ABSTRACT
Objective To investigate effects of laryngeal mask ventilation combined with continuous nerve block analgesia versus the endotracheal intubation under general anesthesia on postoperative lung infection in elderly patients undergoing orthopedic surgery,so as to provide a theoretical basis for a reasonable anesthesia method.Methods A total of 180 elderly patients undergoing lower extremity orthopedic surgery at our hospital from January 2016 to December 2016 were enrolled and randomly divided into two groups.The control group (n =90) were treated with endotracheal intubation under general anesthesia and intravenous analgesia after the operation,and the observation group (n =90)received the ultrasound-guided continuous nerve block analgesia in spontaneous respiration with laryngeal mask ventilation.The anesthetic dosage,awakening time,visual analogue scale(VAS)scores,and incidence of lung infections at 7 days after surgery were compared between the two groups.Pathogenic strains causing lung infections were isolated and identified.Results The anesthetic dosage was lower in the observation group than in the control group(P ＜ 0.05).The awaking time was shorter in the observation group than in the control group[(22.4±4.4) min vs.(34.1±8.5)min,P ＜0.05].The VAS scores under postoperative exercise were lower in the observation group than in the control group(P ＜0.05).The adverse reaction rate after surgery was lower in the observation group than in control group(3.3％ or 3/90 cases vs.41.1％ or 37/90 cases,P ＜0.05).The incidence of lung infections at 7 days after surgery was lower in the observation group than in the control group(3.3％ or 3/90 cases vs.11.1％ or 10/90 cases,P＜0.05).Ten pathogenic strains were isolated from control group,of which 9 strains were gram-negative bacteria,accounting for 90.0％.Three pathogenic strains were isolated from the observation group,of which 2 strains were gram-negative bacteria,accounting for 66.7％.Conclusions Laryngeal mask ventilation combined with continuous nerve block analgesia can reduce the anesthetic dosage,shorten the awaking time,provide a better analgesic effect and decrease the incidence of lung infections in elderly patients undergoing lower extremity orthopedics.The main pathogenic bacteria are gram-negative bacteria.
ABSTRACT
Objective To understand the epidemiological characteristics and related risk factors on HIV,HBV infection of people from the southwest province of China and to provide basic data for the development of related strategies.Methods According to the information on current HIV epidemics,one township from the area was selected as the study field and all the adult population were surveyed using a questionnaire to collect social demographic data and information on infection-related factors.Results A total of 2 290 adults were investigated and data showed as follows:the average HIV infection rate as 7.9％,the average HBV infection rate as 3.1％,and the average HIV/HBV co-infection rate as 1.2％.As for HIV infection,people whose yearly family gross income between 1 000 and 3 000 Yuan (OR=0.28) or more than 5 000 Yuan (OR=0.14) were less likely to be infected with HIV than those people whose annual family gross income less than 1 000 Yuan.People with educational level of primary school and above were more likely to carry HIV than those who were illiterate (OR =3.28).People who had the history of migration were less likely to carry HIV than those who had not (OR=0.33).People who had the history of being drug abusers were more likely to infect HIV than those who had not (OR=46.32).People whose spouses had the history of using drugs were more likely to infect HIV than those who had not (OR=3.52).People whose spouses had been infected with HIV were more likely to infect HIV than those who had not (OR=9.56).As for HBV infection,people who had the history of migration were more likely to infect HBV (OR =2.48).As for HIV/HBV co-infection,people whose spouses had the history of HIV infection were more likely to infect HIV/HBV co-infection than others who did not have the history (OR=6.04).Conclusion There had been a serious HIV/AIDS epidemic in our study field.Other than taking measures as detection and vaccination on HBV,health education should be strengthened,together with measurements as needle exchange and methadone substitution therapy,to control the spread of AIDS.
ABSTRACT
Objective To understand the sensitivity of cytopathogenic effect (CPE) in MadinDarby canine kidney cells(MDCK) that cultured influenza A pharyngeal swab specimens of patients for one,two and three passages. Methods Influenza A pharyngeal swab specimens of patients were inoculated in MDCK for three blind passages. The presence of CPE of every passage was observed by inverted microscope. Results Of the 279 influenza A pharyngeal swab specimens of patients tested by colloidal gold, the presence of CPE in MDCK for one,two and three passages was 65.9%(184/279),91.4%(255/279) and 96.4%(269/279), respectively. Two hundred and seventy-one of 279specimens were identified as influenza A by multiplex reverse transcription-polymerase chain reaction (RT-PCR). Conclusion The positive separation rate can reach more than 95% by inoculating influenza A pharyngeal swab specimens of patients in MDCK for three blind passages.