅰ , collagen Ⅲ and Bax decreased (P < 0. 05) , and Bcl-2 protein levels increased (P < 0. 05) . The mRNA and protein levels and relative staining intensity of CTRP3 and UCHL1 increased (P < 0. 05) . Compared with SeVGMT + CTRP3-Lv group , the addition of UCHL1-sh treatment ( SeVGMT + CTRP3-Lv + UCHL1-sh group) significantly weakened the influence of SeVGMT + CTRP3-Lv on the above indexes (P < 0. 05) .
Conclusion
CTRP3 mediated UCHL1 enhances the therapeutic effect of SeVGMT reprogrammed CFs on MI in mice.
2.Tubeless subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance-shaped sternal elevation device in anterior mediastinal masses
Junmin ZHU ; Junjie WANG ; Jianming YUE ; Yixin SUN ; Yichen LIU ; Lei WANG ; Lin LIN ; Jie LI ; Jinlan ZHAO ; Xuehua TU ; Ningying DING ; Jianrong HU ; Chunmei HE ; Leilei TIAN ; Hongtao TANG ; Jiasheng ZHAO ; Cheng CHEN ; Yongxiang SONG ; Yunwei TIAN ; Yong XIAO ; Kaidi LI ; Lin MA ; Yun WANG ; Longqi CHEN ; Dong TIAN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(11):1603-1609
Objective To assess the clinical value of a novel surgical technique—Tubeless subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance-shaped sternal elevation device in the resection of anterior mediastinal masses. Methods Patients who underwent tubeless subxiphoid uniportal video-assisted thoracoscopic surgery via balance-shaped sternal elevation device in anterior mediastinal masses process at the Department of Thoracic Surgery, West China Hospital, Sichuan University from March to April 2025 were included, and their clinical data were analyzed. Results A total of 4 patients were included, with 2 males and 2 females, aged 58-75 years. The diameter of the tumor was 2.5-3.0 cm. The operation time was 60.0-150.0 min, intraoperative blood loss was 5-10 mL, pain score on the 3rd day after surgery was 0 points, and postoperative hospital stay was 2-3 days. All patients achieved complete resection of the masses and thymus without perioperative complications. Conclusion The tubeless subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance-shaped sternal elevation device technique optimizes surgical visualization and instrument maneuverability while avoiding complications related to conventional anesthesia and tubing, thereby markedly enhancing the minimally invasive profile of anterior mediastinal masses resections. In addition to maintaining procedural safety, this approach effectively reduces postoperative pain and accelerates patient recovery, highlighting its potential for widespread clinical adoption.
3.Annual review of basic research on lung transplantation of China in 2024
Jier MA ; Junmin ZHU ; Lan ZHANG ; Xiaohan JIN ; Xiangyun ZHENG ; Senlin HOU ; Zengwei YU ; Yaling LIU ; Haoji YAN ; Dong TIAN
Organ Transplantation 2025;16(3):386-393
Lung transplantation is the optimal treatment for end-stage lung diseases and can significantly improve prognosis of the patients. However, postoperative complications such as infection, rejection, ischemia-reperfusion injury, and other challenges (like shortage of donor lungs) , limit the practical application of lung transplantation in clinical practice. Chinese research teams have been making continuous efforts and have achieved breakthroughs in basic research on lung transplantation by integrating emerging technologies and cutting-edge achievements from interdisciplinary fields, which has strongly propelled the development of this field. This article will comprehensively review the academic progress made by Chinese research teams in the field of lung transplantation in 2024, with a focus on the achievements of Chinese teams in basic research on lung transplantation. It aims to provide innovative ideas and strategies for key issues in the basic field of lung transplantation and to help China's lung transplantation cause reach a higher level.
4.Analysis of disease burden and trend of pancreatic cancer in our country based on the Global Burden of Disease from 1990-2021
Tong LI ; Meilan LIU ; Qing WANG ; Tianhan SUN ; Jianfu CAO ; Junmin WEI ; Hongyuan CUI
Chinese Journal of Hepatobiliary Surgery 2025;31(9):671-677
Objective:To analyze the disease burden and changing trend of pancreatic cancer in our country from 1990 to 2021, and predict the incidence and mortality trends of pancreatic cancer from 2022 to 2036.Methods:Utilizing the data from the Global Burden of Disease 2021 Study, the age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and disability-adjusted life rate (DALY) of pancreatic cancer in our country from 1990 to 2021 were evaluated. DALY is calculated by adding the number of years of life lost due to pancreatic cancer to the years of life lost due to disability. The Joinpoint model was used to calculate the average annual percentage change (AAPC), the age-period-cohort model was applied to control the influence of age, period and birth cohort, and the Bayesian age-period-cohort model was used to predict the incidence and mortality trends of pancreatic cancer in our country from 2022 to 2036.Results:Compared with 1990, the data of ASIR, ASMR and age-standardized disability-adjusted life years (DALY) rates of pancreatic cancer in our country in 2021 all increased, and the increase in men was more significant than that in women. The peaks of morbidity and mortality in 1990 and 2021 were both occurred in the elderly. The incidence rate, mortality rate and changes of men in all age groups were higher than those of women. The changes in the age-standardized DALY rate were mainly reflected in the male population. The first peaks of the age-standardized DALY rate in 1990 and 2021 both occurred at the age of 70-74, and the second peak of the age-standardized DALY rate in 2021 shifted to the age of 85-89. The peak rate of age-standardized DALY in females is earlier than that in males. The AAPC of ASIR and ASMR for all genders of pancreatic cancer in our country from 1990 to 2021 was 0.72 (95% CI: 0.50-0.94, P<0.001) and 0.56 (95% CI: 0.31-0.82, P<0.001), respectively, and the difference was statistically significant. In our country men with pancreatic cancer, ASIR (AAPC=0.89, 95% CI: 0.68-1.10, P<0.001) and ASMR (AAPC=0.71, 95% CI: 0.49-0.93, P<0.001) were compared with ASIR (AAPC=0.48, 95% CI: ) in women. 0.22-0.73, P<0.001) and ASMR (AAPC=0.33, 95% CI: 0.08-0.58, P=0.010) increased rapidly, and the difference was statistically significant. The ASDR of all genders showed an upward trend (AAPC=0.36, 95% CI: 0.18-0.54, P<0.001), and the difference was statistically significant. The incidence rate and mortality rate of all genders are on the rise. When the age of the population is over 60 years old, the incidence and mortality of specific diseases show an upward trend with the delay of the birth cohort. It is expected that from 2022 to 2036, the ASIR and ASMR of both men and women will increase annuallyand eventually double. Conclusion:From 1990 to 2021, the burden of pancreatic cancer in our country has generally shown an increasing trend, and it is expected that the disease burden will further increase in the future.
5.National bloodstream infection bacterial resistance surveillance report 2023: Gram-positive bacteria
Chaoqun YING ; Jinru JI ; Zhiying LIU ; Qing YANG ; Haishen KONG ; Jiangqin SONG ; Hui DING ; Yanyan LI ; Yuanyuan DAI ; Haifeng MAO ; Pengpeng TIAN ; Lu WANG ; Yongyun LIU ; Yizheng ZHOU ; Jiliang WANG ; Yan JIN ; Donghong HUANG ; Hongyun XU ; Peng ZHANG ; Xinhua QIANG ; Hong HE ; Lin ZHENG ; Junmin CAO ; Zhou LIU ; Ying HUANG ; Yan GENG ; Haiquan KANG ; Dan LIU ; Guolin LIAO ; Lixia ZHANG ; Fenghong CHEN ; Yanhong LI ; Baohua ZHANG ; Haixin DONG ; Xiaoyan LI ; Donghua LIU ; Qiuying ZHANG ; Xuefei HU ; Liang GUO ; Sijin MAN ; Dijing SONG ; Rong XU ; Youdong YIN ; Kunpeng LIANG ; Aiyun LI ; Zhuo LI ; Hongxia HU ; Guoping LU ; Jinhua LIANG ; Qiang LIU ; Yinqiao DONG ; Jilu SHEN ; Shuyan HU ; Liang LUAN ; Jian LI ; Ling MENG ; Dengyan QIAO ; Xiusan XIA ; Bo QUAN ; Dahong WANG ; Chunhua HAN ; Xiaoping YAN ; Fei LI ; Shifu WANG ; Ping SHEN ; Yunbo CHEN ; Yonghong XIAO
Chinese Journal of Clinical Infectious Diseases 2025;18(2):118-132
Objective:To report the nationwide surveillance results of pathogenic profiles and antimicrobial resistance patterns of Gram-positive bloodstream infections in China in 2023.Methods:The clinical isolates of Gram-posttive bacteria from blood cultures were collected in member hospitals of National Bloodstream Infection Bacterial Resistant Investigation Collaborative System(BRICS)during January to December 2023. Antimicrobial susceptibility testing was performed using the dilution method recommended by the Clinical and Laboratory Standards Institute(CLSI). Statistical analyses were conducted using WHONET 5.6 and SPSS 25.0 software.Results:A total of 4 385 Gram-positive bacterial isolates were obtained from 60 participating center. The top five pathogens were Staphylococcus aureus( n=1 544,35.2%),coagulase-negative Staphylococci( n=1 441,32.9%), Enterococcus faecium( n=574,13.1%), Enterococcus faecalis( n=385,8.8%),and α-hemolytic Streptococci( n=187,4.3%). The prevalence of methicillin-resistant Staphylococcus aureus(MRSA)and methicillin-resistant coagulase-negative Staphylococci(MRCNS)was 26.2%(405/1 544)and 69.8%(1 006/1 441),respectively. Notably,all Staphylococci remained susceptible to glycopeptide or daptomycin. Staphylococcus aureus demonstrated excellent susceptibility(>97.0%)to cephalobiol,rifampicin,trimethoprim-sulfamethoxazole,linezolid,minocycline,tigecycline,and eravacycline. No Enterococcus exhibiting resistance to linezolid were detected. Glycopeptide resistance was uncommon but more frequent in Enterococcus faecium(resistance to vancomycin and teicoplanin:both 1.7%)compared to Enterococcus faecalis(both 0.3%). The detection rates of MRSA and MRCNS exhibited significant regional variations across the country( χ2=17.674 and 148.650,respectively,both P<0.001). No vancomycin-resistant Enterococci were detected in central China. Institutional comparison demonstrated higher prevalence of MRSA( χ2=14.111, P<0.001)and MRCNS( χ2=4.828, P=0.028)in provincial hospitals than that in municipal hospitals. Socioeconomic analysis identified elevated detection rates of both MRSA( χ2=18.986, P<0.001)and MRCNS( χ2=4.477, P=0.034)in less developed regions(per capita GDP
6.National bloodstream infection bacterial resistance surveillance report (2023) : Gram-negative bacteria
Jinru JI ; Zhiying LIU ; Chaoqun YING ; Qing YANG ; Haishen KONG ; Jiangqin SONG ; Hui DING ; Yanyan LI ; Yuanyuan DAI ; Haifeng MAO ; Pengpeng TIAN ; Lu WANG ; Yongyun LIU ; Yizheng ZHOU ; Jiliang WANG ; Yan JIN ; Donghong HUANG ; Hongyun XU ; Peng ZHANG ; Xinhua QIANG ; Hong HE ; Lin ZHENG ; Junmin CAO ; Zhou LIU ; Ying HUANG ; Yan GENG ; Haiquan KANG ; Dan LIU ; Guolin LIAO ; Lixia ZHANG ; Fenghong CHEN ; Yanhong LI ; Baohua ZHANG ; Haixin DONG ; Xiaoyan LI ; Donghua LIU ; Qiuying ZHANG ; Xuefei HU ; Liang GUO ; Sijin MAN ; Dijing SONG ; Rong XU ; Youdong YIN ; Kunpeng LIANG ; Aiyun LI ; Zhuo LI ; Hongxia HU ; Guoping LU ; Jinhua LIANG ; Qiang LIU ; Yinqiao DONG ; Jilu SHEN ; Shuyan HU ; Liang LUAN ; Jian LI ; Ling MENG ; Dengyan QIAO ; Xiusan XIA ; Bo QUAN ; Dahong WANG ; Chunhua HAN ; Xiaoping YAN ; Fei LI ; Shifu WANG ; Ping SHEN ; Yunbo CHEN ; Yonghong XIAO
Chinese Journal of Clinical Infectious Diseases 2025;18(1):47-62
Objective:To report the results of bacterial resistant investigation collaborative system(BRICS)on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2023,and provide reference for clinical tretment of bloodstream infections and prevention and control of bacterial resistance.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of BRICS were collected during January 2023 to December 2023. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute(CLSI). WHONET 5.6 and SPSS 25.0 were used to analyze the data.Results:During the study period,11 492 strains of Gram-negative bacteria were collected from 60 hospitals,of which 10 098(87.9%)were Enterobacterales and 1 394(12.1%)were non-fermentative bacteria. The top 5 bacterial species were Escherichia coli(50.0%), Klebsiella pneumoniae(26.1%), Pseudomonas aeruginosa(5.1%), Acinetobacter baumannii complex(5.0%)and Enterobacter cloacae complex(4.1%). The ESBL-producing rates in Escherichia coli, Klebsiella pneumoniae and Proteus mirablilis were 46.8%(2 685/5 741),18.3%(549/2 999)and 44.0%(77/175),respectively. The prevalence of carbapenem-resistant Escherichia coli(CREC)and carbapenem-resistant Klebsiella pneumoniae(CRKP)were 1.3%(76/5 741)and 15.0%(450/2 999);32.9%(25/76)and 78.0%(351/450)of CREC and CRKP were sensitive to ceftazidime/avibactam combination,respectively. 94.7%(72/76)and 90.2%(406/450)of CREC and CRKP were sensitive to aztreonam/avibactam combination. Furthermore,57.9%(44/76)and 79.1%(356/450)were sensitive to imipenem/relebactam combination. The prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)complex was 64.6%(370/573),while more than 80.0% of CRAB complex was sensitive to tigecycline,eravacycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa(CRPA)was 17.0%(99/581). There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of important Gram-negative bacteria resistance among different regions in China,with statistically significant differences in the prevalence of CREC,CRKP,CRPA and CRAB complex( χ2=10.6,28.6,10.8 and 19.3, P<0.05). The prevalence of ESBL-producing Escherichia coli, CREC,CRAB complex and CRKP were higher in provincial hospitals than those in municipal hospitals( χ2=12.5,9.8,12.7 and 57.8,all P<0.01). Conclusions:Gram-negative bacteria are the main pathogens causing bloodstream infections in China,and Escherichia coli is ranked in the top,while the trend of Klebsiella pneumoniae increases continuously with time. CRKP infection shows a slow upward trend,CREC infecton maintains a low prevalence level,and CRAB complex infection continues to exhibit a high prevalence rate. The composition and resistance patterns of pathogens causing bloodstream infections vary to some extent across different regions and levels of hospitals in China.
7.Involvement of sympathetic nerve in the regulation of disuse atrophy of skeletal muscles: a preliminary study
Dongliang CHENG ; Mingming ZHANG ; Jiang LIU ; Junmin SHEN ; Zhongqi WANG ; Xinyu SUN ; Duanyang WANG ; Feifan CHANG ; Haobo ZHANG ; Pincong FU ; Ming CHEN ; Yi LI ; Pengbin YIN ; Licheng ZHANG ; Peifu TANG
Chinese Journal of Orthopaedic Trauma 2025;27(3):242-249
Objective:To investigate the changes in sympathetic nerve activity after lower limb immobilization and the role of sympathetic nerve in regulating disuse atrophy of skeletal muscles.Methods:The experiment was divided into the following 3 parts: ① Twelve 8-week-old male C57 mice were randomly divided into a blank control group and a hind limb fixation group ( n=6). The blank control group received no intervention while the hind limb fixation group received splint fixation of the hind limbs for 2 weeks before the musculoskeletal multi-dimensional characterization was completed at the behavioral, pathological and molecular levels. ② Thirty-six 8-week-old male C57 mice were selected and randomly divided into a control group and 5 hind limb fixation groups (for 1, 3, 5, 7 and 14 days) ( n=6). The control group was fed normally until 14 days without any intervention while the 5 hind limb fixation groups were sampled after fixation for 1, 3, 5, 7 and 14 days, respectively. The level of norepinephrine in the serum and the expression level of tyrosine hydroxylase (TH), a marker of sympathetic nerve activity in the paraventricular nucleus of hypothalamus (PVN), were detected to observe the plasticity of sympathetic nerve activity. ③ Eighteen 8-week-old male C57 mice were selected and randomly divided into a blank control group, a hind limb fixation group and a hind limb fixation plus medication group ( n=6). The blank control group received no intervention while the 2 fixation groups were injected with phosphate buffer (PBS) and propranolol hydrochloride solution for 2 consecutive weeks, respectively. The parameters related to the skeletal muscles were compared between the 3 groups. Results:① Compared with the control group, the mass and function of skeletal muscles in the hind limb fixation group were statistically significantly decreased ( P<0.05). ② The levels of serum norepinephrine [(3.27±1.03) ng/mL, (9.21±1.05) ng/mL, (6.36±0.88) ng/mL, (3.84±1.00) ng/mL, and (3.91±0.75) ng/mL] and the PVN TH levels (42.00%±5.38%, 61.67%±5.57%, 55.82%±3.11%, 50.90%±2.53%, and 39.17%±9.07%) in the 5 hind limb fixation groups (for 1, 3, 5, 7 and 14 days) were significantly higher than those in the control group [(1.81±0.72)] ng/mL and 23.33%±5.50%] ( P<0.05). ③ The wet weight of the gastrocnemius muscle [(93.50±4.32) mg] and the cross-section area of the tibial anterior muscle [(1,180.00±95.09) μm 2] in the hind limb fixation plus medication group were increased significantly compared with those in the hind limb fixation group [(80.83±9.99) mg and (907.80±121.00) μm 2] ( P<0.05). Conclusions:Overactivation of the sympathetic nervous system occurs in the mice model of skeletal muscle disuse atrophy after hind limb fixation. Inhibition of sympathetic nerve activity may reduce the severity of skeletal muscle atrophy at the lower limbs.
8.STAR Recommendations: A novel framework for generating recommendations.
Xu WANG ; Janne ESTILL ; Hui LIU ; Qianling SHI ; Jie ZHANG ; Shilin TANG ; Huayu ZHANG ; Xueping LI ; Zhewei LI ; Yaxuan REN ; Bingyi WANG ; Fan WANG ; Juan JUAN ; Huixia YANG ; Xiuyuan HAO ; Junmin WEI ; Yaolong CHEN
Chinese Medical Journal 2025;138(14):1643-1646
9.Dysphagia in Patients Undergoing Esophageal Atresia Surgery:Risk Factors and Strategies for Management
Shuangshuang LI ; Chuanping XIE ; Yong ZHAO ; Junmin LIAO ; Hengxin LIU ; Jinshi HUANG
Journal of Audiology and Speech Pathology 2025;33(1):12-17
Objective To investigate the occurrence of dysphagia in patients with congenital esophageal atre-sia(EA)after surgery and study the associated risk factors.Methods A retrospective analysis was conducted on clinical data of 103 children who underwent surgery for congenital EA at Beijing Children's Hospital,Capital Medi-cal University,from July 2016 to August 2023.Results A total of 103 eligible cases of congenital EA were includ-ed in this study,among which 74 cases experienced dysphagia,with an incidence rate of 71.8%.Single-factor anal-ysis revealed that primary surgery(x2=4.017,P=0.045),endoscopic surgery(x2=8.315,P=0.004),long-seg-ment defects(x2=10.975,P<0.001),gastroesophageal reflux(x2=16.973,P<0.001),vocal cord paralysis(x2=4.017,P=0.045),tracheomalacia(x2=5.778,P=0.016),and arytenoid movement disorder(x2=10.420,P=0.001)were significantly associated with postoperative dysphagia.Further binary logistic regression analysis indi-cated that endoscopic surgery(OR=24.373,P=0.016),tracheomalacia(OR=17.556,P=0.010),and anasto-motic stenosis(OR=20.453,P=0.032)were independent risk factors for increased incidence of postoperative dys-phagia.Moreover,stratified analysis of dysphagia duration using unordered multinomial logistic regression revealed that tracheomalacia(OR=16.883,P=0.007;OR=4.337,P=0.045),long-segment defects(OR=0.040,P=0.049;OR=0.040,P=0.036),and arytenoid movement disorder(OR=0.127,P=0.039;OR=0.510,P=0.028)were closely associated with dysphagia duration.Conclusion Dysphagia is a common symptom in children with congenital EA after surgery across all age groups.Endoscopic surgery,long-segment defects,tracheomalacia,and anastomotic stenosis are independent factors contributing to postoperative dysphagia.Additionally,tracheoma-lacia,long-segment defects,and arytenoid movement disorder are closely related to the duration of dysphagia.
10.Clinical efficacy analysis of combination of ciprofol and remifentanil for painless fiberoptic bronchoscopy
Yimin YAN ; Huimin LIU ; Mingzhi ZHENG ; Junmin PENG
China Journal of Endoscopy 2025;31(9):1-8
Objective To explore the effect of the combined application of ciprofol and remifentanil in painless fiberoptic bronchoscopy on the quality of recovery and inflammatory response.Methods 90 patients who underwent painless fiberoptic bronchoscopy from October 2023 to October 2024 were selected and randomly divided into the ciprofol combined with remifentanil group(observation group)and the propofol combined with remifentanil group(control group),with 45 cases in each group.The changes of hemodynamic indicators and BIS of the two groups of patients were compared at the time of entering the room(T0),immediately after the laryngeal mask was placed(T1),when the endoscope entered the tracheal protrusion(T2),at the end of the examination(T3),and 5 min after the laryngeal mask was removed(T4).The scores of the quality of recovery-40(QoR-40)before and after fiberoptic bronchoscopy,the levels of serum inflammatory factors,the time of fiberoptic bronchoscopy,the time to complete the instructed actions and the occurrence of adverse reactions were compared between the two groups of patients.Results The expression levels of serum tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and interleukin-6(IL-6)at time point T4 in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The comparison of BIS at T0,T1,T2,T3 and T4 time points between the two groups of patients showed no statistically significant differences(P>0.05).The mean arterial pressure(MAP)at T,time point in the control group was significantly lower than that in the observation group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the comparison of fiberoptic bronchoscopy examination time and the time to complete the instructed actions between the two groups of patients(P>0.05).There was no statistically significant difference in the QoR-40 score at T0 time point between the two groups of patients(P>0.05).At T4 time point,the comfort level,emotional state and total score of QoR-40 in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).No serious adverse reactions occurred in either group.The incidence of hypotension in the control group was 22.2%,significantly higher than 4.4%in the observation group,and the difference was statistically significant(P<0.05).The symptoms were relieved after fluid replacement and appropriate use of vasoactive drugs.The incidence of injection pain in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The combined application of ciprofol and remifentanil in painless fiberoptic bronchoscopy is safe and effective.It has good sedative and analgesic effects,stable hemodynamics in patients,no obvious injection pain,can effectively reduce the level of inflammation cytokines,improve the quality of early recovery and patient comfort.It is worth applying in clinical practice.


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