1.Effects of combined use of active ingredients in Buyang Huanwu Decoction on oxygen-glucose deprivation/reglucose-reoxygenation-induced inflammation and oxidative stress of BV2 cells.
Tian-Qing XIA ; Ying CHEN ; Jian-Lin HUA ; Qin SU ; Cun-Yan DAN ; Meng-Wei RONG ; Shi-Ning GE ; Hong GUO ; Bao-Guo XIAO ; Jie-Zhong YU ; Cun-Gen MA ; Li-Juan SONG
China Journal of Chinese Materia Medica 2025;50(14):3835-3846
This study aims to explore the effects and action mechanisms of the active ingredients in Buyang Huanwu Decoction(BYHWD), namely tetramethylpyrazine(TMP) and hydroxy-safflor yellow A(HSYA), on oxygen-glucose deprivation/reglucose-reoxygenation(OGD/R)-induced inflammation and oxidative stress of microglia(MG). Network pharmacology was used to screen the effective monomer ingredients of BYHWD and determine the safe concentration range for each component. Inflammation and oxidative stress models were established to further screen the best ingredient combination and optimal concentration ratio with the most effective anti-inflammatory and antioxidant effects. OGD/R BV2 cell models were constructed, and BV2 cells in the logarithmic growth phase were divided into a normal group, a model group, an HSYA group, a TMP group, and an HSYA + TMP group. Enzyme-linked immunosorbent assay(ELISA) was used to detect the levels of inflammatory cytokines such as interleukin-1β(IL-1β), tumor necrosis factor-α(TNF-α), and interleukin-6(IL-6). Oxidative stress markers, including superoxide dismutase(SOD), nitric oxide(NO), and malondialdehyde(MDA), were also measured. Western blot was used to analyze the protein expression of both inflammation-related pathway [Toll-like receptor 4(TLR4)/nuclear factor-kappa B(NF-κB)] and oxidative stress-related pathway [nuclear factor erythroid 2-related factor 2(Nrf2)/heme oxygenase-1(HO-1)]. Immunofluorescence was used to assess the expression of proteins such as inducible nitric oxide synthase(iNOS) and arginase-1(Arg-1). The most effective ingredients for anti-inflammatory and antioxidant effects in BYHWD were TMP and HSYA. Compared to the normal group, the model group showed significantly increased levels of IL-1β, TNF-α, IL-6, NO, and MDA, along with significantly higher protein expression of NF-κB, TLR4, Nrf2, and HO-1 and significantly lower SOD levels. The differences between the two groups were statistically significant. Compared to the model group, both the HSYA group and the TMP group showed significantly reduced levels of IL-1β, TNF-α, IL-6, NO, and MDA, lower expression of NF-κB and TLR4 proteins, higher levels of SOD, and significantly increased protein expression of Nrf2 and HO-1. Additionally, the expression of the M1-type MG marker iNOS was significantly reduced, while the expression of the M2-type MG marker Arg-1 was significantly increased. The results of the HSYA group and the TMP group had statistically significant differences from those of the model group. Compared to the HSYA group and the TMP group, the HSYA + TMP group showed further significant reductions in IL-1β, TNF-α, IL-6, NO, and MDA levels, along with significant reductions in NF-κB and TLR4 protein expression, an increase in SOD levels, and elevated Nrf2 and HO-1 protein expression. Additionally, the expression of the M1-type MG marker iNOS was reduced, while the M2-type MG marker Arg-1 expression increased significantly in the HSYA + TMP group compared to the TMP or HSYA group. The differences in the results were statistically significant between the HSYA + TMP group and the TMP or HSYA group. The findings indicated that the combined use of HSYA and TMP, the active ingredients of BYHWD, can effectively inhibit OGD/R-induced inflammation and oxidative stress of MG, showing superior effects compared to the individual use of either component.
Oxidative Stress/drug effects*
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Drugs, Chinese Herbal/pharmacology*
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Animals
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Mice
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Glucose/metabolism*
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Cell Line
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Inflammation/genetics*
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Oxygen/metabolism*
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Pyrazines/pharmacology*
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Microglia/metabolism*
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NF-E2-Related Factor 2/immunology*
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NF-kappa B/immunology*
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Toll-Like Receptor 4/immunology*
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Anti-Inflammatory Agents/pharmacology*
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Humans
2.Early results and indications of Stand-alone oblique lateral interbody fusion in lumbar lesions.
Zhong-You ZENG ; Xing ZHAO ; Wei YU ; Yong-Xing SONG ; Shun-Wu FAN ; Xiang-Qian FANG ; Fei PEI ; Shi-Yang FAN ; Guo-Hao SONG
China Journal of Orthopaedics and Traumatology 2025;38(5):454-464
OBJECTIVE:
To summarize the early clinical results and safety of Stand-alone OLIF application of lumbar lesions, and explored its surgical indications.
METHODS:
Total of 92 cases of lumbar spine lesions treated with Stand-alone OLIF at two medical centers from October 2014 to December 2018 were retrospectively analyzed, including 30 males and 62 females with an average age of (61.20±12.94) years old ranged from 32 to 83 years old. There were 20 cases of lumbar spinal stenosis, 15 cases of lumbar disc degeneration, 11 cases of lumbar degenerative spondylolisthesis, 6 cases of discogenic low back pain, 7 cases of giant lumbar disc herniation, 13 cases of primary lumbar discitis, 6 cases of adjacent vertebral disease after lumbar internal fixation surgery, and 14 cases of degenerative lumbar scoliosis. Pre-operative dual energy X-ray bone density examination 31 cases' T-values ranged from -1 to -2.4, 8 cases' T-values ranged from -2.5 to -3.5, and the rest had normal bone density. The number of fusion segments: 68 cases of single segment, 9 cases of two segment, 12 cases of three segment , and 3 cases of four segment. Fusion site:L1,2 1 case, L2,3 4 cases, L3,4 10 cases, L4,5 53 cases, L2,3-L3,4 3 cases, L3,4-L4,5 6 cases, L1,2L2,3L3,4 1 case, L1,2L3,4L4,5 1 case, L2,3L3,4L4,5 10 cases, L1,2L2,3L3,4L4,5 3 cases. The clinical results and imaging results of this group of cases were observed, as well as the complications.
RESULTS:
The surgical time ranged from 40 to 140 minutes with an average of (60.92±27.40) minutes. The intraoperative bleeding volume was 20 to 720 ml with an average of (68.22±141.60) ml. The patients had a follow-up period of 6 to 84 months with an average of (38.50±12.75) months. The height of the intervertebral space recovered from (9.23±1.94) mm in preoperative to (12.68±2.01) mm in postoperative, and (9.11±1.72) mm at the last follow-up, there was a statistically significant difference(F=6.641, P=0.008);there was also a statistically significant difference between the postoperative and preoperative height of the intervertebral space(t=9.27, P<0.000 1);and there was also a statistically significant difference (t=10.06, P<0.000 1) between the last follow-up and postoperative height of the intervertebral space. At the last follow-up, cage subsidence grading was as follows:level 0 in 69 cases (76 segments), levelⅠin 17 cases (43 segments), level Ⅱin 5 cases (14 segments), and level Ⅲ in 1 case (1 segment);according to the number of segments, normal subsidence accounts for 56.72%, abnormal subsidence accounts for 43.28%. Bone mineral desity of normal subsidence groups was -0.50±0.07 whinch was better than that the abnormal subsidence groups -2.10±0.43, and the difference was statistically significant(χ2=2.275, P=0.014). As well as there was a statistically significant difference in the patient's VAS of backache from (6.28±2.11) in preoperative to (1.48±0.59) in last follow-up(t=8.56, P<0.05). The ODI recovered from (36.30±7.52)% before surgery to (10.20±2.50)% at the last follow-up, with a statistically significant difference (t=7.79, P<0.000 1). Complications involved 4 cases of intraoperative vascular injury, 21 cases of endplate injury, and 4 cases of combined vertebral fractures. The incision skin has no necrosis or infection. There were 4 cases of left sympathetic chain injury, 4 cases of transient left hip flexion weakness, 2 cases of left thigh anterolateral numbness with quadriceps femoris weakness, and 1 case of incomplete intestinal obstruction;8 cases were treated with posterior pedicle screw fixation due to fusion cage settlement accompanied by stubborn lower back pain, and 6 cases were treated with fusion cage settlement and lateral displacement. According to the actual number of cases, there were 38 complications, with an incidence rate of 41.3%.
CONCLUSION
The application of Stand alone OLIF in lumbar spine disease fusion has achieved good early results, with obvious clinical advantages, but also there are high probability of complications. It is recommended to choose carefully. It is necessary to continuously summarize and gradually clarify and complete the surgical indications and specific case selection criteria.
Humans
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Male
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Female
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Middle Aged
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Spinal Fusion/methods*
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Lumbar Vertebrae/injuries*
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Aged
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Adult
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Retrospective Studies
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Aged, 80 and over
3.Application effect of dexmedetomidine combined with ciprofol general anesthesia in laparoscopic radical resection of ovarian cancer
Jun WANG ; Tengna SHI ; Lijie WANG ; Lishuang ZHONG ; Linlin SONG
Journal of Chinese Physician 2025;27(10):1500-1503
Objective:To explore the application effect of dexmedetomidine combined with ciprofol general anesthesia in laparoscopic radical resection of ovarian cancer.Methods:A total of 120 patients who underwent laparoscopic radical resection of ovarian cancer at the Hengshui Second People′s Hospital, Hebei Province from January 2021 to January 2023 were selected as the research objects. They were divided into the control group and the observation group by random number table method, with 60 cases in each group. Both groups underwent surgery under general anesthesia: the control group was given ciprofol, while the observation group was given dexmedetomidine combined with ciprofol. Postoperative recovery, changes in hemodynamics and vital signs, levels of stress indicators, and the occurrence of adverse reactions were compared between the two groups.Results:Compared with the control group, the observation group had fewer presses on the analgesic pump, shorter first flatus time and awakening time, lower Visual Analogue Scale (VAS) score at 1 hour after surgery, and higher Ramsay sedation score (all P<0.05). There were no statistically significant differences in heart rate (HR), mean arterial pressure (MAP), and bispectral index (BIS) between the two groups before induction (T 0) (all P>0.05); MAP at skin incision (T 1), 30 minutes after skin incision (T 2), and after extubation (T 3) in both groups were higher than those at T 0, while HR were lower than those at T 0 (all P<0.05); HR and MAP at T 1, T 2, and T 3 in the observation group were significantly lower than those in the control group (all P<0.05), but there was no statistically significant difference in BIS between the two groups at each time point (all P>0.05). There were no statistically significant differences in serum cortisol (COR) and adrenocorticotropic hormone (ACTH) levels between the two groups at T 0 (all P>0.05); serum COR and ACTH levels at T 3 and 1 hour after surgery (T 4) in both groups were higher than those at T 0 (all P<0.05), and the levels of serum COR and ACTH at T 3 and T 4 in the observation group were lower than those in the control group (all P<0.05). In the control group, there were 3 cases of hypotension, 7 cases of nausea and vomiting, and 1 case of respiratory depression; in the observation group, there were 2 cases of hypotension and 3 cases of nausea and vomiting. No serious adverse reactions occurred in either group, and the total incidence of adverse reactions in the observation group was lower than that in the control group (χ 2=3.354, P<0.05). Conclusions:Dexmedetomidine combined with ciprofol general anesthesia can promote postoperative recovery of patients undergoing laparoscopic radical resection of ovarian cancer, effectively stabilize hemodynamics, and reduce stress response and adverse reactions.
4.Secular trend and projection of overweight and obesity among Chinese children and adolescents aged 7-18 years from 1985 to 2019: Rural areas are becoming the focus of investment.
Jiajia DANG ; Yunfei LIU ; Shan CAI ; Panliang ZHONG ; Di SHI ; Ziyue CHEN ; Yihang ZHANG ; Yanhui DONG ; Jun MA ; Yi SONG
Chinese Medical Journal 2025;138(3):311-317
BACKGROUND:
The urban-rural disparities in overweight and obesity among children and adolescents are narrowing, and there is a need for long-term and updated data to explain this inequality, understand the underlying mechanisms, and identify priority groups for interventions.
METHODS:
We analyzed data from seven rounds of the Chinese National Survey on Students Constitution and Health (CNSSCH) conducted from 1985 to 2019, focusing on school-age children and adolescents aged 7-18 years. Joinpoint regression was used to identify inflection points (indicating a change in the trend) in the prevalence of overweight and obesity during the study period, stratified by urban/rural areas and sex. Annual percent change (APC), average annual percent change (AAPC), and 95% confidence interval (CI) were used to describe changes in the prevalence of overweight and obesity. Polynomial regression models were used to predict the prevalence of overweight and obesity among children and adolescents in 2025 and 2030, considering urban/rural areas, sex, and age groups.
RESULTS:
The prevalence of overweight and obesity in urban boys and girls showed an inflection point of 2000, with AAPC values of 10.09% (95% CI: 7.33-12.92%, t = 7.414, P <0.001) and 8.67% (95% CI: 6.10-11.30%, t = 6.809, P <0.001), respectively. The APC for urban boys decreased from 18.31% (95% CI: 4.72-33.67%, t = 5.926, P = 0.027) to 4.01% (95% CI: 1.33-6.75%, t = 6.486, P = 0.023), while the APC for urban girls decreased from 13.88% (95% CI: 1.82-27.38%, t = 4.994, P = 0.038) to 4.72% (95% CI: 1.43-8.12%, t = 6.215, P = 0.025). However, no inflection points were observed in the best-fit models for rural boys and girls during the period 1985-2019. The prevalence of overweight and obesity for both urban and rural boys is expected to converge at 35.76% by approximately 2027. A similar pattern is observed for urban and rural girls, with a prevalence of overweight and obesity reaching 20.86% in 2025.
CONCLUSIONS
The prevalence of overweight and obesity among Chinese children and adolescents has been steadily increasing from 1985 to 2019. A complete reversal in urban-rural prevalence is expected by 2027, with a higher prevalence of overweight and obesity in rural areas. Urgent action is needed to address health inequities and increase investments, particularly policies targeting rural children and adolescents.
Humans
;
Child
;
Adolescent
;
Female
;
Male
;
Rural Population/statistics & numerical data*
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Overweight/epidemiology*
;
Prevalence
;
China/epidemiology*
;
Pediatric Obesity/epidemiology*
;
Obesity/epidemiology*
;
Urban Population
5.Changes of blood clinical parameters in patients with Graves'ophthalmopathy before and after treatment with tocilizumab
Rongrong XIE ; Xinyu XU ; Zhihui SONG ; Zhong XIN ; Lin HUA ; Tingting SHI
Journal of Capital Medical University 2025;46(4):710-717
Objective To systematically analyze the changes in clinical indicators including blood leukocytes and neutrophils,liver and kidney functions,coagulation function,lipids,and levels of thyroid hormones and antibodies in Graves'ophthalmopathy(GO)patients who had undergone effective treatment with tocilizumab(TCZ)and to explore their clinical significance.Methods Eighty-five patients with moderately or severely active GO who were effectively treated with TCZ were enrolled.Early morning fasting blood was collected and tested for routine blood,biochemical routine,coagulation function,thyroid hormone and antibodies,and basic information such as gender,age,duration of the disease,history of smoking,comorbidities,and medications were also collected from all patients,so changes in the clinical indicators before and after the treatment could be analyzed and correlation analyses could be carried out.Results Patients with moderately to severely active GO treated with TCZ showed a significant decrease in absolute blood leukocyte and neutrophil values compared with before,and a significant decrease in liver function(alanine transaminase,aspartate aminotransferase,creatinine),cholesterol(total cholesterol,high-density lipoprotein and low-density lipoprotein)levels were significantly higher than before,and concentrations of coagulation parameters[prothrombin time,activated partial thromboplastin time,fibrinogen(FIB)and D-dimer]were significantly decreased.The concentrations of thyroid hormone and thyroid-stimulating hormone levels increased significantly,and the antibody titer of thyrotropin receptor antibody(TRAB)was significantly down-regulated after treatment.TRAB levels were significantly correlated with FIB before treatment.Conclusion Thyroid function and antibody levels improved after TCZ treatment in patients with moderately to severely active GO,but blood leukocytes,liver function and coagulation function changed significantly compared with before.The results of this study confirm the therapeutic effect of TCZ on immune disorders in GO ophthalmopathy,while underscoring the importance of monitoring potential adverse effects in clinical treatment.
6.Changes of blood clinical parameters in patients with Graves'ophthalmopathy before and after treatment with tocilizumab
Rongrong XIE ; Xinyu XU ; Zhihui SONG ; Zhong XIN ; Lin HUA ; Tingting SHI
Journal of Capital Medical University 2025;46(4):710-717
Objective To systematically analyze the changes in clinical indicators including blood leukocytes and neutrophils,liver and kidney functions,coagulation function,lipids,and levels of thyroid hormones and antibodies in Graves'ophthalmopathy(GO)patients who had undergone effective treatment with tocilizumab(TCZ)and to explore their clinical significance.Methods Eighty-five patients with moderately or severely active GO who were effectively treated with TCZ were enrolled.Early morning fasting blood was collected and tested for routine blood,biochemical routine,coagulation function,thyroid hormone and antibodies,and basic information such as gender,age,duration of the disease,history of smoking,comorbidities,and medications were also collected from all patients,so changes in the clinical indicators before and after the treatment could be analyzed and correlation analyses could be carried out.Results Patients with moderately to severely active GO treated with TCZ showed a significant decrease in absolute blood leukocyte and neutrophil values compared with before,and a significant decrease in liver function(alanine transaminase,aspartate aminotransferase,creatinine),cholesterol(total cholesterol,high-density lipoprotein and low-density lipoprotein)levels were significantly higher than before,and concentrations of coagulation parameters[prothrombin time,activated partial thromboplastin time,fibrinogen(FIB)and D-dimer]were significantly decreased.The concentrations of thyroid hormone and thyroid-stimulating hormone levels increased significantly,and the antibody titer of thyrotropin receptor antibody(TRAB)was significantly down-regulated after treatment.TRAB levels were significantly correlated with FIB before treatment.Conclusion Thyroid function and antibody levels improved after TCZ treatment in patients with moderately to severely active GO,but blood leukocytes,liver function and coagulation function changed significantly compared with before.The results of this study confirm the therapeutic effect of TCZ on immune disorders in GO ophthalmopathy,while underscoring the importance of monitoring potential adverse effects in clinical treatment.
7.Effects of dexmedetomidine combined with propofol or cyclopropofol on postoperative stress in laparoscopic ovarian cancer surgery
Tengna SHI ; Lijie WANG ; Jun WANG ; Lishuang ZHONG ; Linlin SONG
Journal of Chinese Physician 2025;27(6):841-846
Objective:To investigate the effects of dexmedetomidine (Dex) combined with propofol or cyclopropofol on postoperative stress in laparoscopic ovarian cancer surgery.Methods:A total of 120 ovarian cancer patients who underwent laparoscopic radical resection of ovarian cancer in the Second People′s Hospital of Hengshui from January 2022 to December 2023 were selected and divided into observation group and control group by random number table method, with 60 cases in each group. The control group was given Dex combined with propofol for compound anesthesia, and the observation group was given Dex combined with cyclopropofol for compound anesthesia. The perioperative indicators and intraoperative opioid dosage were compared between the two groups. The heart rate (HR) and mean arterial pressure (MAP) were compared at 3 min after entering the operating room (T 1), intubation (T 2), skin incision (T 3), extubation (T 4) and leaving the operating room (T 5). The Ramsay Sedation Scale (RSS) scores at T 1, T 2, T 3, T 4 and Prince-Henry scores at 2, 6, 12, 24 h after operation were compared. The serum levels of prostin E 2 (PGE 2) and cortisol (Cor) 1 day before operation and 12, 24, 48 h after operation, as well as the incidence of adverse events during treatment were compared between the two groups. Results:The anesthesia recovery time in the observation group was significantly shorter than that in the control group, and the intraoperative dosages of sufentanil and remifentanil were significantly less than those in the control group (all P<0.05). Compared with T 1, there were no significant differences in HR and MAP at T 2, T 3, T 4 in the observation group (all P>0.05); the HR and MAP at T 2, T 3, T 4 in the control group were significantly different from those at T 1 (all P<0.05), and the HR and MAP at T 2, T 3, T 4, T 5 in the observation group were lower than those in the control group (all P<0.05). The RSS scores at T 2, T 3 and T 4 in the observation group were significantly higher than those in the control group (all P<0.05). The Prince-Henry scores at 2, 6, 12, 24 h after operation in the observation group were significantly lower than those in the control group (all P<0.05). The serum PGE 2 and Cor levels at 12, 24 and 48 h after operation in the observation group were significantly lower than those in the control group (all P<0.05). The total incidence of postoperative adverse events in the observation group was 18.33%(11/60), lower than 23.33%(14/60) in the control group ( P<0.05). Conclusions:Compared with Dex combined with propofol, Dex combined with cyclopropofol for compound anesthesia can reduce postoperative stress response in laparoscopic ovarian cancer surgery, improve intraoperative sedation and postoperative analgesia, stabilize hemodynamics, and has good safety.
8.Effects of dexmedetomidine combined with propofol or cyclopropofol on postoperative stress in laparoscopic ovarian cancer surgery
Tengna SHI ; Lijie WANG ; Jun WANG ; Lishuang ZHONG ; Linlin SONG
Journal of Chinese Physician 2025;27(6):841-846
Objective:To investigate the effects of dexmedetomidine (Dex) combined with propofol or cyclopropofol on postoperative stress in laparoscopic ovarian cancer surgery.Methods:A total of 120 ovarian cancer patients who underwent laparoscopic radical resection of ovarian cancer in the Second People′s Hospital of Hengshui from January 2022 to December 2023 were selected and divided into observation group and control group by random number table method, with 60 cases in each group. The control group was given Dex combined with propofol for compound anesthesia, and the observation group was given Dex combined with cyclopropofol for compound anesthesia. The perioperative indicators and intraoperative opioid dosage were compared between the two groups. The heart rate (HR) and mean arterial pressure (MAP) were compared at 3 min after entering the operating room (T 1), intubation (T 2), skin incision (T 3), extubation (T 4) and leaving the operating room (T 5). The Ramsay Sedation Scale (RSS) scores at T 1, T 2, T 3, T 4 and Prince-Henry scores at 2, 6, 12, 24 h after operation were compared. The serum levels of prostin E 2 (PGE 2) and cortisol (Cor) 1 day before operation and 12, 24, 48 h after operation, as well as the incidence of adverse events during treatment were compared between the two groups. Results:The anesthesia recovery time in the observation group was significantly shorter than that in the control group, and the intraoperative dosages of sufentanil and remifentanil were significantly less than those in the control group (all P<0.05). Compared with T 1, there were no significant differences in HR and MAP at T 2, T 3, T 4 in the observation group (all P>0.05); the HR and MAP at T 2, T 3, T 4 in the control group were significantly different from those at T 1 (all P<0.05), and the HR and MAP at T 2, T 3, T 4, T 5 in the observation group were lower than those in the control group (all P<0.05). The RSS scores at T 2, T 3 and T 4 in the observation group were significantly higher than those in the control group (all P<0.05). The Prince-Henry scores at 2, 6, 12, 24 h after operation in the observation group were significantly lower than those in the control group (all P<0.05). The serum PGE 2 and Cor levels at 12, 24 and 48 h after operation in the observation group were significantly lower than those in the control group (all P<0.05). The total incidence of postoperative adverse events in the observation group was 18.33%(11/60), lower than 23.33%(14/60) in the control group ( P<0.05). Conclusions:Compared with Dex combined with propofol, Dex combined with cyclopropofol for compound anesthesia can reduce postoperative stress response in laparoscopic ovarian cancer surgery, improve intraoperative sedation and postoperative analgesia, stabilize hemodynamics, and has good safety.
9.Application effect of dexmedetomidine combined with ciprofol general anesthesia in laparoscopic radical resection of ovarian cancer
Jun WANG ; Tengna SHI ; Lijie WANG ; Lishuang ZHONG ; Linlin SONG
Journal of Chinese Physician 2025;27(10):1500-1503
Objective:To explore the application effect of dexmedetomidine combined with ciprofol general anesthesia in laparoscopic radical resection of ovarian cancer.Methods:A total of 120 patients who underwent laparoscopic radical resection of ovarian cancer at the Hengshui Second People′s Hospital, Hebei Province from January 2021 to January 2023 were selected as the research objects. They were divided into the control group and the observation group by random number table method, with 60 cases in each group. Both groups underwent surgery under general anesthesia: the control group was given ciprofol, while the observation group was given dexmedetomidine combined with ciprofol. Postoperative recovery, changes in hemodynamics and vital signs, levels of stress indicators, and the occurrence of adverse reactions were compared between the two groups.Results:Compared with the control group, the observation group had fewer presses on the analgesic pump, shorter first flatus time and awakening time, lower Visual Analogue Scale (VAS) score at 1 hour after surgery, and higher Ramsay sedation score (all P<0.05). There were no statistically significant differences in heart rate (HR), mean arterial pressure (MAP), and bispectral index (BIS) between the two groups before induction (T 0) (all P>0.05); MAP at skin incision (T 1), 30 minutes after skin incision (T 2), and after extubation (T 3) in both groups were higher than those at T 0, while HR were lower than those at T 0 (all P<0.05); HR and MAP at T 1, T 2, and T 3 in the observation group were significantly lower than those in the control group (all P<0.05), but there was no statistically significant difference in BIS between the two groups at each time point (all P>0.05). There were no statistically significant differences in serum cortisol (COR) and adrenocorticotropic hormone (ACTH) levels between the two groups at T 0 (all P>0.05); serum COR and ACTH levels at T 3 and 1 hour after surgery (T 4) in both groups were higher than those at T 0 (all P<0.05), and the levels of serum COR and ACTH at T 3 and T 4 in the observation group were lower than those in the control group (all P<0.05). In the control group, there were 3 cases of hypotension, 7 cases of nausea and vomiting, and 1 case of respiratory depression; in the observation group, there were 2 cases of hypotension and 3 cases of nausea and vomiting. No serious adverse reactions occurred in either group, and the total incidence of adverse reactions in the observation group was lower than that in the control group (χ 2=3.354, P<0.05). Conclusions:Dexmedetomidine combined with ciprofol general anesthesia can promote postoperative recovery of patients undergoing laparoscopic radical resection of ovarian cancer, effectively stabilize hemodynamics, and reduce stress response and adverse reactions.
10.A multi-center epidemiological study on pneumococcal meningitis in children from 2019 to 2020
Cai-Yun WANG ; Hong-Mei XU ; Gang LIU ; Jing LIU ; Hui YU ; Bi-Quan CHEN ; Guo ZHENG ; Min SHU ; Li-Jun DU ; Zhi-Wei XU ; Li-Su HUANG ; Hai-Bo LI ; Dong WANG ; Song-Ting BAI ; Qing-Wen SHAN ; Chun-Hui ZHU ; Jian-Mei TIAN ; Jian-Hua HAO ; Ai-Wei LIN ; Dao-Jiong LIN ; Jin-Zhun WU ; Xin-Hua ZHANG ; Qing CAO ; Zhong-Bin TAO ; Yuan CHEN ; Guo-Long ZHU ; Ping XUE ; Zheng-Zhen TANG ; Xue-Wen SU ; Zheng-Hai QU ; Shi-Yong ZHAO ; Lin PANG ; Hui-Ling DENG ; Sai-Nan SHU ; Ying-Hu CHEN
Chinese Journal of Contemporary Pediatrics 2024;26(2):131-138
Objective To investigate the clinical characteristics and prognosis of pneumococcal meningitis(PM),and drug sensitivity of Streptococcus pneumoniae(SP)isolates in Chinese children.Methods A retrospective analysis was conducted on clinical information,laboratory data,and microbiological data of 160 hospitalized children under 15 years old with PM from January 2019 to December 2020 in 33 tertiary hospitals across the country.Results Among the 160 children with PM,there were 103 males and 57 females.The age ranged from 15 days to 15 years,with 109 cases(68.1% )aged 3 months to under 3 years.SP strains were isolated from 95 cases(59.4% )in cerebrospinal fluid cultures and from 57 cases(35.6% )in blood cultures.The positive rates of SP detection by cerebrospinal fluid metagenomic next-generation sequencing and cerebrospinal fluid SP antigen testing were 40% (35/87)and 27% (21/78),respectively.Fifty-five cases(34.4% )had one or more risk factors for purulent meningitis,113 cases(70.6% )had one or more extra-cranial infectious foci,and 18 cases(11.3% )had underlying diseases.The most common clinical symptoms were fever(147 cases,91.9% ),followed by lethargy(98 cases,61.3% )and vomiting(61 cases,38.1% ).Sixty-nine cases(43.1% )experienced intracranial complications during hospitalization,with subdural effusion and/or empyema being the most common complication[43 cases(26.9% )],followed by hydrocephalus in 24 cases(15.0% ),brain abscess in 23 cases(14.4% ),and cerebral hemorrhage in 8 cases(5.0% ).Subdural effusion and/or empyema and hydrocephalus mainly occurred in children under 1 year old,with rates of 91% (39/43)and 83% (20/24),respectively.SP strains exhibited complete sensitivity to vancomycin(100% ,75/75),linezolid(100% ,56/56),and meropenem(100% ,6/6).High sensitivity rates were also observed for levofloxacin(81% ,22/27),moxifloxacin(82% ,14/17),rifampicin(96% ,25/26),and chloramphenicol(91% ,21/23).However,low sensitivity rates were found for penicillin(16% ,11/68)and clindamycin(6% ,1/17),and SP strains were completely resistant to erythromycin(100% ,31/31).The rates of discharge with cure and improvement were 22.5% (36/160)and 66.2% (106/160),respectively,while 18 cases(11.3% )had adverse outcomes.Conclusions Pediatric PM is more common in children aged 3 months to under 3 years.Intracranial complications are more frequently observed in children under 1 year old.Fever is the most common clinical manifestation of PM,and subdural effusion/emphysema and hydrocephalus are the most frequent complications.Non-culture detection methods for cerebrospinal fluid can improve pathogen detection rates.Adverse outcomes can be noted in more than 10% of PM cases.SP strains are high sensitivity to vancomycin,linezolid,meropenem,levofloxacin,moxifloxacin,rifampicin,and chloramphenicol.[Chinese Journal of Contemporary Pediatrics,2024,26(2):131-138]

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