Clinical effect of ultrasound-guided nerve block and dexmedetomidine anesthesia on lower extremity operative fracture reduction

BACKGROUND Lower extremity fractures are mainly treated by surgical reduction,but this operation is often affected by the patient’s level of agitation and the type of anesthesia used.The main treatment for lower-extremity fractures is operative reduction.However,operations can often be affected by both agitation and the degree of anesthesia.Therefore,it is of great importance to develop an effective anesthesia program to effectively ensure the progress of surgery.AIM To discuss the effect of ultrasound-guided nerve block combined with dexmedetomidine anesthesia in lower extremity fracture surgery.METHODS A total of 120 hospital patients with lower extremity fractures were selected for this retrospective study and divided into an observation group(n=60)and a control group(n=60)according to the anesthesia scheme;the control group received ultrasound-guided nerve block;the observation group was treated with dextromethomidine on the basis of the control group,and the mean arterial pressure,heart rate(HR),and blood oxygen saturation were observed in the two groups.RESULTS The mean arterial pressure of T1,T2 and T3 in the observation group were 94.40±7.10,90.84±7.21 and 91.03±6.84 mmHg,significantly higher than that of the control group(P<0.05).The observation group’s HR at T1 was 76.60±7.52 times/min,significantly lower than that of the control group(P<0.05);The observation group’s HR at T2 and T3 was 75.40±8.03 times/min and 76.64±7.11 times/min,significantly higher than that of the control group(P<0.05).The observation group’s visual analog score at 2 h,6 h and 12 h after operation was 3.55±0.87,2.84±0.65 and 2.05±0.40.the recovery time was 15.51±4.21 min,significantly lower than that of the control group(P<0.05).Six hours post-anesthesia,epinephrine and norepinephrine in the observation group were 81.10±21.19 pg/mL and 510.20±98.27 pg/mL,significantly lower than that of the control group(P<0.05),and the mini-mental state exam score of the observation group was 25.51±1.15,significantly higher than that in the control group(P<0.05).CONCLUSION Ultrasound-guided nerve block combined with dexmedetomidine has a good anesthetic effect in the operation of lower limb fractures and has little effect on the hemodynamics of patients.

Occurrence and Health Risk of Perfluoroalkyl Acids in Popular Shellfish from a Typical Coastal Area of the East China

As crucial homologous members of per-and polyfluoroalkyl substances(PFASs),perfluoroalkyl acids(PFAAs)have aroused wide public concern because of their unique properties(persistence,bioaccumulation,long-distance migration and toxicity).Studies have shown their potential hazard to wildlife and humans,with food consumption as one of the primary routes of PFAA exposure for general population,especially seafood intake.In this study,17 PFAAs were quantified in 9 shellfish species from Yuhuan City,a typical coastal area of the East China.The total mean concentrations of PFAAs were in the range of 5.03–381 ng/g dry weight(dw),with the highest concentration found in Neverita didyma and the lowest in Babylonia lutosa.Concentrations and composition profiles of PFAAs varied significantly among different species,indicating differences in the bioaccumulation potential of PFAAs among species.Perfluorooctanoic acid(PFOA)was presented as the most abundant PFAA in this study,followed by perfluorobutanoic acid(PFBA).Significant positive correlations were observed among some individual PFAAs(p<0.05),indicating that they may share similar pollution sources or undergo similar compound behaviors.Health risk assessment indicated a relatively high threat for local residents exposed to PFAAs through shellfish consumption.

PM_(2.5)-bound polyhalogenated carbazoles(PHCZs)in urban Beijing,China:Occurrence and the source implication

Polyhalogenated carbazoles(PHCZs)are recently raising much attention due to their toxicity and ubiquitous environmental distribution.However,little knowledge is known about their ambient occurrences and the potential source.In this study,we developed an analytical method based on GC-MS/MS to simultaneously determine 11 PHCZs in PM_(2.5) from urban Beijing,China.The optimized method provided low method limit of quantifications(MLOQs,1.45–7.39 fg/m^(3))and satisfied recoveries(73.4%–109.5%).This method was applied to analyze the PHCZs in the outdoor PM_(2.5)(n=46)and fly ash(n=6)collected from 3 kinds of surrounding incinerator plants(steel plant,medical waste incinerator and domestic waste incinerator).The levels of Σ_(11)PHCZs in PM_(2.5) ranged from 0.117 to 5.54 pg/m^(3)(median 1.18 pg/m^(3)).3-chloro-9H-carbazole(3-CCZ),3-bromo-9H-carbazole(3-BCZ),and 3,6-dichloro-9Hcarbazole(36-CCZ)were the dominant compounds,accounting for 93%.3-CCZ and 3-BCZ were significantly higher in winter due to the high PM_(2.5) concentration,while 36-CCZ was higher in spring,which may be related to the resuspending of surface soil.Furthermore,the levels of11PHCZs in fly ash ranged from 338 to 6101 pg/g.3-CCZ,3-BCZ and 36-CCZ accounted for 86.0%.The congener profiles of PHCZs between fly ash and PM_(2.5) were highly similar,indicating that combustion process could be an important source of ambient PHCZs.To the best of our knowledge,this is the first research providing the occurrences of PHCZs in outdoor PM_(2.5).