[This corrects the article DOI: 10.1039/C9RA07262D.].

目的 研究不同保温方式对胸腔镜肺癌根治术老年患者脑氧饱和度（cerebral regional oxygen saturation，rSO2）变化率和术后认知功能的影响。方法 选取华北理工大学附属医院2021年11月至2022年5月施行胸腔镜肺癌根治术老年患者60例作为研究对象，随机分为R组（电阻加热毯组）和F组（充气式保温毯组），各30例，R组、F组保温方式分别为电阻加热毯、充气式保温毯。比较入手术室（T0）、改变体位前（T1）、单肺通气5、30、45min（T2、T3、T4）、手术结束（T5）、出手术室（T6）的基本生命体征、清醒时间和拔管时间；按T6体温分为低温组（L组）和高温（H组）组，比较T1~T5的rSO2变化率、术前1天、术后1天、术后3天的MMSE评分。结果 两组各时间节点HR、MAP差异无统计学意义（P>0.05），体温比较F组高于R组，差异有统计学意义（P<0.05）。清醒时间、拔管时间F组短于R组，差异有统计学意义（P<0.05）；T1~T5的rSO2变化率R组高于F组，差异有统计学意义（P<0.05），H组术后MMSE评分高于R组（P<0.05）。结论 胸腔镜肺癌根治术老年患者术中使用FAW保温可更好维持体温稳定，利于脑氧供需平衡，从而改善术后认知功能下降的发生情况。

Ischemic stroke is a disabling and fatal disease caused by the insufficient blood supply to the brain. Stellate ganglion block (SGB) is a type of anesthesia commonly used to relieve pain. Here, we sought to identify the effects of SGB on cerebral ischemia-reperfusion (I/R) injury. The middle cerebral artery occlusion (MCAO) model was established in rats. The brain injury was assessed using the 2,3,5-triphenyl-tetrazolium-chloride (TTC) staining assay and neurological score. Ferroptosis was analyzed by detecting cell death, Fe2+ content, glutathione (GSH), malonic dialdehyde (MDA), superoxide dismutase (SOD), and ferroptosis-related factors. The mechanisms of SGB were assessed using the western blot. The results showed that I/R increased brain infarction and damaged neurological function. SGB decreased I/R-induced infarction and improved neurological function. Meantime, SGB inhibited ferroptosis of the hippocampus induced by I/R via the Hippo pathway. and the Yes1 associated transcriptional regulator (YAP) of this pathway was positively correlated with the ferroptosis-related solute carrier family 7 member 11 (SLC7A11). Inhibition of the Hippo pathway reversed the effects of SGB on brain injury and ferroptosis. In conclusion, SGB inhibited ferroptosis of hippocampal neurons via activating the Hippo pathway and thereby alleviated I/R injury. The data provide a novel insight into the treatment of ischemic stroke and even other ischemic encephalopathies.

Objectives Carotid endarterectomy (CEA) is an effective technique for carotid artery stenosis and has been widely used. Stellate ganglion block (SGB) has good effect on the treatment of both painful and non-painful diseases. To investigate the efficacy of SGB in terms of cerebral protection in patients undergoing CEA and to analyze its mechanism Methods In this retrospective analysis, 120 patients who underwent CEA were enrolled and divided into study group (SG) (60 cases, general anesthesia and SGB) and control group (CG) (60 cases, general anesthesia). The differences in hemodynamic indexes, middle cerebral artery (MCA) hemodynamic indexes, and endocrine-related indexes between the two groups at the baseline, after induction of anesthesia (induction), and skin incision (incision) were compared. The differences in neurological function and pain level between two groups 1 day pre-operatively (pre-op 1), 1 day postoperatively (POD 1), 2 day postoperatively (POD 2), and 7 day postoperatively (POD 7) were also evaluated. Perioperative adverse events and intraoperative anesthetics dosage were compared between two groups; Results The systolic blood pressure, diastolic blood pressure, mean pulse pressure difference, and heart rate of SG at incision were lower than those of the CG ( p < 0.05); Vs, Vd, and Vm of MCA were significantly higher in the SG than in CG at induction and incision ( p < 0.05). Cortisol and aldosterone levels were lower and potassium and insulin levels were higher in the SG than in CG at induction and incision ( p < 0.05); At pre-op 1, POD 1, POD 2, and POD 7, the VAS scores of patients in the SG were significantly lower than those in CG at POD 1, POD 2, and POD 7 ( p < 0.05). The patients in SG showed decreased incidence of perioperative adverse events compared with the CG ( p < 0.05); The consumption of anesthetics in the SG was lower than that in CG ( p < 0.05). Conclusion SGB in patients undergoing CEA treatment can improve perioperative cerebral blood supply and reduce the consumption of anesthetics and the incidence of perioperative adverse events, which is safe and feasible as a cerebral protection measure. Meanwhile, SGB may also help stabilize patients’ perioperative hemodynamic indexes, but the result still needs to be supported by further large sample data.

目的 探讨不同靶浓度羟考酮靶控输注对老年患者全麻插入喉罩时的麻醉效果及丙泊酚Cp50的影响.方法 收集80例ASAⅠ～Ⅱ级择期全麻插入喉罩手术患者资料,年龄60～79岁.按照羟考酮靶浓度、患者年龄分为四组,A 组:0.2 mg/L,60～69岁;B 组:0.15 mg/L,60～69岁;C 组:0.2 mg/L,70～79岁;D组:0.15 mg/L,70～79岁.待羟考酮血浆和效应室浓度平衡后,以血浆靶浓度TCI输注丙泊酚,在意识消失后给予咪达唑仑30 μg/kg、顺式阿曲库铵0.2 mg/kg,4 min后插入喉罩.依据改良后的Dixon上下交叉序贯法确定丙泊酚的血浆靶浓度.观察并记录麻醉诱导前(T0)、插入喉罩前1 min(T1)、插入喉罩时(T2)、插入后1 min(T3)时的平均动脉压、心率和BIS值.结果 四组患者性别、年龄、体重指数(BMI)等无统计学意义(P＞0.05).四组患者中T1时点的心率(HR)、平均动脉压(MAP)、脑电双频指数(BIS)值较T0均有降低,四组之间生命体征比较差异均无统计学意义(均P＞0.05).四组患者丙泊酚Cp50分别为:A组(3.95+0.53)μg/ml,B 组(2.85+0.57)μg/ml,C 组(3.10+0.48)μg/ml,D 组(1.95+0.58)μg/ml.与 A 组比较,B组、C组、D组丙泊酚Cp50明显降低(P＜0.05);D组丙泊酚Cp50与C组比较明显降低(P＜0.05),以上结果差异均有统计学意义.B组和C组比较丙泊酚Cp50差异无统计学意义(P＞0.05).四组患者中低血压和心动过缓的发生无统计学意义(均P＞0.05).结论 在全麻插入喉罩的过程中,随着患者年龄和羟考酮效应室靶浓度的增加,丙泊酚的Cp50明显降低.

The mechanical force between cells and the extracellular microenvironment is crucial to many physiological processes such as cancer metastasis and stem cell differentiation. Mitosis plays an essential role in all these processes and thus an in-depth understanding of forces during mitosis gains insight into disease diagnosis and disease treatment. Here, we develop a traction force microscope method based on monolayer fluorescent beads for measuring the weak traction force (tens of Pa) of mitotic cells in three dimensions. We quantify traction forces of human ovarian granulosa (KGN) cells exerted on the extracellular matrix throughout the entire cell cycle in three dimensions. Our measurements reveal how forces vary during the cell cycle, especially during cell division. Furthermore, we study the effect of paclitaxel (PTX) and nocodazole (NDZ) on mitotic KGN cells through the measurement of traction forces. Our results show that mitotic cells with high concentrations of PTX exert a larger force than those with high concentrations of NDZ, which proved to be caused by changes in the structure and number of microtubules. These findings reveal the key functions of microtubule in generating traction forces during cell mitosis and explain how dividing cells regulate themselves in response to anti-mitosis drugs. This work provides a powerful tool for investigating cell-matrix interactions during mitosis and may offer a potential way to new therapies for cancer.

目的 研究七氟醚不同吸入时长对行非心脏手术老年冠心病患者围术期心肌的保护作用.方法 将120例行腹腔镜结直肠癌根治术的老年冠心病患者采用随机数字表法分为七氟醚全程吸入组(T组)、七氟醚半程吸入组(H组)、全凭静脉组(C组).3组均采用静脉诱导麻醉,C组采用丙泊酚联合瑞芬太尼靶控输注维持;T组持续吸入七氟醚使呼气末浓度稳定于1 MAC直至术毕;H组插管后持续吸入七氟醚2h,2h后维持方式同C组直至术毕.监测平均动脉压(MAP)、心率(HR)、心输出量(CO)、心脏指数(CI)、左心室做功(LCW)、外周血管阻力(SVR)及心肌肌钙蛋白Ⅰ(cTnⅠ)、肌酸激酶同工酶(CK-MB)等水平的变化.结果 3组麻醉后血流动力学指标均有下降,T、H组Ta4时的HR低于同时间C组(P＜0.05);3组麻醉后cTnⅠ、CK-MB水平自Tb1逐渐升高,且Tb2～Tb4显著高于Tb0,T、H组显著低于C组(P＜0.05);瑞芬太尼用量C组＞H组＞T组(P＜0.05).结论 与丙泊酚相比,老年冠心病患者行非心脏手术时吸入七氟醚可产生心脏保护作用,并可降低镇痛、镇静药物的用量.

目的:探讨全麻复合右美托咪啶与全麻联合硬膜外阻滞对老年腹腔镜下结直肠癌根治术患者应激反应及术后恢复情况的影响.方法:选择择期行腹腔镜下结直肠癌根治术老年患者60例,年龄≥65岁,ASAⅠ或Ⅱ级,随机分为两组,全麻复合右美托咪啶组(D组)和全麻联合硬膜外阻滞组(E组),每组30例:D组在麻醉诱导前10 min静脉泵注右美托咪啶0.8μg/kg,气管插管后以0.5μg/(kg·h)的速度静脉泵注右美托咪啶,术毕前30 min停药;E组给予硬膜外阻滞,将平面固定在T4行全麻插管,术中间断硬膜外给药.记录两组患者术中全麻药物的用量;分别于诱导前(T0)、气管插管后即刻(T1)、气腹后5 min(T2)、气腹后30 min(T3)、拔管后即刻(T4)抽取静脉血,测定血清肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(Cor)浓度以及血糖的浓度;记录两组患者术后1、6、12、24、48 h的VAS评分,以及排气时间、进食时间和住院时间.结果:T2、T3时D组的心率明显慢于E组(P<0.05);T2、T3时D组的心率与T0相比明显减慢(P<0.05).在T1、T2时间点,D组E、NE、Cor浓度低于E组(P<0.05);在T0、T3、T4时间点,D组与E组的E、NE、Cor浓度差异无统计学意义(P>0.05);D组患者术后VAS评分、术后排气时间、进食时间和住院时间差异无统计学意义(P>0.05).结论:全麻复合右美托咪啶可以有效减轻老年腹腔镜结直肠癌根治术患者围术期的应激反应,其效果优于联合硬膜外阻滞.

目的 探讨右美托咪定对老年患者行腹腔镜结肠癌根治术术后镇痛效果及应激反应的影响.方法 纳入80例腹腔镜结肠癌根治术的老年患者,按照组间匹配的原则分成观察组和对照组,每组各40例.观察组舒芬太尼2μg/kg+右美托咪定1.5μg/kg;对照组舒芬太尼2μg/kg.观察术后6、12、24、48小时两组患者的视觉模拟评分(VAS)以及麻醉诱导前10分钟与术后12小时应激激素[皮质醇(Cor)、肾上腺素(E)、去甲肾上腺素(NE)]水平变化,比较两组患者术后不良反应的发生率.结果 术后48小时内观察组患者按压镇痛泵的次数为13.8±5.9次,对照组患者按压23.7±8.7次,差异有统计学意义(P<0.05);观察组术后6、12、24小时的VAS均低于对照组,差异有统计学意义(P<0.05),但48小时的评分两组差异无统计学意义(P>0.05).术后12小时观察组应激激素水平低于对照组,差异有统计学意义(P<0.05).两组不良反应发生率差异无统计学意义(P>0.05).结论 老年患者在腹腔镜结肠癌根治术后应用右美托咪定,可取得满意的镇痛效果,并有效减少应激反应,有一定的临床应用价值.

目的 探讨目标导向液体治疗对胰十二指肠切除术患者肠道功能的影响.方法 选取2017年6月～2019年6月开滦总医院择期全麻下行腹腔镜胰十二指肠切除术患者60例,根据随机数字表法分为随机分为G组和C组.G组采用目标导向液体治疗,C组采用常规补液治疗.记录两组患者术中液体出入量、血管活性药用量、手术时间、尿量、失血量、浓缩红细胞输入例数、术后气管拔管时间、住院时间.记录麻醉前(T0)、手术开始(T1)、标本切除时(T2)、手术结束(T3)患者的平均动脉压(MAP)、心率(HR)、心脏指数(CI)、中心静脉压(CVP)、每搏量变异度(SVV)、乳酸(Lac)、中心静脉血氧饱和度(Scv02)等情况.在T0～T3及术后第1、2、3天(T4、T5、T6)七个时间点抽取患者中心静脉血,测定血浆二胺氧化酶(DAO)、D-乳酸、脂多醣(LPS);在T0～T3抽取患者中心静脉血,测定血浆神经营养因子-3(NT-3)和甘丙肽(GAL)的浓度.结果 在T2和T3时间点G组与C组相比MAP升高、CVP下降、SVV下降、CI增加、乳酸(Lac)降低、ScvO2升高(P<0.05).与C组相比,G组胶体液入量和多巴胺使用量多,晶体液入量、输液总量少(P<0.05),去甲肾上腺素用量少(P<0.05),气管插管的拔管时间G组比C组要早.在T2～T6时,与C组相比,G组血浆DAO、D-乳酸和LPS降低.术后第1天血浆DAO、D-乳酸和LPS均达到峰值,之后开始下降.与T0比较,在T1～T2时两组患者血浆NT-3均升高,T3时均下降,而G组比C组变化明显,而血浆GAL在T2和T3时持续升高,G组比C组变化明显.结论 在腹腔镜胰十二指肠切除术中应用目标导向液体治疗,可维持有效循环血容量及血压以保证全身灌注,改善微循环,对患者肠黏膜屏障功能和运动功能有保护作用.

目的 研究盐酸右美托咪定不同给药方式对合并轻度认知障碍(mild cognitive impairment,MCI)的老年患者单侧髋关节置换术后短期认知功能的影响.方法 选取120例择期行单侧髋关节置换术合并MCI的老年患者,使用数字表随机分为A组单次给药组(n=40),B组持续泵注组(n=40),C组对照组(n=40).于术前1 d和术后7 d采用简易智力状态检查量表(MMSE)和蒙特利尔认知评估量表(MoCA)评估患者认知功能,并测定血浆载脂蛋白J(Apo J)和α-突触核蛋白(α-syn)的浓度;记录恢复自主呼吸时间、睁眼时间、拔管时间及术中不良事件.结果 C组术后MMSE和MoCA评分低于术前且低于术后A、B组;术后B、C组的Apo J和A、B、C组α-syn浓度高于术前,术后血浆Apo J和α-syn浓度为C组>B组>A组.以上差异均有统计学意义(P<0.05).其余结果差异无统计学意义(P>0.05).结论 本研究表明对合并MCI的老年患者,应用盐酸右美托咪定可以减少术后短期认知功能障碍的发生,对于本手术单次给药方式优于持续缓慢泵注.

①目的 探讨经皮穴位电刺激对非体外循环下冠状动脉旁路移植术患者认知功能的影响.②方法 选取华北理工大学附属医院2015年8月～2018年7月非体外循环下冠状动脉旁路移植术患者72例,采用随机数字表法分为两组,各36例.对照组未实施经皮穴位电刺激,观察组实施经皮穴位电刺激,于手术前后行S100β、神经元特异性烯醇化酶检测,并行洛文斯顿认知功能评定测验评分(LOTCA)、蒙特利尔认知评估量表评分(MoCA)、日常生活活动能力评分(MBI),比较两组手术情况和并发症发生率.③结果 两组手术后检测指标(S100β、神经元特异性烯醇化酶)、相关评分(LOTCA、MoCA、MBI)较手术前显著增加(P<0.05).观察组手术后S100β和神经元特异性烯醇化酶低于对照组(P<0.05);LOTCA评分、MoCA评分、MBI评分高于对照组(P<0.05).两组手术情况(手术持续时间、麻醉持续时间、丙泊酚用量、APACHEⅡ评分、机械通气时间、CCU停留时间、术后住院时间)、并发疾病(泌尿系统感染、肺部感染、胸腔积液、呼吸衰竭、失血性休克等)比较,差异无统计学意义(P>0.05);观察组舒芬太尼用量少于对照组,差异有统计学意义(P<0.05).④结论 经皮穴位电刺激可降低非体外循环下冠状动脉旁路移植术患者术后S100β和神经元特异性烯醇化酶的升高幅度,可改善患者的认知功能状况,麻醉药用量少且安全性高,值得临床推广使用.

目的 观察以每搏量变异度(SVV)、心脏指数(CI)为指导的目标导向液体治疗(GDFT)和以中心静脉压(CVP)、尿量为指导的常规液体治疗对腹腔镜胰十二指肠切除术患者肠道屏障的影响.方法 选取2017年6月至2019年6月择期行腹腔镜胰十二指肠切除术患者60例,根据随机数字表法分为两组,分为GDFT组(G组)和常规液体治疗组(C组),G组将SVV、CI作为GDFT方案,C组以中心静脉压(CVP)、尿量为指导进行液体治疗.记录两组患者手术时间、晶胶体用量、多巴胺和去甲肾上腺素的用量、尿量、出血量、浓缩红细胞输入例数、术后气管拔管时间、住院时间.记录麻醉前(T0)、手术开始(T1)、标本切除时(T2)、手术结束(T3)患者的平均动脉压(MAP)、心率(HR)、CI、CVP、SVV、乳酸(Lac)、中心静脉血氧饱和度(ScvO2)等情况.于T0～T3及术后第1、2、3天(T4、T5、T6)7个时间点抽取患者中心静脉血测定血浆二胺氧化酶(DAO)、D-乳酸和LPS的浓度.结果 T2和T3时间点:与C组比较,G组的MAP、CI、ScvO2升高,CVP、SVV、Lac降低(P＜0.0.5);G组术中输液总量、晶体液入量均小于C组,胶体液入量和多巴胺使用量多于C组,去甲肾上腺素使用量少于C组,气管插管的拔管时间G组比C组要早(P＜0.05).在T2 ～ T6这5个时间点,G组血浆DAO、D-乳酸和LPS均低于C组(P＜0.05),术后第1天血浆DAO、D-乳酸和LPS均达到峰值,之后开始下降.结论 对腹腔镜胰十二指肠切除术患者,与以CVP、尿量为指导的常规液体治疗相比,采用以SVV、CI为指导的GDFT方案治疗能更好维持血流动力学稳定,保证机体组织器官的灌注,并对肠黏膜屏障功能有保护作用.

背景右美托咪定可透过血-脑脊液屏障并对脓毒症大鼠具有一定保护作用,但目前关于其对脓毒症所致认知障碍改善效果的研究报道较少见.目的 探讨右美托咪定对老年脓毒症大鼠Shh信号通路及认知功能的影响.方法 2019年1—9月,选取健康雄性SD大鼠54只,采用随机数字表法分为Sham组、CLP组、Dex组,每组18只.Sham组大鼠仅行剖腹探查术,CLP组大鼠采用盲肠结扎穿孔法制备脓毒症模型,Dex组大鼠于脓毒症模型制备后6 h腹腔注射右美托咪定.比较三组大鼠给药后逃避潜伏期,穿越平台次数,处于平台所在象限时间,脑组织含水量,海马组织Shh、Gli-1、Ptc含量及ZO-1、Claudin-5相对表达量.结果 与Sham组比较,CLP组、Dex组大鼠给药后逃避潜伏期延长,穿越平台次数减少,处于平台所在象限时间缩短(P<0.05);与CLP组比较,Dex组大鼠给药后逃避潜伏期缩短,穿越平台次数增多,处于平台所在象限时间长(P<0.05).与Sham组比较,CLP组、Dex组大鼠给药后脑组织含水量增多(P<0.05);与CLP组比较,Dex组大鼠给药后脑组织含水量少(P<0.05).与Sham组比较,CLP组、Dex组大鼠给药后海马组织Shh、Gli-1含量降低,Ptc含量升高(P<0.05);与CLP组比较,Dex组大鼠给药后海马组织Shh、Gli-1含量升高,Ptc含量降低(P<0.05).(4)与Sham组比较,CLP组、Dex组大鼠给药后海马组织ZO-1、Claudin-5相对表达量降低(P<0.05);与CLP组比较,Dex组大鼠给药后24 h海马组织ZO-1、Claudin-5蛋白相对表达量升高(P<0.05).结论 右美托咪定可有效改善老年脓毒症大鼠认知功能,降低血-脑脊液屏障通透性,其作用机制可能与激活Shh信号通路有关.

Statement of Retraction Statement of Retraction: Silencing of PTEN inhibits the oxidative stress damage and hippocampal cell apoptosis induced by Sevoflurane through activating MEK1/ERK signaling pathway in infant rats We, the Editors and Publisher of the journal Cell Cycle, have retracted the following article: Tiejun Liu, Xiaoliu Dong, Bin Wang, Shubo Zhang, Jing Bai, Wei Ma, Xiaojing Zhao & Xiaotao Wang (2020) ‘Silencing of PTEN inhibits the oxidative stress damage and hippocampal cell apoptosis induced by Sevoflurane through activating MEK1/ERK signaling pathway in infant rats’, Cell Cycle, 19:6, 684-696, DOI: 10.1080/15384101.2020.1717041 Since publication, concerns have been raised about the integrity of the data in the article. When approached for an explanation, the authors checked their data and confirmed there are fundamental errors present. The authors have agreed to the retraction of this article. We have been informed in our decision-making by our policy on publishing ethics and integrity and the COPE guidelines on retractions. The retracted article will remain online to maintain the scholarly record, but it will be digitally watermarked on each page as ‘Retracted’.

目的 研究七氟醚对幼鼠海马发育的神经毒性作用及其机制.方法 按照体重将幼鼠随机分为4组:第1干预组、第2干预组、第3干预组及第4干预组,每组25只.第1干预组暴露于30％O2中;第2干预组暴露于3％七氟醚+30％O2中,前5 min诱导流速为6 L·min-1,然后以1 L·min-1维持,持续4 h;第3干预组给予0.9％NaCl,随后处理与第1干预组相同;第4干预组幼鼠腹腔注射40 mg·kg-1的LY294002,七氟醚暴露过程与第2干预组一致.用蛋白质印迹法检测海马磷脂酰肌醇3激酶(PI3K)、蛋白激酶B(Akt)和缝隙连接蛋白43(Cx43)的蛋白表达量.结果 第1干预组、第2干预组、第3干预组和第4干预组幼鼠第7天海马脑组织中Cx43蛋白相对表达量分别为0.69±0.09,0.72±0.10,0.44±0.05和0.61±0.05;这4组的PI3K蛋白相对表达量分别为0.88±0.07,1.13±0.11,0.62±0.04和0.71±0.06;这4组的Akt蛋白相对表达量分别为1.38±1.03,1.51±1.01,0.70±0.06和0.74±0.06.上述指标:第2干预组与第1干预组比较,差异均有统计学意义(均P<0.05);第4干预组与第2干预组比较,差异均有统计学意义(均P<0.05).结论 七氟醚可能通过激活PI3K/Akt信号通路增加Cx43蛋白表达,并诱导海马神经元凋亡,增加幼鼠认知功能损伤.

目的 探讨吸入不同时长一定浓度七氟烷复合丙泊酚麻醉对老年患者手术后早期认知功能的影响.方法 选择行腹腔镜结直肠癌根治术的老年患者90例,随机分为三组:丙泊酚组(P组)、半程七氟烷组(PS1组)和全程七氟烷组(PS2组),每组30例.三组患者均常规静脉麻醉诱导,之后P组泵注丙泊酚维持麻醉;PS1组麻醉前半程泵注丙泊酚+吸入1.0 MAC七氟烷,后半程仅泵注丙泊酚维持麻醉;PS2组全程泵注丙泊酚+吸入1.0 MAC七氟烷维持麻醉.术前1 d(T0)和术后6 h(T1)、1 d(T2)、3 d(T3)、7 d(T4)对患者进行简易精神状态检查量表(MMSE)评分;将对照组不同时点MMSE评分作为对照,采用Z计分法对患者的认知功能障碍进行判定,计算三组认知功能障碍发生率;采用酶联免疫吸附试验测定三组T0、T1、T2、T3时血清S100β蛋白水平;观察并记录三组苏醒时间、拔管时间、定向力恢复时间.结果 与T0时相比,三组T1、T2时MMSE评分均降低(P<0.05或<0.01).与P组T1、T2时相比,PS1组、PS2组MMSE评分均高(P均<0.05).P组T1、T2、T3、T4的认知功能障碍发生率分别为46.7％、30.0％、13.3％、3.3％,PS1组分别为36.7％、20.0％、6.7％、0,PS2组分别为30.0％、13.3％、6.7％、3.3％,三组比较差异无统计学意义.与T0时相比,三组T1、T2时血清S100β蛋白水平均升高(P均<0.01).与P组T1、T2时相比,PS1组、PS2组血清S100β蛋白水平均低(P均<0.05).与P组相比,PS1组、PS2组苏醒时间、拔管时间及定向力恢复时间均缩短(P均<0.05),但PS1组和PS2组比较差异无统计学意义.结论 七氟烷复合丙泊酚麻醉和丙泊酚麻醉均可引起行腹腔镜结直肠癌根治术的老年患者术后认知功能在短时间内下降,但与丙泊酚静脉麻醉比较,七氟烷复合丙泊酚麻醉对认知功能影响小,术后麻醉复苏快,但吸入不同时间七氟烷对认知功能的影响无明显差异.

Epilepsy is the most common neurological disorder in humans. Electroencephalogram is a prevalent tool for diagnosing the epileptic seizure activity in clinical, which provides valuable information for understanding the physiological mechanisms behind epileptic disorders. Approximate entropy and recurrence quantification analysis are nonlinear analysis tools to quantify the complexity and recurrence behaviors of non-stationary signals, respectively. Convolutional neural networks are powerful class of models. In this paper, a new method for automatic epileptic electroencephalogram recordings based on the approximate entropy and recurrence quantification analysis combined with a convolutional neural network were proposed. The Bonn dataset was used to assess the proposed approach. The results indicated that the performance of the epileptic seizure detection by approximate entropy and recurrence quantification analysis is good (all of the sensitivities, specificities and accuracies are greater than 80%); especially the sensitivity, specificity and accuracy of the recurrence rate achieved 92.17%, 91.75% and 92.00%. When combines the approximate entropy and recurrence quantification analysis features with convolutional neural networks to automatically differentiate seizure electroencephalogram from normal recordings, the classification result can reach to 98.84%, 99.35% and 99.26%. Thus, this makes automatic detection of epileptic recordings become possible and it would be a valuable tool for the clinical diagnosis and treatment of epilepsy.