AIM:To investigate the impact of es-ketamine-mediated opioid-free anesthesia(OFA)on postoperative gastrointestinal function in patients undergoing laparoscopic distal gastrectomy for gas-tric cancer.METHODS:A total of 150 pa-tients,scheduled for elective laparoscopic distal gas-trectomy for gastric cancer and meeting the inclu-sion and exclusion criteria,were randomly assigned to either the OFA group or the opioid-based anes-thesia(OBA)group using a random number ta-ble,with 75 patients in each group.The OFA group was administered an anesthesia regimen pri-marily consisting of esketamine,while the OBA group received conventional opioid anesthesia,pri-marily consisting of sufentanil and remifentanil.The primary outcome measure was postoperative flatus time,defined as the interval from the end of sur-gery to the first passage of gas.RESULTS:The OFA group exhibited a shorter postoperative flatus time compared to the OBA group(P＜0.01).Intraopera-tive blood loss and norepinephrine consumption were significantly less in the OFA group compared to the OBA group(P＜0.05);the postoperative HADS-D score was better in the OFA group than in the OBA group,and both the OFA and OBA groups showed significantly lower postoperative HADS-A and HADS-D scores compared to their preoperative levels(P＜0.05);the incidence rate of abdominal distension was significantly lower in the OFA group compared to the OBA group(P＜0.05).CONCLUSION:The use of esketamine-mediated opioid-free anesthesia can expedite gastrointestinal function recovery,reduce hospital stay duration,and decrease postoperative adverse reactions in patients undergoing laparo-scopic distal gastrectomy for gastric cancer.

AIM:To investigate the impact of es-ketamine-mediated opioid-free anesthesia(OFA)on postoperative gastrointestinal function in patients undergoing laparoscopic distal gastrectomy for gas-tric cancer.METHODS:A total of 150 pa-tients,scheduled for elective laparoscopic distal gas-trectomy for gastric cancer and meeting the inclu-sion and exclusion criteria,were randomly assigned to either the OFA group or the opioid-based anes-thesia(OBA)group using a random number ta-ble,with 75 patients in each group.The OFA group was administered an anesthesia regimen pri-marily consisting of esketamine,while the OBA group received conventional opioid anesthesia,pri-marily consisting of sufentanil and remifentanil.The primary outcome measure was postoperative flatus time,defined as the interval from the end of sur-gery to the first passage of gas.RESULTS:The OFA group exhibited a shorter postoperative flatus time compared to the OBA group(P＜0.01).Intraopera-tive blood loss and norepinephrine consumption were significantly less in the OFA group compared to the OBA group(P＜0.05);the postoperative HADS-D score was better in the OFA group than in the OBA group,and both the OFA and OBA groups showed significantly lower postoperative HADS-A and HADS-D scores compared to their preoperative levels(P＜0.05);the incidence rate of abdominal distension was significantly lower in the OFA group compared to the OBA group(P＜0.05).CONCLUSION:The use of esketamine-mediated opioid-free anesthesia can expedite gastrointestinal function recovery,reduce hospital stay duration,and decrease postoperative adverse reactions in patients undergoing laparo-scopic distal gastrectomy for gastric cancer.

Objective:To explore the correlation between endogenous sex hormone factors and sexual function in Chinese women.Methods:A total of 711 women who met the criteria were investigated in the Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Chaoyang District Maternal and Child Health Care Hospital, Beijing Chaoyang District Taiyanggong Community Health Service Centre from April 2020 to March 2021. Sociodemographic data (data split into two groups according to educational background: high school or above and lower high school; and three categories based on marital relationship: satisfied, average, and dissatisfied) and serum levels of sex hormones were collected. Female sexual dysfunction (FSD) was evaluated using the female sexual function index (FSFI). Participants were divided into three groups according to the Stages of Reproductive Aging Workshop (STRAW+10): reproductive stage group, menopausal transition stage group and postmenopausal stage group. Spearman rank correlation analysis and multiple linear regression analyses were performed to determine the correlation between characteristics and scores of FSFI.Results:The multivariate logistic regression analysis revealed that postmenopausal stage, secondary education level, neutral and dissatisfied marital relations were significantly negatively correlated with total FSFI score (all P<0.01). Secondary education level, neutral and dissatisfied marital relations were negatively associated with nearly all FSFI domains apart from pain score (all P<0.05); postmenopausal stage was negatively associated with lubrication, satisfaction and pain (all P<0.05). FSH was negatively associated with all FSFI domain scores (all P<0.05). There was a significantly positive correlation between estradiol and scores of FSFI dimensions other than orgasm and satisfaction (all P<0.05). Total testosterone positively affected the score of total FSFI and desire (all P<0.05); free testosterone was positively related to orgasm ( P<0.05). Conclusion:Estradiol and total testosterone serve as protective factors for female sexual function.

Objective:To explore the correlation between endogenous sex hormone factors and sexual function in Chinese women.Methods:A total of 711 women who met the criteria were investigated in the Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Chaoyang District Maternal and Child Health Care Hospital, Beijing Chaoyang District Taiyanggong Community Health Service Centre from April 2020 to March 2021. Sociodemographic data (data split into two groups according to educational background: high school or above and lower high school; and three categories based on marital relationship: satisfied, average, and dissatisfied) and serum levels of sex hormones were collected. Female sexual dysfunction (FSD) was evaluated using the female sexual function index (FSFI). Participants were divided into three groups according to the Stages of Reproductive Aging Workshop (STRAW+10): reproductive stage group, menopausal transition stage group and postmenopausal stage group. Spearman rank correlation analysis and multiple linear regression analyses were performed to determine the correlation between characteristics and scores of FSFI.Results:The multivariate logistic regression analysis revealed that postmenopausal stage, secondary education level, neutral and dissatisfied marital relations were significantly negatively correlated with total FSFI score (all P<0.01). Secondary education level, neutral and dissatisfied marital relations were negatively associated with nearly all FSFI domains apart from pain score (all P<0.05); postmenopausal stage was negatively associated with lubrication, satisfaction and pain (all P<0.05). FSH was negatively associated with all FSFI domain scores (all P<0.05). There was a significantly positive correlation between estradiol and scores of FSFI dimensions other than orgasm and satisfaction (all P<0.05). Total testosterone positively affected the score of total FSFI and desire (all P<0.05); free testosterone was positively related to orgasm ( P<0.05). Conclusion:Estradiol and total testosterone serve as protective factors for female sexual function.

Objective: To quantify the effects of short-term walking intervention on body mass index (BMI), waist circumference, and related indicators of working population. Methods: The China Motivational Healthy Walking Program in 2016 recruited 29 224 individuals from 139 demonstration areas for comprehensive prevention and control of chronic and non-communicable diseases at the national level and 70 areas at the provincial level. All subjects volunteered to participate into this program. The intervention lasted 100 days from June to September 2016. The walking behavior, height, weight and waist circumference of subjects were measured using a uniform pedometer, body composition tester, height tester and waist-to-hip caliper before and after the intervention. Daily average steps, daily average effective steps, and the percent of fulfilling continuous walking per day were used as main indicators in this study. Self-administered questionnaires were used to collect demographic characteristics, behaviors and chronic diseases. With the adjustment of potential confounding factors, multilevel regression was used to quantify the effect of walking on BMI and waist circumference, and multilevel logistic regression was used to quantify the effect on overweight or obesity and central obesity. Results: A total of 12 368 subjects completed walking interventions and all measurements included in this study. The mean±SD age of all subjects was (41.19±8.99) years, and 5 155 (59.17%) of them were women. After 100-day intervention, all outcome variables decreased significantly. For every additional 1 000 steps per day, subjects would have extra decrease in BMI of 0.023 kg/m² [β (95%CI): -0.023 (-0.030, -0.017)], in waist circumference of 0.046 cm [β (95%CI): -0.046 (-0.071, -0.020)], and the likelihood for becoming overweight or obesity was 0.97 times [OR (95%CI): 0.97 (0.95, 0.98)] that of before intervention. With additional 1 000 effective steps per day, the difference between baseline and endpoint increased by 0.028 kg/m² [β (95%CI): -0.028 (-0.035, -0.020)] in BMI and 0.062 cm [β (95%CI): -0.062 (-0.091, -0.033)] in waist circumference. The likelihood of progressing into overweight or obesity was 0.97 times [OR (95%CI): 0.97(0.95, 0.98)] that of before-intervention, and the likelihood of becoming central obesity was 0.98 times [OR (95%CI): 0.98(0.96, 0.99)] that of before-intervention. Compared to subjects with low level percent of fulfilling continuous walking per day, those with high level would have an extra decrease in BMI by 0.150 kg/m² [β (95%CI): -0.150 (-0.22, -0.079)], in waist circumference by 0.340 cm [β (95%CI): -0.340 (-0.620, -0.064)], and the likelihood of becoming overweight or obesity decreased to 0.74 times that of the low level group [OR (95%CI): 0.74(0.62, 0.89)] and the likelihood of becoming central obesity decreased to 0.78 times that of the low level group [OR (95%CI): 0.78 (0.68, 0.91)]. Conclusion Strengthening walking exercise in the short term has a positive effect on promoting working population to reduce BMI and waist circumference, and prevent overweight, obesity and central obesity.

Objective To quantify the effects of short?term walking intervention on body mass index (BMI), waist circumference, and related indicators of working population. Methods The China Motivational Healthy Walking Program in 2016 recruited 29 224 individuals from 139 demonstration areas for comprehensive prevention and control of chronic and non?communicable diseases at the national level and 70 areas at the provincial level. All subjects volunteered to participate into this program. The intervention lasted 100 days from June to September 2016. The walking behavior, height, weight and waist circumference of subjects were measured using a uniform pedometer, body composition tester, height tester and waist?to?hip caliper before and after the intervention. Daily average steps, daily average effective steps, and the percent of fulfilling continuous walking per day were used as main indicators in this study. Self?administered questionnaires were used to collect demographic characteristics, behaviors and chronic diseases. With the adjustment of potential confounding factors, multilevel regression was used to quantify the effect of walking on BMI and waist circumference, and multilevel logistic regression was used to quantify the effect on overweight or obesity and central obesity. Results A total of 12 368 subjects completed walking interventions and all measurements included in this study. The mean ± SD age of all subjects was (41.19 ± 8.99) years, and 5 155 (59.17%) of them were women. After 100?day intervention, all outcome variables decreased significantly. For every additional 1 000 steps per day, subjects would have extra decrease in BMI of 0.023 kg/m2 [β (95%CI ): -0.023 (-0.030, -0.017)], in waist circumference of 0.046 cm [β (95%CI ):-0.046 (-0.071, -0.020)], and the likelihood for becoming overweight or obesity was 0.97 times [OR (95%CI): 0.97 (0.95, 0.98)] that of before intervention. With additional 1 000 effective steps per day, the difference between baseline and endpoint increased by 0.028 kg/m2 [β (95%CI ): -0.028 (-0.035,-0.020)] in BMI and 0.062 cm [β (95%CI):-0.062 (-0.091,-0.033)] in waist circumference. The likelihood of progressing into overweight or obesity was 0.97 times [ OR (95%CI ): 0.97(0.95, 0.98)] that of before?intervention, and the likelihood of becoming central obesity was 0.98 times [OR (95%CI): 0.98(0.96, 0.99)] that of before?intervention. Compared to subjects with low level percent of fulfilling continuous walking per day, those with high level would have an extra decrease in BMI by 0.150 kg/m2 [β (95%CI):-0.150 (-0.22,-0.079)], in waist circumference by 0.340 cm [β (95%CI ):-0.340 (-0.620,-0.064)], and the likelihood of becoming overweight or obesity decreased to 0.74 times that of the low level group [ OR (95%CI ): 0.74(0.62, 0.89)] and the likelihood of becoming central obesity decreased to 0.78 times that of the low level group [ OR (95%CI ): 0.78 (0.68, 0.91)]. Conclusion Strengthening walking exercise in the short term has a positive effect on promoting working population to reduce BMI and waist circumference, and prevent overweight, obesity and central obesity.

Objective To quantify the effects of short?term walking intervention on body mass index (BMI), waist circumference, and related indicators of working population. Methods The China Motivational Healthy Walking Program in 2016 recruited 29 224 individuals from 139 demonstration areas for comprehensive prevention and control of chronic and non?communicable diseases at the national level and 70 areas at the provincial level. All subjects volunteered to participate into this program. The intervention lasted 100 days from June to September 2016. The walking behavior, height, weight and waist circumference of subjects were measured using a uniform pedometer, body composition tester, height tester and waist?to?hip caliper before and after the intervention. Daily average steps, daily average effective steps, and the percent of fulfilling continuous walking per day were used as main indicators in this study. Self?administered questionnaires were used to collect demographic characteristics, behaviors and chronic diseases. With the adjustment of potential confounding factors, multilevel regression was used to quantify the effect of walking on BMI and waist circumference, and multilevel logistic regression was used to quantify the effect on overweight or obesity and central obesity. Results A total of 12 368 subjects completed walking interventions and all measurements included in this study. The mean ± SD age of all subjects was (41.19 ± 8.99) years, and 5 155 (59.17%) of them were women. After 100?day intervention, all outcome variables decreased significantly. For every additional 1 000 steps per day, subjects would have extra decrease in BMI of 0.023 kg/m2 [β (95%CI ): -0.023 (-0.030, -0.017)], in waist circumference of 0.046 cm [β (95%CI ):-0.046 (-0.071, -0.020)], and the likelihood for becoming overweight or obesity was 0.97 times [OR (95%CI): 0.97 (0.95, 0.98)] that of before intervention. With additional 1 000 effective steps per day, the difference between baseline and endpoint increased by 0.028 kg/m2 [β (95%CI ): -0.028 (-0.035,-0.020)] in BMI and 0.062 cm [β (95%CI):-0.062 (-0.091,-0.033)] in waist circumference. The likelihood of progressing into overweight or obesity was 0.97 times [ OR (95%CI ): 0.97(0.95, 0.98)] that of before?intervention, and the likelihood of becoming central obesity was 0.98 times [OR (95%CI): 0.98(0.96, 0.99)] that of before?intervention. Compared to subjects with low level percent of fulfilling continuous walking per day, those with high level would have an extra decrease in BMI by 0.150 kg/m2 [β (95%CI):-0.150 (-0.22,-0.079)], in waist circumference by 0.340 cm [β (95%CI ):-0.340 (-0.620,-0.064)], and the likelihood of becoming overweight or obesity decreased to 0.74 times that of the low level group [ OR (95%CI ): 0.74(0.62, 0.89)] and the likelihood of becoming central obesity decreased to 0.78 times that of the low level group [ OR (95%CI ): 0.78 (0.68, 0.91)]. Conclusion Strengthening walking exercise in the short term has a positive effect on promoting working population to reduce BMI and waist circumference, and prevent overweight, obesity and central obesity.

Objective: To examine the effects and associated factors of the China Motivational Healthy Walking Program among occupational population. Methods: The 2016 China Motivational Healthy Walking Program recruited 29 224 participants from 139 demonstration areas for comprehensive prevention and control of chronic and non-communicable disease at national level and 70 at provincial level. Intervention on walking was carried out by adopting group and individual motivating measures. Walking steps were recorded by electronic pedometer. We used percent of days achieving 10 000 steps (P10 000), percent of days fulfilling continuous walking (PCW), and proportion of valid walking (PVW) steps to reflect walking quantity, pattern and quality of participants. Motivation intensity was measured by summing up scores of each motivating activity. Questionnaire-based online survey collected information about demographic characteristics, lifestyle risk factors and chronic diseases. This study finally included 12 368 individuals in the analysis. Multilevel logistic regression model was used to assess the effect of group and individual motivating measures on walking activity and corresponding associated factors. Results: Age of the study sample was (41.2±8.99) years, and 58.17% (7 194) of them were female. After 100-day intervention, the P10 000, PCW and PVW of all participants were 93.89%±14.42%,92.01%±15.97% and 81.00%±7.45%, respectively. The mean P10 000 and PCW increased with rising group-motivated scores, self-motivated scores and individual-activity scores (P<0.001 for all). The mean PVW decreased with both higher group-motivated scores and self-motivated scores (both P<0.05), and varied little among groups with different level individual-activity scores (P=0.525). According to the results from the multilevel model, those who had greater group-motivated scores and self-motivated scores tended to have more likelihood of high-level of P10 000 and PCW. Age, sex, smoking status, education attainment and alcohol drinking were associated with P10 000 and PCW (P<0.05 for all). Conclusion The Motivational Healthy Walking Program had positive effect on promoting healthy walking among occupational population. Group-motivated and self-motivated activities were associated with healthy walking.

Objective To explore the clinical value of serum cathepsin L (CL),matrix metalloproteinase-9 (MMP-9) and heparanase (Hpa) detection in determining the degree of ovarian cancer invasion and metastasis.Methods Enzyme-linked inmunosorbent assay (ELISA) and electrochemiluminescencl immunoassay (ECLIA) were used to detect the serum content of MMP-9,Hpa,CL in 217 cases with untreated ovarian cancer before surgery( in FIGO Ⅰ - Ⅱ stage 83 cases,Ⅲ-Ⅳstage 134 cases),100 cases with benign ovarian tumors and 101 healthy women control.All of the patients from Guangxi Medical University Affiliated Tumor Hospital,from September 2003 to October 2009.The relationship between the clinical pathological factors of ovarian cancer and serum content of MMP-9,Hpa,CL was analyzed.On the basis of clinical pathological diagnosis as “gold standard”,the ROC curves was drawed to evaluate the clinical value of serum CL,MMP-9,Hpa combined detection in determining the degree of ovarian cancer invasion and metastasis before surgery.Results The serum content of CL,MMP-9 and Hpat in patients with ovarian cancer were (21.23 ± 8.17),( 193.95 ± 42.49),(7.68 ± 2.32) μg/L respectively,which was higher than that in patients with benign ovarian tumors [ ( 10.97 ± 3.84),( 143.66 ± 28.47),( 4.86 ± 1.37) μg/L respectively ] and normal control [ (5.59 ± 1.75),( 57.99 ± 1 1.42),( 2.77 ± 0.80) μg/L respectively ],there was difference statistically significant ( t value CL was - 13.242,- 13.498 respectively; MMP-9 was - 14.521 and - 21.290 respectively; Hpa was - 10.896 and - 18.280 respectively,P ＜ 0.001).The serum content of CL [ ( 21.59 ± 8.24) μg/L ] in patients with epithelial ovarian cancer ( EOC) was significantly higher than that [ ( 19.57 ± 7.69) μg/L ] in non-epithelial carcinoma ( F =1 1.209,P =0.048).The serum CL,MMP-9 and Hpa content in FIGO Ⅰ -Ⅱ stage patients was (19.66 ± 7.83),(182.63 ±42.30),(7.21 ±2.05) μg/L,which was lower than that (22.64 ±8.31),(202.81 ±39.74),(8.51 ± 1.92) μg/L in FIGO Ⅲ-Ⅳ stage patients ( F value was 12.452,70.565 and 195.122respectively,P value was 0.030,0.002 and 0.000 respectively).In patients with EOC,the serum CL,MMP-9 and Hpa content in eases with poorly differentiated was ( 23.04 ± 7.67),( 200.12 ± 40.82),(8.22 ± 1.92) μg/L respectively,which was also higher than that in cases with high-moderate differentiated [ ( 18.54 ± 7.30),( 173.43 ± 39.37),(7.20 ± 2.51) iμg/L respectively;F value was 24.545,60.286 and 9.077 respectively; P was 0.004,0.035 and 0.001 respectively ].The serum content of CL and MMP-9(22.96 ± 8.41),(200.44 ±43.82) μg/L respectively in patients with invasion and metastasis in the abdominal cavity was higher than that without invasion and metastasis in the abdominal cavity [ ( 19.07 ±7.36),( 181.04 ± 36.10) μg/L,F value was 12.210,18.084 ; P value was 0.030,0.010 ] ; There was statistically significant relatioship between serum levels of Hpa and patients with distant metastasis ( F =9.430,P =0.042).On base of pathological diagnosis as gold standard,ROC curve showed the sensitivity was 60.9％ (70/115),69.6％ ( 80/115) and 72.2％ ( 83/115) and specificity was 57.4％ ( 26/62),67.2％(20/62) and 68.9％ (19/62),as serum levels of CL,Hpa,MMP-9 preoperative were detected as tumor markers to determine whether there was cancer invasion and metastasis outside the pelvis.Conclusions There is related with CL,MMP-9 and Hpa levels increase and tumor occurrence and progression in ovarian cancer.The serum content of MMP-9,Hpa,CL detection would be certain clinical reference value to determine extent of invasion and metastasis of ovarian cancer before surgery.