China is a country with a high incidence of esophageal cancer.The pathological type is mainly squamous cell carcinoma.Squamous intraepithelial neoplasia is the most recognized precancerous lesion of esopha-geal squamous cell carcinoma,and its monitoring and intervention is an effective method to reduce the incidence of esophageal squamous cell carcinoma and improve the quality of life of patients.Understanding the etiology,clinical features,diagnosis and treatment of esophageal squamous cell carcinoma plays a crucial role in the prevention and early diagnosis and treatment of esophageal squamous cell carcinoma.At present,the clinical research related to esophageal squamous intraepithelial neoplasia is still insufficient,and there are some differences in clinical treat-ment.This review summarizes the risk factors,clinical features,diagnosis,prognosis and treatment of esophageal squamous intraepithelial neoplasia,hoping to provide ideas for the clinical management of esophageal squamous intraepithelial neoplasia.

Objective:To explore the related factors of vascular complications after liver transplantation in children.Methods:This is a retrospective case series research. The clinical data of 89 pediatric liver transplant patients admitted to the Organ Transplantation Center, the Affiliated Hospital of Qingdao University from January 2016 to March 2024 were collected retrospectively. This study included 44 males and 45 females,aged from 4 months to 17 years. The ratio of graft to recipient weight was 0.6% to 7.7%. The primary diseases included 48 cases of biliary atresia and 41 cases of non-biliary atresia. The Wilcoxon rank sum test, χ2 test, and Fisher′s exact probability method were used for data analysis. Multivariate Logistic regression was used to analyze the related factors of vascular complications. Results:All 89 children with liver transplantation completed surgery successfully. There were 8 cases of arterial complications after surgery, including 6 cases of hepatic artery thrombosis and 2 cases of hepatic artery stenosis. There were 16 cases of portal vein complications after surgery, including 9 cases of portal vein stenosis and 7 cases of portal vein thrombosis. The results of univariate analysis showed that the age of the recipient ≤1 year was the relevant factor for hepatic arterial complications( χ 2=4.772, P=0.029). The age of the recipient ≤1 year, the age of the donor, the hepatic phase, and the time of cold ischemia were the relevant factors for the occurrence of portal vein complications( χ 2=7.270, Z=388.500, Z=838.000, Z=894.500;all P<0.05). The results of multivariate analysis showed that age(≤1 year vs. >1 year) and duration of cold ischemia(every additional 1 hour) were independent related factors for portal vein complications after liver transplantation in children(both P<0.05). Conclusion:Children aged ≤1 year and with prolonged cold ischemia are more likely to develop portal vein complications after liver transplantation.

Objective:To explore the related factors of vascular complications after liver transplantation in children.Methods:This is a retrospective case series research. The clinical data of 89 pediatric liver transplant patients admitted to the Organ Transplantation Center, the Affiliated Hospital of Qingdao University from January 2016 to March 2024 were collected retrospectively. This study included 44 males and 45 females,aged from 4 months to 17 years. The ratio of graft to recipient weight was 0.6% to 7.7%. The primary diseases included 48 cases of biliary atresia and 41 cases of non-biliary atresia. The Wilcoxon rank sum test, χ2 test, and Fisher′s exact probability method were used for data analysis. Multivariate Logistic regression was used to analyze the related factors of vascular complications. Results:All 89 children with liver transplantation completed surgery successfully. There were 8 cases of arterial complications after surgery, including 6 cases of hepatic artery thrombosis and 2 cases of hepatic artery stenosis. There were 16 cases of portal vein complications after surgery, including 9 cases of portal vein stenosis and 7 cases of portal vein thrombosis. The results of univariate analysis showed that the age of the recipient ≤1 year was the relevant factor for hepatic arterial complications( χ 2=4.772, P=0.029). The age of the recipient ≤1 year, the age of the donor, the hepatic phase, and the time of cold ischemia were the relevant factors for the occurrence of portal vein complications( χ 2=7.270, Z=388.500, Z=838.000, Z=894.500;all P<0.05). The results of multivariate analysis showed that age(≤1 year vs. >1 year) and duration of cold ischemia(every additional 1 hour) were independent related factors for portal vein complications after liver transplantation in children(both P<0.05). Conclusion:Children aged ≤1 year and with prolonged cold ischemia are more likely to develop portal vein complications after liver transplantation.

Objective:To determine the pharmacodynamics of ciprofol for adjunctive sedation in elderly patients undergoing neuraxial anesthesia.Methods:This was a prospective study. American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ patients of either sex, aged ≥65 yr, with a body mass index of 18-30 kg/m 2, scheduled for elective knee replacement under neuraxial anesthesia from June to September 2023 in the Second Hospital of Shanxi Medical University, were selected. After completion of neuraxial anesthesia, ciprofol was pumped intravenously at a loading dose of 0.05 mg/kg (administered for approximately 4 min). The maintenance dose was determined by the sequential method. The initial maintenance dose was 0.2 mg·kg -1·h -1, and the dose gradient was 0.02 mg·kg -1·h -1. If the patient was satisfactorily sedated, the dose of ciprofol was decreased by 0.02 mg·kg -1·h -1 in the next patient; if the sedation was unsatisfactory, the dose of ciprofol was increased by 0.02 mg·kg -1·h -1 in the next patient, and the trial was terminated after 8 transitions. The occurrence of adverse reactions was recorded during administration and emergence. The median effective dose (ED 50), 95% effective dose (ED 95) and the corresponding 95% confidence interval ( CI) of ciprofol were calculated using the probit regression analysis. Results:Thirty-five patients were finally included in this study.The ED 50 of ciprofol for adjunctive sedation was 0.246 mg·kg -1·h -1 (95% CI 0.217-0.300 mg·kg -1·h -1), and the ED 95 was 0.325 mg·kg -1·h -1 (95% CI 0.284-0.771 mg·kg -1·h -1) in elderly patients undergoing knee arthroplasty under neuraxial anesthesia. During the administration of ciprofol, bradycardia occurred in 4 cases (11%), hypotension in 2 cases (6%), and hypoxemia in 2 cases (6%), which improved after treatment. No injection pain, abnormal limb movements, agitation during emergence, dizziness, headache, nausea and vomiting and postoperative delirium developed in patients. Conclusions:The ED 50 of ciprofol for adjunctive sedation is 0.246 mg·kg -1·h -1 and the ED 95 is 0.325 mg·kg -1·h -1 in elderly patients undergoing neuraxial anesthesia.

OBJECTIVE:To observe the effects of remifentanil-induced controlled hypotension (CH) on postoperative cogni-tive dysfunction (POCD) and serum S100β protein in elderly patients underwent spinal surgery,and to investigate their relation-ship. METHODS:Sixty elderly patients undergoing selective laminectomy decompression internal fixation of lumbar or thoracic fractures under general anesthesia were selected prospectively from orthopedics department of our hospital during Jan. 2014-Dec. 2015,and then divided into CH group and non-CH group in accordance with random number table,with 30 cases in each group. Both groups received general anesthesia of injection and inhalation via endotracheal intubation. Mean arterial pressure (MAP) of CH group were reduced to 70%-80%of the basic values by adjusting remifentanil infusion rate;those of non-CH group were main-tained at basic level. Surgery duration,anesthesia duration,intraoperative blood loss,the incidence of POCD and serum concentra-tion of S100β protein were observed in 2 groups. The relationship of serum concentration of S100β protein with POCD was ana-lyzed,and the occurrence of ADR was recorded. RESULTS:The intraoperative blood loss of CH group was significantly less than that of non-CH group,with statistical significance (P<0.05). There was no statistical significance in the incidence of POCD be-tween 2 groups on the 1st and 7th day after surgery(P>0.05). The incidence of POCD and serum concentration of S100β protein in CH group were significantly higher than in non-CH group on the 2nd and 3rd day after surgery,with statistical significance(P<0.05). The serum concentration of S100β protein may be related to the incidence of POCD (r=0.992 7,P=0.001 3). CONCLU-SIONS:Remifentanil CH used in elderly patients underwent spinal surgery can reduce intraoperative blood loss,but increase the se-rum concentration of S100βprotein and the incidence of POCD at early stage.

Objective To investigate the clinical application of serum interleukin-6 (IL-6)and interleukin-22 (IL-22) levels in predicting the recurrence of hepatitis B virus (HBV)-related early hepatocellular carcinoma (HCC) after receiving microwave ablation (MWA).Methods Preoperative peripheral blood samples were collected in 49 patients with early-stage HBV-related HCC,and serum concentrations of IL-6 and IL-22 were measured by using ELISA.Thirty healthy volunteers were recruited and used as the control group.The xtile software was used to define the best cut-off value,and the IL-6 and IL-22 levels were divided into highlevel group and low-level group.The tumor-free survivals of high-level and low-level groups were analyzed with Kaplan-Meier analysis,log rank test was adopted to determine the difference,and Cox regression model was employed to screen the risk factors affecting HBV-related HCC recurrence.Results The serum IL-6 and IL-22 levels of HCC group were 13.20 pg/ml (11.87-15.79 pg/ml) and 42.18 pg/ml (34.39-57.44 pg/ml) respectively,which were significantly higher than 10.47 pg/ml (9.50-13.82 pg/ml) and 25.45 pg/ml (22.31-30.12 pg/ml) of the control group (P=0.001 and P＜0.001 respectively).Kaplan-Meier analysis revealed that preoperative lower IL-6,higher total bilirubin and lower albumin levels indicated a shorter disease-free survival (DFS),and IL-22 levels had no statistically significant effect on the recurrence of HCC.Cox regression multivariate analysis showed that lower serum IL-6 level (≤ 13.2 pg/ml;hazard ratio=3.721;95％ CI=1.674-8.272;P=0.001) and lower serum albumin level (≤41.0 g/L;hazard mtio=2.085;95％CI=1.101-3.950;P=0.024) were independent risk factors affecting HBV-related HCC recurrence Conclusion Preoperative serum IL-6 level and serum albumin level can be used as the predictors of HCC recurrence in patients with HBV-related early HCC who are receiving MWA treatment.(J Intervent Radiol,2017,26:232-236)

Objective To investigate the risk factors of surgical site infection in patients with colorectal cancer.Methods Clinical data of 542 patients with colorectal cancer were retrospectively studied.According to the infection of surgical site or not,all patients were assigned into infection group (n =48) or non-infection group (n =494).The risk factors of surgical site infection were analyzed.Results Compared with non-infection group,the patients in the infection group got significant increase in age [(67.74 ± 9.46) years vs.(57.63 ± 9.94) years,t =7.593,P =0.000],significantly higher rate of diabetes (25.00％ vs.8.70％,x2 =12.843,P =0.000),significantly x higher rate of open surgery (70.83％ vs.33.81％,x2 =25.946,P =0.000),and significantly longer operation duration [(123.45 ± 23.56) min vs.(110.47 ± 19.47) min,t =10.485,P =0.000].Logistic study showed that age,diabetes,open surgery and operation duration were risk factors for the development of surgical site infection (all P ＜ 0.05).Conclusion Age,diabetes,open surgery and operation duration are risk factors for the development of surgical site infection in colorectal cancer.

Objective To study the effect of parecoxib sodium preemptive analgesia on the postoperative cognition and inflammatory cytokines in elderly patients.Methods Sixty elderly male patients undergoing replace-ment of total hip were randomly divided into two groups:the control group(group C,30 cases) and the parecoxib sodi-um group(group P,30 cases).In group C,physiological saline 5 ml was injected after induction of anesthesia.Pare-coxib sodium 40 mg was injected after induction of anesthesia in group P.Peripheral venous blood was collected at the following time points:2h before operation(T0 ),and 4h(T1 ),24h(T2 ) and 48h(T3 ) after operation.And the serum concentrations of IL -1β,IL -6,tumor necrosis factor α(TNF -α) were measured by enzyme linked immunosorbent assay(ELISA).Cognitive function was assessed by mini -mental state examination(MMSE) at the time of T0 -T3 . Results The MMSE scores in group P[(25.4 ±0.6) points,(27.2 ±0.1)points] were significantly higher than those in group C at T1 and T2 .The concentrations of IL -1β,IL -6 and TNF -αin group P[T1:(18.43 ±4.45)pg/mL, (165.34 ±9.57)pg/mL,(34.43 ±3.83)pg/mL;T2:(14.59 ±2.59)pg/mL,(98.99 ±7.28)pg/mL,(22.32 ± 3.81)pg/mL]were lower than those in group C[T1:(23.97 ±3.85)pg/mL,(204.19 ±12.44)pg/mL,(37.77 ± 4.81)pg/mL;T2:(19.33 ±3.18)pg/mL,(121.35 ±9.67)pg/mL,(29.01 ±3.39)pg/mL]at T1 ,T2 .The concen-trations of IL -1β,IL -6 and TNF -αand the MMSE scores had no differences in group P and group C at T3 .The concentrations of IL -1β,IL -6 and TNF -αin group P at T1 and T2 [(9.57 ±2.24)pg/mL,(46.15 ±6.18)pg/mL, (14.48 ±3.14)pg/mL] were lower than those at T0,and had no difference at T3 .Conclusion Parecoxib sodium preemptive can reduce the incidence of POCD in elderly patients by inhibiting the release of early postoperative pro -inflammatory cytokines.

Objective To observe the effect of continuous pumped dexmedetomidine on hemodynamics, awakening quality and stress response in double -lumen tube extubation patients.Methods 60 patients with thoracic surgery were divided into saline group(group N,n =30)and Dex group(group D,n =30).Both two groups were continuously pumped NS and dexmedetomidine respectively 20min before anesthesia.MAP,HR and SpO2 at different time points during the surgery were recorded.Extracted 5ml arterial blood at the time point of T0 and T3,centrifugated and stored at -80 ℃ for testing renin levels.The extubation time,restlessness incidence,orientation recovery time, extubation quality score were recorded.Results The values of MAP in group D at time points of T0,T1,T2,T3,T4 were (97 ±15)mmHg,(102 ±12)mmHg,(103 ±11)mmHg,(98 ±12)mmHg,(96 ±13)mmHg.The values of HR in group D at different time points were (69 ±9)times/min,(80 ±6)times/min,(90 ±7)times/min,(74 ±5)times/min,(73 ±6)times/min.The values of SpO2 in group D at different time points were (95 ±3)%,(98 ±2)%,(98 ± 2)%,(95 ±3)%,(96 ±2)%.The values of MAP in group N at time points of T0,T1,T2,T3,T4 were (96 ± 15)mmHg,(112 ±16)mmHg,(120 ±12)mmHg,(117 ±14)mmHg,(102 ±15)mmHg.The values of HR in group N at different time points were (68 ±7)times/min,(84 ±8)times/min,(105 ±6)times/min,(89 ±6)times/min, (80 ±7)times/min.The values of SpO2 in group N at different time points were (96 ±2)%,(98 ±2)%,(97 ± 3)%,(93 ±3)%,(92 ±4)%.The values of MAP,HR,SpO2 at different time points in group D were significantly lower than those in group N,the differences were statistically significant (the t values of MAP at different time points were tT1 =2.74,tT2 =5.72,tT3 =25.63,tT4 =1.66,all P <0.05;the t values of HR at different time points were tT1 =2.20,tT2 =8.91,tT3 =10.52,tT4 =4.16,all P <0.05;the t values of SpO2 at different time points were tT1 =0.00,tT2 =1.52,tT3 =2.58,tT4 =4.9,PT3 <0.05,PT4 <0.05).There was significant difference between the two groups in orientation recovery time[(3.3 ±2.2)min vs (5.2 ±2.3)min,P =0.0018].There was significant difference between the two groups in agitation score[(1.3 ±0.9)vs (2.4 ±1.2)].There was significant difference between the two groups in extubation quality score[(2.1 ±1.2)vs (3.2 ±1.4),P =0.0018].There was statistical difference between the two groups in T3 adrenal hormones[(N:120 ±25.3)pmol/L,(D:93.4 ±23.2)pmol/L,P =0.00].The dose of sufentanil (60.5 ±9.2)μg in group N was higher than (40.4 ±10.2)μg in group D (P =0.001).The dose of remifentanil (3.3 ±0.8)mg in group N was higher than (2.4 ±0.9)mg in group D (P =0.001).Conclusion Continuous pumped dexmedetomidine can effectively improve awakening quality of patients with double -lumen tube.

Objective To compare the security between the sevoflurane anesthesia via laryngeal mask airway (LMA) composited nerve block in groin area and ketamine anesthesia in the pediatric hemioplasty.Methods 80 children (aged 2 -6,weight 10 -25kg,ASAⅠ -Ⅱ)with high ligation of hernia sac were divided into two groups according to the random number table method:group S -sevoflurane combined with inguinal region block under laryngeal airway ventilation;group K -ketamine combined with caudal block.Group S was inhalated with 6% -8% sevoflurane for foundation anesthesia,and then followed with vein induction:fentanyl 2μg/kg and propofol 2mg/kg.The laryngeal mask was placed when the temporomandibular joint was relaxed.Inguinal region was blocked by the surgeon after disinfect and spread towels.Anesthesia was maintained by 3% to 4% sevoflurane with mechanical ventilation interop-eration.Group K was adopted the intramuscular ketamine (5mg/kg)for basic anesthesia and then used modified sacral canal blocking.Ketamine 1mg/kg was administered before skin incision.Additional ketamine 0.5mg/kg was intravenously injected when it was appeared with body move,choking cough,etc.The values of MAP and HR in the two groups were recorded respectively at the time point of 1min before skin cutting (T0 ),1min after skin cutting (T1 ),5min after skin cutting (T2 ),the end of operation (T3 )and awaken time (T4 ).The body movement was observed intraoperation,the number of SpO2≤95% and awaken restlessness,the recovery time and residence time in anesthesia recovery room were recorded.Results The values of MAP in group S at time points of T1 ,T2 ,T3 were (77.6 ±6.2)mmHg,(77.8 ±6.4)mmHg,(76.5 ±4.7)mmHg respectively,and the values of MAP in group K at time points of T1 ,T2 ,T3 were (86.9 ±8.1)mmHg,(88.1 ±5.3)mmHg,(86.4 ±6.5)mmHg respectively.The t values at time points of T1 ,T2 ,T3 were 5.766,7.893,7.806 respectively when the group S compared with group K(P <0.0001),the group S was superior to group K.The values of HR in group S at time points of T1 ,T2 ,T3 were (121.3 ± 9.6)times/min,(121.9 ±8.4)times/min,(120.3 ±7.8)times/min respectively,and the values of HR in group K at time points of T1 ,T2 ,T3 were (138.6 ±9.4)times/min,(136.5 ±7.5)times/min,(128.7 ±6.9)times/min respec-tively.The t values at time points of T1 ,T2 ,T3 were 8.144,8.200,5.101 respectively(P <0.0001),the group S was superior to group K.The MAP and HR were more smoothly in group S than in group K.The recovery time in group S and K was (7.5 ±3.4)min and (16.7 ±5.5)min respectively(t =8.99,P <0.0001),it was shorter in group S than in group K.The residence time in anesthesia recovery room was (15.4 ±4.2)min and (23.7 ±6.3)min respectively (t =6.93,P <0.0001),it was shorter in group S than in group K.Intraoperative body movements was 3 cases and 15 cases respectively in group S and group K(χ2 =10.32,P <0.001);Cases of SpO2 ≤95% was 4 and 12 respec-tively in group S and group K(χ2 =10.32,P <0.001),the occurrence of body movements and SpO2 ≤95% cases was lower in group S than in group K.Conclusion The sevoflurane anesthesia via LMA composited nerve block in groin area has the advantages of faster induction,faster recovery,the hemodynamics was more stable,adverse reactions was fewer and so on,it can be safely used in pediatric anesthesia.