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The Journal of Biomedical Research 2024年第1期38卷 66-75页

作者： Mingfeng He Chanjuan Gong Yinan Chen Rongting Chen Yanning Qian department of anesthesiology and Perioperative Medicine the First Affiliated Hospital of Nanjing Medical UniversityNanjingJiangsu 210029China

The current study aimed to compare the effects between remimazolam and propofol on hemodynamic stability during the induction of general anesthesia in elderly patients.We used propofol at a rate of 60 mg/(kg·h)in the propofol group(group P)or remimazolam at a rate of 6 mg/(kg·h)in the remimazolam group(group R)for the induction.A processed electroencephalogram was used to determine whether the induction was successful and when to stop the infusion of the study drug.We measured when patients entered the operating room(T_(0)),when the induction was successful(T_(1)),and when before(T_(2))and 5 min after successful endotracheal intubation(T_(3)).We found that mean arterial pressure(MAP)was lower at T_(1–3),compared with T_(0) in both groups,but higher at T_(2) in the group R,whileΔMAP_(T0–T2) andΔMAP_(max) were smaller in the group R(ΔMAP_(T0–T2):the difference between MAP at time point T_(0) and T_(2),ΔMAP_(max):the difference between MAP at time point T_(0) and the lowest value from T_(0) to T_(3)).Cardiac index and stroke volume index did not differ between groups,whereas systemic vascular resistance index was higher at T_(1–3) in the group R.These findings show that remimazolam,compared with propofol,better maintains hemodynamic stability during the induction,which may be attributed to its ability to better maintain systemic vascular resistance levels.

关键词： remimazolam propofol elderly patients hypotension left ventricular systolic function systematic vascular resistance

Airway management of a patient with linear immunoglobulin A bullous dermatosis:A case report

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World Journal of Clinical Cases 2024年第13期12卷 2263-2268页

作者： Olga C Nin Robert Hutnik Neil N Chheda David Hutchinson department of anesthesiology University of Florida College of MedicineGainesvilleFL 32610United States department of Otolaryngology University of Florida College of MedicineGainesvilleFL 32610United States

BACKGROUND There is limited literature on managing the airway of patients with linear immunoglobulin A(IgA)bullous dermatosis,a rare mucocutaneous disorder that leads to the development of friable bullae.Careful clinical decision making is necessary when there is a risk of bleeding into the airway,and a multidisciplinary team approach may lead to decreased patient morbidity during these high-risk scenarios,especially when confronted with an unusual cause for bleeding.CASE SUMMARY A 45-year-old African American female presented to our ambulatory surgical center for right corneal transplantation due to corneal perforation after blunt trauma in the setting of cicatricial conjunctivitis and diffuse corneal neovascularization from linear IgA bullous dermatosis.The diagnosis of IgA dermatosis was recent,and the patient had been lost to follow-up.The severity of the disease and extent of airway involvement was unknown at the time of the surgery.Significant airway bleeding was noticed upon intubation and the otorhinolaryngology team had to be called to the operating room.The patient required transfer to the intensive care unit where a multidisciplinary team was involved in her case.The patient was extubated on postoperative day 4.CONCLUSION A multidisciplinary approach to treating this disease is the best course of action before a surgical procedure.In our case,key communication between the surgery,anesthesia,and dermatology teams led to the quick and safe treatment of our patient’s disease.Ambulatory surgery should not be considered for these cases unless they are in full remission and there is no mucous membrane involvement.

关键词： Airway management Bleeding risk Linear immunoglobulin A bullous dermatosis Multidisciplinary approach Outpatient procedure Case report

Prohibitin 1 inhibits cell proliferation and induces apoptosis via the p53-mediated mitochondrial pathway in vitro

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World Journal of Gastrointestinal Oncology 2024年第2期16卷 398-413页

作者： Juan-Juan Shi Yi-Kai Wang Mu-Qi Wang Jiang Deng Ning Gao Mei Li Ya-Ping Li Xin Zhang Xiao-Li Jia Xiong-Tao Liu Shuang-Suo Dang Wen-Jun Wang department of Infectious Diseases The Second Affiliated Hospital of Xi’an Jiaotong UniversityXi'an 710004Shaanxi ProvinceChina department of operating Room The Second Affiliated Hospital of Xi’an Jiaotong UniversityXi'an 710004Shaanxi ProvinceChina

BACKGROUND Prohibitin 1(PHB1)has been identified as an antiproliferative protein that is highly conserved and ubiquitously expressed,and it participates in a variety of essential cellular functions,including apoptosis,cell cycle regulation,prolifera-tion,and survival.Emerging evidence indicates that PHB1 may play an important role in the progression of hepatocellular carcinoma(HCC).However,the role of PHB1 in HCC is controversial.AIM To investigate the effects of PHB1 on the proliferation and apoptosis of human HCC cells and the relevant mechanisms in vitro.METHODS HCC patients and healthy individuals were enrolled in this study according to the inclusion and exclusion criteria;then,PHB1 levels in the sera and liver tissues of these participates were determined using ELISA,RT-PCR,and immunohistoche-mistry.Human HepG2 and SMMC-7721 cells were transfected with the pEGFP-PHB1 plasmid and PHB1-specific shRNA(shRNA-PHB1)for 24-72 h.Cell prolif-eration was analysed with an MTT assay.Cell cycle progression and apoptosis were analysed using flow cytometry(FACS).The mRNA and protein expression levels of the cell cycle-related molecules p21,Cyclin A2,Cyclin E1,and CDK2 and the cell apoptosis-related molecules cytochrome C(Cyt C),p53,Bcl-2,Bax,caspase 3,and caspase 9 were measured by real-time PCR and Western blot,respectively.RESULTS Decreased levels of PHB1 were found in the sera and liver tissues of HCC patients compared to those of healthy individuals,and decreased PHB1 was positively correlated with low differentiation,TNM stage III-IV,and alpha-fetoprotein≥400μg/L.Overexpression of PHB1 significantly inhibited human HCC cell proliferation in a time-dependent manner.FACS revealed that the overexpression of PHB1 arrested HCC cells in the G0/G1 phase of the cell cycle and induced apoptosis.The proportion of cells in the G0/G1 phase was significantly increased and the proportion of cells in the S phase was decreased in HepG2 cells that were transfected with pEGFP-PHB1 compared with untreated control and empty vector-trans

关键词： Prohibitin 1 Hepatocellular carcinoma cells Apoptosis Cell cycle Mitochondrial pathway

Correlation between critical thinking and emotional intelligence:a national crosssectional study on operating room nursing students in Iran

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Frontiers of Nursing 2024年第1期11卷 99-104页

作者： Armin Fereidouni Esmaeil Teymoori Tayebeh Bahmani Hamid Reza Sabet Zahra Maleki Mina Gharibi department of operating Room Technology Community Based Psychiatric Care Research CenterSchool of Nursing and MidwiferyShiraz University of Medical SciencesShirazIran department of operating Room Technology School of Paramedical SciencesAJA University of Medical SciencesTehranIran department of operating Room School of Allied Medical ScienceFasa University of Medical SciencesFasaIran Clinical Education Research Center Shiraz University of Medical SciencesShirazIran Medical Journalism department School of Paramedical SciencesShiraz University of Medical SciencesShirazIran department of Epidemiology Student Research CommitteeShiraz University of Medical SciencesShirazIran

Objective:According to the World Federation of Medical Education,critical thinking should be part of the training of medical and paramedical students.Professionals can improve the quality of care of patients after surgery by having or acquiring this skill in health care.Also,Emotional intelligence is introduced as an impor tant and effective factor on the professional performance and mental health of healthcare professionals.Thus,the present study was designed and implemented to determine the relationship between emotional intelligence and critical thinking among operating room nursing students of medical sciences universities in Iran.Methods:This cross-sectional study was done on 420 operating room students in 10 top medical sciences universities of Iran in 2022.The sampling method in this research was multistage sampling.The data collection instruments included demographic characteristics,Rickett's critical thinking,and Bradberry-Greaves'emotional intelligence questionnaires.After receiving the ethics code,data collection was done for 2 months.For data analysis,descriptive and inferential analyses including independent t-tests,analysis of variance,and Pearson correlation were used.The collected data were analyzed by SPSS 18(IBM Corporation,Armonk,New York,United States).P-value<0.05 was considered significant.Results:The mean age of the students participating in this study was 23.02±3.70 years,with women constituting 67.4%of them.The results of data analysis indicated that the mean total score of critical thinking and emotional intelligence was 124.10±37.52 and 114.12±43.63,respectively.A direct significant correlation between critical thinking and emotional intelligence(r=0.459,P-value<0.001)and a significant relationship between gender and emotional intelligence(P-value=0.028)were found.Conclusions:Based on the present study results,educational managers in the Ministry of Health are suggested to consider suitable educational programs for improving critical thinking and emotional intelligence to enhance the qu

关键词： critical thinking emotional intelligence operating room students operating room nurses

Impact of frailty on short-term postoperative outcomes in patients undergoing colorectal cancer surgery:A systematic review and meta-analysis

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 893-906页

作者： Yao Zhou Xiao-Lei Zhang Hong-Xia Ni Tian-Jing Shao Ping Wang department of operating Room Affiliated Tumor Hospital of Nantong University&Nantong Tumor HospitalNantong 226361Jiangsu ProvinceChina department of Gastrointestinal Surgery The Affiliated Tumor Hospital of Nantong University&Nantong Tumor HospitalNantong 226361Jiangsu ProvinceChina

BACKGROUND Colorectal cancer is a major global health challenge that predominantly affects older people.Surgical management,despite advancements,requires careful consideration of preoperative patient status for optimal outcomes.AIM To summarize existing evidence on the association of frailty with short-term postoperative outcomes in patients undergoing colorectal cancer surgery.METHODS A literature search was conducted using PubMed,EMBASE and Scopus databases for observational studies in adult patients aged≥18 years undergoing planned or elective colorectal surgery for primary carcinoma and/or secondary metastasis.Only studies that conducted frailty assessment using recognized frailty assess-ment tools and had a comparator group,comprising nonfrail patients,were included.Pooled effect sizes were reported as weighted mean difference or relative risk(RR)with 95%confidence intervals(CIs).RESULTS A total of 24 studies were included.Compared with nonfrail patients,frailty was associated with an increased risk of mortality at 30 d(RR:1.99,95%CI:1.47-2.69),at 90 d(RR:4.76,95%CI:1.56-14.6)and at 1 year(RR:5.73,95%CI:2.74-12.0)of follow up.Frail patients had an increased risk of any complications(RR:1.81,95%CI:1.57-2.10)as well as major complications(Clavien-Dindo classification grade≥III)(RR:2.87,95%CI:1.65-4.99)compared with the control group.The risk of reoperation(RR:1.18,95%CI:1.07-1.31),readmission(RR:1.70,95%CI:1.36-2.12),need for blood transfusion(RR:1.67,95%CI:1.52-1.85),wound complications(RR:1.49,95%CI:1.11-1.99),delirium(RR:4.60,95%CI:2.31-9.16),risk of prolonged hospitalization(RR:2.09,95%CI:1.22-3.60)and discharge to a skilled nursing facility or rehabilitation center(RR:3.19,95%CI:2.0-5.08)was all higher in frail patients.CONCLUSION Frailty in colorectal cancer surgery patients was associated with more complications,longer hospital stays,higher reoperation risk,and increased mortality.Integrating frailty assessment appears crucial for tailored surgical management.

关键词： Frailty Frail adults Colorectal surgery Colorectal cancer Complications Mortality Survival Slinical outcomes Meta-analysis

Aggressive fluid management may be associated with disease progression in suspected sepsis patients admitted to the intensive care unit: a retrospective cohort study

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World Journal of Emergency Medicine 2024年第1期15卷 52-55页

作者： Miao Bian Zhihao Wang Yanling Chen Yue Sun Hongsen Ji Yutao Wang Li Pang department of Respiratory Qianwei Hospital of Jilin ProvinceChangchun 130012China department of Geriatrics Jilin Provincial Geriatric Medicine Clinical Research Centerthe First Hospital of Jilin UniversityChangchun 130021China department of Emergency the First Hospital of Jilin UniversityChangchun 130021China The First operating Room the First Hospital of Jilin UniversityChangchun 130021China

Sepsis is a lethal condition characterized by multiple organ dysfunction due to disrupted host responses to severe infections.[1]Aff ected patients often have a Sequential Organ Failure Assessment(SOFA)score≥2.[2]Patients with a SOFA score<2 and at least one of the following were considered as“suspected sepsis”:(1)quick SOFA(qSOFA)score≥2;(2)SOFA score=1;or(3)National Early Warning Score(NEWS)4-6.[3]Compared with studies on fluid resuscitation in sepsis patients,there are few studies on fluid management in patients with suspected sepsis.Therefore,we conducted a retrospective cohort study to evaluate the relationship between fluid management and disease progression in suspected sepsis patients.

关键词： patients sepsis admitted

Prognostic factors associated with gastrointestinal dysfunction after gastrointestinal tumor surgery:A meta-analysis

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1420-1429页

作者： Jia Song Cong Zhou Tian Zhang department of operating Room The Fourth Affiliated Hospital of Nanjing Medical UniversityNanjing 210031Jiangsu ProvinceChina department of Gastrointestinal Surgery Tongji Hospital of Huazhong University of Science and TechnologyWuhan 430073Hubei ProvinceChina department of Disinfection Supply Center The Fourth Affiliated Hospital of Nanjing Medical UniversityNanjing 210031Jiangsu ProvinceChina

BACKGROUND Explore the risk factors of gastrointestinal dysfunction after gastrointestinal tumor surgery and to provide evidence for the prevention and intervention of gastrointestinal dysfunction in patients with gastrointestinal tumor surgery.AIM To investigate the potential risk factors for gastrointestinal dysfunction following gastrointestinal tumor surgery and to present information supporting the prevention and management of gastrointestinal dysfunction in surgery patients.METHODS Systematically searched the relevant literature from PubMed,Web of Science,Cochrane Library,Embase,CNKI,China Biomedical Database,Wanfang Database,and Weipu Chinese Journal Database self-established until October 1,2022.Review Manager 5.3 software was used for meta-analysis after two researchers independently screened literature,extracted data,and evaluated the risk of bias in the included studies.RESULTS A total of 23 pieces of literature were included,the quality of which was medium or above,and the total sample size was 43878.The results of meta-analysis showed that the patients were male(OR=1.58,95%CI:1.25-2.01,P=0.002)and≥60 years old(OR=2.60,95%CI:1.76-2.87,P<0.001),physical index≥25.3 kg/m2(OR=1.6,95%CI:1.00-1.12,P=0.040),smoking history(OR=1.89,95%CI:1.31-2.73,P<0.001),chronic obstructive pulmonary disease(OR=1.49,95%CI:1.22-1.83,P<0.001),enterostomy(OR=1.47,95%CI:1.26-1.70,P<0.001),history of abdominal surgery(OR=2.90,95%CI:1.67-5.03,P<0.001),surgical site(OR=1.2,95%CI:1.40-2.62,P<0.001),operation method(OR=1.68,95%CI:1.08-2.62,P=0.020),operation duration(OR=2.65,95%CI:1.92-3.67,P<0.001),abdominal adhesion grade(OR=2.52,95%CI:1.90-3.56,P<0.001),postoperative opioid history(OR=5.35,95%CI:3.29-8.71,P<0.001),tumor TNM staging(OR=2.58,95%CI:1.84-3.62,P<0.001),postoperative blood transfusion(OR=2.92,95%CI:0.88-9.73,P=0.010)is a risk factor for postoperative gastrointestinal dysfunction in patients with gastrointestinal tumors.CONCLUSION There are many factors affecting gastrointestinal dysfunction in gastrointestinal patients

关键词： Gastrointestinal tumor surgery Postoperative gastrointestinal dysfunction Intestinal paralysis Risk factors Metaanalysis

Effects of psychological intervention on negative emotions and psychological resilience in breast cancer patients after radical mastectomy

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World Journal of Psychiatry 2024年第1期14卷 8-14页

作者： Jing Wang Dong-Xue Kang Ai-Jun Zhang Bing-Rui Li department of Surgery The Fourth Affiliated Hospital of China Medical UniversityShenyang 110033Liaoning ProvinceChina operating Room The Fourth Affiliated Hospital of China Medical UniversityShenyang 110033Liaoning ProvinceChina department of Central Sterile Supply The Fourth Affiliated Hospital of China Medical UniversityShenyang 110033Liaoning ProvinceChina

Breast cancer(BC)is the most common malignant tumor in women,and the treatment process not only results in physical pain but also significant psychological distress in patients.Psychological intervention(PI)has been recognized as an important approach in treating postoperative psychological disorders in BC patients.It has been proven that PI has a significant therapeutic effect on postoperative psychological disorders,improving patients'negative emotions,enhancing their psychological resilience,and effectively enhancing their quality of life and treatment compliance.

关键词： Breast cancer Psychological intervention Negative emotions Psychological resilience Radical surgery

The clinical application and advancement of robot-assisted McKeown minimally invasive esophagectomy for esophageal cancer

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Laparoscopic, Endoscopic and Robotic Surgery 2024年第1期7卷 6-10页

作者： Raojun Luo Yiming Li Xiumin Han Yunzheng Wang Zhengfu He Peijian Yan Ziyi Zhu department of Thoracic Surgery Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016China department of operating Room Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016China

Robotic surgery systems,as emerging minimally invasive approaches,have been increasingly applied for the treatment of esophageal cancer because they provide a high-definition three-dimensional surgical view and mechanical rotating arms that surpass the limitations of human hands,greatly enhancing the accuracy and flexibility of surgical methods.Robot-assisted McKeown esophagectomy(RAME),a common type of robotic esophagectomy,has been gradually implemented with the aim of reducing postoperative complications,improving postoperative recovery and achieving better long-term survival.Multiple centers worldwide have reported and summarized their experiences with the RAME,and some have also discussed and analyzed its perioperative effects and survival prognosis compared with those of video-assisted minimally invasive esophagectomy.Compared to traditional surgery,the RAME has significant advantages in terms of lymph node dissection although there seems to be no difference in overall survival or disease-free survival.With the continuous advancement of technology and the development of robotic technology,further development and innovation are expected in the RAME field.This review elaborates on the prospects of the application and advancement of the RAME to provide a useful reference for clinical practice.

关键词： Esophageal cancer Minimally invasive esophagectomy Robot-assisted McKeown esophagectomy Lymph node dissection

Exploration of potential biomarkers and therapeutic targets for trauma-related acute kidney injury

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Chinese Journal of Traumatology 2024年第2期27卷 97-106页

作者： Peng Qi Meng-Jie Huang Wei Wu Xue-Wen Ren Yong-Zhi Zhai Chen Qiu Hai-Yan Zhu department of Emergency First Medical Center of Chinese PLA General HospitalBeijing100853China department of Nephrology.First Medical Center of Chinese PLA General Hospital Beijing100853China department of anesthesiology.First Medical Center of Chinese PLA General Hospital Beijing100853China department of Orthopedics Fourth Medical Center of Chinese PLA General HospitalBeijing100853China

Purpose:Acute kidney injury(AKI)is one of the most common functional injuries observed in trauma patients.However,certain trauma medications may exacerbate renal injury.Therefore,the early detection of trauma-related AKI holds paramount importance in improving trauma prognosis.Methods:Qualified datasets were selected from public databases,and common differentially expressed genes related to trauma-induced AKI and hub genes were identified through enrichment analysis and the establishment of protein-protein interaction(PPI)networks.Additionally,the specificity of these hub genes was investigated using the sepsis dataset and conducted a comprehensive literature review to assess their plausibility.The raw data from both datasets were downloaded using R software(version 4.2.1)and processed with the"affy"package19 for correction and normalization.Results:Our analysis revealed 585 upregulated and 629 downregulated differentially expressed genes in the AKI dataset,along with 586 upregulated and 948 downregulated differentially expressed genes in the trauma dataset.Concurrently,the establishment of the PPI network and subsequent topological analysis highlighted key hub genes,including CD44,CD163,TIMP metallopeptidase inhibitor 1,cytochrome b-245 beta chain,versican,membrane spanning 4-domains A4A,mitogen-activated protein kinase 14,and early growth response 1.Notably,their receiver operating characteristic curves displayed areas exceeding 75%,indicating good diagnostic performance.Moreover,our findings postulated a unique molecular mechanism underlying trauma-related AKI.Conclusion:This study presents an alternative strategy for the early diagnosis and treatment of trauma-related AKI,based on the identification of potential biomarkers and therapeutic targets.Additionally,this study provides theoretical references for elucidating the mechanisms of trauma-related AKI.

关键词： Trauma Acutekidney injury Bioinformatic analysis Differentially expressed genes Biomarker