Objective:To evaluate the effects of different doses of sufentanil on the pupillary dilation reflex (PDR) during induction of general anesthesia.Methods:In this randomized controlled study, 124 patients of either sex, aged 18-64 yr, with a body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, undergoing surgery with general anesthesia, were divided into 4 groups ( n=31 each) using a random number table method: control group (group C) and different doses of sufentanil groups (S1-S3 groups). Sufentanil 0.2, 0.4 and 0.6 μg/kg were intravenously injected in S1-S3 groups, respectively, and the equal volume of normal saline was injected instead in group C. Tetanic stimulation (50 mA, 50 Hz, 5 s) was applied at 5 min after injection of sufentanil. Pupil diameter was measured and the pupillary dilation value and dilation rate were calculated upon entering the operating room while awake, after loss of consciousness, 5 min after intravenous injection of sufentanil, and at maximal pupil diameter after tetanic stimulation. The presence or absence of PDR, PDR latency and PDR duration were also recorded. Results:The pupillary dilation values and dilation rates decreased progressively from group C through groups S1 to S3 ( P<0.05). Compared to group C, the disappearance rate of PDR was significantly increased, and the latency of PDR was prolonged in groups S2 and S3, and the duration of PDR was significantly shortened in groups S1-S3 ( P<0.05). Compared to group S1, the disappearance rate of PDR was significantly increased, and the latency of PDR was prolonged in S2 and S3 groups ( P<0.05). Conclusions:The inhibitory effect of sufentanil on the PDR during induction of general anesthesia is dose-dependent.

Musculoskeletal disorders (MSDs) are characterized by extensive pathological involvement and high prevalence and cause a significant disease burden. Long-term drug administration often causes by adverse effects with poor therapeutic efficacy. Low-intensity pulsed ultrasound (LIPUS), as a specialized therapeutic modality, delivers acoustic energy at a low intensity in a pulsed wave mode, thus ensuring stable energy transmission to the target tissues while minimizing thermal effects. This non-invasive approach has demonstrated significant potential for MSD treatment by delivering effective physical stimulations. Extensive animal and clinical studies have demonstrated the efficacy of LIPUS for accelerating the healing process of fresh fractures and nonunions, promoting soft tissue regeneration and suppressing inflammatory responses. Emerging evidence suggests promising applications of LIPUS in skeletal muscle injury treatment and promoting tissue regeneration and repair. This review outlines the recent advancements and mechanistic studies of LIPUS for treatment of common MSDs including fractures, nonunions, muscle injuries, and osteoarthritis, addressing also the technical parameters of commercially available LIPUS devices, current therapeutic approaches, the existing challenges, and future research directions.
Humans ; Ultrasonic Therapy/methods* ; Musculoskeletal Diseases/therapy* ; Ultrasonic Waves ; Osteoarthritis/therapy* ; Muscle, Skeletal/injuries*

Objective To investigate the relationship between ferroptosis-related genes[heme oxygenase-1(HO-1),solute carrier family 7 member 11(SLC7A11),and long-chain acyl-coenzyme A synthetase 4(ACSL4)]expression and cardiovascular events in patients with chronic renal failure(CRF),aiming to pro-vide clinical insights for risk assessment of cardiovascular complications.Methods A total of 124 CRF pa-tients(CRF group)admitted to the hospital from January 2020 to January 2023 and 124 healthy people(con-trol group)who underwent physical examination in the hospital during the same period were selected as the research objects.The levels of ferroptosis-related gene HO-1,SLC7A11 and ACSL4 were detected and com-pared between the two groups.CRF patients were followed up for 12 months after discharge,and they were di-vided into concurrent group(n=56)and non-concurrent group(n=66)according to the occurrence of cardio-vascular events.Spearman correlation analysis was used to investigate the correlation between iron death relat-ed genes HO-1,SLC7A11,ACSL4 and cardiovascular events in CRF patients.Univariate and multivariate Lo-gistic regression analysis were used to investigate the influencing factors of cardiovascular events in CRF pa-tients.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of iron death re-lated genes HO-1,SLC7A11,and ACSL4 for cardiovascular events in CRF patients.Results Serum HO-1 and SLC7A11 levels in CRF group were lower than those in control group(P＜0.05),and the ACSL4 level was higher than that in control group(P＜0.05).The serum HO-1 and SLC7A11 levels in concurrent group were lower than those in non-concurrent group(all P＜0.05),and the serum ACSL4 level was higher than that in non-concurrent group(P＜0.05).Ferroptosis-related genes HO-1 and SLC7A11 were negatively correlated with cardiovascular events(r=-0.708,—0.721,P＜0.05),while ACSL4 was positively correlated with car-diovascular events(r=0.699,P＜0.05).High serum ACSL4 expression and high cTnT level were risk fac-tors for cardiovascular events in CRF patients(P＜0.05),and high hemoglobin level and high serum HO-1 and SLC7A11 expression were protective factors for cardiovascular events in CRF patients(P＜0.05).ROC curve analysis results showed that the area under the curve(AUC)of serum HO-1,SLC7A11,ACSL4,hemo-globin and cTnT alone for predicting cardiovascular events in CRF patients were 0.787,0.735,0.773,0.651 and 0.782,respectively.The AUC of the combined prediction of ferroptosis-related genes was 0.837,and the AUC of the combined application of five factors was 0.880.According to Delong's test,the AUC of both com-bined application models was significantly higher than those of individual application(P＜0.05).The nomo-gram model showed that all ferroptosis-related genes were positively expressed(HO-1＜1.5,SLC7A11＜1.15,ACSL4≥2.75),and the risk of developing concurrent cardiovascular events in CRF patients could reach over 75％.Conclusion The expression of serum HO-1 and SLC7A11 in CRF patients is decreased,and the ACSL4 expression is increased,which is closely related to cardiovascular events,and the combined detection of three indexes has high value in predicting cardiovascular events in CRF patients.

Objective:To evaluate the effects of different doses of sufentanil on the pupillary dilation reflex (PDR) during induction of general anesthesia.Methods:In this randomized controlled study, 124 patients of either sex, aged 18-64 yr, with a body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, undergoing surgery with general anesthesia, were divided into 4 groups ( n=31 each) using a random number table method: control group (group C) and different doses of sufentanil groups (S1-S3 groups). Sufentanil 0.2, 0.4 and 0.6 μg/kg were intravenously injected in S1-S3 groups, respectively, and the equal volume of normal saline was injected instead in group C. Tetanic stimulation (50 mA, 50 Hz, 5 s) was applied at 5 min after injection of sufentanil. Pupil diameter was measured and the pupillary dilation value and dilation rate were calculated upon entering the operating room while awake, after loss of consciousness, 5 min after intravenous injection of sufentanil, and at maximal pupil diameter after tetanic stimulation. The presence or absence of PDR, PDR latency and PDR duration were also recorded. Results:The pupillary dilation values and dilation rates decreased progressively from group C through groups S1 to S3 ( P<0.05). Compared to group C, the disappearance rate of PDR was significantly increased, and the latency of PDR was prolonged in groups S2 and S3, and the duration of PDR was significantly shortened in groups S1-S3 ( P<0.05). Compared to group S1, the disappearance rate of PDR was significantly increased, and the latency of PDR was prolonged in S2 and S3 groups ( P<0.05). Conclusions:The inhibitory effect of sufentanil on the PDR during induction of general anesthesia is dose-dependent.

Objective:To understand the current status of self-management positivity of postoperative patients with esophageal cancer and to analyze its influencing factors.Methods:From August 2022 to September 2023, 158 postoperative patients with esophageal cancer at Sun Yat-sen University Cancer Prevention and Control Center were selected by convenience sampling method, and were investigated using a general information questionnaire, Patient Activation Measure (PAM), Fear of Progression Questionnaire Short Form (FOP-Q-SF), and Family APGAR Index (IAPGAR) for a cross-sectional survey, and multiple linear regression was used to analyze the influencing factors of the self-management positivity in patients with postoperative esophageal cancer.Results:Totally 144 questionnaires were effectively collected, of which 106 males and 38 females, with 22 cases aged 18-39 years old, 55 cases aged 40-59 years old, and 67 cases aged ≥ 60 years old. Totally 144 patients scored (59.61 ± 16.07) points on the PAM, (40.45 ± 9.76) on the FOP-Q-SF, and (11.41 ± 2.36) on the IAPGAR, and the results of the multiple linear regression analysis showed that the literacy level, fear of disease progression, and family caring index were the influencing factors of the positivity of the patients′ self-management after the surgery of esophageal cancer ( t=2.54, -13.49, 2.45, all P<0.05). Conclusions:There is always room for improvement in the degree of active self-management of postoperative patients with esophageal cancer. Clinical care workers should pay close attention to the current status of self-management positivity of postoperative patients with esophageal cancer, and formulate a systematic, scientific, and effective intervention strategy for self-management positivity.

OBJECTIVE To explore the changes in chemical compositions and the characteristics of “fried charcoal and saving properties” based on the carbon-frying process of Sophora japonica and its bud. METHODS The slightly， moderately and heavily carbon-fried samples of S. japonica and its bud were prepared. The fingerprints of S. japonica， its bud and carbon-fried samples were established， and common peaks were identified. HPLC method was used to determine the contents of identified components and differential analysis was also performed； the differential components were screened by using chemometric methods， and their content ratios were used to characterize the “fried charcoal and saving properties” of S. japonica and its bud. RESULTS There were 9 common peaks in the fingerprints of S. japonica and its carbon-fried samples， 8 common peaks in those of S. japonica bud and its carbon-fried samples. In the fingerprints of S. japonica and its bud， and their different fried products， 6 components were identified， such as rutin， kaempferol-3-O-rutinoside， isorhamnetin-3-O-rutinoside， quercetin， kaempferol，isorhamnetin. Among them， the contents of rutin， kaempferol-3-O-rutinoside and isorhamnetin-3-O-rutinoside were the highest in slightly carbon-fried samples of S. japonica bud， and the contents of quercetin and isorhamnetin were the highest in moderately carbon-fried samples of S. japonica bud， and the contents of kaempferol were higher in moderately and healily carbon-fried samples of S. japonica bud. The chemometric results showed that the variable importance projection values of rutin and quercetin were both greater than 1. The range of rutin-quercetin content ratio between 9.00-14.00 and 3.00-6.00 respectively could characterize “fried charcoal and saving properties” of S. japonica and its bud. CONCLUSIONS There are significant differences in the chemical compositions of raw and fried products of S. japonica and its bud. Rutin and quercetin may be the differential components that affect their quality， and the ratio range of the two can be used to characterize the “fried charcoal and saving properties” of S. japonica and its bud in the future.

Objective:To explore the occurrence and influencing factors of post-burn psychological stress disorder in preschool children.Methods:This study was a multi-center cross-sectional survey. From January 2022 to February 2023, 85 preschool children (aged 1 to 6 years) with burns admitted to the Affiliated Hospital of North Sichuan Medical College, Nanchong Central Hospital, Suining Central Hospital, Guang'an People's Hospital, and Guangyuan Central Hospital who met the inclusion criteria were selected as respondents. A self-made general information questionnaire was used to investigate the children's general data including gender, age group, residential area, main caregiver and their education level, and family type, as well as the injury condition including cause of injury and burn severity. The Child Stress Disorders Checklist was used to investigate the occurrence of psychological stress disorder in children at 3 days to 1 month after injury, and the incidence rate was calculated. The children were classified according to their general data and injury condition, and the occurrence of psychological stress disorder in children at 3 days to 1 month after injury was recorded, and the influencing factors for post-burn psychological stress disorder in preschool children were screened.Results:A total of 85 questionnaires were distributed and 85 valid questionnaires were recovered, with an effective recovery rate of 100%. Among the children, there were 45 boys and 40 girls, with most children aged 1 to 3 years. There were slightly more children in rural areas than in cities. About half of the children were mainly cared for by their parents and grandparents, respectively, and the education level of the main caregivers was mainly high school/technical secondary school. The family type was mainly core family and extended family. The main cause of injury was hydrothermal scald, and the severity of burns was mainly moderate. The incidence rate of psychological stress disorder in this group of children at 3 days to 1 month after injury was 34.12% (29/85). There were statistically significant differences in the occurrence of psychological stress disorder in children with different age groups, causes of injuries, and burn severity at 3 days to 1 month after injury (with χ2 values??of 9.18, 7.80, and 25.47, respectively, P<0.05); there were no statistically significant differences in the occurrence of psychological stress disorder in children with different genders, residential area, main caregivers, main caregivers' education levels, or family types at 3 days to 1 month after injury ( P>0.05). Multivariate logistic regression analysis showed that age group and burn severity were independent influencing factors for the occurrence of psychological stress disorder in preschool children after burns (with odds ratios of 8.21 and 33.99, respectively, and 95% confidence intervals of 1.57-43.04 and 5.55-207.93, respectively, P<0.05), the older the child and the more severe the burn, the higher the possibility of the occurrence of psychological stress disorder. Conclusions:The incidence rate of psychological stress disorder is high in preschool children after burns. Age group and burn severity are independent influencing factors for the occurrence of post-burn psychological stress disorder in this type of children.

Objective To analyze the influencing factors of aspiration risk in patients with acute poisoning during gastric lavage,and to build and validation a prediction model of aspiration risk in patients with acute poisoning during gastric lavage.Methods Through literature search and analysis,the risk factors of aspiration during gastric lavage was summarized in patients with acute poisoning.A retrospective study was conducted on patients with acute poisoning in the emergency department of a tertiary A general hospital in Ningbo from January 2020 to June 2023.Through R 4.2.1 and Python 3.11 programming language,the random forest,logistic regression,extreme gradient boosting tree and gradient boosting decision tree algorithms in machine learning were used to establish a prediction model of aspiration risk during gastric lavage in patients with acute poisoning and carry out internal verification.The prediction effects of the 4 prediction models were evaluated by confusion matrix,calibration curve,receiver operating characteristic curve,area under curve,Kolmogorov-Smirnov value,accuracy,precision,recall rate and F1 score,and the best model was selected.Results The modeling results of the 4 machine learning algorithms show that the area under the curve of the Random Forest,Logistic Regression,Extreme Gradient Boosting Tree,and Gradient Boosting Decision Tree algorithms are 0.954(0.934～0.974),0.878(0.843～0.913),0.910(0.880～0.939),and 0.917(0.889～0.945),respectively.The internal validation results show that the area under the curve of the random forest,logistic regression,extreme gradient boosting tree,and gradient boosting decision tree algorithms are 0.910(0.864～0.955),0.877(0.824～0.931),0.849(0.790～0.908),and 0.873(0.819～0.928),respectively.Age,state of consciousness,D-dimer and the time of absorption of poison are the 3 characteristics that are particularly prominent in the order of importance of the influencing factors of aspiration during gastric lavage in patients with acute poisoning.Conclusion Among the 4 prediction models,random forest model has better prediction effect,with good discrimination ability for the risk of aspiration during gastric lavage in patients with acute poisoning,and it is convenient for clinical use,which can provide references for medical staff to take preventive treatment and care.

Background There is a lack of research evidence on the association between sugar-sweetened beverage (SSB) consumption and gestational diabetes mellitus (GDM) in China. Objective To explore the association between frequency of SSB consumption before pregnancy and risk of GDM in pregnant women in Shaanxi Province, and to provide a scientific basis for targeted interventions to control maternal blood glucose. Methods The recruitment to the China Birth Cohort study started in October 2020. Pregnant women at 6-16 weeks who had their first prenatal examination at five hospitals in Shaanxi Province were recruited. A maternal health questionnaire was used to collect basic information about pregnant women. A semi-quantitative food frequency questionnaire was used to collect the consumption of carbonated beverages, fruit and vegetable juice beverages, coffee beverages, and milk tea beverages in one year before pregnancy, which were summed to obtain the SSB consumption. Pregnant women were divided into three groups according to SSB consumption, namely <1 serving·week⁻¹, 1-4 servings·week⁻¹, and ≥5 servings·week⁻¹. GDM was confirmed by oral glucose tolerance test (OGTT) between 24-28 weeks of gestation. A binary logistic regression model was applied to explore the association between SSB consumption and risk of GDM. Multiple linear regression was applied to investigate the associations between SSB consumption (per 1-serving·d⁻¹ increase) and OGTT fasting plasma glucose, 1-hour glucose, and 2-hour glucose. Results A total of 3811 pregnant women were finally enrolled in this study, of which 752 developed GDM, with an incidence rate of 19.7%. The incidence rates of GDM in pregnant women with SSB consumption frequency of <1 serving·week⁻¹, 1-4 servings·week⁻¹, and ≥5 servings·week⁻¹ were 18.0%, 21.1%, and 26.8%, respectively. After adjusting for maternal age, pre-pregnancy body mass index (BMI), education, number of children born, family history of diabetes, smoking, alcohol consumption, physical activity level, and total energy intake, the risk of GDM increased by 26% (OR=1.26, 95%CI: 1.05, 1.50) in the 1-4 servings·week⁻¹ group and by 76% (OR=1.76, 95%CI: 1.31, 2.38) in the ≥5 servings·week⁻¹ group compared to the <1 serving·week⁻¹ SSB consumption group, respectively. Further stratified analysis revealed no interaction effect (P_interaction>0.05) between SSB consumption and maternal age, pre-pregnancy BMI, or first labor or not. For each additional SSB consumption per day, the risk of GDM increased by 94% (OR=1.94, 95%CI: 1.37, 2.75); and the maternal OGTT 1-hour glucose and 2-hour glucose increased by 0.33 mmol·L⁻¹ and 0.18 mmol·L⁻¹, respectively (P<0.05), and no significant increase in fasting plasma glucose was found (P>0.05). Conclusion Higher SSB consumption before pregnancy increases the risk of GDM in pregnant women.

OBJECTIVE To study the correlation between processing time, chroma value and UPLC fingerprint map of Dipsaci Radix. METHODS Established the UPLC fingerprint of Dipsaci Radix. Monitored the changes of chemical components in the processing process of wine and salt processed Dipsaci Radix, spectrophotometer was used to objectively quantify the chroma value of different processed products. SPSS 20.0 and SIMCA 14.0 statistical software was used to analyze the correlation between processing time and chroma value and fingerprint. RESULTS In the process of processing, the decoction pieces color of the powder deepened and L*, b* and E* values decreased. The correlation analysis showed that the processing time was significantly correlated with the chroma value and fingerprint of decoction pieces. CONCLUSION The method of UPLC fingerprint is stabled and reliabled, combines with the objective discriminant analysis of the chroma value of the Dipsaci Radix processed products, which lay the foundation for standardizing the processing technology of wine and salt processed products and evaluating the quality of Dipsaci Radix.