Objective:To evaluate the effect of exogenous short-chain fatty acids (SCFAs) preconditioning on the expression of zonula occludens-1 (ZO-1) in lung tissues of rats undergoing extracorporeal circulation (ECC).Methods:Thirty-six clean-grade healthy adult male Sprague-Dawley rats, weighing 320-420 g, were divided into sham operation group (S group), ECC group (E group) and SCFAs group, with 12 rats in each group. Seven days before the ECC, short-chain fatty acids dissolved in 2 ml of normal saline was given by gavage daily in SCFAs group, while the equal volume of normal saline was given by gavage in S group and E group. On the 8th day, E group and SCFAs group underwent arteriovenous catheterization and ECC for 1 h, while S group only underwent catheterization without ECC. Lung tissues were collected to observe the pathological results and detect the expression of ZO-1 (by Western blot), and the wet/dry lung weight ratio was calculated.Results:Compared with S group, the wet/dry lung weight ratio was significantly increased ( P<0.05), the expression of ZO-1 protein in lung tissue was down-regulated ( P<0.05), and the pathological damage of lung tissues was aggravated in E group and SCFAs group. Compared with E group, the wet/dry lung weight ratio was significantly decreased, the expression of ZO-1 protein in lung tissues was up-regulated ( P<0.05), and the pathological damage of lung tissues was significantly alleviated in SCFAs group. Conclusions:The mechanism by which SCFAs preconditioning attenuates lung injury may be related to up-regulation of ZO-1 expression in lung tissues of rats undergoing ECC.

Objective To compare the safety and adverse effects of esketamine alone or fentanyl combined with propofol for interventional occlusion of congenital heart disease in children,so as to provide a more suitable sedation and analgesia plan for these patients.Methods A prospective randomized controlled study was adopted.A total of 104 cases of congenital heart disease,including 53 cases of atrial septal defect(ASD),31 cases of ventricular septal defect(VSD),and 20 cases of patent ductus arteriosus(PDA),who underwent interventional occlusion under general anesthesia while preserving spontaneous breathing from January to March 2025,were taken as the research subjects.The children were divided into two groups by random number table method:esketamine group(group ES)and fentanyl+propofol group(group AP),with 52 cases in each group.The children in the group ES and the group AP were anesthetized by esketamine 0.5 mg/kg and fentanyl 2 ug/kg+propofol 2.5 mg/kg,respectively,and sevoflurane inhalation anesthesia was maintained during the operation.The mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR)and pulse oxygen saturation(SpO2)were recorded at the time of entry(T0),1 min after induction of general anesthesia(T1),femoral artery puncture(T2),occluder insertion(T3),recovery(T4),and 10 min after recovery(T5).The operation time,dosage of sevoflurane,anesthesia induction time and recovery time of the two groups were recorded.The occurrence of adverse events during general anesthesia was recorded,including hypoxemia after general anesthesia induction,respiratory depression and intraoperative body movement,restlessness during the recovery period,and increased secretion during the recovery period.Results There were significant differences in MAP,HR,SpO2 and RR in time points within each group,between two groups,and across the time×group interaction(P<0.05).There was no significant difference in operation time,dosage of sevoflurane,anesthesia induction time,and recovery time between the two groups(P>0.05).The incidence of hypoxemia in the group ES was significantly lower than that in the group AP[1.9%(1/52)vs.28.9%(15/52),χ2=14.477,P=0.000],the incidence of respiratory depression in the group ES was significantly lower than that in the group AP[0.0%(0/52)vs.11.5%(6/52),P=0.027],and the incidence of intraoperative body movement in the group ES was significantly lower than that in the group AP[0.0%(0/52)vs.11.5%(6/52),P=0.027].Conclusions During the three interventional occlusion procedures for congenital heart disease in children,compared with fentanyl combined with propofol injection,esketamine can better maintain the stability of respiratory circulation,and has a lower incidence of adverse events such as intraoperative hypoxemia,respiratory depression and intraoperative body movement.Compared with traditional anesthetic drugs,eketamine can be used as a better choice for sedation and analgesia during interventional occlusion for the three types of congenital heart diseases in children.

Objective:To evaluate the effect of exogenous short-chain fatty acids (SCFAs) preconditioning on the expression of zonula occludens-1 (ZO-1) in lung tissues of rats undergoing extracorporeal circulation (ECC).Methods:Thirty-six clean-grade healthy adult male Sprague-Dawley rats, weighing 320-420 g, were divided into sham operation group (S group), ECC group (E group) and SCFAs group, with 12 rats in each group. Seven days before the ECC, short-chain fatty acids dissolved in 2 ml of normal saline was given by gavage daily in SCFAs group, while the equal volume of normal saline was given by gavage in S group and E group. On the 8th day, E group and SCFAs group underwent arteriovenous catheterization and ECC for 1 h, while S group only underwent catheterization without ECC. Lung tissues were collected to observe the pathological results and detect the expression of ZO-1 (by Western blot), and the wet/dry lung weight ratio was calculated.Results:Compared with S group, the wet/dry lung weight ratio was significantly increased ( P<0.05), the expression of ZO-1 protein in lung tissue was down-regulated ( P<0.05), and the pathological damage of lung tissues was aggravated in E group and SCFAs group. Compared with E group, the wet/dry lung weight ratio was significantly decreased, the expression of ZO-1 protein in lung tissues was up-regulated ( P<0.05), and the pathological damage of lung tissues was significantly alleviated in SCFAs group. Conclusions:The mechanism by which SCFAs preconditioning attenuates lung injury may be related to up-regulation of ZO-1 expression in lung tissues of rats undergoing ECC.

Objective To compare the safety and adverse effects of esketamine alone or fentanyl combined with propofol for interventional occlusion of congenital heart disease in children,so as to provide a more suitable sedation and analgesia plan for these patients.Methods A prospective randomized controlled study was adopted.A total of 104 cases of congenital heart disease,including 53 cases of atrial septal defect(ASD),31 cases of ventricular septal defect(VSD),and 20 cases of patent ductus arteriosus(PDA),who underwent interventional occlusion under general anesthesia while preserving spontaneous breathing from January to March 2025,were taken as the research subjects.The children were divided into two groups by random number table method:esketamine group(group ES)and fentanyl+propofol group(group AP),with 52 cases in each group.The children in the group ES and the group AP were anesthetized by esketamine 0.5 mg/kg and fentanyl 2 ug/kg+propofol 2.5 mg/kg,respectively,and sevoflurane inhalation anesthesia was maintained during the operation.The mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR)and pulse oxygen saturation(SpO2)were recorded at the time of entry(T0),1 min after induction of general anesthesia(T1),femoral artery puncture(T2),occluder insertion(T3),recovery(T4),and 10 min after recovery(T5).The operation time,dosage of sevoflurane,anesthesia induction time and recovery time of the two groups were recorded.The occurrence of adverse events during general anesthesia was recorded,including hypoxemia after general anesthesia induction,respiratory depression and intraoperative body movement,restlessness during the recovery period,and increased secretion during the recovery period.Results There were significant differences in MAP,HR,SpO2 and RR in time points within each group,between two groups,and across the time×group interaction(P<0.05).There was no significant difference in operation time,dosage of sevoflurane,anesthesia induction time,and recovery time between the two groups(P>0.05).The incidence of hypoxemia in the group ES was significantly lower than that in the group AP[1.9%(1/52)vs.28.9%(15/52),χ2=14.477,P=0.000],the incidence of respiratory depression in the group ES was significantly lower than that in the group AP[0.0%(0/52)vs.11.5%(6/52),P=0.027],and the incidence of intraoperative body movement in the group ES was significantly lower than that in the group AP[0.0%(0/52)vs.11.5%(6/52),P=0.027].Conclusions During the three interventional occlusion procedures for congenital heart disease in children,compared with fentanyl combined with propofol injection,esketamine can better maintain the stability of respiratory circulation,and has a lower incidence of adverse events such as intraoperative hypoxemia,respiratory depression and intraoperative body movement.Compared with traditional anesthetic drugs,eketamine can be used as a better choice for sedation and analgesia during interventional occlusion for the three types of congenital heart diseases in children.

Objective:To analyze the comprehensive blood inflammation index of the patients with stage I pneumoconiosis complicated with pulmonary infection, and to explore its value in predicting the patients' disease.Methods:In September 2023, 83 patients with stage I pneumoconiosis who were treated in Tianjin Occupational Diseases Precaution and Therapeutic Hospital from November 2021 to August 2023 were selected and divided into non-infected group (56 cases) and infected group (27 cases) according to whether they were combined with lung infection. Workers with a history of dust exposure but diagnosed without pneumoconiosis during the same period were selected as the control group (65 cases) . By referring to medical records and collecting clinical data such as gender, age, occupational history, past medical history, hematology testing, the differences in the comprehensive blood inflammation indexes among the three groups were compared, ROC curve was drawn, and the relationship between comprehensive blood inflammation indexes and stage I pneumoconiosis and its combined lung infection was analyzed.Results:There were significtant differences in the number of neutrophils (N) , the number of lymphocytes (L) , the number of monocytes (M) , C-reactive protein (CRP) , the neutrophil to lymphocyte ratio (NLR) , the monocyte to lymphocyte ratio (MLR) , the platelet to lymphocyte ratio (PLR) , the systemic immune-inflammatory index (SII) , the systemic inflammation response index (SIRI) , the aggregate index of systemic inflammation (AISI) , the derived neutrophil to lymphocyte ratio (dNLR) , the neutrophil to lymphocyte and platelet ratio (NLPR) , and the C-reactive protein to lymphocyte ratio (CLR) ( P<0.05) . Compared with the control group, MLR, SIRI and AISI in the non-infected group were significantly increased ( P<0.05) . NLR, MLR, PLR, SII, SIRI, AISI, dNLR, NLPR, CLR were significantly increased ( P<0.05) . Compared with the non-infected group, NLR, PLR, SII, SIRI, AISI, dNLR, NLPR and CLR were significantly increased in the infected group ( P<0.05) . ROC analysis showed that NLR, MLR, PLR, SII, SIRI and AISI had a certain predictive capability for stage I pneumoconiosis ( P<0.05) , among which MLR had the highest efficacy, with an AUC of 0.791 (95% CI: 0.710-0.873) , the cut-off value was 0.18, the sensitivity was 71.4%, and the specificity was 78.5%. NLR, MLR, PLR, SII, SIRI, AISI, dNLR, NLPR and CLR all had a certain predictive capability forstage I pneumoconiosis combined lung infection ( P<0.05) , among which CLR had the highest efficacy, with an AUC of 0.904 (95% CI: 0.824~0.985) , the cut-off value was 5.33, sensitivity was 77.8%, specificity was 98.2%. Conclusion:The comprehensive blood inflammation index may be an auxiliary predictor of stage I pneumoconiosis and its combined lung infections.

Objective:To analyze the comprehensive blood inflammation index of the patients with stage I pneumoconiosis complicated with pulmonary infection, and to explore its value in predicting the patients' disease.Methods:In September 2023, 83 patients with stage I pneumoconiosis who were treated in Tianjin Occupational Diseases Precaution and Therapeutic Hospital from November 2021 to August 2023 were selected and divided into non-infected group (56 cases) and infected group (27 cases) according to whether they were combined with lung infection. Workers with a history of dust exposure but diagnosed without pneumoconiosis during the same period were selected as the control group (65 cases) . By referring to medical records and collecting clinical data such as gender, age, occupational history, past medical history, hematology testing, the differences in the comprehensive blood inflammation indexes among the three groups were compared, ROC curve was drawn, and the relationship between comprehensive blood inflammation indexes and stage I pneumoconiosis and its combined lung infection was analyzed.Results:There were significtant differences in the number of neutrophils (N) , the number of lymphocytes (L) , the number of monocytes (M) , C-reactive protein (CRP) , the neutrophil to lymphocyte ratio (NLR) , the monocyte to lymphocyte ratio (MLR) , the platelet to lymphocyte ratio (PLR) , the systemic immune-inflammatory index (SII) , the systemic inflammation response index (SIRI) , the aggregate index of systemic inflammation (AISI) , the derived neutrophil to lymphocyte ratio (dNLR) , the neutrophil to lymphocyte and platelet ratio (NLPR) , and the C-reactive protein to lymphocyte ratio (CLR) ( P<0.05) . Compared with the control group, MLR, SIRI and AISI in the non-infected group were significantly increased ( P<0.05) . NLR, MLR, PLR, SII, SIRI, AISI, dNLR, NLPR, CLR were significantly increased ( P<0.05) . Compared with the non-infected group, NLR, PLR, SII, SIRI, AISI, dNLR, NLPR and CLR were significantly increased in the infected group ( P<0.05) . ROC analysis showed that NLR, MLR, PLR, SII, SIRI and AISI had a certain predictive capability for stage I pneumoconiosis ( P<0.05) , among which MLR had the highest efficacy, with an AUC of 0.791 (95% CI: 0.710-0.873) , the cut-off value was 0.18, the sensitivity was 71.4%, and the specificity was 78.5%. NLR, MLR, PLR, SII, SIRI, AISI, dNLR, NLPR and CLR all had a certain predictive capability forstage I pneumoconiosis combined lung infection ( P<0.05) , among which CLR had the highest efficacy, with an AUC of 0.904 (95% CI: 0.824~0.985) , the cut-off value was 5.33, sensitivity was 77.8%, specificity was 98.2%. Conclusion:The comprehensive blood inflammation index may be an auxiliary predictor of stage I pneumoconiosis and its combined lung infections.

Objective To summarize the experience of anesthesia management of transapical transcatheter aortic valve replacement(TA-TAVR).Methods Clinical data of 60 cases of TA-TAVR in the Cardiovascular Surgery Department of our hospital from January 2023 to January 2024 were retrospectively analyzed,including 34 cases of aortic stenosis and 26 cases of aortic insufficiency.According to the New York Heart Association(NYHA)functional classification,there were 4 cases of class Ⅱ,11 cases of class Ⅲ,and 45 cases of class Ⅳ.According to the American Society of Anesthesiologists(ASA)classification,there were 12 cases of grade Ⅱ,44 cases of grade Ⅲ,2 cases of grade Ⅳ,and 2 cases of grade V.The European System for Cardiac Operative Risk Evaluation Ⅱ(EuroSCORE Ⅱ)score was 8.3％-54.1％[mean,(20.0±10.3)％].All the patients received general anesthesia with endotracheal intubation.Results Intraoperative ventricular fibrillation occurred in 3 cases.The median mechanical ventilation time of the 60 patients was 17 h(range,0-192 h),including 5 cases of 0 h(extubation in the operating room,which was ultra-fast track anesthesia),17 cases of extubation within 6 h after surgery(fast track anesthesia),31 cases of extubation between 6 and 48 h,and 7 cases of mechanical ventilation time＞48 h.Rescue analgesia after surgery was required in 8 cases.The median ICU stay time was 21 h(range,3-407 h),and the postoperative hospital stay was(7.8±4.5)d.Postoperative complications included 1 case of emergency thoracotomy because of artificial aortic valve dislocation,3 cases of permanent pacemaker implantation because of third-degree atrioventricular block,and 2 cases of tracheal intubation again because of hypoxemia.Conclusion Optimizing the anesthesia intervention measures(anesthesia details,anesthesia monitoring methods,and anesthesia analgesia plan)is helpful for early extubation,achieving ultra-fast track and fast track anesthesia of TA-TAVR.

Objective:To evaluate the improved efficacy of transversus thoracic muscle plane (TTP) block combined with general anesthesia for off-pump coronary artery bypass grafting (OP-CABG).Methods:Sixty American Society of Anesthesiologists physical status Ⅲ or Ⅳ patients of both sexes, aged 55-63 yr, weighing 65-81 kg, scheduled for elective OP-CABG, were divided into 2 groups ( n=30 each) using a random number table method: TTP block combined with general anesthesia group (group TG) and general anesthesia group (group G). Midazolam-propofol-sufentanil-rocuronium was used to induce anesthesia, and sevoflurane-remifentanil-propofol was used to maintain anesthesia.In group TG, ultrasound-guided TTP block was performed at 20 min before anesthesia induction, and 0.375% ropivacaine plus 0.5% lidocaine 20 ml was injected between bilateral intercostal and transverse pectoral muscles.Both groups received patient-controlled intravenous analgesia with sufentanil, oxycodone 0.05 mg/kg was intravenously injected as rescue analgesic, and the postoperative visual analogue scale scores were maintained≤ 4 points.The intraoperative consumption of remifentanil and propofol, consumption of sufentanil within 24 h after operation, and requirement for rescue analgesia were recorded.The postoperative length of stay in intensive care unit, time to first flatus, length of hospitalization, postoperative nausea/vomiting, lung inflammation, pruritus and nerve block-related complications were recorded. Results:Compared with group G, the consumption of intraoperative remifentanil and postoperative sufentanil after operation were significantly reduced, the requirement for postoperative rescue analgesia was decreased, the postanesthesia care unit stay time, length of hospitalization and time to first flatus were shortened, and the incidence of postoperative nausea/vomiting and lung inflammation was decreased in group TG ( P<0.05). No pruritus and nerve block-related complications were found in the two groups. Conclusion:Ultrasound-guided TTP block combined with general anesthesia can provide good perioperative analgesia for the patients undergoing OP-CABG and reduce the amount of opioids used, which is helpful in improving the prognosis.

Objective To evaluate the effect of sevoflurane on the expression of aquaporin 8 (AQP8) in the intestinal mucosa in a pig model of hemorrhagic shock.Methods Twenty-four Bama miniature pigs of both sexes, weighing 22-25 kg, were randomly divided into 3 equal groups using a random number table: sham operation group (group S), hemorrhagic shock group (group HS) and sevoflurane group (group PS).The femoral artery and jugular vein were cannulated for blood pressure monitoring, blood-letting, and blood sampling in anesthetized pigs.Hemorrhagic shock was induced by withdrawing blood from the right femoral artery.Hemorrhagic shock was induced after cannulation in group HS.In group PS, 2％ sevoflurane was inhaled for 30 min after the model of hemorrhagic shock was successfully established.Before anesthesia, and at 0.5, 1, 1.5, 2, 3 and 4 h after hemorrhagic shock, blood samples were collected from the jugular vein for determination of serum D-lactic acid and intestinal fatty acid-binding protein (I-FABP) concentrations.The animals were sacrificed at 4 h after hemorrhagic shock, and the intestinal specimens were obtained for microscopic examination and for determination of AQP8 expression in the intestinal mucosa (by enzyme-linked immunosorbent assay).The intestinal water content was calculated.Results Compared with group S, the serum D-lactic acid and I-FABP concentrations, AQP8 expression, and intestinal water content were significantly increased in HS and PS groups (P＜0.05).Compared with group HS, the serum D-lactic acid and I-FABP concentrations, AQP8 expression, and intestinal water content were significantly decreased in group PS (P＜0.05).The pathological changes of intestinal tissues were significantly reduced in group PS as compared with group HS.Conclusion Sevoflurane can decrease the intestinal mucosal edema through inhibiting AQP8 expression, thus reducing hemorrhagic shockinduced damage to the intestinal mucosa in pigs.

Objective To evaluate the effect of dexmedetomidine on lung injury induced by renal ischemia/reperfusion (l/R) in rats.Methods Healthy male Sprague-Dawley rats,aged 4-5 months,weighing 250-300 g,were randomized into 4 groups (n =10 each) using a random number table:sham operation group (group S); group I/R; dexmedetomidine pretreatment group (group D1) and dexmedetomidine postconditioning group (group D2).Renal I/R was induced by right nephrectomy and occlusion of the left kidney for 45 min followed by reperfusion in animals anesthetized with intraperitoneal chloral hydrate.In group D1,dexmedetomidine was infused intravenously starting from 30 min before ischemia until beginning of ischemia.In group D2,starting from onset of reperfusion until 30 min of reperfusion,dexmedetomidine was infused intravenously for 10 min at a rate of 1 μg· kg-1 · h-1,and then infused for 20 min at 0.5 μg· kg-1 · h 1.Blood samples were collected at 6 h of reperfusion to determine serum creatinine,blood urea nitrogen,interleukin-1β (IL-1β),IL-6 and tumor necrosis factor-α (TNF-α) concentrations,and IL-1β,IL-6 and TNF-α concentrations in broncho-alveolar lavage fluid (BALF).Lungs were removed for microscopic examination and for determination of wet/dry lung weight ratio.Results Compared with group S,wet/dry lung weight ratio,serum creatinine and blood urea nitrogen concentrations,and IL-1β,TNF-α and IL-6 concentrations in serum and BALF were significantly increased in the other three groups (P ＜ 0.05).The parameters mentioned above were significantly lower in D1 and D2 groups than in I/R group (P ＜ 0.05).Microscopic examination showed that the pathological changes were significantly attenuated in D1 and D2 groups as compared with I/R group.Conclusion Both dexmedetomidine pretreatment and postconditioning can attenuate lung injury induced by renal I/R and inhibition of inflammatory responses is involved in the mechanism.