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@#Objective To explore the risk factors and predictive value of acute kidney injury (AKI) after total aortic arch replacement. Methods The clinical data of patients undergoing total aortic arch replacement in our hospital from January 2018 to June 2019 were retrospectively analyzed, and patients receiving preoperative renal replacement therapy and missing creatinine values were excluded. According to whether postoperative AKI occurred, patients were divided into an AKI group and a control group. The univariate and multivariate analyses (logistic regression) were used to explore the independent risk factors of AKI. The receiver operating characteristic curve was used to analyze the significant factors in predicting the occurrence of AKI after total aortic arch replacement. Results A total of 162 patients were included in the study, including 135 (83.3%) males and 27 (16.7%) females, with an average age of 52.61±9.90 years (range: 22 to 73 years). The incidence of AKI was 68.5% (n=111). The results of univariate and multivariate analyses showed that the postoperative serum cystatin C level (OR=76.145, 95%CI 15.575-372.260, P<0.01) was an independent risk factor for AKI after total aortic arch replacement. When its cut-off value was above 1.08 mg/L, the specificity for predicting postoperative AKI was 70.59%, and the sensitivity was 85.59%. Conclusion The postoperative cystatin C level is an independent risk factor for AKI after total aortic arch replacement and has predictive value.
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Objective To evaluate the postoperative efficacy and safety of dexmedetomidine for cardiac surgery patients in intensive care unit. Methods A total of 90 cardiac surgery patients in the intensive care unit (ICU)were randomly assigned into dexmedetomidine group(D group,45 cases)and propofol group(P group,45 cases)to receive dexmedetomidine or propofol respectively for post-operative sedation. The ratio of sedation satisfac-tion was evaluated and calculated by Riker sedation-agitation scale(SAS),and the duration of mechanical ventila-tion,24-hour consumption of sufentanil,ICU staying time,and the incidences of side-effects(such as hypoten-sion,bradycardia,delirium etc)were recorded during the observation period. Results No significant differences were found in the ratio of sedation satisfaction and the incidences of bradycardia and delirium between the two groups (P > 0.05). The duration of mechanical ventilation and ICU staying time were significantly shorter in D group than that in P group(P<0.01),while the 24-hour consumption of sufentanil and the incidences of hypoten-sion and delirium were significantly lower than that in P group(P<0.05). Conclusion Using the dexmedetomi-dine as a postoperative sedation drug for post cardiac surgical patients in ICU is clinically effective and safe ,and the postoperative recovery of patients may be enhanced by the drug using.
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Objective To study the effects of remifentanil with propofol and no positive pressure ventilation induction of anesthesia in 5 minutes-cesarean section on parturients and neonates. Methods Sixty pregnant women were randomly divided into ketamine anesthesia group (group L) and remifentanil anesthesia group (group R).In group L,anaesthesia was induced with ketamin 0.5 mg/kg+propofol 2 mg/kg and group R with remifentanil 1 μg/kg+propofol 2 mg/kg.Blood pres-sure,heart rate,oxygen saturation and pulse rate of maternal were recorded at intubation (T1 ),inci-sion (T2 ),and cutting the umbilical cord (T3 ).The infant Apgar scores at 1 minute and 5 minute af-ter birth,the delivery time of the fetus and umbilical blood gas values were recorded.Results The systolic blood pressure (SBP)and heart rate (HR)were significantly higher at T1 and T2 in group L than those in group R (P <0.05).The SBP,DBP and HR had not significant difference at T3 .The delivery time of the fetus and the infant Apgar scores at 1 minute and 5 minute between the two groups had no statistically significant differences.Conclusion Remifentanil combined with propofol and without positive pressure ventilation induction of anesthesia can be safely used in 5 minutes-cesar-ean section.The maternal hemodynamics is more stable without increasing the risk of neonatal respira-tory depression.
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Objective To analyze the coincidence situation of the results of neonatal ABO blood group reciprocal stereotypy with crossmatching test of allotype blood and to investigating the limitations of cross-matching test in infant blood transfusion and effec-tive measures for ensuring the neonatal safe blood transfusion.Methods The micro-column gel test was adopted to identify the ABO blood group and conduct the crosshatching test of allotype blood in 1 095 cases of neonatal blood samples.Results Among the 1 095 samples,the detected rates of weak A and weak B antigen were 3.99% and 17.93% respectively,and the weak B antigen was predominant.The negative rates of anti-A and anti-B antibody were 53.72% and 60.70% respectively;in the cross-matching test with allotype blood,the main side without appearing agglutination accounted for 52.87% and weak agglutination accounted for 33.27%,and the secondary side appearing weak agglutination accounted for 9.49%.Conclusion The maturity of antibody and an-tigen and the coincidence rates of group typing and reciprocal stereotypy in the newborns are less than those in the adults;so blood transfusion according to the cross-matching test results has certain limitation;high attention should be paid to the accuracy of neo-natal ABO blood type,the individual blood transfusion strategy in the newborn should be determined in order to avoid hemolytic blood transfusion reaction caused by ABO allotype blood transfusion and ensure the blood transfusion safety in newborns.
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Objective To investigate the incidence of poverty ,population carrying rate and its genetic type through the thalasse‐mia screening analysis of 2 650 cases of childbearing women .Methods Hematologic examination and hemoglobin electrophoresis were applied in people who were laboratory tested the crowd ,screening suspected people ,then use the genetic analysis confirm the diagnoses .Results Preliminary screening of the 536 cases which were suspected the thalassemia (or gene carriers) ,hematologic ex‐amination showed that the red blood cells ,reticulocyte counts in the cases were significantly higher than those in the controls ;and hemoglobin ,mean corpuscular volume (MCV)and mean corpuscular hemoglobin (MCH) were significantly lower .Hemoglobin elec‐trophoresis test showed that in 512 abnormal cases ,68 cases were diagnosed as α thalassemia and 438 cases were β thalassemia(506 cases in total ,accounting for 19 .09% of the total number) .In this area ,Southeast Asia(SEA) heterozygotes(‐SEA /αα) ,right hetero‐zygotes(‐α3 .7 /αα) ,left heterozygotes(‐α4 .2 /αα) ,Hb Constant Spring(‐αCS /αα) were common type of α thalassemia ;CD41‐42 hetero‐zygotes ,CD17 heterozygotes ,CD71‐72 heterozygotes and CD28 heterozygotes were common type of β thalassemia .Conclusion In Guangxi ,there was high incidence rate of thalassemia ,thus ,though premarital and prenancy anterior screening ,guide the rational marriage and pregnancy ,and through the crowd to intervene to prevent common human monogenic death and disabling genetic dis‐orders are of great importance for prepotency promotion and population quality improve .
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OBJECTIVE: To optimize the microwave-assisted extraction of total organic acids from Isatis indigotica. METHODS: With the dissolution rate of total organic acids as indexes, the content of total organic acids was determiend by acid-base titration and the three main factors including volume of solvent, microwave power and extraction time in the extraction process were optimized by orthogonal test. RESULTS: The optimal extraction process is to add 15 times amount of water and extract at a microwave power of 522 W for 20 minutes. Under the above condition, the extraction rate was 4.83%, close to the extraction yield achieved by water decoction for 2 h. CONCLUSION: The microwave-assisted extraction of total organic acids from Radix Isatidis is characterized by rapid, simple, efficient and energy-saving etc, thus deserving to be be popularized.
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OBJECTIVE:To establish TLC identification for Niuhuang xiaoyanling capsule.METHODS:Beisisu,a characteristic chemical constituent in Niuhuang xiaoyanling capsule,was identified by two different TLC methods.RESULTS:The test sample was similar to reference substance in that the TLC spots at the corresponding place were of the same color.CONCLUSION:The method is simple,rapid,reproducible and specific,and it can be used for the quality control of Niuhuang xiaoyanling capsule.