Objective:To evaluate the relationship between the preoperative sleep quality and postoperative delirium (POD) in elderly patients.Methods:Three hundred and eighty-nine patients of either sex, aged 65-90 yr, with American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, who underwent elective knee/hip arthroplasty under combined spinal-epidural anesthesia in Qingdao Municipal Hospital from May 2022 to October 2023, were selected. The Pittsburgh Sleep Quality Index scale was applied at 1 day before surgery to assess the sleep quality within 1 month before surgery. The cerebrospinal fluid (CSF) specimens 2 ml were withdrawn from the subarachnoid space before anesthesia for determination of the concentrations of biomarkers (β-amyloid), total tau protein [t-tau], and phosphorylated tau protein [p-tau]) by enzyme-linked immunosorbent assay. Patients were divided into POD group and non-POD group based on whether delirium occurred within 7 days after surgery. Logistic regression was used to identify the risk factors for POD, and the sensitivity analysis was used to test the stability of the regression models. The mediation model was used to examine whether CSF biomarkers mediated the link between sleep quality and POD. The accuracy of preoperative sleep quality and CSF biomarker concentrations in predicting the occurrence of POD was evaluated by plotting the receiver operating characteristic curve and calculating the area under the curve.Results:Two hundred and seventy-nine patients were finally included, with 33 patients in POD group and 246 patients in non-POD group. The results of logistic regression analysis showed that shorter sleep duration, use of hypnotics, daytime dysfunction within 1 month before surgery, elevated t-tau concentrations in CSF, and elevated p-tau concentrations in CSF were risk factors for POD after adjusting for multiple confounding factors such as age, sex, body mass index, years of education, Mini-Mental State Examination score, and VAS score. The results of mediating effect showed that the effect of use of hypnotics and daytime dysfunction within 1 month before surgery on POD was partially mediated by p-tau concentrations in CSF (>10%). The area under the curve of combination of daytime dysfunction, sleep duration, use of hypnotics within 1 month before surgery, and CSF biomarker concentrations in predicting POD was 0.979.Conclusions:Shortened sleep duration, use of hypnotic, and daytime dysfunction with 1 month before surgery are risk factors for POD in elderly patients, and the association between use of hypnotics and daytime dysfunction and POD is partially mediated by p-tau in CSF.

Objective:To evaluate the relationship between hippocampal macrophage polarization and perioperative neurocognitive disorders in mice with tibial fractures.Methods:Forty-five clean-grade healthy male C57/BL6 mice, aged 5-7 months, were divided into 3 groups ( n=15 each) using the random number table method: control group (group C), anesthesia group (group A) and anesthesia surgery group (group AS). Group C received no treatment. Group A was anesthetized with isoflurane inhaled for 15 min. In AS group, intramedullary nail fixation of tibial fracture was performed under anesthesia through inhalation of 2% isoflurane. Morris water maze test and open field test were performed before anesthesia/on 1 day before surgery and after anesthesia/on 1, 3 and 7 days after operation. Five mice were randomly selected after the behavioral experiments were completed at each time point, and hippocampal tissues were taken after the animals were sacrificed for determination of the expression of tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), IL-6, chemokine (c-c motif) ligand 12 (CCL2), CCL5, CCL8, iNOS and Arg-1 mRNA (by quantitative real-time polymerase chain reaction), expression of iNOS and Arg-1 proteins (by Western blot), and percentage of CD11b, CD45, CD86 and CD206 cells in hippcampal area (by immunofluorescence staining). Results:Compared with group C, the escape latency was significantly prolonged after operation, the number of crossing the platform was reduced after operation, the expression of TNF-ɑ, IL-6, CCL5 and CCL8 mRNA and iNOS protein and mRNA was up-regulated, the expression of Arg-1 protein and mRNA was down-regulated, the percentages of CD11b + CD45 + cells and CD11b + CD86 + cells in the hippocampus were increased, and the percentages of CD11b + CD206 + cells were decreased in AS group ( P<0.05), and no significant change was found in the parameters mentioned above in group A ( P>0.05). Compared with group A, the escape latency was significantly prolonged after surgery, the frequency of crossing the platform was reduced after surgery, the expression of iNOS mRNA was up-regulated, the percentages of CD11b + CD45 + cells and CD11b + CD86 + cells were increased, and the percentages of CD11b + CD206 + cells were decreased in AS group ( P<0.05). Conclusions:The occurrence of PND may be related to increased polarization to M1 macrophages in the hippocampus and decreased polarization to M2 macrophages in mice with tibial fracture, which further leads to central inflammatory responses.

Objective To investigate the effects of particle size, wind speed and dumping velocity on aerosol concentration distribution during powder dumping in a reprocessing plant. Methods CeO₂ powder was selected as the substitute material of PuO₂. FLUENT software was used to calculate the pouring process of CeO₂ powder under different operation conditions. Then the aerosol concentration distribution under different dumping speeds was measured by particle size spectrometer to verify the accuracy of simulation results. Results The particles with small particle size are more likely to be separated from the mainstream area by the drag force of the surrounding gas, and the radius of the diffusion range also increases with the decrease of the particle size. 2) When the ventilation speed is less than 1 m/s, the dust lifting can be reduced and the concentration of dust particles in the chamber can be reduced to a certain extent. 3) In the process of powder dumping, the spoon is rotated anticlockwise at a speed of 100° in 2～3 s, and less dust aerosol is produced on the right side of the tray. Conclusion When operating the powder particles with smaller particle size, more attention should be paid to the monitoring of aerosol at different positions; the change of air inlet velocity makes the flow field in glove box more complex, and the volume fraction of dust particles is related to the size and location of vortex formed by airflow. The greater the wind speed, the greater the impact on the powder dumping process. The experimental results are basically consistent with the simulation results, and the results show that the lower the dumping speed, the smaller the aerosol concentration near the tray.

Objective: To investigate current situation communication ability and training needs of standardized training nurses, in order to provide reference for improving the communication courses. Methods: A cross-sectional study was conducted and randomized sampling method was used to choose 100 nurses who participated in standardized training in Chengdu Fifth People′s Hospital. Nurses' communication ability was evaluated by Nurse-Patient Communication Ability Scale, and whose training needs of communication were investigated. Results: The average score of the Nurse-Patient Communication Ability Scale was 140.43±13.94. The educational background (t=-3.717, P<0.01), standardized training time (t=-2.812, P<0.01), and whether they had received communication training in the last year (t=2.231, P<0.05) had significant influence on nurse-patient communication ability. 88.00% (88/100) thought it necessary to carry out nurse-patient communication ability training during standardized training. Among them, 88.64% (78/88) hoped to carry out humanistic knowledge training, 65.91% (58/88) hoped that at least four training methods would be combined, and 44.32% (39/88) hoped that teachers from multiple disciplines would conduct training. Conclusions The nurse-patient communication ability of standardized training nurses needs to be improved. It is necessary to strengthen the theoretical research and curriculum design of training, pay attention to practical teaching, so that the training effect can be improved.

Objective To investigate the effects of the failure rate of laparoscopic apparatus with power through detecting the electrical properties before packaging it. Methods The laparoscopic apparatus with power used in the operation in January to June 2014 were randomly selected and divided into the control group and the observation group according to whether they underwent electricity performance detection. The control group did not receive testing of electrical properties before packing. The observation group tested the electrical conductivity of the single or double pole conductor, unipolar electric coagulation hook, bipolar electric coagulation forceps, the handle of electric knife by digital multimeter and the performance of the uterus rotary cutting machine by electric hysterectomy controller before packing. The difference of equipment in the number of failures, the type of failure, the number of cases and the satisfaction of medical personnel were observed between the two groups. Results In the observation group, 12 cases with unipolar and bipolar coagulation failure, 10 cases with electrocision handle failure, 2 cases with uterine rotary- cutting failure, 18 cases with adverse conductive or non-conductive, 6 cases with short circuit, which were significantly lower than those in the control group (36,25, 11, 48, and 26 cases), the differences were statistically significant (χ2=5.627-12.063, P<0.05). The satisfaction degree in the observation group was 94.74% (36/38), which was better than 76.32%(29/38) of the control group, the difference was statistically significant (Z=-2.267, P<0.05). Conclusions Testing the electric performance of laparoscopic apparatus with power before packing could reduce the incidence of intraoperative equipment failure rate, This method can provide safe and high quality surgical instruments.

Objective To compare the antitumor effect of self-developed albumin bound paclitaxel for injection ( PAB) and commercial albumin-bound paclitaxel for injection ( Abraxane ) . Methods The antineoplastic effects of PAB and Abraxane were evaluated in H22, Lewis and RM-1 allograft tumor mouse models after repeated intravenous injection (13. 4, 20. 0, 30. 0 and 45. 0 mg·kg-1 PAB and 20. 0 and/or 30. 0 mg·kg-1 Abraxane, respectively). Results PAB significantly inhibited H22 tumor growth at from the doses of 13. 4, 20. 0, 30. 0, and 45. 0 mg·kg-1,and the antitumor effect of PAB at 20. 0 mg·kg-1 was not significantly different from Abraxane at 20. 0 mg·kg-1 . PAB dose-dependently inhibited Lewis and RM-1 tumor growth at the doses of 20. 0, 30. 0, and 45. 0 mg·kg-1 . The no observed adverse effect level of PAB and Abraxane was 20. 0 mg· kg-1 in Lewis and RM-1 bearing C57 female mice. The antitumor effect and toxicity was not significantly different between PAB and Abraxane at equivalent doses. Conclusion At the same dose level, the antitumor activity and toxicity of PAB was equivalent to those of Abraxane.

OBJECTIVETo investigate the association of human chorionic gonadotropin (HCG) level on day 3 of embryo culture with embryo development.

METHODSSpent culture media were collected from individually cultured embryos on day 3 of in vitro fertilization and embryo transfer (IVF-ET) cycles. HCG concentration in the culture media was measured using an ELISA kit and its association with embryo development was assessed.

RESULTSIn the 163 samples of embryo culture media from 60 patients, HCG was positive in 153 sample (93.8%) with a mean level of 0.85 ± 0.43 mIU/ml. The concentration of hCG in the culture media increased gradually as the number of blastomeres increased (F=2.273, P=0.03), and decreased as the morphological grade of the embryo was lowered (F=3.900, P=0.02).

CONCLUSIONELISA is capable of detecting HCG levels in spent culture media of embryos on day 3 of in vitro culture. The concentration of HCG in spent culture media is positively correlated with the status of early embryo development and implantation rate and thus serves as a useful marker for embryo selection in IVF-ET procedure.

Biomarkers ; chemistry ; Chorionic Gonadotropin ; chemistry ; Culture Media ; chemistry ; Embryo Transfer ; Embryonic Development ; Fertilization in Vitro ; Humans

Objective To evaluate the value of the new ovarian function marker serum anti-Mullerian hormone (AMH)and to clarify the effect of hysterectomy on the ovarian function of the younger women.Methods The serum AMH,follicle stimulating hormone (FSH)and luteinizing hormone (LH)levels in 35 women suffered uterus benign lesion aged 36-45 years and 35 women suffered hysteromyoma without operation were measured at different time.And the ovarian arterial blood flow resistance index (RI ) was measured by Doppler ultrasound. Results Compred with before operation, the serum AMH levels of the patients in hysterectomy group 2 d and 3 months after operation were significantly decreased (P<0.05 or P<0.01).Compared with control group,the serum AMH levels of the patients in hysterectomy group 2 d and 3 months after operation were also decreased (P<0.05).The ovarian arterial blood flow RI of the patients in hysterectomy group 1 and 3 months after operation were increased compared with control group (P<0.05).There were no significant differences in the serum FSH and LH levels in each group between different time points (P>0.05).Conclusion Hysterectomy can affect the ovarian function,and the serum AMH level 3 months after operation is decreased and the ovarian arterial blood flow RI is increased.AMH is superior to FSH or LH in evaluating the changes of ovarian function.

Objective To investigate the association of human chorionic gonadotropin (HCG) level on day 3 of embryo culture with embryo development. Methods Spent culture media were collected from individually cultured embryos on day 3 of in vitro fertilization and embryo transfer (IVF-ET) cycles. HCG concentration in the culture media was measured using an ELISA kit and its association with embryo development was assessed. Results In the 163 samples of embryo culture media from 60 patients, HCG was positive in 153 sample (93.8%) with a mean level of 0.85 ± 0.43 mIU/ml. The concentration of hCG in the culture media increased gradually as the number of blastomeres increased (F=2.273, P=0.03), and decreased as the morphological grade of the embryo was lowered (F=3.900, P=0.02). Conclusion ELISA is capable of detecting HCG levels in spent culture media of embryos on day 3 of in vitro culture. The concentration of HCG in spent culture media is positively correlated with the status of early embryo development and implantation rate and thus serves as a useful marker for embryo selection in IVF-ET procedure.

Objective To investigate the association of human chorionic gonadotropin (HCG) level on day 3 of embryo culture with embryo development. Methods Spent culture media were collected from individually cultured embryos on day 3 of in vitro fertilization and embryo transfer (IVF-ET) cycles. HCG concentration in the culture media was measured using an ELISA kit and its association with embryo development was assessed. Results In the 163 samples of embryo culture media from 60 patients, HCG was positive in 153 sample (93.8%) with a mean level of 0.85 ± 0.43 mIU/ml. The concentration of hCG in the culture media increased gradually as the number of blastomeres increased (F=2.273, P=0.03), and decreased as the morphological grade of the embryo was lowered (F=3.900, P=0.02). Conclusion ELISA is capable of detecting HCG levels in spent culture media of embryos on day 3 of in vitro culture. The concentration of HCG in spent culture media is positively correlated with the status of early embryo development and implantation rate and thus serves as a useful marker for embryo selection in IVF-ET procedure.