Efficacy of different doses of apatinib combined with chemotherapy in the treatment of advanced gastric cancer and its effect on prognosis / 中国基层医药

Objective:To investigate the efficacy of different doses of apatinib combined with chemotherapy in the treatment of advanced gastric cancer and its effect on prognosis.Methods:Sixty-nine patients with advanced gastric cancer who received treatment in Lishui City People's Hospital from January 2015 to February 2019 were retrospectively analyzed. All patients received apatinib combined with teggio chemotherapy. These patients were divided into groups A, B and C according to the different dosages of apatinib used: 250 mg/d ( n = 21, group A), 500 mg/d ( n = 23, group B) and 850 mg/d ( n = 23, group C). The control rate of gastric cancer, serum levels of carcinoembryonic antigen, carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 72-4 (CA72-4), toxic and side effects, and survival within 1 year after surgery were determined among the three groups. Results:By the end of follow-up, one patient from group A was lost, one patient from group B interrupted medication because of personal reasons, and two patients from group C withdrew from the treatment due to serious discomfort caused by drugs. After treatment, disease control rate in group C was significantly higher than that in group A [91.30% (21/23) vs. 60.00% (12/20), χ2 = 6.484, P < 0.05]. Serum levels of carcinoembryonic, CA19-9 and CA72-4 in group C were (27.51 ± 2.21) μg/L, (101.46 ± 8.02) g/L, (46.34 ± 6.15) U/mL, respectively, which were significantly lower than those in group B [(29.33 ± 2.17) μg/L, (106.67 ± 8.10) g/L, (50.67 ± 6.20) U/mL, t = 2.786, 2.168, 2.352, all P < 0.05]. Serum levels of carcinoembryonic, CA19-9 and CA72-4 in group B were significantly lower than those in group A [(31.63 ± 2.92) μg/L, (112.12 ± 8.38) g/L, (55.12 ± 6.48) U/mL, t = 2.915, 2.142, 2.274, all P < 0.05]. The incidences of hand foot syndrome and gastrointestinal discomfort in group C were (34.78% (8/23) and (39.13% (9/23), respectively, which were significantly higher than those in group A [15.00% (3/23) and 25.00% (5/20), χ2 = 5.734, 4.769, both P < 0.05]. After 1-year follow-up,1-year survival rate in group C was significantly higher than that in group A [39.13% (9/23) vs. 10.00% (2/20), log-Rank χ2 = 6.600, P < 0.05]. Conclusion:High-dose apatinib combined with chemotherapy in the treatment of advanced gastric cancer has a high disease control rate and a high 1-year survival rate, but it has serious adverse drug reactions.

Effect of "工" type adhesive tape fixation method on tracheal tube fixation in children's adenoids and tonsils surgery / 中国医师进修杂志

Objective@#To investigate the effect of "工" type adhesive tape fixation method on tracheal tube fixation in children′s adenoids and tonsils surgery.@*Methods@#Eighty children who underwent selective adenoids and tonsils surgery from January to June 2019 in Shengjing Hospital of China Medical University were selected. The children were divided into control group and experimental group by random digits table method with 40 cases each. The tracheal tube of control group was fixed by traditional double-adhesive tape fixation method, and the tracheal tube of experimental group was fixed by "工" type adhesive tape fixation method. The distance between tracheal tube and right corner of mouth at the time of tracheal tube fixation, mouth opener insertion and the end of surgery by a soft ruler were recorded as an index of tracheal tube displacement. The detubation and skin damage were also recorded.@*Results@#The displacement distances of tracheal tube from tracheal tube fixation to mouth opener insertion and from tracheal tube fixation to the end of surgery in experimental group were significantly smaller than those in control group: (0.38 ± 0.16) cm vs. (0.74 ± 0.25) cm and (0.51 ± 0.20) cm vs. (1.69 ± 0.51) cm, and there were statistical differences (t = 7.67 and 13.62, P<0.05). There was no statistical difference in the incidence of detubation between 2 groups (P>0.05). The pressure ulcers did not occur in 2 groups; there was no statistical difference in the incidence of breakage between 2 groups (P>0.05); the incidences of redness and total skin damage in experimental group were significantly lower than those in control group: 20.0% (8/40) vs. 55.0% (22/40) and 20.0% (8/40) vs. 62.5% (25/40), and there were statistical differences (χ2 = 13.07 and 14.90, P<0.01).@*Conclusions@#The "工" type adhesive tape fixation method is used for the fixation of tracheal tube in adenoids and tonsils surgery in children, which is easy to operate and fixes firmly, and can effectively reduce the displacement of tracheal tube and reduce the degree of skin damage. It is worthy of clinical application.

Investigation of anxiety and depression in patients from the emergency department during COVID-19 epidemic / 南方医科大学学报

OBJECTIVE@#To investigate the status of anxiety and depression in patients requiring emergency treatment during the epidemic of COVID-19 to identify the patients with acute psychological stress disorder.@*METHODS@#During the COVID-19 epidemic, the medical staff divided the patients visiting the emergency department into suspected group, fever group and control group through interview of the patients at triage. Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were distributed to each patient, and a trained medical staff was responsible for assisting the patient to complete the scales.@*RESULTS@#A total of 557 sets of scales were distributed, including 211 in suspected COVID-19 case group, 167 in fever group and 179 in the control group. A total of 516 scales were retrieved, including 197 in suspected case group, 151 in fever group and 168 in control group. In the 3 groups, the incidence rates of anxiety and depression were 57.87% and 58.88%, 48.34% and 43.71%, and 18.31% and 18.99%, respectively, and the rates were significantly higher in suspected group and fever group than in the control group ( < 0.01), and significantly higher in suspected group than in fever group ( < 0.05). The standardized anxiety and depression scale scores in suspected case group, fever group and control group were 57.38±16.25 and 42.58±14.27, 51.23±15.29 and 38.32±15.39, and 32.58±17.8 and 12.25±12.94, respectively. Compared with the control group, both suspected case group and fever group had significantly higher standard scores for anxiety and depression ( < 0.01), and suspected case group had significantly higher standardized scores than fever group ( < 0.01).@*CONCLUSIONS@#Among the patients visiting the emergency treatment, the patients with suspected COVID-19 and common fever are more likely to develop anxiety and depressive symptoms.

Application of teachers standardized patient in the clinical anesthesia teaching / 中华医学教育探索杂志

Objective:To study the teaching effect of the teaching model of the teachers standardized patient (TSP) in clinical anesthesia teaching.Methods:Sixty students majoring in anesthesiology specialized in Shengjing Hospital of China Medical University were randomly divided into control group ( n=30) and observation group ( n=30). The teaching mode of TSP was adopted in the observation group, and the traditional teaching mode was applied in the control group. The differences of theoretical knowledge and clinical practice ability between the two groups were compared, and the satisfaction of the students was investigated by questionnaire. Data were analyzed by t-test and chi-square test using SPSS 20.0 software. Results:The clinical practice ability and clinical case analysis of the observation group were significantly better than those of the control group ( P<0.05), while there was no significant difference in the scores of theoretical knowledge between the two groups ( P>0.05). The questionnaire survey showed that the teaching mode of TSP had advantages in stimulating interest in learning, improving the ability of data collection, plan formulation, communication and emergency response, and enhancing their confidence in anesthesia and team cooperation ( P<0.05), while there was no significant difference in teaching satisfaction ( P>0.05). Conclusion:TSP teaching mode can ameliorate the clinical teaching effect of anesthesiology, especially in improving clinical practice ability.

Effect of "工" type adhesive tape fixation method on tracheal tube fixation in children's adenoids and tonsils surgery / 中国医师进修杂志

Objective To investigate the effect of "工" type adhesive tape fixation method on tracheal tube fixation in children's adenoids and tonsils surgery.Methods Eighty children who underwent selective adenoids and tonsils surgery from January to June 2019 in Shengjing Hospital of China Medical University were selected.The children were divided into control group and experimental group by random digits table method with 40 cases each.The tracheal tube of control group was fixed by traditional double-adhesive tape fixation method,and the tracheal tube of experimental group was fixed by "工" type adhesive tape fixation method.The distance between tracheal tube and right comer of mouth at the time of tracheal tube fixation,mouth opener insertion and the end of surgery by a soft ruler were recorded as an index of tracheal tube displacement.The detubation and skin damage were also recorded.Results The displacement distances of tracheal tube from tracheal tube fixation to mouth opener insertion and from tracheal tube fixation to the end of surgery in experimental group were significantly smaller than those in control group:(0.38 ± 0.16) cm vs.(0.74 ± 0.25) cm and (0.51 ± 0.20) cm vs.(1.69 ± 0.51) cm,and there were statistical differences (t =7.67 and 13.62,P＜0.05).There was no statistical difference in the incidence of detubation between 2 groups (P ＞ 0.05).The pressure ulcers did not occur in 2 groups;there was no statistical difference in the incidence of breakage between 2 groups (P ＞ 0.05);the incidences of redness and total skin damage in experimental group were significantly lower than those in control group:20.0％ (8/40) vs.55.0％ (22/40) and 20.0％ (8/40) vs.62.5％ (25/40),and there were statistical differences (x2 =13.07 and 14.90,P ＜ 0.01).Conclusions The "工" type adhesive tape fixation method is used for the fixation of tracheal tube in adenoids and tonsils surgery in children,which is easy to operate and fixes firmly,and can effectively reduce the displacement of tracheal tube and reduce the degree of skin damage.It is worthy of clinical application.

Correlation between the Depth of the Left-Sided Double-Lumen Tube and Specific Body Landmarks / 中国医科大学学报

Objective To investigate the correlation between the insertion depth of the left-sided double-lumen tube (DLT) and some specific body landmarks in order to guide left-sided DLT intubation. Methods Ninety-five adult patients who underwent thoracic surgery were chosen, and the age (A), sex (S), height (H), weight (W), distance between the cricothyroid membrane and upper notch of the sternum angle (L), size of the left-sided DLT (F), and predicted depth of intubation (y) were recorded. After anesthesia induction, the final corrected insertion depth of the left-sided DLT (Y) were recorded using fiberoptic bronchoscopy. The Y and y were compared.Linear regression and Pearson's correlation analysis were used to analyze the data. Results There was no difference between the Y and y (P＞ 0.05). The Y was significantly correlated with H, W, and L (P ＜ 0.01), and was not correlated with A (P＞ 0.05). Three linear regression equations for H, L, and Y were obtained. H and L were linearly dependent on Y, and the determination coefficients R2 were 0.43 (Y=7.285+0.128 H) and 0.41 (Y=19.305+0.866 L), respectively. Using both H and L as the independent variables, the determination coefficient R2 was 0.56 (Y=8.127+0.087 H+0.559 L). Conclusion The linear regression equation Y=8.127+0.559 H+0.087 L could be used as a rapid method to assess the insertion depth of the left-sided DLT. However, the ideal insertion depth of the left-sided DLT still needs to be confirmed using fiberoptic bronchoscopy.

Clinical Applications of Goal-Directed Fluid Therapy for Pancreatoduodenectomy / 中国医科大学学报

Objective To investigate the clinical applications of goal-directed fluid therapy for pancreatoduodenectomy. Methods A total of 40 patients undergoing pancreatoduodenectomy under general anesthesia were randomly divided into two groups, G and C, with 20 cases in each group. Goal-directed fluid therapy was used in Group G, whereas conventional fluid therapy was used in group C. The intraoperative hemodynamics, liquid management, duration of the first postoperative gastrointestinal ventilation, postoperative renal function, serum lactate, and the incidence of postoperative complications were recorded. Results Compared with group C, the CI increased and SVV decreased (P ＜ 0.05) at T3 to T5, and MAP increased at T4 to T5 (P ＜ 0.05). The amount of fluid infusion and total infusion in group G were less than that of group C (P ＜ 0.05), and the number of vasoactive drugs was greater than that of group C (P ＜ 0.05). The duration of the first postoperative gastrointestinal ventilation in group G was shorter than that of group C (P ＜ 0.05). There were no significant differences between the 2 groups for the incidence of serum lactate, BUN, Cr, and the incidence of postoperative complications (P＞ 0.05).Conclusion For major complex operations, such as pancreaticoduodenectomy, goal-directed fluid therapy can guide intraoperative fluid therapy more accurately with individual optimizations, and has more advantages in maintaining intraoperative hemodynamics stability and improving postoperative outcome.

Application of intermittent epidural bolus without background infusion in postoperative analgesia of transurethral resection of prostate / 中国医师进修杂志

Objective To observe the effect and safety of intermittent epidural bolus without background infusion combined with patient-control epidural analgesia (PCEA) in transurethral resection of prostate. Methods Sixty patients with benign prostatic hyperplasia in Shengjing Hospital of China Medical University from January to August 2018 were selected, and the patients were treated with transurethral (plasma) resection of prostate. The patients were divided into test group and control group according to the random digits table method with 30 cases each. Postoperative epidural analgesia of 2 groups used the electronic analgesia pump. The analgesia mode of test group was intermittent epidural bolus without background infusion combined with PCEA, and the analgesia mode of control group was continuous infusion combined with PCEA. The visual analogue score (VAS), Ramsay sedation score, improved Bromage score, adverse reaction and satisfaction of patients end of surgery to 48 h after operation were compared between 2 groups. Results There were no statistical difference in VAS and Ramsay sedation score between 2 groups (P＞0.05). The improved Bromage score 6 h after operation in test group was significantly lower than that in control group: 0 (0, 0) score vs. 0.5 (0, 1.0) scores, there was statistical difference (P＜0.05). The dosage of electronic analgesic pump 48 h after operation in test group was significantly lower than that in control group: (159.73 ± 22.58) ml vs. 250 ml, there was statistical difference (P＜0.01). The patients in 2 groups were satisfied, and there was no obvious dissatisfaction. There was no statistical difference in incidence of adverse reaction between 2 groups (P＞0.05). Conclusions In the postoperative analgesia of transurethral (plasma) resection of prostate, intermittent epidural bolus without background infusion combined with PCEA can decrease the drug dosage without the decline of analgesia.

Role of glucose transporter 2 and 4 in insulin resistance in spontaneous hyperuricemia mice / 中华内分泌代谢杂志

Objective To investigate the role of glucose transporter ( GLUT ) 2 and 4 in hyperuricemia-induced insulin resistance. Methods Male uric acid oxidase gene knock-out spontaneous hyperuricemia mice ( KO) and wild-type mice ( WT) were fed with high-fat diet to establish an insulin resistance model. Then, some of KO mice were treated with allopurinol for lowering uric acid. Uric acid, fasting plasma glucose (FPG), and fasting insulin ( FINS) were detected. Intraperitoneal glucose tolerance test ( IPGTT ) and insulin tolerance test ( ITT ) were performed. Finally, the expression levels of Slc2a4 and Slc2a2 mRNA in tissues were determined by real-time PCR, while those of GLUT2 and GLUT4 proteins in tissues were analyzed by Western blot. Results There was no significant difference in FPG among various groups. The level of FINS in KO group was significantly higher than that in WT group [(0.636± 0.07) vs (0.456 ± 0.03) ng/ml, P<0.01], with decreased insulin sensitivity and impaired glucose tolerance. The uric acid level in the KO group remained at a high level [ ( 549. 68 ± 48. 7 ) vs ( 216. 61 ± 27. 5 )μmol/L] . After uric acid level in KO mice was reduced by allopurinol, insulin sensitivity and glucose metabolism were improved. Compared with WT group, the expression levels of Slc2a4 and GLUT4 in the gastrocnemius muscle were decreased while the expression levels of Slc2a2 and GLTU2 in liver were increased in KO group, which were reversed by allopurinol-mediated uric acid reduction. Conclusion Uric acid may induce insulin resistance via decreasing Slc2a4/GLUT4 expressions in skeletal muscle, and increasing Slc2a2/GLTU2 expressions in liver.

Clinical Observation of Different Patient-controlled Analgesia Modes in Laparoscopic Hysteromyomectomy / 中国医科大学学报

Objective To investigate the clinical effect of different patient-controlled analgesia (PCA) modes in patients undergoing laparoscopic hysteromyomectomy.Methods Sixty patients scheduled for a laparoscopic hysteromyomectomy were randomly divided into three groups.All patients received an intravenous infusion of parecoxib sodium (40 mg) as preventive analgesia 15 min prior to the skin incision.Thirty minutes prior to the end of surgery,they received an intravenous injection of sufentanil (0.1 μg/kg) as a loading dose.The following data were collccted:the total dosage of sufentanil,the total and valid frequency of the PCA press,visual analog pain score,sedation score,the incidence of adverse reactions,the incidence of adverse reactions per group.Results Compared to groups 1 and 2,group 0 had the lowest dosage of sufentanil.There was no significant difference in the incidence of adverse reactions between the three groups (P ＞0.05).Conclusion The PCA-only mode,in conjunction with parecoxib sodium as preventive analgesia,was more suitable for patients undergoing laparoscopic hysteromyomectomy.

Comparing Closed-and Open-loop Control Anesthesia Infusion in Gynecological Laparoscopic Operation / 中国医科大学学报

Objective To evaluate and compare the effectiveness of propofol-remifentanil closed-loop and open-loop anesthesia in gynecological laparoscopic operation under bispectral index (BIS) monitoring.Methods Forty female patients undergoing elective gynecological laparoscopic operation were recruited and randomly divided into closed-loop (group Ⅰ) and open-loop (group Ⅱ) groups.During anesthesia maintenance,the closed-loop group was administered with a BIS-feedback system to regulate the target effect-site concentration;whereas,the open-loop group was administered the target effect-site concentration according BIS value manually.The variation of non-invasive mean arterial pressure (MAP),heart rate (HR),SpO2,BIS,extubation time,consumption of propofol and remifentanil,Ramsay index,and subjective comfort grade were recorded at the selected time points.Results The extubation time in group Ⅰ was shorter than in group Ⅱ.The total dosage of propofol administered in group Ⅰ was less than that in group Ⅱ,but there was no significant difference in the total consumption of remifentanil.HR in group Ⅰ was steadier than in group Ⅱ.However,the MAP and Ramsay index were similar in both the groups.The subjective comfort grade in group Ⅰ was higher than in group Ⅱ.Conclusion The use of propofol-remifentanil closed-loop system by BIS-feedback anesthesia is safer,more controllable,with higher degree of satisfaction and sparing side-effects,we therefore recommend it during gynecological laparoscopic operations.

Analysis of risk factors for susceptibility of subcutaneous tophi in people with gout / 中华内分泌代谢杂志

Objective To discuss the risk factors for susceptibility of subcutaneous tophi with an aim to provide clinical evidence for the prevention and treatment of tophi.Methods A total of 5 321 cases of gout patients whose course of disease was less than 10 years were selected and divided into two groups according to whether a subcutaneous tophus was present. The clinical information was collected and relevant biochemical indices were detected.Results There were significant differences in the ratios of regular exercise, involvement of upper limb joints, combining renal insufficiency, kidney stone and coronary heart disease between the tophus group and the non-tophus group(P0.05). Further logistic regression analysis indicated that disease duration, a large number of joints involved, the involvement of upper limb joints, combining kidney stones, higher serum uric acid level, and higher diastolic pressure were risk factors of the early onset of subcutaneous tophi, while regular exercise and body mass index were protective factors.Conclusion Patients with long duration, high serum level of uric acid, a large number of joints involved, upper limb joint involved, kidney stones, and hypertension were more likely to develop subcutaneous tophi. These risk factors should be intervened actively in clinic.

Comparative analysis of different factors associated with hypertension between subjects with and without gout / 中华内分泌代谢杂志

Objective To compare and analyze different factors that influence hypertension between subjects with and without gout, and to recognize and understand them further. Methods A total of 7395 patients ( 6935 males and 460 females) from the gout clinic of Affiliated Hospital of Qingdao University between May 2009 and January 2016 were chosen as gout group, while 8379 people without gout (7858 males and 521 females) were served as control group. The height, weight, waist circumference, hip circumference, blood pressure, fasting plasma glucose ( FPG) , triglyceride(TG), cholesterol(TC), blood urea nitrogen (BUN), creatinine(Cr), and uric acid (UA) of both groups were monitored. Clinical and biochemical differences of the two groups were analyzed. The morbidity rate of hypertension in the two groups was also compared. According to different criteria, the subjects were divided into several subgroups. The data were analyzed mainly by Empower statistical software. Results The risk ratio of hypertension in gout group was 63. 25%, and it was higher than that in control group(49. 19%,x2=316. 25,P<0. 01). The risk ratio of hypertension in gout group was 1. 173 times higher than that in control group. After adjusting UA, it would drop to 1. 065 times, but the difference still remained significant. In groups with diabetes, hyperlipidemia, hypercholesterolemia, obesity, the risk ratio of hypertension increased by 13. 7%, 15. 3%, 21. 8%, and 23. 6% respectively, in gout group. FPG, TG, TC, BMI, and WHR were all associated with HP in both gout and normal groups, but Cr was associated with HP in gout group only(OR=1. 396, 95%CI 1. 197-1. 629). Age had different saturation effects in two groups. Conclusion The factors influence hypertension differently in patients with and without gout, especially those of gout itself and creatinine. The precision medicine should be applied.

Risk Factors for Postoperative Nausea and Vomiting in Gynecological Patients Administered Prophylactic Antiemetics / 中国医科大学学报

Objective To study the risk factors for postoperative nausea and vomiting (PONV) in gynecological patients administered prophylactic antiemetics.Methods A total of 1 000 gynecological surgical cases were reviewed.Data on patient characteristics,anesthesia,surgeries,and 1st postoperative day nausea and vomiting were collected and analyzed statistically.Results Multivariate logistic regression analysis included a history of motion sickness,the use of an analgesic pump,the duration of anesthesia,and the use of neostigmine.The odds ratios (ORs),in decreasing order,were that of a history of motion sickness [OR =1.953,95％ confidence interval (CI):1.404-2.716],the use of neostigmine (OR =1.831,95％ CI:1.203-2.786),the use of an analgesic pump (OR =1.472,95％ CI:1.017-2.129),and the duration of anesthesia (OR =1.256,95％ CI:1.058-1.492).The predictive model was described by the following equation:P=1/(1+e(1623-0.669X1-0.386X2-0.228X3+0.605X4)).Tne predictive accuracy of this model for the incidence of PONV in gynecological patients was 70.6％,and the area under the receiver operating characteristic curve for the predictive result was 0.642.Conclusion The independent risk factors for PONV in gynecological patients administered prophylactic antiemetics are a history of motion sickness,the use of neostigmine,the use of an analgesic pump,and the duration of anesthesia,in decreasing order of significance.

Effects of Ethanol Extract of Crataegus Pinnatifida Bge. Var. major N. E. Br. from Heilongjiang Province on Hemodynamics of Acute Myocardial Ischemia and Platelet Aggregation in Rats / 中国药师

Objective: To observe the effect of ethanol extract of Crataegus Pinnatifida Bge. Var. major N. E. Br. from Hei-longjiang province on hemodynamics of acute myocardial ischemia caused by ligation and platelet aggregation induced by isoproterenol. Methods:After the model establishment of acute myocardial ischemia by ligation in rats, the systolic blood pressure ( SBP) ,diastolic blood pressure ( DBP ) , heart rate ( HR ) , left ventricular systolic pressure ( LVSP ) , left ventricular end-diastolic pressure ( LV-EDP) , left ventricular peak systolic ( +) and diastolic ( -) rate ( ± dp ·dt max-1 ) were recorded. Meanwhile, the acute myocar-dial ischemia model induced by isoproterenol was established. The platelet aggregation was measured by a platelet aggregation instru-ment. Results:The ethanol extract of Crataegus Pinnatifida Bge. Var. major N. E. Br. from Heilongjiang province could significantly increase the SBP, DBP, LVSP, +dp · dtmax-1 and HR, and reduce LVEDP,-dp·dtmax-1 in high dose group with statistical sig-nificance (P<0. 05). The medium dose group had small impact on the DBP, while showed statistically significant effect on the other hemodynamic indices. The low dose group had statistically significant effect on the SBP, LVSP and ± dp·dtmax-1 (P<0. 05), while showed no notable effects on the other indices. The results of aggregation rate in 1 min and 5 min after the determination and the maxi-mum one in the high and medium dose groups showed that the ethanol extract could significantly inhibit the platelet aggregation with sta-tistical significance (P<0. 05). Conclusion:The ethanol extract of Crataegus Pinnatifida Bge. Var. major N. E. Br. can improve the blood flow of acute myocardial ischemia in rats and reduce platelet aggregation after ischemia.

Improvement of postoperative pulmonary function during general anesthesia for open abdominal surgery with lung protective ventilation strategy and alveolar recruitment maneuvers / 中国医师进修杂志

Objective To observe the improvement of postoperative pulmonary function and oxygen partial pressure during general anesthesia for open abdominal surgery with lung protective ventilation strategies and alveolar recruitment maneuvers. Methods Seventy patients who underwent selective open abdominal surgery were selected, and they were divided into standard ventilation group (tidal volume 8 ml/kg) and protective ventilation group (tidal volume 6 ml/kg, 5 cmH2O positive end-expiratory pressure, and alveolar recruitment maneuvers, 1 cmH2O=0.098 kPa) according to the random digits table method with 35 cases each. The airway pressure, blood pressure, pulse oxygen saturation (SpO2), end-tidal partial pressure of carbon dioxide (PETCO2) and adverse reactions were observed. The SpO2, partial pressure of O2 (PaO2) and pulmonary function before surgery and 1, 3, 5 d after surgery were measured. Results The respiratory rate, airway pressure and PETCO2 levels in protective ventilation group were significantly higher than those in standard ventilation group: (12.3 ± 2.1) times/min vs. (10.2 ± 1.0) times/min, (15.1 ± 2.8) cmH2O vs. (13.5 ± 2.3) cmH2O, (34.6 ± 2.1) mmHg (1 mmHg=0.133 kPa) vs. (32.1 ± 1.4) mmHg, and there were statistical differences (P0.05). The SpO2 and PaO2 levels at 1, 3 d after surgery in protective ventilation group were significantly higher than those in standard ventilation group:0.951 ± 0.018 vs. 0.936 ± 0.016 and 0.964 ± 0.018 vs. 0.949 ± 0.018, (74.8 ± 6.8) mmHg vs. (65.0 ± 6.2) mmHg and (79.6 ± 6.0) mmHg vs. (70.6 ± 5.3) mmHg, and there were statistical differences (P<0.05). The forced expiratory volume in 1 s (FEV1), percentage of the estimated value of FEV1, forced vital capacity (FVC) and percentage of the estimated value of FVC at 1, 3 and 5 d after surgery in protective ventilation group were significantly higher than those in standard ventilation group, the FEV1/FVC at 1 d after surgery was significantly higher than that in standard ventilation group, and there were statistical differences (P<0.05). Conclusions The lung protective ventilation strategy and alveolar recruitment maneuvers can improve the postoperative pulmonary function and oxygen partial pressure during general anesthesia for abdominal surgery. Low vital volume, appropriate positive end-expiratory pressure and recruitment maneuvers can protect the lung in general anesthesia patients.

Effects of Autologous Blood Transfusion and Allogenic Blood Transfusion on the Patients Undergoing Selective Operation of Intervertebral Fusion with Cage / 中国医科大学学报

Objective To compare the effects of autologous blood transfusion and allogenic blood transfusion on the patients undergoing selective operation of intervertebral fusion with cage. Methods Forty patients who underwent selective operation of intervertebral fusion with cage in the De?partment of Orthopedics of our hospital from September 2012 to June 2014 were recruited for the study,including 20 cases that received autologous blood transfusion only(group A)and 20 cases that received allogenic blood transfusion only(group B). Preoperative and postoperative results of blood routine examination,body temperature,postoperative recovery indicators and expense of blood transfusion were compared between the two groups. Results The postoperative erythrocyte and hemoglobin of the patients in group A were significantly higher than those in group B(P<0.05). When the amount of blood used during the operation reaches or exceeds 4 units,the expense of autologous blood transfusion was lower than that of allogenic blood transfusion. Conclusion Autologous blood transfusion contributes to higher levels of postoperative erythrocyte and hemoglo?bin. When a large amount of blood is used during an operation,autotransfusion can help to reduce the expense of blood transfusion.

Effects of different doses of dexmedetomidine on the recovery quality from general anesthesia undergoing thyroidectomy / 中华危重病急救医学

Objective To investigate effects of two doses of dexmedetomidine (Dex) on the recovery quality from general anesthesia undergoing thyroidectomy.Methods A prospective randomized controlled double-blind trial was conducted in 90 patients admitted to Shengjing Hospital of China Medical University who were scheduled for thyroidectomy.They were randomly divided into three groups:group D0.4 received Dex 0.4 μg/kg intravenously,group D0.8 received Dex 0.8 μg/kg intravenously,and control group with same volume of normal saline.There were 30 patients in each group,and all the patients received the above drug or saline 30 minutes after intubation.The heart rate (HR),systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded before Dex administration,at the end of surgery,time of eye opening and extubation,and 10 minutes after extubation.Time of eye opening after surgery and time of extubation after eye opening were recorded.End-tidal partial pressure of carbon dioxide (PETCO2) before and after operation as well as restlessness score (RS),Ramsay sedative score,and visual analogue pain scale (VAS) scores at 10 minutes after extubation were recorded.Events during extubation including cough,nausea and vomiting,respiratory depression were also recorded.Results ① Compared with control group,in D0.4 and D0.8 groups incidence of lowering of HR,SBP and DBP was lower at time of eye opening and extubation,and 10 minutes after extubation.Compared with D0.4 group,D0.8 group had lower HR at the time of extubation and 10 minutes after extubation,SBP was lower at the time of eye opening and extubation,and lower DBP at the time of eye opening.② D0.4 and D0.8 groups showed lower RS and VAS scores than those of control group,Ramsay sedative score in groups D0.4 and D0.8 was higher than that in control group (RS:1.40±0.51,1.20±0.42 vs.1.90±0.56; VAS:1.50±0.52,0.80±0.63 vs.2.50 ± 0.52; Ramsay:2.10 ± 0.56,2.40 ± 0.51 vs.1.60 ± 0.51,P＜0.05 or P＜0.01),and VAS score in group D0.8 was lower than that in D0.4 group (P＜0.01).The time of eye opening and extubation were longer in group D0.8 as compared with those in control and D0.4 groups (minutes:12.50 ± 1.08 vs.10.50 ± 1.58,10.40 ± 1.26; 15.00 ± 0.94 vs.13.00 ± 1.63,12.80 ± 1.13,P＜0.05 or P＜0.01),but there was no significant difference between the latter two groups.No significant difference in PETCO2 was found among three groups before and after surgery.③ The incidence rate of cough,nausea and vomiting in control group (16.7％,13.3％) were significantly higher than those in groups D0.4 (3.3％,0) and D0.8 (0,0).There was no respiratory depression in the three groups.Conclusion Adjunctive infusion of Dex 0.4 μg/kg at 30 minutes after anesthesia induction was recommended as it may result in more steady hemodynamics,with shorter recovery time and extubation time after thyroidectomy.

Relationship between GLUT9 rs13137343 polymorphism and hyperuricemia in a Chinese male population / 中华内分泌代谢杂志

A possible association between the polymorphism of glucose transporter 9 (GLUT9) rs1 3137343 and hyperuricemia was investigated in Chinese male population and the calculated genotype frequencies and allelic frequencies by PCR method and direct sequencing were reported.Data showed that there was statistical difference in GLUT9 rs13137343 genotype frequencies between hyperuricemia cases and controls(x2 =7.024,P =0.030).

The protective effect of prenatal hypoxia adaptation on the brain of newborn rat / 中华麻醉学杂志

Objective To examine whether the prenatal hypoxia adaptation has any protective effect on the brain of the newborn rat Methods 12 22 day pregnant Wistar rats were randomly divided into 2 groups: the control group and the treated group In the treated group the pregnant rats were placed in a tightly closed hypoxia adaptation chamber When the O 2% in the chamber dropped to 15%, the rat was taken out to breathe fresh air for 5 min then put back in the chamber This process was repeated until its natural delivery In control the chamber was not tightly closed (O 2%=21%) 40 newborn rats weighing 6 8g were selected and subjected to brain ischemia and hypoxia, Left common carotid artrey was ligated under ether anesthesia 2h after recovery from surgery the newborn rats were placed in hypoxia chamber (T=36℃?1℃,O 2%=9%)for 1 5h 24h later they were sacrificed and brain was removed for microscopic examination (optical and electron) and flow cytometry measurement Results In the treated group most newborns were normal There were a few apoptosis cells in early stage The rate of apoptosis was 2 9%, necrosis cells could hardly be seen In the control group, although most neurons were also normal but there were apoptosis cells in early, middle and late stage and even necrosis cells The rate of apoptosis was 9 51%, which was significantly different from that in the treated group Conclusions Prenatal hypoxia adaptation has protective effect on the brain of newborn rat