ABSTRACT
<p><b>Background</b>The pathogenesis of postural tachycardia syndrome (POTS) remains unclear. This study aimed to explore the changes and significance of sulfur dioxide (SO) in patients with POTS.</p><p><b>Methods</b>The study included 31 children with POTS and 27 healthy children from Peking University First Hospital between December 2013 and October 2015. A detailed medical history, physical examination results, and demographic characteristics were collected. Hemodynamics was recorded and the plasma SOwas determined.</p><p><b>Results</b>The plasma SOwas significantly higher in POTS children compared to healthy children (64.0 ± 20.8 μmol/L vs. 27.2 ± 9.6 μmol/L, respectively, P < 0.05). The symptom scores in POTS were positively correlated with plasma SOlevels (r = 0.398, P < 0.05). In all the study participants, the maximum heart rate (HR) was positively correlated with plasma levels of SO(r = 0.679, P < 0.01). The change in systolic blood pressure from the supine to upright (ΔSBP) in POTS group was smaller than that in the control group (P < 0.05). The ΔSBP was negatively correlated with baseline plasma SOlevels in all participants (r = -0.28, P < 0.05). In the control group, ΔSBP was positively correlated with the plasma levels of SO(r = 0.487, P < 0.01). The change in HR from the supine to upright in POTS was obvious compared to that of the control group. The area under curve was 0.967 (95% confidence interval: 0.928-1.000), and the cutoff value of plasma SOlevel >38.17 μmol/L yielded a sensitivity of 90.3% and a specificity of 92.6% for predicting the diagnosis of POTS.</p><p><b>Conclusions</b>Increased endogenous SOlevels might be involved in the pathogenesis of POTS.</p>
ABSTRACT
Objective To explore the risk factors for measles among children under 7 years old in Wenzhou, and to provideevidence for establishing scientific strategies on measles elimination. Methods A case-control study was carried out usingmeasles cases(age <7) reported between 2013 to 2015 from the Wenzhou Measles Surveillance System (WZMSS) . Asample of 198 cases were generated from the WZMSS confirmed cases of measles, and 371 controls were generated from theWZMSS excluded cases of measles. General characteristics and potential risk factors were collected, such as sex, age,original place of residence, length of stay in Wenzhou, history of hospital exposure and measles immunization history(i.e.receiving measles-containing vaccine) and so on. An univariate and multivariate logistic regression models were used toassess the association between different factors and the incidence of measles , and to investigate the risk factors that influencethe incidence of measles. Results A total of 198 measles cases among children under age 7 were reported between 2013 to2015 in Wenzhou, taking up 67.58% of the total reported measles cases of WZMSS, and suggesting an average of annualincidence rate of 8.85/10 million. The incidence ratio of male to female was 1.57:1.00. Children of 6-8 months old had thehighest incidence rate of 151.66/10 million. The incidence rate among migrant children was 15.01/10 million and wassignificantly higher thanlocal children(P<0.05) . Univariate logistic regression showed that the incidence of measles weresignificantly associated with age, original place of residence, length of stay in Wenzhou, history of hospital exposure andmeasles immunization history(P<0.05) . Multivariate logistic regression showed that migrant children(OR =2.28, 95%CI:1.56-3.33), no measles immunization history(OR=3.83, 95%CI: 2.48-5.92) and having hospital exposure(OR =2.35, 95%CI: 1.58-3.47) were risk factors for the incidence of measles. Conclusion Children of 6-8 months old had thehighest incidence rate of measles. Migrant children, nomeasles immunization history and having hospital exposurecould increase the incidence rate of measles among children younger than 7.
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Objective To evaluate the immunization coverage of the first dose of measles containing vaccine (MCV1 )by using the incidence of measles in Wenzhou City.Methods Descriptive epidemiological methods were used to analyze measles cases that reported in Wenzhou city from 2007 to 2012 and evaluate the immunization coverage of the first dose of measles containing vaccine.Results The average annual incidence rate was 10.46/100 000 from 2007 to 2012,and the annual incidence rate was 43.44/100 000 for children aged from 8 months to 83 months (42.59%).Based on the proportion of immunized measles cases vaccine effectiveness (VE)of MCV,the evaluated coverage rate of MCV1 was 73.80% (VE=90%)or 84.92% (VE=95%)in children aged from 13 to 83 months.The evaluated coverage rate of MCV1 was 83.25%(VE=90%)or 90.86%(VE=95%)in local children and 69.5 1%(VE=90%)or 82.02%(VE=95%)in migrating children.The timely immunization rate of MCV1 was 59.48% (VE =90%)or 74.59% (VE =95%).Conclusion The coverage rate and timely coverage rate of MCV1 are still low.It is important to strengthen the management of migrating population and enhance propaganda to ensure a high level vaccination rate to accelerate the elimination of measles.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the efficacy of continuous propofol infusion via the common carotid artery for general anesthesia.</p><p><b>METHODS</b>Forty adult patients scheduled for abdominal surgery were randomly assigned into 2 groups to receive propopol via the common carotid artery (IC group, n=20) or via the median cubital vein (IV group, n=20). Anesthesia was induced with intravenous administration of drugs and maintained with continuous propofol infusion via the common carotid artery or the median cubital vein, with the CSI stabilized at 40-/+5 till the end of the operation. During the anesthesia, intravenous injection of fentanyl (3 microg.kg(-1).h(-1)) and vecuronium (50 microg.kg(-1).h(-1)) were given intermittently to maintain the analgesia and muscular relaxation. The dose of propofol used, hemodynamics and recovery of the patients were observed.</p><p><b>RESULTS</b>The dose of propofol used during the surgery to maintain a CSI of 40-/+5 was significantly lower in group IC and than in group IV (2.57-/+0.67 vs 5.72-/+1.37 mg.kg(-1).h(-1), P<0.01). In group IC, the blood pressure was elevated in more than half of the patients and in some cases, the elevation exceeded one third of baseline value and needed intervention with hypotensive drugs. In the IV group, the patients' blood pressure remained stable and varied within the amplitude of 15% of the baseline level. Recovery of spontaneous breathing and consciousness was more quickly in group IC than in group IV (P<0.05).</p><p><b>CONCLUSION</b>Loss of consciousness and nervous reflex can be achieved with propofol infusion via the common carotid artery, which reduces propofol dose by about 50% in comparison with intravenous infusion and allows more rapid recovery of spontaneous breath and consciousness.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Abdomen , General Surgery , Analgesics, Opioid , Anesthesia, General , Methods , Carotid Artery, Common , Fentanyl , Hypnotics and Sedatives , Infusions, Intra-Arterial , Nicotinic Antagonists , Propofol , Treatment Outcome , Vecuronium BromideABSTRACT
<p><b>OBJECTIVE</b>To compare the effects of common carotid artery and femoral vein administration of propofol for electrocerebral silence (ES) on circulatory and respiratory function and the dosage of propofol required during ES in dogs.</p><p><b>METHODS</b>Eight dogs were anesthetized by common carotid arterial and femoral vein administration of propofol for ES for 1 h. The time of consciousness loss and recovery, dose of propofol during ES, mean arterial pressure, heart rate, respiration rate, end-tidal carbon dioxide, SpO2, cerebral state index (CSI) and anal temperature were continuously monitored. Changes in the outcome variables were analyzed at 7 time points, namely the baseline, upon loss of consciousness, at 10 s, 30 min and 1 h of CSI=0, and recovery of CSI and consciousness.</p><p><b>RESULTS</b>Carotid artery propofol administration produced ES with only half of the dose for intravenous administration. Compared with the baseline values, the mean artery pressure and respiration rate remained unchanged or decreased transiently during ES with carotid artery propofol administration. In contrast, intravenous propofol administration resulted in systemic hypotension and severe respiratory depression.</p><p><b>CONCLUSION</b>Carotid artery propofol administration produces ES with a much smaller dose than intravenous propofol administration without causing systemic hypotension or respiratory depression.</p>