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Background and purpose: Remimazolam is a newly developed benzodiazepine drug with water-soluble, esterase degradation, and ultra-short-acting properties. The dose for general anesthesia induction in obese patients was not known. This study aimed to determine the optimal dose of remimazolam in combination with sufentanil for the induction of general anesthesia in obese patients.Methods: It was a prospective observational study. We recruited 46 patients scheduled for bariatric surgery from October 2022 to December 2023. One patient refused to provide informed consent, and six patients were receiving psychotropic medication. Thirty-nine patients were enrolled. The Modified Observer’s Assessment of Alertness/Sedation (MOAA/S) scale was used to assess the patient’s response. The dose of sufentanil was 0.5 µg/kg (lean body weight [LBW]). The initial dose of remimazolam was 0.3 mg/kg (LBW). The dose of remimazolam was modified using the up-and-down allocation technique. Successful sedation (negative group) was characterized by achieving a MOAA/S score ≤ 1 within 3 min of commencing remimazolam infusion. If negative, the next patient received a low-level dose at a ratio of 0.9. Failed sedation (positive group) was defined as a MOAA/S score of >1 within 3 min of commencing remimazolam infusion. The patients in the positive group received propofol 0.5 mg/kg as a remedial measure, and the next dose was increased to a higher level. The primary outcome was to determine the half-effective dose (ED50) and 95% effective dose (ED95) of remimazolam in combination with sufentanil 0.5 µg/kg for induction in obese patients. The secondary outcome was to determine the occurrence of adverse effects such as hypotension, hypertension, and intraoperative awareness.Results: The ED50 and ED95 values of remimazolam (LBW) combined with sufentanil (0.5 µg/kg) (LBW) were 0.115 mg/kg (95% CI: 0.072–0.137) and 0.179 mg/kg (95% CI: 0.150–0.434), respectively, and the time of loss of consciousness in the negative group was 120.13 ± 25.03 s. The cardiovascular system was stable during the induction period. The incidence of post operative nausea and vomiting (PONV) was 38.5% in 39 patients. Respiratory depression, allergic reaction, intraoperative awareness, and delayed emergence were not observed in any patient.Conclusion: Remimazolam combined with sufentanil (0.5 µg/kg) (LBW) can be effectively used for general anesthesia induction in obese patients. The ED50 and ED95 values of remimazolam (LBW) were 0.115 mg/kg and 0.179 mg/kg, respectively.Clinical Trial Registration: www.chictr.org.cn, identifier ChiCTR2200065602.

In this study, micron-sized monodisperse SiO2 microspheres were used as sacrificial templates, and chitosan/polylactic acid (CTS/PLA) bio-microcapsules were produced using the layer-by-layer (LBL) assembly method. Microcapsules isolate bacteria from their surroundings, forming a separate microenvironment and greatly improving microorganisms’ ability to adapt to adverse environmental conditions. Morphology observation indicated that the pie-shaped bio-microcapsules with a certain thickness could be successfully prepared through LBL assembly method. Surface analysis showed that the LBL bio-microcapsules (LBMs) had large fractions of mesoporous. The biodegradation experiments of toluene and the determination of toluene degrading enzyme activity were also carried out under external adverse environmental conditions (i.e., unsuitable initial concentrations of toluene, pH, temperature, and salinity). The results showed that the removal rate of toluene by LBMs can basically reach more than 90% in 2 days under adverse environmental conditions, which is significantly higher than that of free bacteria. In particular, the removal rate of toluene by LBMs can reach four times that of free bacteria at pH 3, which indicates that LBMs maintain a high level of operational stability for toluene degradation. Flow cytometry analysis showed that LBL microcapsules could effectively reduce the death rate of the bacteria. The results of the enzyme activity assay showed that the enzyme activity was significantly stronger in the LBMs system than in the free bacteria system under the same unfavorable external environmental conditions. In conclusion, the LBMs were more adaptable to the uncertain external environment, which provided a feasible bioremediation strategy for the treatment of organic contaminants in actual groundwater.