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Objective:To evaluate the effect of goal-directed fluid therapy (GDFT) based on permissive high stroke volume variation (SVV) guidance on residual liver function in elderly patients undergoing laparoscopic hepatectomy.Methods:A total of 100 elderly patients of either sex, aged 65-80 yr, with body mass index of 18.5-24.9 kg/m 2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with Child-Pugh grade A or B, scheduled for elective laparoscopic hepatectomy, were divided into 2 groups ( n=50 each) by the random number table method: SVV-guided GDFT group (group SG) and CVP-guided fluid replacement group (group C). Intraoperative fluid management was divided into 2 stages.The first stage was from the start of surgery to the completion of liver resection, the SVV was maintained at 13%-20% in group SG, and the low CVP was maintained at 0-5 cmH 2O in group C. The second stage was from completion of liver resection to the end of the operation, SVV was maintained at 9%-13%, additional hydroxyethyl starch 3 ml/kg was given or repeatedly administered when SVV>13% (for 5 min) or when the response to previous fluid replacement was positive (SVV increased by more than 10%), and the infusion rate was slowed down when the SVV was 9%-13% in group SG, and CVP was maintained at 5-12 cmH 2O in group C. Mean arterial pressure and heart rate were recorded on admission to the operating room, at skin incision (T 1), at the start of liver resection (T 2), at completion of liver resection (T 3) and at the end of operation (T 4). The operation time, intraoperative blood loss, transfusion volume, urine volume and levels of serum lactic acid before operation and at the end of operation were recorded.Blood samples from the median cubital vein were collected at T 0-4 to measure blood glucose and cortisol concentrations.The concentrations of serum aspartate aminotransferase, alanine aminotransferase, total bilirubin and albumin were measured before operation, at 1, 3 and 5 days after operation, and prothrombin time, activated partial thromboplastin time, thrombin time and Fib were recorded.The concentrations of serum interleukin-6, tumor necrosis factor-alpha and C-reactive protein were measured by enzyme-linked immunosorbent assay before operation and at the end of operation, and the postoperative complications and length of hospital stay were recorded. Results:Compared with group C, mean arterial pressure and heart rate were significantly decreased at T 2, 3, blood loss was reduced, transfusion volume and urine volume were increased, prothrombin time and activated partial thromboplastin time were shortened at the end of operation, serum concentrations of interleukin-6 and lactic acid and concentrations of aspartate aminotransferase and alanine aminotransferase in serum at 5 days after operation were decreased, and the length of hospital stay was shortened in group SG ( P<0.05). Conclusions:GDFT based on permissive high SVV guidance can improve residual liver function in elderly patients undergoing laparoscopic hepatectomy.
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Objective:To learn about the status of thyroid function and intelligence quotient (IQ) of children in areas with different iodine nutrition levels in Xinjiang Uygur Autonomous Region, and to explore the health risk of children with median urinary iodine of 200 - 299 μg/L, and to provide a basis for scientific iodine supplementation.Methods:In May 2019, in Xinjiang Uygur Autonomous Region, Altay Prefecture and Kashgar Prefecture were selected, where the median urinary iodine of children aged 8 to 10 years were 100 - 199 and 200 - 299 μg/L for three consecutive years (2017 - 2019). A stratified random sampling method was used to select 400 children aged 8 to 10 years in each of the two regions, urine and blood samples were collected to detect urinary iodine and thyroid function [thyrotropin stimulating hormone (TSH), free thyroxine (FT 4), free triiodothyronine (FT 3), anti-thyroglobulin antibody (TgAb), and anti-thyroperoxidase antibody (TPOAb)]. At the same time, children's IQ was measured and determined by Second Revision of Combined Raven's Test (CRT-C2) in China and Second Revision of Combined Raven's Test for Children-the Rural, in China (CRT-RC2). Results:The median urinary iodine of children aged 8 to 10 years in Altay Prefecture and Kashgar Prefecture was 188.6 and 250.1 μg/L, respectively. There was no statistically significant difference in thyroid function indexes TSH and FT 3 levels between the two regions ( Z = - 0.58, t = 0.49, P > 0.05), while there was statistically significant difference in FT 4 level ( t = 60.08, P < 0.001). There was no statistically significant difference in TgAb positive rate [3.6% (14/394), 4.0% (16/399)] between the two regions (χ 2 = 0.11, P = 0.736), but the difference of TPOAb positive rate [9.6% (38/394), 30.6% (122/399)] was statistically significant (χ 2 = 53.93, P < 0.001), while the difference of dual antibody positive rate [0.8% (3/394), 2.0% (8/399)] was not statistically significant ( P = 0.134). There was no statistically significant difference in the detection rates of subclinical hypothyroidism [8.9% (35/394), 11.0% (44/399)], subclinical hyperthyroidism [1.0% (4/394), 1.3% (5/399)] and hyperthyroidism [0.3% (1/394), 0.8% (3/399)] in children between the two regions ( P > 0.05). The IQ results of children in the two regions were 96.55 ± 11.36 and 89.57 ± 12.35, respectively, and there was no significant difference between them ( t = 2.79, P = 0.095). Conclusions:The thyroid function status of children is similar in the two regions with median urinary iodine of 100 - 199 μg/L and 200 - 299 μg/L in children aged 8 to 10 years, but the TPOAb positive rate is significantly different. Children whose iodine nutritional level is at or above the appropriate level have no obvious changes in intelligence. It is suggested that median urinary iodine at 200 - 299 μg/L is a relatively safe iodine nutrition state.
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Objective:To evaluate the effect of permissive high stroke volume variability (SVV) on postoperative delirium (POD) in elderly patients undergoing laparoscopic hepatectomy.Methods:A total of 100 elderly patients of either sex, with body mass index of 18.5-24.9 kg/m 2, aged 65-80 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with Child-Pugh grade A or B, scheduled for elective laparoscopic hepatectomy, were divided into 2 groups ( n=50 each) using a random number table method: permissive high SVV group (group S) and control group (group C). Group S was given goal-directed fluid infusion with a target of high SVV (13%-20%), and fluid replacement was performed according to the intraoperative CVP in group C. Oxygen extraction ratio was calculated on admission to the operating room (T 0), at skin incision (T 1), at the beginning of liver resection (T 2), completion of liver resection (T 3) and at the end of operation (T 4). Intraoperative blood loss, volume of fluid infused and urine volume were recorded.Lactic acid concentrations were measured at T 0 and T 4.Regional cerebral oxygen saturation (rSO 2) was continuously recorded, and the maximum percentage of decrease in rSO 2 from baseline (rSO 2max%) was calculated.Peripheral venous blood samples were collected at 1 day before operation, at the end of operation, and at 1 and 3 days after operation to determine the concentrations of serum S100β and neuron-specific enolase.POD was evaluated at 1, 3 and 7 days after operation, and the hospitalization time was recorded. Results:Compared with group C, the intraoperative blood loss was significantly decreased, the volume of fluid infused and urine volume were increased, the lactic acid concentration at T 4, rSO 2max%, oxygen extraction ratio at T 2-4, serum S100β and neuron-specific enolase concentrations and incidence of POD at 1 and 3 days after operation were decreased, and the hospitalization time was shortened in group S ( P<0.05). Conclusion:Permissive high SVV can decrease the development of POD in elderly patients undergoing laparoscopic hepatectomy, which is related to reduction of cerebral oxygen metabolism.
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OBJECTIVES@#To understand the psychological status of the staff in a general hospital during the coronavirus disease 2019 and its influential factors, and to provide references for the mental health services to hospital staff.@*METHODS@#Using star platform of questionnaire, the staff in the general hospital were investigated via Depression, Anxiety, Stress Scale (DASS-21), Social Support Rating Scale (SSRS) and Simplified Coping Style Questionnaire (SCSQ). The influential factors were discussed by descriptive analysis, rank sum test, single factor analysis, correlation analysis and multiple factors binary logistic regression analysis.@*RESULTS@#A total of 2 060 valid questionnaires were collected. The negative emotions of nurses and cleaners were the most obvious. The depression scores, anxiety scores and stress scores for nurses and cleaners were 5.06±7.47, 6.36±7.84, 9.75±8.65, and 6.72±8.84, 4.51±6.56, 9.69±9.56, respectively. Multivariate binary logistic regression analysis showed that staff types, education levels, job status, economic situation and concerns on the supplies of protective goods were the main influential factors for depression; staff types, contacting status with infected patients, economic situation, concerns on the supplies of protective goods, history of disease were the main influential factors for anxiety; contacting status with infected patients, economic situation, concerns on the supplies of protective goods were the main influential factors for stress.@*CONCLUSIONS@#There are differences in psychological characteristics among different groups of staff in the general hospital under the outbreak. Thus psychological protection and intervention measures should be formulated according to different groups and work status.
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Humans , Adaptation, Psychological , Anxiety , Diagnosis , Betacoronavirus , China , Coronavirus Infections , Psychology , Cross-Sectional Studies , Depression , Diagnosis , Disease Outbreaks , Hospitals, General , Pandemics , Personnel, Hospital , Psychology , Pneumonia, Viral , Psychology , Stress, Psychological , Surveys and QuestionnairesABSTRACT
Objective:To explore the rates of suicide ideation and the relevant factors among patients with HIV/AIDS (PLWHA) in Changsha for obtaining scientific evidence to reduce suicidal ideation rates among PLWHA.Methods:A total of 504 PLWHA were surveyed in an MDS hospital in Changsha,by using Self-Made Socio-Demographic Scale,Self-rating Depression Scale,Self-rating Anxiety Scale,and Beck Scale for Suicide Ideation-Chinese Version.Results:There were 13.9％,26.6％ and 27.2％ of PLWHA suffered suicidal ideation in the last week,at the most depressive moments and all their lives,respectively.Being a gay (OR=4.79,2.66,2.37) or with suicide history (OR=8.56,5.63,5.56) were the risk factors for suffering suicidal ideation in the last week,at the most depressive moments and all their lives.Moreover,anxiety was the risk factor for suffering suicidal ideation at the most depressive moments and all their lives (OR=3.28,3.05),and depression was the risk factor for suffering suicidal ideation in the last week (OR=4.97).Conclusion:Among PLWHA,gay is a high risk factor for suffering suicidal ideation,and suicide history is a risk factor.
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AIM:To screen and verify the effective ingredient of traditional Chines medicine (TCM) Q0409 in improving learning and memory ability of mice.METHODS:The mouse learning and memory impairment model was induced by intraperitoneal injection of scopolamine.The mice in each group were given the corresponding drug by gavage at the same time for 14 d in succession.Morris water maze test was used to measure the learning and memory ability of the mice, and then the hippocampal tissue homogenate was taken to determine the activity of acetylcholinesterase (AChE).The animals were divided into 8 groups according to L8(27) orthogonal table.The variance analysis and factorial analysis were used to analyze the pharmacological effects of seven kinds of single herbal in TCM Q0409 and determine the screening ingredients.The animals were divided into 6 groups according to the results of the preliminary screening results, and further testing and validation of TCM Q0409 screening ingredients were performed to get the final simplified ingredients.RESULTS:Three medicinal herbs of Polygalae, Panax ginseng and Acori graminei rhizome were screened by the orthogonal results of Morris water maze test and the activity of AChE in mouse hippocampal tissues.The simplified ingredients of TCM Q0409 were obtained through the variance results of Morris water maze test and the activity of AChE in mouse hippocampal tissues.CONCLUSION:Polygala and ginseng were eventually determined as simplified ingredients of TCM Q0409 and it was verified that they improve the learning and memory ability of the mice with learning and memory impairment.
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Objective To investigate the specific absorption rate (SAR)in 3.0T MR brain examination.Methods All 280 patients underwent 3 .0 MR brain examination.And the patients were divided into three groups:a group of 0-3 years old without hands intersection, inluding 40 cases through conventional MRI examination,40 cases through MRA,as well as 40 cases through DWI;a group of more than 20 years old without hands intersection,including 40 cases through conventional MRI examination,40 cases through MRA,as well as 40 cases through DWI;a group of more than 20 years old with hands intersection,consisting of 40 cases through MRA.The SAR values of each group were recorded,respectively.And the independent samples t test was used to compare statistical difference of different SAR values between groups.Results Compared the group of 0-3 years old without hands intersection and the group of more than 20 years old without hands intersection,the SAR values of all six sequences in front group were significantly higher than that those in latter one,but not exceed the safety standard of 3 w/kg in the United States FDA.There was no significant statistical differences in the SAR values of two groups which more than 20 years old with hands intersection or not (P>0.05).Conclusion The SAR values of each sequence in the group of 0-3 years old without hands intersection were significantly higher than those in the group of more than 20 years old without hands intersection,but in a safe and reasonable range.The brain scanning with two hands intersect of 20 years old and above,and there was no significant increase on the SAR values in the brain examination of the group of more than 20 years old with hands intersection.So it is of great significance to guide the daily work,settle doubts and improve success rates of the MR examination.
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Objective To investigate the specific absorption rate (SAR)in 3.0T MR brain examination.Methods All 280 patients underwent 3 .0 MR brain examination.And the patients were divided into three groups:a group of 0-3 years old without hands intersection, inluding 40 cases through conventional MRI examination,40 cases through MRA,as well as 40 cases through DWI;a group of more than 20 years old without hands intersection,including 40 cases through conventional MRI examination,40 cases through MRA,as well as 40 cases through DWI;a group of more than 20 years old with hands intersection,consisting of 40 cases through MRA.The SAR values of each group were recorded,respectively.And the independent samples t test was used to compare statistical difference of different SAR values between groups.Results Compared the group of 0-3 years old without hands intersection and the group of more than 20 years old without hands intersection,the SAR values of all six sequences in front group were significantly higher than that those in latter one,but not exceed the safety standard of 3 w/kg in the United States FDA.There was no significant statistical differences in the SAR values of two groups which more than 20 years old with hands intersection or not (P>0.05).Conclusion The SAR values of each sequence in the group of 0-3 years old without hands intersection were significantly higher than those in the group of more than 20 years old without hands intersection,but in a safe and reasonable range.The brain scanning with two hands intersect of 20 years old and above,and there was no significant increase on the SAR values in the brain examination of the group of more than 20 years old with hands intersection.So it is of great significance to guide the daily work,settle doubts and improve success rates of the MR examination.
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Objective To study the changes of diamine oxidase (DAO)levels in neonates with hypoxic -is-chemic encephalopathy (HIE)treated with selective brain hypothermi,also to further evaluate Scores for Newborn Gastrointestinal Functior (SNGF).Methods 60 newborns with moderate and severe HIE who were in the NICU of our department from June 2013 to December 2014 were collected.The 60 newborns were randomly divided into hypo-thermia treatment group (HG)and conventional treatment group(CG).The serum was collected and ELISA method was used to test the consistency of DAO on admission and 7 days afterwards,respectively.Meanwhile,the SNGF level of the two groups at the two time points was compared.Results Neither the DAO and SNGF level of the two groups had statistical difference on admission(all P >0.05).Seven days later,both the DAO of the two groups and the SNGF decreased[(12.51 ±1.53)u/mL vs (7.88 ±1.87)u/mL,however,the variation of the hypothermia treatment group was apparently more significant than the change of the conventional treatment group(P =0.011).The SNGF scores of the two groups all decreased,while the hypothermia treatment group was significantly lower than the conventional treat-ment group,the difference were statistically significant (P =0.044,0.006,0.013).Besides,there was remarkably positive correlation between serum DAO level and SNGF (r1 =-0.825,r2 =-0.876,all P <0.05).Conclusion Hypothermia treatment could effectively reduce the injury of asphyxia neonatal gastrointestinal tract by inhibiting the level of DAO,thus improve the gastrointestinal function.
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BACKGROUND:Problems regarding the prosthesis in the horizontal plane and the rotation of the femur and tibia prosthesis on line are relatively weak. The distal femoral rotation axis is mainly the transepicondylar axis. Due to patient differences as wel as anatomy and intraoperative display, it is difficult to accurately locate the axis in the process of knee arthroplasty. OBJECTIVE:To investigate application of magnetic resonance technique in determining the axis of rotation of the distal femur, to provide reference and basis for femoral rotational alignment during total knee arthroplasty. METHODS:Data of 122 cases without knee joint disease, who were diagnosed and treated in the Department of Orthopedics of Nanyang City Center Hospital from September 2014 to October 2015, were analyzed. Magnetic resonance technique was used to measure femoral epicondyle axes (STEA), femoral epicondyle axes (CTEA), the anteroposterior axis (APL) and femoral shaft (PCL). Simultaneously, magnetic resonance technique was utilized to measure femoral ankle angle (PCA), ankle twist angle (CTA), axis vertical line and ankle axis angle (PAPA). Each data were tested three times, and the average value was calculatd. We analyzed the method of magnetic resonance technique to determine reference axis of distal femoral rotation. RESULTS ANDCONCLUSION: (1) Accuracy of the angle close to surgical transepicondylar axis: 3° PCL> CTEA > APL verticalline. (2) No significant difference in PCA was detected in two sets of measurements (P> 0.05). CTA and PAPA parameters in the first measurement by magnetic resonance imaging diagnosis were significantly lower than the second measurement (P< 0.05). (3) Results indicate that magnetic resonance technology provides ideal reference for distal femoral rotation, can accurately measure the CTA, PCA, PAPA andother indicators. It is a more reliable determination method and can be used in scientific determination of femoral rotational alignment reference axis in total knee arthroplasty. Except STEA, the accuracy of 3° PCL is highest.
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Objective To learn the impacts of major diagnosis, other diagnoses, major surgery and other surgeries on the grouping of DRGs, and to optimize the DRGs data grouping quality by analyzing the main influencing factors of DRGs.Methods Based on regrouping results of the 1 940 questionable cases which have been corrected, using SPSS 13.0 to study the impacts of the questions found on the grouping of DRGs.Results 438 Patient records affecting DRGs grouping were regrouped according to major diagnosis, other diagnoses, major surgery and other surgeries.Influences of the above four groups on the grouping vary in general For comparison between two groups, P＞0.007 1 between main surgery and other surgeries;while P＜0.007 1 for comparison between other groups.Conclusion The highest influence of grouping was found in questionable major diagnosis, much higher than such other factors as other diagnoses, major surgery and other surgeries.This conclusion conforms to the steps of basic DRGs grouping logic-sorting the eases according to major diagnosis first of all Correct naming of surgery influences DRGs grouping, but the influence extent of major surgery and other surgeries is close.
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Objective To explore the correlation between MRI performance and biological factors of estrogen receptor (ER),progesterone receptor (PR),human epidermal growth factor receptor 2 (c-erbB-2)and p53 through a group cases of breast cancer.Methods The MRI characteristics of 39 cases with breast cancers confirmed by surgery were analyzed .The MRI characteristics of rim enhancement,speculate, the type of time-intensity curve (TIC),the early-phase enhancement ratio,peak to time,apparent diffusion coefficient (ADC)value were recorded and the lesions’pathological results of inmmunohistochemistry:the expression of ER,PR,c-erbB-2,p53 were aslo collected.The correlation between MRI characteristics and biological factors were analyzed with statistical software SPSS1 9.0.Results Spiculate was positively correlated with ER positive expression in breast cancer.Peak time of breast cancer and positive expression of p53 was negatively correlated.ADC value of breast cancer and positive expression of p53 was negatively correlated.Conclusion There are certain correlations between MRI characteristics and biological factors of breast cancer ER,PR,c-erbB-2,p53.
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Objective To explore the expression of phosphoinositide 3 kinase (PI3K)and Akt in gastric carcinoma tissues and the distal normal tissues,and to analyze their correlation with the clinical pathologic characteristics of gastric cancer.Methods The S-P immunohistochemistry and RT-PCR were used to detect the expression of PI3K and Akt protein and mRNA in 60 cases of gastric carcinoma tissues and 25 cases of normal gastric mucosal tissues.Results The expression of PI3K and Akt in the gastric carcinoma tissues was significantly higher than that in the distal normal gastric tissues with statistical difference (P <0.05)and their expression in gastric carcinoma tissues was significantly related with the pathologic differentiation degree,TNM stage,invasion depth and lymph node metastasis (P <0.05).Conclusion PI3k/Akt protein and mRNA participate in the occurrence,development, infiltration and metastasis process of gastric cancer,and play an important role in the canceration of gastric carcinoma.
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Purpose To probe into the value of M-mode echocardiography and spectral Doppler echocardiography in diagnosing fetal atrial premature beats.Materials and Methods Echocardiography examinations were given to the seventy-three fetuses around 16-40 gestational weeks which were found suffering from fetal arrhythmia in the clinical examinations by using M-mode echocardiography and spectral Doppler. Thirty-two of them were screened out with fetal atrial premature beats, and their ultrasonic cardiograms were analyzed. The follow-up visits were later conducted.Results Among the thirty-two cases with fetal atrial premature beats, fourteen were attacked frequently, and the other eighteen were attacked accidentally. Two cases were documented with muscular ventricular septal defect. Apart from two missing cases, the rest thirty cases were found to be recovered from arrhythmia before or after birth in the follow-up visits. The disappearance rate of atrialpremature beats in the fetuses attacked frequently by the disease before birth was clearly lower than that in those attacked accidentally (P<0.05). Muscular ventricular septal defect in the two cases were found closed after birth. Conclusion M-mode echocardiography and spectral Doppler echocardiography, as non-invasive imagining techniques to take antenatal examination of fetal arrhythmia, have advantages such as reliable, direct, convenient and can be used repetitively, therefore can provide important information for clinical treatment and prognosis.
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Objective To investigate the risk factors and drug resistance in elderly patients with ventilator associated pneumonia(VAP).Methods From April 2012 to April 2014,the clinical data of 160 senile VAP patients in ICU were selected,the relationship of VAP with age,duration of mechanical ventilation,whether tracheotomy and the original diseases were analyzed .The drug susceptibility test was made to analyze the drug resistance .Results The incidence rates of VAP in patients with chronic obstructive pulmonary disease ,duration of mechanical ventilation more than 7d,over 65 years old (16.8%,13.4%,18.5%) were significantly increased (χ2 =11.592,11.989,13.187,all P0.05).The main pathogenic bacteria in elderly patients with VAP infection were Pseudomonas aeruginosa , Klebsiella pneumoniae , Escherichia coli , Enter-obacter cloacae .Drug sensitive experiment found that patients had multi-drug resistance ,the strains had higher resist-ance rate to ampicillin,piperacillin,ciprofloxacin,ofloxacin and ceftriaxone .Conclusion The original chronic lung disease,mechanical ventilation time and over 65 years old are risk factors of elderly VAP ,the patients have multi-drug resistance ,and the strains show the highest resistance to ampicillin .
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Objective To investigate the clinical significance of fetal tricuspid regurgitation (TR) in the screening of chromosomal abnormalities at the first-trimester. Methods Screening for chromosomal abnormalities was carried out in 1 262 fetuses at 11+0 to 13+6 weeks. Ultrosound was performed to measure crown rump length and nuchal translucency (NT) thickness, and to acquire tricuspid waveform. All the neonates were followed up for 6 months after birth. Results Among the 1 262 fetuses, 68 were found to have TR. TR was present in 54 (4.4%) of the 1 239 chromosomally normal fetuses, and in 14 (61%) of the 23 with chromosomal abnormalities. Cardiac malformations were detectable in 28 fetuses. The prevalence of TR was 64%in those with cardiac malformations and 1.5%in those without cardiac malformations. Conclusions Tricuspid regurgitation is an effective predictor for the detection of fetal chromosomal abnormalities at the first trimester.
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<p><b>OBJECTIVE</b>To study the effects of dopamine and phenylephrine for treatment of hypotension during cesarean section under combined spinal epidural anesthesia (CSEA) on the stereology of the placenta.</p><p><b>METHODS</b>Forty puerperants undergoing cesarean section under CSEA were randomly divided into dopamine group and phenylephrine group. Ropivacaine (16 mg) was administered immediately after spinal anethesia. Blood pressure was maintained near the baseline by adjusting the drug infusion rate. Fetal blood gas, Apgar score, and placental villus microvascular stereological changes were observed during the operation.</p><p><b>RESULTS</b>The microvascular density was significantly lower in dopamine group than in phenylephrine group (P<0.05). Phenylephrine group showed significantly lower umbilical artery blood pH than dopamine group (P<0.05). The Apgar score and blood pressure were comparable between the two groups (P>0.05). Compared to the baseline, both of the two groups showed significantly lowered heart rate during the operation (P<0.01).</p><p><b>CONCLUSION</b>Dopamine is associated with the risk of fetal acidosis. Phenylephrine is helpful for preventing hypotension by increasing placental blood flow and improving oxygen supply to ensure maternal and fetal safety during cesarean section.</p>
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Female , Humans , Infant, Newborn , Pregnancy , Amides , Anesthesia, Spinal , Apgar Score , Blood Gas Analysis , Blood Pressure , Cesarean Section , Dopamine , Fetal Blood , Fetus , Heart Rate , Hypotension , Drug Therapy , Oxygen , Phenylephrine , Placenta , Physiology , Vasoconstrictor AgentsABSTRACT
Objective To study the changes and significance of plasma atrial natriuretic peptide (ANP),endothehn-1 (ET-1),von Willebrand factor (vWF) levels in newborns with persistent pulmonary hypertension (PPHN) after the treatment of sildenafil.Methods Sixty-six cases with PPHN group and 40 cases with non-PPHN (control group) were enrolled.PPHN group was in the treatment of sildenafil.Collected the blood when before the treatment of sildenafil and 3,7 d after treatment,respectively.Arterial blood gas were done and pulmonary arterial systolic pressure (PASP) was measured before treatment and 3,7 d after treatment,and by the same time recording pulse oxygen saturation (SpO2).Plasma ANP,ET-1,vWF levels were measured by ELISA method.Results The levels of PASP,SpO2 arterial partial pressure of oxygen (PaO2),arterial partial pressure of carbon dioxide (PaCO2) and plasma ANP,ET-1,vWF in PPHN group before treatment [(66.5 ± 13.4)mm Hg (1 mm Hg =0.133 kPa),0.726 ±0.531,(46.3 ±7.2)mm Hg,(59.2 ± 7.4) mm Hg,(272.6 ± 20.3)ng/L,(221.3 ± 24.3) ng/L,(142.5 ± 20.3)％] compared with controlgroup [(25.0±6.2) mm Hg,0.896 ± 0.767,(88.3 ±7.6) mm Hg,(41.1 ±6.1) mm Hg,(68.4 ± 7.9) ng/L,(39.8 ± 6.5) ng/L,(95.3 ± 18.5)％] were statistically significant(P ＜ 0.05).Their levels in PPHN group 3 dafter treatment[(48.3 ± 3.2) mm Hg,0.841 ± 0.416,(73.6 ± 9.3)mm Hg,(50.5 ± 7.2) mm Hg,(102.6 ±20.3) ng/L,(79.6 ± 15.2) ng/L,(103.6 ± 14.1)％] were significantly improved,there was significantdifference compared with before treatment and control group(P ＜ 0.05).Their levels in PPHN group 7 d aftertreatment [(25.2 ± 3.6) mm Hg,0.882 ± 0.724,(85.4 ± 7.4) mm Hg,(40.2 ± 6.4) mm Hg,(64.4 ± 3.6)ng/L,(37.3 ± 5.4)ng/L,(92.9 ± 11.7)％] were significantly improved,there was significant difference compared with 3 d after treatment (P ＜ 0.05),the difference was no statistically significant compared with control group (P＞ 0.05).Linear correlation analysis showed that ANP,ET-1,vWF and PASP,PaCO2 were significantly positively correlated (P ＜ 0.01),ANP,ET-1,vWF and SpO2,PaO2 were significantly negatively correlated (P＜ 0.01).On the basis of cardiac ultrasound monitoring PASP,ANP evaluation of the efficacy of sildenafil sensitivity was 82.2％,specificity was 83.4％ ;ET-1 was 86.4％ and 87.6％; vWF was 85.1％ and 84.7％.Conclusion ANP,ET-1,vWF may play an important role in the mechanism of the treatment of PPHN by sildenafil,and could be used as an objective index to evaluate the effect of sildenafil on PPHN.
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Objective To approach the value of MR urography (MRU) in diagnosis of congenital renal dysplasia in children.Methods 13 children with congenital renal dysplasia and renal inadequacy were examined by routine MRI and MRU with heavy T_2 weighted single stimulation fast spin echo sequences.Results The congenital atopic dysplastic rens located at pelvis in one case and at below nephritic pit in one case were not detected by MR imaging and original MRU images,respectively.Multicystic dysplastic kidney could be well showed by MRU MIP images, but the cases with clubbed renal pelvis were not well demonstrated by MRU. All cases and the complications were correctly diagnosed by routine MRI, original MRU and MRU MIP images.Conclusion MR urography in combination with routine MRI is of important value in diagnosing congenital renal dysplasia in children.
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Objective To evaluate the value of MR imaging in diagnosing autologous lashes within rabbit vitreous body.Methods 5 lashes were placed into the right vitreous bodys in 24 experimental animals.All of the experimental animals underwent MRI examination with and without overlying moist swab and 2% lidocaine retrobulbar anesthesia after operations 2 hours later.Results The intravitreous lashes could be demonstrated on T_2WI in 6 animals and 17 animals without and with overlying moist swab and 2% lidocaine retrobulbar anesthesia,respectively.Conclusion The methods of artifacts-suprresing is useful for diagnosing intravitreous lases foreign body within rabbits at MR imaging examination.