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Objective:To evaluate the relationship between the development of postoperative delirium and sleep quality in elderly patients undergoing non-cardiac surgery.Methods:The medical records of elderly patients who underwent elective non-cardiac surgery from May 2011 to November 2013, aged ≥ 65 yr, with American Society of Anesthesiologists physical status Ⅱ or Ⅲ, were collected. The patient′s age, gender, body mass index, years of education, preoperative comorbidities, and results of the last preoperative laboratory examination; sedatives given at the night before surgery, anesthesia methods, intraoperative medication, anesthesia time, surgical time, surgical type, whether it was a malignant tumor, and intraoperative intake and output; postoperative analgesia methods, subjective sleep quality scores and postoperative delirium were collected.The patients were divided into delirium group and non-delirium group according to whether delirium occurred on the morning of 1st postoperative day and later. Multivariable logistic regression analysis was used to determine the risk factors for postoperative delirium and evaluate the relationship between postoperative delirium and sleep quality.Results:A total of 700 patients were ultimately enrolled, and 111 patients developed delirium, with an incidence of 15.9%.The results of multivariable logistic regression analysis showed that poor sleep quality on the night of surgery, advanced age, previous stroke history and postoperative intensive care unit admission of patients with catheters were risk factors for postoperative delirium ( P<0.05). Conclusions:Poor sleep quality on the night of surgery, advanced age, previous stroke history and postoperative intensive care unit admission of patients with catheters are the risk factors for postoperative delirium.
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Platelets transfusion is one of the most important methods to prevent and treat hemorrhagic diseases.At present, the vitro storage of platelets with gentle agitation at (22±2)℃ is short and susceptible to bacterial contamination, which greatly affects the availability and safety of clinical platelets transfusion.Studies at home and abroad have shown that storage at 4°C could prolong the preservation period of platelets.However, refrigeration may aggravate platelets storage lesion (PSL) and accelerate the clearance mechanism after transfusion, which seriously restricts the clinical application of refrigerated platelets.This paper reviews the research advances in PSL caused by 4℃ storage and the clearance mechanism after transfusion.
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ObjectiveTo establish a traditional Chinese medicine （TCM） syndrome model with yin deficiency and internal heat， discuss the rationality of model evaluation， and analyze differentially expressed genes in multiple dimensions to explore the molecular mechanism-signaling pathways as well as key targets of Baihe Dihuangtang （BHDH） in treating depression with Yin deficiency and internal heat. MethodForty male SD rats were randomly divided into a blank control group，a model group，a fluoxetine group （positive drug），a BHDH group， and a Zhibai Dihuangtang group （positive drug for Yin deficiency and internal heat）. The depression model with Yin deficiency and internal heat was induced by chronic unpredictable mild stress （CUMS）combined with Chinese herbal drugs with warm and heat nature. The model established was comprehensively evaluated by the detection of the basic condition， behavioral performance， and biochemical indicators of rats in each group. The differentially expressed genes were screened out by mRNA sequencing and underwent Gene Ontology（GO） and Kyoto Encyclopedia of Genes and Genomes（KEGG） pathway enrichment analyses. The protein-protein interaction （PPI） network was plotted and key genes were analyzed to explore the underlying mechanism of BHDH in treating depression with Yin deficiency and internal heat. ResultThe comparison of basic conditions， behavioral assays， energy metabolism， endocrine hormones， cytokines， and neurotransmitters showed that the model was properly induced. BHDH could significantly improve depression with Yin deficiency and internal heat by regulating the pathways related to the nervous system， endocrine system， and inflammatory and immune system. The key genes of the PPI network were Fos， Epha8， Npy2r， Htr2c， and Nr4a1. ConclusionUnder the guidance of TCM theories of treatment based on syndrome differentiation and etiology and pathogenesis，this study established a depression model with yin deficiency and internal heat in animals and evaluation system in accordance with the symptoms and signs of emotional diseases， and further confirmed the scientificity of the modeling method and the underlying mechanism of BHDH in interfering with depression with Yin deficiency and internal heat based on the results of mRNA sequencing.
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From August 1st to 7th, 2017, the breastfeeding knowledge of medical staff were collected from 52 medical health institutions in 29 provinces through a network system. A total of 35 243 questionnaires were included in the study to analyze the current status of breastfeeding knowledge and related factors. The qualified rate of breastfeeding knowledge questionnaires for medical staff in this study was 75.3% (26 546/35 243). Compared with those in the eastern region and those who were mothers, the qualified rate of breastfeeding knowledge of medical staff in the central region or the western region and medical staff who were fathers or expectant parents was lower, with OR (95%CI) values about 0.71 (0.67-0.75), 0.66 (0.61-0.72), 0.63 (0.55-0.72) and 0.87 (0.80-0.95), respectively. Compared with those attaining high school education or below and those with children aged<1 month, the qualified rate of breastfeeding knowledge was higher in medical staff with bachelor′s degree, graduate degree or above, and with children aged 1-5, 6-23 and ≥24 months, with OR (95%CI) values about 1.92 (1.80-2.05), 2.16 (1.94-2.42), 2.28 (1.93-2.70), 2.41 (2.06-2.83) and 1.99 (1.72-2.32), respectively.
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Autism spectrum disorders(ASDs)refers to a wide variety of complex developmental disor-ders that typically present deficits in social communication and restricted patterns of behavior.Families of indi-viduals with ASDs often face stress from various aspects because of the early symptoms,poor prognosis and spe-cial forms.The source of parents'psychological stress is universal and multidimensional.Adverse psychological stress will affect the physical and mental health of parents,which produces negative attitude.Domestic and for-eign scholars have to be concerned about this particular population and have conducted a systematic study of psy-chological stress of them.This article will describe the levels of stress,stressors and coping strategies of families of individuals with ASDs,to provide implications and recommendations for future research,to improve the status of psychological stress ASDs parents,and to improve the quality of life of children and their parents.
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AIM:To investigate the clinical effect of anti-vascular endothelial growth factor (VEGF) drugs combined with laser photocoagulation for diabetic macular edema (DME).METHODS: Totally 94 patients (141 eyes) with DME from June to December 2015 in our hospital were selected and randomly divided into combined group of 47 cases (68 eyes, ranibizumab combined with laser therapy) and the control group of 47 cases (73 eyes, laser treatment).The levels of best corrected visual acuity (BCVA), macular central retinal thickness (CRT), total macular volume (TMV) and macular edema level were compared between the two groups at different time after treatment.RESULTS: The mean values of BCVA in the combined group were higher than those in the control group at 2, 6 and 12wk, and the difference was statistically significant (P<0.05).At 2, 6 and 12wk after treatment, the CRT and TMV values of the combined group were lower than those of the control group, the difference was statistically significant (P<0.05).After treated for 12wk, patients with macular edema of combined group was 80.9% in mild level, 17.7% in moderate level, 1.5% in severe level, those of the control group was 60.0%, 31.5%, 5.5%, the difference between the two groups was statistically significant (P<0.05).CONCLUSION: The effect of anti-VEGF drugs combined with laser therapy for DME patients is better than that of single laser therapy alone.
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Objective To investigate the efficacy of intermittent epidural bolus ( IEB) for patient?controlled epidural analgesia ( PCEA) during delivery. Methods Eighty?five parturients requesting epi?dural analgesia, who were at full term ( 37-42 weeks of gestation) with a singleton fetus in vertex presenta?tion, of American Society of Anesthesiologists physical statusⅠorⅡ, with body mass index0.05) . Conclusion IEB can be safely and effectively used for PCEA during deliver?y, and the efficacy is better than that of CEI in the parturients.
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Objective:To investigate the expression and its possible role of Oct4B1 subtype of Embryonic stem cell transcription factor Oct4 in colorectal cancer stem cells. Methods: 3D microspheres were cultured by suspension culture to human colorectal cancer cell line SW480 cells. The 3D microspheres and SW480 cells were used as the research objects. Whether 3D microspheres were enriched cancer stem cells,we used the methods of cell differentiation experiments,soft agar cloning experiments,and the expression levels of cancer stem cells markers CD133,CD44 detected by flow cytometry. The expression levels of Oct4B1 mRNA were detected by RT-qPCR. Results:3D microspheres could differentiate into normal cancer cells. Compared with the parental SW480 cells,in vitro colony formation was significantly enhanced(P<0. 01),the percentage of positive cells of CD133 and CD44 were significantly increased ( P < 0. 01 ), the expression levels of Oct4B1 mRNA were obviously higher ( P < 0. 01 ) in 3D microspheres. Conclusion: Oct4B1 subtype of Embryonic stem cell transcription factor Oct4 in 3D microspheres enriched human colorectal cancer stem cells,which may be involved in the regulation of colorectal cancer stem cells.
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OBJECTIVE: To observe the effect and safety of exenatide therapy in type 2 diabetes patients with failure to metformin. METHODS: Sixty patients with type 2 diabetes who did not achieve satisfactory blood glucose control were randomly assigned either to add exenatide or glargine. postprandial blood glucose, HbA1C, blood lipid, and body mass index of the patients before and after treatment were recorded, and the side effects were also recorded for 52 weeks. RESULTS: The FPG and HbA1C of patients decreased more significantly after exenatide therapy than glargine treatment (P<0.05). The exenatide group had a significantly higher level of ΔHOMA-13 than the glargine group. CONCLUSION: Exenatide can be used for long-term control of blood glucose with improving lipid metabolism and low occurrence of hypoglycemia, without increasing body weight.
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Objective To evaluate the effects of different storage periods at room temperature on domestic cisatracurium-induced neuromuscular (N-M) block.Methods One hundred and twenty ASA Ⅰ or Ⅱ patients,aged 18-64 yr,scheduled for elective operations under general anesthesia,were randomly divided into 3 groups (n =40 each):cisatracurium stored for 60 days at 4-8 ℃ group (group LT),cisatracurium stored for 30 days at room temperature group (group RT30) and cisatracurium stored for 60 days at room temperature group (group RT60).Anesthesia was induced with iv injection of midazolam and target-controlled infusion of propofol (target plasma concentration 3 μg/ml) and remifentanil (target effect-site concentration 3-5 ng/ml).A bolus of cisatracurium 0.2 mg/kg was given intravenously over 5-10 s as soon as the patients lost consciousness.N-M block was monitored with TOF-Watch SX (Organon,Netherlands).Single stimulation was applied to the ulnar nerve at wrist.The maximal degree of N-M block,onset time,clinical duration,recovery index and 75 ％ recovery time were recorded.The patients were intubated and mechanically ventilated when N-M block reached the maximal degree.The intubation condition was evaluated.Hypotension,bradycardia and skin allergy were recoded.Results Compared with group LT,no significant change was found in the onset time,clinical duration,recovery index and 75％ recovery time in group RT30 (P ＞ 0.05),and the onset time was significantly prolonged,clinical duration and 75％ recovery time were shortened in group RT60 (P ＜ 0.05).The onset time was significantly longer and clinical duration was shorter in group RT60 than in group RT30 (P ＜ 0.05).The intubation condition was excellent or good in the three groups and there was no significant difference among the three groups.There was no significant difference in the incidence of hypotension and bradycardia among the three groups (P ＞ 0.05).No patients developed skin allergy.The maximal degree of N-M block was 100％ in groups LT,RT30 and RT60 except one case with 95％ in group RT60.Conclusion No significant change is found in the N-M block induced by domestic cistracurium when stored for 30 days at room temperature,however,the N-M block is significantly attenuated when stored for 60 days at room temperature.
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<p><b>OBJECTIVE</b>To explore the impact of inflammation, water metabolism and immune function on the establishment of a mouse model of damp-heat syndrome with MHV-A59 infection.</p><p><b>METHODS</b>Twenty-four mice were randomly divided into control group, virus group, damp-heat group and model group. The peripheral blood CD4(+) and CD8(+) lymphocytes were detected by flow cytometry, and the serum levels of IFN-γ and IL-4 were assayed by ELISA. The expressions of NF-κB and AQP4 in the liver and stomach were determined using immunohistochemistry.</p><p><b>RESULTS</b>The expression of NF-κB and CD4(+)/CD8(+) ratio in the virus and model groups were significantly higher than those in the damp-heat and control groups, while the expression of AQP4 was significantly higher in the model and damp-heat groups than in the other groups. Compared with the control group, the model group showed a significantly higher ratio of IFN-γ/IL-4.</p><p><b>CONCLUSIONS</b>MHV-A59 virus is the main cause of elevated NF-κB expression and CD4(+)/CD8(+)/ ratio, while damp-heat syndrome is responsible for increased AQP4 expression, and their synergistic effect results in increased IFN-γ/IL-4 ratio. The mouse model established using MHV-A59 virus and the damp-heat factors can mimic damp-heat syndrome described in traditional Chinese medicine theory.</p>
Subject(s)
Animals , Male , Mice , Aquaporin 4 , Metabolism , CD4-CD8 Ratio , Disease Models, Animal , Hepatitis, Viral, Animal , Diagnosis , Virology , Interferon-gamma , Blood , Interleukin-4 , Blood , Medicine, Chinese Traditional , Mice, Inbred BALB C , Murine hepatitis virus , NF-kappa B p50 Subunit , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To establish a method for detecting the fingerprint of Radix Astragali by RRLC-UV-MS.</p><p><b>METHOD</b>Separation was performed on an Agilent Zorbax Extend C18 column (2.1 mm x 100 mm, 1.8 microm). Gradient elution was performed by the mobile phases consisting of acetonitrile and 0.1% formic acid with the flow rate of 0.3 mL x min(-1), the detection wavelength was set at 254 nm, and the column temperature was 30 degrees C.</p><p><b>RESULT</b>The method of fingerprint analysis on Radix Astragali by RRLC-UV-MS was established. Eleven samples of Radix Astragali were analyzed, the similarities were over 0.92, and seven peaks in the fingerprint were designated.</p><p><b>CONCLUSION</b>The method can be applied to the quality control and studies on chemical constituents of Radix Astragali.</p>
Subject(s)
Astragalus Plant , Chemistry , Benzoates , Chromatography, High Pressure Liquid , Methods , Drugs, Chinese Herbal , Chemistry , Plant Extracts , Chemistry , Plant Roots , Chemistry , Spectrometry, Mass, Electrospray Ionization , MethodsABSTRACT
<p><b>OBJECTIVE</b>To investigate the correlation between ABO blood type gene and attention-deficit hyperactivity disorder (ADHD) in children.</p><p><b>METHODS</b>ABO blood types were determined using glass sheet method in 96 children with ADHD and their parents. O gene was identified using polymerase chain reaction and restriction fragment length polymorphism in patients with A or B blood type. Haplotype-based haplotype relative risk (HHRR), transmission-disequilibrium test (TDT) and Chi-square test were used to examine the association between ABO gene and ADHD.</p><p><b>RESULTS</b>TDT results showed significant differences in the allele of ABO between the 96 children with ADHD and within-family controls (chi2=6.017, df=2, P< 0.05). Chi-square test results showed differences in the allele of A and B (chi2=3.289, df=1, P=0.07) as well as O and B (chi2=3.629, df=1, P=0.057 ) between ADHD children and within-family controls. The frequencies of O and A genes were higher than that of B gene in ADHD children.</p><p><b>CONCLUSIONS</b>There was correlation between ABO blood type gene and ADHD in children. The risk of ADHD is increased in the presence of alleles O and A, but the risk is reduced in the presence of allele B.</p>
Subject(s)
Adolescent , Child , Female , Humans , Male , ABO Blood-Group System , Genetics , Alleles , Attention Deficit Disorder with Hyperactivity , Blood , Genetics , HaplotypesABSTRACT
<p><b>OBJECTIVE</b>To study the antiviral constituents in the stems and leaves of Pithecellibium clypearia.</p><p><b>METHOD</b>The constituents of P. clypearia were systematically separated with various chromatographic techniques in combination with antiviral activity monitoring. Their structures were elucidated by physical and chemical properties and spectral data.</p><p><b>RESULT</b>Six compounds were isolated from P. clypearia and were identified as: tricetiflavan (5, 7, 3', 4', 5'-pentahydroxylflavan) (1), myricitrin (myricetin-3-O-alpha-L-rhamnopyranoside) (2), quercitrin (quercetin-3-O-alpha-L-rhamnopyranoside) (3), quereetin (4), methyl gallate (5) and gallic acid (6).</p><p><b>CONCLUSION</b>Compound 1 approximately 5 were obtained from this plant for the first time. Compound 4 was found to show an obvious anti-respiratory syncytial virus (RSV) activity.</p>
Subject(s)
Antiviral Agents , Chemistry , Pharmacology , Fabaceae , Chemistry , Flavonoids , Chemistry , Pharmacology , Gallic Acid , Chemistry , Pharmacology , Inhibitory Concentration 50 , Plant Leaves , Chemistry , Plant Stems , Chemistry , Plants, Medicinal , Chemistry , Quercetin , Chemistry , Pharmacology , Respiratory Syncytial VirusesABSTRACT
<p><b>OBJECTIVE</b>To investigate the effects, side-effects and security of bupivacaine, ropivacaine combined with fentanyl in postoperative continuous epidural analgesia.</p><p><b>METHODS</b>A total of 1 600 postoperative continuous epidural analgesia patients receiving different agents in SICU were divided into two groups: 0.1% bupivacaine +5 microg/ml fentanyl group (group B, n = 920) and 0.2% ropivacaine +2 microg/ml fentanyl group (group R, n = 680). The effects (visual analog-scale score and content to analgesia), side effects were analyzed retrospectively in the two groups.</p><p><b>RESULTS</b>Compared with group B, patients in group R had higher analgesia contentment (P < 0.05), but no difference in visual analog-scale score was found in the two groups. The incidences of urinary retention, nausea and vomiting, skin itching in group B were significantly higher than those in group R (P < 0.05). In each group, patients over sixty had higher ratio of hypotension than those under sixty (P < 0.05); The female patients had a higher incidence of nausea and vomiting than male patients (P < 0.05); The incidence of debility and numbness of lower limbs in patients with lumbar segments epidural analgesia was higher than those with thoracic analgesia (P < 0.05).</p><p><b>CONCLUSIONS</b>0.1% bupivacaine +5 microg/ml fentanyl and 0.2% ropivacaine +2 microg/ml fentanyl can provide adequate pain relief in postoperative continuous epidural analgesia, and 0.2% ropivacaine +2 microg/ml fentanyl comes with less side effects. The incidence of complication is related with analgesics, age, gender and the position of epidural puncture.</p>