Objective:To investigate the effect of preoperative continuous fascia iliaca compartment block (FICB) on perioperative opioids dosage and quality of postoperative recovery in elderly patients with frail.Methods:A prospective study method was used. Sixty elderly frail patients underwent selective unilateral femoral head replacement surgery from November 2022 to October 2024 in Sihui People′s Hospital were selected. The patients were divided into control group and FICB group by random digits table method with 30 cases each. The patients in control group did not receive continuous FICB before surgery, and the patients in FICB group received continuous FICB 1 d before surgery. The perioperative use of opioids and analgesic effect, operative time, intraoperative blood loss, postoperative hospital stay, quality of recovery-40 (QoR-40) score at discharge and postoperative complications were compared between the two groups.Results:A total of 57 patients completed the study, with 29 cases in the FICB group and 28 cases in the control group. There were no statistical differences in operative time, intraoperative blood loss and postoperative hospital stay between the two groups ( P>0.05). The sufentanil dosage of patient-controlled analgesia (PCA), perioperative nalbuphine dosage, frequency of perioperative visual analog score (VAS)>4 scores, rate of preoperative rescue analgesia, rate of postoperative rescue analgesia and pressing frequency of PCA in FICB group were significantly lower than those in control group: (94.1 ± 5.4) μg vs. (102.1 ± 6.1) μg, 0 (0, 0) mg vs. 10.0 (0, 20.0) mg, 3.0 (2.0, 5.0) times vs. 5.0 (4.0, 6.0) times, 3.4% (1/29) vs. 32.1% (9/28), 13.8% (4/29) vs. 39.3% (11/28) and 2.0 (1.0, 3.0) times vs. 4.0 (3.0, 5.0) times, and there were statistical differences ( P<0.01 or <0.05). The total QoR-40 score and physical comfort, pain scores in FICB group were significantly higher than those in control group: 156(153, 161) scores vs. 153 (148, 159) scores, 47 (45, 50) scores vs. 45 (43, 47) scores and 30 (29, 31) scores vs. 28 (25, 30) scores, and there were statistical differences ( P<0.05 or <0.01); there were no statistical differences in emotional state, physical independence and psychological support scores between the two groups ( P>0.05). The incidences of dizziness and nausea vomiting in FICB group were significantly lower than those in control group: 13.8% (4/29) vs. 42.9% (12/28) and 10.3% (3/29) vs. 35.7% (10/28), and there were statistical differences ( P<0.05); there were no statistical difference in the incidences of delirium, pulmonary infection and deep vein thrombosis in the lower extremities between the two groups ( P>0.05). Conclusions:Preoperative continuous FICB can reduce perioperative opioids dosage in elderly patients with frail, and improve early stage postoperative recovery quality.

Objective:To investigate the association between the polymorphism of the hepatic lipase gene(LIPC)and the sensitivity to exercise intervention in the Han Chinese population with prediabetes mellitus(PDM)in the cold northern region of China,and to identify molecular markers related to exercise sensitivity in glucose me-tabolism disorders.Method:From January to September 2022,32 PDM patients were recruited in Harbin sports university,and 40％—59％VO2max aerobic exercise(3 times/week,30-60min/time)combined with 50％—70％1RM elastic band training(2 times/week,15-30 min/time)was performed for 12 weeks.FPG,HbA1c,FINs,TC,TG,HDL-c and LDL-c were measured before and after the intervention,SNP microarray chip was used to analyze the LIPC-514C/T locus in saliva,and SPSS26.0 was used to compare the differences in efficacy indicators among PDM patients with different LIPC-514C/T genotypes.Result:①The CC type of LIPC-514C/T locus accounted for 37.5％,and CT/TT accounted for 62.5％in PDM patients.The gene frequency distribution was consistent with Hardy-Weinberg equilibrium(P>0.05).②The HDL-c level of LIPC-514 CC type in PDM patients was lower than those in CT/TT type,with a signifi-cant difference(P<0.05),while there was no significant difference in other indicators(P>0.05).③After 12-week exercise intervention,the levels of FPG,HbA1c,TC,TG,LDL-c and HOMA-IR were significantly lower(P<0.05),and HDL-c,FINs and HOMA-IS were significantly higher than those before intervention(P<0.05).④The change in FPG,HOMA-IR,TG and HDL-c in CC type PDM patients was significantly higher than those in CT/TT genotype after intervention(P<0.05).Conclusion:A 12-week moderate-intensity aerobic exercise combined elastic band resistance strength training can improve the glucose and lipid metabolism in PDM in cold region.The effect of exercise intervention in re-ducing blood compared to the CT/TT genotype of the LIPC-514C/T locus,which can be used as a molecular marker to evaluate the efficacy of exercise intervention in the Han Chinese population with glucose metabolism disorders in cold region of northern China.

Artificial intelligence (AI) integrated with time-lapse (TL) imaging for embryo selection significantly minimizes subjectivity and workload in traditional methods, marking a pivotal advancement in the realm of assisted reproductive technology. This review comprehensively summarizes the representative studies conducted in recent years within these domains and delves into the application of AI combined with TL imaging for embryo selection from three perspectives: data selection, model selection, and model evaluation. While AI research has yet to fully achieve automated embryo selection, it has already commenced assisting embryologists in annotating and selecting embryos to a considerable extent, thereby reducing subjective discrepancies and easing the workload. Existing software for oocyte quality scoring, embryo ploidy prediction, and transfer outcome forecasting has exhibited promising performance in studies. However, there remains an ongoing need for the development of high-quality datasets and the conduct of prospective, multicenter studies with large sample sizes across diverse devices. The evolution of AI combined with TL imaging in the field of embryo selection merits heightened attention from both clinicians and embryologists.

Objective:To investigate the association between the polymorphism of the hepatic lipase gene(LIPC)and the sensitivity to exercise intervention in the Han Chinese population with prediabetes mellitus(PDM)in the cold northern region of China,and to identify molecular markers related to exercise sensitivity in glucose me-tabolism disorders.Method:From January to September 2022,32 PDM patients were recruited in Harbin sports university,and 40％—59％VO2max aerobic exercise(3 times/week,30-60min/time)combined with 50％—70％1RM elastic band training(2 times/week,15-30 min/time)was performed for 12 weeks.FPG,HbA1c,FINs,TC,TG,HDL-c and LDL-c were measured before and after the intervention,SNP microarray chip was used to analyze the LIPC-514C/T locus in saliva,and SPSS26.0 was used to compare the differences in efficacy indicators among PDM patients with different LIPC-514C/T genotypes.Result:①The CC type of LIPC-514C/T locus accounted for 37.5％,and CT/TT accounted for 62.5％in PDM patients.The gene frequency distribution was consistent with Hardy-Weinberg equilibrium(P>0.05).②The HDL-c level of LIPC-514 CC type in PDM patients was lower than those in CT/TT type,with a signifi-cant difference(P<0.05),while there was no significant difference in other indicators(P>0.05).③After 12-week exercise intervention,the levels of FPG,HbA1c,TC,TG,LDL-c and HOMA-IR were significantly lower(P<0.05),and HDL-c,FINs and HOMA-IS were significantly higher than those before intervention(P<0.05).④The change in FPG,HOMA-IR,TG and HDL-c in CC type PDM patients was significantly higher than those in CT/TT genotype after intervention(P<0.05).Conclusion:A 12-week moderate-intensity aerobic exercise combined elastic band resistance strength training can improve the glucose and lipid metabolism in PDM in cold region.The effect of exercise intervention in re-ducing blood compared to the CT/TT genotype of the LIPC-514C/T locus,which can be used as a molecular marker to evaluate the efficacy of exercise intervention in the Han Chinese population with glucose metabolism disorders in cold region of northern China.

Abdominal aortic balloon occlusion is an emerging interventional treatment method,which has been used to control the risk of postpartum hemorrhage caused by pernicious placenta previa(PPP).Numerous studies have shown that abdominal aortic balloon occlusion can not only significantly reduce the difficulty and risk of surgery,shorten the time spent for surgery,but also further increase the success rate of surgery,which undoubtedly has a positive impact on both the delivery woman and neonate.This paper aims to make a brief introduction of the development history of abdominal aortic balloon occlusion and its technical principles,and to expound the timing of using abdominal aortic balloon occlusion and the clinical application of the balloon with different properties,focusing on the advantages of using abdominal aortic balloon in patients with PPP.It is expected that this paper can provide a reference for formulating clinical treatment strategies.

Artificial intelligence (AI) integrated with time-lapse (TL) imaging for embryo selection significantly minimizes subjectivity and workload in traditional methods, marking a pivotal advancement in the realm of assisted reproductive technology. This review comprehensively summarizes the representative studies conducted in recent years within these domains and delves into the application of AI combined with TL imaging for embryo selection from three perspectives: data selection, model selection, and model evaluation. While AI research has yet to fully achieve automated embryo selection, it has already commenced assisting embryologists in annotating and selecting embryos to a considerable extent, thereby reducing subjective discrepancies and easing the workload. Existing software for oocyte quality scoring, embryo ploidy prediction, and transfer outcome forecasting has exhibited promising performance in studies. However, there remains an ongoing need for the development of high-quality datasets and the conduct of prospective, multicenter studies with large sample sizes across diverse devices. The evolution of AI combined with TL imaging in the field of embryo selection merits heightened attention from both clinicians and embryologists.

Objective:To investigate the effect of preoperative continuous fascia iliaca compartment block (FICB) on perioperative opioids dosage and quality of postoperative recovery in elderly patients with frail.Methods:A prospective study method was used. Sixty elderly frail patients underwent selective unilateral femoral head replacement surgery from November 2022 to October 2024 in Sihui People′s Hospital were selected. The patients were divided into control group and FICB group by random digits table method with 30 cases each. The patients in control group did not receive continuous FICB before surgery, and the patients in FICB group received continuous FICB 1 d before surgery. The perioperative use of opioids and analgesic effect, operative time, intraoperative blood loss, postoperative hospital stay, quality of recovery-40 (QoR-40) score at discharge and postoperative complications were compared between the two groups.Results:A total of 57 patients completed the study, with 29 cases in the FICB group and 28 cases in the control group. There were no statistical differences in operative time, intraoperative blood loss and postoperative hospital stay between the two groups ( P>0.05). The sufentanil dosage of patient-controlled analgesia (PCA), perioperative nalbuphine dosage, frequency of perioperative visual analog score (VAS)>4 scores, rate of preoperative rescue analgesia, rate of postoperative rescue analgesia and pressing frequency of PCA in FICB group were significantly lower than those in control group: (94.1 ± 5.4) μg vs. (102.1 ± 6.1) μg, 0 (0, 0) mg vs. 10.0 (0, 20.0) mg, 3.0 (2.0, 5.0) times vs. 5.0 (4.0, 6.0) times, 3.4% (1/29) vs. 32.1% (9/28), 13.8% (4/29) vs. 39.3% (11/28) and 2.0 (1.0, 3.0) times vs. 4.0 (3.0, 5.0) times, and there were statistical differences ( P<0.01 or <0.05). The total QoR-40 score and physical comfort, pain scores in FICB group were significantly higher than those in control group: 156(153, 161) scores vs. 153 (148, 159) scores, 47 (45, 50) scores vs. 45 (43, 47) scores and 30 (29, 31) scores vs. 28 (25, 30) scores, and there were statistical differences ( P<0.05 or <0.01); there were no statistical differences in emotional state, physical independence and psychological support scores between the two groups ( P>0.05). The incidences of dizziness and nausea vomiting in FICB group were significantly lower than those in control group: 13.8% (4/29) vs. 42.9% (12/28) and 10.3% (3/29) vs. 35.7% (10/28), and there were statistical differences ( P<0.05); there were no statistical difference in the incidences of delirium, pulmonary infection and deep vein thrombosis in the lower extremities between the two groups ( P>0.05). Conclusions:Preoperative continuous FICB can reduce perioperative opioids dosage in elderly patients with frail, and improve early stage postoperative recovery quality.

Objective To investigate the protective effect of permissive hypercapnia in infants undergoing one-lung ventilation(OLV). Methods A total of 64 infants were randomly divided into Group N(normocapnia group,n=32)and Group H(hypercapnia group,n=32).Arterial blood gas samples were collected at four differ-ent time points:10 minutes after intubation(T1),30 and 60 minutes after artificial pneumothorax(T2,T3),and 30 minutes after being sent to post anesthesia care unit(T4)while vital signs(HR,MAP,SpO2and temperature) and ventilation parameters(Ppeak,Vt,PEEP,RR,MVV,and FiO2)were recorded simultaneously;OI was calcu-lated by corresponding equation. Bronchoalveolar lavage fluid(BALF)was collected before and after surgery for the measurement of RAGE. Results Compared with those at T1,MAP and PaO2were significantly lower but Ppeak was obviously higher in group N,while HR,Ppeakas well as PaCO2were increased(P<0.05)and Vt,MVV,pH, PaO2as well as lactic acid were decreased in group H(P < 0.05)at T2and T3. Compared with those in group N, MAP,HR as well as PaCO2were higher while Ppeak,Vt,MVV,pH,and lactic acid were lower in group H at T2 and T3(P<0.05).There was a significant increase of RAGE in both groups after surgery and it was much higher in group N when compared with that in group H after surgery(P<0.05). Conclusion PHC not only has advantages in improving tissue oxygenation,but also has the potential of lung protection for infants undergoing OLV.

Objective To explore the impact of different hemoglobin on postoperative cognitive functions in female patients underwent laparoscopic surgery. Methods 215 female patients who were underwent laparoscopic total hysterectomy or laparoscopic myomectomy from January 2016 to December 2016 in our hospital were selected. The patients were divided into 3 groups according to their hemoglobin:Group N with normal hemoglobin ,Group A with hemoglobin concentration of 9 ~ 11 g/L ,and Group B with hemoglobin concentration of 6 ~ 9 g/L. Same anesthesia and recovery plan were performed in all patients. Basic and operative information were recorded. The score of MoCA on the day before surgry ,the day after surgry ,3 days after surgry and 30 days after surgry were recorded. Blood samples were collected on the day before surgry and the day after surgry for the determina-tion of serum S-100β protein and IL-6 concentrations. Results No significant difference was found in basic and operative information among three groups. The recovery time was much longer in Group B than that in Group N. No difference were found among three group in the score of MoCA on the day before surgry and 30 days after surgry ,while the score in the day after surgry and 3 days after surgry were lower in Group B com-pared with Group N. The incidence of POCD were higher in Group B compared with Group N. Compared with the day before surgry ,the concentration of serum S-100β protein and IL-6 were much higher. And compared with Group N ,the concentration of serum S-100β protein was higher in Group A and B in the day after surgry , while IL-6 was higher in Group B. The concentration of serum S-100βprotein and IL-6 were much higher in Group B compared with Group A in the day after surgry. Conclusion Female patients with hemoglobin concen-tration of 6 ~ 9 g/L are susceptible to POCD ,which might be contributed by operative central nerve system damage induced by excessive inflammation.

BACKGROUND:The chemical compositions and structure of calcium phosphate bone cement are similar to those of human bone, which can fil the bone colapse caused by fracture and induce osteogenesis, but its degradation rate is slow. OBJECTIVE:To evaluate the biocompatibility of the calcium phosphate cement/fibrin glue and the feasibility of repairing radius defects. METHODS: In vitro cytotoxicity experiment: Mouse fibroblasts were cultured in the calcium phosphate bone cement/fibrin glue extracts, phenol solution, and RPMI 1640 culture medium containing 10% fetal bovine serum, respectively, to detect the cytotoxicity grade. Hemocompatibility experiment: Calcium phosphate bone cement/fibrin glue extracts, normal saline and distiled water were respectively added into the rabbit anticoagulation, to detect the hemolytic rate. Forty-five New Zealand white rabbits were enroled and modeled into bilateral radius defects, folowed by randomly alotted into three groups: blank control group without any intervention, experimental and control groups were given the implantation with calcium phosphate bone cement/fibrin glue and autologous radius, respectively. X-ray, histology, bone mineral density and biomechanical test were performed at postoperative 4, 8 and 16 weeks. RESULTS AND CONCLUSION:The toxicity grade of the calcium phosphate cement/fibrin glue was 0 to 1. The hemolytic rate of the calcium phosphate cement/fibrin glue was 3.15%. At 16 weeks postoperatively, X-ray showed that in the experimental and control groups, the fracture line disappeared completely, pulp cavity was recanalized, and in plastic completely. Histology showed that the reconstructed bone trabecular was obvious, plate layer of bone was mature, and medulary cavity recanalization appeared in the control group; there were a large number of new grid-shaped woven bone tissues growing into the material in the experimental group, with overt degradation, and degradation rate was in paralel to bone ingrowth. The bone density, the maximum load, maximum stress and failure energy in the experimental and control groups were significantly higher than those in the blank control group (P < 0.05), and al above indicators showed no significant differences between the experimental and control groups. These results manifest that the calcium phosphate bone cement/fiber protein glue composite material holding a good biocompatibility can promote bone tissue regeneration for bone defect repair, achieving similar curative effect with autologous bone transplantation.