This study was aimed at investigating the location of gastric cancer by using a gastroscope image based on an artificial intelligence algorithm for gastric cancer and the effect of ultrasonic-guided nerve block combined with general anesthesia on patients undergoing gastric cancer surgery. A total of 160 patients who were undergoing gastric cancer surgery from March 2019 to March 2021 were collected as the research objects, and the convolutional neural network (CNN) algorithm was used to segment the gastroscope image of gastric cancer. The patients were randomly divided into a simple general anesthesia group of 80 cases and a transversus abdominis plane block combined with rectus abdominis sheath block combined with the general anesthesia group of 80 cases. Then, compare the systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) at the four time points T0, T1, T2, and T3. The times of analgesic drug use within 48 hours after operation and postoperative adverse reactions were recorded. The visual analog scale (VAS) scores were also recorded at 4 h, 12 h, 24 h, and 48 h. The results show that the image quality after segmentation is good: the accuracy of tumor location is 75.67%, which is similar to that of professional endoscopists. Compared with the general anesthesia group, the transversus abdominis plane block combined with the rectus sheath block combined with the general anesthesia group had fewer anesthetics, and the difference was statistically significant ( P < 0.05 ). Compared with the general anesthesia group, SBP, DBP, and HR were significantly reduced at T1, T2, and T3 in the transverse abdominis plane block combined with rectus sheath block and general anesthesia group ( P < 0.05 ). Compared with the simple general anesthesia group, the VAS scores of the transversus abdominis plane block combined with rectus sheath block combined with the general anesthesia group decreased at 4 h, 12 h, and 24 h after surgery, and the difference was statistically significant ( P < 0.05 ). The number of analgesics used in transversus abdominis plane block combined with the rectus sheath block combined with the general anesthesia group within 48 hours after operation was significantly less than that in the general anesthesia group, and the difference was statistically significant ( P < 0.05 ). The average incidence of adverse reactions in the nerve block combined with the general anesthesia group was 2.5%, which was lower than the average incidence of 3.75% in the general anesthesia group. In summary, the CNN algorithm can accurately segment the lesions in the ultrasonic images of gastric cancer, which was convenient for doctors to make a more accurate judgment on the lesions, and provided a basis for the preoperative examination of radical gastrectomy for gastric cancer. Ultrasonic-guided nerve block combined with general anesthesia can effectively improve the analgesic effect of radical gastrectomy for gastric cancer, reduced intraoperative and postoperative adverse reactions and analgesic drug dosage, and had a good effect on postoperative recovery of patients. The combined application of these two methods can further improve the precision treatment of gastric cancer patients and accelerate postoperative recovery.

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Purpose: To evaluate the role of miR-20a in sevoflurane (SEV)-induced cognitive impairment in rats and to elucidate the mechanism of action. Methods: A SEV-induced cognitive impairment rat model was developed. The Morris water maze test and fear assay were carried out to assess impaired learning and memory. A cellular SEV-impaired model was developed and the miR-20a level was measured in the animal and cellular models. TUNEL staining and immunoblot assay were performed to determine the SEV effect on apoptosis. Bioinformatic analysis and luciferase assay were conducted to identify the target of miR-20a action. A rescue assay involving miR-20a overexpression in cellular and animal models was developed and used to evaluate function of miR-20a in cognitive defects. Results: The rats showed significant cognitive impairment upon SEV treatment, which inhibited the expression of miR-20a and promoted neuronal apoptosis. Further findings identified EphA4 as a target of miR-20a, which regulates its expression. Overexpression of miR-20a in rats effectively reduced cognitive dysfunction and apoptosis of hippocampus somatic cells caused by SEV treatment. Conclusion: Evidently, miR-20a ameliorates SEV anesthesia-induced cognitive impairment in rats and thus has the potential to serve as a therapeutic target for the treatment of post-operative cognitive dysfunction.

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Dong et al.: Correlation between Cardiac Troponin I and the Prognosis of Sepsis Adopt meta-analysis method to study the relationship between troponin I and prognosis of sepsis patients and to explore the predictive value of troponin I on prognosis of sepsis patients. In PubMed, EMBASE and Ovid MEDLINE, the clinical studies published as of September 2021 were comprehensively searched and screened through inclusion and exclusion criteria. The qualified clinical studies were incorporated to conduct quality evaluation and data extraction. Adopt RevMan 5.3 software for meta-analysis and evaluate the relationship between the troponin I level and indicators such as the mortality rate, length of hospital stay in patients with sepsis. The statistical results are represented by forest plots and the publication bias is tested by funnel plots. This research contains 14 independent studies and 3104 patients participated in the study. Meta-analysis results showed that compared with patients with sepsis in the troponin I-negative group; The mortality of patients in the troponin I positive group was significantly higher [odds ratio=2.21, 95 % confidence interval (1.88, 2.61), p<0.001]; No significant difference was found in incidence of septic shock in troponin I-positive group [odds ratio=1.32, 95 % confidence interval (0.65, 2.70), p=0.44]; It possessed no significant difference in length of hospital stay in troponin I-positive group [standardized mean difference=0.08, 95 % confidence interval] (-0.10, 0.25), p=0.39]. Compared with troponin I-negative sepsis patients, troponin I-positive sepsis patients have a higher fatality rate; however, the incidence of septic shock and the length of hospitalization between the two groups were not significantly different. Elevated troponin I has certain predictive value for prognosis of sepsis patients.