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简介：AbstractBackground:Ophthalmic ambulatory surgery is preferred to be performed under general anesthesia either by total intravenous anesthesia (TIVA) or by inhalational anesthesia to increase the patient comfort. However, anesthesia-controlled time (ACT) can cause increased non-operative operating room (OR) time which may adversely affect the ORs efficiency. This study was aimed to compare the ACT of desflurane with that of propofol-remifentanil in strabismus ambulatory surgery.Methods:From November 2016 to December 2017, a total of 200 strabismus patients (aged 18-60 years old, and scheduled for elective ambulatory surgery at Zhongshan Ophthalmic Center) were randomly assigned to receive either propofol-based TIVA (group TIVA) or desflurane anesthesia (group DES) for maintenance of anesthesia. The primary outcome was the extubation time. Secondary outcomes included surgical time, anesthetic time, OR exit time, and Phase I and II recovery time. The intraoperative incidences of hypotension, bradycardia and oculocardiac reflex (OCR), and the incidences of any post-operative complications were recorded. Mann-Whitney U test and Chi-square or Fisher exact tests were used to compare the two groups.Results:We found that the extubation time (5.5 [3.9-7.0] vs. 9.7 [8.5-11.4] min, P < 0.001) and the incidence of prolonged time to extubation (0 vs. 6%, P = 0.029) in the DES group were significantly decreased compared with those in the TIVA group. The patients in the DES group displayed shorter OR exit time as compared with that in the TIVA group (7.3 [5.5-8.7] vs. 10.8 [9.3-12.3] min, P < 0.001). The patients using desflurane exhibited more stable hemodynamics during surgery than the patients using propofol-based TIVA, as demonstrated by lower incidences of hypotension (1% vs. 22%, P < 0.001), bradycardia (2% vs. 13%, P = 0.002), and OCR (17% vs. 44%, P < 0.001).Conclusion:DES enhanced the ophthalmic OR efficiency by reducing the extubation time and OR exit time, and provided more stable hemodynamics intra-operatively than TIVA in patients undergoing strabismus ambulatory surgery.Trial registration:ClinicalTrials.gov, No. NCT02922660; https://clinicaltrials.gov/ct2/show/NCT02922660?id=NCT02922660&draw=2&rank=1

简介：ForumofAnesthesiaandMonitoringisoneoftheleadingpublicationsforthespecialtiesofAnesthesia,IntensiveCareandPaininChina,sponsoredbyBeijingCommitteeofAnesthesiologistsofChineseMedicalAssociationandMedicalInformationLimited.Publishedsince1993,itiswidelyregardedasthepopularscientificjournalinthespecialty.Thisisevidencednotjustbyitscirculation,butbyitsinfluencestotheyounganesthetistsinChina.

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简介：StabilizedorChebyshevexplicitmethodshavebeenwidelyusedinthepasttosolvestiffordinarydifferentialequations.MakinguseofspecialpropertiesofChebyshev-likepolynomials,thesemethodshavefavorablestabilitypropertiescomparedtostandardexplicitmethodswhileremainingexplicit.Anewclassofsuchmethods,calledROCK,introducedin[Numer.Math.,90,1-18,2001]hasrecentlybeenextendedtostiffstochasticdifferentialequationsunderthenameS-ROCK[C.R.Acad.Sci.Paris,345(10),2007andCommun.Math.Sci,6(4),2008].InthispaperwediscusstheextensionoftheS-ROCKmethodstosystemswithdiscretenoiseandproposeanewclassofmethodsforsuchproblems,theT-ROCKmethods.Onemotivationforsuchmethodsisthesimulationofmulti-scaleorstiffchemicalkineticsystemsandsuchsystemsarethefocusofthispaper,butournewmethodscouldpotentiallybeinterestingforotherstiffsystemswithdiscretenoise.TwoversionsoftheT-ROCKmethodsarediscussedandtheirstabilitybehaviorisanalyzedonatestproblem.ComparedtotheT-leapingmethod,asignificantspeed-upcanbeachievedforsomestiffkineticsystems.Thebehavioroftheproposedmethodsaretestedonseveralnumericalexperiments.

简介：Withtheadventofmoderntechniques,drugs,andmonitoring,generalanesthesiahascometobeconsideredanunlikelycauseofharm,particularlyforhealthypatients.Whilethisislargelytrue,newlyemergingclinicalandlaboratorystudieshavesuggestedthatexposuretoanestheticagentsduringearlychildhoodmayhavelong-lastingadverseeffectsoncognitivefunction.Thisconcernhasbeenthefocusofintensestudyinthefieldof

简介：AbstractTonsillectomy with and without adenoidectomy is a frequently performed surgical procedure in children. Although a common procedure, it is not without significant risk. It is critical for anesthesiologists to consider preoperative, intraoperative, and postoperative patient factors and events to optimize safety, especially in young children. In the majority of cases, the indication for adenotonsillectomy in young children is obstructive breathing. Preoperative evaluation for patient comorbidities, especially obstructive sleep apnea, risk factors for a difficult airway, and history of recent illness are crucial to prepare the patient for surgery and develop an anesthetic plan. Communication and collaboration with the otolaryngologist is key to prevent and treat intraoperative events such as airway fires or hemorrhage. Postoperative analgesia planning is critical for safe pain control especially for those patients with a history of obstructive sleep apnea and opioid sensitivity. In young children, it is important to also consider the impact of anesthetic medications on the developing brain. This is an area of continuing research but needs to be weighed when planning for surgical treatment and when discussing risks and benefits with patients’ families.

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简介：Inthispaper,standardandeconomicalcascadicmultigridmethodsareconsideredforsolvingthealgebraicsystemsresultingfromthemortarfiniteelementmethods.Bothcascadicmultigridmethodsdonotneedfullellipticregularity,sotheycanbeusedtotacklemoregeneralellipticproblems.Numericalexperimentsarereportedtosupportourtheory.

简介：付春敏老师向我们推荐了这篇罗德尼·马丁有关教师在培养学生写作结构中促进思维能力发展的文章。在文中我们可以看到,以英文为母语的西方,教师更加着力于对学生的构思结构"大局"观的思维培养。文中对培养学生写作结构思维能力的剖析,望能对老师们的教育教学有所启示。

简介：BioscienceMethods(ISSN1925-1920)isanopenaccess,peerreviewedjournalpublishedonlinebyBioPublisher.Thejournalpublishesallthelatestandoutstandingresearcharticles,lettersandreviewsinallareasofbioscience,therangeoftopicsincluding(butarenotlimitedto)technologyreview,techniqueknow-how,labtool,statisticalsoftwareandknown

简介：BioscienceMethods(ISSN1925-1920)isanopenaccess,peerreviewedjournalpublishedonlinebyBioPublisher.Thejournalpublishesallthelatestandoutstandingresearcharticles,lettersandreviewsinallareasofbioscience,therangeoftopicsincluding(butarenotlimitedto)technologyreview,techniqueknow-how,labtool,statisticalsoftwareandknown

简介：BioscienceMethods(ISSN1925-1920)isanopenaccess,peerreviewedjournalpublishedonlinebyBioPublisher.Thejournalpublishesallthelatestandoutstandingresearcharticles,lettersandreviewsinallareasofbioscience,therangeoftopicsincluding(butarenotlimitedto)technologyreview,techniqueknow-how,labtool,statisticalsoftwareandknowntechnologymodification.Casestudiesontechnologiesforgenediscoveryandfunction

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简介：AbstractImportance:In children, anesthesia dosages are based on population pharmacokinetics and patient hemodynamics rather than patient-specific brain activity. Brain function is highly susceptible to the effects of anesthetics.Objective:The primary objective of this retrospective pilot study was to assess the prevalence of electroencephalography (EEG) burst suppression—a sign of deep anesthesia—in children undergoing general anesthesia.Methods:We analyzed EEG in patients aged 1-36 months who received sevoflurane or propofol as the primary anesthetic. Patient enrollment was stratified into two age groups: 1-12 months and 13-36 months. Burst suppression (voltage ≤ 5.0 mV, lasting > 0.5 seconds) was characterized by occurrence over anesthesia time. Associations with patient demographics and anesthetics were determined.Results:In total, 54 patients (33 males and 21 females) were included in the study [age 11.0 (5.0-19.5) months; weight 9.2 (6.5-11.0) kg]. The total prevalence of burst suppression was 56% (30/54). Thirty-three percent of patients experienced burst suppression during the surgical phase. The greatest proportion of burst suppression occurred during the induction phase. More burst suppression event occurrences (18/30) were observed in the patient under sevoflurane anesthesia (P = 0.024). Virtually all patients who received propofol boluses had burst suppression (P = 0.033). More burst suppression occurred in patients with hypotension (P < 0.001). During the surgical phase, a younger age was associated with more burst suppression (P = 0.002).Interpretation:EEG burst suppression was associated with younger age, inhalation anesthetics, propofol bolus, and lower arterial pressure.

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