Thoracic anesthesia with spontaneous respiration represents a form of precision anesthesia meticulously customized to individual patients.Considering the more stringent requirements this anesthesia approach imposes on the regulation of respiratory function,the writing group of the"Consensus of Experts on the Management of Thoracic Anesthesia with Spontaneous Respiration"has formulated elaborate guidelines regarding indications and contraindications,preoperative evaluation,anesthesia implementation,common complications,and treatment strategies.This was accomplished by referencing relevant domestic and international literature and integrating it with actual clinical requirements.The objective is to standardize the rational application of this anesthesia method.

Thoracic anesthesia with spontaneous respiration represents a form of precision anesthesia meticulously customized to individual patients.Considering the more stringent requirements this anesthesia approach imposes on the regulation of respiratory function,the writing group of the"Consensus of Experts on the Management of Thoracic Anesthesia with Spontaneous Respiration"has formulated elaborate guidelines regarding indications and contraindications,preoperative evaluation,anesthesia implementation,common complications,and treatment strategies.This was accomplished by referencing relevant domestic and international literature and integrating it with actual clinical requirements.The objective is to standardize the rational application of this anesthesia method.

Purpose/Significance To analyze the influencing factors of user satisfaction on mobile medical platform,and to put for-ward suggestions to improve the quality of medical service and user satisfaction.Method/Process Taking the evaluation texts of users from eight tertiary hospitals in Guangxi in the online mobile medical service platform of haodf.com as the research object,the paper uses the software of ROST content mining system to filter meaningless words,carries out emotional analysis,word frequency statistical analysis and co-occurrence matrix semantic network analysis.Result/Conclusion The degree of satisfaction and recognition of users to the mo-bile medical service platform is high.From the perspective of influencing factors and departments,it puts forward some suggestions on how to improve the satisfaction of mobile medical service users.

Objective:To explore the ventilation strategy of using pressure controlled ventilation-volume guaranteed (PCV-VG) mode combined with personalized positive end expiratory pressure (PEEP) during surgery, and its impact on oxygenation function and incidence of postoperative pulmonary complications (PPCs) in patients undergoing brain tumor surgery.Methods:Sixty patients who underwent elective brain tumor surgery at the Linyi People′s Hospital from January 2023 to June 2023 were selected. The patients were randomly divided into PCV-VG ventilation mode group (T group) and volume controlled ventilation (VCV) mode group (C group) using a random number table method, with 30 patients in each group. One patient was excluded from group T due to changes in the condition, and 29 patients were actually included. Group T adopted PCV-VG ventilation mode and searched for the maximum dynamic lung compliance (Cdyn) by titrating PEEP. The PEEP corresponding to the maximum Cdyn value was the optimal PEEP, which was maintained until the end of mechanical ventilation. Group C adopted a ventilation mode of VCV plus 5 cmH 2O fixed value PEEP. All patients underwent arterial blood gas analysis before anesthesia induction (T 1), 15 minutes after setting ventilation mode (T 2), and 15 minutes after extubation (T 3), recording arterial oxygen partial pressure (PaO 2), carbon dioxide partial pressure (PaCO 2), lactate (Lac), and blood glucose (Glu), and calculating oxygenation index (PaO 2/FiO 2). The levels of white blood cells (WBC), C-reactive protein (CRP), and procalcitonin (PCT) were recorded before and 72 hours after surgery. The incidence of postoperative PPCs at 72 hours was observed. Results:There was a statistically significant difference in the grouping effect and time effect of PaO 2 and PaCO 2 between group C and group T (all P<0.05), while there was no statistically significant difference in the interaction effect (all P>0.05); The differences in grouping effects, time effects, and interaction effects of PaO 2/FiO 2 between group C and group T were statistically significant (all P<0.05); The average value of the optimized PEEP obtained by T-group titration was 7.48 cmH 2O, corresponding to an average platform pressure (Pplat) of 14.90 cmH 2O, and an average value of 53.37 ml/cmH 2O corresponding to the maximum Cdyn value. Compared with the Pplat and Cdyn corresponding to the fixed value of 5 cmH 2O PEEP in Group C, the Pplat corresponding to the optimized PEEP in Group T was lower than that in Group C ( P<0.05), and the Cdyn was higher than that in group C ( P<0.05). The CRP level and incidence of PPCs in group T after 72 hours of surgery were significantly lower than those in group C (all P<0.05). Conclusions:Compared with VCV, the ventilation mode of PCV-VG combined with personalized PEEP can improve intraoperative lung ventilation and oxygenation function in patients with brain tumors, reduce the occurrence of pulmonary inflammation 72 hours after surgery, and lower the incidence of PPCs.

Objective To explore the effects of Huoxue Jiedu Formula on the expression of the apoptosis-related factors B-cell lymphoma-2(Bcl-2)and survivin in submaxillary gland cells in mice with Sj?gren syndrome(SS).Methods Using 15 healthy C57BL/6J female mice as the blank control group.Seventy-five of non-obese diabetes mellitus female mice were classified as SS model.They were randomly assigned to the model group,total glucosides of paeony capsule group(TGP group,0.233 g/kg),Huoxue Jiedu Formula low-(15.925 g/kg),middle-(31.850 g/kg),and high-dose(62.335 g/kg)groups,with 15 mice in each group.The blank control and model groups received distilled water by gavage,and the other groups received respective drug doses by gavage once a day for 8 consecutive weeks.After 1,2,4,6,and 8 weeks of gavage,the salivary secretion volume of the mice was measured.The submaxillary gland index was calculated.Pathological changes in the submaxillary gland of mice were observed by hematoxylin-eosin staining.The expression of apoptosis-related factors Bcl-2 and survivin was detected by Western blotting and real-time fluorescence PCR.Results There was statistical significance in salivary secretion volume from aspects of between-group,time-point,and interaction effects(P<0.05).After 8 weeks of treatment,compared to the blank control group,salivary secretion volume,submaxillary gland index,and protein and mRNA expressions of Bcl-2 and survivin in the model group were decreased,while the pathological score grading increased(P<0.05).Compared to the model group,the TGP group and the Huoxue Jiedu Formula low-,medium-,and high-dose groups showed an increase in saliva secretion after 8 weeks of treatment and an increase in submaxillary gland index,Bcl-2,and survivin mRNA expression levels,and a decrease in pathological score levels.The protein expressions of Bcl-2 and survivin in the Huoxue Jiedu Formula medium-and high-dose groups were increased(P<0.05).Compared to the TGP group,salivary secretion volume and submaxillary gland index in the Huoxue Jiedu Formula low-dose group were lower at weeks 4 and 6,while the pathological score grading was higher(P<0.05).The pathological score grading in the Huoxue Jiedu Formula high-dose group was lower.The protein and mRNA expressions of Bcl-2 in the Huoxue Jiedu Formula low-and medium-dose groups were lower(P<0.05).Conclusion Huoxue Jiedu Formula may relieve the submaxillary gland lesions and increase the salivary secretion volume of the submaxillary gland in SS model mice by regulating the expressions of apoptosis-related factors such as Bcl-2 and survivin in the submaxillary gland.

Objective::To determine the role of regular diet recovery after restoration of normal muscle strength of both lower extremities in promoting postoperative recovery in women undergoing elective cesarean section.Methods::This was a prospective observational cohort study. Patients who underwent elective cesarean section at Xiangya Hospital, Central South University, from October 2022 to December 2022, were categorized into two groups based on the duration of postoperative fasting: the observation group resumed eating after regaining lower extremity muscle strength, while the control group adhered to traditional postoperative fasting guidelines, waiting 6 hours before eating. Primary outcomes included postoperative pain levels assessed by visual analog scale (VAS) pain scores and time to first flatus. Demographic characteristics, time to first lactation, hospital stay length, and patient satisfaction were also assessed. Statistical analysis was conducted using Student’s t test and Chi-squared test, with significance set at P < 0.05. Results::Out of a total of 300 patients, 240 were included in the analysis, comprising 112 in the control group and 128 in the observation group. There were no significant differences in baseline demographic characteristics. The median values of the first flatus time and the first lactation time were 33.37 ± 1.22 vs. 18.06 ± 6.34 hours ( P = 0.003) and 26.34 ± 8.21 vs. 7.05 ± 1.26 hours ( P = 0.001) in the control and observation groups, respectively. The median hospital stay duration in the control and observation groups was 6.54 ± 0.53 vs. 4.84 ± 0.18 days ( P = 0.000), respectively. Median postoperative VAS pain scores and patient satisfaction values were 8.57 ± 0.11 vs. 4.91 ± 0.27 ( P = 0.000) and 9.36 ± 0.16 vs. 9.72 ± 0.08 ( P = 0.005) in the control and observation groups, respectively. There were no statistically significant differences in other postoperative outcomes, such as intestinal obstruction, infection, and readmission within 42 days ( P > 0.05). Conclusion::Food intake after restoration of lower extremity muscle strength improves first flatus, relieves postoperative pain, shortens hospital stay, and enhances satisfaction after elective cesarean section, without adverse effects. It is crucial for postoperative rehabilitation and should be encouraged.

Objective To explore the effects of Huoxue Jiedu Formula on the expression of the apoptosis-related factors B-cell lymphoma-2(Bcl-2)and survivin in submaxillary gland cells in mice with Sj?gren syndrome(SS).Methods Using 15 healthy C57BL/6J female mice as the blank control group.Seventy-five of non-obese diabetes mellitus female mice were classified as SS model.They were randomly assigned to the model group,total glucosides of paeony capsule group(TGP group,0.233 g/kg),Huoxue Jiedu Formula low-(15.925 g/kg),middle-(31.850 g/kg),and high-dose(62.335 g/kg)groups,with 15 mice in each group.The blank control and model groups received distilled water by gavage,and the other groups received respective drug doses by gavage once a day for 8 consecutive weeks.After 1,2,4,6,and 8 weeks of gavage,the salivary secretion volume of the mice was measured.The submaxillary gland index was calculated.Pathological changes in the submaxillary gland of mice were observed by hematoxylin-eosin staining.The expression of apoptosis-related factors Bcl-2 and survivin was detected by Western blotting and real-time fluorescence PCR.Results There was statistical significance in salivary secretion volume from aspects of between-group,time-point,and interaction effects(P<0.05).After 8 weeks of treatment,compared to the blank control group,salivary secretion volume,submaxillary gland index,and protein and mRNA expressions of Bcl-2 and survivin in the model group were decreased,while the pathological score grading increased(P<0.05).Compared to the model group,the TGP group and the Huoxue Jiedu Formula low-,medium-,and high-dose groups showed an increase in saliva secretion after 8 weeks of treatment and an increase in submaxillary gland index,Bcl-2,and survivin mRNA expression levels,and a decrease in pathological score levels.The protein expressions of Bcl-2 and survivin in the Huoxue Jiedu Formula medium-and high-dose groups were increased(P<0.05).Compared to the TGP group,salivary secretion volume and submaxillary gland index in the Huoxue Jiedu Formula low-dose group were lower at weeks 4 and 6,while the pathological score grading was higher(P<0.05).The pathological score grading in the Huoxue Jiedu Formula high-dose group was lower.The protein and mRNA expressions of Bcl-2 in the Huoxue Jiedu Formula low-and medium-dose groups were lower(P<0.05).Conclusion Huoxue Jiedu Formula may relieve the submaxillary gland lesions and increase the salivary secretion volume of the submaxillary gland in SS model mice by regulating the expressions of apoptosis-related factors such as Bcl-2 and survivin in the submaxillary gland.

Objective::To determine the role of regular diet recovery after restoration of normal muscle strength of both lower extremities in promoting postoperative recovery in women undergoing elective cesarean section.Methods::This was a prospective observational cohort study. Patients who underwent elective cesarean section at Xiangya Hospital, Central South University, from October 2022 to December 2022, were categorized into two groups based on the duration of postoperative fasting: the observation group resumed eating after regaining lower extremity muscle strength, while the control group adhered to traditional postoperative fasting guidelines, waiting 6 hours before eating. Primary outcomes included postoperative pain levels assessed by visual analog scale (VAS) pain scores and time to first flatus. Demographic characteristics, time to first lactation, hospital stay length, and patient satisfaction were also assessed. Statistical analysis was conducted using Student’s t test and Chi-squared test, with significance set at P < 0.05. Results::Out of a total of 300 patients, 240 were included in the analysis, comprising 112 in the control group and 128 in the observation group. There were no significant differences in baseline demographic characteristics. The median values of the first flatus time and the first lactation time were 33.37 ± 1.22 vs. 18.06 ± 6.34 hours ( P = 0.003) and 26.34 ± 8.21 vs. 7.05 ± 1.26 hours ( P = 0.001) in the control and observation groups, respectively. The median hospital stay duration in the control and observation groups was 6.54 ± 0.53 vs. 4.84 ± 0.18 days ( P = 0.000), respectively. Median postoperative VAS pain scores and patient satisfaction values were 8.57 ± 0.11 vs. 4.91 ± 0.27 ( P = 0.000) and 9.36 ± 0.16 vs. 9.72 ± 0.08 ( P = 0.005) in the control and observation groups, respectively. There were no statistically significant differences in other postoperative outcomes, such as intestinal obstruction, infection, and readmission within 42 days ( P > 0.05). Conclusion::Food intake after restoration of lower extremity muscle strength improves first flatus, relieves postoperative pain, shortens hospital stay, and enhances satisfaction after elective cesarean section, without adverse effects. It is crucial for postoperative rehabilitation and should be encouraged.

Objective:To review the scope of related factors that affect the elderly′s participation in digital health intervention, and to provide a certain reference for the application and development of smart elderly technology.Methods:Based on the scope review guidelines issued by the Joanna Briggs Institute in Australia in 2019, the inclusion and exclusion criteria were determined according to the PCCS principles. Chinese and English literatures were searched in PubMed, Cochrane Library, JBI, CINAHL, Web of Science, Scopus, CNKI, Wanfang database and Chinese biomedical literature database. The search time limit was from the establishment of the database to November 30, 2021. Two researchers independently read, and used EndNoteX9 and Excel tables to extract relevant data from the literature for summary and analysis.Results:Totally 20 articles were selected, including 2 mixed studies, 10 cross-sectional studies, 6 qualitative studies, and 2 quasi-experimental studies. Relevant factors affecting the participation of the elderly in digital health interventions involved the developers, users and the user himself of digital health intervention systems, including the degree of system integration of system development, the degree of autonomy of the elderly, the credibility and accessibility of system equipment and ease of use; the degree of compatibility of equipment in the process of use, the degree of digital infrastructure configuration, the degree of Internet penetration, the availability and reliability of health information resources, the degree of training and education, the degree of communication with the elderly in the process of participation, financial payment, etc.; the four inherent factors of the elderly included the cost of technology use, technical anxiety, privacy and safety, and health needs.Conclusions:The elderly, medical staff, developers and other stakeholders should jointly participate in decision-making on the development and management of the digital health intervention system for the elderly, especially by inviting and empowering the elderly , and improve the training and feedback of the system application and use process, accelerate the popularization and promotion of technical resources, and increase social capital and financial payment incentives to reduce the burden on the elderly and the medical system.

Objective:To explore the application of laparoscopic training in the standardized residency training of pediatric general surgery.Methods:A total of 36 rotating residents who received the standardized residency training in the department of pediatric general surgery of Shenzhen Children's Hospital from January 2017 to December 2019 were selected for laparoscopic training. The training content includes the study and training of laparoscopic theory knowledge, laparoscopic surgery video, skills operation of simulated operating system. Assessment was conducted before and after the training, and statistical analysis was performed to compare the difference of scores before and after the training. The self-evaluation of resident's learning efficiency and the satisfaction with teachers were investigated by questionnaires. SPSS 20.0 was used for paired t-test. Results:After receiving the standardized residency training of pediatric general surgery, the theoretical knowledge and cognition of the application on pediatric general laparoscopic surgery were significantly improved among the 36 residents. The time that the skills spent in vitro simulation box during the simulated operation training was significantly reduced after training, with a statistically significant difference ( P < 0.05). According to the questionnaire survey, resident's satisfaction with self-evaluation of learning efficiency was 97.22% (35/36), their satisfaction with teachers was 94.44% (34/36), and their satisfaction with teaching curriculum was 100.00% (36/36). Conclusion:Laparoscopic training can effectively improve the clinical practice ability of pediatric general surgery residents, which is worthy of promotion.