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论文信息一

2020年8月7日，解放军总医院第一医学中心米卫东教授课题组在Experimental and Therapeutic Medicine （中科院四区，IF=2.7）期刊上在线发表论文，标题为 “Dexmedetomidine improves early postoperative neurocognitive disorder in elderly male patients undergoing thoracoscopic lobectomy” （右美托咪定改善老年男性胸腔镜肺叶切除术后早期神经认知障碍）。

通讯作者：中国人民解放军总医院麻醉手术中心Weidong Mi（音译 米卫东）

第一作者：内蒙古医科大学附属医院麻醉科Haixia Shi（音译 石海霞）

基金支持：本研究由国家自然科学基金资助（81371204和81471119）。

论文信息二

2020年12月31日，内蒙古医科大学附属医院石海霞、于建设教授课题组在Research Square平台上在线发表论文预印本，标题为“Effectiveness of Intraoperative Dexmedetomidine on Early Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Video-Assisted Thoracoscopic Lobectomy: A Randomized Controlled Trial”（右美托咪定对老年电视胸腔镜下肺叶切除术后早期认知功能障碍的疗效：一项随机对照试验）。

通讯作者：内蒙古医科大学麻醉科Haixia Shi（音译 石海霞）

第一作者：内蒙古医科大学麻醉科Na He（音译 何娜）

读者质疑

质疑一：

两篇论文的临床试验注册号相同，第一篇论文研究对象为106名男性，第二篇论文研究对象为男性和女性一共96名。

The first reports a study of 106 male subjects (53 per group) with outcomes Mini Mental State Exam (MMSE), Montreal Cognitive Assessment (MoCA) and Confusion Assessment Method (CAM).

The second reports of study of 96 male and female subjects (48 per group) with outcomes "POCD" (tests not defined) and plasma IL-6.

Both papers state the same ethics approval and clinical trial registration numbers. The clinical trial registration (https://www.chictr.org.cn/showproj.html?proj=18287) indicates it was to be a study in males only, makes no mention whatsoever of any cognitive assessments as outcomes, has BIS as the primary outcome (mentioned as an outcome in neither publication), includes ASA 1 and 2 patients (the papers only have ASA 2 and 3 subjects), has secondary outcomes IL-1beta, TNF-alpha and S100beta (doesn't mention IL-6 at all), and so on.

Can the authors please clarify, firstly, how two quite different studies (apparently different subjects) can be reported with the same ethics approval and clinical trial registration? And can the authors clarify why neither study is consistent with the clinical trial registration?

质疑二：

两篇论文的研究对象不同，但是统计数据惊人地相似。

Given these two papers describe different populations (all male in one, both male and female in the other, 53/group in one, 46/group in the other etc), can the authors please explain the extraordinary similarity between the demographic summary data?

质疑三：

两项研究的疼痛评分数据也基本相同。

Further, the pain scores presented for these two studies with different populations also appear to be in large part identical, with the exception of the integer part of the movement scores in one group (circled in dark blue here). Are the authors able to explain this extraordinary similarity?

质疑四：

作者使用的CAM的方法和结论有误。

Further, table 4 in this paper reports scores for the Confusion Assessment Method. CAM does not conventionally have a score. Can the authors please clarify how this score was derived and what version of the CAM they used?

In the Methods it is stated "POD was diagnosed when CAM <22", but delirium/confusion results in a higher number of positive responses to the features in CAM, not lower, so this statement is very confusing. Neither of the papers cited in support of this methodological statement say anything relevant to this. Can the authors also please clarify?

参考信息：

https://pubpeer.com/publications/8DFB6F002B66C99339E8A9696B3310

https://pubmed.ncbi.nlm.nih.gov/32855737/

https://www.researchsquare.com/article/rs-127973/v1

https://doi.org/10.3892/etm.2020.9113

https://www.chictr.org.cn/showproj.html?proj=18287

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