Phacoemulsification with intraocular lens implantation(Phaco+lOL)has become the main treatment for cataracts due to small incision and fast recovery. Phacoemulsification can damage the conjunctiva, cornea and other ocular surface tissues, causing local inflammation, which in turn leads to eye dryness and discomfort after surgery. According to studies, patients who suffer from phacoemulsification most experience dry eye syndrome within 24 h, which gradually worsens and reaches its peak in the following 1 wk, seriously affecting their quality of life. The review aims to comprehensively investigate the effects of preoperative patient physical conditions and local ocular status, intraoperative maneuvers and postoperative treatments on postoperative dry eye, with the expectation of formulating scientific and effective preventive measures for potential dry eye patients after phacoemulsification, and providing a theoretical basis for postoperative dry eye treatment.

Objective To evaluate the effect of remimazolam for general anesthesia on cellular im-mune function and quality of postoperative recovery in patients undergoing laparoscopic radical surgery for colorectal cancer.Methods Sixty patients undergoing laparoscopic radical surgery for colorectal cancer,36 males and 24 females,aged 18-80 years,BMI 18.5-28.0 kg/m2,ASA physical status Ⅰ or Ⅱ,were en-rolled in this study.The patients were divided into remimazolam group(group R)and propofol group(group P)by using a random number,with 30 patients in each group.Induction of anesthesia was as follows:remimazolam at a dose of 0.2-0.3 mg/kg was intravenously infused(intravenous injection time>1 minute)in group R,propofol at a dose of 1.0-2.0 mg/kg was intravenously infused in group P,and sufen-tanil at a dose of 0.3-0.5 μg/kg and cisatracurium at a dose of 0.15-0.2 mg/kg were intravenously in-fused injected after the patients consciousness disappeared,that is the modified observer's assessment of alertness/sedation score of 1-2 in two groups to complete tracheal intubation.Anesthesia maintenance was as follows:remimazolam at a dose of 1.0-2.0 mg·kg-1·h-1 was intravenously infused in group R,propo-fol at a dose of 4.0-12.0 mg·kg-1·h-1 was intravenously infused in group P,remifentanil at a dose of 0.1-0.2 μg·kg-1·min-1 was intravenously infused in two groups,and intravenous cisatracurium was in-jected intermittently to maintain the BIS value at 40-60 intraoperatively.The two groups percentage of CD3+,CD4+,CD8+T lymphocytes,natural killer cell and CD4+/CD8+ratio were collected before induction of anesthesia,at immediately after the end of the surgery,and 24,72 hours after surgery.The HR,MAP,percutaneous oxygen saturation,and bispectral index were collected before induction of anesthesia,immedi-ately after endotracheal intubation,immediately after surgical incision,immediately after endotracheal extu-bation.The incidence of intraoperative adverse cardiovascular events and utilization rate of vasoactive drugs were collected.The quality of recovery-15(QoR-15)scores before induction of anesthesia,and 24,72 hours after surgery were recorded.The Riker and Ramsay scores at awakening,emergence time,tracheal ex-tubation time,duration of post-anesthesia care unit(PACU)stay,first postoperative expiration time,and postoperative length of hospital stay were recorded.And the incidence of nausea,vomiting and sleepiness in the postoperative period of 24 hours were collected.Results Compared with group P,group R had signifi-cantly higher NK,CD3+,and CD4+cells immediately after the end of the surgery and 24 hours after surgery(P<0.05),significantly faster HR and higher MAP immediately after the end of the surgery(P<0.05),significantly lower incidence of intraoperative hypotension,bradycardia and the utilization rate of vasoactive drugs(P<0.05),and significantly higher QoR-15 scores 24,72 hours after surgery(P<0.05).There were no significant differences in the Riker and Ramsay scores between the two groups.Conclusion Com-pared with propofol,general anesthesia with remimazolam has less impact on the perioperative cellular im-mune function in patients undergoing laparoscopic radical surgery for colorectal cancer,with lower incidence of intraoperative hypotension and bradycardia,and higher quality of postoperative recovery.

Intratumoral bacteria are a group of bacteria that exist within tumors and make up the tumor microenvironment. They play a significant role in tumorigenesis and progression, as well as in influencing the response of tumors to chemotherapy and immunotherapy through various mechanisms. This article primarily discusses the sources and mechanisms of action of intratumoral bacteria, with a specific focus on their composition and functions in the digestive system. Further-more, it explores the potential application of intratumoral bacteria in anti-tumor therapy, aiming to provide valuable references for future clinical use.

Objective:To investigate the mortality burden among permanent residents in Shenzhen from 2014 to 2021 and to provide scientific evidence for establishing precision disease prevention and control strategy.Methods:Based on the cause-of-death surveillance data, we described the distribution of mortality rate, cause-specific rankings, and years of life lost (YLL) for the total population and subgroups in Shenzhen from 2014 to 2021. The seventh national population census data was used as the standard population to calculate the standardized mortality rate. Joinpoint log-linear regression model was used to analyze the chronic trend of mortality burden.Results:From 2014 to 2021, 49 734 deaths among the permanent population were recorded in Shenzhen, with a 140.90/100 000 average crude mortality rate, standardized as 366.77/100 000. Both the crude mortality rate and standardized mortality rate showed fluctuating increases from 2014 to 2016 [annual percent change (APC)=20.72%, P=0.048, APC=28.59%, P=0.016] and fluctuating decreases from 2016 to 2021 (APC=-1.55%, P=0.317, APC=-1.89%, P=0.190). The mortality rates of the <20 and 20- age groups decreased over time, with a statistically significant decrease observed in the <20 age group [average annual percent change (AAPC)=-11.91%, P<0.001]. The mortality rates of the 40-, 60-, and ≥80 age groups increased over time, with an increase observed in the ≥80 age group from 2014 to 2016 (APC=45.25%, P=0.016) and a decrease from 2016 to 2021 (APC=-2.18%, P=0.280). There was no statistical significance in the mortality rate trend for the remaining age groups (all P>0.05). The top three causes of death among permanent residents in Shenzhen from 2014 to 2021 were consistently malignant tumors, cardiovascular and cerebrovascular diseases, and respiratory system diseases, with crude mortality rates of 49.59/100 000, 47.95/100 000, and 7.90/100 000 respectively in 2021. From 2014 to 2021, 1 003 287.43 YLL were observed, with YLL for the total population, males and females all showing an upward trend (all P<0.001). Conclusions:The mortality burden among the elderly permanent residents in Shenzhen displayed a continuously increasing trend from 2014 to 2021. Strengthening the need for substantial efforts and actions to improve the prevention and control of chronic non-communicable diseases.

Objective:To analyze the disease burden in middle-aged and elderly population aged ≥55 in Shenzhen from 2016 to 2030 and provide evidence for the development of healthy aging strategies.Methods:The years of life lost (YLL), years lost due to disability (YLD), and the disability-adjusted life year (DALY) in this population from 2016 to 2022 were calculated. Joinpoint log-linear regression model was used to analyze the time trend. Bayesian age-period-cohort model and grey system model were used to predict YLL, YLD, and DALY in this population in 2030.Results:From 2016 to 2022, the crude DALY rate showed a transient fluctuation in age group 55-74 years, but a pronounced increase in age group ≥85 years. The proportions of YLL and YLD due to non-communicable diseases in all age groups was considerably higher than those due to communicable and nutritional diseases and injuries. In 2022, in all age groups, the YLL due to neoplasms (55-74 years old) and cardiovascular disease (≥75 years old) ranked first, and the YLD due to musculoskeletal disorder ranked first. By 2030, the causes of YLL and YLD ranking first in each age group would be remained, while the ranks of some causes would increase.Conclusions:The age specific characteristics of current and predicted disease burden differed in individuals aged ≥55 years. Therefore, it is necessary to allocate social and medical resources according to the disease burden pattern.

AIM:To evaluate the effect of astaxanthin(AST)on cognitive function of intestinal ischemia/re-perfusion(I/R)injury in rats and the role of autophagy.METHODS:Eight-week-old SPF-grade male Sprague-Dawley(SD)rats were randomly divided into sham group,I/R group,AST group and AST+3-methyladenine(3-MA)group,with 12 animals in each group.The superior mesenteric artery(SMA)of the rats in sham group was only exposed without clamping.The SMA in other 3 groups was clamped for 90 min,and then the arterial clamp was released to restore blood supply and perform reperfusion,thus establishing the intestinal I/R model.The rats in AST group were intraperitoneally in-jected with AST(45 mg·kg-1·d-1)3 d before modeling,and those in AST+3-MA group were intraperitoneally injected with AST(45 mg·kg-1·d-1)+3-MA(1.5 mg·kg-1·d-1)3 d before modeling.Morris water maze was used to evaluate the cogni-tive function of rats 48 h after surgery.Hematoxylin-eosin(HE)staining was used to evaluate intestinal tissue damage.Nissl staining of the frontal cortex was used to evaluate neuronal damage.The levels of interleukin-6(IL-6),IL-1β and tu-mor necrosis factor-α(TNF-α)in the frontal cortex and hippocampus were measured by ELISA kits.The protein levels of beclin-1,microtubule-associated protein 1 light chain 3(LC3)and P62 in the frontal cortex and hippocampus were detected by Western blot.RESULTS:Compared with sham group,the swimming distance of rats in I/R group was increased,with prolonged latency,elevated Chiu's score and decreased number of neurons(P<0.01),while the levels of IL-6,IL-1β and TNF-α in the frontal cortex and hippocampus were increased(P<0.01).Beclin-1 expression and LC3-II/LC3-I ratio in the frontal cortex and hippocampus were increased(P<0.05 or P<0.01).Compared with I/R group,the swimming distance and latency of rats in AST group were shortened,with decreased Chiu's score,increased neuronal number(P<0.01),de-creased IL-6,IL-1β and TNF-α levels in the frontal cortex and hippocampus(P<0.01),and increased beclin-1 expres-sion and decreased of P62 expression in the frontal cortex and hippocampus(P<0.05 or P<0.01).Compared with AST group,the swimming distance of rats in AST+3-MA group was increased,with prolonged latency,elevated Chiu's score,decreased number of neurons(P<0.05),increased levels of IL-6,IL-1β and TNF-α in the frontal cortex and hippocam-pus,and decreased beclin-1 expression and LC3-II/LC3-I ratio and increased P62 expression in the frontal cortex and hip-pocampus(P<0.01).CONCLUSION:Astaxanthin alleviates intestinal I/R-induced cognitive impairment in rats by pro-moting autophagy and inhibiting neuroinflammation.

AIM:To investigate the possible mech-anisms by observing the effects of sodium butyrate on the blood-brain barrier and cognitive function after intestinal ischemia/reperfusion in rats.METH-ODS:SD rats were randomly divided into 4 groups of 12 rats each,(1)sham-operated group(the Sham group);(2)intestinal ischemia/reperfusion group(the Ⅱ/R group);(3)intestinal ischemia/re-perfusion+sodium butyrate group(the NaB group):gavage of NaB 500 mg·kg-1·d-1 for 1 week before modeling;(4)intestinal ischemia/reperfusion+sodi-um butyrate+ITSA-1 group(the ITSA-1 group):NaB 500 mg·kg-1·d-1 gavage 1 week before modeling+IT-SA-1 0.5 mg/kg intraperitoneal injection in the first 5 d,3 d and 1 d.Intestinal mucosal injury was eval-uated by HE staining.Morris water maze test evalu-ated the cognitive function of rats.The microstruc-ture of the blood-brain barrier was observed by transmission electron microscope.The levels of in-flammatory cytokines IL-1β,IL-6,TNF-α,Claudin5,ZO-1,and MMP-9 in brain tissue were detected by ELISA.Western blotting detected Claudin5,ZO-1,CypA,and MMP-9 levels.RESULTS:Compared with the Sham group,Chiu's score in the Ⅱ/R group was increased(P<0.001).The swimming distance was increased(P<0.05),the proportion of the non-plat-form quadrant was increased(P<0.001),and the in-cubation period was prolonged(P<0.05).The micro-structure of the blood-brain barrier was changed under the transmission electron microscope.The inflammatory cytokines IL-1β,IL-6,and TNF-α were increased(P<0.001),the expressions of CypA and MMP-9 were increased(P<0.01),and the expres-sions of Claudin5 and ZO-1 were decreased(P<0.01,P<0.001).Compared with the Ⅱ/R group,neu-roinflammation,and blood-brain barrier damage were reduced,and cognitive function was im-proved in the Ⅱ/R+NaB group.The above injuries in group Ⅱ/R+NaB+ITSA-1 were similar to those in group Ⅱ/R.CONCLUSION:Sodium butyrate can ameliorate Ⅱ/R-induced neurocognitive dysfunction in rats by alleviating blood-brain barrier damage,possibly related to inhibiting the CypA/MMP-9 pathway.

Objective To investigate the factors influencing the implementation status of cardiac rehabilitation by cardiovascular nurses. Methods A self-designed questionnaire titled "Survey on Factors Influencing the Implementation of Cardiac Rehabilitation by Cardiovascular Nurses" was used to survey cardiovascular nurses from tertiary hospitals in Beijing, Anhui Province, and other regions through convenience sampling. Results A total of 655 questionnaires were distributed, with 548 valid responses, yielding an effective response rate of 83.66%. The main promoting factors for nurses in cardiology departments to implement cardiac rehabilitation were nurses' experience in guiding patients through cardiac rehabilitation, the establishment of dedicated cardiac rehabilitation centers in hospitals, and the inclusion score of cardiac rehabilitation in national medical insurance of (4.32±0.79) points; the main obstacles were patients' lack of understanding of cardiac rehabilitation [(3.03±1.04) points], the high turnover rate in the department [(4.21±0.79) points], and incomplete laws and regulations related to cardiac rehabilitation [(3.56±0.88) points]. Conclusion The implementation of cardiac rehabilitation by nurses in cardiology departments is related to factors such as the nurses, patients, hospitals, and policies. Clinical importance should be given to these factors, and corresponding measures should be taken to promote the implementation of cardiac rehabilitation.

Objective To investigate the current status of knowledge-attitude-practice of cardiac rehabilitation in patients undergoing coronary artery bypass grafting(CABG) and analyze its influencing factors. Methods From July to November 2022, 288 patients with CABG in the coronary heart disease surgery center of Beijing Anzhen Hospital Affiliated to Capital Medical University were conveniently included, and general information questionnaire and cardiac rehabilitation knowledge and practice questionnaire were used to investigate the general situation and the level of knowledge-attitude-practice of cardiac rehabilitation in patients with coronary heart disease. Results A total of 290 questionnaires were sent out in this study, and 288 were effectively collected, with an effective recovery rate of 99.31%. The total score of the questionnaire was (106.81±13.35), and the total score rate was 62.83%, including the knowledge questionnaire scoring (39.34±9.13), belief questionnaire scoring (32.86±3.39) and behavior questionnaire scoring (34.61±3.54). The scoring rates of knowledge, attitude and practice questionnaire were 46.28%, 82.15% and 76.91%, respectively. Multiple linearregression analysis showed that patients who lived in rural areas, had education background of primary school or below, were farmers, had public health insurance, and had no previous coronary intervention, had lower levels of knowledge-attitude-practice of cardiac rehabilitation (P < 0.05). Conclusion The knowledge-attitude-practice of cardiac rehabilitation, especially the level of knowledge, in patients with CABG is needed to be improved. The factors that affect the level of knowledge-attitude-practice of cardiac rehabilitation in this population are diversified, suggesting that individual cardiac rehabilitation guidance should be implemented according to different people and local conditions, and diversified cardiac rehabilitation models should be established to improve the long-term and compliance of cardiac rehabilitation.

Humans ; Adult ; Serum Albumin, Human ; Consensus ; Cardiac Surgical Procedures ; Thoracic Surgery