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Objective@#To determine the HIV infection of a 13-year-old leukemia patient Wei using molecular tracing technique.@*Methods@#Three blood samples were collected from the persons who were associated with HIV positive blood donation member Lang. The viral load was tested and pol gene was sequenced and analyzed. At the same time using HyPhy2.2.4 and Cytoscape 3.6.1 to establish the molecular network with these 3 samples sequences and other HIV subtypes sequences obtained from Luzhou.@*Results@#The HIV-1 viral load test result of the three patients were: Lang 933 CPS /ml (treated, blood donor), Wei (blood recipitent) 89 813 CPS /ml, Deng (blood recipitent) 85 158 CPS /ml. The subtype of HIV-1 of these three samples were all recombinant HIV CRF01_AE, and the pol gene similarity was 98.8% (Lang and Wei), 99.7% (Lang and Deng), and 99.1% (Wei and Deng), respectively. The gene sequences of the three samples were linked into clusters (the gene distance was less than 0.004).@*Conclusions@#The patient Wei with leukemia was infected with HIV-1 due to blood transfusion during the seroconversion period, and the three patients were more likely to be infected with the same HIV-1 strain. It is necessary to popularize the use of high-sensitivity nucleic acid detection method in blood collection and supply institutions, which can effectively improve the safety of blood use.
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Objective To investigate the radioactivity levels in foods in environmental protection area around a decommissioned uranium mine in Yunnan province,in order to timely discover the release of radioactive substances and to provide accumulated baseline data.Methods Radioactivity levels in grains,vegetables and fresh tea at 20 sampling points were measured in the environmental protection area within 3 km of a decommissioned the uranium mine.After field pretreatment and laboratory preparation,the radionuclides in samples were analyzed by means of γ spectrometry.Results Radionuclides in foods in the area mainly include natural radionuclides (238 U,232Th,226Ra,40 K) and man-made radionuclide (137 Cs).Radioactivity level of 238U,232Th,226Ra and 40K was (0.17 ± 0.05),(0.25 ± 0.17),(0.43 ±0.28)and (103.49 ±25.10)Bq/kg(fresh weight),respectively.Radioactivity levels of 232Th,226Ra,40K and 137Cs in fresh tea were all higher than those in grains and vegetables.Conclusions Radioactivity levels in foods around the area are lower than the relevant national limits.No man-made radionuclide other than 137Cs was found in the area.
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Objective@#To investigate the role of des-gamma-carboxy prothrombin (DCP) in assessment of liver function and prognosis of patients with liver cirrhosis. @*Methods@#From January 2013 to August 2016, a total of 137 patients with liver cirrhosis in Shanghai Changzheng Hospital were enrolled. The serum DCP level was measured, the clinical data was collected and the complication and survival situation was followed up. The 137 patients were divided into DCP negative group (DCP≤40 mAU/mL, 118 cases) and DCP positive group (DCP>40 mAU/mL, 19 cases). Forty-five patients with compensated liver cirrhosis were divided into high-level DCP group (DCP>16.5 mAU/mL, 32 cases) and low-level DCP group (DCP≤16.5 mAU/mL, 13 cases). Chi square test was used to analyze the difference in the positive rate of DCP in patients with different Child-Pugh classification. Spearman correlation test was performed to analyze the correlation between DCP and model for end-stage liver disease (MELD) scores. Kaplan-Meier survival curve was used to analyze the correlation between DCP and liver disease related mortality. @*Results@#Compared to that of DCP negative group, albumin level of patients in DCP positive group decreased (35 g/L, 20 to 57 g/L vs. 29 g/L, 17 to 42 g/L), however, total bilirubin (TBil), prothrombin time (PT), and international normalized ratio all increased (12.9 mg/L, 1.80 to 83.0 mg/L vs.22.2 mg/L, 6.4 to 169.0 mg/L; 15.5 s, 11.7 to 35.7 s vs.17.5 s, 13.9 to 33.4 s; 1.24, 0.96 to 3.72 vs.1.44, 1.09 to 3.22), and the differences were statistically significant (Z=-2.785, -2.891, -2.945 and -2.879, all P<0.01). The DCP positive (DCP>40 mAU/mL) rates of Child-Pugh A, B and C patients were 1.8% (1/55), 21.2% (11/52) and 23.3% (7/30), respectively, and the difference was statistically significant (χ2=11.246, P=0.003). The DCP levels of patients with Child-Pugh class B and C cirrhosis were significantly correlated with MELD scores (r=0.259, P=0.021). There were 16 and three patients with ascites and spontaneous bacterial peritonitis (SBP) of DCP positive group, and the incidence was higher than that of DCP negative group (55.1%, 65/118 and 1.7%, 2/118), and the differences were statistically significant (χ2=5.744 and 97.636, both P<0.05). Patients in high-level DCP group had a higher proportion of clinical decompensation than low-level DCP group (53.1% (17/32) and two cases), the difference was statistically significant (χ2=5.397, P=0.024). The overall survival rate of DCP positive group (nine survival cases) were lower than that of DCP negative group (87.9%, 87/99), and the difference was statistically significant (χ2=5.442, P=0.020). @*Conclusions@#Serum DCP level is closely related to liver function, ascites and SBP in patients with liver cirrhosis. Furthermore, it is associated with occurrence of decompensation in compensated patients and liver-related mortality in patients with liver cirrhosis. DCP may be a useful serum marker for evaluation of disease severity and prognosis in patients with liver cirrhosis in clinical practice.
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Objective To explore the analgesic effect of ropivacaine combined with sufentanil in epidural anesthesia on walk on painless labor.Methods 134 cases of maternal pregnancy were selected and randomly divided into two groups.61 cases were treated with conventional delivery,73 cases in the experiment group were treated with walk on painless labor.The visual analogue scale and improved Bromage classification score were compared at the first stage of labor,the second stage of labor,the third stage of labor.Results Compared with the control group,the rate of cesarean section was higher(P<0.05),The visual analogue scale was higher at the first stage of labor,the second stage of labor,the third stage of labor,the duration of labor were lower at the first stage of labor,the second stage of labor,the third stage of labor(P<0.05),and there was no significant difference between the two groups in the motor nerve block.Conclusion Ambulatory labor analgesia on maternal effect significantly,can significantly reduce the pain degree of maternal birth process and deliverry time,postpartum less complications.
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Objective To determine the dose?response relationship of bupivacaine coadministered with sufentanil for subarachnoid block in severely preeclamptic patients undergoing cesarean delivery. Methods Two hundred patients with severe preeclampsia, of American Society of Anesthesiologists physi?cal statusⅠ?Ⅲ, scheduled for elective cesarean delivery, were divided into 4 groups ( n=50 each) using a random number table: bupivacaine 4 mg group ( group B4 ) , bupivacaine 6 mg group ( group B6 ) , bupivacaine 8 mg group ( group B8 ) , and bupivacaine 10 mg group ( group B10 ) . In B4 , B6 , B8 and B10 groups, bupivacaine 4, 6, 8 and 10 mg plus 2.5μg sufentanil in 2.5 ml of normal saline were injected into the subarachnoid space, respectively. Effective anesthesia was defined as bilateral sensory block of T6 achieved at 10 min after intrathecal administration when measured by pin?prick test, and with no need for epidural supplementation ( lidocaine ) . A probit analysis was used to estimate the 50% effective dose ( ED50 ) and 95% effective dose ( ED95 ) with 95% confidence intervals for bupivacaine, coadministered with sufentanil, when used for subarachnoid block in severely preeclamptic patients underwent cesarean de?livery. Results When coadministered with sufentanil, the ED50 and ED95 ( 95% confidence interval) of bupivacaine were 5.67 ( 5. 20-6. 10) mg and 8. 82 ( 8. 14-9.87) mg, respectively, for subarachnoid block in severely preeclamptic patients underwent cesarean delivery. Conclusion The ED50 and ED95 of bupivacaine for subarachnoid block, when coadministered with sufentanil 2.5 μg, are 5.67 and 8.82 mg, respectively, in severely preeclamptic patients undergoing cesarean delivery.
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Objective To explore the effect of comorbidities on the surgical outcomes of elderly patients with hip fracture. Methods The Age,gender,weight,type of fracture,preoperative comorbidities and surgical outcomes of 117 patients aged 80 yr or over who undergoing hip fracture surgery in our hospital were recorded. Patients were divided into rehabilitation group and postoperative in-hospital death group ac-cording to surgical outcomes. The potential predictors of postoperative in-hospital death were identified by univariate model and were then entered into multiple Logistic regression analysis. Results Twenty three patients(19. 7%)had no comorbidity,94 patients(80. 3%)had one or more comorbidities. Ten patients(8. 5%)died in hospital after the operation. Predictors of postoperative in-hospital death were preoperative respiratory diseases and three or more comorbidities. Conclusion Surgical outcomes of elderly patients with hip fracture may be predicted by analysing preoperative comorbidities. Preoperative preparations must be sufficient in order to ensure successful operation.
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Objective To investigate the efficacy of endoscopic intranasal structure reconstruction surgery for rhinogenous headache. Methods 82 cases of rhinogenous headache were given endoscopic intranasal structure reconstruction. Compared VAS scores before and 6 months after treatment, counted the effective rate. Results Among the 82 patients, 69 patients(84. 1%) were cured, 8 cases (9. 8%) were of obvious effect, 5 cases (6. 1%) were invalid, and the total efficiency was 93. 9%. VAS scores of the mucosal contact headache group before treatment were greater than that of the sinus headache group (P0. 05). Conclusion Endoscopic surgical operation can remove the extrusion of the nasal cavity and paranasal sinuses and factors of nasal congestion, and then reconstruct normal anatomical structure of nasal cavity, thus restoring normal function of paranasal sinuses. It has good therapeutic effect on rhinogenic headache.
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Objective To explore the most effective formula to predict the catheterization length of the right internal jugular vein by an-terior approach. Methods Sixty-seven cases performed with right internal jugular vein catheterization from January 2013 to June 2013 were enrolled in this study and 4 formulas were selected to predict the catheterization lengths. Comparing their predicted lengths with the actual lengths defined as the lengths of the internal catheters which terminals were inserted to a accurate position,and analyse their predictive validi-ty. Results The predictive error percentages of the 4 formulas were all less than 15%. Comparing the predicted lengths and the actual lengths, there was no difference between the predicted length of the 1st formula and the actual one(P>0. 05),and the predicted lengths of the other three formulas were significantly less than the actual ones(P0. 05). Conclusion The predictive error of all the 4 formulas is less than 15%, and the 1st formula is simple,practical and associated with a much smaller error,more suitable to estimate the length of the right internal jugular vein catheterization by anterior approach.
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Objective To evaluate T cell and CD4+ CD28-T in the development and progression of abdominal aortic aneurysms (AAAs).Methods Fifty Wistar rats were randomly divided into 5 groups (n =10 each).An AAA animal model is established by enhancing perfusing elastase to the infrarenal abdominal aorta of the rats.The levels of T cell,B cell and macrophage cell of abdominal aorta of the rats on days 3,7,14 and 28,were detected by enzyme linked immunosorbent assay(ELISA).CD4+ CD28-T cell of the peripheral blood were measured by flow cytometry.Result There was significant T-lymphocyte infiltration both in middle and outer membrane of the artery of the rats on day 7 after surgery.T-lymphocyte,B-lymphocyte and macrophage cell infiltration were on the peak in middle and outer membrane of the artery on day 14 after surgery.The ratio of CD4+ CD28-T cell in rat peripheral blood reached peak on day 7(P ＜0.05).Conclusions T cell and CD4+ CD28-T cell expression increased in peripheral blood and abdominal aorta in AAA rat model,suggesting a potential role of T cell and CD4+ CD28-T cells in the pathogenesis of AAAs,especially during the early development of AAAs.
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Objective To compare the efficacy of laryngeal tube suction Ⅱ (LTS Ⅱ ) and ProSeal laryngeal mask airway (PLMA) for airway management during general anesthesia. Methods One hundred and twenty adult ASA Ⅰ or Ⅱ female patients, aged 30-50, with body mass index ＜ 30 kg/m2, undergoing general anesthesia for elective surgery were randomly divided into 2 groups ( n = 60 each) : PLMA group and LTS Ⅱ group. Each group was further divided into 2 subgroups: PLMA controlled ventilation group (group PC), PLMA spontaneous breathing group (group PS), LTS Ⅱ controlled ventilation group (group LC) and LTS Ⅱ spontaneous breathing group (group LS) . The rate of successful insertion was recorded. PetCO2 , peak airway pressure, lung compliance and incidence of gas leakage during controlled ventilation were recorded before operation, 10 min after the start of operation and at the end of operation. The tidal volume and PetCO2 were recorded in patients breathing spontaneously when the breathing was stable. The bucking and body movement were observed during removal of LTS Ⅱ or PLMA. The side effects in 24 h after surgery were recorded.Results Insertion was successful in all the patients. During either spontaneous breathing or controlled ventilation, the peak airway pressure was significantly higher in the patients with LTS Ⅱ than in the patients with PLMA ( P ＜ 0.05), and there wag no significant difference in the other ventilatory parameters between the two devices. There was no significant difference in the incidences of postoperative complications among the groups ( P ＞ 0.05) . Conclusion The efficacy of PLMA for airway manage ment is better than that of LTSⅡ during general anesthesia.