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Objective To observe the clinical effects of Dexmedetomidine in combination with Sevoflurane for hysteroscopic resection. Methods 72 patients underwent hysteroscopic resection from January 2014 to December 2015 were divided into study group and control group according to the anesthesia mode. Patients in study group were in combination anesthesia mode of intravenous infusion of Dexmedetomidine and Sevoflurane inhalation, while patients in control group received Sevoflurane inhalation only. The clinical parameters and adverse reactions were observed and studied. Results Compared with control group, significant differences were shown in patients heart rate at T2, T3 and T4 and breathing rate at T2 in observation group (P 0.05). Compared with control group, the respiratory depression, sedative effect of Ramsay sedation score, wakefulness, alertness / sedation score of observation method (OAA/S), digital pain score (NPRS), postoperative uterine contraction pain score, postoperative nausea and vomiting of study group had significant statistical differences (P < 0.05). Conclusion Combination anesthesia mode of intravenous pumping Dexmedetomidine and inhalation of Sevoflurane has good clinical effects for patients undergoing hysteroscopic resection.
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Objective To analyze the early risk factors of overweight and obesity in preschool children.Methods Using stratified cluster sampling,the data of 1 335 preschool children's physical examination in High-tech Zone,Urumqi,Xinjiang were collected,and the case group had 153 overweight and obese children,the control group had 1 182 non-overweight and obese children;a case-control study was conducted.The basic data of mothers and the basic data of neonatal birth were analyzed retrospectively.The univariate and unconditional multivariate logistic regression analysis was performed.Results The prevalence of overweight and obesity in preschool children in High-tech Zone in Urumqi was 11.5％.Non-conditional multivariate logistic regression analysis showed that children's age (OR=1.31,95％ CI:1.07-1.61),mother's pre-pregnancy BMI (OR=1.11 95 ％,CI:1.06-1.17) and whether mothers had gestational hypertension (OR=1.99 95％,CI:1.03-3.85) were the risk factors for overweight and obesity in preschool children (P＜0.05).Conclusion In Urumqi high school district preschool children's overweight and obesity rate was high;mothers with high BMI before pregnancy,and those with high blood pressure during pregnancy can increase the risk of overweight and obesity in children,preschool children's increased age may increase the risk of overweight and obesity in children.
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Through the expert questionnaire (Delphi Indagate) to form Traditional Chinese Medicine (TCM) Healthy Lifestyle Guiding Principles.We conducted two rounds of surveys of TCM experts in the field of preventive health care on the basis of previous literature research.This study was aimed to form the framework in order to entry to the TCM Healthy Life-style Guiding Principles.The results showed that the positive coefficient of experts in two rounds of investigation were 84.31％ and 100％,respectively.The authoritative decree were both more than 0.7.The expert opinion score mean median was 9.21 and 9.085.Median mean values were 7.965 and 7.925.The median scores of full marks were higher than 65.12％ and 66.67％.The minimum coefficients of variation were 0.11 and 0.10.It was concluded that in the investigation and study,the enthusiasm of the experts,professional standards and credibility were high.Expert opinion is more concentrated.Expert opinion is well coordinated and gradually converges through two rounds of surveys.Through the Delphi indagate,the basic framework and items of TCM guiding principles of healthy lifestyle were established,which laid the foundation for further standardizing the guiding principles of TCM in healthy lifestyle.
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Objective To investigate the effect of radiotherapy on carotid plaque ulcer formation by using ultrasound imaging.Methods Totally 93 cases diagnosed with head and neck cancers which had complete carotid ultrasound data and other baseline data before and after radiotherapy (RT) were retrospectively enrolled.The total number of plaques,average intima-media thickness,maximum plaque area,total number of ulcer plaques,maximum ulcer plaque area and the maximum area of the ulcer pit were compared in RT side and non RT side before and after RT respectively.Results The average interval time was 6.1±1.9 years between twice RT.Before RT,there were no statistical differences between RT side and non-RT side in the total number of plaques,the average intima-media thickness,maximum plaque area,total number of ulcer plaques,maximum ulcer plaque area and maximum area of the ulcer pit.After RT,compared with those of non-RT side,there were more lesions of the total number of plaques,the thicker average intima-media thickness,the larger maximum plaque area,the more maximum number of ulcer plaques,the larger maximum ulcer plaque area and maximum area of the ulcer pit in RT side,which had statistical defference (all P＜0.05).Conclusion RT can lead to the formation and progression of carotid atherosclerotic plaque in patients with head and neck cancers,and the plaque has a vulnerability characteristics.
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Nitrous oxide/oxygen is one of the inhaled anesthetics that receives attention by scholars at home and abroad for its unique characteristics of excellence comparing with intravenous sedation analgesia which is more commonly used. In addition, the nurses who are the main body personnels of the pain management have certain differences in the implementation of the nitrous oxide/oxygen sedation analgesia both at home and abroad. In this paper, the nitrous oxide/oxygen analgesia and sedation and its nursing implications were reviewed from the physical and chemical properties, pharmacokinetic characteristics, excellent properties, mechanism of action and clinical application, then development directions of management in the future are put forwarded so as to provide theoretical evidences and practical guidelines for domestic medical staffs cooperating to implement the technology.
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Objective To compare the diagnostic value between ultrasound radiography with enhanced CT in patients with focal liver lesions.Methods 80 patients with focal liver lesions were enrolled.They were detected through ultrasound radiography and enhanced CT.Results In 80 patients,there were 21 cases with primary liver cancer,18 cases with metastatic cancer,20 cases with hepatic hemangioma,11 cases with focal hepatic fatty infiltration,7 cases with hepatic focal nodular hyperplasia and 5 cases with liver hardening of nodules.17 patients with metastatic cancer were diagnosized through ultrasound radiography and 16 cases were diagnosized through enhanced CT.7 patients with hepatic focal nodular hyperplasia were diagnosized through ultrasound radiography and 6 cases were diagnosized through enhanced CT.There were no significant differences in the diagnostic results between the two groups (x2 =0.0379,0.0835,all P ＞ 0.05).Conclusion There are different enhanced modes in ultrasound radiography for different nature of focal liver lesions,which has a equal diagnostic value with enhanced CT.
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Objective To analyze the clinical features of 385 postoperative thyroid nodules patients,and to compare the correlation affected by different factors between benign and malignant thyroid nodules.Methods Total 385 patients underwent thyroid operation in general surgery department of our hospital were enrolled.Their clinical data,ultrasonic scanning of thyroid,and pathological results were compared between benign and malignant thyroid nodules.Results (1)264 cases with benign nodules (68.57％) and 121 cases with malignant nodules (31.43 ％)were found among 385 cases.The average age of benign group was (48.1 ± 13.4) years old,while malignant nodules group was (45.6 ± 12.5) years old.(2) No gender difference was found between benign and malignant nodules group (P＞0.05).(3) According to body mass index (BMI),the highest prevalence of malignant nodules was in overweight group,followed by obesity group.(4) Fasting blood glucose was (5.61 ± 1.07) mmol/L in benign group and (5.86±1.21) mmol/L in malignant group(P＜0.05).(5) Thyroid-stimulating hormone (TSH) in benign nodules group was (1.62 ± 1.30) mIU/L,while in malignant nodules group,which was (2.02 ±2.59) mIU/L(P＜0.05).(6) Irregular shape,unclear boundary,calcification,and lymph node metastasis were more frequent in malignant group than those in benign group under ultrasonic scanning (P＜0.05).(7) Logistic regression analysis revealed that the existence of thyroid cancer was significantly associated with age,fasting blood glucose,ultrasonic images(lymph node metastasis,irregular shape,and calcification).Conclusion (1) Fasting blood glucose levels and TSH in the malignant nodules group are higher than those in the benign group.(2) A negative correlation exists between age and thyroid cancer prevalence.(3) Ultrasonic images,including lymph node metastasis,irregular nodule shape,and calcification,may suggest the high possibility of thyroid cancer.
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Objective To assess the efficacy of early detection of breast cancer and the prognostic value of breast self-examination(BSE).Methods Randomized controlled trials(RCTs)involving BSE were included the present meta-analysis based on their qualities.The pooled analysis was performed with RevMany 4.2.8.Results Three RCTs were identified and then they were included the present metaanalysis.In women who conducted a BSE.the rate of biopsy fora lump in breast was 1.27%in the first 5 years,2.47%in more than 5 years but less than or equal to 10 years,and 2.50%in more than 10 years, respectively,all of which were significantly higher than in those who could not conduct a BSE(P<0.05) There was no significant difierence in the rate of final diagnosis and the mortality for breast cancer between the two populations in any follow-up time(P>0.05).Conclusion The rate of biopsy for a lump in breast in women could be increased by a BSE.which should not have been discarded from the early detection of breast cancer completely despite it is not helpful in increasing the rate of final diagnosis and decreasing the mortality for breast cancer.
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BACKGROUND: Hyperuricemia (HUA), serving as a component of metabolic syndromes (MS), has a major regulatory role in inflammatory responses. However, the correlation between G-308A tumor necrosis factor-α (TNF-α) and MS is still controversial.OBJECTIVE: To study the correlation among G-308A TNF-α genotype distribution, TNF-α mRNA expression and C-reactive protein (CRP) in patients with HUA.DESrGN: Patients with HUA were selected as the subjects, while normal peoplewere taken as the controls.SETTING: Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology.PARTICIPANTS: Subjects were selected from 5 003 people, including 188 patients with HUA and 51 healthy people.Patients with HUA included 40 patients with simple HUA, 42 patients with HUA and dyslipidemia, 80 patients with HUA and dyslipidemia and hypertension, and 26 patients with gout (administration of allopurinol was stopped at one week before the experiment).METHODS: TNF-α gene promoter G-308A genotype was determined by using PCR application followed by Nco/digestion.TNF-α mRNA expression was studied by RT-PCR with semi-quantitative analysis. Antibody sandwich method and enzyme linked immunosorbent assay (ELISA) were adopted to determine the CRP concentration. And the serum uric acid was measured by uricase method, while the insulin resistance index (IRI) was evaluated with homeostasis model.MArN OUTCOME MEASURES: ① Hardy-Weinberg equilibrium test of genotypic frequency. ② Changes in distribution of G-308A TNF-α genotypes and TNF-α mRNA expression in patients with HUA. ③ Changes in TNF-α mRNA expression and other parameters in G-308A TNF-α AA+GA and GG groups. ④ Multiple stepwise regression analysis.RESULTS: A total of 188 patients and 51 normal people were involved in the analysis of results. ① G-308A TNF-α genotypes distribution in 239 enrolled subjects accorded with Hardy-Weinberg equilibrium. ② AA+GA was compared with GG due to lower frequency of AA in population. The results revealed the HUA with dyslipidemia and hypertension group displayed a greater prevalence in G-308A TNF-α AA+GA genotype (30%) than that in the control group (12%) (P ＜ 0.05),while there were no significant differences among other groups. ③ TNF-α mRNA expression and CRP concentration were the highest in the gout group, and HUA accompanied by dyslipidemia and hypertension group listed the second,and then was the HUA and dyslipidemia group, while simple HUA group listed the last, all of which were higher than those in the normal control group (P ＜ 0.05-0.01). TNF-α mRNA expression in HUA accompanied by dyslipidemia and hypertension group, gout group was higher than that in the normal control group (P ＜ 0.05-0.01). The WHR, SBP, DBP,serum uric acid, triglycerides, TNF-α mRNA expression and CRP concentration in AA+GA group were remarkably higher than those in the GG group (P ＜ 0.05-0.01). ④ After adjustment of age, gender, systolic pressure, diastolic pressure,fasting blood glucose, and multiple variable linear stepwise regression showed that triglycerides, uric acid, TNF-α 308 A carrier were related with quantityof TNF-α mRNA expression. Meanwhile, the uric acid concentration, WHR and the quantity expression of TNF-α were significantly in positive association with CRP concentration.CONCLUSTON:The genotype of TNF-α 308 A carriers is associated with TNF-α expression and plasma CRP levels in HUA patients.
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BACKGROUND: Recent studies have found that hyperuricemia and gout are closely correlated with the occurrence and development of diabetes, coronary heart disease, hypertension and cerebrovascular diseases. It is of significance to investigate their prevalence so as to find way of early interventions.OBJECTIVE: To determine the prevalence and risk factors of gout and hyperuricemia among residents above 20 years old in Shandong coastal area.DESIGN: A randomized, stratified cluster sampling survey.SETTING: Department of Endocrinology, Affiliated Hospital of Qingdao University Medical College.PARTICIPANTS: A random, stratified cluster sampling was conducted in Shandong coastal area including Qingdao,Yantai, Weihai, Rizhao and Dongying. Residents lived in these areas for 5 years or more, aged between 20 to 80 years, were selected, and they were surveyed by family as a unit.METHODS: A randomized, stratified cluster sampling survey was conducted. The prevalence of gout and hyperuricemia were investigated among about 5 000 residents in Qingdao, Yantai, Weihai, Rizhao and Dongying. The serum uric acid, lipids, glucose and creatinine were detected with Sysmex chemix-180 total automatic biochemical analyzer. Those with uric acid higher than reference level were reexamined by collecting fasting blood sample on the third day. The comparison between rates was taken with the Chi-square test, means between two groups with the t test, means between multiple groups with analysis of variance, correlation between dependent and independent variables with logistic regression analysis.MATN OUTCOME MEASURES: Prevalance of hyperuricemia; Level of serum uric acid; Prevalence of gout in patients with hyperuricemia; Influencing factor of hyperuricemia.RESULTS: This investigation planned to include 5 500 subjects while in fact 5 003 subjects were investigated and the response rate was 91%, in which males were 2 395 (47.87%) and females were 2 608 (52.13%). ① The prevalence of hyperuricemia was 13.19% with standardized rate of 13.27% according to the Shandong population in 2000; The pevalence was higher in males than in females (18.32%, 8.56%, x2=108.52, P＜ 0.01). The risk in males was 2.5 times higher than that in females (OR =2.5). The prevalence of gout was 1.14% with standardized rate of 1.10%; and the prevalence in males was higher than that in females (1.94%, 0.42%, x2=30.38, P ＜ 0.01). The risk in males was 5.3 times higher than that in females (OR =5.3). ②The average value of serum uric acid in normal males was higher than in normal females [(343.40±84.54), (258.90±70.90) μmol/L, t =48.03, P ＜ 0.01]. It was obviously higher in male patients with hyperuricemia than in female ones [(469.43±48.08), (399.73±104.91) μmol/L, t =11.70, P ＜ 0.01]. It was higher in male patients with gout than in female ones [(502.44±106.76), (403.48±52.72) μmol/L, t =2.07, P ＜ 0.05]. ③The prevalence of gout in patients with hyperuricemia was 8.34%. ④ The prevalence of hyperuricemia and gout were climbing up with age after 40 years old in females and those elder than 70 years old were of high risk; while in males,the prevalence of hyperuricemia and gout increased with age before 60 years old and those aged 50-59 years were of high risk, yet after 60 years, it climbed up with age again. Nevertheless, the mean ages of hyperuricemia and gout in females were older than male. The average episode ages of hyperuricemia and gout in females were later than in males respectively by 7.5 and 8.5 years. ⑤ Non-conditional Logistic regression analysis showed that drinking frequency,drinking quantity, the quantity and frequency of seashell intake, BUN, Cr, TG, TC, BMI and WHR were the independent risk factors of male patients with hyperuricemia [OR =1.016-30.217, 95%C/ (1.010-1.023)-(9.955-214.869)]; while HDL-C and heavy physical labour were the protective factors (OR =0.492, 95%C/ 0.339-0.713; OR =0.755, 95% CI 0.575-0.991).As for females, age, hypertension, the quantity of seashell food intake, BUN, Cr, TG, WHR and light physical labour were the independent risk factors of hyperuricemia [OR =1.022-27.34, 95%CI (1.006-1.040)-(9.955-214.869)]. Similarly, HDL-C was a protective factor (OR =0.428, 95%CI0.223-0.820).CONCLUSION: ① The prevalence of hyperuricemia and gout are different between genders: ② The risk factors of hyperuricemia and gout among residents in Shandong coastal area include the high intake of marine products such as seashell foods, less physical activity, abdominal obesity and kidney insufficiency, as well as the existence of metabolic syndrome. Drinking is also involved in the increased prevalence in males, and age in females. ③ Higher risk for hyperuricemia and gout are noticed in all age groups in males, whereas in females after 50 years old.
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BACKGROUND: What are the influencing factors of serum uric acid of inhabitants from coastal area? What is the critical concentration of serum uric acid to prevent and treat metabolic syndrome?OBJECTIVE: To probe into the relationship between serum uric acid and metabolic syndrome in female inhabitants aged more than 20 years from coastal area of Shandong province.DESIGN: A clusting stratified random sampling survey.SETTING: Department of Endocrinology, Affiliated Hospital of Medical College of Qingdao University.PARTICIPANTS: The survey was carried out in the female inhabitants of five cities from coastal area of Shandong province (Qingdao, Rizhao, Yantai, Weihai and Dongying) between May and October 2004. The inhabitants, aged 20 to 80 years, lived there for 5 or more than 5 years, and they were natural crowd taking family as unit.METHODS: Investigations in the manner of entering every family and being on the spot were combined. Questionnaires were filled in on the first day, and fasting blood was taken to perform serum uric acid examination on the morning of the second day. For those with serum uric acid higher than normal, they were given rechecking on the third day, and education about prevention and treatment of gout and hyperuricemia was conducted at the same time.MAIN OUTCOME MEASURES: ① Investigation on general condition:Including health status, diet, physical activity, labour intensity and economics. ② Investigation on nutrition: Consists of food intake frequency and dietary. ③ Body height, body mass, waistline, hip circum, blood pressure and body mass index. ④ Levels of fasting blood glucose(FBG), serum uric acid, total cholesterol (TC), triacylglycerol (TG), high-density lipoprotein cholesterol(HDL-C), urea nitrogen (UN) and creatinine(Cr).RESULTS: ① With the increase of concentration of serum uric acid, levels of systolic pressure (SP), diastolic pressure (DP), pulse pressure (PP),body mass index(BMI) , waistline, waist-to-hip ratio(WHR), UN, Cr, TG,TC were all gradually increased. Each index was significantly higher in the serum uric acid 280-319 μmol/L group, serum uric acid 320-349 μmol/L group and serum uric acid ＞ 350 μmol/L group (hyperuricemia group)than that in serum uric acid ＜ 280 μmol/L (P ＜ 0.05-0.01 ), While the concentration of HDL-C was decreased with the increase of concentration of serum uric acid (all P ＜ 0.01). ② The incidence of hypertension, lipid metabolic disorder, overweight and obesity, glycometabolism disorder as well as metabolic syndrome was increased with the increase of uric acid;Compared with serum uric acid ＜ 280 μmol/L group, OR value of metabolic syndrome was 2.29(95%CI: 1.81-2.89),4.15(95%CI:3.10-5.55),4.96 (95%CI:3.85-6.39) in the serum uric acid 280-319 μmol/L group,320-349 μmol/L group and hyperuricemia group , respectively. ③Noncondition Logistic multiple stepwise regression analysis showed that age,hypertension, shellfish intake volume, UN, Cr, TG and WHR and light physical activity were the independent risk factors for female patients with hyperuricemia and HDL-C was protective factor.CONCLUSION: The incidence of metabolic syndrome is increased with the increase of concentration of serum uric acid in female inhabitants from coastal area of Shandong province. 280 μmol/L should be as the critical concentration of serum uric acid to prevent and treat metabolic syndrome.Controlling metabolic syndrome and reducing intake of shellfish and other marine products which contain high level of purine is one of means to prevent hyperuricemia. Clinical physicians should paid more attention to the pathopoiesis of hyperuricemia.