BACKGROUND Postoperative pain management and cognitive function preservation are crucial for patients undergoing thoracoscopic surgery for lung cancer(LC).This is achieved using either a thoracic paravertebral block(T...BACKGROUND Postoperative pain management and cognitive function preservation are crucial for patients undergoing thoracoscopic surgery for lung cancer(LC).This is achieved using either a thoracic paravertebral block(TPVB)or sufentanil(SUF)-based multimodal analgesia.However,the efficacy and impact of their combined use on postoperative pain and postoperative cognitive dysfunction(POCD)remain unclear.AIM To explore the analgesic effect and the influence on POCD of TPVB combined with SUF-based multimodal analgesia in patients undergoing thoracoscopic radical resection for LC to help optimize postoperative pain management and improve patient outcomes.METHODS This retrospective analysis included 107 patients undergoing thoracoscopic radical resection for LC at The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital between May 2021 and January 2023.Patients receiving SUF-based multimodal analgesia(n=50)and patients receiving TPVB+SUF-based multimodal analgesia(n=57)were assigned to the control group and TPVB group,respectively.We compared the Ramsay Sedation Scale and visual analog scale(VAS)scores at rest and with cough between the two groups at 2,12,and 24 h after surgery.Serum levels of epinephrine(E),angio-tensin Ⅱ(Ang Ⅱ),norepinephrine(NE),superoxide dismutase(SOD),vascular endothelial growth factor(VEGF),transforming growth factor-β1(TGF-β1),tumor necrosis factor-α(TNF-α),and S-100 calcium-binding proteinβ(S-100β)were measured before and 24 h after surgery.The Mini-Mental State Examination(MMSE)was administered 1 day before surgery and at 3 and 5 days after surgery,and the occurrence of POCD was monitored for 5 days after surgery.Adverse reactions were also recorded.RESULTS There were no significant time point,between-group,and interaction effects in Ramsay sedation scores between the two groups(P>0.05).Significantly,there were notable time point effects,between-group differences,and interaction effects observed in VAS scores both at rest and with cough(P<0.05).The VAS scores at rest and with cough at 12 and 24 h after surgery were lower than those at 2 h after surgery and gradually decreased as postoperative time increased(P<0.05).The TPVB group had lower VAS scores than the control group at 2,12,and 24 h after surgery(P<0.05).The MMSE scores at postoperative days 1 and 3 were markedly higher in the TPVB group than in the control group(P<0.05).The incidence of POCD was significantly lower in the TPVB group than in the control group within 5 days after surgery(P<0.05).Both groups had elevated serum E,Ang Ⅱ,and NE and decreased serum SOD levels at 24 h after surgery compared with the preoperative levels,with better indices in the TPVB group(P<0.05).Marked elevations in serum levels of VEGF,TGF-β1,TNF-α,and S-100β were observed in both groups at 24 h after surgery,with lower levels in the TPVB group than in the control group(P<0.05).CONCLUSION TPVB combined with SUF-based multimodal analgesia further relieves pain in patients undergoing thoracoscopic radical surgery for LC,enhances analgesic effects,reduces postoperative stress response,and inhibits postoperative increases in serum VEGF,TGF-β1,TNF-α,and S-100β levels.This scheme also reduced POCD and had a high safety profile.展开更多
Objective:To study the effects of Dexmedetomidine combined with Sufentanil on hemodynamics, stress state, helper T cytokines and pain degree during the waking period of general anesthesia in elderly patients with lowe...Objective:To study the effects of Dexmedetomidine combined with Sufentanil on hemodynamics, stress state, helper T cytokines and pain degree during the waking period of general anesthesia in elderly patients with lower limb fracture surgery were studied.Methods:From June 2017 to July 2018, 95 elderly patients with lower limb fracture who visited First Affiliated Hospital of Xi 'an Jiaotong University and received fracture surgery and general anesthesia were collected. According to their different anesthesia methods, 46 patients were divided into the sufentanil maintenance anesthesia group (Sufentanil group), and 49 patients were divided into the metopidine combined with sufentanil maintenance anesthesia group (Joint group). Changes in hemodynamics (HR, SpO2, MAP) of the two groups were monitored at different times throughout the operation. Using enzyme-linked immunoassay detection of two groups of patients in maintain anesthesia and anesthesia to stress index (Cor, E, FIns and HOMA-IR). The the changes of pain mediators (NO,β-EP, SP) and helper T cytokines (IFN-γ, TNF-α) were compared between the two groups before and 24 hours after surgery. Results:In the combined group, HR, SpO2, MAP and sufentanil groups showed little change in SpO2 during anesthesia, with no significant difference. The HR and MAP of T2 and T3 in the sufentanil group were significantly higher than those in the combined group at T2 and T3. The stress indicators Cor, E, FIns and HOMA-IR in the anesthesia of the two groups were significantly higher than those in the anesthesia maintenance. The serum stress indexes of Cor, E, FIns and HOMA-IR were significantly lower in the combined group than in the sufentanil group. The IFN-γ level of the combined group was significantly higher than that of the sufentanil group, and the TNF-α level was significantly lower than that of the control group. Serum levels of NO,β-EP and SP were significantly higher in the two groups 24 h after surgery. Serum pain mediators NO,β-EP and SP in the combined group were significantly lower than those in the sufentanil group before and 24 h after surgery.Conclusion: Combined anesthesia with Remifentanil and Propofol can stabilize the hemodynamic state of patients undergoing craniotomy, reduce cardiovascular stress response and inflammatory response, reduce nerve damage, and play a role in brain protection.展开更多
Two sets of CCD photometric observations for contact binary TU Boo were obtained in 2020 and 2021.Different from its asymmetric light curves published from the literature,our BVRcIc-band curves show that the heights o...Two sets of CCD photometric observations for contact binary TU Boo were obtained in 2020 and 2021.Different from its asymmetric light curves published from the literature,our BVRcIc-band curves show that the heights of maximum are almost equal.These distortions of light curves possibly indicate that the components were active in past 25 yr,but they were stable in the last two years.For total-eclipse binary TU Boo,due to some star-spots on the surface of the components,the physical structure obtained by many investigators are different.Therefore,the symmetric multi-color light curves in 2020,2021 are important for understanding configuration and evolution of this system.By using the Wilson–Devinney program,it is confirmed that TU Boo is an A-type shallow-contact binary with the temperature difference ofΔT=152 K and fill-out of f=14.67%.In the O−C diagram of orbital period analysis,a cyclic oscillation superimposed on a continuous decrease was determined.The long-term decreasing is often explained by the mass transfer from the more massive star to less massive one,this system will evolve into a deeper contact binary with time.The cyclic oscillations computed from much more CCD times of light minimum maybe result from the light-travel time effect via the presence of a third body.These characters of structure,evolution and ternary belong to typical A-type W UMa binaries with spectral G.展开更多
文摘BACKGROUND Postoperative pain management and cognitive function preservation are crucial for patients undergoing thoracoscopic surgery for lung cancer(LC).This is achieved using either a thoracic paravertebral block(TPVB)or sufentanil(SUF)-based multimodal analgesia.However,the efficacy and impact of their combined use on postoperative pain and postoperative cognitive dysfunction(POCD)remain unclear.AIM To explore the analgesic effect and the influence on POCD of TPVB combined with SUF-based multimodal analgesia in patients undergoing thoracoscopic radical resection for LC to help optimize postoperative pain management and improve patient outcomes.METHODS This retrospective analysis included 107 patients undergoing thoracoscopic radical resection for LC at The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital between May 2021 and January 2023.Patients receiving SUF-based multimodal analgesia(n=50)and patients receiving TPVB+SUF-based multimodal analgesia(n=57)were assigned to the control group and TPVB group,respectively.We compared the Ramsay Sedation Scale and visual analog scale(VAS)scores at rest and with cough between the two groups at 2,12,and 24 h after surgery.Serum levels of epinephrine(E),angio-tensin Ⅱ(Ang Ⅱ),norepinephrine(NE),superoxide dismutase(SOD),vascular endothelial growth factor(VEGF),transforming growth factor-β1(TGF-β1),tumor necrosis factor-α(TNF-α),and S-100 calcium-binding proteinβ(S-100β)were measured before and 24 h after surgery.The Mini-Mental State Examination(MMSE)was administered 1 day before surgery and at 3 and 5 days after surgery,and the occurrence of POCD was monitored for 5 days after surgery.Adverse reactions were also recorded.RESULTS There were no significant time point,between-group,and interaction effects in Ramsay sedation scores between the two groups(P>0.05).Significantly,there were notable time point effects,between-group differences,and interaction effects observed in VAS scores both at rest and with cough(P<0.05).The VAS scores at rest and with cough at 12 and 24 h after surgery were lower than those at 2 h after surgery and gradually decreased as postoperative time increased(P<0.05).The TPVB group had lower VAS scores than the control group at 2,12,and 24 h after surgery(P<0.05).The MMSE scores at postoperative days 1 and 3 were markedly higher in the TPVB group than in the control group(P<0.05).The incidence of POCD was significantly lower in the TPVB group than in the control group within 5 days after surgery(P<0.05).Both groups had elevated serum E,Ang Ⅱ,and NE and decreased serum SOD levels at 24 h after surgery compared with the preoperative levels,with better indices in the TPVB group(P<0.05).Marked elevations in serum levels of VEGF,TGF-β1,TNF-α,and S-100β were observed in both groups at 24 h after surgery,with lower levels in the TPVB group than in the control group(P<0.05).CONCLUSION TPVB combined with SUF-based multimodal analgesia further relieves pain in patients undergoing thoracoscopic radical surgery for LC,enhances analgesic effects,reduces postoperative stress response,and inhibits postoperative increases in serum VEGF,TGF-β1,TNF-α,and S-100β levels.This scheme also reduced POCD and had a high safety profile.
文摘Objective:To study the effects of Dexmedetomidine combined with Sufentanil on hemodynamics, stress state, helper T cytokines and pain degree during the waking period of general anesthesia in elderly patients with lower limb fracture surgery were studied.Methods:From June 2017 to July 2018, 95 elderly patients with lower limb fracture who visited First Affiliated Hospital of Xi 'an Jiaotong University and received fracture surgery and general anesthesia were collected. According to their different anesthesia methods, 46 patients were divided into the sufentanil maintenance anesthesia group (Sufentanil group), and 49 patients were divided into the metopidine combined with sufentanil maintenance anesthesia group (Joint group). Changes in hemodynamics (HR, SpO2, MAP) of the two groups were monitored at different times throughout the operation. Using enzyme-linked immunoassay detection of two groups of patients in maintain anesthesia and anesthesia to stress index (Cor, E, FIns and HOMA-IR). The the changes of pain mediators (NO,β-EP, SP) and helper T cytokines (IFN-γ, TNF-α) were compared between the two groups before and 24 hours after surgery. Results:In the combined group, HR, SpO2, MAP and sufentanil groups showed little change in SpO2 during anesthesia, with no significant difference. The HR and MAP of T2 and T3 in the sufentanil group were significantly higher than those in the combined group at T2 and T3. The stress indicators Cor, E, FIns and HOMA-IR in the anesthesia of the two groups were significantly higher than those in the anesthesia maintenance. The serum stress indexes of Cor, E, FIns and HOMA-IR were significantly lower in the combined group than in the sufentanil group. The IFN-γ level of the combined group was significantly higher than that of the sufentanil group, and the TNF-α level was significantly lower than that of the control group. Serum levels of NO,β-EP and SP were significantly higher in the two groups 24 h after surgery. Serum pain mediators NO,β-EP and SP in the combined group were significantly lower than those in the sufentanil group before and 24 h after surgery.Conclusion: Combined anesthesia with Remifentanil and Propofol can stabilize the hemodynamic state of patients undergoing craniotomy, reduce cardiovascular stress response and inflammatory response, reduce nerve damage, and play a role in brain protection.
基金sponsored by Natural Science Foundation of Xinjiang Uygur Autonomous Region (No.2022DO1A164)the Joint Research Found (No.U1831109)in Astronomy under cooperative agreement between the National Natural Science Foundation of China (NSFC)and Chinese Academy of Sciences (CAS)the Natural Science Foundation of Shandong Province (No.ZR2020QA048)。
文摘Two sets of CCD photometric observations for contact binary TU Boo were obtained in 2020 and 2021.Different from its asymmetric light curves published from the literature,our BVRcIc-band curves show that the heights of maximum are almost equal.These distortions of light curves possibly indicate that the components were active in past 25 yr,but they were stable in the last two years.For total-eclipse binary TU Boo,due to some star-spots on the surface of the components,the physical structure obtained by many investigators are different.Therefore,the symmetric multi-color light curves in 2020,2021 are important for understanding configuration and evolution of this system.By using the Wilson–Devinney program,it is confirmed that TU Boo is an A-type shallow-contact binary with the temperature difference ofΔT=152 K and fill-out of f=14.67%.In the O−C diagram of orbital period analysis,a cyclic oscillation superimposed on a continuous decrease was determined.The long-term decreasing is often explained by the mass transfer from the more massive star to less massive one,this system will evolve into a deeper contact binary with time.The cyclic oscillations computed from much more CCD times of light minimum maybe result from the light-travel time effect via the presence of a third body.These characters of structure,evolution and ternary belong to typical A-type W UMa binaries with spectral G.
