Jointly organized By Sino-US Innovation and Entrepreneurship Summit Organizing Committee of Carnegie Mellon University (CMU), the Chinese Students and Scholars Association (CMU-CSSA)
BACKGROUND Sleep disturbance on the first postoperative night commonly develops for patients after day surgeries. The choice of either total intravenous anesthesia by propofol or total inhalation anesthesia with sevof...BACKGROUND Sleep disturbance on the first postoperative night commonly develops for patients after day surgeries. The choice of either total intravenous anesthesia by propofol or total inhalation anesthesia with sevoflurane has become an issue for preventing sleep disturbance.AIM To compare sleep quality on the first postoperative night for female patients after total intravenous anesthesia by propofol and total inhalation anesthesia with sevoflurane.METHODS We enrolled 61 American Society of Anesthesia(ASA) class Ⅰ-Ⅱ outpatients who underwent minor gynecologic surgeries by either propofol or sevoflurane anesthesia. Sleep quality of the very night was assessed by the Pittsburgh Sleep Quality Index(PSQI) on the next day, and PSQI scores were compared by the Wilcoxon signed-rank test and paired t-test pre-operatively and postoperatively.RESULTS For the propofol group, the mean postoperative global PSQI score(3.3 ± 1.3) was lower than the mean preoperative global PSQI score(4.9 ± 2.3)(P < 0.001);for the sevoflurane group, the mean postoperative global PSQI score(6.5 ± 2.8) was higher than the mean preoperative global PSQI score(5.5 ± 3.2)(P = 0.02). Eighty percent of patients receiving propofol anesthesia subjectively reported improved sleep quality, but only 17% of patients receiving sevoflurane anesthesia reported improved sleep quality.CONCLUSION Sleep quality assessed by the PSQI is better improved in ASA class Ⅰ-Ⅱ female patients receiving propofol anesthesia other than sevoflurane anesthesia for undergoing minor gynecologic surgeries.展开更多
Background Pittsburgh modified TNM criteria is one of the prognostic models of orthotopic liver transplantation(OLT)for hepatocellular carcinoma(HCC).In this study,we applied this prognostic system in a series of HCC ...Background Pittsburgh modified TNM criteria is one of the prognostic models of orthotopic liver transplantation(OLT)for hepatocellular carcinoma(HCC).In this study,we applied this prognostic system in a series of HCC patients receiving OLT to verify its reliability in the clinical prognostic prediction.Methods The clinical record and follow-up data of 102 patients with HCC underwent OLT was collected.The patients were classified by 3 staging systems:the Pittsburgh Modified TNM Criteria,International Union Against Cancer(UICC)pTNM Staging System,and Milan Criteria.Survival rates of the patients were analyzed using the Kaplan-Meier method and the Log-Rank test,and then the prognostic values of the 3 staging systems were compared.Results Among the 3 staging systems,the Pittsburgh Modified TNM Criteria showed the best stratification of patients with different prognosis.The overall survival rates of the patients at the Pittsburgh modified TNM stageⅠ,Ⅱ,Ⅲ,andⅣwere 94.4%,83.3%,58.2%,and 36.8%at 1 year,and 79.4%,62.5%,26.2%,and 10.5%at 3 years,respectively.For those patients exceeding the Milan Criteria,the patients at Pittsburgh stages I and II had a significant higher survival rate than those at Pittsburgh stages III and IV(P〈0.001).Conclusions The Pittsburgh Modified TNM Criteria is a more reliable postoperative staging system than the UICC pTNM staging system for HCC patients receiving OLT.As providing more accurate prognostic classification,it could be reasonable to combine the Milan Criteria for recipient selection.展开更多
Sleep disturbances are among the most prevalent neuropsychiatric symptoms in individuals who have recovered from severe acute respiratory syndrome coronavirus 2 infections.Previous studies have demonstrated abnormal b...Sleep disturbances are among the most prevalent neuropsychiatric symptoms in individuals who have recovered from severe acute respiratory syndrome coronavirus 2 infections.Previous studies have demonstrated abnormal brain structures in patients with sleep disturbances who have recovered from coronavirus disease 2019(COVID-19).However,neuroimaging studies on sleep disturbances caused by COVID-19 are scarce,and existing studies have primarily focused on the long-term effects of the virus,with minimal acute phase data.As a result,little is known about the pathophysiology of sleep disturbances in the acute phase of COVID-19.To address this issue,we designed a longitudinal study to investigate whether alterations in brain structure occur during the acute phase of infection,and verified the results using 3-month follow-up data.A total of 26 COVID-19 patients with sleep disturbances(aged 51.5±13.57 years,8 women and 18 men),27 COVID-19 patients without sleep disturbances(aged 47.33±15.98 years,9 women and 18 men),and 31 age-and gender-matched healthy controls(aged 49.19±17.51 years,9 women and 22 men)were included in this study.Eleven COVID-19 patients with sleep disturbances were included in a longitudinal analysis.We found that COVID-19 patients with sleep disturbances exhibited brain structural changes in almost all brain lobes.The cortical thicknesses of the left pars opercularis and left precuneus were significantly negatively correlated with Pittsburgh Sleep Quality Index scores.Additionally,we observed changes in the volume of the hippocampus and its subfield regions in COVID-19 patients compared with the healthy controls.The 3-month follow-up data revealed indices of altered cerebral structure(cortical thickness,cortical grey matter volume,and cortical surface area)in the frontal-parietal cortex compared with the baseline in COVID-19 patients with sleep disturbances.Our findings indicate that the sleep disturbances patients had altered morphology in the cortical and hippocampal structures during the acute phase of infection and persistent changes in cortical regions at 3 months post-infection.These data improve our understanding of the pathophysiology of sleep disturbances caused by COVID-19.展开更多
文摘Jointly organized By Sino-US Innovation and Entrepreneurship Summit Organizing Committee of Carnegie Mellon University (CMU), the Chinese Students and Scholars Association (CMU-CSSA)
文摘BACKGROUND Sleep disturbance on the first postoperative night commonly develops for patients after day surgeries. The choice of either total intravenous anesthesia by propofol or total inhalation anesthesia with sevoflurane has become an issue for preventing sleep disturbance.AIM To compare sleep quality on the first postoperative night for female patients after total intravenous anesthesia by propofol and total inhalation anesthesia with sevoflurane.METHODS We enrolled 61 American Society of Anesthesia(ASA) class Ⅰ-Ⅱ outpatients who underwent minor gynecologic surgeries by either propofol or sevoflurane anesthesia. Sleep quality of the very night was assessed by the Pittsburgh Sleep Quality Index(PSQI) on the next day, and PSQI scores were compared by the Wilcoxon signed-rank test and paired t-test pre-operatively and postoperatively.RESULTS For the propofol group, the mean postoperative global PSQI score(3.3 ± 1.3) was lower than the mean preoperative global PSQI score(4.9 ± 2.3)(P < 0.001);for the sevoflurane group, the mean postoperative global PSQI score(6.5 ± 2.8) was higher than the mean preoperative global PSQI score(5.5 ± 3.2)(P = 0.02). Eighty percent of patients receiving propofol anesthesia subjectively reported improved sleep quality, but only 17% of patients receiving sevoflurane anesthesia reported improved sleep quality.CONCLUSION Sleep quality assessed by the PSQI is better improved in ASA class Ⅰ-Ⅱ female patients receiving propofol anesthesia other than sevoflurane anesthesia for undergoing minor gynecologic surgeries.
文摘Background Pittsburgh modified TNM criteria is one of the prognostic models of orthotopic liver transplantation(OLT)for hepatocellular carcinoma(HCC).In this study,we applied this prognostic system in a series of HCC patients receiving OLT to verify its reliability in the clinical prognostic prediction.Methods The clinical record and follow-up data of 102 patients with HCC underwent OLT was collected.The patients were classified by 3 staging systems:the Pittsburgh Modified TNM Criteria,International Union Against Cancer(UICC)pTNM Staging System,and Milan Criteria.Survival rates of the patients were analyzed using the Kaplan-Meier method and the Log-Rank test,and then the prognostic values of the 3 staging systems were compared.Results Among the 3 staging systems,the Pittsburgh Modified TNM Criteria showed the best stratification of patients with different prognosis.The overall survival rates of the patients at the Pittsburgh modified TNM stageⅠ,Ⅱ,Ⅲ,andⅣwere 94.4%,83.3%,58.2%,and 36.8%at 1 year,and 79.4%,62.5%,26.2%,and 10.5%at 3 years,respectively.For those patients exceeding the Milan Criteria,the patients at Pittsburgh stages I and II had a significant higher survival rate than those at Pittsburgh stages III and IV(P〈0.001).Conclusions The Pittsburgh Modified TNM Criteria is a more reliable postoperative staging system than the UICC pTNM staging system for HCC patients receiving OLT.As providing more accurate prognostic classification,it could be reasonable to combine the Milan Criteria for recipient selection.
基金supported by grants from Major Project of Science and Technology of Guangxi Zhuang Autonomous Region,No.Guike-AA22096018(to JY)Guangxi Key Research and Development Program,No.AB22080053(to DD)+6 种基金Major Project of Science and Technology of Guangxi Zhuang Autonomous Region,No.Guike-AA23023004(to MZ)the National Natural Science Foundation of China,Nos.82260021(to MZ),82060315(to DD)the Natural Science Foundation of Guangxi Zhuang Autonomous Region,No.2021GXNSFBA220007(to GD)Clinical Research Center For Medical Imaging in Hunan Province,No.2020SK4001(to JL)Key Emergency Project of Pneumonia Epidemic of Novel Coronavirus Infection in Hunan Province,No.2020SK3006(to JL)Science and Technology Innovation Program of Hunan Province,No.2021RC4016(to JL)Key Project of the Natural Science Foundation of Hunan Province,No.2024JJ3041(to JL).
文摘Sleep disturbances are among the most prevalent neuropsychiatric symptoms in individuals who have recovered from severe acute respiratory syndrome coronavirus 2 infections.Previous studies have demonstrated abnormal brain structures in patients with sleep disturbances who have recovered from coronavirus disease 2019(COVID-19).However,neuroimaging studies on sleep disturbances caused by COVID-19 are scarce,and existing studies have primarily focused on the long-term effects of the virus,with minimal acute phase data.As a result,little is known about the pathophysiology of sleep disturbances in the acute phase of COVID-19.To address this issue,we designed a longitudinal study to investigate whether alterations in brain structure occur during the acute phase of infection,and verified the results using 3-month follow-up data.A total of 26 COVID-19 patients with sleep disturbances(aged 51.5±13.57 years,8 women and 18 men),27 COVID-19 patients without sleep disturbances(aged 47.33±15.98 years,9 women and 18 men),and 31 age-and gender-matched healthy controls(aged 49.19±17.51 years,9 women and 22 men)were included in this study.Eleven COVID-19 patients with sleep disturbances were included in a longitudinal analysis.We found that COVID-19 patients with sleep disturbances exhibited brain structural changes in almost all brain lobes.The cortical thicknesses of the left pars opercularis and left precuneus were significantly negatively correlated with Pittsburgh Sleep Quality Index scores.Additionally,we observed changes in the volume of the hippocampus and its subfield regions in COVID-19 patients compared with the healthy controls.The 3-month follow-up data revealed indices of altered cerebral structure(cortical thickness,cortical grey matter volume,and cortical surface area)in the frontal-parietal cortex compared with the baseline in COVID-19 patients with sleep disturbances.Our findings indicate that the sleep disturbances patients had altered morphology in the cortical and hippocampal structures during the acute phase of infection and persistent changes in cortical regions at 3 months post-infection.These data improve our understanding of the pathophysiology of sleep disturbances caused by COVID-19.
