The objective of this article is to investigate the effects of intensive patients’ education and lifestyle improving program (IPEL) on anxiety, depression, and overall survival (OS) in coronary artery disease (CAD) patients with anxiety and depression. In all, 224 CAD patients with anxiety and depression were randomly assigned to IPEL or control group. In Stage I, the IPEL group received IPEL and usual care, while the control group only received usual care. In Stage II, patients were further followed up and OS analysis was performed. Hospital Anxiety and Depression Scale–anxiety (HADS-A) and HADS–depression (HADS-D) were used to assess anxiety and depression. IPEL reduced HADS-A score at Month 9 (M9)/M12, and the percentage of anxiety at M12 and HADS-A score changed. IPEL reduced HADS-D score at M12, and the percentage of depression at M12 and HADS-D score changed compared with control. Patients with nonanxiety/nondepression at M12 in the IPEL group showed better OS. IPEL reduces anxiety and depression and improves OS in CAD patients.

Cerebral hemorrhage is a kind of intracranial hemorrhage caused by nontraumatic vascular rupture of the cerebral parenchyma, which is a common cerebrovascular disease with a high disability rate and mortality. This study aimed to explore the effects of oropharyngeal aspiration in reducing ventilator-associated pneumonia in patients with cerebral hemorrhage in ICU. In this study, 96 patients with cerebral hemorrhage were selected as the subjects. They received surgical treatment, and then they were transferred into ICU of Fourth Affiliated Hospital of Harbin Medical University from December 2019 to March 2020. The patients were randomly divided into intervention group and control group, with 48 in each group. The intervention group received periodic oropharyngeal aspiration, while the control group received routine nursing measures. After the intervention, the incidence of ventilator-associated pneumonia and the positive rate of amylase α-trachea cannula specimens were recorded and compared between the two groups. After the intervention, the incidence of ventilator-associated pneumonia was 14.89% in the intervention group and 39.58% in the control group, with a statistically significant difference. And, the α-amylase positive rate, mechanical ventilation time, and ICU care duration of endotrachea cannula specimens in the intervention group were significantly lower than those in the control group. In conclusion, oropharyngeal aspiration can effectively reduce the incidence of ventilator-associated pneumonia after cerebral hemorrhage and shorten mechanical ventilation and ICU care duration. It promotes the rehabilitation of patients.

Background: Satisfactory intraoperative analgesia is critical for percutaneous transforaminal endoscopic discectomy (PTED). Local anesthesia (LA) and epidural anesthesia (EA) are recommended for PTED. However, LA cannot achieve satisfactory pain management during PTED, and traditional EA, which involves implanting an epidural catheter through the midline or paramedian, has disadvantages such as difficulty in catheterization and increased preoperative preparation time. Rather than performing conventional EA, we injected local anesthetics through the intervertebral foramen during the puncture process, which we termed lumbar transforaminal EA (LTEA), and observed its feasibility and safety. This study aimed to conduct a comprehensive comparison of differences in analgesia between LA and LTEA in patients with PTED. Methods: We performed a retrospective analysis of patients who underwent PTED between January 2018 and January 2021. Patients were divided into LA and LTEA groups. Data obtained from the electronic medical records included primary outcomes (visual analog scale [VAS] scores and anesthesia satisfaction rate) and secondary outcomes, including vital signs such as heart rate (HR), mean arterial pressure (MAP), total dosage of fentanyl, operation time, X-ray exposure time, Oswestry Disability Index (ODI)scores, and complications. Results: In total, 160 patients (80 in each group) were analyzed in this study. The VAS scores for lumbar and leg pain were significantly lower in the LTEA group than in the LA group (P < 0.0001). The anesthesia satisfaction rate was 90.0% in the LTEA group and 72.5% in the LA group (P < 0.005). MAP and HR values in the LTEA group were significantly lower than those in the LA group (P < 0.05). The total dose of fentanyl in the LTEA group was significantly lower than that in the LA group (P < 0.05). As for ODI values, the average operation time, X-ray exposure time, and incidence of complications were not significantly different between the two groups (P > 0.05). Conclusions: LTEA simplifies the process of EA and can achieve a good analgesic effect intraoperatively without increasing the preoperative preparation time; thus, it may be adopted as an alternative mode of anesthesia during PTED surgery.

Background Lung inflation with hydrogen improves the quality of donor lungs by mitigating ischemia-reperfusion injury. However, the underlying mechanism of hydrogen remains uncertain. We investigated whether the protective effects of lung inflation with 3% hydrogen during the cold ischemia phase is related to affecting energy metabolism in lung grafts of rats. Method Adult male Wistar rats were randomized into four groups: sham group (underwent thoracotomy without lung transplantation), control group (donor lungs were deflated at 4 for 2 hours), oxygen group (donor lungs were inflated with 40% oxygen mixed gas for 2 hours during cold storage), and hydrogen group (inflating the donor lungs with 3% hydrogen + 40% oxygen containing mixed gas). Orthotopic left lung transplantation was performed in control group, oxygen group, and hydrogen group, followed by 2 hours of reperfusion. Lung grafts were assayed for static compliance, histological, lactic acid content, pyruvic acid content, ATP content, mitochondrial respiratory complex I to IV activity, and reactive oxygen species content. Results Compared with the control group and oxygen group, hydrogen group reduced pyruvate and lactic acid contents and increased adenosine triphosphate contents in lung grafts. Furthermore, hydrogen improved mitochondrial morphology, increased mitochondrial complex enzyme I, II, and III activity, and reduced reactive oxygen species contents in lung grafts when comparing with the control group and the oxygen group. The severity of pulmonary injury, static compliance, and the PaO2/FiO2 of lung grafts in the hydrogen group and the oxygen group were comparable. Conclusion Donor Lung inflation with 3% hydrogen during cold storage is associated with reduced anaerobic metabolism level and improvements of mitochondrial morphology and function in lung grafts.