Efficacy of remimazolam for induction and maintenance of general anesthesia in patients undergoing abdominal surgery / 中华麻醉学杂志

Objective:To evaluate the efficacy of remimazolam for induction and maintenance of general anesthesia in patients undergoing abdominal surgery.Methods:A total of 100 patients of both sexes, aged 18-64 yr, with body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing elective abdominal surgery with general anesthesia requiring tracheal intubation, were enrolled in this study and divided into 2 groups ( n=50 each) using a random number table method: remimazolam group (group R) and propofol group (group P). Anesthesia was induced by intravenously infusing propofol 1.0-2.5 mg/kg in group P and remimazolam 0.15-0.35 mg/kg in group R. Sufentanil 0.4-0.5 μg/kg and rocuronium 0.6 mg/kg were intravenously injected in group R and group P. Anesthesia was maintained by intravenously injecting remimazolam 0.3-1.0 mg·kg -1·h -1 in group R and propofol 4-12 mg·kg -1·h -1 in group P. Remifentanil 8-15 μg·kg -1·h -1 was intravenously injected in group R and group P. Narcrotrend index (NI) was maintained at 37-64 (D 0-D 2). The success of sedation, time for loss of consciousness, time of disappearance of eyelash reflex, time when NI dropped to D 0, incidence of tidal volume, respiratory rate and apnea after the patients lost consciousness, duration of stay in post-anesthesia care unit, the fluctuation range of mean arterial pressure at 1, 3 and 5 min of induction, and the development of intraoperative and postoperative adverse events. Results:The success rate of sedation in group R and group P was 100%.Compared with group P, time for loss of consciousness, time of disappearance of eyelash reflex and time when NI dropped to D 0 were significantly prolonged, tidal volume and respiratory rate were increased, the incidence of apnea after the patients lost consciousness was decreased, awakening time was shortened, the incidence of intraoperative sinus bradycardia, injection pain and dream was decreased, fluctuation range of blood pressure at 1, 3 and 5 min of induction was decreased in group R ( P<0.05). Conclusion:Remimazolam can be safely and effectively used for induction and maintenance of general anesthesia in patients undergoing abdominal surgery, and its induction dose is 0.15-0.35 mg/kg, and maintenance dose is 0.3-1.0 mg·kg -1·h -1.

Study on the metabonomics of vitamin A deficiency urine of left-behind children under 1 year old in Zunyi area based on hydrogen-nuclear magnetic resonance / 中华实用儿科临床杂志

Objective:Explore the hydrogen-nuclear magnetic resonance ( 1H-NMR) application potential of metabolomics in early screening of vitamin A deficiency(VAD). Methods:From January to June 2019, 40 cases of left-behind children with confirmed VAD <1 year old were enrolled in Zunyi area as VAD group, and 40 healthy children were selected as healthy control group.Urine from the 2 groups of children was collected and 1H-NMR spectrum was measured.By combining metabonomics technology and multivariate statistical analysis, the 2 groups of metabolites were compared, and the differential metabolites of children with VAD were screened out. Results:Compared with VAD group [(0.56±0.10)μmol/L], the difference in the serum retinol concentration of healthy control group [(1.35±0.18)μmol/L] was statistically significant ( t=23.93, P<0.001). Compared with healthy group, VAD group showed higher level of methylmalonate, 2-ketoisovalerat, N-acetyl glycoprotein signal, dimethylglycine and betaine, with statistically significant differences (| r|>0.602, all P<0.05). The level of Isovalerylglycine, 2-hydroxyisobutyrate, creatine, phosphate choline/glycerophosphocholine, 4-PY and Hippurate were significantly decreased, with statistically significant differences (| r|>0.602, all P<0.05). Conclusions:Compared with healthy children, children with VAD have differences in urine Metabolites.Differential metabolites are closely correlated with intestinal microecological ba-lance, digestive system diseases, respiratory system diseases, immune-related diseases, energy metabolism, growth and development.Urine 1H-NMR metabolomics analysis has potential application value in the early screening of VAD.

Genetic testing and pregnancy outcome of 337 fetuses with urinary system anomalies / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis and pregnancy outcome of fetuses with urinary system anomalies.@*METHODS@#Ultrasonographic features, genetic testing and pregnancy outcomes of 337 fetuses with urinary system anomalies identified by prenatal ultrasonograhy were collected for analysis.@*RESULTS@#Ultrasonographic features of the fetuses were mainly characterized by hydronephrosis or hydronephrosis, polycystic kidney disease, and renal dysplasia. Thirty four fetuses (10.1%) were found to harbor a genetic defect, including 14 numerical chromosomal disorders, 10 structural chromosomal aberrations, and 10 pathogenic copy number variations (CNVs). In 31 cases, the parents elected induced labor. For the 303 fetuses with negative findings, 142 were born by spontaneous delivery or Caesarean section, 48 cases underwent induced labor, 1 case had miscarriage, and the remaining 112 cases had unknown or missed pregnancy outcomes.@*CONCLUSION@#Hydronephrosis or hydronephrosis, polycystic kidney disease, and renal dysplasia are the most common findings among fetuses with urinary system anomalies. Approximately 10.1% of such fetuses are positive by genetic testing.

Application of SNP-array technology in the genetic analysis of pediatric patients with growth retardation / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To explore the value of single nucleotide polymorphism array (SNP-array) for the analysis of pediatric patients with growth retardation.</p><p><b>METHODS</b>One hundred eighty one children with growth retardation were enrolled. DNA was extracted from peripheral samples from the patients, and whole genome copy number variations (CNVs) were detected using Illumina Human Cyto SNP-12. All identified CNVs were further analyzed with reference to databases including ClinGen, ClinVar, DECIPHER, OMIM and DGV as well as comprehensive review of literature from PubMed to determine their pathogenicity.</p><p><b>RESULTS</b>Forty seven patients (26%) with abnormal CNVs were detected, which included 12 known microdeletions/microduplications syndrome (26%), 10 pathogenic non-syndromic CNVs (21%), 3 numerical chromosome aberrations (6%), 3 unbalanced translocations (6%), 4 pathogenic mosaicisms (9%) and 15 cases with unknown clinical significance (32%). After excluding obvious numerical and/or structural chromosomal abnormalities, this study has detected 15 pathogenic microdeletions/microduplications sized 5 Mb or less, which may be missed by routine chromosomal karyotyping. In addition, there were 3 cases with loss of heterozygoisty (LOH) containing known or predicted imprinting genes as well as 2 cases with suspected parental consanguinity.</p><p><b>CONCLUSION</b>SNP-array technology is a powerful tool for the genetic diagnosis of children with growth disorders with advantages of high resolution and improved accuracy.</p>

Investigation of Syndrome Types of Traditional Chinese Medicine in Senile Hypertension Patients：An Analysis of 495 Cases / 广州中医药大学学报

Objective To investigate the syndrome types of traditional Chinese medicine ( TCM) in senile hypertension patients by cluster analysis. Methods Case report sheet for senile hypertension was formed, and then the general data and TCM syndrome information of 495 cases of senile hypertension were recorded. The frequency of syndrome information of the enrolled cases was analyzed, and then the syndrome types were classified by cluster analysis. Results The symptoms with high frequency in senile hypertension patients were dizziness ( 75.9%) , insomnia ( 33.1%) , chest distress ( 29.9%) , poor appetite ( 23.2%) , headache (22.4%), slippery pulse (54.9%), greasy fur (51.7%), stringy pulse (49.7%), and white fur (47.8%) . The main syndrome patterns of 495 cases of senile hypertension were upward hyperactivity of liver yang (23.8%), Qi deficiency and phlegm turbidity (21%), kidney qi deficiency (19.8%), phlegm blended with blood stasis (18.4%), and phlegm heat (17.0%) . Conclusion Senile hypertension patients are dominated with the syndrome types of upward hyperactivity of liver yang, Qi deficiency and kidney deficiency, and are usually complicated with phlegm turbidity, phlegm heat and blood stasis. The complicated syndromes of phlegm turbidity and blood stasis are commonly-seen. The results of cluster analysis are expected to supply evidence for the syndrome differentiation of senile hypertension.