Cranial ultrasound in perioperative period of acute severe traumatic brain injury

Objective To observe the value of cranial ultrasound for perioperative patients with acute severe traumatic brain injury(sTBI).Methods Data of 55 sTBI patients who underwent craniotomy were retrospectively analyzed.The patients were divided into observation group(n=15)and control group(n=40)according to received perioperative cranial ultrasound or not.The general data and surgical data were compared between groups,and ultrasonic data of observation group were analyzed.Results The proportions of good prognosis 1 and 6 months after operation in observation group were both higher than those in control group,while the incidence of cerebral infarction in observation group was lower than that in control group(all P<0.05).No significant difference of general data nor other surgical data was found between groups(all P>0.05).Acute encephalocele occurred in 1 case in observation group during operation,and cranial ultrasound accurately showed the contralateral secondary epidural hematoma.Increased intracranial pressure in different degrees were found in all 15 cases(15/15,100%)in observation group after operation with transcranial color coded Doppler(TCCD)or transcranial Doppler(TCD),while cerebral vascular spasm was observed in 5 cases(5/15,33.33%),among them 4 cases(4/5,80.00%)were diagnosed cerebral infarction based on CT examination.Conclusion Cranial ultrasound could be used to evaluate changes of sTBI in perioperative period and guide adjusting treatment strategy in time,being valuable for reducing risk of postoperative cerebral infarction and improving prognosis.

Advancements in nutritional diagnosis and support strategies during the perioperative period for patients with liver cancer

Liver cancer represents a grave hepatic condition and constitutes a significant global health concern.Surgical resection remains the principal therapeutic modality for liver cancer.Nevertheless,perioperative malnutrition exerts a notable impact on patients with liver cancer,emerging as an independent risk factor for disease mortality and adverse outcomes.Hence,precise nutritional diagnosis and timely nutritional support hold the potential to enhance therapeutic efficacy and quality of life for liver cancer patients.This study represents a meticulous foray into the literature,extracting data from PubMed,Web of Science,and EMBASE databases,with a focus on the past 5 years.It scrutinizes the impact of malnutrition on patients undergoing liver cancer surgery,the etiological underpinnings of malnutrition within this patient cohort,the critical assessment of perioperative nutritional status,and the strategic approaches to nutritional support.Utilizing rigorous inclusion and exclusion criteria,the amassed scholarly works are meticulously synthesized,methodically organized,and categorically elaborated upon.Ultimately,the authors propose the incorporation of a multidisciplinary nutrition management team during the perioperative period,comprising nutritionists,pharmacists,physicians,nurses,psychologists,and rehabilitation therapists,among other specialized professionals.Together,they collaborate to devise and implement personalized nutritional support plans,monitor patients’nutritional status,and make necessary adjustments as required.Through comprehensive management and intervention,improvements in the nutritional status of liver cancer patients can be achieved,thereby enhancing surgical success rates and facilitating postoperative recovery.It is believed that this manuscript will offer valuable insights to advance the nutritional management during the perioperative phase of liver cancer,aiding in ameliorating patients'nutritional status and treatment outcomes.

Analysis of the Effect of Intensive Nursing Care on Improving Sleep Quality During the Perioperative Period of Severed Finger Reimplantation

Objective:To investigate the clinical effect of perioperative intensive nursing on patients who underwent severed finger reimplantation and its influence on sleep quality.Methods:62 patients who underwent severed finger reimplantation between January 2023 and December 2023 were included.They were divided into two groups:the observation group(n=31)and the control group(n=31).The control group received basic nursing interventions,while the observation group received intensive nursing care.The comparison parameters included visual analog pain score(VAS),incidence of vascular crises,length of hospitalization,Pittsburgh Sleep Quality Index(PSQI),Hamilton Depression Score(HAM-D),Hamilton Anxiety Score(HAM-A),and patient satisfaction.Results:Postoperative VAS score,incidence of vascular crisis,hospitalization time,PSQI score,and HAM-A and HAM-D scores of the observation group were lower than those of the control group(P<0.05).Meanwhile,the patient satisfaction of the observation group was higher than that of the control group(P<0.05).Conclusion:Perioperative intensive nursing care for patients undergoing severed finger reimplantation demonstrates significant benefits.It reduces postoperative pain,lowers the incidence of vascular crises,shortens hospitalization durations,enhances sleep quality,alleviates negative emotions,and improves nursing satisfaction.These findings underscore the importance and applicability of such care practices.

The Application of Midline Catheter in Perioperative Period of Patients with Laryngopharyngeal Cancer

Objective: To investigate the application value of midline catheters in patients with larynx cancer during the postoperative period. Methods: 150 patients with larynx cancer treated in our hospital from May 2019 to May 2022 were selected as the study objects. According to the random number method, 75 cases were divided into a control group and a study group. The study group used a midline catheter during treatment, and the control group used a Peripheral venous indwelling needle during treatment. The indwelling time, puncture times, complication rate, daily catheter maintenance cost and catheterization satisfaction rate of the two groups were compared. Result: The retention time of the study group (11.53 ± 6.91 days) was significantly higher than that of the control group (2.92 ± 1.41 days) (P . The total puncture times were significantly lower than that of the control group (P cidence of complications such as catheter blockage, catheter detachment, drug extravasation and phlebitis were lower than those of the control group. The difference was statistically significant (P < 0.05), the average daily maintenance cost of the two groups was not statistically significant (P > 0.05), and the satisfaction rate of the study group was significantly higher than that of the control group, the difference was statistically significant (P Conclusion: Compared with the Peripheral venous indwelling needle, postoperative application of a midline catheter in patients with larynx cancer can effectively reduce the number of puncture times and the incidence of catheter-related adverse reactions, and has higher economic benefits and satisfaction rate, which is worthy of clinical application.

Harnessing interventions during the immediate perioperative period to improve the long-term survival of patients following radical gastrectomy

Although the incidence and mortality of gastric cancer(GC)have been decreasing steadily worldwide,especially in East Asia,the disease burden of this malignancy is still very heavy.Except for tremendous progress in the management of GC by multidisciplinary treatment,surgical excision of the primary tumor is still the cornerstone intervention in the curative-intent treatment of GC.During the relatively short perioperative period,patients undergoing radical gastrectomy will suffer from at least part of the following perioperative events:Surgery,anesthesia,pain,intraoperative blood loss,allogeneic blood transfusion,postoperative complications,and their related anxiety,depression and stress response,which have been shown to affect long-term outcomes.Therefore,in recent years,studies have been carried out to find and test interventions during the perioperative period to improve the long-term survival of patients following radical gastrectomy,which will be the aim of this review.

Thrombelastography and color Doppler flow imaging in the perioperative period after closed lower limb fracture

Objective To observe the changes of thrombelastography (TEG) and color Doppler flow imaging (CDFI) in the perioperative period after closed lower limb fracture.Methods Fasting venous blood samples in the morning from 11 healthy adults were used

Targeted montoring to surgical site infection and investigation of standard application of antibiotics during perioperative period

Objective To investigate current surgical site infection and perioperative antibiotics in inpatients and explore the controlling aim and methods. Methods The infection rates of surgical sites of 287 operated cases from May to Dec 31,2007 were studied and compared with

Progress in research on the application of nursing models for breast cancer patients during the perioperative period

Nursing models at home and abroad for breast cancer patients during the perioperative period were screened, including eight types of models： the nursing model guided by self-care theory, the plan-do-check-act cycle combined with the four-in-one model, the peer support nursing model, the nursing model guided by transcultural theory, the multidisciplinary cooperative nursing model, the knowledge-attitude-practice nursing model, the safe nursing management model, and the case nursing model. These models were analyzed and described with the aim of providing a reference for the clinical breast surgery nursing staff in China and for promoting the development of nursing in China for breast cancer the perioperative period.

Clinical Application and Research Progress of Accelerated Rehabilitation Surgery in Perioperative Period of Advanced Gastric Cancer in the Elderly

Enhanced recovery after surgery (ERAS) has been used in various surgical professions in recent years and is widely accepted by doctors. This concept not only helps patients speed up postoperative recovery, reduce the incidence of related complications and shorten hospital stays, but also has been proved to be effective and safe in the perioperative application of gastric cancer. This article reviews the clinical application and research progress of enhanced recovery after surgery in the perioperative period of advanced gastric cancer in the elderly.

Progress in Analgesic-Sedative Treatment in Perioperative Period of Hypertensive Intracerebral Hemorrhage

Hypertensive intracerebral hemorrhage (HICH) refers to intra cerebral hemorrhage at basal ganglia, thalamus, ventricle, cerebellum and brainstem in patients with history of explicit hypertension disease, excluding secondary cerebral hemorrhage caused by trauma, vascular structural disorders, coagulation disorders, hematologic diseases, systematic diseases and neoplastic diseases. HICH is characteristic of high morbidity, fatality rate, disability rate and recurrence rate. HICH is the most common type of spontaneous cerebral hemorrhage and various surgical interventions are one of the major treatments for HICH. Surgical treatment is to eliminate hematoma, relieve oppression of hematoma on surrounding brain tissues, lower intracranial pressure and alleviate secondary brain tissue damages, thus enabling to decrease fatality rate of patients and improve the long-term quality of life. Patients with HICH often may have different degrees of coma, pains, dysphoria, anxiety and delirium in the postoperative period. After central pivot was damaged, the sympathetic central excitability spreading is strengthened in the state of cortical inhibition, which also might be accompanied by paroxysmal sympathetic hyperexcitation syndrome to strengthen disease conditions of patients and thereby influence subsequent treatment. Several professional guidelines all recommend analgesic-sedative treatment as an important component of ICU therapy. However, it lacks support by large sample sized clinical research results of analgesic-sedative treatment of HICH in the postoperative period. This study analyzed literature concerning analgesic-sedative treatment of HICH in the postoperative period in recent years, aiming to guide specific clinical implementation.

Worsening of coronary spasm during the perioperative period:A case report

We present the case of a 65-year-old male with vasospastic angina(VSA)whose condition worsened during the perioperative period.He had been diagnosed with VSA 10 years prior.He was treated with two types of vasodilators and had not experienced any chest symptoms for 5 years.At this juncture,he underwent surgery for relapsed maxillary sublingual carcinoma.He had taken two vasodilators one day prior to surgery.Intravenous infusion of nitroglycerin(NTG)was initiated immediately before the surgery and continued the following day.Instead of stopping NTG,a dermal isosorbide dinitrate tape was applied on post-operative day 1.Two days later,a complete atrioventricular block with pulseless electrical activity appeared.After cardiopulmonary resuscitation,emergent coronary angiography showed severe coronary spasm in both the left and right coronary arteries.Intracoronary infusion of nitroglycerin and epinephrine with percutaneous cardiopulmonary support relieved the coronary spasm.During the perioperative period,several factors can trigger coronary vasospasm,including the discontinuation of vasodilators.Thus,surgeons,anesthetists,and cardiologists should watch for coronary vasospasm during this period and for worsening coronary spasm when discontinuing vasodilators in patients at risk for VSA.

Study of the changes of serum MMP, TIMP and RAAS during the perioperative period of glioma patients

Objective:The value of the changes of serum MMP, TIMP and RAAS during the perioperative period of brain glioma patients was analyzed and analyzed.Methods: A total of 49 cases of glioma surgery in our hospital were selected as the observation group, and 40 healthy people as control group. The changes of serum MMP, TIMP and RASS indexes in the observation group before and after operation were detected and compared with those in the control group.Results:the indexes of MMP in the observation group were significantly higher than those in the control group at all times, and the indexes of MMP in the observation group were significantly lower than those before operation. The observation group of patients with TIMP-1 and TIMP-2 were significantly higher than that of the control group, while the level of TIMP-4 was significantly lower than the control group, the time of TIMP-1 and TIMP-2 were significantly lower than the preoperative patients in the observation group, and the level of TIMP-4 was significantly higher than that before operation. The indexes of RAAS in each time of the observation group were significantly higher than that of the control group, and the indexes of RAAS in the observation group were significantly lower than those before the operation.Conclusion: the preoperative MMP, TIMP and RAAS of the patients with glioma were significantly different than those of the normal group, and the indexes of the patients were improved after operation.

Clinical application progress of regional oxygen saturation monitoring in perioperative period

Regional oxygen saturation (rSO2) is a new method to evaluate regional oxygen supply and demand balance by near-infrared spectroscopy. It has the advantages of noninvasive, continuous and sensitive, and has been successfully applied in clinical guidance. Regional oxygen saturation is usually referred to as regional cerebral oxygen saturation (rScO2) and regional tissue oxygen saturation (rStO2) depending on the site of monitoring. Initially, cerebral oxygen saturation monitoring has been used in cardiothoracic surgery and in non-cardiac surgery for elderly and critically ill patients. With the increase of clinical application, regional oxygen saturation is gradually extended to the determination of oxygen saturation in peripheral tissues, which is used to evaluate the relationship between peripheral tissue microcirculation function and the prognosis of patients. Timely detection of tissue ischemia and hypoxia and intervention can optimize the whole clinical treatment management, especially for major surgery and critically ill patients can reduce the incidence of complications during hospitalization, shorten hospitalization time, improve the prognosis of patients. This article will focus on the clinical application of cerebral oxygen saturation and tissue oxygen saturation in perioperative period.

Clinical Significance of Preoperative Nutritional Risk Screening and Support in the Perioperative Period of Gastric Cancer Patients

Objective:To investigate the clinical value of using preoperative nutritional risk screening and support in gastric cancer patients.Methods:In this paper,70 gastric cancer patients selected from July 2017 to July 2020 treated in our hospital were grouped concerning the lottery method,and the reference group(n=35)used conventional nutritional support,while the experimental group(n=35)used preoperative dietary risk screening and support,comparing the clinical treatment differences between gastric cancer patients in the experimental group and the reference group.Results:After the intervention,IgA,IgM,IgG,serum albumin,complication rate,NRS score,hospitalization time and anal exhaust time of gastric cancer patients in the experimental group were compared with those in the reference group,P<0.05,and there was statistical validation analysis significance between the data indicators.P<0.05 for the comparison of IgA,IgM,IgG,serum albumin after the intervention and pre-intervention for gastric cancer patients in the experimental group and the reference group,with statistical validation analysis significance between the data indicators.Conclusion:Preoperative nutritional risk screening and support is of significant value in gastric cancer patients and can improve patients’nutritional status.

Predictive value of initial procalcitonin level in perioperative period of critically ill cancer patients

The predictive value of the initial procalcitonin(PCT)level was explored in the perioperative peniod of citically ill cancer patients.Background:It is quite important to predict infections in patients in the intensive care unit (ICU).Cancer surgery is characterized by large trauma,long duration,and wide operation scope;and there are many inflammatory factors in the tumor.Common manifestations of systermic inflammatory response syndrome(SIRS)。such as fever,elevated white blood cells,and elevated infammatory indicators,frequently occur in patients during the penioperative period as a result of the above factors.These factors are diverse and complex;additionally,advanced cancer and the trauma of major surgery are important factors that influence PCT blood levels.Because all of the aforementioned factors make it dificult to distinguish the postoperative inflammatory response fom the true infection in clinical practice,conventional methods cannot prediet disease sevenity or disease course.Methods:A total of 53 patients with endotracheal intubation admitted to the ICU of Tianjin Medical University Cancer Institute and Hospital from January 2020 to May 2020,were retrospectively selected.According to the patient source,35 cases were assigned to ORIG(Operating Room to ICU Group),and 18 cases were assigned to General Ward to ICU group(GWO).At the ICU admission,the patient's age,sex,surgical site of tumor,reason for ICU and other data were recorded to form a database;PCT,B-type natiuretic peptide(BNP),high sensitivity toponin I(hsTni),serumn creatinine(Cr),serum cystatin C(Cys-c)and other laboratory indicators were detected;scores of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)and sequential organ failure assessment(SOFA)were marked 24 h after ICU admission;Proportion of Antibiotics,Time Antibiotic Application,and Time Indicators(Ventilator support Time,Endotracheal Intubation Time,ICU Stay Time)were recorded during the period from ICU admission to ICU discharge.Results:APAHCE Ⅱ score and SOFA score increased significantly in the GWIG,compared with the ORIG,and the differences were statistically significant(P<0.01);the GWIG had a significantly longer Time Antibiotic Application than the ORIG,and the difference was statistically significant(P<0.01);in tems of blood indicators,the PCT,BNP,and hsTNi levels were elevated in the GWIG compared with the ORIG,and the differences were statistically significant(p<0.01);no statistical differences were found in Cr and Cys-C levels(P>0.05).In terms of time indicators,the Ventilator support Time,Endotracheal Intubation Time,and ICU Stay Time were prolonged in the GWIG compared with the ORIG,and the differences were statistically significant(P<0.01).The PCT level was statistically signifcant(P<0.01)when correlated with the Ventilator Supporting Time and Endotracheal Intubation Time;however,the PCT level was negatively correlated with the ICU Stay Time,with a small r(correlation cofficient)value and no statistical significance(P>0.05)when correlated with the ICU Stay Time.Conclusion:The initial PCT level can predict the disease severity in critically ill cancer patients treated with mechanical ventilation during the perioperative period.

Ultrafast dynamics of femtosecond laser-induced high spatial frequency periodic structures on silicon surfaces

Femtosecond laser-induced periodic surface structures(LIPSS)have been extensively studied over the past few decades.In particular,the period and groove width of high-spatial-frequency LIPSS(HSFL)is much smaller than the diffraction limit,making it a useful method for efficient nanomanufacturing.However,compared with the low-spatial-frequency LIPSS(LSFL),the structure size of the HSFL is smaller,and it is more easily submerged.Therefore,the formation mechanism of HSFL is complex and has always been a research hotspot in this field.In this study,regular LSFL with a period of 760 nm was fabricated in advance on a silicon surface with two-beam interference using an 800 nm,50 fs femtosecond laser.The ultrafast dynamics of HSFL formation on the silicon surface of prefabricated LSFL under single femtosecond laser pulse irradiation were observed and analyzed for the first time using collinear pump-probe imaging method.In general,the evolution of the surface structure undergoes five sequential stages:the LSFL begins to split,becomes uniform HSFL,degenerates into an irregular LSFL,undergoes secondary splitting into a weakly uniform HSFL,and evolves into an irregular LSFL or is submerged.The results indicate that the local enhancement of the submerged nanocavity,or the nanoplasma,in the prefabricated LSFL ridge led to the splitting of the LSFL,and the thermodynamic effect drove the homogenization of the splitting LSFL,which evolved into HSFL.

ON THE STABILITY OF PERIODIC SOLUTIONS OF PIECEWISE SMOOTH PERIODIC DIFFERENTIAL EQUATIONS

In this paper,we address the stability of periodic solutions of piecewise smooth periodic differential equations.By studying the Poincarémap,we give a sufficient condition to judge the stability of a periodic solution.We also present examples of some applications.

Enhanced recovery after surgery in perioperative period of liver transplantation

End-stage liver disease(ESLD)usually causes multi-organ dys-function which increases the risk for perioperative complications and mortality[1].Liver transplantation is the only curative ther-apy for ESLD.However,liver transplantation is a major and chal-lenging surgery with a great level of complexity as a result of the interaction between donor and recipient factors.Consequently,this procedure brings a high risk of complications that significantly affect 1-year mortality and graft loss[2].In addition,immuno-suppressant applications are required postoperatively.These factors make perioperative care of patients with liver disease complicated,and the risk of poor patient prognosis increases accord-ingly.Optimized perioperative management strategies benefit the patient rehabilitation and prolong survival.Enhanced recovery after surgery(ERAS)is a multimodal and evidence-based program of care to minimize the surgical stress,reduce perioperative morbid-ity and hospital stay[3].

Factors Associated with Increases in Glucose Levels in the Perioperative Period in Non-Diabetic Patients

Background: Blood glucose levels are elevated during the perioperative period as a result of the neuro-endocrine response to the stress of surgery. In nondiabetic patients, blood glucose levels are not a part of routine preoperative testing nor are they monitored during surgery or in the post anesthesia care unit (PACU). We measured blood glucose levels in nondiabetic patients during the perioperative period to identify how many patients had high glucose levels and what factors were associated with increases in blood glucose levels. Methods: This prospective observational study included two hundred and ninety five nondiabetic patients between the ages of 18 and 80 years, undergoing elective noncardiac surgery. Blood glucose levels were measured preoperatively and at frequent, predetermined intervals during surgery and in the PACU. Patient characteristics, surgical and anesthetic factors, and pain scores in the PACU were recorded, as were postoperative complications. Results: Forty nine percent (49%) of the patients had maximum intraoperative glucose levels of 126 mg/dl or higher and fifty three percent (53%) had maximum postoperative glucose levels of 126 mg/dl or higher. Preoperative glucose levels, family history of diabetes and amount of blood loss were statistically significantly associated with both max-intra-op and max-post-op glucose levels. Additionally, blood administration, surgery duration and race were significantly associated with max-intra-op glucose levels, while amount of intravenous fluids and sex were significantly associated with max-post-op glucose levels. Conclusion: A large number of nondiabetic patients in our study had maximum glucose levels >126 mg/dl in the perioperative period. Certain patient characteristics, as well as surgical/anesthetic factors, were associated with increases in the glucose levels. More studies are indicated to determine which patients may benefit from glucose monitoring in the perioperative period.