Objective:To evaluate left ventricular systolic function in patients with systemic scleroderma (SSc) with normal left ventricular ejection fraction using pressure-strain loop (PSL) .Methods:To collect 30 patients with SSc who were treated in the Rheumatology and Immunology Department of Jining Medical University from January 2022 to March 2024 as the observation group, 30 healthy volunteers were selected as the control group after 1:1 matching with the observation group according to the age ±3 years old and the same gender. Clinical and ultrasound data were collected, PSL was used to evaluate and compare the differences between the two groups in left ventricular longitudinal strain (GLS), global work index (GWI), global useful work (GCW), global useless work (GWW) and global work efficiency (GWE), and the statistically significant variables were analyzed by multivariate logistic regression to analyze the independent predictors of early left ventricular function impairment in patients with SSc,and constructed receiver operating characteristic (ROC) curve to analyze the predictive value of GLS, GWI, GCW, GWW and GWE in early left ventricular function impairment in SSc patients.Results:Compared with the control group, the observation group GLS,GWI, GCW and GWE decreased( P<0.05), while the GWW increased( P<0.05). Multivariate logistic regression analysis showed that GLS[ OR(95% CI)=0.51(0.26, 1.02), P=0.055]、GWI[ OR(95% CI)=1.00(0.99, 1.01), P=0.969)、GCW[ OR(95% CI)=1.00(0.99, 1.02), P=0.771]、GWW[ OR(95% CI)=0.90(0.81, 1.01), P=0.075]and GWE[ OR(95% CI)=0.02(0.00, 0.55), P=0.022], in which GWE had the highest significance in predicting left ventricular myocardial work in SSc patients. ROC curve showed that compared with GLS, GWI, GCW and GWW, the area under GWE curve (0.953) was the largest, and the sensitivity of GWE≤94% to predict myocardial damage in SSc patients was 80.0%, and the specificity was 93.3%. The results of the repeatability test showed that the reproducibility of the intra-observer and inter-observer measurements was good. Conclusion:The PSL provides a new method for the quantitative assessment of early left ventricular systolic function impairment in patients with SSc, and GWE can be used as a sensitive index to predict early left ventricular systolic function impairment in patients with SSc.

Objective:To evaluate the efficacy and safety of 1 064 nm Nd:YAG picosecond laser of dual-mode with auxiliary functional product introduction in treatment of melasma.Methods:A prospective study was conducted from March 2022 to September 2023 at the Department of Cosmetic Dermatology, Guangzhou Zesee Plastic Surgery Hospital, including 46 female patients with melasma, aged 26-53 (38.5±7.0) years. Patients were randomly divided into two groups using a random number table: experimental group (1 064 nm Nd:YAG picosecond laser dual-mode treatment followed by the introduction of functional product) and control group (1 064 nm Nd:YAG picosecond laser of dual-mode treatment followed by the introduction of 0.9% NaCl), with 23 patients in each group. By using the melasma area and severity index (MASI) score, the physician′s global assessment and the patient′s satisfaction evaluation as evaluation indicators, the treatment effects were assessed at different time points. Adverse reactions were recorded in both groups.Results:At 4 and 12 weeks after the third treatment, the MASI scores in the experimental group were lower than those of the control group ( P<0.001). At 4 weeks after the third treatment, the rate of moderate or above improvement in pigment spots was 95.7% (22/23) in the experimental group, which was higher than the 69.6% (16/23) in the control group ( P=0.011). At 12 weeks after the third treatment, the rate of moderate or above improvement in the experimental group was 30.4% (7/23), which was higher than the 8.7% (2/23) in the control group ( P=0.006). At 24 weeks after the third treatment, the rate of moderate or above improvement in the experimental group was 13.0% (3/23), which was higher than the 0% (0/23) in the control group ( P=0.015). At 4 weeks after the third treatment, the satisfactory rate in the experimental group was 73.9% (17/23), which was higher than the 43.5% (10/23) in the control group ( P=0.009). At 12 weeks after the third treatment, the satisfactory rate in the experimental group was 69.6% (16/23), which was higher than the 39.1% (9/23) in the control group ( P=0.040). At 24 weeks after the third treatment, the satisfactory rate in the experimental group was 56.5% (13/23), which was higher than the 4.4% (1/23) in the control group ( P=0.002). One patient in the experimental group experienced mild itching on the cheek on the second day post-treatment. In the control group, two patients experienced mild itching and erythema on the second day post-treatment. No serious adverse reactions, such as blisters, scabs, or pigmentation, were observed in either group during the treatment or follow-up periods. Conclusion:The 1 064 nm Nd:YAG picosecond laser of dual-mode with auxiliary functional product introduction in treatment of melasma has a better efficacy, with a shorter recovery period and fewer adverse reactions.

Objective:To evaluate the efficacy and safety of 1 064 nm Nd:YAG picosecond laser of dual-mode with auxiliary functional product introduction in treatment of melasma.Methods:A prospective study was conducted from March 2022 to September 2023 at the Department of Cosmetic Dermatology, Guangzhou Zesee Plastic Surgery Hospital, including 46 female patients with melasma, aged 26-53 (38.5±7.0) years. Patients were randomly divided into two groups using a random number table: experimental group (1 064 nm Nd:YAG picosecond laser dual-mode treatment followed by the introduction of functional product) and control group (1 064 nm Nd:YAG picosecond laser of dual-mode treatment followed by the introduction of 0.9% NaCl), with 23 patients in each group. By using the melasma area and severity index (MASI) score, the physician′s global assessment and the patient′s satisfaction evaluation as evaluation indicators, the treatment effects were assessed at different time points. Adverse reactions were recorded in both groups.Results:At 4 and 12 weeks after the third treatment, the MASI scores in the experimental group were lower than those of the control group ( P<0.001). At 4 weeks after the third treatment, the rate of moderate or above improvement in pigment spots was 95.7% (22/23) in the experimental group, which was higher than the 69.6% (16/23) in the control group ( P=0.011). At 12 weeks after the third treatment, the rate of moderate or above improvement in the experimental group was 30.4% (7/23), which was higher than the 8.7% (2/23) in the control group ( P=0.006). At 24 weeks after the third treatment, the rate of moderate or above improvement in the experimental group was 13.0% (3/23), which was higher than the 0% (0/23) in the control group ( P=0.015). At 4 weeks after the third treatment, the satisfactory rate in the experimental group was 73.9% (17/23), which was higher than the 43.5% (10/23) in the control group ( P=0.009). At 12 weeks after the third treatment, the satisfactory rate in the experimental group was 69.6% (16/23), which was higher than the 39.1% (9/23) in the control group ( P=0.040). At 24 weeks after the third treatment, the satisfactory rate in the experimental group was 56.5% (13/23), which was higher than the 4.4% (1/23) in the control group ( P=0.002). One patient in the experimental group experienced mild itching on the cheek on the second day post-treatment. In the control group, two patients experienced mild itching and erythema on the second day post-treatment. No serious adverse reactions, such as blisters, scabs, or pigmentation, were observed in either group during the treatment or follow-up periods. Conclusion:The 1 064 nm Nd:YAG picosecond laser of dual-mode with auxiliary functional product introduction in treatment of melasma has a better efficacy, with a shorter recovery period and fewer adverse reactions.

Objective:To evaluate left ventricular systolic function in patients with systemic scleroderma (SSc) with normal left ventricular ejection fraction using pressure-strain loop (PSL) .Methods:To collect 30 patients with SSc who were treated in the Rheumatology and Immunology Department of Jining Medical University from January 2022 to March 2024 as the observation group, 30 healthy volunteers were selected as the control group after 1:1 matching with the observation group according to the age ±3 years old and the same gender. Clinical and ultrasound data were collected, PSL was used to evaluate and compare the differences between the two groups in left ventricular longitudinal strain (GLS), global work index (GWI), global useful work (GCW), global useless work (GWW) and global work efficiency (GWE), and the statistically significant variables were analyzed by multivariate logistic regression to analyze the independent predictors of early left ventricular function impairment in patients with SSc,and constructed receiver operating characteristic (ROC) curve to analyze the predictive value of GLS, GWI, GCW, GWW and GWE in early left ventricular function impairment in SSc patients.Results:Compared with the control group, the observation group GLS,GWI, GCW and GWE decreased( P<0.05), while the GWW increased( P<0.05). Multivariate logistic regression analysis showed that GLS[ OR(95% CI)=0.51(0.26, 1.02), P=0.055]、GWI[ OR(95% CI)=1.00(0.99, 1.01), P=0.969)、GCW[ OR(95% CI)=1.00(0.99, 1.02), P=0.771]、GWW[ OR(95% CI)=0.90(0.81, 1.01), P=0.075]and GWE[ OR(95% CI)=0.02(0.00, 0.55), P=0.022], in which GWE had the highest significance in predicting left ventricular myocardial work in SSc patients. ROC curve showed that compared with GLS, GWI, GCW and GWW, the area under GWE curve (0.953) was the largest, and the sensitivity of GWE≤94% to predict myocardial damage in SSc patients was 80.0%, and the specificity was 93.3%. The results of the repeatability test showed that the reproducibility of the intra-observer and inter-observer measurements was good. Conclusion:The PSL provides a new method for the quantitative assessment of early left ventricular systolic function impairment in patients with SSc, and GWE can be used as a sensitive index to predict early left ventricular systolic function impairment in patients with SSc.

Ultrasound-guided peripheral nerve block is widely used in clinical practice because of its high accuracy and safety. Residents must pass formal training to master this technique. However, residents are not familiar with the related anatomical structure of nerve block, and lack of basic ultrasonic knowledge, operation skills, simulation training, understanding of the corresponding complications, the optimal concentration and dose of local anesthetic drugs. In order to solve the above problems, we have taken measures such as basic theoretical knowledge learning, application of anatomy and ultrasound software, simulation training and grading training so that residents in standardized training of anesthesiology could fully grasp the clinical application of ultrasound-guided peripheral nerve block techniques.

Objective To investigate the effect of ultrasound-guided quadratus lumborum block (QLB) on postoperative analgesia after caesarean section.Methods Sixty parturientsscheduled for cesarean section, aged 20-40 years, ASA physical status Ⅰ orⅡ, were randomly divided into 2 groups (n = 30 each) using a random number table:QLB group (group Q) and control group (group C).Parturients in group Q received bilateral QLB with the use of 20 ml 0.33％ ropivacaine per side after surgery, while QLB was not done in group C.Both groups received patient-controlled intravenous analgesia (PCIA) after surgery which contains 800 mg tramadol, 40 mg nefopam and 80 ml normal saline.The accumulative consumption of tramadol, the score of numerical rating scale (NRS) for pain at rest and on movement and the bruggrmann comfort scale (BCS) score were recorded at 4, 8, 12, 24, 48 hafter operation.The cutaneous sensory block area was determined in group Q at 4, 8, 12, 24, 48 hafter operation.The patient′s satisfaction with postoperative analgesia and adverse reactions were also recorded.Results The consumption of tramadol in group Q was significantly decreased compared with that in group C (P<0.05) at 4, 8, 12, 24, 48 hafter surgery.NRS for pain at rest at all times, NRS for pain when cough at 12, 24 hafter surgery and NRS for pain when turning over at 4, 48 hafter surgery were significantly lower, while the BCS score was higher in group Q than that in group C (P<0.05).Quadratus lumborum block affected T7-L1 dermatomes at 4, 8, 12 hafter surgery and T8-L1 dermatomes at 24 hafter surgery.The analgesic plane of quadratus lumborum block disappeared at 48 hours after operation.The patient's satisfaction with postoperative analgesia was higher in group Q compared with that in group C (P<0.05).The incidence of postoperative nausea, vomiting and dizziness was similar between the two groups.Conclusion Ultrasound-guided quadratus lumborum block can remarkably reduce the consumption of tramadol after caesarean section, lower the postoperative pain score, improve the patient′s comfort and satisfaction.

Objective To evaluate the effect of serratus plane block (SPB) combined with general anesthesia and SPB with patient-controlled nerve analgesia (PCNA) after surgery on the early postoperative quality of recovery in the patients undergoing radical mastectomy.Methods Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ female patients,aged 18-64 yr,weighing 45-70 kg,scheduled for elective unilateral modified radical mastectomy under general anesthesia,were assigned into 3 groups (n=20 each) using a computer software:SPB and general anesthesia plus patient-controlled intravenous analgesia (PCIA) group (SG+PCIA group),SPB and general anesthesia plus SPB with PCNA group (SG+PCNA group),and general anesthesia plus PCIA group (G+PCIA group).Ultrasound-guided ipsilateral SPB was performed before anesthesia induction.Analgesia was maintained with propofol-remifentanilsevoflurane,rocuronium or vecuronium was intermittently injected to maintain muscle relaxation.PCIA solution contained tramadol 800 mg and flurbiprofen axetil 100 mg in 54 ml of normal saline,and the PCA pump was set up to deliver a 2 ml bolus dose,with a 15 min lockout interval and background infusion at a rate of 0.5 ml/h after a loading dose of 5 ml.The location of the indwelling catheter was confirmed again using ultrasound at the end of surgery,PCNA solution contained 1％ ropivacaine 500 mg in 250 ml of normal saline,and the PCA pump was set up to deliver a 5 ml bolus dose,with a 45 min lockout interval and background infusion at a rate of 5 ml/h after a loading dose of 5 ml.The PCA pumps were used until 48 h after surgery.The automatic key was pressed when pain scores (numerical rating scale [NRS] scores) ≥ 4 at rest or during activity (at 45° ipsilateral upper extremity-up tilt).Quality of Recovery-40 (QoR-40) score was used to assess the early postoperative quality of recovery at 24 and 48 h after surgery.NRS scores at rest or during activity were recorded at 6,8,12,24 and 48 h after surgery.The total pressing times of PCA and occurrence of adverse reactions such as respiratory depression,pruritus,infection at the puncture site or pneumothorax were also recorded.Results Compared with group G+PCIA,the postoperative QoR40 scores were significantly increased,NRS scores at rest or during activity were decreased at each time point after surgery,and the total pressing times of PCA were reduced in SG+PCIA and SG+PCNA groups,the incidence of nausea and vomiting was significantly decreased in group SG+PCIA,and the incidence of nausea and vomiting and dizziness was significantly decreased in group SG+PCNA (P＜0.05 or 0.01).Compared with group SG+PCIA,the postoperative QoR-40 scores were significantly increased at 24 h after surgery,and NRS scores at rest or during activity were decreased after surgery in group SG+PCNA (P＜ 0.05 or 0.01).Conclusion SPB combined with general anesthesia and SPB with PCNA after surgery can raise the early postoperative quality of recovery in the patients undergoing modified radical mastectomy.

Objective To evaluate the efficacy of quadrates lumborum block for unilateral inguinal hernia repair in elderly patients. Methods Fifty-eight elderly patients with unilateral inguinal hernia of both sexes, aged 65-80 yr, with body mass index of 18-25 kg∕m2 , of American Society of Anesthesiolo-gists physical status Ⅱ or Ⅲ, scheduled for elective unilateral tension-free repair, were divided into 2 groups ( n=29 each) using a random number table method: iliohypogastric-ilioinguinal nerve block group (group T) and quadrates lumborum block group (group Q). Iliohypogastric-ilioinguinal nerve block with arteria circumflexa ilium profunda as a marker was carried out with 0. 33％ ropivacaine 20 ml under ultra-sound guidance in group T. The anterior approach to quadratus lumborum block was performed with 0. 33％ropivacaine 20 ml under ultrasound guidance in group Q. Operation was started after the height of sensory block was assessed by pin-prick test at 30 min after block. When the blocking effect did not meet the opera-tion requirements, an increment of 1％ lidocaine 2. 5 ml was given every time in the surgical field until op-eration requirements were met. Dexmedetomidine was intravenously infused at a rate of 0. 03-0. 07μg·kg-1 ·min-1 during surgery until the end of surgery to maintain Narcotrend index between 80 and 90. When postoperative visual analogue scale score >3, parecoxib sodium 40 mg was intravenously injected, and if marked pain relief was not found 10 min later, tramadol hydrochloride 50-100 mg was intravenously injected. The upper spread of sensory block and intraoperative requirement for additional local anesthetics were recorded at 30 min after nerve block. The requirement for parecoxib and tramadol was recorded within 48 h after operation. The development of inadvertent intravascular injection of local anesthetics, local anes-thetic intoxication and postoperative nausea and vomiting, nerve block of lower extremity and uroschesis was recorded. Results Skin pain disappeared at the plane of T11-L1 in group T and at the plane of T9-L1 in group Q. Compared with group T, the intraoperative requirement for and consumption of local anesthetics, postoperative requirement for parecoxib and tramadol, and postoperative incidence of nausea and vomiting were significantly decreased in group Q ( P<0. 05) . Conclusion Quadrates lumborum block provides bet-ter efficacy for unilateral inguinal hernia repair than iliohypogastric-ilioinguinal nerve block in elderly pa-tients.

Objective To evaluate the effectiveness of lumbosacral plexus block combined with the use of dexmedetomidine in elderly patients undergoing proximal femoral nail antirotation (PFNA).Methods A total of 60 patients received elective PFNA were divided into tracheal intubation combined with inhalation anesthesia group (group G) and ultrasound and nerve stimulator-guided lumbosacral plexus block following with dexmedetomidine infusion group (group N).Then we observed HR,SBP,DBP for both groups at the time entering the theater (T0),immediately after tracheal intubation or after dexmedetomidine infusion (T1),skin incision moment (T2) and 30 minutes after skin incision (T3).Visual analogue scale (VAS) scores were assessed for both groups at the time point of 2,6,12,24 and 48 hours after surgery.The number of use of patient controlled intravenous analgesia (PCIA),assessment of consciousness status 1-3 days after surgery,adverse reactions were recorded for both groups as well.The following post-surgery data were recorded:the time of first feeding,first urination and first ambulation,the length of hospitalization,the expense of hospital stay.Results HR,SBP,DBP of the group G changed more significantly at T1,T2,T3 than those of T0 (P＜0.05).The VAS scores and the number of use of PCIA of group N were lower than those of group G at all time points after operation (P＜0.05).The group N had lower CAM-CR scores and less adverse reactions of nausea and vomiting and dizziness than those of group G on days 1 to 3 after surgery (P＜0.01).Compare to group G,the group N were early in terms of post-operation first feeding,first urination and first ambulation (P＜0.01).The length of hospitalization was shorter and the cost of the hospital stay was lower in the group N than the group G (P＜0.01).Conclusion Ultrasound and nerve stimulator-guided lumbosacral plexus block combined with low dose of dexmedetomidine could meet the needs of elderly patients undergoing PFNA.

Objective To investigate the effects of Olaparib on cell proliferation and radiosensitization of human non-small cell lung cancer cells.Methods Non-small cell lung H460 and H1299 cell lines were cultured in vitro and the cells in logarithmic growth phase were selected for experiments.MTT and colony formation assays were used to determine cell proliferation and radiosensitization,respectively.Single cell gel electrophoresis assay (comet assay) was used to detect irradiation-induced DNA damage.Results The results of MTT assay showed that Olaparib inhibited the proliferation of H460 and H1299 cells in a dose-dependent pattern (all P＜0.05).H1299 cell line was more sensitive to Olaparib than H460 cells.The results of colony formation assay showed that Olaparib enhanced the radiosensitizition of H460 and H1299 cells (all P＜0.05).The results of comet assay showed that Olaparib increased γ ray-induced DNA damage.Conclusions Olapani can enhance the radiosensitization of human non-small cell lung cancer cells,and the radiosensitization effect of Olaparib may be associated with the inhibition of cell proliferation and induction of irradiation-induced DNA damage.