Objective:To analyze the current status of anesthesiology research in the world and China in 2023 and to identify the anesthesiology research hotspots using bibliometrics.Methods:The literature related to anesthesiology published in PubMed in 2023 was searched, and the country and author of the literature, as well as the key words of the literature were visually analyzed by using the software CiteSpace6.2. R4.Results:A total of 22 473 articles were included, the country with the largest number of publications was the United States, and China ranked second. The author with the highest number of publications in the field of anesthesiology in the worldwide in 2023 was Kaye Alan D from the United States. Chronic pain, general anesthesia and pain management were the research hotspots in the field of anesthesiology worldwide in 2023. The research hotspots in the field of anesthesiology in China focused on general anesthesia, oxidative stress and neuropathic pain.Conclusions:The United States is the leader in the research in the field of anesthesiology, with China following behind. The keywords of the literature in the field of anesthesiology between China and the world are roughly the same, reflecting the convergence of Chinese scientific research with global scientific research. Domestic anaesthesia practitioners can refer to or learn from the research hotspots of related countries and strengthen communication and cooperation between teams while conducting academic research.

In this paper, the domestic and international demand and development trend of clinical diagnostic radionuclides are analyzed, and the medium and high-energy cyclotrons, adequate and systematic facilities, and preparation techniques required for the production of medical radionuclides based on solid targets are introduced. This paper focuses on the research and development carried out by some important medical institutions and scientific research institutes in China over the years in the aspects of medium and high-energy cyclotrons, beam transmission lines, high-power irradiation target stations and new medical isotope production processes etc. It also looks forward to some new directions for the development of medical radionuclides in China during the 14th Five-Year Plan period.

Objective    To analyze the effect of carotid artery stenosis degree and intervention for carotid artery stenosis on the incidence of central nervous system complications after off-pump coronary artery bypass grafting (OPCABG) and explore the influencing factors. Methods    A total of 1 150 patients undergoing OPCABG in our hospital from June 2018 to June 2021 were selected and divided into two groups according to whether there were central nervous system complications, including a central nervous system complication group [n=61, 43 males and 18 females with a median age of 68.0 (63.0, 74.0) years] and a non-central nervous system complication group [n=1 089, 796 males and 293 females with a median age of 65.5 (59.0, 70.0) years]. The risk factors for central nervous system complications after OPCABG were analyzed. Results    Univariate analysis showed that age, smoking, hyperlipidemia, preoperative left ventricular ejection fraction, intra-aortic ballon pump (IABP), postoperative arrhythmia, postoperative thoracotomy and blood transfusion volume were associated with central nervous system complications. The incidence of central nervous system complications in patients with severe carotid artery stenosis or occlusion (11.63%) was higher than that in the non-stenosis and mild stenosis patients (4.80%) and moderate stenosis patients (4.76%) with a statistical difference (P=0.038). The intervention for carotid artery stenosis before or during the operation did not reduce the incidence of central nervous system complications after the operation (42.11% vs. 2.99%, P<0.001). Age, postoperative arrhythmia, severe unilateral or bilateral carotid artery stenosis and occlusion were independent risk factors for postoperative central nervous system complications (P<0.05). Conclusion     The age, smoking, hyperlipidemia, preoperative left ventricular ejection fraction, intraoperative use of IABP, postoperative arrhythmia, secondary thoracotomy after surgery, blood transfusion volume and OPCABG are associated with the incidence of postoperative central nervous system complications in patients. Age, postoperative arrhythmia, severe unilateral or bilateral carotid artery stenosis and occlusion are independent risk factors for postoperative central nervous system complications. In patients with severe carotid artery stenosis, preoperative treatment of the carotid artery will not reduce the incidence of central nervous system complications.

Objective:To evaluate the application of metagenomic next-generation sequencing (mNGS) in the diagnosis of osteoarticular infection.Methods:The clinical data of 37 inpatients aged 32-90 year with osteoarticular infection admitted in the Department of Spine Surgery of Qingdao Chest Hospital from January to December 2019 were retrospectively analyzed. There were 31 cases of spine infection and 6 cases of other joint infection. The tissue samples were obtained from the infected sites through puncture or surgical approach in all patients. The tissue samples were subjected to routine culture of mycobacteria, aerobic bacteria and anaerobic bacteria, respectively. The gene amplification and mNGS were performed for detection of mycobacterium tuberculosis DNA (MTB-DNA). The chi-square test or Fisher’s exact test were used to compare the detection rates of pathogen and simple bacterial infection between mNGS and conventional culture. The conventional culture, mNGS and MTB-DNA amplification detection were performed for all samples; with clinical diagnosis as the gold standard, the diagnostic values of 3 methods were evaluated with receiver operating characteristic curve (ROC). Paired sample t test was used to compare white blood cell(WBC) count, erythrocyte sedimentation rate, C-reactive protein of patients before and after treatment. P<0.05 was considered statistically significant. Results:The pathogens were detected by mNGS for 42 times: bacteria for 39 times (92.8%), fungi for twice (4.8%) and Kirks body for once (2.4%). Among 37 patients there were 29 cases of pure bacterial infection (78.4%), 2 cases of pure fungi infection (5.4%), 1 case of pure Kirks body infection (2.7%), and 5 cases of mixed infection of two or more pathogens (13.5%). The detection rates of mNGS and conventional culture were 100.0% (37/37) and 67.6% (25/37), respectively ( χ2=13.987, P<0.05). The detection rates of mNGS and conventional culture in 29 patients with pure bacterial infection were 100.0% (29/29) and 69.0% (20/29), respectively ( χ2=16.913, P<0.05). The area under the ROC curve (AUC) of conventional culture, mNGS, and MTB-DNA in the diagnosis of osteoarticular tuberculosis infection was 0.958 (95% CI: 0.866-1.000, P<0.05), 1.000 (95% CI: 1.000-1.000, P<0.05) and 0.958 (95% CI: 0.866-1.000, P<0.05). All the 37 patients were treated with anti-infective drugs according to the results of mNGS and conventional culture. Among them, 28 patients received surgical intervention. The patients were followed up until April 30, 2020, 1 patient died. After 3 months of follow-up, the WBC count, erythrocyte sedimentation rate and C-reactive protein were (5.5±1.5)×10 9/L, (41±38)mm/h and (5.0±4.6) mg/L, respectively, which were lower than those before anti-infection treatment [(8.0±2.9)×10 9/L, (79±42)mm/h and(63±52)mg/L] ( t=6.536, 8.302 and 6.373, all P<0.05). Conclusion:The metagenomic next-generation sequencing may have important clinical value in the differential diagnosis of osteoarticular infection.

Objective    To compare short- and medium-term effects of Leonardo da Vinci robot-assisted and traditional mitral valvuloplasty. Methods    We conducted a retrospective analysis of 74 patients who underwent mitral valvuloplasty in our hospital from January 2015 to March 2017. The patients were divided into two groups according to the mode of operation: a da Vinci group (n=29, 13 males, 16 females at an average age of 52 years) and a routine group (n=45, 18 males, 27 females at an average age of 53 years). The perioperative data of patients in the two groups were compared and analyzed. Results    There was no significant difference in sex, age, weight, height, body mass index (BMI), cardiac function (NYHA), hypertension, diabetes, postoperative blood transfusion and postoperative complications between the two groups (P>0.05). The tracheal intubation time, ICU retention time, hospital stay time, blood loss and postoperative drainage in the da Vinci group were shorter or less than those in the routine group (P<0.05). The operation time, cardiopulmonary bypass time and aortic clamping time in the da Vinci group were longer than those in the routine group (P<0.05). Different surgical procedures had no significant effect on left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF) and mitral regurgitation (MR) 3 years after operation. There was no interaction between the mode of operation and the time of follow-up. There was no significant difference in echocardiographic evaluation in the same period (P>0.05). Conclusion    Da Vinci operation shortens the rehabilitation process of patients compared with traditional surgery. For short- and medium-term follow-up results, there is no difference between Leonardo da Vinci and traditional mitral valve surgeries, and the clinical effect of da Vinci robot-assisted mitral valvuloplasty is satisfactory, which is worthy of further clinical promotion.

Objective: To evaluate the reliability and validity of the Chinese version of the Sickness Experience Questionnaire (CESQ) in breast cancer patients, and to provide a scientific basis for caring for female breast cancer patients and reducing the level of stigma. Methods: The English version of CESQ was translated and culturally adjusted. 200 questionnaires were sent out to breast cancer patients in our hospital from May 2017 to August 2018 by convenient sampling method. 190 questionnaires were effectively recovered. Sixty patients were randomly selected and retested after 2 weeks. Reliability and validity was examined by SPSS21.0 and AMOS21.0. Results: The Chinese version of CESQ scale Cronbach α coefficient was 0.819, Guttman′s split-half reliability coefficient was 0.844, the correlation coefficient between each item score was 0.405-0.809, and the correlation coefficient between each item score and CESQ total score was 0.499-0.812 (P <0.05). The test-retest reliability coefficient was 0.898. Four experts rated the Chinese version of CESQ with a content validity index of 0.801 to 1.000, an overall consistency content validity index CVI of 0.804, and an average content validity index of 0.830. Principal component analysis was used to conduct exploratory factor analysis. After the orthogonal rotation of the variance, one common factor was obtained, and the cumulative variance contribution rate was 55.65%. Using AMOS 17.0, the data was subjected to confirmatory factor analysis with a chi-square/degree-of-freedom ratio of 1.20 and a goodness-of-fit index of 0.909. The approximate error root mean square was 0.069, the gauge fit index was 0.957, the relative fit index was 0.944, and the value-added fit index was 0.904. Non-standard fit The index was 0.907, the comparative fit index was 0.911, and the normalized regression coefficient was 0.435-0.668. Conclusions The Chinese version of CESQ has a good reliability and validity in evaluating the stigma of breast cancer patients. It has application value in evaluating the stigma of breast cancer patients in China.

Objective? To analyze hot research areas of nutrition support for cancer patients from 2008 to 2017, so as to provide guidance for the development of researchin nutrition support for the cancer patients in our country. Methods? Databases including CNKI, Wanfang, and VIP were searched with the subject or key words of "tumor""cancer""nutrition support/nutritional support", and databases including PubMed, Web of Science were searched with the subject or keywords of "cancer""tumor""malignant tumor"and"nutrition support/nutritional support" to review the relevant literature published from 2008 to 2017. Softwares including BICOMB 2.0 and SPSS 23.0 were used to generate high-frequency keywords, and construct cluster analysis. Results A total of 889 articles were retrieved and the number of articles showed an increasing trend on the whole. There were 69 core authors with≥3 published articles, and 62 high frequency subject words with word frequency ≥21 times. Cluster analysis showed that the research mainly focused on four fields: perioperative nursing of gastrointestinal cancer patients; nutritional risk screening and prognostic factors in gastrointestinal cancer patients; nutritional status and quality of life of patients treated with chemotherapy/radiotherapy;nutritional assessment and intervention for malignant oncology patients. Conclusions? The concept of tumor nutrition has been gradually developed, but there is still great room for development in the future in terms of the depth and breadth of research, early identification of patients with nutritional risk, nutritional assessment, formulation of feasible nutritional intervention programs and measures to improve the prognosis of patients and their quality of life.

Objective To explore the feasibility and effectiveness of otoacoustic emission (OAE) in hearing screening for preschool children .Methods A total of 616 preschool children aged 3～6 (mean age 4 .6 years old) were included in this study .All the subjects received transiently evoked otoacoustic emission (TEOAE) test by trained personnel .The children who failed the hearing screening received diagnostic examination in the hearing ex-amination center .Results Of 616 children ,66 (10 .71％ ) failed the hearing screening and 16 children received audi-ological assessment .In these 16 children ,8 had otitis media with effusion (5 with mild conductive hearing loss ) ,5 had impacted cerumen ,3 had normal hearing ,and none had sensorineural hearing loss .Conclusion OAE can be used effectively in the hearing screening for preschool children .But how to improve the referral rate of children who failed the hearing screening needs further discussion .

Objective To investigate and analyze the current situation of nurse standardized training in Dongguan City. Methods 55 hospitals in Dongguan City of current situation of nurse standardized training were investigated by the convenient stratified sampling method. Results A total of 55 hospitals (40 public hospitals and 15 private hospitals) responded to the survey. 54 questionnaires were statistically valid and 1 were invalid, with a recovery rate of 98. 18％. Compared with private hospitals, the standardized training of nurses in public hospitals was relatively good, and the degree of participation was higher, but there were still some defects, such as the uneven level of training teachers, imperfect training facilities and equipment, the training and assessment stage cannot be completed in accordance with the standardized training program of Dongguan nurses and the training methodsare not standardized. Conclusion The popularization of standardized training for nurses in hospitals at all levels in Dongguan should be further expanded, and the training programs should be more standardized and standardized, trainers should be trained in a unified manner to gain access so as to achieve homogenization.

Objective To evaluate the effectiveness of carboprost methylate suppository for cervical ripening before diagnostic hysteroscopy in premenopausal women. Methods From July 2014 to July 2015, 1614 women who were undergone diagnostic hysteroscopy in 12 hospitals were randomly assigned into study group(n=1209)and control group(n=405). The cases in study group were given 1 mg carboprost methylate suppository in vagina before hysteroscopy, the cases in control group were given 1 mg placebo. The extent of cervical ripening, the time of dilated cervix, pain scoring, incidence of drug side reactions after 24, 48, 72 hours, satisfaction degree of operators and patients, the time of hysteroscopy, incidence of complications between the two groups were observed and compared. Results (1) Mean cervical widths in the study and control groups were 6.11 ± 1.11 and 5.95 ± 1.11, and showed a significant difference(P=0.034);the percentage of women requiring cervical dilatation in study group was lower than the percentage in control group significantly [28.3％(342/1209)versus 34.6％(140/405), P=0.020].(2) The time of dilated cervix in study group was shorter than the time in control group significantly [(34 ± 25) versus(52 ± 49)s, P=0.028] for the patients whose mean cervical widths≤4.(3)There was no significant difference in pain scores between the two groups(P>0.05).(4)The incidence of side reactions 24, 48, 72 hours after operation were no significant difference between the two groups (P>0.05). (5) The satisfaction degree of operators and patients, the time of hysteroscopy, incidence of complications between the two groups were no singnifcant difference between the two groups (all P>0.05). Conclusion Application of carboprost methylate suppository by vagina before hysteroscopy is an effective and safe method of cervical ripening.