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Background@#This study aimed to observe the effect of internship in a pre-anesthetic clinic on the teaching quality of pre-anesthesia evaluation for undergraduates. @*Methods@#A total of 120 undergraduates from July 2017 to July 2018 in the anesthesia department of our hospital were randomly divided into two groups: pre-anesthetic clinic internship teaching group (n = 60) and traditional teaching group (n = 60). The knowledge in the pre-anesthesia evaluation teaching chapters was evaluated between the two groups of undergraduates. @*Results@#There were no significant differences in the demographic information between the two groups. The scores in the case analysis and theoretical knowledge test in the pre-anesthetic clinic internship teaching group were significantly higher than those in the traditional teaching group. In addition, the students’ satisfaction with the curriculum design was significantly higher in the pre-anesthetic clinic internship teaching group than in the traditional teaching group. @*Conclusion@#Pre-anesthetic clinic internships can improve the quality of pre-anesthesia assessment teaching for undergraduates.
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Background@#This study aimed to observe the effect of internship in a pre-anesthetic clinic on the teaching quality of pre-anesthesia evaluation for undergraduates. @*Methods@#A total of 120 undergraduates from July 2017 to July 2018 in the anesthesia department of our hospital were randomly divided into two groups: pre-anesthetic clinic internship teaching group (n = 60) and traditional teaching group (n = 60). The knowledge in the pre-anesthesia evaluation teaching chapters was evaluated between the two groups of undergraduates. @*Results@#There were no significant differences in the demographic information between the two groups. The scores in the case analysis and theoretical knowledge test in the pre-anesthetic clinic internship teaching group were significantly higher than those in the traditional teaching group. In addition, the students’ satisfaction with the curriculum design was significantly higher in the pre-anesthetic clinic internship teaching group than in the traditional teaching group. @*Conclusion@#Pre-anesthetic clinic internships can improve the quality of pre-anesthesia assessment teaching for undergraduates.
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BACKGROUND@#Zika virus (ZIKV) has emerged as a global pathogen causing significant public health concerns. China has reported several imported cases where ZIKV were carried by travelers who frequently travel between China and ZIKV-endemic regions. To fully characterize the ZIKV strains isolated from the cases reported in China and assess the risk of ZIKV transmission in China, comprehensive phylogenetic and genetic analyses were performed both on all ZIKV sequences of China and on a group of scientifically selected ZIKV sequences reported in some of the top interested destinations for Chinese travelers.@*METHODS@#ZIKV genomic sequences were retrieved from the National Center for Biotechnology Information database through stratified sampling. Recombination event detection, maximum likelihood (ML) phylogenetic analysis, molecular clock analysis, selection pressure analysis, and amino acid substitution analysis were used to reconstruct the epidemiology and molecular transmission of ZIKV.@*RESULTS@#The present study investigated 18 ZIKV sequences from China and 70 sequences from 16 selected countries. Recombination events rarely happens in all ZIKV Asian lineage. ZIKV genomes were generally undergone episodic positive selection (17 sites), and only one site was under pervasive positive selection. All ZIKV imported into China were Asian lineage and were assigned into two clusters: Venezuela-origin (cluster A) and Samoa-origin cluster (cluster B) with common ancestor from French Polynesia. The time of most recent common ancestors of Cluster A dated to approximately 2013/11 (95% highest posterior density [HPD] 2013/06, 2014/03) and cluster B dated to 2014/08 (95% HPD 2014/02, 2015/01). Cluster B is more variable than Cluster A in comparison with other clusters, but no varied site of biological significance was revealed. ZIKV strains in Southeast Asia countries are independent from strains in America epidemics.@*CONCLUSIONS@#The genetic evolution of ZIKV is conservative. There are two independent introductions of ZIKV into China and China is in danger of autochthonous transmission of ZIKV because of high-risk surrounding areas. Southeast Asia areas have high risk of originating the next large-scale epidemic ZIKV strains.
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Background@#Zika virus (ZIKV) has emerged as a global pathogen causing significant public health concerns. China has reported several imported cases where ZIKV were carried by travelers who frequently travel between China and ZIKV-endemic regions. To fully characterize the ZIKV strains isolated from the cases reported in China and assess the risk of ZIKV transmission in China, comprehensive phylogenetic and genetic analyses were performed both on all ZIKV sequences of China and on a group of scientifically selected ZIKV sequences reported in some of the top interested destinations for Chinese travelers.@*Methods@#ZIKV genomic sequences were retrieved from the National Center for Biotechnology Information database through stratified sampling. Recombination event detection, maximum likelihood (ML) phylogenetic analysis, molecular clock analysis, selection pressure analysis, and amino acid substitution analysis were used to reconstruct the epidemiology and molecular transmission of ZIKV.@*Results@#The present study investigated 18 ZIKV sequences from China and 70 sequences from 16 selected countries. Recombination events rarely happens in all ZIKV Asian lineage. ZIKV genomes were generally undergone episodic positive selection (17 sites), and only one site was under pervasive positive selection. All ZIKV imported into China were Asian lineage and were assigned into two clusters: Venezuela-origin (cluster A) and Samoa-origin cluster (cluster B) with common ancestor from French Polynesia. The time of most recent common ancestors of Cluster A dated to approximately 2013/11 (95% highest posterior density [HPD] 2013/06, 2014/03) and cluster B dated to 2014/08 (95% HPD 2014/02, 2015/01). Cluster B is more variable than Cluster A in comparison with other clusters, but no varied site of biological significance was revealed. ZIKV strains in Southeast Asia countries are independent from strains in America epidemics.@*Conclusions@#The genetic evolution of ZIKV is conservative. There are two independent introductions of ZIKV into China and China is in danger of autochthonous transmission of ZIKV because of high-risk surrounding areas. Southeast Asia areas have high risk of originating the next large-scale epidemic ZIKV strains.
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Objective To assess the diagnostic and prognostic value of measuring presepsin in patients with acute respiratory distress syndrome (ARDS).Methods Plasma prsepsin was collected from 81 patients with ARDS,27 patients with cardiogenic pulmonary edema (CPE) and 20 healthy volunteers at enrollment.Levels of presepsin were measured using the PATHFAST(R) analysis system based on a chemiluminescent enzyme immunoassay (CLEIA).The differences of plasma prsepsin were compared between different groups.The 28-day mortality were followed in ARDS patients,and the characteristics of the surviors and non-surviors were compared.Results ARDS patients had significantly higher median levels of presepsin compared to CPE patients [926.89 (485.41-2 662.32)pg/mL vs.376.21 (247.16-568.52) pg/mL,P＜0.001] at enrollment.The difference between infected and non-infected ARDS patients did not showed statistical significance [(934.74 (456.44-3 322.51) pg/mL vs.798.12 (485.41-2 561.40) pg/mL,P--0.079).In ARDS patients,the presepsin levels of non-survivors was significantly higher than that of survivors [3 158.3 (963.91-4 489.33) pg/mL vs.729.09 (398.05-1 467.24) pg/mL,P＜0.001],and multivariate Logistic regression showed that presepsin (OR =1.51,P =0.027) was the independent predictor for 28-day mortality in ARDS patients with acute lung injury (ALI).Conclusions Presepsin was an effective indicator in diagnosing ARDS,and it also was a strong prognostic marker for short-term mortality in ARDS.
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In recent years, with continuous research efforts targeted at studying the effects of pre- and after-treatment of inhaled anesthetics, significant progress has been made regarding the common clinical use of low concentrations of inhaled sevoflurane and its effect on induced central ischemia tolerance by pre- and post-treatment. In this study, we collected, analyzed, classified, and summarized recent literature regarding the effect of sevoflurane on central ischemia tolerance and its related mechanisms. In addition, we provide a theoretical basis for the clinical application of sevoflurane to protect the central nervous system and other important organs against ischemic injury.
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Anesthetics , Central Nervous System , IschemiaABSTRACT
Objective To investigate the diagnostic and prognostic value of plasma soluble CD163 (sCD163) levels in patients with acute respiratory distress syndrome (ARDS).Methods A total of 124 individuals,83 patients with ARDS,20 patients with cardiogenic pulmonary edema (CPE),and 21 healthy controls,were enrolled in this study.ARDS patients were classified into survivors and nonsurvivors according to 28-day mortality.The concentration of plasma sCD163 was measured by enzymelinked immunosorbent assay (ELISA).Receiver operating characteristic (ROC) curves were employed to evaluate the accuracy of sCD163 in diagnosing ARDS and predicting 28-day ICU outcome.Cumulative survival curve was carried out by Kaplan-Meier survival analysis.Logistic regression analysis was assessed by univariate and multivariate analysis to identify independent predictors of outcome controlling for reported risk factor of mortality.Results Patients with ARDS had significantly higher median levels of sCD163 compared to patients with CPE [496.7(421.8-577.5) ng/mL vs.284.5(141.7-459.2) ng/mL,P＜0.001] upon admission to ICU.The sCD163 levels of non-survivors was significantly higher than that of survivors [577.5 (503.7-623.4) ng/mL vs.479.6 (395.4-520.8) ng/mL,P＜0.001].Multivariate logistic regression showed sCD163 (OR =1.02,P =0.001)was the independent predictor for 28-day mortality in patients with ARDS.Conclusions Plasma sCD163 is a potential biomarker for diagnosis of ARDS and differenting the severity of ARDS.Meanwhile,sCD163 was an independent prognostic marker for 28-day mortality in ARDS patients.
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Cleft palate is one of the most common congenital malformations of the oral and maxillofacial region, with an incidence rate of around 0.1%. Early surgical repair is the only method for treatment of a cleft lip and palate. However, because of the use of inhalation anesthesia in children and the physiological characteristics of the cleft palate itself combined with the particularities of cleft palate surgery, the incidence rate of postoperative emergence agitation (EA) in cleft palate surgery is significantly higher than in other types of interventions. The exact mechanism of EA is still unclear. Although restlessness after general anesthesia in children with cleft palate is self-limiting, its effects should be considered by clinicians. In this paper, the related literature on restlessness after surgery involving general anesthesia in recent years is summarized. This paper focuses on induction factors as well as prevention and treatment of postoperative restlessness in children with cleft palate after general anesthesia. The corresponding countermeasures to guide clinical practice are also presented in this paper.
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Child , Humans , Anesthesia, General , Anesthesia, Inhalation , Cleft Lip , Cleft Palate , Dihydroergotamine , Incidence , Methods , Palate , Psychomotor AgitationABSTRACT
With the use of high pure HF and HNO3 reagents, and autoclaves made of high purity Rerfluoroalkoxy ( PFA ) material, a solution sample digestion technique effective for phosphate samples, subjected to high temperature fusion, was established. The whole procedure was concise, fast and of low blank value. Key factors such as the amount and ratios of the reagents, the digestion temperature and time, were systematically optimized, it was found that within 0. 5 h at 150 ℃, only 1. 7 mL of total reagent consumption could lead to a complete sample decomposition. Most importantly, the samples were not required to be ground to fine powder, which greatly reduced the risk of contamination. In addition, an effective liquid_liquid extraction procedure based on 5_nonylsalicylaldehyde oxime as the extractant was established for matrix separation and analyte preconcentration. Under the optimal extraction conditions of 5 mL of 15% extractant, 0. 5% HNO3 of extraction acidity and 20% HNO3 of back_extraction acidity, a matrix separation efficiency of over 99. 999% could be realized and a preconctration factor of 10 could be obtained, which resulted in complete elimination of the matrix_induced interference and great enhancement of the analytical sensitivity. After optimization of the operation parameters of ICP_MS, high signal to background detection of Cu in 20%HNO3 at 840 W of plasma power and low sample uptake rate were realized. The detection limits of 2. 5 ng/g, RSD of 3. 3% for six detections of parallel samples, and the recovery of 94. 3% for spike test were obtained, respectively. The method was finally applied to three real samples analysis, and the results agreed well with the data from laser adsorption loss experiment.
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OBJECTIVE: To establish a rapid column-switching-ultra high performance liquid chromatography method for determining meropenem concentration in human plasma. METHODS: Meropenem plasma samples were diluted by internal standard aqueous solution (doxofylline), filtrated by microporous membrane, and then extracted by on-line column-switching method. The samples were chromatographed on Waters Acquity UPLC@BEH-C18 column using gradient elution method (mobile phase A and extracting mobile phase C: methanol -0.05 mol·L-1 K2HPO4 (pH 7.0) 5:95; mobile phase B: methanol). The maximum absorption wavelength of meropenem was 299 nm. The column temperature were 35°C. The meropenem concentration was calculated by internal standard method and external standard method, respectively. The results of the two methods were compared by paired t-test using SPSS statistical software. RESULTS: The liner range of the calibration curve for meropenem was 0.67-86.00 mg·L-1 (r=0.9999). The method recovery was (93.59±1.15)%-(99.21±4.06)% and extraction recovery was above 85.0%, relative standard deviation was below 5.0%. The SPSS statistic results indicated there was no significant difference between the concentrations calculated by the two methods and existed good correlation. The transformed equation is ρInternal=1.039ρExternal-0.468 (r=0.9970). CONCLUSION: On-line column-switching method is used and it is proved to be rapid, sensitive and suitable for therapeutic drug monitoring and pharmacokinetic investigation of meropenem in human plasma.
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AnewmethodwasdevelopedforfastdeterminationofAlresidueinpolyetherketoneketone ( PEKK) special polymer material by graphite furnace atomic absorption spectrometry ( GF-AAS) . Instead of high temperature ashing, sample was dissolved in concentrated sulfuric acid and diluted by tetrahydrofuran, then was directly analyzed by GF-AAS. Systematical investigation was made on sample preparation, it was found that for 0. 2 g of sample weight, a clear sample solution could be obtained by heating at 220 ℃ with 2 mL of concentrated H2 SO4 for 4 min, and the obtained solution was ready for the subsequent mixing with tetrahydrofuran for sample dilution or dispersion before analysis. Redesign of the GF-AAS temperature program was also made, on the basis of the recommended program a pre-ashing step was added, which greatly helped increasing the analytical precision when the temperature was set at 400 ℃ and the total time was set at 40 s. The detection limits ( 3σ) were 38. 5 ng/g, the RSD for six parallel determinations of real samples was 2. 2%, and the recoveries for spiked tests were 99%-105%, respectively. In comparison with the traditional high-temperature ashing technique, the established method was more concise, faster and less exposed to contamination during sample preparation.
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<p><b>OBJECTIVE</b>To develop a new high-performance liquid chromatographic (HLPC) method for determination of propofol in human serum.</p><p><b>METHODS</b>Human serum samples were precipitated with 20% perchloric acid and centrifuged to obtain 50 microl of the supernatant for analysis by HPLC coupled with fluorescence detection. The analysis was performed with a C(18) reversed-phase column using a acetonitrile-water (90:10) phase delivered at 1.0 ml/min, with the excitation wavelength of 276 nm and emission wavelength of 310 nm.</p><p><b>RESULTS</b>The calibration curves were linear (r=0.997 5) within the concentration range of 0.05-10 microg/ml, the limit of propofol quantification was 50 ng/ml and the intra- and inter-day precisions were between -/+15%.</p><p><b>CONCLUSIONS</b>The method is accurate, sensitive and simple for propofol determination in clinical anesthesia.</p>