Incidence Rate Of Adverse Reactions Research Articles

Comparison of the Efficacy, Immune Function and Survival Rate of Sorafenib and Apatinib in the Treatment of Advanced Hepatocellular Carcinoma

Objective: To explore the influence of sorafenib combined with apatinib in treating advanced hepatocellular carcinoma (HCC) and its influence on immune function. Methods: One hundred and ninety-nine patients with advanced HCC who received treatment in our hospital were collected. Ninety-eight patients were treated with sorafenib and included in the control group (CG). One hundred and one patients received sorafenib combined with apatinib and they were included in the study group (SG). After therapy, the therapeutic effect, immune function and other indexes were compared between the two groups. Results: After therapy, the total effective rate (ORR) and disease control rate (DCR) in SG were obviously higher than those in CG (P<0.05). After therapy, the serum interleukin -10 (IL-10) and interleukin -18 (IL-18) were obviously declined in both groups (P<0.05), and the decline of IL-10 and IL-18 in SG was obviously greater than that in CG (P<0.05). After therapy, vascular endothelial growth factor (VEGF) declined obviously in both groups (P<0.05), and the reduction of VEGF in SG was obviously greater than that in CG (P<0.05). After therapy, the number of alpha fetal protein (AFP) decreased in SG was obviously higher than that in CG (P<0.05). In SG, it could obviously ameliorate the progression free survival (PFS) and overall survival (OS) of patients with advanced HCC (P = 0.01, P<0.05), and there were no obvious differences in the incidence rate of adverse reactions in both groups (P>0.05). Conclusion: Sorafenib combined with apatinib can obviously improve the therapeutic effect, immune function and survival rate in treating patients with advanced HCC, and it is safe and worthy of clinical promotion.

Efficacy and safety of CalliSpheres drug-eluting beads for bronchial arterial chemoembolization for refractory non-small-cell lung cancer and its impact on quality of life: A multicenter prospective study.

This study aimed to prospectively observe the efficacy and safety of CalliSpheres drug-eluting beads bronchial arterial chemoembolization (DEB-BACE) for refractory non-small-cell lung cancer (NSCLC). The interventional therapy plan was as follows: 300-500 μm CalliSpheres drug-loaded microspheres were loaded with epirubicin, and then slow embolization of tumor supplying artery was performed after microcatheter superselection. Chest enhanced computed tomography and related hematological examination were reviewed after 2 months of DEB-BACE, and the tumor response after the first interventional therapy was evaluated using modified response evaluation criteria in solid tumors. The overall survival (OS) of patients was determined, and the quality of life and the incidence rate of adverse reactions were observed. From January 2019 to January 2021, 43 patients with refractory NSCLC were enrolled. The patients were followed up until June 2022. All 43 patients underwent DEB-BACE 1.79 ± 0.69 times on average. The 3-, 6-, 12-, and 24-month survival rates were 100%, 86.0%, 41.9%, and 11.8%, respectively. The median OS was 11.5 months. After the first interventional treatment, cough and wheezing significantly improved in 31 patients, hemoptysis was effectively controlled in 12 patients, and superior vena cava compression disappeared in 2 patients after 2 times of treatment. The general health status of the patients after treatment significantly improved compared with that before treatment, including the improvement in physical and emotional functions. Fatigue, nausea and vomiting, dyspnea, and insomnia improved significantly after treatment. No serious adverse events, such as spinal cord injury and cerebral embolism, were observed during the perioperative period. The main adverse reaction after DEB-BACE was chest pain (13/43, grade 1) followed by fever (10/43, grade 1-2), which was significantly relieved within 3-5 days after symptomatic treatment. Other adverse reactions included irritating cough, nausea and vomiting, and bone marrow suppression, and the incidence was less than 20%. DEB-BACE was effective and safe in treating refractory NSCLC, which could significantly improve patients' quality of life and was worthy of clinical promotion and application.

Efficacy and Safety of Picosecond Laser in the Treatment of Melasma: A Network Meta-analysis.

The role of lasers in the treatment of melasma and acquired hyperpigmentation disease of the skin has been suggested by clinicians. However, there is no consensus on the most efficient and safe treatment method. To systematically evaluate the efficacy and safety of picosecond laser in the treatment of melasma. PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Chinese scientific journal database, and Wanfang database were searched. The data for therapeutic efficacy, melasma area and severity score, and incidence rate of adverse reactions were extracted from the included studies. A total of 20 studies involving 1,182 patients were included in this network meta-analysis. Combined therapy with carbamic acid and 1064-nm picosecond laser was the best measure. Melasma area and severity index score of patients after low-power fractional CO2 laser treatment was higher than that of patients after the treatment with 1064-nm picosecond laser. Aminomethyl cyclic acid combined with 1064-nm picosecond laser may have the highest effective rate after treatment. Low-power fractional CO2 laser provided the lowest melasma area and severity index score after treatment, and the incidence rate of adverse reactions after treatment, was highest when intense pulsed light was used.

Analysis of the value and safety of thyroid-stimulating hormone in the clinical efficacy of patients with thyroid cancer.

Thyroid cancer (TC) is a common malignant tumor in the endocrine system. In recent years, the incidence and recurrence rates of TC have been raising due to increasing work pressure and irregular lifestyles. Thyroid-stimulating hormone (TSH) is a specific parameter for thyroid function screening. This study aims to explore the clinical value of TSH in regulating the progression of TC, so as to find a breakthrough for the early diagnosis and treatment of TC. To explore the value and safety of TSH in the clinical efficacy of patients with TC. 75 patients with TC admitted to the Department of Thyroid and Breast Surgery of our hospital from September 2019 to September 2021 were selected as the observation group, and 50 healthy subjects were selected as the control group during the same period. The control group was treated with conventional thyroid replacement therapy, and the observation group was treated with TSH suppression therapy. The soluble interleukin (IL)-2 receptor (sIL-2R), IL-17, IL-35 levels, free triiodothyronine (FT3), free tetraiodothyronine (FT4), CD3+, CD4+, CD8+, CD44V6, and tumor supplied group of factor (TSGF) levels were observed in the two groups. The occurrence of adverse reactions was compared between the two groups. After treatment with different therapies, the levels of FT3, FT4, CD3+, and CD4+ in the observation group and the control group were higher than those before treatment, while the levels of CD8+, CD44V6, and TSGF were lower than those before treatment, and the differences were statistically significant (P < 0.05). More importantly, the levels of sIL-2R and IL-17 in the observation group were lower than those in the control group after 4 wk of treatment, while the levels of IL-35 were higher than those in the control group, and the differences were statistically significant (P < 0.05). The levels of FT3, FT4, CD3 +, and CD4 + in the observation group were higher than those in the control group, and the levels of CD8+, CD44V6, and TSGF were lower than those in the control group. There was no significant difference in the overall incidence rate of adverse reactions between the two groups (P > 0.05). TSH suppression therapy can improve the immune function of patients with TC, lower the CD44V6 and TSGF levels, and improve serum FT3 and FT4 levels. It demonstrated excellent clinical efficacy and a good safety profile.

Efficacy and safety of rituximab in children and adolescents with mature B-cell non-Hodgkin's lymphoma: a Meta analysis

To study the efficacy and safety of rituximab combined with chemotherapy in the treatment of children and adolescents with mature B-cell non-Hodgkin's lymphoma (B-NHL) through a Meta analysis. The databases including PubMed, Embase, the Cochrane Library, ClinicalTrials.gov, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and Weipu were searched to obtain 10 articles on rituximab in the treatment of mature B-NHL in children and adolescents published up to June 2022, with 886 children in total. With 3-year event-free survival (EFS) rate, 3-year overall survival (OS) rate, complete remission rate, mortality rate, and incidence rate of adverse reactions as outcome measures, RevMan 5.4 software was used for Meta analysis, subgroup analysis, sensitivity analysis, and publication bias analysis. The rituximab+chemotherapy group showed significant increases in the 3-year EFS rate (HR=0.38, 95%CI: 0.25-0.59, P<0.001), 3-year OS rate (HR=0.29, 95%CI: 0.14-0.61, P=0.001), and complete remission rate (OR=3.72, 95%CI: 1.89-7.33, P<0.001) as well as a significant reduction in the mortality rate (OR=0.31, 95%CI: 0.17-0.57, P<0.001), as compared with the chemotherapy group without rituximab. There was no significant difference in the incidence rate of adverse reactions between the two groups (OR=1.28, 95%CI: 0.85-1.92, P=0.24). The addition of rituximab to the treatment regimen for children and adolescents with mature B-cell non-Hodgkin's lymphoma can bring significant survival benefits without increasing the incidence of adverse reactions.

Analgesic effects of oxycodone hydrochloride injection after laparoscopic cholecystectomy and influence on substance P, 5-hydroxytryptamine, and patient-controlled intravenous analgesia

Abstract Introduction We sought out to evaluate the effects of oxycodone hydrochloride injection on laparoscopic cholecystectomy (LC), substance P, 5-hydroxytryptamine (5-HT), and patient-controlled intravenous analgesia (PCIA). Materials and Methods A total of 120 eligible patients were randomly divided into an observation group (n=60) and control group (n=60). Oxycodone (0.07 mg/kg) and fentanyl (0.7 μg/kg) were intravenously injected during LC. Substance P and 5-HT were detected by ELISA. Results Heart rate (HR), mean arterial pressure (MAP), and blood oxygen saturation (SpO2) were recorded. Visual analogue scale (VAS), Ramsay scores, and incidence rates of adverse reactions were recorded. The observation group was less prone to agitation, with less affected HR, MAP and SpO2 during recovery. Before and after extubation, and upon leaving the recovery room, substance P and 5-HT increased more slowly in the observation group. After extubation, the control group had higher VAS and Ramsay scores and a higher incidence rate of adverse reactions. Using oxycodone before the end of LC does not delay awakening or affect extubation, but reduces hemodynamic fluctuations, incidence of agitation and release of substance P and 5-HT. It has high safety and stable circulation during recovery. Conclusions Oxycodone used in PCIA after LC effectively mitigates postoperative pain, with milder adverse reactions, which is superior to fentanyl.

Immunogenicity and safety of a live attenuated varicella vaccine co-administered with inactive hepatitis A vaccine: A phase 4, single-center, randomized, controlled trial

ABSTRACT Co-administration of vaccines can facilitate the introduction of new vaccines in immunization schedules. This study aimed to evaluate the immunogenicity and safety of co-administration with live attenuated varicella vaccine (VarV) and inactivated hepatitis A vaccine (HepA) among children aged 12 ~ 15 months. In this phase 4 clinical trial, 450 children were randomized with a ratio of 1:1 to receive VarV and Hep A simultaneously (Group A) or separately (Group B). The primary endpoints were the seroconversion rate of anti-varicella-zoster virus (VZV) antibodies 42 days after vaccination of VarV and the seroconversion rate of anti-Hepatitis A virus (HAV) antibodies 30 days after two-dose vaccination of HepA. After full immunization, the seroconversion rates of anti-VZV antibodies were 91.79% in Group A and 92.15% in Group B; the geometric mean titers (GMTs) were 11.80 and 12.19, respectively. The seroconversion rates of anti-HAV antibodies were 99.48% in Group A and 100.0% in Group B; the geometric mean concentrations (GMCs) reached 9499.11 and 9528.36 mIU/ml, respectively. The lower limits of the 95% CI for the seroconversion difference of anti-VZV antibodies and anti-HAV antibodies were −5.86% and −2.90%, which greater than the predefined non-inferiority margin (−10%). The incidence rate of adverse reactions in Group A was lower than Group B (9.33% vs 16.22%), and only one serious adverse event was reported in Group B, which was unrelated to the study vaccine. In conclusion, the co-administration of VarV with HepA has non-inferior immunogenicity and safety profiles were quite comparable with the separate administration of both vaccines. Trial registration number: NCT05526820 (ClinicalTrials.gov).

Lot-to-lot consistency, immunogenicity, and safety of an inactivated SARS-CoV-2 vaccine (CoronaVac) in healthy adults: A randomized, double-blind, phase IV trial

ABSTRACT Previous phase I to III clinical trials have shown that the inactivated SARS-CoV-2 vaccine namely CoronaVac has good efficacy, safety, and immunogenicity. This phase IV trial aims to evaluate the lot-to-lot consistency, immunogenicity, and safety on a commercial scale in healthy adults, which could provide data to support stable manufacturing. In this single-center, randomized, double-blind study, 1,080 healthy adults aged 26-45 years were randomly assigned into three groups to receive one of three lots of vaccines. All subjects received two doses of CoronaVac with an interval of 28 days. Serum samples were collected before the first dose and 28 days after the second dose to assess the immunogenicity. Solicited local and systemic adverse events (AEs) within 7 days and unsolicited AEs within 28 days after each dose of vaccination were recorded. A total of 1,039 participants completed the study and were included in the per-protocol set (PPS). The GMTs were 75.2 (68.5,82.6), 65.0 (59.0,71.7), and 65.3 (59.4,71.8), respectively, and the seroconversion rates of neutralizing antibody were all higher than 98%. The GMT ratios of each pair of lots were 1.16 (1.01,1.32), 1.15 (1.01, 1.32), and 0.99 (0.87, 1.14), respectively, meeting the immunological equivalence criteria. The incidence rates of adverse reactions (ARs) were 19.17%, 13.89%, and 18.33%, with no statistical difference. The ARs were all in grade 1 and grade 2, with incidences of 15.46% and 2.50%. Non-vaccine-related serious adverse events (SAEs) were reported. These results showed robust lot-to-lot consistency, immunogenicity, and safety. The stable production indicated that CoronaVac is suitable for large-scale use.Trial registration number: NCT04894227 (ClinicalTrials.gov).

Adverse reactions of methimazole in children with hyperthyroidism

To investigate the incidence rate of adverse reactions of methimazole in children with hyperthyroidism. A retrospective analysis was performed on the medical data of 304 children with hyperthyroidism who were hospitalized in Shengjing Hospital of China Medical University from January 2015 to May 2021. The incidence rate of methimazole-related adverse reactions was analyzed. The risk factors for common adverse reactions were evaluated. Among the 304 children, 87 (28.6%) experienced adverse reactions, among whom there were 20 boys (23%) and 67 girls (77%). Common adverse reactions included neutropenia (12.8%), rash (11.8%), elevated alanine aminotransferase (9.5%), and joint pain (3.0%), and some children experienced multiple adverse reactions simultaneously or intermittently. Neutropenia often occurred within 3 months after administration (25/39, 64%), elevated alanine aminotransferase often occurred within 1 month after administration (17/29, 59%), and rash often occurred within 3 months after administration (30/36, 83%). Most of the above adverse reactions returned to normal after symptomatic treatment. The multivariate logistic regression analysis showed that younger age and lower absolute neutrophil count before treatment were risk factors for neutropenia after methimazole treatment (P<0.05). The adverse reactions of methimazole are common in children with hyperthyroidism, and most adverse reactions occur within 3 months after administration and can be relieved after symptomatic treatment. Children with a younger age or a lower baseline absolute neutrophil count may have a higher risk of neutropenia.

Efficacy of the combination of Tenghuangjiangu tablets, alfacalcidol capsules and caltrate D3 tablets in osteoporotic vertebral compression fracture, and their effects on bone metabolic indices

Purpose: To investigate the efficacy of the combination of Tenghuangjiangu tablets, Alfacalcidol capsules and Caltrate D3 tablets in osteoporotic vertebral compression fracture (OVCF) and their effects on bone metabolic indices. &#x0D; Methods: Ninety-six patients with OVCF were randomly categorized into study group (SG) and control group (CG). Patients in the CG orally took Caltrate D3 tablets, while those in the SG were given Tenghuangjiangu tablets and Alfacalcidol capsules in addition to caltrate D3 tablets. The Bone mineral density (BMD) values and the treatment efficacy were compared. The levels of bone metabolism markers (PINP, β-CTX, BGP, NBAP), CT and PTH were determined using electrochemiluminescence immunoassay, while Ca2+ levels were assessed using liquid level detection. The incidence of adverse reactions (re-fracture, gastrointestinal reaction, hypotension and abnormal coagulation function) were compared. &#x0D; Results: Treatment efficacy in the SG was 91.67 %, which was significantly higher than that in the CG (81.25 %; p &lt; 0.05). Before treatment, the two groups showed no significant differences in BMD, PINP, β-CTX, BGP, NBAP, Ca2+, CT, and PTH levels (p &gt; 0.05). After treatment, the SG exhibited significantly higher BMD, PINP, BGP, NBAP, Ca2+ and CT levels, and showed lower β-CTX and PTH levels than the CG (p &lt; 0.05). The SG exhibited a significantly lower incidence rate of adverse reactions than that the CG (p &lt; 0.05). &#x0D; Conclusion: The combination of Tenghuangjiangu tablets, Alfacalcidol capsules, and Caltrate D3 tablets, improves bone metabolic indices, bone density and treatment efficacy while reducing the incidence rate of adverse reactions.

Effects of ultrasound-guided brachial plexus block in combination with sevoflurane general anesthesia via laryngeal mask on upper limb tumor and fracture surgery for children based on inflammatory stress response

Sevoflurane is used successfully for general anesthesia via laryngeal mask on upper limb tumors like osteosarcoma and Ewings sarcoma and fractures in orthopedic care centers. With the advancement in interventional radiology, many procedures are now available to support surgeons to carry out such procedures without complications. In this study, we tried to evaluate the effects of ultrasound-guided brachial plexus block in combination with sevoflurane general anesthesia via laryngeal mask for upper limb tumor (osteosarcoma in the metaphysic of long bones of upper limb and Ewing sarcoma-second most malignant tumor in children) and fracture surgery in children based on inflammatory stress response. Eighty-six children who were admitted to undergo surgery for upper limb tumor and fractures from June 2018 to November 2019 were selected and divided into control and study groups according to anesthesia methods (n= 43). The control group received only sevoflurane superficial general anesthesia via laryngeal mask, besides which the study group received ultrasound-guided brachial plexus block. The surgical, anesthetic outcomes and adverse reactions were compared. Pain was assessed by the visual analogue scale (VAS) 4 h, 8 h and 12 h after surgery. The serum levels of interleukin-1β (IL-1β), IL-10, C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), epinephrine (E), norepinephrine (NE), cortisol (Cor) and insulin (Ins) were measured before surgery, on the day of surgery and 3 days after surgery, respectively. Compared with the control group, the surgical time and recovery time of the study group were shorter, the pain occurred later, the intraoperative respiration was slower, and the incidence rate of adverse reactions was significantly lower. The VAS scores of the study group were significantly lower than those of the control group 4 h, 8 h and 12 h after surgery. The IL-1β, IL-10, CRP, TNF-α, E, NE, Cor, and Ins levels of the study group were also significantly lower than those of the control group on the day of surgery and 3 days after surgery. Observations of this study suggest that sevoflurane superficial general anesthesia via laryngeal mask in combination with brachial plexus block can be used in the upper limb tumor removal and fracture surgery for children. This strategy has the advantages of short recovery time, few adverse reactions, obvious sedative and analgesic effects, and low inflammatory stress response.

Adverse reactions to four types of monovalent antivenom used in the treatment of snakebite envenoming in South China

To evaluate the adverse reactions associated with the four types of monovalent antivenom currently used in China, we retrospectively analysed the data of all patients admitted for snakebites who received antivenom treatment at the main institution for the treatment of venomous snakebites in Guangzhou from January 2013 to December 2021. A total of 1658 patients were analysed in our study, and 60.7% (n = 1007) of the snakebite patients received antivenom treatment. The incidence rate of adverse reactions that occurred after the administration of all types of monovalent antivenom was 4.9% (n = 49), and the incidence rate of acute adverse reactions was 2.7% (n = 27). The number of adverse reactions that occurred was 38/744 (5.1%) in patients who received prophylactic application of glucocorticoids alone and 10/217 (4.6%) in those who received a combination of antihistamines and glucocorticoids (P = 0.83). The average doses of the antivenoms used in patients exhibiting acute adverse reactions and serum sickness were 3.31 ± 0.75 vials and 2.36 ± 0.26 vials, respectively (P = 0.28). The antivenom skin test showed high specificity (98.3%, 95% CI: 97.24%–99.01%) but low sensitivity (14.3%, 95% CI: 6.41%–27.86%). Our results showed that the four types of monovalent antivenom were safe. No significant difference was observed between the use of glucocorticoids alone and the use of antihistamines combined with glucocorticoids as premedication for the prevention of adverse reactions. Reducing the dose of antivenoms or reducing the combination of antivenoms did not help to reduce the occurrence of adverse reactions. Skin testing should not be recommended due to its low sensitivity.

Combination of Methotrexate and Leflunomide Is Efficient and Safe for 60 Patients with Rheumatoid Arthritis.

The present work is aimed at exploring the clinical efficacy and safety of methotrexate (MTX) and leflunomide (LEF) combination therapy for rheumatoid arthritis. From June 2019 to June 2021, a total of 120 individuals with rheumatoid arthritis received a diagnosis. Sixty patients each were randomly assigned to the control and observation groups. The observation group received MTX and LEF combo medication while the control group only received MTX treatment. Clinical efficacy, complication incidence, and the alleviation of inflammatory markers, joint pain, and clinical symptoms were compared between the 2 groups. Posttreatment, the observation group had overall response rate of 96.66%, while the control group had 86.67%, with significant differences. Compared with pretreatment, both control and observation group patients showed decreasing trends of IL-1 levels and increasing trends of IL-10 levels posttreatment, with significant differences (P < 0.05). Compared with the control group, patients in the observation group had lower IL-1 and TNF-α levels with significant differences (P < 0.05) and higher levels of IL-10 with significant difference (P < 0.05). In both groups, the pain score and the number of painful joints were much lower than they were prior to treatment. Following treatment, the observation group displayed significantly lower levels of erythrocyte sedimentation rate, rheumatoid factor, and C-reactive protein than the control group (P < 0.05). Clinical measures in the observation group were all lower than those in the control group with statistically significant differences (P < 0.05). Moreover, the incidence rate of adverse reactions showed no significant difference between these 2 groups (P > 0.05). In conclusion, the combination therapy of MTX and LEF is efficacious for rheumatic arthritis.

Safety of an inactivated 2019-nCoV vaccine (Vero) in adults aged 60 years and older

Objective: To analyze the safety of an inactivated 2019-nCoV vaccine (Vero cell) in adults aged 60 years and older. Methods: A randomized, double-blind, placebo-controlled clinical study was conducted in May 2020 The eligible residents aged 60 and above were recruited in Renqiu city, Hebei Province. A total of 422 subjects (phase Ⅰ/Ⅱ:72/350) were enrolled. Two doses of the trial vaccine or placebo were randomly administered according to a 0 and 28-day immunization schedule. Subjects were randomly divided into two groups in Phase Ⅰ. Within each group, participants received vaccine or placebo in a ratio of 2∶1. Subjects were randomly divided into four groups in phase Ⅱ to receive low-dose, medium-dose, high-dose vaccine and placebo, respectively, in a ratio of 2∶2∶2∶1. A combination of regular follow-up and active reporting was used to observe adverse reactions within 28 days after vaccination, and compare the incidence rate of adverse reactions in the trial and control groups. Results: 422 subjects were (66.45±4.70) years old, and 48.82% were male (206/422). There were 100, 124, 124 and 74 patients enrolled into the low-dose, medium-dose, high-dose vaccine groups and the placebo group, respectively. One person without the vaccination was removed, and 421 participants who received at least one dose of vaccine were included in the safety analysis. Within 28 days after the first or second dose, a total of 20.67% (87/421) subjects had adverse reactions (both solicitation and non-solicitation). About 76 patients suffered grade 1 adverse reactions [18.05% (76/421)] and 22 patients suffered grade 2 adverse reactions [5.23% (22/421)]. No grade 3 or above adverse reactions occurred. A total of 19.71% (83/421) subjects had solicited adverse reactions. The most common grade 1 adverse reaction was injection site pain, followed by fever and fatigue. The most common grade 2 adverse reactions were fever and fatigue, followed by muscle pain and injection site redness. A total of 2.61% (11/421) subjects had unsolicited adverse reactions. A total of 1.66% (7/421) subjects had serious adverse events after vaccination, and no serious vaccine-related adverse events were reported. Conclusions: The inactivated SARS-CoV-2 vaccine is safe for people aged 60 years and above.

Optimal Dose of Dexmedetomidine for Preemptive Analgesia Combined with Transversus Abdominis Plane Block after Colon Cancer Surgery.

Pain after colon cancer surgery can be effectively relieved by transversus abdominis plane (TAP) block. We aimed to determine the optimal dose of dexmedetomidine for preemptive analgesia when combined with TAP block after colon cancer surgery. A total of 120 patients undergoing laparoscopic resection for colon cancer from March 2018 to October 2019 were randomly assigned to control (group C), low-dose (group L, 0.5 μg/kg), moderate-dose (group M, 1 μg/kg), and high-dose groups (group H, 1.5 μg/kg) (n=30 each). After puncture under ultrasound guidance, the designated dexmedetomidine dose and 0.25% ropivacaine were injected on both sides (20 mL each side). Mean arterial pressure (MAP), heart rate (HR), numeric rating scale (NRS) score, and Ramsay score were compared at 2 h (T0), 4 h (T1), 8 h (T2), 12 h (T3), 24 h (T4), and 48 h (T5) after surgery. The area sensitive to mechanical stimulation-induced pain at the incision was measured at T4, T5, and 72 h after surgery (T6). Adverse reactions were compared. MAP and HR were lower in the dexmedetomidine groups, especially groups M and H, than in group C (P<0.05). NRS scores at T0-T5 and pain-sensitive areas at T4-T6 were lower in the dexmedetomidine groups than in group C (P<0.05), but Ramsay scores were similar (P>0.05). Compared with group L, groups M and H had lower NRS scores and pain-sensitive areas (P<0.05). The incidence rates of adverse reactions were lower in the dexmedetomidine groups than in group C (P<0.05). Dexmedetomidine 1 or 1.5 μg/kg is effective and did not increase adverse reactions. A dose of 1 μg/kg is recommended as an adjuvant to ropivacaine for TAP block.

Effectiveness and Safety Analysis of Plasma Beam in the Treatment of Facial Depressed Scars.

The study aimed to analyze the effectiveness and safety of microplasma beam in the treatment of facial depression scars. 106 patients with facial depression scars treated in the hospital between January 2017 and September 2021 were selected as the observation subjects. According to different treatment methods, the patients were divided into the control group (receiving ultrapulsed carbon dioxide lattice laser treatment, n = 51) and the observation group (undergoing plasma beam treatment, n = 55). The two groups were treated for 6 months, and the treatment effects were compared between the two groups. The Visual Analogue Scale (VAS) was used to compare the pain between the two groups, and the duration of pain and the time of scab shedding were recorded. The improvement of scars was compared between the two groups according to the Evaluation Clinique des Cicatrices d' Acne (ECCA), and the adverse reactions during treatment were compared between the two groups. A clinical effective rate of 94.55% in the observation group was higher than a clinical effective rate of 82.35% in the control group (P < 0.05). The VAS score in the observation group was lower than that in the control group, and the pain duration and the scab shedding time were shorter than those in the control group (P < 0.05). ECCA scores in the observation group after twice and 3 times of treatments were lower than those in the control group (P < 0.05). The total incidence rate of adverse reactions of 10.91% in the observation group was lower, whereas it was 25.49% in the control group (P > 0.05). Plasma beam has a significant efficacy in the treatment of facial depressed scars, and it has mild pain, quick recovery, and high safety. Clinical Trial Registration Number. The clinical trial registration number is T2017081.

Effects of serratus anterior plane block and thoracic paravertebral nerve block on analgesia, immune function and serum tumor markers in patients after thoracoscopic radical resection of lung cancer.

ABSTRACTWe aimed to assess the effects of serratus anterior plane block (SAPB) and thoracic paravertebral nerve block (TPVB) on analgesia, immune function and serum tumor markers in patients after thoracoscopic radical resection of lung cancer. A total of 132 patients enrolled from February 2019 to November 2020 were prospectively selected and randomly divided into 3 groups (n=44). Control group received general anesthesia. After induction of general anesthesia, TPVB or SAPB group was given TPVB or SAPB. Their clinical data, operation conditions, Visual Analogue Scale (VAS) score, immune function, serum tumor markers and adverse reactions were compared. TPVB and SAPB groups had lower dosage of sufentanil during operation, later time of first pressing patient-controlled intravenous analgesia (PCA) pump after operation and smaller number of pressing PCA pump within 48 h after operation than those of control group (P<0.05). VAS scores at rest and coughing decreased 6 and 12 h after operation in TPVB and SAPB groups compared with that in control group (P<0.05). Cluster of differentiation 3 (CD3)+, CD4+ and CD4+/CD8+ ratio were higher, while CD8+ was lower 24 and 48 h after operation in TPVB and SAPB groups than those of control group (P<0.05). TPVB and SAPB groups had lower serum tumor marker levels 24 h after operation than those of control group (P<0.05). The three groups had similar incidence rates of adverse reactions (P>0.05). SAPB and TPVB can markedly improve postoperative analgesic effect, enhance immune function and decrease serum tumor marker levels in patients receiving thoracoscopic radical resection of lung cancer, without increasing adverse reactions. However, TPVB may puncture the pleura.

Effects of pre-injection of pressors on pressor response and bispectral index of patients receiving lower abdominal surgery under total intravenous anesthesia

Surgery in the lower abdomen can cause many adverse reactions in nervous system, metabolic and endocrine systems. Conventional intravenous anesthesia applied for lower abdominal surgery can cause the drop in blood pressure leading to hypoperfusion of vital organs. Hence, an ideal anesthesia state is required to make patients unconscious, unaware and have no postoperative memory during anesthesia. In this study, we investigated the effects of pre-injection of different pressors on the pressor response and bispectral index (BIS) of patients receiving lower abdominal surgery under total intravenous anesthesia. For this, 300 patients undergoing lower abdominal surgery under total intravenous anesthesia were divided into normal saline (Gr. A), ephedrine (Gr. B) and phenylephrine groups (Gr. C) (n=100). Hemodynamics indices were recorded before anesthesia induction (T0) and 1, 3, 5, 7 and 9 min after drug injection (T1-T5, respectively). We observed the following reactions and recorded. BIS values at T0-T5 as well as the time points when the values rose to 65, 75, 85 and 95 and those for respiratory recovery, consciousness recovery and extubation after stopping target-controlled infusion were recorded. Compared with Gr. A, Gr. B had significantly higher systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR) and cardiac output (CO) at T1-T5 (P <0.05), and Gr. C had higher SBP, DBP, MAP and lower HR (P <0.05). Adverse reactions viz., intraoperative hypotension, hypertension, postoperative bradycardia, tachycardia, nausea and vomiting were also observed. The incidence rates of hypotension and total adverse reactions in groups B and C were significantly lower than those of Gr. A (P <0.05). Group B had significantly higher BIS values at T1-T5 than those of Gr. A (P <0.05). The time when BIS values recovered to 65 and 75 in group B was significantly shorter than that of Gr. A (P <0.05). Pre-injection of ephedrine and phenylephrine to patients undergoing lower abdominal surgery under total intravenous anesthesia elevated the blood pressure and reduced the incidence rate of adverse reactions without affecting the recovery time.

Effectiveness and safety of vancomycin powder injection locally applied in theprevention of prosthetic joint infection

Prosthetic joint infection is a rare but serious complication that is associated with considerable morbidity and financialburdens and other hardships for the individual. The available treatment options for PJI include both surgery andantimicrobial therapy. The surgical option includes debridement, antibiotics and implant retention (DAIR), that is usuallyrecommended at initial stages, one stage or two stage revision arthroplasty at advanced stages. These treatments are muchexpensive and time consuming and have around 11-30% failure rate. Therefore, there is an urgent need for a appropriate andaffordable treatment strategy. Vancomycin serves as an active agent against the pathogens that have ability to causepotential damage to the wounds after surgery. In its powder form, it ensures adequate surgical site concentrations whileminimizing the adverse effects caused by undetectable systemic distribution. Thus, we explored the effectiveness and safetyof vancomycin powder injection locally applied in the prevention of prosthetic joint infection (PJI). A total of 90 inpatientswho underwent total hip and knee arthroplasty from January 2018 to December 2019 were selected and randomly dividedinto control group (routine preventive antibiotic therapy) and treatment group (vancomycin applied based on the treatmentof control group). The incidence of PJI and adverse reactions within 3 months after operation was observed. The changes inbody temperature, neutrophil count, interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) levels wererecorded before operation and 1, 3 and 7 days after treatment. Ninety days after treatment, the incidence rate of PJI intreatment group (0.00) was significantly lower than that of control group (8.89%) (P <0.05). Within a short period of time (1d and 3 d) after treatment, the body temperature, neutrophil count, IL-6 and hs-CRP levels were all lower in treatment groupthan those in control group (P <0.05). However, the above indices had no significant differences between the two groups at1 week (7 d) after treatment (P >0.05). There were 3 cases (6.67%) and 2 cases (4.44%) of adverse reactions in treatmentgroup and control group, respectively. The incidence rates of adverse reactions were similar (χ2=0.212, P=0.645).Vancomycin powder injection locally applied can control the body temperature, and reduce the neutrophil count, IL-6 andhs-CRP levels within a short period of time after operation, which is superior to routine preventive antibiotic therapy. It candecrease the incidence rate of PJI after arthroplasty.

Application of Chain Nursing Process in the Nursing of Elderly Inpatients with Implantable Venous Infusion Port.

Objective To explore the application effects of chain nursing process in the nursing of elderly inpatients with implantable venous infusion port. Methods 81 elderly inpatients who were treated with implantable venous infusion port in the hospital were selected between February 2018 and December 2021, and they were divided into the routine group (given routine nursing of implantable venous infusion port, n = 40) and the study group (given chain nursing process intervention on the basis of the routine group, n = 41) according to the random number table method. The patients in both groups were intervened for 1 month. The catheter-related indicators and incidence rates of adverse events (drug extravasation, local hematoma, infusion port blockage, catheter-related infection) were compared between the two groups of patients. Generalized Anxiety Disorder 7-item scale (GAD-7) and Athens Insomnia Scale (AIS) were used to compare the psychological states of the two groups before and after intervention, and Newcastle Satisfaction with Nursing Scale (NSNS) was adopted to compare the nursing satisfaction of patients before and after intervention. Results After intervention, the catheter maintenance operation time in the study group was shorter than that in the routine group (P < 0.05), and there were no significant differences in the accidental extubation rate and re-intubation rate between the two groups (P > 0.05). The incidence rate of adverse reactions of 2.44% in the study group was lower than 15.00% in the routine group (P < 0.05). After intervention, the scores of GAD-7 and AIS in the two groups were reduced compared with those before intervention, and the above scores in the study group were lower than those in the routine group (P < 0.05). Before intervention, there were no significant differences in the NSNS scores between the two groups (P > 0.05). After intervention, the NSNS scores in the study group were higher than those in the routine group (P < 0.05). Conclusion Chain nursing process can help to enhance the maintenance quality of implantable venous infusion port, reduce the incidence of adverse events, relieve the tension and anxiety, and improve the satisfaction of patients with nursing.