ObjectiveTo investigate the role and potential mechanism of microRNA-544 （miRNA-544） in lipopolysaccharide （LPS）-induced liver injury in mice with sepsis， and to provide a new target for the treatment of liver injury in sepsis. MethodsA total of 40 C57BL/6J mice were randomly divided into control group （intraperitoneal injection of normal saline）， model group （intraperitoneal injection of LPS at a dose of 5 mg/kg）， agonist group （intraperitoneal injection of LPS and miR-544 agonist at a dose of 5 mg/kg）， and miR-544 inhibitor group （intraperitoneal injection of LPS and miR-544 inhibitor at a dose of 5 mg/kg）， with 10 mice in each group. An automatic biochemical analyzer was used to measure the levels of alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， and total bilirubin （TBil） in serum and the liver； Western blot was used to measure the expression levels of monocyte chemotactic protein-1 （MCP-1）， CD16/32， and proteins associated with the NF-κB signaling pathway in the liver； q-PCR and ELISA were used to measure the expression levels of tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， and interleukin-1β （IL-1β） in serum. A one-way analysis of variance was used for comparison between multiple groups， and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the control group， the model group of LPS-induced sepsis had a significant reduction in the expression level of miR-544 in serum and liver tissue （P0.01）， significant pathological changes of the liver （such as inflammatory cell infiltration and central vein congestion）， and significant increases in the levels of liver injury markers （ALT， AST， and TBil） in serum and the liver （all P0.001）， the expression levels of inflammatory factors （MCP-1， CD16/32， TNF-α， IL-6， and IL-1β） （all P0.01）， and the phosphorylation levels of key proteins of the NF-κB pathway （p-IKK， p-I-NF-κ， and p-p65） （all P0.01）. Compared with the model group， the miR-544 inhibitor group had a significant reduction in the expression level of miR-544 in serum and liver tissue （P0.01）， aggravated pathological changes of the liver， and significant increases in the levels of liver injury markers and inflammatory factors （ALT， AST， TBil， MCP-1， CD16/32， TNF-α， IL-6， and IL-1） （all P0.05）， as well as significant increases in the phosphorylation levels of key proteins of the NF-κB pathway （p-IKK， p-I-κB-α， and p-p65） （all P0.01）. On the contrary， the miR-544 agonist group had a significant increase in the expression level of miR-544 in serum and liver tissue （P0.01）， significant alleviation of liver pathological changes， and significant reductions in the levels of liver injury markers and inflammatory factors （ALT， AST， TBil， MCP-1， CD16/32， TNF-α， IL-6， and IL-1β） （all P0.05）， as well as significant reductions in the phosphorylation levels of key proteins of the NF-κB pathway （p-IKK， p-I-κB-α， and p-p65） （all P0.05）. ConclusionThis study shows that miR-544 can alleviate LPS-induced liver injury in mice with sepsis by inhibiting the expression of inflammatory-related proteins and the activation of the NF-κB signaling pathway.

Objective:To analyze the effect of different concentrations of ropivacaine on the quality of postoperative recovery in patients undergoing radical resection of esophageal cancer under ultrasound guided thoracic paravertebral nerve block (TPVB) combined with general anesthesia.Methods:The clinical data of 97 patients with radical resection of esophageal cancer treated from Jun. 2022 to Jan. 2025 in Shangqiu First People’s Hospital were retrospectively analyzed.All patients underwent ultrasound-guided TPVB combined with general anesthesia,and were divided into group A (0.25%) and group B (0.5%) according to the intraoperative ropivacaine concentration.The analgesic effect at extubation,2 hours and 12 hours after surgery was evaluated by VAS score.The cerebral oxygen metabolism indicators at tracheal intubation,15 minutes after the start of surgery and extubation were evaluated by CERO 2 and Da-jvO 2.The indicators related to recovery and the occurrence of adverse reactions were statistically analyzed.The quality of recovery was evaluated by QoR-40 score. Results:VAS scores were compared between the two groups; At 2 h and 12 h after surgery, VAS scores in both groups were higher than those at extubation, and lower at 12 h than at 2 h after surgery ( P<0.05). There were significant differences in CERO 2 and Da-jvO 2 between groups, time and interaction between groups A and B ( P<0.05). CERO 2 and Da-jvO 2 in both groups were higher than those in tracheal intubation 15min after operation. At extubation, CERO 2 and Da-jvO 2 in both groups were lower than those at tracheal intubation and 15 minutes after operation ( P<0.05). During endotracheal intubation, there was no significant difference in CERO 2 or Da-jvO 2 between the two groups ( P>0.05). CERO 2 and Da-jvO 2 in group A were lower than those in group B at 15min after operation and extubation ( P<0.05). The recovery time in group A was shorter than that in group B, and the QoR-40 score was higher than that in group B ( P<0.05). The total incidence of adverse reactions had no statistical difference between the two groups ( P>0.05) . Conclusion:The application of 0.25% ropivacaine in ultrasound-guided TPVB combined with general anesthesia can shorten the postoperative recovery time and improve the recovery quality of patients undergoing radical resection of esophageal cancer.

Objective:To analyze the efficacy of different doses of esketamine in maintaining general anesthesia in elderly patients undergoing radical resection of esophageal cancer.Methods:A total of 98 elderly patients who underwent radical resection of esophageal cancer and admitted from Jun. 2023 to May. 2025 in Shangqiu First People’s Hospital were selected and divided into Group A ( n=50, 0.25 mg·kg -1·h -1) and Group B ( n=48,0.5 mg·kg -1·h -1) according to the dose of esketamine. The following situations between the two groups were compared: (1) hemodynamics [mean arterial pressure (MAP), heart rate (HR) ] before anesthesia induction (T0), 30 minutes after the start of the operation (T1), and at extubation (T2) ; (2) Stress inflammatory indicators [norepinephrine (NE), C-reactive protein (CRP) ] before the operation and 1 day after the operation; (3) Analgesia status [Dosage of propofol and remifentanil, remedial analgesia rate, and the degree of analgesia was evaluated by visual analogue scale (VAS) 2 hours after the operation]; (4) Postoperative recovery [postoperative eye-opening time, extubation time, anesthesia recovery time, and postoperative recovery quality was evaluated using the Chinese version of the 15-item Quality of Recovery (QoR-15) Scale 1 day after the operation]; (5) Safety. Results:(1) At time T1, MAP of both groups was lower than that at time T0,and at time T2, MAP of group B was higher than that at time T1 ( P<0.05). At times T1 and T2, HR of both groups was lower than that at time T0, and HR of both groups at time T2 was higher than that at time T1 ( P<0.05). At time T1, MAP and HR in group B were lower than those in group A ( P<0.05). (2) The dosages of propofol and remifentanil in group B were lower ( P<0.05) ,while the comparison of remedial analgesia rate and VAS score between the two groups showed P>0.05. (3) One day after the operation,the levels of serum NE and CRP in both groups were higher than those before the operation,while those in group B were even lower ( P<0.05). (4) The incidence of adverse reactions in group B (20.83%) was slightly higher than that in group A (10.00%). (5) The eye-opening time,extubation time and anesthesia recovery time after surgery in group B were all longer than those in group A ( P<0.05), while the comparison of QoR-15 scores between the two groups showed P>0.05. Conclusions:In the maintenance of general anesthesia for elderly patients undergoing radical resection of esophageal cancer, the intraoperative hemodynamic fluctuations of low-dose esketamine are smaller. Although the dosages of propofol and remifentanil are higher and the postoperative recovery time is longer, there are no significant differences in analgesic effect, adverse reactions or recovery quality, while the stress and inflammatory responses of high-dose esketamine are smaller.

Objective:To explore the application effect of family participatory multisensory support programme based on the theory of enriched environment on preterm infants and their mothers in neonatal intensive care unit (NICU).Methods:A historical comparative study was conducted. One hundred and sixteen pairs of preterm infants and their mothers admitted to NICU, Affiliated Hospital of Youjiang Medical University for Nationalities from March to October 2023 were selected by convenience sampling method and divided into control group and experimental group according to the time of admission. The control group was given routine care, while the experimental group implemented a family participatory multisensory support programme based on the enriched environment theory on the basis of the control group. The amplitude-integrated electroencephalography (aEEG) scores and the Chinese version of Parent-Child Interaction Feeding Scale (PCI-FS-C) scores before and after intervention, the Gesell developmental quotients at 40 weeks and 3 months of gestational age, the Chinese version of Maternal Attachment Inventory (CMAI) scores of preterm mothers on the day of discharge and 1 and 3 months after discharge were compared between the two groups.Results:A total of 105 pairs of premature infants and their mothers were included, 52 premature infants of control group, 29 males and 23 females; 53 premature infants of experimental group, including 32 males and 21 females. Before intervention, there were no significant differences in aEEG scores and PCI-FS-C scores between the two groups (all P>0.05). After intervention, the scores of aEEG and PCI-FS-C in the experimental group were (10.91 ± 2.18) and (12.62 ± 1.32) points, respectively, which were higher than (9.67 ± 1.94) and (10.42 ± 1.45) points in the control group, and the differences were statistically significant ( t=3.06, 8.15, both P<0.05). The Gesell developmental quotient were (54.03 ± 9.73), (55.17 ± 11.19), (57.20 ± 11.04), (53.60 ± 9.74), (55.17 ± 10.11) at 40 weeks of gestational age, and (77.15 ± 11.55), (76.62 ± 9.90), (72.76 ± 11.90), (81.47 ± 10.01), (76.51 ± 12.25) at 3 months of gestational age, respectively, which were higher than the control group (49.70 ± 9.07), (49.06 ± 8.61), (52.41 ± 9.01), (49.28 ± 8.78), (50.07 ± 12.52), and (71.10 ± 11.87), (69.02 ± 12.53), (65.77 ± 12.24), (75.08 ± 11.08), (68.63 ± 10.89), the differences were statistically significant ( t values were 2.30-3.49, all P<0.05). The CMAI scores of preterm mothers in the experimental group were (82.81 ± 12.85), (87.70 ± 10.29), (95.91 ± 8.76) points on the day of discharge and 1 and 3 months after discharge, respectively, which were higher than (68.71 ± 14.15), (82.04 ± 11.87), (90.98 ± 11.13) points of the control group, the differences were statistically significant ( t=5.35, 2.61, 2.52, all P<0.05). Conclusions:The family participatory multisensory support programme based on the theory of enriched environment can accelerate the maturation of brain electrical activity in preterm infants and promote brain function and neurobehavioural development; meanwhile, it improves maternal sensitivity and promotes the establishment of mother-infant attachment relationship in preterm infants.

Objective:To analyze the effect of different concentrations of ropivacaine on the quality of postoperative recovery in patients undergoing radical resection of esophageal cancer under ultrasound guided thoracic paravertebral nerve block (TPVB) combined with general anesthesia.Methods:The clinical data of 97 patients with radical resection of esophageal cancer treated from Jun. 2022 to Jan. 2025 in Shangqiu First People’s Hospital were retrospectively analyzed.All patients underwent ultrasound-guided TPVB combined with general anesthesia,and were divided into group A (0.25%) and group B (0.5%) according to the intraoperative ropivacaine concentration.The analgesic effect at extubation,2 hours and 12 hours after surgery was evaluated by VAS score.The cerebral oxygen metabolism indicators at tracheal intubation,15 minutes after the start of surgery and extubation were evaluated by CERO 2 and Da-jvO 2.The indicators related to recovery and the occurrence of adverse reactions were statistically analyzed.The quality of recovery was evaluated by QoR-40 score. Results:VAS scores were compared between the two groups; At 2 h and 12 h after surgery, VAS scores in both groups were higher than those at extubation, and lower at 12 h than at 2 h after surgery ( P<0.05). There were significant differences in CERO 2 and Da-jvO 2 between groups, time and interaction between groups A and B ( P<0.05). CERO 2 and Da-jvO 2 in both groups were higher than those in tracheal intubation 15min after operation. At extubation, CERO 2 and Da-jvO 2 in both groups were lower than those at tracheal intubation and 15 minutes after operation ( P<0.05). During endotracheal intubation, there was no significant difference in CERO 2 or Da-jvO 2 between the two groups ( P>0.05). CERO 2 and Da-jvO 2 in group A were lower than those in group B at 15min after operation and extubation ( P<0.05). The recovery time in group A was shorter than that in group B, and the QoR-40 score was higher than that in group B ( P<0.05). The total incidence of adverse reactions had no statistical difference between the two groups ( P>0.05) . Conclusion:The application of 0.25% ropivacaine in ultrasound-guided TPVB combined with general anesthesia can shorten the postoperative recovery time and improve the recovery quality of patients undergoing radical resection of esophageal cancer.

Objective:To analyze the efficacy of different doses of esketamine in maintaining general anesthesia in elderly patients undergoing radical resection of esophageal cancer.Methods:A total of 98 elderly patients who underwent radical resection of esophageal cancer and admitted from Jun. 2023 to May. 2025 in Shangqiu First People’s Hospital were selected and divided into Group A ( n=50, 0.25 mg·kg -1·h -1) and Group B ( n=48,0.5 mg·kg -1·h -1) according to the dose of esketamine. The following situations between the two groups were compared: (1) hemodynamics [mean arterial pressure (MAP), heart rate (HR) ] before anesthesia induction (T0), 30 minutes after the start of the operation (T1), and at extubation (T2) ; (2) Stress inflammatory indicators [norepinephrine (NE), C-reactive protein (CRP) ] before the operation and 1 day after the operation; (3) Analgesia status [Dosage of propofol and remifentanil, remedial analgesia rate, and the degree of analgesia was evaluated by visual analogue scale (VAS) 2 hours after the operation]; (4) Postoperative recovery [postoperative eye-opening time, extubation time, anesthesia recovery time, and postoperative recovery quality was evaluated using the Chinese version of the 15-item Quality of Recovery (QoR-15) Scale 1 day after the operation]; (5) Safety. Results:(1) At time T1, MAP of both groups was lower than that at time T0,and at time T2, MAP of group B was higher than that at time T1 ( P<0.05). At times T1 and T2, HR of both groups was lower than that at time T0, and HR of both groups at time T2 was higher than that at time T1 ( P<0.05). At time T1, MAP and HR in group B were lower than those in group A ( P<0.05). (2) The dosages of propofol and remifentanil in group B were lower ( P<0.05) ,while the comparison of remedial analgesia rate and VAS score between the two groups showed P>0.05. (3) One day after the operation,the levels of serum NE and CRP in both groups were higher than those before the operation,while those in group B were even lower ( P<0.05). (4) The incidence of adverse reactions in group B (20.83%) was slightly higher than that in group A (10.00%). (5) The eye-opening time,extubation time and anesthesia recovery time after surgery in group B were all longer than those in group A ( P<0.05), while the comparison of QoR-15 scores between the two groups showed P>0.05. Conclusions:In the maintenance of general anesthesia for elderly patients undergoing radical resection of esophageal cancer, the intraoperative hemodynamic fluctuations of low-dose esketamine are smaller. Although the dosages of propofol and remifentanil are higher and the postoperative recovery time is longer, there are no significant differences in analgesic effect, adverse reactions or recovery quality, while the stress and inflammatory responses of high-dose esketamine are smaller.

Objective:To explore the application effect of family participatory multisensory support programme based on the theory of enriched environment on preterm infants and their mothers in neonatal intensive care unit (NICU).Methods:A historical comparative study was conducted. One hundred and sixteen pairs of preterm infants and their mothers admitted to NICU, Affiliated Hospital of Youjiang Medical University for Nationalities from March to October 2023 were selected by convenience sampling method and divided into control group and experimental group according to the time of admission. The control group was given routine care, while the experimental group implemented a family participatory multisensory support programme based on the enriched environment theory on the basis of the control group. The amplitude-integrated electroencephalography (aEEG) scores and the Chinese version of Parent-Child Interaction Feeding Scale (PCI-FS-C) scores before and after intervention, the Gesell developmental quotients at 40 weeks and 3 months of gestational age, the Chinese version of Maternal Attachment Inventory (CMAI) scores of preterm mothers on the day of discharge and 1 and 3 months after discharge were compared between the two groups.Results:A total of 105 pairs of premature infants and their mothers were included, 52 premature infants of control group, 29 males and 23 females; 53 premature infants of experimental group, including 32 males and 21 females. Before intervention, there were no significant differences in aEEG scores and PCI-FS-C scores between the two groups (all P>0.05). After intervention, the scores of aEEG and PCI-FS-C in the experimental group were (10.91 ± 2.18) and (12.62 ± 1.32) points, respectively, which were higher than (9.67 ± 1.94) and (10.42 ± 1.45) points in the control group, and the differences were statistically significant ( t=3.06, 8.15, both P<0.05). The Gesell developmental quotient were (54.03 ± 9.73), (55.17 ± 11.19), (57.20 ± 11.04), (53.60 ± 9.74), (55.17 ± 10.11) at 40 weeks of gestational age, and (77.15 ± 11.55), (76.62 ± 9.90), (72.76 ± 11.90), (81.47 ± 10.01), (76.51 ± 12.25) at 3 months of gestational age, respectively, which were higher than the control group (49.70 ± 9.07), (49.06 ± 8.61), (52.41 ± 9.01), (49.28 ± 8.78), (50.07 ± 12.52), and (71.10 ± 11.87), (69.02 ± 12.53), (65.77 ± 12.24), (75.08 ± 11.08), (68.63 ± 10.89), the differences were statistically significant ( t values were 2.30-3.49, all P<0.05). The CMAI scores of preterm mothers in the experimental group were (82.81 ± 12.85), (87.70 ± 10.29), (95.91 ± 8.76) points on the day of discharge and 1 and 3 months after discharge, respectively, which were higher than (68.71 ± 14.15), (82.04 ± 11.87), (90.98 ± 11.13) points of the control group, the differences were statistically significant ( t=5.35, 2.61, 2.52, all P<0.05). Conclusions:The family participatory multisensory support programme based on the theory of enriched environment can accelerate the maturation of brain electrical activity in preterm infants and promote brain function and neurobehavioural development; meanwhile, it improves maternal sensitivity and promotes the establishment of mother-infant attachment relationship in preterm infants.

Hip fracture in the elderly is characterized by high incidence, high disability rate, and high mortality and has been recognized as a public health issue threatening their health. Surgery is the preferred choice for the treatment of elderly patients with hip fracture. However, lower extremity deep venous thrombosis (DVT) has an extremely high incidence rate during the perioperative period, and may significantly increase the risk of patients′ death once it progresses to pulmonary embolism. In response to this issue, the clinical guidelines and expert consensuses all emphasize active application of comprehensive preventive measures, including basic prevention, physical prevention, and pharmacological prevention. In this prevention system, basic prevention is the basis of physical and pharmacological prevention. However,there is a lack of unified and definite recommendations for basic preventive measures in clinical practice. To this end, the Orthopedic Nursing Professional Committee of the Chinese Nursing Association and Nursing Department of the Orthopedic Branch of the China International Exchange and Promotive Association for Medical and Health Care organized relevant nursing experts to formulate Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture ( version 2024) . A total of 10 recommendations were proposed, aiming to standardize the basic preventive measures for lower extremity DVT in elderly patients with hip fractures during the perioperative period and promote their subsequent rehabilitation.

Objective:To explore the effect of dexmedetomidine on cough reactions and related indexes during recovery from general anesthesia in thyroid tumor surgery.Methods:A total of 90 patients with thyroid tumor who underwent general anesthesia for thyroid tumor surgery from July 2019 to July 2021 in the First People's Hospital of Shangqiu City, Henan Province were selected and divided into the observation group (45 cases) and the control group (45 cases) according to the random number table method. The observation group was given dexmedetomidine 0.5 μg/kg intravenously at the beginning of the surgery, and the intravenous drip time should not be less than 10 min; the control group was given the same dose of normal saline intravenously. The recovery time and extubation time of the two groups were compared, and the incidence of cough reactions during the recovery from general anesthesia was compared. Changes of visual analogue scale (VAS) of pain at 6 h, 24 h and 48 h after surgery, and the changes of stress response indexes [cortisol (Cor), epinephrine (E) and norepinephrine (NE)] and pain factors [prostaglandin E2 (PGE2), neuropeptide Y (NPY) and β-endorphin (β-EP)] before and 48 h after surgery were compared.Results:The recovery time and extubation time in the observation group [(15.62 ± 3.64), (18.27 ± 4.25) min] were faster than those in the control group [(23.12 ± 4.53), (25.65 ± 3.89) min, P < 0.001]. The incidence of cough reactions during recovery from general anesthesia in the observation group [8.89% (4/45)] was lower than that in the control group [28.89% (13/45), P = 0.015]. The VAS score in the observation group was lower than that in the control group at 6 h, 24 h and 48 h after surgery ( P < 0.001). The levels of serum Cor, E and NE at 48 h after surgery in both groups were higher than those before surgery ( P < 0.001); and the serum Cor, E, and NE levels in the observation group were lower than those in the control group at 48 h after surgery ( P < 0.001). The serum PGE2 and NPY levels of the two groups at 48 h after surgery were higher than those before surgery, while β-EP level was lower than that before surgery ( P < 0.001); the serum PGE2 and NPY levels in the observation group were lower than those in the control group at 48 h after surgery, while β-EP level was higher than that in the control group ( P < 0.001). Conclusion:Dexmedetomidine can reduce the cough reactions during recovery from general anesthesia in thyroid tumor surgery, significantly reduce pain, and has little effect on stress response and pain factors.

Objective:To evaluate the test-retest reliability of MRI criteria in the 2019 Bosniak classification of cystic renal masses (CRMs) and to analyze the impact of lesions′ property, size and readers′ experience on the test-retest reliability.Methods:From January 2009 to June 2019, 207 patients with 207 CRMs were included in this retrospective study. All of them underwent renal MRI and surgical-pathologic examination. According to Bosniak classification, version 2019, all CRMs were independently classified twice by eight radiologists with different levels of experience. All radiologists were blinded to the pathology of the lesions. By using intraclass correlation coefficient (ICC), test-retest reliability was evaluated for all CRMs and for subgroups with different pathological properties (benign and malignant) and different sizes (≤40 mm and>40 mm). The test-retest reliability of 4 senior readers (≥10 years of experience) and 4 junior readers (<10 years of experience) were evaluated respectively. The comparison of ICC was performed using Z test. Results:The 207 CRMs included 111 benign lesions (83 benign cysts, 28 benign tumors) and 96 malignant tumors. There were 87 lesions with maximum diameter ≤40 mm and 120 with maximum diameter>40 mm. The test-retest reliability (ICC) of each reader for all lesions was 0.776-0.888, the overall ICC was 0.848 (95%CI 0.821-0.872). The ICCs of senior and junior readers were 0.853 (95%CI 0.824-0.880) and 0.843 (95%CI 0.811-0.871) respectively, without significant difference between the two groups ( Z=0.85, P=0.374). The ICC of all readers was 0.827 for benign lesions and 0.654 for malignant lesions, showing significant difference ( Z=2.80, P=0.005). The ICC was 0.770 for lesions ≤40 mm and 0.876 for lesions>40 mm, which was significantly different ( Z=-2.36, P=0.018). For CRM subgroups with different pathological properties and different sizes, there was no significant difference in test-retest reliability between senior and junior readers (all P>0.05). Conclusion:The test-retest reliability of MRI criteria in the 2019 Bosniak classification of CRMs is excellent and unaffected by readers′ experience. The reliabilities are not consistent among CRMs of different pathological properties and different sizes, but all reached the level of good and above.