Search

Background Far from now, there is still a lack of studies on dexamethasone combined with ropivacaine for ultrasound-guided thoracic paravertebral block (TPVB). Our study aims to observe the analgesic effect of 0.2mg/kg dexamethasone combined with ropivacaine for TPVB on patients undergoing thoracoscopic lobectomy to evaluate postoperative analgesic effect of the compound and prgnosis of patients. Methods 92 patients who underwent thoracoscopic lobectomy from August 2020 to March 2021 were randomly divided into ropivacaine group (group R) and dexamethasone combined with ropivacaine group (group RD), 46 cases in each group. The group R was performed thoracic paravertebral block with 20ml 0.5% ropivacaine, then the group RD was injected with 20ml of 0.2mg/kg dexamethasone and 0.5% ropivacaine mixture, and general anesthesia induction was performed 30 minutes after the completion of thoracic paravertebral nerve block. The onset time and width of sensory block were observed and recorded. VAS scores were recorded at 1h(T1), 6h(T2), 12h(T3) and 24h(T4). Additional analgesic and sedative drugs for salvage use within 24 hours after operation were recorded. The preoperative fasting glucose level and the postoperative one-day fasting glucose level were recorded. The incidence of side-effects such as skin pruritus, nausea and vomiting were recorded. The extubation time of tracheal intubation and total hospital stay were recorded. Results There was no significant difference in the onset time and width of sensory block between the two groups(P > 0.05); The VAS scores at T1, T2, T3 and T4 in group RD were significantly lower than group R(P < 0.05); Compared with group R, the proportion of patients in group RD who received additional morphine rescue analgesia within 24 hours after operation was significantly lower(P P > 0.05); The incidence of postoperative nausea and vomiting was similar between the two groups(P > 0.05); There was no significant difference between the preoperative fasting blood glucose and the postoperative one-day fasting blood glucose in group R(P > 0.05); The fasting blood glucose showed an increase on the first day after operation than that before operation in group RD(P P P > 0.05). Conclusion 0.2mg/kg dexamethasone combined with ropivacaine for TPVB can significantly enhance the analgesic effect of ropivacaine in nerve blocks, provide effective and comprehensive postoperative analgesia for patients undergoing thoracoscopic lobectomy, shorten extubation of tracheal tube after operation, and with no increasing incidence of side effects, but exhibit rare influence on the extent of nerve block and total length of hospital stay. Clinical trial registration: No. ChiCTR2000033956, registrated at the Chinese Clinical Trial Registry, principal investigator: Xiaopei Gao, date of registration: 18/06/2020.

Although scholars and practitioners have highlighted the significance of students’ attitudes for their future employment, few empirical examinations have attempted to determine the potential association between students’ future orientation and their perceived employability. Thus, drawing on career construction theory, we test the positive effect of students’ future orientation on their perceived employability by exploring the mediator of problem-based learning and the moderators of job market knowledge and proactive personality. Collecting our data via a time-lagged design (N = 368), we have found that the positive association between future orientation and employability is mediated by problem-based learning. Our moderation analyses further revealed that job market knowledge positively moderates the relationship between future orientation and problem-based learning and that students’ proactive personality positively moderates the relationship between problem-based learning and perceived employability.

BACKGROUND: Currently, antireflux mucosectomy (ARMS) and Stretta radiofrequency (SRF) are the most commonly used minimally invasive antireflux therapies. To date, there have not been any reports comparing ARMS and SRF. Our aim was to compare the clinical efficacies of these two therapeutic methods. METHODS: We analyzed data from gastroesophageal reflux disease (GERD) patients, including 39 who received ARMS treatment and 30 who received SRF treatment between January 2020 and May 2021. Symptom control, gastroesophageal reflux disease questionnaire (GERDQ) score, gastroesophageal reflux disease health-related quality of life (GERD-HRQL) score, proton pump inhibitor (PPI) withdrawal, and PPI reduction were analyzed and compared. RESULTS: After 6 months of follow-up, the results showed that both therapies were effective in improving symptoms and quality of life. No difference was found between the ARMS group and SRF group in GERDQ score, GERD-HRQL score, PPI withdrawal rate, or PPI reduction rate (P>0.05). There was no significant difference in the PPI withdrawal rate between the two therapies among patients with gastroesophageal flap valve (GEFV) grade II and grade III (P>0.05), but the PPI withdrawal rate in the ARMS group was significantly higher than that in the SRF group among patients with GEFV grade IV (P