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Objective:To investigate the status quo of spiritual nursing needs and its influencing factors of patients with permanent enterostomy, and analyze its correlation with disability acceptance and stigma, so as to provide a reference for the construction of targeted spiritual nursing intervention programs.Methods:A total of 351 patients with permanent enterostomy in Xiangya Hospital Central South University and Hunan Cancer Hospital were selected by convenience sampling from January 2021 to March 2022. A cross-section by using the self-made general information questionnaire, Nurse Spiritual Therapeutics Scale (NSTS), Acceptance of Disability Scale (ADS), and Stigma Scale for Chronic Illness (SSCI). And multiple linear regression was used to analyze the influencing factors of spiritual nursing needs of patients with permanent enterostomy.Results:The total score of spiritual nursing needs of patients with permanent enterostomy was 30.15 ± 6.46, and the average score of items was 2.51 ± 0.78. Among the five dimensions, the highest average score was creating a good atmosphere 3.10 ± 0.98, and and the lowest was helping religious practice 1.65 ± 0.70. The total score of disability acceptance was 81.94 ± 13.86; the total score of stigma was 64.03 ± 14.28. The total scores of spiritual nursing needs were positively correlated with the total scores of disability acceptance ( r=0.703, P<0.01), and negatively correlated with the total scores of stigma ( r=-0.516, P<0.01). Multivariate linear regression analysis showed that religious beliefs, educational level, residence, course of disease, disability acceptance, and stigma were the main influencing factors for the spiritual nursing needs of patients with permanent enterostomy ( t values were -13.26-13.56, all P<0.01), accounting for 52.5% of the total variation. Conclusions:The spiritual nursing needs of patients with permanent enterostomy were moderate. It is suggested that nurses can develop targeted spiritual nursing measures according to the individualized characteristics of patients, improve their disability acceptance and reduce their stigma level, so as to meet their spiritual nursing needs and realize their spiritual safety.
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Objective To develop a magnetic anastomosis device for infrahepatic inferior vena cava and verify its feasibility and safety in rat models. Methods According to the anatomical characteristics of rat inferior vena cava, a magnetic device suitable for end-to-end anastomosis of infrahepatic inferior vena cava was designed and manufactured. The device consisted of the inner and outer rings. The inner ring was a coated neodymium-iron-boron magnetic ring, and the outer ring was made of polyetheretherketone by 3D printing. Ten fine holes are evenly distributed on the outer ring, of which 5 fine holes were used to load the fine needles, and the other 5 fine holes were mutually connected with the fine needles of the contralateral anastomosis ring during anastomosis. The outer ring was uniformly loaded with fine needles and then bonded with the inner ring to form a magnetic anastomosis complex. Bilateral ends of vessels passed through the anastomosis ring and were fixed to the fine needles, and then end-to-end vascular anastomosis was performed by mutual attraction of two magnetic anastomosis rings. Twenty SD rats were selected and received end-to-end anastomosis of infrahepatic inferior vena cava with magnetic anastomosis device. The time of vascular occlusion, postoperative survival, postoperative anastomotic patency, gross observation and histological examination of anastomotic stoma were analyzed. Results All rats successfully completed end-to-end magnetic anastomosis of the infrahepatic inferior vena cava, and the time of vascular occlusion was 4~6 min. One rat died at 10 d after operation, and the other rats survived within postoperative 2 months. The patency rates of anastomotic stoma in surviving rats at postoperative 1 d, 3 d, 1 month and 2 months were 100%, 100%, 95% and 95%, respectively. At 2 months after operation, no obvious displacement and angulation of the anastomosis device were seen. No signs of corrosion and cracking of the anastomosis rings were observed. No evident hyperplasia and edema of surrounding tissues were noted. Bilateral ends of vessels were completely healed, and no obvious stenosis or thrombosis was found at the anastomotic stoma. Histological examination showed high continuity of bilateral vascular walls of anastomotic stoma, the inner surface of anastomotic stoma was covered by endothelial cells, and no thrombus or fibrous tissue was attached. Conclusions It is safe and feasible to utilize the self-designed magnetic anastomosis device to perform end-to-end magnetic anastomosis of infrahepatic inferior vena cava in rat models.
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Background and Objectives@#Endoscopic prelacrimal recess approach (PLRA) was introduced to treat maxillary sinus inverted papilloma (IP) without sacrificing the inferior turbinate and nasolacrimal duct. This study aimed to compare surgical outcomes of prelacrimal recess approach with the conventional Caldwell-Luc approach (CLA) to remove IP of maxillary sinus and to evaluate the usefulness of the PLRA.Subjects and Method We retrospectively reviewed medical records of 51 patients who were treated in our institution for IP of nasal cavity and sinuses between March 2010 and June 2019. Twenty patients had maxillary sinus IP. Sixteen patients underwent endoscopic sinus surgery combined with either CLA (n=8) or PLRA (n=8). Demographic data, surgical technique, site of IP origin, intra- and postoperative complications, duration of follow-up, recurrence rate and pathologic diagnosis were reviewed. @*Results@#IP was the pathologic diagnosis for all 16 cases. Gross total removal was achieved in all cases. The mean follow-up period was 20.1 months in CLA group and 12.5 months in PLRA group. There was one case of massive bleeding during operation requiring transfusion and postoperative ICU care in CLA group. On postoperative follow-up, two patients from the CLA group had recurrence during the follow-up period. One patient had numbness around the gingival area, another patient had transient wound dehiscence, and another had persistent oro-antral fistula. In PLRA group, one patient had periorbital swelling after blowing nose; otherwise, no other patient from the PLRA group developed subjective complaints after surgery. @*Conclusion@#Endoscopic prelacrimal recess approach showed lower complication rates and recurrence rates compared to CLA. PLRA is a safe and effective method for the excision of primary maxillary sinus IP.
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BACKGROUND AND OBJECTIVES@#Various surgical approaches have been employed for the complete resection of inverted papilloma (IP) of the nose and paranasal sinus. Sacrificing the inferior turbinate (IT) and nasolacrimal duct (NLD) is often unavoidable due to the anatomy of maxillary sinus. However, the prelacrimal recess approach (PLRA) provides a wider entrance to the maxillary sinus without the ablation of NLD and IT. We present seven cases of IP successfully treated by the PLRA.SUBJECTS AND METHOD: We collected data from seven different cases involving patients who underwent resection of IP by means of the PLRA from 2016 to 2017. If the lesion could not be removed first via middle meatal antrostomy (MMA), then PLRA was attempted. The surgical specimens were all confirmed to be IP.@*RESULTS@#Preoperative imaging studies demonstrated that the lesions of IP were located mainly in the maxillary sinus. All of the seven patients had unilateral lesions and all tumors were completely resected via PLRA. The follow-up ranged from 3 to 24 months, during which no recurrence or complications were observed in any of the seven patients.@*CONCLUSION@#PLRA provides an adequate operation field without unfavorable scars. It allows the preservation of sinus structure and function. PLRA is feasible and can be used for the diffuse maxillary sinus IP.
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Obstructive sleep apnea (OSA) is a common clinic sleep disorder, and characterized by obstruction of upper airway during sleep, resulting in sleep fragmentation and intermittent hypoxemia. We reviewed the brain imaging studies in OSA patients compared with healthy subjects, including studies of functional magnetic resonance imaging (fMRI) and electroencephalography (EEG). The resting-state EEG studies showed increased power of δ and θ in the front and central regions of the cerebral cortex in OSA patients. While resting-state fMRI studies demonstrated altered large-scale networks in default-mode network (DMN), central executive network (CEN) and salience network (SN). Evidence from resting-state studies of both fMRI and EEG focused on the abnormal activity in prefrontal cortex (PFC), which is correlated with OSA severity. These findings suggested that the PFC may play a key role in the abnormal function of OSA patients. Finally, based on the perspectives of treatment effect, multimodal data acquisition, and comorbidities, we discussed the future research direction of the neuroimaging study of OSA.
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Humans , Brain , Diagnostic Imaging , Brain Mapping , Electroencephalography , Magnetic Resonance Imaging , Sleep Apnea, Obstructive , Diagnostic ImagingABSTRACT
BACKGROUND AND OBJECTIVES: Various surgical approaches have been employed for the complete resection of inverted papilloma (IP) of the nose and paranasal sinus. Sacrificing the inferior turbinate (IT) and nasolacrimal duct (NLD) is often unavoidable due to the anatomy of maxillary sinus. However, the prelacrimal recess approach (PLRA) provides a wider entrance to the maxillary sinus without the ablation of NLD and IT. We present seven cases of IP successfully treated by the PLRA. SUBJECTS AND METHOD: We collected data from seven different cases involving patients who underwent resection of IP by means of the PLRA from 2016 to 2017. If the lesion could not be removed first via middle meatal antrostomy (MMA), then PLRA was attempted. The surgical specimens were all confirmed to be IP. RESULTS: Preoperative imaging studies demonstrated that the lesions of IP were located mainly in the maxillary sinus. All of the seven patients had unilateral lesions and all tumors were completely resected via PLRA. The follow-up ranged from 3 to 24 months, during which no recurrence or complications were observed in any of the seven patients. CONCLUSION: PLRA provides an adequate operation field without unfavorable scars. It allows the preservation of sinus structure and function. PLRA is feasible and can be used for the diffuse maxillary sinus IP.
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Humans , Cicatrix , Follow-Up Studies , Maxillary Sinus , Methods , Nasolacrimal Duct , Nose , Papilloma, Inverted , Recurrence , TurbinatesABSTRACT
In order to provide a basic theory for the materials of repairing central nervous system injury, we have studied the growth and differentiation of neural stem cells (NSCs) on poly (L-lysine) modified silk fibroin film. First, we used poly (L-lysine) to modify silk fibroin film and confirmed by UV-vis and 1H NMR spectra. Then NSCs were isolated and seeded on the silk fibroin film (Silk group), poly (L-lysine) (PLL group) and poly (L-lysine) modified Silk fibroin film (Silk-PIL group). The proliferation of NSCs was evaluated by Cell Counting Kit-8 (CCK-8) assay on days 1, 3, 5 and 7 after seeding. Immunofluorescence was used to analyze the differentiation of NSCs at the 7th day. The levels of apoptosis were detected by Western blotting and TUNEL. The mRNA level of brain derived neurotrophic factor (BDNF) was identified by real-time PCR. UV-vis and 1H NMR spectra confirmed that poly (L-lysine) was successfully grafted onto the silk fibroin film. From the 3rd day after seeding to the 7th day, the CCK-8 test showed that proliferation rate of NSCs in the Silk-PIL was significantly higher than Silk group (P<0.05) but had no significant difference compared with PLL group (P>0.05). Immunofluorescence staining displayed that more NSCs in Silk-PIL group were differentiated into neuron compared with Silk group (P<0.05), however, there was no significant difference compared with PLL group (P>0.05). The number of NSCs differentiated into astrocytes was not significantly different between the three groups. Western blotting and TUNEL test presented that the degree of apoptosis of NSCs in the Silk-PIL group was significantly lower than Silk group (P<0.05). RT-PCR exhibited that mRNA level of brain derived neurotrophic factor (BDNF) of NSCs was higher in Silk-PIL group compared with Silk group (P<0.05) but had no significant difference compared with PLL group (P>0.05). Thus, poly (L-lysine) modified silk fibroin film could promote the proliferation of NSCs and reduce NSCs apoptosis. Furthermore, it also can enhance the differentiation of NSCs into neurons. It is expected to become a new type of tissue engineering scaffold carrying NSCs to repair central nervous system injury.
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AIM To observe the clinical role for Supplemented Xijiao Powder (Bubali cornu,Coptidis Rhizoma,Cimicifugae Rhizoma,etc.) in management of hepatitis B virus (HBV) associated acute-on-chronic liver failure.METHOD Seventy-five patients,including the ones receiving internal medicine treatment,were divided into control group and experimental group.The experimental group received conventional treatment and additionally took Supplemented Xijiao Powder for one month.The clinical symptoms and signs were observed.Levels of ALT,AST,TBIL,ALB,CHE,PTA were measured,and the incidence of liver failure was evaluated.RESULTS Supplemented Xijiao Powder could improve symptoms,signs and the level of PTA.The incidence of liver failure tended to reduce.The comparison of other indexes had no marked difference.CONCLUSION Supplemented Xijiao Powder has a certain therapeutic effect on HBV associated prioracute-on-chronic liver failure.Its mechanism may be related to blocking the occurrence of liver failure.
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BACKGROUND:Whether controling of post-injury inflammatory response combined with neural stem cel (NSC) transplantation can improve the curative efficacy for spinal cord injury stil remains unclear. OBJECTIVE:To investigate the repair of spinal cord tissue, myelin regeneration, axon regeneration, motor function recovery and the possible mechanism after early application of tumor necrosis factor α antagonist (Etanercept) combined with tyrosine kinase C (TrkC) gene-modified NSC transplantation. METHODS:TrkC-overexpressed NSCs (TrkC-NSCs) were constructed by lentiviral transfection technique. The rat models of spinal cord transection injury were prepared, and then subjected to Etanercept combined with TrkC-NSCs transplantation. The number of neurons and neuroregeneration after injury were measured by Nissl's staining, immunofluorescence and western blot. The rat motor function was detected by Basso Beattie Bresnahan score and evoked potential. The myelin regeneration was detected by electron microscopy and toluidine blue staining. RESULTS AND CONCLUSION:Compared with the other groups, the Etanercept combined with TrkC-NSCs transplantation group had more survived anterior horn motor neurons at 28 days after injury, more myelin-encapsulated axons, higher Basso Beattie Bresnahan score, greater amplitude of the evoked potentials, and relatively shorter latency (alP < 0.05). These findings indicate that early application of tumor necrosis factor-α antagonist combined with TrkC-NSCs transplantation after spinal cord injury in rats can effectively promote myelin regeneration, axon regeneration, and further promote motor function recovery.
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Objective To compare the effects of isoflurane and pentobarbital on the establishment of subarachnoid block model in rats.Methods 60 SD rats aged 4 months were randomly divided into Group A (n =30) and Group B (n=30).Rats in Group A received intraperitoncal injection of 10 g/L pentobarbital sodium solution 30 mg/kg and 1/4 of the initial dosage was added according to the operation effect.The induction and maintenance of anesthesia were achieved by isoflurane inhalation in Group B during operation.We recorded the time of anesthesia induction,quality of anesthesia,time of anesthesia,time of operation,and recovery time.The heart rate,respiration frequency,temperature,and saturation of blood oxygen were recorded during operation.We compared death from anesthesia and success of modeling in the two groups.Results There was no significant difference between the groups with regard to age,weight,body temperature or saturation of blood oxygen (P＞ 0.05).Compared to Group B,heart rate decreased 1-60 minutes after anesthesia and respiration frequency decreased 5 minutes after anesthesia in Group A (P＜0.05).The time of anesthesia induction,time of anesthesia,time of operation,and recovery time were shorter in Group B (P＜0.05).The quality of anesthesia was better in Group B (P＜0.05).The success rate of modeling was higher but mortality rate of anesthesia was lower in Group B than in Group A (P＜0.05).Conclusion Compared with intraperitoneal injection of pentobarbital sodium,isoflurane inhalation can provide a better anesthetic effect during the operation to establish a rat model of subarachnoid block.
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In this paper,a hypertension management system based on mobile intelligent computation is built,intorduces its overall architecture and function realization.The user side can implement collection and monitoring of body signs,behavior monitoring,hypertension riskassessment and emergence help,etc.In addition,the doctor side can assist the doctor in diagnosis service.With the help of this system,the user can know his/her physical status and make self-adjustment in time,and the doctor can quickly track the progressof the patient and provide health guidance.As a result,the personalized hypertension management for both the doctor and the patient can be achieved.
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Objective To investigate if glucose-insulin-potassium (GIK)would relieve the liver injury induced by endotoxemia in rats.Methods Sixty SD male rats,weight 200-250g,were randomly divided into three groups (n = 20):control group (group C),lipopolysaccharide group (group LPS,LPS 8 mg/kg)and Glucose-insulin-potassium group(group GIK,8 mg/kg LPS+GIK 4 ml·kg-1 ·h-1 ).All the rats were injected with 20 mg/kg ketamine intraperitonealy before trial. Erythrocin was daubed on the wound to avoid infection.The rats of group LPS and group GIK were injected LPS 8 mg/kg intraperitoneal,then,rats in group LPS and group GIK received saline(4 ml·kg-1 ·h-1 )or GIK(Glucose 200 g/L,Insulin 60 IU/L,KCL 60 mmol/L)infusion continuously. Liver and serum samples were collected on before injection,3 days after injection and 5 days after in-jection.Serum concentrations of ALT and AST were measured.TNF-αlpha of liver homogenate was detected by ELISA.The severity of liver damage was assessed by an approprite histopathological sco-ring system and apoptosis of parenchymal cells were assessed by TUNEL immunofluorescence assay. Results Compared with group control,the level of serum ALT and AST in group LPS and group GIK were significantly higher at 3 days after injection.The level of hepatic TNF-α,the hepatic damage score and the index of hepatic apoptosis in group LPS and group GIK were significantly higher on 3 days after injection and 5 days after injection.(P<0.05).Compared with group LPS,the level of hepatic TNF-αand the hepatocyte apoptosis rates decreased significantly in group GIK on 3 days after injection.The level of serum ALT and AST,hepatic TNF-α,the hepatic damage score and the hepatocyte apoptosis rates decreased significantly in group GIK at 5 days after injection(P <0.05).Conclusion Intraperitoneal injection of endotoxin can cause liver injury in rats,resulting in the liver hepatdysfunction and hepatocyte damage.GIK has protective effects on LPS induced liver injury in rats.
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Objective:To explore value of 256-slice spiral CT pulmonary artery angiography (CTPA)evaluating right heart function in patients with acute pulmonary embolism (APE).Methods:According to death risk assessment of APE patients, a total of 67 APE patients were divided into high risk APE group (n=41)and non-high risk APE group (n=35).CTPA was used to analyze and compare CTPA obstructive index and right heart function indexes between two groups.Correlations among CTPA obstructive index and right heart function indexes were also analyzed.Results:Compared with non-high risk APE group,there were significant rise in CTPA constructive index [8.58% vs.24.69%],percentages of straight or left protruded ventricular septum (31.46% vs.73.17%)and bronchial artery dilation (5.71% vs.24.69%);Except the supe- rior vena cava diameter,the rest right heart function parameters had difference significance in two groups,P<0.05 or<0.01. Spearman correlation analysis indicated that CTPA obstructive index was significant positively correlated with right ventricular maximal short axis (RVMSA),RV:LV,diameters of main pulmonary artery,superior vena cava and azygos (r=0.684~0.954),and significant inversely correlated with LVMSA (r=-0.786),P<0.01 all.ROC curve analysis indicated that AUCs of CTPA RV:LV (0.949)was the biggest diagnosing APE severity.Conclusion:Right heart func- tion indexes measured by multi-detector CT are accurate and practical indexes evaluating APE severity,and it possesses im- portant significance.
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Bilateral choanal atresia is a rare disorder characterized by bilateral obstruction of the posterior end of the nasal cavity. It can be present in isolation or associated with multiple disorders such as coloboma, heart defect, choanal atresia, retarded growth, genital hypoplasia, ear abnormalities (CHARGE) syndrome. Because congenital bilateral choanal atresia presents as respiratory distress at birth, immediate diagnosis and adequate treatment is required. Traditionally, using stents was a part of the postoperative treatment to provide a low rate of restenosis but recently it is controversial. Currently nasal endoscopic approach is mainly used with or without stenting. We report a case of CHARGE syndrome with bilateral choanal atresia treated by transnasal endoscopic approach without stenting.
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CHARGE Syndrome , Choanal Atresia , Coloboma , Diagnosis , Ear , Heart , Nasal Cavity , Parturition , StentsABSTRACT
ABSTRACT:Objective To a rare case of double primary cancer (hepatocellular carcinoma with gallbladder)to guide clinical application.Methods and Results We reported one case of primary hepatocellular carcinoma and gallbladder.A male patient,54 years old,had main complaints of intermittent right upper quadrant pain for 4 days. The abdominal CT of the local county hospital showed gallstones,gallbladder with liver infiltration.And then he went to the First Affiliated Hospital of Xi’an Jiaotong University for further treatment.Laboratory examination revealed:HBsAg(+),HBcAb(+),alpha-fetoprotein (AFP)> 60 500 ng/mL,carcinoembryonic antigen (CEA) 5.25 ng/mL.Abdominal CT showed hilar slightly stronger light echo groups:liver cancer or gallbladder cancer? Hepatic artery and portal vein CT imaging (CTA+CTV)examination showed the malignant tumor shadow in the inside of the left hepatic lobe huge,uneven thickening of the gallbladder wall,suspected liver disease with gallbladder infringement or gallbladder disease with liver infringement. With the preoperative preliminary consideration of primary liver cancer with infiltration of the gallbladder,we chose the operation as the resection of segment Ⅳ b and Ⅴ of the liver,cholecystectomy and T tube drainage.Pathological examination postoperative showed the bulky liver carcinoma grade Ⅲ and the poorly differentiated adenocarcinoma of gallbladder.A month later,abdominal CT showed the tumor spread intrahepatic,prompting the poor prognosis.Conclusion The two which are not continuous,which is the standard of double primary cancer,are not suitable for all double primary cancers.This case provides useful experience for future similar diagnosis and treatment of disease,and also helps us with timely and accurate identification of “metastatic”or “primary”,which is the key point for clinicians to give patients an effective treatment.
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Objective To evaluate the effect of glucose-insulin-potassium (GIK) on intestinal injury in endotoxemic rats.Methods Sixty male Sprague-Dawley rats, weighing 200-250 g, were equally and randonly divided into endotoxemia group (lipopolysaccharide [LPS] group) and GIK group.LPS 8 mg/kg was injected intraperitoneally once a day for 3 times in total to establish the model of endotoxemia-caused intestinal injury.Starting from 2 h after the initial injection of LPS, normal saline was continuously infused at 4 ml · kg 1 · h-t in group LPS, and GIK 4 ml · kg 1 · h 1was infused intravenously in group GIK.Before establishment of the model, and at 3 and 5 days after establishment of the model, 10 rats in each group were sacrificed, and blood samples were collected from the abdominal aorta for determination of tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) and diamine oxidase (DAO) concentrations in plasma by enzyme-linked immunosorbent assay.TNF-α/IL-10 ratio was calculated.A segment of ileum of 2 cm in length, 20 cm from the ileocecal junction, was removed for microscopic examination.The degree of damage to the intestinal mucous membrane was scored according to Chiu.Results Compared with the values before establishment of the model, the plasma TNF-α/IL-10 ratio, DAO concentration, and Chiu's scores were significantly increased at 3 days after establishment of the model in the two groups, the plasma TNF-α/IL-10 ratio, DAO concentration, and Chiu's scores were increased at 5 days after establishment of the model in group LPS, and the plasma DAO concentration, and Chiu's scores were increased at 5 days after establishment of the model in group GIK (P＜0.05).Compared with the values at 3 days after establishment of the model, the TNF-α/IL-10 ratio and plasma DAO concentration were significantly increased in group LPS, and the TNF-α/IL-10 ratio and plasma DAO concentration were decreased in group GIK at 5 days after establishment of the model in group GIK (P＜0.05).Compared with group LPS, the TNF-α/IL-10 ratio, plasma DAO concentration, and Chiu's scores were significantly decreased at 3 and 5 days after establishment of the model in group G1K (P＜0.05).Conclusion GIK can reduce intestinal injury in endotoxemic rats.
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Objective To evaluate the effects of the laryngeal mask airway for spontaneous breath-ing in short pediatric operation under Sevoflurane inhalation anesthesia.Methods Eighty children undergo-ing hernia surgery, of whom ASA Ⅰ or Ⅱ, in accordance with the random number table, were randomly divided into two groups( each 40 cases):the laryngeal mask airway for spontaneous breathing with Sevoflu-rane inhalation anesthesia in group A,and tracheal intubation for controlled ventilation with Sevoflurane inha-lationa nesthesia in group B.Children in the two groups were fasting for 6 hours and without drinking for 4 hours before anesthse ia.Anestheis a was induced with Sevoflurane inhalation fro all patients.The laryngela mask airway was insertde soon afet r induction of anesthesia with Sevoflurane inhalation,and anse thesia main-tained with Sevoflurane in halta ion in gor up A.P atients in gruo p B wereg iven cisatracurium 0.15 mg/kg intravenous injectio n before tracheal intubation, and anesthesia maintained with Sevoflurane inhalation, 40 minutes before the end of the surgeryt o sot p using muscle relaxant.Ten minutes before the end of the operation to stop Sevoflurane inhalation,in two groups.The end-tidal carbon dioxide partial pressure(PETCO2 ), mean blood pressure,heart rate,respiratory rate,pulse oxygen saturation and end-tidal sevoflurane partial pres-sure(PETSev) were recorded one minute before the induction of anesthesia,15 min,30 min,45 min,and 60 min after the induction of anesthesia.Both the time to regain consciousness and the time to remove laryngeal mask airway or tracheal catheter were recorded in two groups.Results The mean blood pressure, heart rate decreased in two groups after the induction of anesthesia(P<0.05).The value of PaCO2 increased and that of base excess decreased in 30 min after the induction of anesthesia in group A(P<0.05).The value of PETCO2 increased, and that of pH decreased in 45 min after the induction of anesthesia in group A (P<0.05).The movements of the limbs and head induced by operative stimulation in group A were more than those in group B(P<0.05),but the incidences of cough and laryngospasm induced by removing the laryngeal mask airw ay or tracheal catheter in group B were higher than those in group A(P<0.05).Both the time to regain consciousness and the time to remove laryngeal mask airway or tracheal catheter were shorter in group A than those in group B ( P<0.05 ) .Conclusion It is safe that the laryngeal mask airway for spontaneous breathing with Sevoflurane inhalation anesthesia in short pediatric operation.The time of anesthe-sia is beyond half an hour during operation and the artificial respiration sholu d be implemented.
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This study analyzed the genetic evolution of neuraminidases (NAs) of influenza A subtype N9 viruses with the aim of determining the genetic origin of the novel avian A/H7N9 influenza virus. The NA sequences of influenza A subtype N9 viruses available from NCBI were used to construct a phylogenetic tree using the programs ClustalX 2.0 and MEGA 6.0. This analysis indicated that the novel avian A/H7N9 influenza virus is located in the modern Eurasian phylogenetic cluster. This cluster was then further analyzed by estimating the overall rate of evolutionary change and the selective pressure at the nucleotide level using the program BEAST 2.1.2 and the web interface Datamonkey, and by generating an amino acid sequence entropy plot using Bioedit software. In this cluster, the mean rate of nucleotide substitutions in NA was found to be 3.8354 x 10(-3) and the mean ratio of non-synonymous (dN) to synonymous (dS) substitutions per site (dN/dS) was 0.140413. A particularly high level of amino acid mutation entropy was identified at nucleotides 16, 19, 40, 53, 81, 84, 112, 256, 335, 359, and 401. This genetic evolution analysis suggests that the nucleotide substitutions that characterize the novel avian A/H7N9 influenza virus neuraminidase are likely to result from the overall genetic evolution of influenza A subtype N9 virus NAs, and not from selective stress. Phylogenetic analysis suggests that the influenza A virus (A/duck/Siberia/700/1996(H11N9)) isolated in 1996 appears to be the common ancestor of the more recent influenza A subtype N9 viruses NAs.
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Animals , Humans , Amino Acid Substitution , Birds , Evolution, Molecular , Influenza A Virus, H7N9 Subtype , Chemistry , Genetics , Influenza in Birds , Virology , Influenza, Human , Virology , Molecular Sequence Data , Neuraminidase , Chemistry , Genetics , Phylogeny , Sequence Homology, Amino Acid , Viral Proteins , Chemistry , GeneticsABSTRACT
A nasoseptal perforation is a defect of cartilage, bone, and mucosa of nasal septum, caused by nasal surgery, malignancy, inflammation, or drugs. Although various surgical treatments and procedures are well known, there is no consensus on the procedures due to low success rate (25-90%) and high recurrence rate (12-48%). One of the major factors that affect surgical results is the size of perforation. For large perforations, the surgical success rate is reported to range from 23% to 70%. The authors report two successful cases of repair surgery of nasoseptal perforation, using unilateral pedicled nasoseptal rotational mucosal flap with releasing incision and interpositional dermal allograft. Although larger study populations and long-term follow-up periods are needed, the authors believe that our method is an effective way to minimalize possible inconveniences observed in the cases of comparatively large perforations, or where there is a lack of autografts or donor site defects.