Viral hepatitis and related liver diseases are among the most significant global healthcare issues. Viral hepatitis not only directly affects liver function but also interacts with the gut microbiota through the gut-liver axis. Imbalance in the gut microbiota may be associated with the occurrence, development and prognosis of viral hepatitis and related liver diseases. Detection and analysis of the gut microbiota can help to comprehensively understand the health status of patients with viral hepatitis and related liver diseases, providing a basis for early diagnosis. Recovery of gut microbiota dysbiosis may help to alleviate liver inflammation and to improve liver function. Regulating the gut microbiota through gut microbiota transplantation, probiotics and prebiotics may be new strategies for treating viral hepatitis and related liver diseases. By analyzing the latest research progress of gut microbiota in viral hepatitis and related liver diseases, this article provides new methods for the diagnosis and treatment of viral hepatitis and related liver diseases.

Viral hepatitis and related liver diseases are among the most significant global healthcare issues. Viral hepatitis not only directly affects liver function but also interacts with the gut microbiota through the gut-liver axis. Imbalance in the gut microbiota may be associated with the occurrence, development and prognosis of viral hepatitis and related liver diseases. Detection and analysis of the gut microbiota can help to comprehensively understand the health status of patients with viral hepatitis and related liver diseases, providing a basis for early diagnosis. Recovery of gut microbiota dysbiosis may help to alleviate liver inflammation and to improve liver function. Regulating the gut microbiota through gut microbiota transplantation, probiotics and prebiotics may be new strategies for treating viral hepatitis and related liver diseases. By analyzing the latest research progress of gut microbiota in viral hepatitis and related liver diseases, this article provides new methods for the diagnosis and treatment of viral hepatitis and related liver diseases.

Objective To observe the anesthesia effect of propofol combined with small dose of sufentanyl in the painless gastroscopy.Methods From January 2017 to June 2017,68 patients with painless gastroscopy in Lishui Central Hospital were selected in the research.According to the digital table,the patients were randomly divided into observation group (propofol and sufentanil ) and control group (propofol plus fentanyl ),with 34 cases in each group. The anesthesia effect , the intraoperative vital signs , directional recovery and consciousness recovery time were compared between the two groups.The adverse reactions were recorded.Results The effective rate of anesthesia in the observation group was 100.00%,which was significantly higher than 82.35%in the control group (χ2＝8.856, P＜0.05).After medication, the MAP, HR, RR, SpO2in the observation group were ( 73.15 ±6.15 ) mmHg, (67.52 ±9.15)times/min,(11.02 ±2.54)times/min,(91.54 ±1.02)%,respectively,compared with those before medication [(87.51 ±8.16)mmHg,(81.02 ±10.24)times/min,(18.24 ±1.52)times/min,(98.45 ±1.52)%], the differences were statistically significant (t＝8.194,5.732,14.305,5.732,all P＜0.05).After medication,the MAP,HR,RR,SpO2in the control group were (73.20 ±6.16) mmHg, (67.62 ±9.14) times/min, (11.03 ± 2.58)times/min,(91.58 ±1.05)%,respectively,compared with those before medication [(87.59 ±8.14)mmHg, (81.05 ±10.28) times/min,(18.25 ±1.56) times/min,(98.46 ±1.58)%],the differences were statistically significant (t＝8.219,5.692,13.963,21.146,all P＜0.05).The differences of MAP,HR,RR and SpO2between the two groups after medication were not statistically significant (t ＝0.033,0.045,0.019,0.159,all P＞0.05).The orientation force recovery time and consciousness recovery time in the observation group were (3.01 ±0.75) min, (2.02 ±1.05)min,respectively,which were shorter than those in the control group [(4.67 ±1.20)min,(3.71 ± 1.18)min],the differences were statistically significant (t＝6.840,6.238,all P＜0.05).The dosage of propofol of the observation group was (1.03 ±0.19)mg/kg,which was less than (1.77 ±1.58)mg/kg of the control group,the difference was statistically significant (t＝2.711,P＜0.05).The incidence rate of adverse reaction in the observation group (0.00%) was lower than that in the control group (20.59%) (χ2＝7.803,P ＜0.05).Conclusion Application of propofol combined with small dose of sufentanil in painless gastroscopy has satisfactory anesthetic effect,and with stable vital signs,redirected restore and consciousness recovery time ,small adverse reactions,drug safety,it is worthy of clinical promotion.

Objective To evaluate the effects of doxofyline on intraoperative pulmonary function in patients receiving double lumen endotracheal intubation for one-lung ventilation. Methods Fifty patients who underwent elective pulmonary lo-bectomy under general anesthesia using double lumen endotracheal intubation were randomly divided into two groups ( n=25 each):control group (group C) and doxofyline group (group D).Doxofyline (4 mg?kg-1) was injected intravenously after double lumen endotracheal intubation in group D,while equal volume of 0.9% sodium chloride was intravenously given in group C.Total intravenous anesthesia with target controlled infusion was performed during the operation.Two milliliter blood samples were taken from the radial artery for blood gas analysis immediately before administration ( t0 ) ,at 30 min ( t1 ) ,60 min ( t2 ) after one-lung ventilation and at the moment of two-lung ventilation after chest closing ( t3 ) . The PaCO2 , PaO2 , peak airway pressure (Ppeak),airway plateau pressure (Pplat),airway resistance (Raw) and lung compliance (Compl) were recorded at t0-3. Results The Ppeak,Pplat and Raw were significantly decreased and the Compl and PaO2 significantly increased at t1-t3 in group D when com-pared with those in group C (P<0.05).The Ppeak,Pplat and Raw were significantly increased and Compl and PaO2 significantly de-creased at t3 as compared with those at t0 in group C ( P<0.05) . Conclusion Doxofyline can improve intraoperative pulmonary function in patients who undergo double lumen endotracheal intubation for one-lung ventilation.

Objective:To investigate the clinical efficacy of gabapentin capsules( GBP)combined with amitriptyline and tramadol in the treatment of patients with postherpetic neuralgia( PHü)and anxiety. Methods:Totally 106 PHü patients with anxiety symptoms at different degree were selected and divided into group A(n=53)and group B(n=53). Group A was given GBP,amitriptyline and tramadol,while group was given GBP only. The anxiety,depression,quality of life and pain-relieving intensity( by VAS)of the pa-tients were determined before the medication( T1 )and in the first week( T2 )and the fourth week( T3 )after the medication. Follow-up was carried out regularly according to the requirements to evaluate the clinical efficacy. Results:The anxiety,depression and VAS scores in the two groups on T2 were statistically significant lower than the corresponding results on T1(P<0.05). On T3,however, there were statistically significant differences between the two groups(P<0. 05). The total adverse reaction rate of group A was signif-icantly lower than that of group B(P<0. 05). The total effective rate of group A was significantly higher than that of group B(P<0. 05). Conclusion:GBP combined with tramadol and amitriptyline in the treatment of PHü patients with anxiety can effectively con-trol the pain of the patients,significantly reduce the scores of VAS and improve the quality of life of the patients.

Objective To evaluate the feasibility of using lumbar plexus block for unilateral extremity artificial vascular graft between femoral artery and deep femoral artery in elderly patients.Methods Forty ASA physical status Ⅱ or Ⅲ patients,aged 67-81 yr,weighing 47-65 kg,scheduled for extremity artificial vascular graft between femoral artery and deep femoral artery,were randomly divided into 2 groups (n =20 each) using a random number table:spinal anesthesia group (group S) and lumbar plexus block group (group L).In group S,0.5 ％ hyperbaric ropivacaine 3 ml was injected into the subarachnoid space.In group L,lumbar plexus block was performed with 30 ml of 0.5 ％ ropivacaine under the guidance of a nerve stimulator.The onset time and duration of sensory block,anesthetic efficacy,and requirement for ephedrine and volume of fluid infused during operation,and development of lumbar plexus block-related adverse events were recorded.Results Compared with group S,the onset time and duration of sensory block were significantly prolonged,the requirement for ephedrine and volume of fluid infused during operation were decreased,and no significant change was found in anesthetic efficacy in group L.No lumbar plexus block-related adverse events developed in group L.Conclusion Lumbar plexus block can be used for unilateral extremity artificial vascular graft between femoral artery and deep femoral artery in elderly patients.

Objective To evaluate the efficacy of midazolam premedication for prevention of emergence agitation (EA) after sevoflurane anesthesia in children undergoing minor surgery.Methods One hundred and twenty ASA physical status Ⅰ or Ⅱ paediatric patients,aged 3-9 yr,weighing 15-35 kg,scheduled for elective tonsillectomy and adenoidectomy,were randomly divided into 4 groups (n =30 each):control group (group C) and midazolam 0.25,0.50 and 0.75 mg/kg groups (groups M1-3).The 10 ml mixture of midazolam 0.25,0.50 and 0.75 mg/kg and 10％ glucose was taken orally at 30 min before anesthesia in M1-3 groups,respectively,while 10 ml of 10％ glucose was taken orally in group C.Anesthesia was induced with inhalation of sevoflurane and maintained with iv infusion of remifentanil and inhalation of sevoflurane.EA was assessed using the Pediatric Anesthesia Emergence Delirium (PAED) scale.Results Compared with group C,the PAED scores and incidence of EA were significantly decreased in groups M2 and M3 (P ＜ 0.05),and no significant change was found in group M1 (P ＞ 0.05).Compared with group M1,the PAED scores and incidence of EA were significantly decreased in groups M2 and M3 (P ＜ 0.05).There was no significant difference in the PAED scores and incidence of EA between groups M3 and M2 (P ＞ 0.05).Conclusion Premedication with oral midazolam can prevent EA following sevoflurane anesthesia in children undergoing minor surgery and the optimum dose is 0.50 mg/kg.

OBJECTIVETo investigate the protective effects of puerarin against myocardial injury in patients with hypertension during perioperational period.

METHODSThirty-four patients with hypertension underwent general anesthesia were randomly divided into the control group and the puerarin group, 500mg puerarin was given to the puerarin group 1hr before anesthesia induction by venoclysis and to the control group, normal saline was given instead. The concentration of serum cardiac troponin I (cTnI) and isoenzyme of creatine kinase containing M and B subunits (CK-MB) were measured before anesthesia induction and 2 hrs after operation respectively.

RESULTSThe serum concentration of cTnI and CK-MB were insignificantly different in the two groups before induction, the two indexes increased in different degrees (P <0.01) 2 hrs after operation in both groups, but the increments in the puerarin group were significantly lower than those in the control group (P< 0.01).

CONCLUSIONStress of operation and anesthesia could induce myocardial injury in patients with hypertension, which can be prevented by puerarin medicated during perioperational period.

Adult ; Aged ; Aged, 80 and over ; Anesthesia, General ; Creatine Kinase, MB Form ; blood ; Female ; Humans ; Hypertension ; drug therapy ; surgery ; Isoflavones ; therapeutic use ; Male ; Middle Aged ; Myocardial Reperfusion Injury ; prevention & control ; Perioperative Care ; Phytotherapy ; Troponin I ; blood