Objective:To investigate the clinical effect of preemptive analgesia with pentazocine on perioperative pain management in partial splenectomy.Methods:A total of 100 patients with traumatic splenic rupture who underwent partial splenectomy at Yiwu Central Hospital between October 2019 and November 2021 were randomly assigned to either the control group or the study group, with 50 patients in each group using the random number table method. Both groups received patient-controlled analgesia postoperatively. Additionally, the study group received intravenous pentazocine administration before surgery. The amount of anesthetic used during surgery, postoperative anesthesia recovery indices, postoperative pain response, serum inflammatory factor levels, and the number of effective patient-controlled analgesia pump presses within 48 hours postoperatively were recorded and evaluated. Any adverse drug reactions were also monitored.Results:The dosages of propofol [(462.24 ± 27.13) mg] and remifentanil [(365.98 ± 26.78) μg] in the study group were significantly lower than those in the control group [(511.82 ± 26.32) mg, (406.86 ± 26.08) μg, t = 14.49, 12.63, both P < 0.001). The recovery time of spontaneous breathing [(6.86 ± 0.97) minutes], anesthesia recovery time [(13.24 ± 0.82) minutes] and extubation time [(17.14 ± 1.07) minutes] were significantly shorter than those in the control group [(7.62 ± 0.90) minutes, (14.32 ± 0.84) minutes, (18.22 ± 1.06) minutes, t = 5.80, 8.58, 6.93, all P < 0.001]. The Visual Analogue Scale (VAS) scores in the study group were significantly lower than those in the control group at 24 and 48 hours after surgery, both in resting and coughing state ( t = 7.82, 9.31, 4.95, 8.47, all P < 0.001). The serum levels of tumor necrosis factor-alpha, interleukin-1, and interleukin-6 were significantly lower in the study group than in the control group ( t = 21.53, 25.61, 18.45, 16.90, 17.33, 14.86, all P < 0.001), while the serum level of interleukin-10 was significantly higher in the study group than in the control group ( t = -20.85, -19.61, both P < 0.001). The number of effective patient-controlled pump analgesia presses within 48 hours postoperatively in the study group [(6.24 ± 1.17) times] was significantly lower than that in the control group [(10.26 ± 1.34) times, t = 12.95, P < 0.05). In addition, the overall incidence of adverse drug reactions in the study group [4.00% (2/50)] was significantly lower than that in the control group [18.00% (9/50), χ2 = 5.01, P < 0.05]. Conclusion:Preemptive analgesia with pentazocine for patients undergoing partial splenectomy can effectively reduce the dosage of anesthetics during surgery and the dosage of analgesics after surgery, enhance the recovery from postoperative anesthesia, suppress postoperative inflammatory reactions, alleviate pain responses, and minimize the risk of adverse drug reactions.

Objective To explore the corr-elation between cognitive impairment and event-related potential P300 in patients with acute ischemic stroke-related obstructive sleep apnea(OSA).Methods A total of 114 patients with acute ischemic stroke-related OSA admitted to the Department of Neurology of Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine of Hebei from January 2022 to August 2023 were selected as the research subjects.Patients with cognitive impairment were included in the observation group(n=38),and patients without cognitive impairment were included in the control group(n=76).A standardized mini-mental state examination(MMSE)was used to test the cognitive function of patients in the two groups,and the MMSE scores of patients in the two groups were compared.The brain regions affected by infarct lesions of patients in the two groups were examined by using cranial magnetic resonance diffusion-weighted imaging and magnetic resonance imaging.The SC-500 non-contact,non-intrusive sleep monitoring sensor mattress was used to screen and assess stroke-related OSA in the two groups.The American Nerosscan 64-channel 10/20 electroencephalographic system was employed to detect event-related potential P300 of patients in the two groups.Univariate and multivariate logistic regression analysis were conducted to examine the correlation between cognitive impairment and event-related potential P300 in patients with acute ischemic stroke-related OSA.Results The total MMSE score and the scores in each dimension,including orientation,immediate memory,attention and calculation,recall ability,and language ability of patients in the observation group were significantly lower than those in the control group(P＜0.05).Age,proportions with a history of diabetes,hyperhomocysteinemia,and apnea-hypopnea index(AHI)of patients in the observation group were significantly higher than those in the control group,while the years of education was significantly lower than that in the control group(P＜0.05).The proportions of patients with infarct lesions located in the frontal lobe,temporal lobe,parietal lobe,occipital lobe,thalamus,basal ganglia,brainstem,and centrum semiovale in the observation group were significantly higher than those in the control group(P＜0.05).The P300 latency in the prefrontal,central,and parietal regions of patients in the observation group was significantly longer than that in the control group(P＜0.05).The P300 amplitude in the central and parietal regions of patients in the observation group was significantly lower than that in the control group(P＜0.05).The results of multivariate logistic regression analysis indicated that the years of education was a protective factor against cognitive impairment in patients with acute ischemic stroke-related OSA(P＜0.05).Thalamic infarction,high AHI,and prolonged P300 latency in the parietal region were independent risk factors for cognitive impairment in patients with acute ischemic stroke-related OSA(P＜0.05).Conclusion Patients with acute ischemic stroke-related OSA are prone to cognitive impairment in multiple domains.The P300 latency in the parietal region is closely associated with cognitive impairment in patients with acute ischemic stroke-related OSA and serves as an independent risk factor for cognitive impairment in these patients.

Organoids are three-dimensional (3D) biological structures constructed in vitro by stem cells, which partially mimic the function of real organs. Brain organoids are an extremely important branch of organoid research. This technology can differentiate pluripotent stem cells into the required cell types in a 3D culture environment, and self-assemble into structural bodies, but it is currently unable to fully replicate the structural and physiological features of the real human brain. The maturity of brain organoids may form consciousness, which poses ethical issues such as determining moral status and informed consent in brain organoids research. This paper elaborated on the research progress and future development direction of brain organoids, and proposed multidimensional governance strategies for ethical issues faced in brain organoids research from the perspectives of ethical principles, ensuring public informed consent, and legal supervision. By exploring the above issues, reference will be provided for formulating ethical principles to guide the research and application of brain organoids in the future.

This paper reviews the status quo and influencing factors of family life quality of the elderly with dementia, mainly from effect of the elderly with dementia on the family at home and abroad, the predictive factors affecting family quality of life and social support system, so as to provide theoretical basis for improving family quality of life of the elderly with dementia in the future.

Objective:To explore the effect of imaginative relaxation training in children with acute appendicitis after surgery.Methods:A total of 60 children with acute appendicitis who underwent laparoscopic surgery and received general anesthesia with laryngeal mask from January to October 2021 in the Second Department of Pediatric Surgery, Linyi People's Hospital, were retrospectively selected as the research subject. The 30 children admitted from January to May 2021 were included in the control group, and the 30 children admitted to from June to October 2021 were included in the observation group. The control group was given routine nursing, and the observation group received imaginative relaxation training on the basis of the control group. The postoperative pain, treatment compliance and parental satisfaction of the two groups of children were compared.Results:The postoperative pain score of the observation group was lower than that of the control group, and the treatment compliance and parental satisfaction were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Imaginative relaxation training on the basis of routine nursing for children with acute appendicitis can effectively promote postoperative recovery, relieve postoperative pain, and improve children's treatment compliance and parents' satisfaction with nursing work.

Objective:To explore the effect of imaginative relaxation training in children with acute appendicitis after surgery.Methods:A total of 60 children with acute appendicitis who underwent laparoscopic surgery and received general anesthesia with laryngeal mask from January to October 2021 in the Second Department of Pediatric Surgery, Linyi People's Hospital, were retrospectively selected as the research subject. The 30 children admitted from January to May 2021 were included in the control group, and the 30 children admitted to from June to October 2021 were included in the observation group. The control group was given routine nursing, and the observation group received imaginative relaxation training on the basis of the control group. The postoperative pain, treatment compliance and parental satisfaction of the two groups of children were compared.Results:The postoperative pain score of the observation group was lower than that of the control group, and the treatment compliance and parental satisfaction were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Imaginative relaxation training on the basis of routine nursing for children with acute appendicitis can effectively promote postoperative recovery, relieve postoperative pain, and improve children's treatment compliance and parents' satisfaction with nursing work.

Objective:To explore the value of blood glucose at different time points in the 7-point peripheral blood glucose spectrum in predicting asymptomatic hypoglycemia at night in elderly patients with type 2 diabetes mellitus (T2DM) based on continuous glucose monitoring system (CGMS) .Methods:From January to October 2019, convenience sampling was used to select 225 elderly T2DM patients who were hospitalized in Xinxiang Central Hospital. We monitored the peripheral blood glucose at 7 time points after admission, and performed 72-hour continuous glucose monitoring (CGM) simultaneously. We investigated the occurrence of night hypoglycemia of patients, and divided patients into night symptomatic hypoglycemia group and night asymptomatic hypoglycemia group according to the results. We compared the hypoglycemia related indicators of two groups, drew the receiver operating characteristic (ROC) curve, calculated the area under the curve (AUC) to determine the best cut-point value of each indicator and the occurrence of asymptomatic hypoglycemia at night.Results:In the CGM of 225 patients, 74 cases had hypoglycemia at night, and the incidence was 32.89%, and 34 cases of them had asymptomatic hypoglycemia at night, accounting for 45.95% (34/74) . The fasting blood glucose, blood glucose after dinner and before bedtime of patients in night asymptomatic hypoglycemia group were lower than those of night symptomatic hypoglycemia group. The best cut-off points of blood glucose before bedtime and fasting blood glucose for predicting asymptomatic hypoglycemia at night were 6.9 mmol/L and 6.0 mmol/L respectively, and the AUC were 0.822 and 0.651 respectively.Conclusions:We should be alert to the occurrence of asymptomatic hypoglycemia at night in elderly patients with T2DM. Blood glucose before bedtime <6.9 mmol/L or fasting blood glucose <6.0 mmol/L indicates an increased risk of asymptomatic hypoglycemia at night.

Objective To determine the occurrence and clinical characteristics of ectopic pituitary adenoma (EPA) in China.Methods The study are done by searching systematically and comprehensively on major Chinese and English medical literature databases and conference papers before 2015,which are only limited to collected,summarized,sorted and analyzed EPA cases that reported by Chinese authors in English or Chinese occurred in China.Results ① Among the 86 Chinese articles and 27 English articles related to ectopic pituitary adenoma (EPA) gathered by the author,except for cases that have been confirmed as repeated reports,a total of 73 EPA cases were found.Of 70 cases with complete data,31 were male cases,accounting for 44.29％;39 were female cases,accounting for 55.71％;the ratio is 1:1.3.The frequency of EPA occurrence according to the location of the lesion,from high to low in turn,was sphenoid sinus (31 cases,42.47％),nasopharynx (7 cases,9.59％),suprasellar region (7 cases,9.59％),clivus (5 cases,6.85％),followed by the third ventricle,sphenoid sinus/clivus,nasal cavity,and the temporal lobe of the brain,with the same incidence of 4.11％.According to the functional properties of EPA,the frequency of different secreting hormones adenoma was PRL-ma(21 cases,28.77％),NF-ma (21 cases,28.77％),ACTH-ma (15 cases,20.55％),GH-ma (10 cases,13.70％),TSH-ma (2 cases,2.74％) and FSH-ma (1 cases.1.37％).Three cases of EPA were uncertain in their property due to lack of information.The incidence of PRL and nonfunctional tumors was the highest,which was different from what was reported in other countries.Among them,one case of EPA was in pineal region and one in parapharyngeal space,which was even more rare and were never reported abroad.(② Except for 3 cases with incomplete medical records,15 out of 70 cases of EPA were accompanied by empty sella,accounting for 21.43％,among which 11 (73.33％) cases involved the sphenoid sinus,and 3 (20％) cases involved clivus.The sphenoid sinus and clivus cases together accounted for 93.33％.(③ 29 out of the 69 cases of EPA with complete record were invasive pituitary adenomas,accounting for 42.03％ and including 1 case of pituitary adenocarcinoma,which accounted for 1.45％.(④ All cases were treated with surgery as the first choice,and some of them were treated with radiotherapy or drug therapy.Conc lusion Ectopic pituitary adenoma is extremely rare.By the end of 2015,the total number of cases reported in China is only 73,which are mostly located in the sphenoid sinus,suprasellar region and nasopharynx.In the functional classification,the most common types are still PRL adenoma and nonfunctional adenoma as in situ pituitary adenoma.42.03％ of EPA adenomas are invasive.Surgical resection of EPA is the first choice and some cases can be treated with radiotherapy and drug therapy.

Objective To construct the key-point guidelines of bowel preparation for elderly patients with colonoscopy. Methods The guidelines were made based on literature review,theoretical analysis,qualitative interview.Then they were determined by 14 clinical nurse specialists, nursing education experts and medical experts from 6 provinces or cities through two rounds of expert consultations. Results The response rate of two rounds'questionnaire was 100.00%. The authority of experts coefficient in the two rounds were 0.89. The coefficients of variation of the first and second rounds were respectively 0.07~0.27 and 0.05~0.13. The coordination coefficients for the 2 rounds were 0.377 and 0.404 respectively (Χ2=105.473 and 124.307,P<0.001).In the first round,the average of the importance rating was 3.50~4.95, with a standard deviation of 0.35~0.95.In the second round,the average of the importance rating was 4.71~4.93,with a standard deviation of 0.27~0.61.The key-point guidelines of bowel preparation included 3 key points for bowel preparation, 4 key moments,7 key guidance contents, 4 criteria for the process of bowel preparation and the corresponding remedial measures. Conclusion This study established the key-point guidelines of bowel preparation for elderly patientsand the degree of enthusiasm,authority,coordination and concentration of the experts was high so as to provide a reference for the clinical implementation of standardized bowel preparation guidance.

Objective To explore the factors affecting non-compliance in bowel preparation for patients undergoing colonoscopy and to provide evidence for improving patients' compliance. Methods Guided by the phenomenological research method, semi-structured interviews were performed among 16 patients who had poor bowel preparation for colonoscopy at the digestive endoscopy center in 3 Class Ⅲ Grade A hospitals in Suzhou from January to April 2017. The data were analyzed by Colaizzi analysis method. Results Through the interviews, the factors influencing bowel preparation compliance were summed up into 3 themes: the neglect of the importance of strict compliance with bowel preparation, the inability to tolerate bowel preparation, and lack of specialized knowledge of bowel preparation. Conclusions To improve the compliance of bowel preparation for patients undergoing colonoscopy, medical staff should correctly guide the patients to understand the importance of bowel preparation and ensure the full grasp of the specific requirements, on the other hand, should actively strive to improve the patient's tolerance of bowel preparation.