ABSTRACT
Objective:To investigate the effect of ultrasound-guided early removal of indwelling catheter on recovery quality and catheter-related infection of patients with general anesthesia in post anesthesia recovery unit (PACU).Methods:From September 2019 to April 2020, 146 patients with gynecological benign diseases who underwent hysteroscopic surgery in the Department of Anesthesiology, Shenzhen Hospital of Southern Medical University were selected prospectively and randomly divided into two groups, with 4 cases excluded. The function of the bladder was evaluated by ultrasound in the anesthesia recovery room after operation. In the ultrasound group, 71 patients had no abnormality, and the catheter was removed after the residual urine of the bladder was drained. 71 patients in the control group were normal, and the catheter was removed 24 hours after operation. The residual urine volume, urine retention, incidence of restlessness, urinary tract infection rate, time to first walking and hospital stay were observed in the two groups after the first bladder emptying.Results:The incidence of agitation in PACU was 7.0%(5/71) in the ultrasound group and 22.5%(16/71) in the control group, with statistically significant difference ( P<0.01); the first postoperative walking time in the ultrasound group and the control group was statistically significant [(10.5±4.1)h vs (18.9±6.5)h, P<0.05]; the postoperative hospital stay in the ultrasound group and the control group was statistically significant [(3.2±1.3)d vs (5.1±2.5)d, P<0.05]. The incidence of urinary tract infection and urinary tract irritationin in ultrasound group was significantly lower than that in control group (1.4% vs 9.8%, 1.4% vs 14.0%, P<0.05). Conclusions:For uncomplicated patients after gynecological laparoscopic surgery, ultrasound evaluation of bladder function, extraction of residual urine immediately after the removal of catheter, is more conducive to the early recovery of patients than 24 hours after the removal of catheter.
ABSTRACT
Background@#This study aims to assess whether the TSI PortaCount (Model 8020) is a measuring instrument comparable with the flame photometer. This would provide an indication for the suitability of the PortaCount for determining the workplace protection factor for particulate filtering facepiece respirators. @*Methods@#The PortaCount (with and without the N95-Companion™) was compared with a stationary flame photometer from Moores (Wallisdown) Ltd (Type 1100), which is a measuring instrument used in the procedure for determining the total inward leakage of the particulate filtering facepiece respirator in the European Standard. Penetration levels of sodium chloride aerosol through sample respirators of two brands (A and B) were determined by the two measuring systems under laboratory conditions. For each brand, thirty-six measurements were conducted. The samples were split into groups according to their protection level, conditioning before testing, and aerosol concentration. The relationship between the gauged data from two measuring systems was determined. In addition, the particle size distribution inside the respirator and outside the respirator was documented. Linear regression analysis was used to calculate the association between the PortaCount (with and without the N95-Companion™) and the flame photometer. @*Results@#A linear relationship was found between the raw data scaled with the PortaCount (without N95-Companion™) and the data detected by the flame photometer (R2 = 0.9704) under all test conditions. The distribution of particle size was found to be the same inside and outside the respirator in almost all cases. @*Conclusion@#Based on the obtained data, the PortaCount may be applicable for the determination of workplace protection factor.
ABSTRACT
Objective To explore the synergism efficacy and mechanism of Warm Purgative and Strengthening Spleen (WPSS) therapy combined with antibiotics in the treatment of sepsis. Methods Thirty-two SPF Spargue-Dawley (SD) rats were used to replicate the rat sepsis model by cecum ligation perforation (CLP) method and equally divided into model control (MC) group, ceftriaxone group, Chinese herbal medicine (CHM) group and ceftriaxone +CHM group. Eight SD rats underwent sham surgery were used as a sham operation (Sham) group. Rats in Sham and MC groups were administered with 0.9% normal saline (NS) by intraperitoneal injection and gavage. Rats in CHM group were administered with modified Dahuang Fuzi Decoction (DFD, 8 mg/kg) by gavage + 0.9% NS by intraperitoneal injection, Bid. Rats in ceftriaxone group were administered with 0.9% NS by gavage and ceftriaxone (120 mg/kg) by intraperitoneal injection, Bid. Rats in ceftriaxone + CHM group were administered with modified DFD (8 mg/kg) by gavage and ceftriaxone (120 mg/kg) intraperitoneal injection, Bid. The drugs were given for 2 days. The mortality of rats in each group was observed after treatment. The intestinal flora changes and intestinal permeability [intestinal mucosa injury index (IMII), intestinal mucosa secretory immunoglobulin (sIgA), serum D-lactic acid, diamine oxidase (DAO) and sIgA] were detected. Meanwhile, the levels of serum inflammation indexes [lipopolysaccharide (LPS), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6)] were detected. Results ① Mortality: ceftriaxone+CHM group (25.0%) < CHM group (37.5%) and ceftriaxone group (37.5%) < MC group (50.0%), the differences between groups were statistically significant (all P < 0.05). ② 16S rDNA sequencing analysis: the ratio of Bacteroidetesin in MC group was lower than that in the Sham group [(24.36±7.15)% vs. (45.20±6.05)%], and the ratio of Proteobacteria in MC group was higher than that in Sham group [(10.03±7.55)% vs. (0.41±0.21)%]. The diversity of intestinal flora in ceftriaxone group was significantly lower than that in Sham and CHM groups (404.60±17.09 vs. 470.80±16.97, 469.20±14.59), the differences between groups were statistically significant (all P < 0.05). The principal component analysis (PCA) suggested that the composition of CHM group was closer to that of Sham group, which indicated that WPSS therapy could reduce intestinal flora disorders in rats with sepsis. ③The pathological changes of intestinal mucosa: light microscope showed the intestinal mucosa of Sham group was intact; the intestinal mucosa became thinner, and local inflammatory cells had infiltration in MC group. The thickness of intestinal mucosa in CHM, ceftriaxone and CHM+ceftriaxone groups was slightly thicker, and the infiltration of local inflammatory cells was less than that in MC group. The thickness of intestinal mucosa in CHM group and ceftriaxone+CHM group was slightly thicker than that in the ceftriaxone group, and the arrangement was more regular than that in MC group and ceftriaxone group.④Intestinal mucosa permeability and inflammatory state: IMII, D-lactic acid, DAO, LPS, TNF-α and IL-6 of rats in MC group were higher than those of rats in Sham group [IMII: 4.37±0.56 vs. 0.26±0.29, D-lactic acid (mg/L):12.35±0.83 vs. 7.30±1.29, DAO (kU/L): 2.16±0.43 vs. 0.32±0.06, LPS (kU/L): 0.663±0.012 vs. 0.095±0.003, TNF-α (μg/L): 251.03±82.69 vs. 52.15±6.25, IL-6 (μg/L): 160.50±4.77 vs. 54.30±3.36], while sIgA in MC group was lower than that in Sham group (mg/L: 11.57±0.17 vs. 26.76±1.99). IMII, D-lactic acid, DAO, LPS, TNF-α and IL-6 of rats in CHM, ceftriaxone and CHM+ ceftriaxone groups were significantly lower than those of rats in MC group, while sIgA in CHM, ceftriaxone and CHM+ceftriaxone groups were significantly higher than that of rats in MC group. The change of CHM+ceftriaxone group was more significant than those of CHM group and ceftriaxone group [IMII:1.78±0.23 vs. 1.96±0.62, 3.39±0.43, D-lactic acid (mg/L): 8.56±0.37 vs. 9.62±0.57,11.42±0.39, DAO (kU/L):1.14±0.12 vs. 1.72±0.24, 2.01±0.32, sIgA (mg/L): 25.34±1.49 vs. 23.99±7.85, 17.46±1.20, LPS (kU/L):0.302±0.007 vs. 0.387±0.004, 0.715±0.013, TNF-α (μg/L): 57.10±3.98 vs. 101.49±21.49, 141.91±20.20, IL-6 (μg/L): 93.71±2.39 vs. 87.12±7.31, 104.27±1.84]. Conclusion WPSS therapy may improve the efficacy of antibiotics in the treatment of sepsis by regulating the intestinal flora and reducing the intestinal mucosa permeability and inflammation level.