Objective:To investigate the effects of dexmedetomidine (Dex) combined with propofol or cyclopropofol on postoperative stress in laparoscopic ovarian cancer surgery.Methods:A total of 120 ovarian cancer patients who underwent laparoscopic radical resection of ovarian cancer in the Second People′s Hospital of Hengshui from January 2022 to December 2023 were selected and divided into observation group and control group by random number table method, with 60 cases in each group. The control group was given Dex combined with propofol for compound anesthesia, and the observation group was given Dex combined with cyclopropofol for compound anesthesia. The perioperative indicators and intraoperative opioid dosage were compared between the two groups. The heart rate (HR) and mean arterial pressure (MAP) were compared at 3 min after entering the operating room (T 1), intubation (T 2), skin incision (T 3), extubation (T 4) and leaving the operating room (T 5). The Ramsay Sedation Scale (RSS) scores at T 1, T 2, T 3, T 4 and Prince-Henry scores at 2, 6, 12, 24 h after operation were compared. The serum levels of prostin E 2 (PGE 2) and cortisol (Cor) 1 day before operation and 12, 24, 48 h after operation, as well as the incidence of adverse events during treatment were compared between the two groups. Results:The anesthesia recovery time in the observation group was significantly shorter than that in the control group, and the intraoperative dosages of sufentanil and remifentanil were significantly less than those in the control group (all P<0.05). Compared with T 1, there were no significant differences in HR and MAP at T 2, T 3, T 4 in the observation group (all P>0.05); the HR and MAP at T 2, T 3, T 4 in the control group were significantly different from those at T 1 (all P<0.05), and the HR and MAP at T 2, T 3, T 4, T 5 in the observation group were lower than those in the control group (all P<0.05). The RSS scores at T 2, T 3 and T 4 in the observation group were significantly higher than those in the control group (all P<0.05). The Prince-Henry scores at 2, 6, 12, 24 h after operation in the observation group were significantly lower than those in the control group (all P<0.05). The serum PGE 2 and Cor levels at 12, 24 and 48 h after operation in the observation group were significantly lower than those in the control group (all P<0.05). The total incidence of postoperative adverse events in the observation group was 18.33%(11/60), lower than 23.33%(14/60) in the control group ( P<0.05). Conclusions:Compared with Dex combined with propofol, Dex combined with cyclopropofol for compound anesthesia can reduce postoperative stress response in laparoscopic ovarian cancer surgery, improve intraoperative sedation and postoperative analgesia, stabilize hemodynamics, and has good safety.

Objective:To explore the application effect of dexmedetomidine combined with ciprofol general anesthesia in laparoscopic radical resection of ovarian cancer.Methods:A total of 120 patients who underwent laparoscopic radical resection of ovarian cancer at the Hengshui Second People′s Hospital, Hebei Province from January 2021 to January 2023 were selected as the research objects. They were divided into the control group and the observation group by random number table method, with 60 cases in each group. Both groups underwent surgery under general anesthesia: the control group was given ciprofol, while the observation group was given dexmedetomidine combined with ciprofol. Postoperative recovery, changes in hemodynamics and vital signs, levels of stress indicators, and the occurrence of adverse reactions were compared between the two groups.Results:Compared with the control group, the observation group had fewer presses on the analgesic pump, shorter first flatus time and awakening time, lower Visual Analogue Scale (VAS) score at 1 hour after surgery, and higher Ramsay sedation score (all P<0.05). There were no statistically significant differences in heart rate (HR), mean arterial pressure (MAP), and bispectral index (BIS) between the two groups before induction (T 0) (all P>0.05); MAP at skin incision (T 1), 30 minutes after skin incision (T 2), and after extubation (T 3) in both groups were higher than those at T 0, while HR were lower than those at T 0 (all P<0.05); HR and MAP at T 1, T 2, and T 3 in the observation group were significantly lower than those in the control group (all P<0.05), but there was no statistically significant difference in BIS between the two groups at each time point (all P>0.05). There were no statistically significant differences in serum cortisol (COR) and adrenocorticotropic hormone (ACTH) levels between the two groups at T 0 (all P>0.05); serum COR and ACTH levels at T 3 and 1 hour after surgery (T 4) in both groups were higher than those at T 0 (all P<0.05), and the levels of serum COR and ACTH at T 3 and T 4 in the observation group were lower than those in the control group (all P<0.05). In the control group, there were 3 cases of hypotension, 7 cases of nausea and vomiting, and 1 case of respiratory depression; in the observation group, there were 2 cases of hypotension and 3 cases of nausea and vomiting. No serious adverse reactions occurred in either group, and the total incidence of adverse reactions in the observation group was lower than that in the control group (χ 2=3.354, P<0.05). Conclusions:Dexmedetomidine combined with ciprofol general anesthesia can promote postoperative recovery of patients undergoing laparoscopic radical resection of ovarian cancer, effectively stabilize hemodynamics, and reduce stress response and adverse reactions.

This report detailed a case of intrauterine intervention for fetal left-sided congenital cystic adenomatoid malformation with intralobar pulmonary sequestration. The mother had no significant medical history. Ultrasound at 22 gestational weeks showed a giant cystic-solid thoracic mass [32 mm×46 mm×61 mm; congenital pulmonary airway malformation volume ratio (CVR) 2.57], and the diagnosis was congenital cystic adenomatoid malformation complicated by intralobar pulmonary sequestration. After disease progression despite one course of antenatal corticosteroids (55 mm×47 mm×56 mm; CVR 3.33), ultrasound-guided percutaneous intrauterine laser ablation was performed at 24 +6 weeks to precisely coagulate the lesion's dominant feeding artery (confirmed by Doppler). Postoperatively, the mass showed progressive regression with normalized hemodynamic parameters. The infant was delivered vaginally at 37 weeks of gestation. The infant underwent resection of residual left lower lung lesions at five months of age, with normal cardiopulmonary function and developmental milestones confirmed at 15-month follow-up.

Objective:To investigate the effects of dexmedetomidine (Dex) combined with propofol or cyclopropofol on postoperative stress in laparoscopic ovarian cancer surgery.Methods:A total of 120 ovarian cancer patients who underwent laparoscopic radical resection of ovarian cancer in the Second People′s Hospital of Hengshui from January 2022 to December 2023 were selected and divided into observation group and control group by random number table method, with 60 cases in each group. The control group was given Dex combined with propofol for compound anesthesia, and the observation group was given Dex combined with cyclopropofol for compound anesthesia. The perioperative indicators and intraoperative opioid dosage were compared between the two groups. The heart rate (HR) and mean arterial pressure (MAP) were compared at 3 min after entering the operating room (T 1), intubation (T 2), skin incision (T 3), extubation (T 4) and leaving the operating room (T 5). The Ramsay Sedation Scale (RSS) scores at T 1, T 2, T 3, T 4 and Prince-Henry scores at 2, 6, 12, 24 h after operation were compared. The serum levels of prostin E 2 (PGE 2) and cortisol (Cor) 1 day before operation and 12, 24, 48 h after operation, as well as the incidence of adverse events during treatment were compared between the two groups. Results:The anesthesia recovery time in the observation group was significantly shorter than that in the control group, and the intraoperative dosages of sufentanil and remifentanil were significantly less than those in the control group (all P<0.05). Compared with T 1, there were no significant differences in HR and MAP at T 2, T 3, T 4 in the observation group (all P>0.05); the HR and MAP at T 2, T 3, T 4 in the control group were significantly different from those at T 1 (all P<0.05), and the HR and MAP at T 2, T 3, T 4, T 5 in the observation group were lower than those in the control group (all P<0.05). The RSS scores at T 2, T 3 and T 4 in the observation group were significantly higher than those in the control group (all P<0.05). The Prince-Henry scores at 2, 6, 12, 24 h after operation in the observation group were significantly lower than those in the control group (all P<0.05). The serum PGE 2 and Cor levels at 12, 24 and 48 h after operation in the observation group were significantly lower than those in the control group (all P<0.05). The total incidence of postoperative adverse events in the observation group was 18.33%(11/60), lower than 23.33%(14/60) in the control group ( P<0.05). Conclusions:Compared with Dex combined with propofol, Dex combined with cyclopropofol for compound anesthesia can reduce postoperative stress response in laparoscopic ovarian cancer surgery, improve intraoperative sedation and postoperative analgesia, stabilize hemodynamics, and has good safety.

Objective:To explore the application effect of dexmedetomidine combined with ciprofol general anesthesia in laparoscopic radical resection of ovarian cancer.Methods:A total of 120 patients who underwent laparoscopic radical resection of ovarian cancer at the Hengshui Second People′s Hospital, Hebei Province from January 2021 to January 2023 were selected as the research objects. They were divided into the control group and the observation group by random number table method, with 60 cases in each group. Both groups underwent surgery under general anesthesia: the control group was given ciprofol, while the observation group was given dexmedetomidine combined with ciprofol. Postoperative recovery, changes in hemodynamics and vital signs, levels of stress indicators, and the occurrence of adverse reactions were compared between the two groups.Results:Compared with the control group, the observation group had fewer presses on the analgesic pump, shorter first flatus time and awakening time, lower Visual Analogue Scale (VAS) score at 1 hour after surgery, and higher Ramsay sedation score (all P<0.05). There were no statistically significant differences in heart rate (HR), mean arterial pressure (MAP), and bispectral index (BIS) between the two groups before induction (T 0) (all P>0.05); MAP at skin incision (T 1), 30 minutes after skin incision (T 2), and after extubation (T 3) in both groups were higher than those at T 0, while HR were lower than those at T 0 (all P<0.05); HR and MAP at T 1, T 2, and T 3 in the observation group were significantly lower than those in the control group (all P<0.05), but there was no statistically significant difference in BIS between the two groups at each time point (all P>0.05). There were no statistically significant differences in serum cortisol (COR) and adrenocorticotropic hormone (ACTH) levels between the two groups at T 0 (all P>0.05); serum COR and ACTH levels at T 3 and 1 hour after surgery (T 4) in both groups were higher than those at T 0 (all P<0.05), and the levels of serum COR and ACTH at T 3 and T 4 in the observation group were lower than those in the control group (all P<0.05). In the control group, there were 3 cases of hypotension, 7 cases of nausea and vomiting, and 1 case of respiratory depression; in the observation group, there were 2 cases of hypotension and 3 cases of nausea and vomiting. No serious adverse reactions occurred in either group, and the total incidence of adverse reactions in the observation group was lower than that in the control group (χ 2=3.354, P<0.05). Conclusions:Dexmedetomidine combined with ciprofol general anesthesia can promote postoperative recovery of patients undergoing laparoscopic radical resection of ovarian cancer, effectively stabilize hemodynamics, and reduce stress response and adverse reactions.

This report detailed a case of intrauterine intervention for fetal left-sided congenital cystic adenomatoid malformation with intralobar pulmonary sequestration. The mother had no significant medical history. Ultrasound at 22 gestational weeks showed a giant cystic-solid thoracic mass [32 mm×46 mm×61 mm; congenital pulmonary airway malformation volume ratio (CVR) 2.57], and the diagnosis was congenital cystic adenomatoid malformation complicated by intralobar pulmonary sequestration. After disease progression despite one course of antenatal corticosteroids (55 mm×47 mm×56 mm; CVR 3.33), ultrasound-guided percutaneous intrauterine laser ablation was performed at 24 +6 weeks to precisely coagulate the lesion's dominant feeding artery (confirmed by Doppler). Postoperatively, the mass showed progressive regression with normalized hemodynamic parameters. The infant was delivered vaginally at 37 weeks of gestation. The infant underwent resection of residual left lower lung lesions at five months of age, with normal cardiopulmonary function and developmental milestones confirmed at 15-month follow-up.

Objective:To study the application effect of the Benner's theory stratified training based on the "Protect the World" platform for nurses specialized in neurological rehabilitation.Methods:A total of 70 nurses who underwent on-the-job training for neurorehabilitation nursing specialists in 2023 were divided into control group ( n=35) and observation group ( n=35) based on random odd and even numbers to receive different training methods. The control group received routine nursing training, while the observation group received Benner's theory stratified training based on the "Protect the World" platform. The theoretical and skill assessment scores, job competency, and satisfaction scores of two groups of nurses were compared before and after training. SPSS 25.0 was used for t-test and chi-square test. Results:Before training, there were no significant differences between the two groups of nurses in terms of theory scores [(88.35±4.41) vs. (89.43±4.07)] and skill assessment scores [(89.22±3.27) vs. (88.43±3.16)]. After training, the theoretical and skill assessment scores were significantly higher in the observation group as compared with the control group [(95.51±5.01) vs. (90.24±4.99) and (95.15±4.24) vs. (91.13±4.33), both P<0.05]. After training, the competency scores and total scores of education guidance, management function, diagnostic function, assistance role, and intervention treatment were significantly higher in the observation group than in the control group ( P<0.05). The satisfaction survey scores were significantly higher in the observation group than in the control group ( P<0.05). Conclusions:The Benner's theory stratified training based on the "Protect the World" platform can improve the theoretical and skill assessment scores of nurses specialized in neurological rehabilitation. This approach significantly boosts their overall professional competence and holds considerable potential for broader adoption.

Objective:To explore the effects of different approaches for second-trimester multifetal pregnancy reduction on pregnancy outcome in women with dichorionic triamniotic (DCTA) triplet.Methods:A retrospective study was performed on 51 women with DCTA triplet pregnancies who were referred to Guangdong Women and Children Hospital for second-trimester multifetal pregnancy reduction from January 2014 to January 2020. All participants were divided into either preventive group ( n=39) or treatment group ( n=12) according to the indication for multifetal pregnancy reduction, and they were further allocated to three subgroups based on different reduction methods, which were reduction to dichorionic twin by radiofrequency ablation (RFA) (RFA subgroup), reduction to monochorionic singleton (KCl-singleton subgroup) or monochorionic twin (KCl-twin subgroup) by cardiac injection of potassium chloride. Pregnancy loss rate, neonatal birth weight, gestational age at delivery, incidence of intrauterine death, and neonatal death were compared and analyzed between different groups using t-test, analysis of variance, Chi-square test, Fisher's exact test and Bonferroni correction. Results:(1) The mean gestational week at operation in the treatment group was significantly later than that in the preventive group [(18.5±3.1) vs (15.0±2.3) weeks, t=-4.209, P<0.001]. In the preventive group, the mean gestational week at operation in the RFA subgroup was later than the KCl-singleton and KCl-twin subgroup[(17.2±1.6) vs (13.8±1.5) and (12.7±1.0) weeks, t=6.630 and 3.875, respectively, both P<0.05]. (2) The postoperative pregnancy loss rate in the preventive group was decreased compared with the treatment group [10.3%(4/39) vs 5/12, Fisher's exact test, P<0.05], and the live birth ratio was increased [ 85.7%(48/56) vs 10/18, χ2=5.640, P=0.018]. No live birth infants with birth weight <1 500 g was reported in the KCl-singleton subgroup in preventive group, and the statistical significance was observed in the intra-group differences ( P<0.05) rather than the pairwise comparison differences in the preventive group. For the proportion of live births, there was a statistically significant difference in the intra-group comparison in the treatment group, which was higher in the RFA subgroup than that in the KCl-twin subgroup (6/6 vs 1/6, P=0.045). No significant difference was revealed among pregnancy loss rate, gestational weeks at delivery, the mean birth weight, premature delivery <32 gestational weeks, and full-term birth rate among three different approaches within the two groups. (3) No monochorionic twin complications or perinatal death occurred in any RFA or KCl-singleton subgroups in the two groups. In the KCl-twin subgroups including five cases with ten fetuses, including three live birth, four miscarriage, three intrauterine death occured, while no neonatal death was reported. One case with selective fetal uterine growth restriction in the preventive group delivered two live births, and one case with twin-to-twin transfusion syndrome in the treatment group had intrauterine death in one fetus and one survival neonate. Conclusions:The pregnancy outcome of multifetal pregnancy reduction to dichorionic diamniotic twins by RFA or reduction to singleton by cardiac injection of potassium chloride are comparative in women with DCTA triplet, regardless of whether it is a preventive or therapeutic reduction.

We report the intrauterine treatment of a case of fetal persistent supraventricular tachycardia complicated by heart failure. The ultrasound findings at 32 +1 weeks of gestation showed fetal tachycardia of 242 beats/min, fetal generalized edema, ascites, and visible pulsation spectrum in the intra-abdominal segment of the umbilical vein. Fetal cardiac arrhythmia persisted after maternal oral digoxin for 46 hours. In view of the continuous deterioration of the fetal condition with the persistent umbilical vein pulsation spectrum and worsening edema, fetal intramuscular injection of cedilanid under ultrasound guidance was performed, resulting in successful cardioversion. The pregnant woman gave birth to a baby girl by cesarean section due to premature rupture of membranes and oligohydramnios at 34 +6 weeks of gestation, with normal functions of heart and other organs. During a follow-up to 8 months, no obvious abnormalities were found.

Objective: To assess the effectiveness of radiofrequency ablation (RFA) in the treatment of multiple pregnancies. Methods: In this retrospective study, 84 cases (total 174 fetuses) of complex monochorionic pregnancies treated with RFA for selective fetal reduction were analyzed. All cases were managed in the Guangdong Women and Children Hospital from January 2015 to January 2018. Indications for offering RFA, details of the procedure and pregnancy outcomes were collected and analyzed. Results: (1)The rate of miscarriage and fetal intrauterine death was 21% (18/84), termination of pregnancy because of fetal malformation or oligohydramnion occurred in 10% (8/84) of cases. Total live birth rate was 69% (58/84) and the gestation age at delivery was (35.0±3.0) weeks. (2) The live birth rate of twin reversed arterial perfusion sequence (TRAPS) was the lowest (6/11), followed by twin to twin transfusion syndrome (TTTS; 66%, 27/41), structural or genetic abnormalities of one fetus in monochorionic twin pregnancy (10/14), triplet pregnancy reduction (4/6) and selective intrauterine growth restriction (sIUGR) (11/12). (3) The live birth rate was 67% (20/30) in stage Ⅲ of TTTS and 7/11 in the stage Ⅳ of TTTS (P>0.05). The average gestational age was (33.6±3.0) weeks in stage Ⅲ of TTTS compared with (36.5±2.4) weeks in the stage Ⅳof TTTS (P<0.05). Conclusions RFA appears to be a reliable option for selective fetal reduction in monochorionic multiple pregnancies. The indication of RFA is an influencing factor on its pregnancy outcomes. Type Ⅱand type Ⅲ sIUGR may choose this technique as a priority. Compared with stage Ⅲ of TTTS, the live birth rate and the gestation age at delivery in stage Ⅳ of TTTS, there are no significant differences.