Abstract:Objective To investigate the effects of dexmedetomidine anesthesia on hemodynamics and satisfaction in hemodialysis patients with renal insufficiency.Methods A total of 80 hemodialysis patients with renal insufficiency admitted to Tangshan Central Hospital,Hebei Province from November 2020 to November 2023 were selected,and they were divided into control group and observation group according to the random number table method,with 40 cases in each group.The control group was given routine treatment,and the observation group was given intravenous infusion of dexmedetomidine hydrochloride on the basis of the treatment of the control group.Blood pressure,heart rate and pulse oximetry(SpO2)were compared between the two groups before and 20 min and 30 min after anesthesia.The renal function indicators β2-microglobulin(β2-MG),serum creatinine,serum uric acid,blood urea nitrogen,and blood phosphorus levels in both groups were compared.The self-designed satisfaction questionnaire was used to compare the satisfaction of patients in the two groups.Results The systolic blood pressure,diastolic blood pressure and heart rate of the observation group were lower than those of the control group 20 min and 30 min after anesthesia(all P＜0.05);there was no significant difference in SpO2 between the two groups(all P＞0.05).The levels of β2-MG,serum creatinine,serum uric acid,blood urea nitrogen,and blood phosphorus in the observation group were lower than those in the control group[(30±5)mg/L vs(35±6)mg/L,(120±14)μmol/L vs(181±21)μmol/L,(257±32)mmol/L vs(295±34)mmol/L,(10±3)mmol/L vs(18±5)mmol/L,(1.1±0.3)mmol/L vs(1.4±0.4)mmol/L](all P＜0.05).The total satisfaction rate of patients in the observation group was significantly higher than that in the control group[100.0％(40/40)vs 82.5％(33/40)](P＜0.05).Conclusion The application of dexmedetomidine in hemodialysis patients with renal insufficiency can stabilize the hemodynamic indexes of patients and improve patient satisfaction,which has good clinical application value.

Abstract:Under physiological conditions,the metabolism of energy substances such as lipids,glucose,ketone bodies and amino acids in the heart maintains a dynamic balance to meet the energy needs of the heart.During sepsis,the inflammatory responses caused by some chemical mediators such as endotoxin and nitric oxide,as well as the activation or inhibition of certain signaling pathways,will lead to changes in cardiac energy metabolism,which is both a compensatory process and the cause of organ dysfunction.This review will focus on the changes in energy metabolism during sepsis,especially the energy metabolism of the heart,aiming to provide new research directions and strategies for the future treatment of cardiac dysfunction caused by sepsis.

Abstract:In recent years,microneedles have attracted much attention due to their small size(500 to 1 000 μm in length)and high surface area,which allow painless and effective drug delivery through the skin.In addition to the great success of microneedle-based transdermal drug delivery,an increasing number of studies have shown that the application of microneedles has expanded to various organ applications,including the delivery of alopecia,eye diseases,and oral mucosal treatments.This article discusses the current treatment of hair loss,eye diseases,oral diseases and cardiovascular diseases,and outlines the latest progress in the application of microneedle drug delivery system in these four non-skin organ and tissue diseases.At the same time,the development trend and challenges of microneedle drug delivery systems in the future are emphasized.

Abstract:Objective To explore the mechanism of Yiqi Huoxue Jiedu decoction in the treatment of platinum-resistant ovarian cancer(PROC).Methods A total of 12 patients with PROC in the Department of Oncology,Guang'anmen Hospital,China Academy of Chinese Medical Sciences from September 2022 to March 2023 were selected.According to different treatment methods,the patients were divided into traditional Chinese medicine group and control group,with 6 cases in each group.The control group was treated with the regimen selected by the doctor,and the traditional Chinese medicine group was treated with the Yiqi Huoxue Jiedu decoction on the basis of the regimen selected by the doctor.Peripheral blood was collected,RNA was extracted from peripheral blood,reverse transcribed and cDNA was purified after qualified quality control,and transcriptome sequencing was performed using Illumina sequencing platform.DESeq2 software was used to screen differential long-chain non-coding RNA(lncRNA)and differential expression gene(DEG)between the two groups.The target genes of lncRNA were predicted by cis-regulation,and the results of predicted target genes and sequenced DEG were intercrossed to obtain important target genes and lncrnas regulating them.Gene ontology,Kyoto Encyclopedia of Genes and Genomes and protein interaction network(PPI)analyses were performed.Results Solute carrier family 3 member 2(SLC3A2)and BCL2-like protein 11(BCL2L11)were the important target genes regulated by Yiqi Huoxue Jiedu decoction,and they were regulated by lncRNA SNHG1,MIR4435-2HG and AC108463.3.The DEG regulated by Yiqi Huoxue Jiedu decoction was enriched in the functions of cell metabolism,cell autophagy and protein-DNA binding.Vascular endothelial growth factor receptor signaling pathway,apoptosis,autophagy,choline metabolism in cancer,and mammalian target of rapamycin signaling pathway were enriched.PPI showed that Yiqi Huoxue Jiedu decoction mainly regulated proteins with apoptosis,cell metabolism,DNA repair function,as well as classic oncogene sarcoma gene,mitogen-activated protein kinase 3,etc.Conclusion The targets of Yiqi Huoxue Jiedu decoction in the treatment of PROC patients are SLC3A2 and BCL2L11 regulated by lncRNA SNHG1,MIR4435-2HG and AC 108463.3,thereby regulating the biological behavior of cancer cells such as programmed cell death and the classical pathway of cancer.

Abstract:Objective To investigate the efficacy and safety of new double-tube laryngeal mask airway in the treatment of esophageal and gastric varices sclerotherapy combined with tissue glue injection in patients with liver cirrhosis.Methods A prospective study was conducted on 80 patients with liver cirrhosis who were treated with esophagogastric varices sclerotherapy combined with tissue glue injection under gastroscopy in Beijing Ditan Hospital,Capital Medical University from August 2021 to July 2023.The patients were divided into observation group and control group by random number table method,with 40 cases in each group.The control group was given oxygen inhalation with the mask after the mouth opener placement,and the observation group was given oxygen inhalation with the new double-tube laryngeal mask inserted and connected with the breathing tube.The mean arterial pressure(MAP),heart rate,pulse oxygen saturation(SpO2),and bispectral index(BIS)were recorded and compared before anesthesia(T1),after laryngeal mask/bite placement(T2),5 min after placement(T3)and at the time of exit from the endoscope(T4).The incidence of adverse reactions and postoperative satisfaction of patients and doctors were compared between the two groups.Results There were no statistically significant differences in age,gender,body mass index,American Society of Anesthesiologists classification,operation time,anesthesia time,and propofol dosage between the two groups(all P＞0.05).There were no significant differences in MAP,heart rate and BIS value between the two groups at each time point(all P＞0.05).At T2,T3,and T4 time points,the SpO2 in the observation group were higher than those in the control group[(96.6±2.4)％vs(94.3±3.3)％,(97.1±2.1)％vs(92.2±3.9)％,(96.1±1.5)％vs(95.3±1.9)％](all P＜0.05).The incidence of hypoxemia in the observation group was significantly lower than that in the control group[2.5％(1/40)vs 20.0％(8/40)](P＜0.05).There were no statistically significant differences in the incidences of other adverse reactions between the two groups(both P＞0.05).The satisfaction of doctors in the observation group was significantly higher than that in the control group[97.5％(39/40)vs 52.5％(21/40)](P＜0.001).There was no statistically significant difference in patient satisfaction between the two groups(P=0.709).Conclusion The new double-tube laryngeal mask airway can ensure oxygenation and has good safety in the treatment of esophageal and gastric varices sclerotherapy combined with tissue adhesive injection in patients with liver cirrhosis.

Abstract:Coronary artery spasm is secondary to almost complete or complete occlusion of blood vessels after constriction.This process can cause ischemia,leading to typical variant angina pectoris,atypical angina pectoris,acute myocardial infarction,sudden death,various types of arrhythmia,heart failure and so on.It is fatal if not detected and treated in time.Among them,cardiac arrest caused by coronary artery spasm is rare.This article reports the clinical data of a case of cardiac arrest caused by severe coronary artery spasm successfully rescued by extracorporeal membrane oxygenation,in order to improve the vigilance of clinicians for cardiac arrest caused by coronary artery spasm,and to provide a reference for the treatment of cardiac arrest by extracorporeal membrane oxygenation.

Abstract:Multiple myeloma(MM)is a heterogeneous disease of plasma cells.Autophagy is a biological process of eukaryotic cells to maintain the homeostasis of the internal environment.It has a dual role in the occurrence and development of MM,which can promote or inhibit the development of tumor.This article reviews autophagy and its regulatory mechanism,the role of autophagy in MM,and the treatment strategies of autophagy-related MM,in order to provide new ideas for the clinical diagnosis and treatment of MM.

Abstract:Objective To systematically evaluate the incidence of peripherally inserted central catheter(PICC)-related thrombosis in neonates.Methods Medline,Embase,Web of Science,CINAHL,China Biology Medicine Disc,China National Knowledge Infrastructure,VIP Database and Wanfang Database were searched for studies on the incidence of PICC-related thrombosis in neonates by computers.The search time limit was from the establishment of the database to May 17,2022.After screening and quality evaluation by two reviewers,Meta-analysis was performed using Stata 16.0 software.Results A total of 5 studies were included,with a total sample size of 4 573 cases,among which 104 cases of PICC-related thrombosis occurred.Meta-analysis showed that the incidence of PICC-related thrombosis in neonates was 1.7％(95％confidence interval:0.5％-3.6％).The results of subgroup analysis showed that the incidence of PICC-related thrombosis in neonates published from 2017 to 2021 and those with catheterization through the lower extremity vein was higher.Conclusion The incidence of PICC-related thrombosis in neonates is 1.68％.The incidence of thrombosis is higher in neonates with lower extremity venous catheterization.Therefore,for neonates with coagulopathy and high risk of thrombosis,lower extremity venous catheterization should be avoided.

Abstract:Autoimmune diseases(AID)are a group of chronic inflammatory diseases caused by autoim-mune imbalance involving multiple systems.The disease is widespread in the population,the etiology is unknown,and it has a great impact on the health of the patients themselves and the whole people.Granzyme B,a serine protease,can cleave a wide range of substrates inside and outside the cell,which may be an important factor affecting the development of AID.At present,the role of granzyme B in AID remains to be explored.This review summarizes the gene structure,expression regulation,mechanism of granzyme B entry into target cells,and intra-cellular and extracellular functions of granzyme B,and summarizes the role of granzyme B in various AID such as systemic lupus erythematosus,rheumatoid arthritis,systemic sclerosis,vasculitis and idiopathic inflammatory myopathy.The purpose of this review is to summarize the etiology of AID and provide ideas for further research on diagnosis,prevention and prognosis.

Abstract:Objective To investigate the improvement of pulmonary arterial hypertension(PAH)in patients with aortic stenosis(AS)and PAH after transcatheter aortic valve implantation(TAVI)and analyze the related factors.Methods A total of 168 AS patients with PAH undergoing TAVI in Beijing Anzhen Hospital,Capital Medical University from January 2022 to December 2023 were retrospectively analyzed.According to the pulmonary artery pressure 1 month after surgery,the patients were divided into PAH improvement group and PAH non-improvement group.The preoperative general data and echocardiographic parameters of the two groups were compared,and the influencing factors of the improvement of PAH after operation were analyzed.Results Among 168 patients,123 patients(73.2％)had improvement in PAH after surgery(PAH improvement group),and 45 patients(26.8％)did not improve(PAH non-improvement group).There were significant differences in atrial fibrillation,left atrial diameter(LAD),left ventricular end-diastolic diameter,left ventricular end-diastolic volume,left ventricular end-systolic volume,and moderate or severe tricuspid regurgitation(TR)between the two groups(all P＜0.05).Multivariate Logistic regression analysis showed that atrial fibrillation(odds ratio=0.444,95％confidence interval:0.201-0.981,P=0.045),LAD(odds ratio=1.086,95％confidence interval:1.008-1.169,P=0.029),combined with moderate or severe TR(odds ratio=0.428,95％confidence interval:0.189-0.967,P=0.041)were independent influencing factors for the improvement of PAH after TAVI.Conclusions TAVI can effectively improve the degree of PAH in AS patients with PAH.Preoperative atrial fibrillation,preoperative LAD and moderate or severe TR are the influencing factors for the improvement of PAH after TAVI.

Abstract:Objective To investigate the effect of the modified model for end-stage liver disease(MELD-XI)score on the prognosis of patients after heart transplantation.Methods The clinical data of 192 recipients who underwent single-organ heart transplantation in the 7th People's Hospital of Zhengzhou,Henan Province from May 2018 to July 2023 were retrospectively analyzed.The survival status of all heart transplant recipients within 5 years after operation was used as the state variable,and the preoperative MELD-XI score was used as the test variable.The X-tile software was used to determine the optimal threshold of preoperative MELD-XI score for predicting the postoperative survival of heart transplant recipients.According to the optimal threshold,the recipients were divided into two groups.Kaplan-Meier survival analysis was used to compare the 5-year overall survival rates between the two groups.The perioperative conditions and long-term prognosis of the two groups were compared,and the relationship between clinical indicators under MELD-XI score and the risk of postoperative death was explored.Results X-tile analysis showed that the best diagnostic point of preoperative MELD-XI score in predicting postop-erative survival of heart transplantation patients was 8.3.According to the best diagnostic point of preoperative MELD-XI score,the patients were divided into MELD-XI score＞8.3 group(46 cases)and MELD-XI score ≤8.3 group(146 cases).Kaplan-Meier survival analysis showed that the overall survival rates of heart transplant recipients in the MELD-XI score＞8.3 group were significantly lower than those in the MEID-XI score ≤8.3 group at 1,3,and 5 years postoperatively(P＜0.001).Logistic regression analysis showed that preoperative extracor-poreal membrane oxygenation,donor age,and postoperative ventilator use time were significantly correlated with the risk of death after heart transplantation(all P＜0.05).Cox regression analysis showed that postoperative ventilator use time(hazard rate=1.001,95％confidence interval:1.001-1.001,P＜0.001)was a high risk factor for death of heart transplant recipients.Preoperative hemoglobin(hazard rate=0.970,95％confidence interval:0.955-0.985,P＜0.001)was a protective factor for death in heart transplant recipients.Conclusion Preoperative MELD-XI score can be used to evaluate the risk of postoperative mortality and long-term overall survival in heart transplant recipients.

Abstract:Objective To analyze the application value of clinical,ultrasound radiomics and fusion model in evaluating the clinical course of Hashimoto's thyroiditis(HT).Methods The retrospective analysis method was used in this article.The clinical data of 80 patients with HT admitted to the Affiliated Traditional Chinese Medicine Hospital of Guangzhou Medical University from February to November 2023 were collected.The patients were included in the observation group and randomly divided into a training set(50 cases)and a validation set(30 cases).Another 80 healthy people in the same period were selected as the control group.The clinical data and ultrasound radiomics features of the two sets of patients were compared.The radiomics model was established.The independent risk factors affecting the clinical course of patients were analyzed by univariate and multivariate regression methods.The clinical ultrasound radiomics fusion model was constructed,and the calibration curve,receiver operating characteristic(ROC)curve and clinical decision curve were used to evaluate the efficacy of the model.Results There was no significant difference in clinical data and ultrasound radiomics features between the two sets of patients(all P＞0.05).Multivariate analysis showed that thyroid stimulating hormone,free thyroxine,thyroid peroxidase antibody,thyroglobulin antibody,gland enlargement,diffuse hypoechoic and shear wave velocity were independent risk factors affecting the clinical course of HT patients(all P＜0.05).The sensitivity of the fusion model(area under the curve:0.807)was 73.19％,the specificity was 72.65％,and the accuracy was 74.28％,and the area under the curve was higher than that of the clinical model and ultrasound radiomics model(0.718 and 0.741).The results of calibration curve and clinical decision curve showed that the fitting effect of the fusion model was significant,and the consistency index was 0.866(95％confidence interval:0.702-0.943),and its prediction performance was good.Conclusion The application value of the fusion model in the evaluation of the clinical process of HT is higher than those of clinical and ultrasound radiomics alone,and it can be used as a clinical basis for predicting the clinical process of HT patients.

Abstract:Objective To investigate the relationship between serum osteopontin and interleukin-17(IL-17)expression and the prognosis of triple-negative breast cancer(TNBC).Methods The clinical data and serum samples of 102 TNBC patients who underwent surgical treatment in Zhongshan Hospital Affiliated Fudan University from May 2018 to May 2021 were collected.Totally 18(17.6％)TNBC patients who had recurrence or metastasis within 3 years after surgery were classified into the poor prognosis group,and the remaining 84(82.4％)TNBC patients were classified into the good prognosis group.The relationship between serum osteopontin and IL-17 and the prognosis of TNBC after surgery were analyzed by dose-response relationship,interaction and receiver operating characteristic(ROC)curve.Results The levels of serum osteopontin and IL-17 in the poor prognosis group were higher than those in the good prognosis group[(99±12)μg/L vs(85±11)µg/L,(43±4)ng/L vs(37±4)ng/L](both P＜0.05).The analysis of restricted cubic spline showed that the serum levels of osteopontin and IL-17 had a non-linear dose-response relationship with the prognosis of TNBC patients treated with surgery(all P＜0.05).When the serum levels of osteopontin and IL-17 were＞85.12 μg/L and＞37.40 ng/L,respectively,the risk of poor prognosis increased with the increase of the levels of the indexes.After adjusting the confounding factors,there was a positive interaction between serum osteopontin and IL-17 on the prognosis of TNBC treated with surgery.When both of them were overexpressed,the risk of poor prognosis was 13.000 times as high as that when both were low.When both of them were overexpressed,the risk of poor prognosis was 11.307 times as high as that of other factors.The synergistic effect was 5.198 times of the sum of the effects of the two alone,and 75.38％of the risk of their coexistence was caused by their interaction.ROC curve analysis showed that the area under the curve of serum osteopontin,IL-17 and their combination for predicting the prognosis of TNBC after surgery was 0.810,0.826 and 0.891,respectively.The value of combined prediction was better than that of single prediction(both P＜0.05).Conclusions Serum osteopontin and IL-17 are related to the prognosis of TNBC after surgical treatment.High expression of serum osteopontin and IL-17 May increase the risk of poor prognosis of TNBC after surgical treatment.There is a positive interaction between the two factors,which synergistically increases the risk of poor prognosis of TNBC after surgical treatment,which should be paid attention to in clinical practice.

Abstract:In recent years,the relationship between attention deficit hyperactivity disorder(ADHD)and cardiovascular disease has attracted increasing attention.The risk of cardiovascular disease in patients with ADHD is significantly increased.It is very important to understand its pathogenesis and early identification and intervention.The mechanisms of ADHD comorbid with cardiovascular disease can be divided into biological and behavioral mechanisms.The biological mechanisms include genetic correlation,inflammatory dysregulation,hypothalamic-pituitary-adrenal axis imbalance,oxidative stress,and lipid abnormalities,etc.The behavioral mechanisms include obesity,smoking,psychiatric comorbidities,and drug treatment,etc.This article aims to review the latest research progress on the risk mechanism of ADHD comorbid with cardiovascular disease,in order to provide ideas for the identification,diagnosis,treatment and prevention of ADHD comorbid with cardiovascular disease.

Abstract:Objective To analyse the clinical characteristics and pregnancy outcomes of pregnant women after mitral valve replacement with mechanical prosthetic valves,in order to provide evidence for the safe diagnosis and treatment of this population.Methods The clinical data of 49 pregnant women after mechanical mitral valve replacement admitted to Beijing Anzhen Hospital,Capital Medical University from January 2013 to January 2023 were retrospectively analyzed.The maternal age,gestational age,valve replacement time,neonatal weight,inter-national normalized ratio,delivery mode and echocardiography differences were retrospectively analyzed,and the clinical data characteristics and pregnancy outcomes of the patients were summarized.Results Forty-nine pregnant women were aged(31±4)years,gestational week(26±14)weeks,gestational time to valve replacement(8±5)years,hemoglobin(115±10)g/L,glutamate transaminase(13±8)U/L,blood creatinine(45±7)μmol/L,international standardized ratio 1.8±0.6,mitral mechanical valve orifice area(2.4±0.6)cm2,mitral mechanical valve orifice velocity(197±49)cm/s,left ventricular end diastolic diameter(47±5)mm,and left ventricular ejection fraction(61±6)％.Among them,5 cases were found to have valve dysfunction,of which 3 cases had mechanical valve blockage during mid pregnancy(28 weeks in case 1,30 weeks in case 2 and 19 weeks in case 5).Case 1 suffered fetal death at 28 weeks and underwent valve replacement.Case 2 was treated with conservative dual antiplatelet therapy and delivered by cesarean section at 34 weeks of gestation with normal birth.In case 5,valve replacement was performed to protect the fetus,and the fetus was delivered by cesarean section at 37 weeks of gestation.Conclusion A reasonable anticoagulation strategy should be developed for pregnant women after mechanical valve replacement.Due to changes in physiological conditions during pregnancy,the anticoagulation regimen needs to be continuously adjusted.During the whole pregnancy,blood pressure,heart rate and various anticoagulation indicators should be closely monitored,and echocardiography should be performed regularly.At the same time,a multidisciplinary comprehensive evaluation method should be taken to ensure the safety of pregnancy and provide reliable diagnosis and treatment basis for pregnant women to ensure the safety of mother and child.

Abstract:Metabolic syndrome is characterized by insulin resistance,obesity/overweight,and abnormalities in glucose and lipid metabolism,as well as hypertension.Epicardial adipose tissue(EAT)is a specialized type of adipose tissue with both the physiological function of energy storage and mechanical protection,and high secretory activity that releases various anti-inflammatory/inflammatory factors while regulating the intake/release of free fatty acids.It plays a crucial role in maintaining metabolic stability in individuals with metabolic syndrome.The rela-tionship between EAT and the components of metabolic syndrome has been extensively studied from the perspectives of ectopic fat deposition,free fatty acid overload,low-grade inflammation,and oxidative stress to elucidate the core mechanisms underlying this condition.Lifestyle modifications,drug interventions,and surgical procedures can reduce EAT volume to improve metabolic syndrome outcomes and decrease cardiovascular events.This review provides a comprehensive summary of the correlation between EAT and metabolic syndrome,its influencing mechanisms,as well as treatment strategies.

Abstract:Pulmonary hypertension associated with congenital heart disease in pregnant population is a serious heart and lung disease involving multiple disciplines.The risk of mother and child increases significantly during pregnancy,and how to manage pregnancy and delivery needs special attention.Pregnancy risk should be rigorously assessed in the preparation of pregnancy or when pregnancy is first detected.If there is a great risk of pregnancy,contraception or early termination of pregnancy should be performed.If the pregnancy can be continued after the evaluation,prenatal care should be strengthened during pregnancy,and risk assessment and multidisciplinary cooperative treatment should be paid attention to.Early identification,timely evaluation,active intervention and strengthening management during pregnancy can minimize adverse maternal and infant outcomes.

Abstract:Objective To investigate the clinical application value of detachable string magnetically controlled capsule endoscopy(ds-MCE)in patients with a positive fecal occult blood test(FOBT)and underlying cardiovascular disease(CVD).Methods CVD patients with positive FOBT who underwent MCE at the Depart-ment of Gastroenterology,Beijing Anzhen Hospital,Capital Medical University from October 2023 to October 2024 were retrospectively enrolled.The patients who underwent ds-MCE were included in the string group,while those who underwent wireless magnetically controlled capsule endoscopy were included in the wireless group.The general information,complications,antithrombotic drug use,visualization of magnetically controlled capsule endoscopy,detected lesions,adverse reactions and adverse events related to the examination were collected.The primary outcome was the visual difference between the two groups,and the secondary outcome was the safety of ds-MCE.Results Finally,158 patients were included,including 53 cases in the string group and 105 cases in the wireless group.The visualization rates of the 4 quadrants and ≥3 quadrants for the upper,middle,and lower esophagus,as well as the dentate line,were significantly higher in the string group compared to the wireless group(all P＜0.01).In terms of gastric visualization,the visualization rate of gastric cardia in the string group was higher than that in the wireless group(P＜0.05).There was no significant difference in the detection rate of gastric and small intestinal lesions between the two groups(P＞0.05).In the string group,31(58.5％)patients did not experience any discomfort,21 cases(39.6％)reported mild pharyngeal discomfort,17 cases(32.1％)reported mild nausea,10 cases(18.9％)reported mild cough,and 1 case(1.9％)reported moderate nausea,all of which were tolerated.None of the patients had any adverse events such as capsule retention and aspiration etc.Conclusions The ds-MCE can be used to examine the esophagus,stomach and small intestine simultaneously in CVD patients with positive FOBT.It is safe and can provide accurate evidence for clinical diagnosis.

Abstract:Objective To explore the effects of remimazolam and sevoflurane on postoperative agitation after daytime adenoidectomy in children with adenoid hypertrophy under general anesthesia,and to evaluate their application effect in children undergoing general anesthesia.Methods A total of 50 children with adenoid hyper-trophy who underwent daytime surgery in Beijing Tongren Hospital,Capital Medical University from August to December 2023 were selected.According to the random number table method,they were divided into sevoflurane group and remimazolam group,with 25 cases in each group.The sevoflurane group and remimazolam group received sevoflurane and remimazolam for maintenance of anesthesia,respectively.The general data,intraoperative conditions,pediatric anesthesia emergence delirium(PAED)scale score,incidence of agitation during recovery period,recovery time of spontaneous breathing,recovery time,extubation time,postoperative pain intensity,and adverse events were compared between the two groups.Results The scores of PAED scale at 5,10,20 min after extubation and at the time of leaving the postanesthesia care unit in the remimazolam group were lower than those in the sevoflurane group(all P＜0.05).The incidence of agitation in remimazolam group was lower than that in sevoflurane group[12.0％(3/25)vs 44.0％(11/25)](x2=6.340,P=0.012).The recovery time of spontaneous breathing,recovery time and extubation time in the remimazolam group were shorter than those in the sevoflurane group(all P＜0.05).There was no significant difference in the incidence of adverse events between the two groups(P=0.733).There was no significant difference in pain intensity between the two groups at 5,10,20 min after extubation,at the time of leaving the postanesthesia care unit,and 6 h after extubation(all P＞0.05).Conclusion Remimazolam can effectively reduce the incidence of postoperative agitation after daytime adenoidec-tomy in children,and can promote the postoperative rehabilitation of children.

Abstract:Objective To investigate the effect of moist exposed burn ointment combined with concentrated growth factor in the treatment of diabetic foot.Methods A total of 90 patients with diabetic foot admitted to Nanxishan Hospital of Guangxi Zhuang Autonomous Region from January 2022 to January 2024 were selected as the research objects.They were divided into control group 1,control group 2 and combined group by random number table method,with 30 cases in each group.On the basis of basic comprehensive treatment,the control group 1 was treated with moistexposed burn ointment,the control group 2 was treated with concentrated growth factor,and the combined group was treated with moistexposed burn ointment combined with concentrated growth factor.The clinical efficacy,wound healing indicators,growth factor levels,inflammatory factor levels,and treatment safety were compared among the three groups.Results The total effective rate of the combined group was higher than those of the control group 1 and the control group 2[93.3％(28/30)vs 73.3％(22/30),70.0％(21/30)](both P＜0.05).After treatment,the wound healing area of combined group was larger than those of control group 1 and control group 2,while the growth time of new granulation tissue,healing time,and treatment cost of combined group were shorter/lower than those of control group 1 and control group 2(all P＜0.05).After treatment,the levels of vascular endothelial growth factor,basic fibroblast growth factor and epidermal growth factor in the combined group were higher than those in the control group 1 and the control group 2,and the levels of high-sensitivity C-reactive protein,tumor necrosis factor-α and interleukin-6 in the combined group were lower than those in the control group 1 and the control group 2(all P＜0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P＞0.05).Conclusion Moist exposed burn ointment combined with concentrated growth factors has a good effect in the treatment of diabetic foot,which can promote wound healing,reduce treatment cost,improve the level of growth factors,reduce the level of inflammatory factors,and has good safety.