Objective:To evaluate the effects of low-dose esketamine on postoperative pain and depression degree in patients undergoing radical surgery for colorectal cancer.Methods:A prospective randomized controlled study was conducted. Eighty-four patients who plan to undergo elective radical resection for colorectal cancer at Shanxi Province Cancer Hospital from December 2023 to March 2024 were divided into esketamine group (observation group) and 0.9% NaCl solution group (control group) using the random number table method, with 42 patients in each group. The observation group was given intravenous infusion of 0.25 mg/kg esketamine 30 minutes before anesthesia induction and 30 minutes before the end of surgery, while the control group was given intravenous infusion of the equal dose of 0.9% NaCl solution. The remaining anesthesia methods were the same for both groups. The postoperative pain number rating scale (NRS) scores, Ramsay sedation score and perioperative dosages of sufentanil, remifentanil and propofol were compared between the two groups. The Hamilton depression rating scale (HAMD) score was used to evaluate the degree of depression before and after surgery in two groups of patients and the score was compared between the two groups.Results:Two cases were discharged from the observation group and two cases were discharged from the control group due to postoperative catheterization and return to the intensive care unit. There were no statistically significant differences in gender, age, body mass index, anesthesia time, recovery time, extubation time, intraoperative fluid replacement volume, and fluid output between the two groups of patients (all P > 0.05). The dosage of remifentanil in the observation group was lower than that in the control group [(481±117) mg vs. (718±161) mg], and the difference was statistically significant ( t = 7.52, P < 0.001). The NRS scores of the observation group were lower than those of the control group at 1 and 2 hours after surgery, and the differences were statistically significant (both P < 0.001). The perioperative salvage analgesia rate in the observation group was lower than that in the control group [12.5% (5/40) vs. 32.5% (13/40)], and the difference was statistically significant ( χ2 = 4.59, P = 0.032). The Ramsay sedation scores of the observation group were higher than those of the control group at 1, 2, and 4 hours after surgery, and the differences were statistically significant (all P < 0.001). The HAMD scores of the observation group at 3 and 7 days after surgery were lower than those before surgery, and both were lower than those of the control group, and the differences were statistically significant (all P < 0.05). Conclusions:Low-dose esketamine used in radical surgery for colorectal cancer can not only effectively reduce perioperative pain and improve sedative effects, but also alleviate patients' depression and improve the quality and speed of postoperative recovery.

Objective:To evaluate the effects of low-dose esketamine on postoperative pain and depression degree in patients undergoing radical surgery for colorectal cancer.Methods:A prospective randomized controlled study was conducted. Eighty-four patients who plan to undergo elective radical resection for colorectal cancer at Shanxi Province Cancer Hospital from December 2023 to March 2024 were divided into esketamine group (observation group) and 0.9% NaCl solution group (control group) using the random number table method, with 42 patients in each group. The observation group was given intravenous infusion of 0.25 mg/kg esketamine 30 minutes before anesthesia induction and 30 minutes before the end of surgery, while the control group was given intravenous infusion of the equal dose of 0.9% NaCl solution. The remaining anesthesia methods were the same for both groups. The postoperative pain number rating scale (NRS) scores, Ramsay sedation score and perioperative dosages of sufentanil, remifentanil and propofol were compared between the two groups. The Hamilton depression rating scale (HAMD) score was used to evaluate the degree of depression before and after surgery in two groups of patients and the score was compared between the two groups.Results:Two cases were discharged from the observation group and two cases were discharged from the control group due to postoperative catheterization and return to the intensive care unit. There were no statistically significant differences in gender, age, body mass index, anesthesia time, recovery time, extubation time, intraoperative fluid replacement volume, and fluid output between the two groups of patients (all P > 0.05). The dosage of remifentanil in the observation group was lower than that in the control group [(481±117) mg vs. (718±161) mg], and the difference was statistically significant ( t = 7.52, P < 0.001). The NRS scores of the observation group were lower than those of the control group at 1 and 2 hours after surgery, and the differences were statistically significant (both P < 0.001). The perioperative salvage analgesia rate in the observation group was lower than that in the control group [12.5% (5/40) vs. 32.5% (13/40)], and the difference was statistically significant ( χ2 = 4.59, P = 0.032). The Ramsay sedation scores of the observation group were higher than those of the control group at 1, 2, and 4 hours after surgery, and the differences were statistically significant (all P < 0.001). The HAMD scores of the observation group at 3 and 7 days after surgery were lower than those before surgery, and both were lower than those of the control group, and the differences were statistically significant (all P < 0.05). Conclusions:Low-dose esketamine used in radical surgery for colorectal cancer can not only effectively reduce perioperative pain and improve sedative effects, but also alleviate patients' depression and improve the quality and speed of postoperative recovery.

Objective To investigated the effect of stenosis characteristics (vascular elasticity and plaque properties) on myocardial ischemia. Methods An ideal geometric multi-scale coronary stenosis model based on fluid-structure interaction was established, and the fractional flow reserve (FFR) was simulated to evaluate myocardial ischemia. The effects of vascular elastic wall (elastic modulus of 1 MPa) and rigid wall, plaque types (lipid-rich plaque and calcified plaque) and plaque volume on myocardial ischemia were considered separately. Results The FFRCT simulation result of vessels with elastic wall was larger than that with rigid wall under all stenosis situations. The FFRCT of vessels in lipid-rich lesions was higher than that of calcified plaque (P=0.001). The trapezoidal plaque volume was larger than the cosine plaque volume, and the FFRCT of vessels in trapezoidal plaque was smaller than that of cosine plaque (P=0.001). Conclusions Vascular elasticity is a critical factor to simulate vascular hemodynamics. In moderate stenosis, calcified plaques are more likely to induce myocardial ischemia due to the larger luminal deformation and dilation of rich lipid plaque. When the stenosis is constant, the smaller the plaque volume, the higher the FFRCT and the smaller the possibility of myocardial ischemia.

Objective:To evaluate effects of different medication forms of dexmedetomidine on perioperative cognitive function in elderly patients undergoing radical operation of gastric carcinoma, and Ramsay sedation score.Methods:A total of 150 patients aged 65 years and 75 years scheduled for elective radical operation of gastric carcinoma from December 2018 to December 2019 in Shanxi Provincial Cancer Hospital were enrolled, and they were divided into 3 groups according to random number table method: different medication forms of dexmedetomidine groups (group A, group B) and the control group (group C), 50 cases in each group. The patients in group A and group B continued to pump dexmedetomidine at a rate of 0.5 μg·kg -1·h -1 and 0.3 μg·kg -1·h -1 respectively for 15 min before induction of anesthesia. And the patients in group C were given intravenous pumping of an equal volume of 0.9% NaCl for 15 min. Subsequently, patients in group A and group B received continuous intravenous infusion of 0.3 μg·kg -1·h -1 for 30 min before the end of operation, the patients in group C received 0.9% NaCl infusion of equal volume until the end of operation. The cognitive function of the patients was measured by using the Monterey cognitive assessment scale (MoCA) the day before surgery and on day 1,3 and 7 after surgery, and the incidence of perioperative neurocognitive disorder (PND) was counted. Ramsay sedation score at 30 min, 24 h and 48 h after surgery was compared among the three groups. Results:There were 3 patients in group A and 3 patients in group C were excluded because they were transferred to ICU due to serious postoperative complications. There were significant differences in MoCA score among the three groups on day 1, 3, 7 after operation (all P < 0.01); MOCA score of group A, B and C on day 7 after operation was (26.9±0.7) scores, (26.6±1.0) scores, (26.3±1.2) scores, respectively, and the difference between group A and group C was statistically significant ( P < 0.01). The incidence of PND among the three groups on day 1, 3, 7 after surgery had statistically significant differences (all P < 0.05), and the incidence of PND in group A was lower than that in group B and C (all P < 0.05). Ramsay sedation score among the three groups at 30 min and 24 h, 48 h after operation showed statistically significant differences (all P < 0.01), and that in group C was lower than that in group A and group B, and the differences were statistically significant (all P < 0.01). Ramsay sedation score at 24 h after operation in group A was high than that in group B and group C (all P < 0.01). Conclusions:Dexmedetomidine assisted with anesthesia can reduce the incidence of PND in elderly patients undergoing radical operation of gastric carcinoma and enhance the sedative effect. What's more, the most obvious effect is the infusion of 0.5 μg·kg -1·h -1 before anesthesia induction.