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1.
Chinese Journal of Hospital Administration ; (12): 776-780, 2021.
Article in Chinese | WPRIM | ID: wpr-912847

ABSTRACT

Quality supervision is the important guarantee of hospital quality and patient safety, and also the core content of the fourth cycle grade hospital evaluation in Zhejiang province. Based on the evaluation standards, Hangzhou Women′s Hospital used information technology to optimize the hospital′s quality supervision and feedback system, and set up a traceable and closed-loop quality and safety supervision system. The system realized five function points: storage and extraction of supervision problems, online recording of supervision results, real-time feedback of supervision results, online feedback of rectification opinions of supervised departments, and tracking and evaluation of functional departments. After the operation of the system, the quality supervision process of the hospital realized information operation, and could be tracked online at all time points, which improved the efficiency of hospital quality management, better ensured the implementation of medical system and patient safety, and promoted the continuous improvement of medical quality indicators.

2.
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care ; (6): 465-468, 2017.
Article in Chinese | WPRIM | ID: wpr-659108

ABSTRACT

Objective To investigate the changes of microRNA-223 (miR-223) in patients with complication of sepsis after mini-invasive surgery of upper urinary tract stones, and to approach the value of miR-223 in the early diagnosis of sepsis. Methods Patients with upper urinary tract stones underwent micro-invasive treatment in the Department of Urology Surgery of the Affiliated Hospital of Hangzhou Normal University from January 2014 to January 2017 were enrolled. There were 60 patients with sepsis within 24 hours after surgery were assigned in the sepsis group, and 60 patients without sepsis were included in the non-sepsis group. The clinical data of miR-223, CD4+CD25+regulatory T cells (CD4+CD25+ Treg), procalcitonin (PCT) interleukin-10 (IL-10), tumor necrosis factor-α(TNF-α), C-reactive protein (CRP) in the blood, etc were collected within 24 hours after surgery. The differences in above indexes were compared between the two groups. The receiver operating characteristic curve (ROC curve) was drawn to evaluate the diagnostic values of blood mir-223, PCT and CRP in the patients, predicting whether septic complication after urinary calculi surgery would occur. Correlation analyses were used to analyze the correlations between mir-223 and CD4+CD25+ Treg, IL-10 and TNF-α. Results The miR-223 expression level and the contents of CD4+CD25+ Treg, IL-10, TNF-α, PCT and CRP in sepsis group were obviously higher than those in non-sepsis group [2ΔΔCt (×10-4):2.81±1.04 vs. 2.13±0.91, CD4+CD25+ Treg(×10-2): 17.61±4.48 vs. 8.37±2.71, IL-10 (ng/L): 58.42±16.38 vs. 34.68±12.45, TNF-α (pg/L): 249.41±30.69 vs. 167.54±25.98, PCT (ng/L): 4.45±1.89 vs. 0.31±0.08, CRP (μg/L):10.29±3.63 vs. 4.13±1.57, all P < 0.05); in sepsis group, the miR-223 expression and the level of CD4+CD25+ Treg (r = 0.367, P = 0.004) and IL-10 (r = 0.516, P = 0.006) were also significantly positively correlated, but miR-223 and TNF-α were not markedly correlated (r = 0.237, P > 0.05). The area under ROC curve (AUC), sensitivity, specificity and 95% confidence interval (95%CI) of miR-223 predicting sepsis occurrence after urinary operation were higher than those of CRP, PCT (AUC: 0.923 vs. 0.547, 0.769, the sensitivity: 81.73% vs. 71.23%, 66.59%, specificity: 86.00%vs. 42.00%, 83.00%, 95%CI: 0.862-0.979 vs. 0.351-0.679, 0.682-0.927). Conclusions The expression levels of plasma miR-223 in patients with sepsis after mini-invasive treatment for upper urinary tract lithotrity can reflect their immune reaction status, and can be one of the early diagnostic markers of whether the sepsis complication may occur after the surgery.

3.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 316-317,318, 2017.
Article in Chinese | WPRIM | ID: wpr-606067

ABSTRACT

Objective To evaluate the necessity of construction of hospital information system integration platform for county Hospital as the urban and rural medical hub in the context of the development of modern medical information.Methods By referring to the development of the domestic and international integration platform,and comprehensively considered the development status of the county hospital,and analyzed based on the perspective of sustainable development.Results The hospital information integration platform was formed to meet the needs of the county hospital,and it platform was used to open up the internal and external medical information resources,realize the integration of business resources and process optimization..Conclusion The county hospital building information system integration platform is the inevitable trend of the current construction of information technology,and its comple-ted construction can enhance province -city-county tertiary care facility data communication,reduce the coupling within the hospital business systems,and make the county hospital more flexible in the future construction and devel-opment.

4.
Chinese Journal of Endocrine Surgery ; (6): 417-420, 2017.
Article in Chinese | WPRIM | ID: wpr-695466

ABSTRACT

Objective To investigate the change of ischemia modified albumin (IMA) in polycystic ovary syndrome (PCOS) women,and to examine the relationship between IMA and metabolic disorder.Methods 31 PCOS women (PCOS group) and 28 age-and BMI-matched healthy women (control group) were recruited.Serum IMA levels and related biochemical indexes were compared between the two groups,and the correlation between IMA and each index was analyzed.Results Serum IMA level in PCOS group was significantly higher than that in the control group (P<0.05).Correlation analysis showed that serum IMA levels were positively correlated with testosterone levels (r=0.57,P=0.03).Conclusion Serum IMA levels in PCOS patients are significantly elevated and closely related to testosterone,suggesting that oxidative stress may be involved in the pathogenesis and development of hyperandrogenemia.

5.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 2756-2759, 2017.
Article in Chinese | WPRIM | ID: wpr-614533

ABSTRACT

Objective To study the level and clinical value of differential display code 3 (DD3) in peripheral blood of patients with prostate cancer.Methods 27 patients with prostate cancer from April 2014 to April 2015 in Affiliated Hospital of Hangzhou Normal University were researched.26 patients with non prostate diseases were selected as control group.DD3 mRNA levels were detected in peripheral blood of all patients.DD3 absorbance value of three groups of patients,the relationship between the relative content of DD3 mRNA and the clinical characteristics of prostate cancer,DD3 mRNA in urine and peripheral blood of patients with prostate cancer and benign prostatic hyperplasia were observed.Results In the patients with benign hyperplasia of prostate and non prostate diseases,a total of 4 patients did not appear to be DD3 specific bands.In prostate cancer patients,all patients were found to have DD3 specific bands.The relative content of patients with non prostate diseases was (0.18 ± 0.05) copies/mL.The relative content of benign prostatic hyperplasia patients was (0.30 ± 0.09) copies/mL.The relative content of prostate cancer patients was (0.78 ± 0.23) copies/mL.The positive expression rates of DD3 mRNA in peripheral blood and urine of patients with prostate cancer were 85.18% (23/27),51.85% (14/27),respectively,which were significantly higher than those in patients with benign prostatic hyperplasia[21.42% (6/28),7.14% (2/27)] (x2 =22.416,13.319,all P < 0.05).Conclusion The specific expression of DD3 mRNA in peripheral blood of patients with prostate cancer can be used as an effective basis for judging the patients' condition,and it has certain value for the treatment and prognosis of patients with prostate cancer.

6.
Chinese Journal of cardiovascular Rehabilitation Medicine ; (6): 74-77, 2017.
Article in Chinese | WPRIM | ID: wpr-510295

ABSTRACT

Objective:To explore therapeutic effect of ticagrelor on patients with acute ST elevation myocardial in‐farction (STEMI) and its influence on short‐term prognosis .Methods :A total of 180 STEMI patients undergoing e‐mergency percutaneous coronary intervention (PCI) were selected ,randomly divided into clopidogrel group (n=90) and ticagrelor group (n=90) .Clinical therapeutic effect was compared between two groups ;platelet function ,inci‐dence of major adverse cardiovascular events (MACE) ,adverse reactions and bleeding events were observed in two groups .Results:Total effective rate of ticagrelor group was significantly higher than that of clopidogrel group (93.4% vs .87.8% ,P=0.036);compared with clopidogrel group on 24h and 7d after operation ,there were signif‐icant reductions in platelet aggregation rate [24h :(62.1 ± 5.2)% vs . (56.5 ± 5.4)% ,7d:(47.3 ± 6.1)% vs . (38.7 ± 5.2)% ] and P2Y12 reaction unit [24h:(218.1 ± 12.3) U vs . (201.3 ± 11.1) U ,7d:(173.4 ± 11.8) U vs . (152.6 ± 12.6) U] in ticagrelor , P0. 05 all .Conclusion:Compared with clopi‐dogrel ,ticagrelor can better reduce platelet aggregation rate and improve clinical therapeutic effect without increas‐ing incidence of adverse reactions and bleeding events .

7.
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care ; (6): 465-468, 2017.
Article in Chinese | WPRIM | ID: wpr-657248

ABSTRACT

Objective To investigate the changes of microRNA-223 (miR-223) in patients with complication of sepsis after mini-invasive surgery of upper urinary tract stones, and to approach the value of miR-223 in the early diagnosis of sepsis. Methods Patients with upper urinary tract stones underwent micro-invasive treatment in the Department of Urology Surgery of the Affiliated Hospital of Hangzhou Normal University from January 2014 to January 2017 were enrolled. There were 60 patients with sepsis within 24 hours after surgery were assigned in the sepsis group, and 60 patients without sepsis were included in the non-sepsis group. The clinical data of miR-223, CD4+CD25+regulatory T cells (CD4+CD25+ Treg), procalcitonin (PCT) interleukin-10 (IL-10), tumor necrosis factor-α(TNF-α), C-reactive protein (CRP) in the blood, etc were collected within 24 hours after surgery. The differences in above indexes were compared between the two groups. The receiver operating characteristic curve (ROC curve) was drawn to evaluate the diagnostic values of blood mir-223, PCT and CRP in the patients, predicting whether septic complication after urinary calculi surgery would occur. Correlation analyses were used to analyze the correlations between mir-223 and CD4+CD25+ Treg, IL-10 and TNF-α. Results The miR-223 expression level and the contents of CD4+CD25+ Treg, IL-10, TNF-α, PCT and CRP in sepsis group were obviously higher than those in non-sepsis group [2ΔΔCt (×10-4):2.81±1.04 vs. 2.13±0.91, CD4+CD25+ Treg(×10-2): 17.61±4.48 vs. 8.37±2.71, IL-10 (ng/L): 58.42±16.38 vs. 34.68±12.45, TNF-α (pg/L): 249.41±30.69 vs. 167.54±25.98, PCT (ng/L): 4.45±1.89 vs. 0.31±0.08, CRP (μg/L):10.29±3.63 vs. 4.13±1.57, all P < 0.05); in sepsis group, the miR-223 expression and the level of CD4+CD25+ Treg (r = 0.367, P = 0.004) and IL-10 (r = 0.516, P = 0.006) were also significantly positively correlated, but miR-223 and TNF-α were not markedly correlated (r = 0.237, P > 0.05). The area under ROC curve (AUC), sensitivity, specificity and 95% confidence interval (95%CI) of miR-223 predicting sepsis occurrence after urinary operation were higher than those of CRP, PCT (AUC: 0.923 vs. 0.547, 0.769, the sensitivity: 81.73% vs. 71.23%, 66.59%, specificity: 86.00%vs. 42.00%, 83.00%, 95%CI: 0.862-0.979 vs. 0.351-0.679, 0.682-0.927). Conclusions The expression levels of plasma miR-223 in patients with sepsis after mini-invasive treatment for upper urinary tract lithotrity can reflect their immune reaction status, and can be one of the early diagnostic markers of whether the sepsis complication may occur after the surgery.

8.
Chinese Journal of Microbiology and Immunology ; (12): 481-486, 2016.
Article in Chinese | WPRIM | ID: wpr-495761

ABSTRACT

Objective To investigate the effects of ch1D1, an anti-CD86 chimeric antibody, on autoreactive B lymphocytes isolated from patients with systemic lupus erythematosus ( SLE) . Methods Flow cytometry analysis was performed to measure the expression of CD86 on the surface of B cells isolated from patients with SLE and to analyze the effects of ch1D1 on the activation of CD4+T cells. The method of magnetic bead sorting was used to separate B cells, NK cells and CD4+T cells from PBMC collected from healthy subjects and patients with SLE for subsequent experiments. Antibody-dependent cell-mediated cyto-toxicity (ADCC) and complement-dependent cytotoxicity (CDC) that were mediated by ch1D1 were meas-ured with LDH release assay. Effects of ch1D1 on the secretion of auto-antibodies and the proliferation of CD 4+ T were detected by ELISA and 3 H -thymidine ( 3 H-TdR) incorporation assay, respectively. Results The levels of CD80 (68. 08±14. 28 vs 46. 10±12. 14, n=24, P<0. 000 1) and CD86 (44. 72±14. 90 vs 13. 99±10. 74, n=24, P<0. 000 1) expressed on the surface of B cells isolated from patients with SLE were significantly higher than those from the healthy subjects, suggesting the abnormal activation of B cells. Com-pared with the negative control group and the murine monoclonal antibody 1D1, ch1D1 was more effective in mediating the ADCC and CDC responses (P=0. 017 2, P=0. 038 8). Activated T cells significantly en-hanced the secretion of auto-antibodies by B cells isolated from patients with SLE. Compared with the nega-tive control group, the enhanced secretion of auto-antibodies was significantly inhibited by treatment with ch1D1 (P=0. 001 9). Moreover, ch1D1 significantly inhibited the proliferation and activation of CD4+T cells induced in patients with SLE (P=0. 002 4, P=0. 049 5). Conclusion ch1D1, the anti-CD86 chim-eric antibody, could effectively mediate the ADCC and CDC responses against autoreactive B cells isolated from patients with SLE, inhibit the secretion of auto-antibodies and suppress the proliferation and activation of auto-reactive CD4+T cells. It might be a potential immunotherapy agent for the treatment of SLE.

9.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 2238-2240, 2016.
Article in Chinese | WPRIM | ID: wpr-492703

ABSTRACT

Based on the current county hospital information construction in the problem of integration,pro-posed a scheme based on a unified architecture application integration platform.The original business system interface standardization of the construction of hospital information systems analysis and integration platform architecture and integration framework,the framework can be achieved through integrated hospital between heterogeneous systems.A unified standardized interfaces can achieve a good cross -system data integration.The construction of county hospitals information system integration platform,data sharing and interaction is conducive to solve the problem of data islands facing the county hospital,hospital to enhance business development capabilities and scale.

10.
Chinese Journal of Microbiology and Immunology ; (12): 448-452, 2015.
Article in Chinese | WPRIM | ID: wpr-476373

ABSTRACT

normal pregnancy and RSA (P=0.0250).Compared with women with normal pregnancy, those with RSA showed significantly decreased levels of Arg-1 ( P=0.0474) and suppressed activities of MDSCs against CD8+T cell proliferation (P=0.0230).Conclusion The MDSCs might play an important role in the main-tenance of maternal immune tolerance.Decreased number and inhibited function of MDSCs in the peripheral blood of women with RSA might be responsible for the development of RSA.

11.
Chinese Journal of Laboratory Medicine ; (12): 115-119, 2015.
Article in Chinese | WPRIM | ID: wpr-470801

ABSTRACT

Objective To observe the expression changes of peripheral endothelial progenitor cells (EPCs) and Ang-1/Tie2 in patients with pulmonary arterial hypertension (PAH).Methods From Jun 2011 to Dec 2012,45 patients with PAH charged in Affiliated Hospital of Hangzhou Normal University were divided into 3 groups according to mean pulmonary arterial blood pressure (15 per group):mild(Group L),moderate(Group M),and severe(Group S),with another 15 normal people as control group(Group C).The EPCs were isolated from peripheral blood of every patient,number counting using fluorescence activated cell sorter (FACS),function test using cell culture in vitro.Expression of Ang-1 and Tie2 in the peripheral EPCs were measured by RT-PCR or Western-blot.Non normal data was analyzed by non parametric statistical test.Results The statistical discrepancy existed among Group L,M,S and the control in the number of EPCs [32.0 (27.0,37.0),26.0 (19.0,31.0),24.0 (22.0,26.0) vs 40.0 (37.0,51.0),P < 0.05].The ability of migration [32.1 (26.5,37.5),26.8 (22.4,35.4),21.0 (17.8,34.0) vs 39.0 (33.3,42.4),P<0.05] and adhesion of the EPCs [57.1(50.9,61.8),51.8(45.2,58.7),46.0 (37.2,55.1) vs 64.1 (56.2,75.0),P < 0.05] among study groups and control group was different in statistic,the same with the proliferation activity of EPCs in different groups [0.6 (0.5,0.7),0.5 (0.4,0.6),0.4(0.3,0.5) vs 0.7(0.6,0.8),P <0.05].The mRNA expression of Ang-1 and Tie2 in Group M & S were significantly reduced compared with control [4.33 (2.49,4.62) and 2.89 (2.39,3.44) vs 5.31(3.78,6.22),P<0.05],Tie2 mRNA[1.32(1.23,1.34)and 1.23(1.08,1.42)vs 1.49(1.25,1.66),P < 0.05],and the protein expression of the phosphorylated Tie 2 in Group M &S were decreased [0.16 (0.15,0.24) and 0.12 (0.08,0.18) vs 0.22 (0.19,0.28),P < 0.05].No significant difference of Ang-1 and Tie2 expression was observed between Group L and control [5.42 (4.72,5.95),1.54 (1.43,1.66) and0.23(0.19,0.33),P=0.674,0.867 and 0.674].Conelusion With the severity of PAH,the number and function of circulating EPCs decreased,as consistent with Ang-1 and Tie2 expression changes,suggesting that function decrease of EPCs in patients with PAH may be associated with the decrease of Ang-1/Tie2 expression.

12.
Chinese Journal of Burns ; (6): 25-29, 2014.
Article in Chinese | WPRIM | ID: wpr-311992

ABSTRACT

<p><b>OBJECTIVE</b>To analyze the drug resistance and drug resistance genes of imipenem-resistant Pseudomonas aeruginosa (IRPA) strains isolated from burn wards.</p><p><b>METHODS</b>From June 2011 to June 2012, 30 strains of IRPA were isolated from wound excretion, sputum, and venous catheter attachment from burn patients hospitalized in Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine. Drug resistance of the IRPA to 12 antibiotics commonly used in clinic, including ceftazidime, amikacin, ciprofloxacin, etc., was tested with K-B paper agar disk diffusion method. Metallo-β-lactamase (MBL)-producing IRPA was detected by synergism test with imipenem-2-mercaptoethanol. Plasmid of IRPA was extracted, and it was inserted into competent cells, producing transformation strains (TSs). Drug resistance of TSs to imipenem and the MBL-producing TSs were detected. The genes blaIMP, blaVIM, blaOXA-1, blaOXA-2 and blaOXA-10 of IRPA and the TSs were detected by polymerase chain reaction. The drug resistance of IRPA producing MBL or OXA enzyme was summed up.</p><p><b>RESULTS</b>The sensitive rates of the 30 strains of IRPA to the 12 antibiotics were equal to or above 60.0%. Six strains of MBL-producing IRPA were screened. Twenty-four TSs were resistant to imipenem, and 6 strains among them were MBL-producing positive. Among the 30 strains of IRPA, 6 strains and their corresponding TSs carried blaVIM; 20 strains and their corresponding TSs carried blaOXA-10; no strain was detected to carry blaIMP, blaOXA-1 or blaOXA-2. Two strains and their corresponding TSs were detected carrying both blaVIM and blaOXA-10. No significant difference of drug resistance was observed between strains producing only MBL or OXA enzyme, with the same high resistance to β-lactam antibiotics and some degree of sensitivity to aminoglycoside antibiotics. Strains producing enzymes MBL and OXA were all resistant to the 12 antibiotics.</p><p><b>CONCLUSIONS</b>IRPA strains isolated from burn wards of Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine are multidrug-resistant, and they mainly produce type B and D carbapenemases.</p>


Subject(s)
Humans , Burns , Microbiology , Cross Infection , Microbiology , Drug Resistance, Multiple, Bacterial , Genetics , Imipenem , Microbial Sensitivity Tests , Pseudomonas aeruginosa , Genetics
13.
Chinese Journal of Laboratory Medicine ; (12): 808-811, 2014.
Article in Chinese | WPRIM | ID: wpr-458771

ABSTRACT

Malignant tumors are the most common lethal diseases in China.Because of complexity of etiology and pathogenesis , and the lack of specific markers for early diagnosis , delayed diagnosis and treatment of cancer , the fatality rate is high.With the development of basic research , more and more early specific markers were found , but the current detection mostly depend on the professional laboratories , time-consuming , high price and have a number of inconveniences to patients on time and money.Meanwhile , it′s difficult to extend to zoon of medicine resources deficient.Recently, point-of-care testing (POCT) has been rapidly developed , because of its portability , getting results quickly , can be operated in basic medical units and economic backward areas , so it′s benefit to cancer screening in human.By the application in tumor markers, POCT can be done for the cancer early detection , early diagnosis and early treatment , so then cuts the death rate.

14.
Chinese Journal of Laboratory Medicine ; (12): 494-497, 2013.
Article in Chinese | WPRIM | ID: wpr-435179

ABSTRACT

Cardiovascular disease (CVD) is one of the most common diseases and the leading causes of death in China.It is of great importance to detect cardiac markers for early diagnosis,treatment and prognosis of CVD.Point of care testing (POCT) is emerging as a new test mode and development trend of laboratory medicine.Application of POCT technology in cardiovascular field is the fastest growing parts of all POCT.It promotes the application and development of POCT because of the contradiction between the important value of cardiac markers and the needs of quick results in severe CVD.With the technological diversification of POCT,the progressing innovation of test devise and standardized test results with reference to the Central Laboratory (CLT),the application of POCT will be more extensive and promote the development of laboratory medicine together with traditional test mode.

15.
Chinese Journal of Behavioral Medicine and Brain Science ; (12): 247-249, 2011.
Article in Chinese | WPRIM | ID: wpr-414273

ABSTRACT

Objective To investigate the changes of autonomic nerve function of coronary heart disease (CHD) patients with panic disorder(PD). Methods All the subjects who met with the diagnostic code of CHD and PD were divided into CHD group(n=40) ,PD group(n=36) ,comorbid CHD and PD group(n=27) ,and 40physical examinee were recruited as normal control group. They had a 24 hours Holter ECG monitoring by time and frequency domain analysis of heart rate variability. ANOVA analysis was utilized to statistic the collected data. Results Compared with normal controls,the patients of others groups had every indexs of HRV were reduced. The indexs of HRV of comorbid CHD and PD were lower than the patients of CHD or PD group. The score of time domain SDNN(70.40 ± 14.74)ms,SDANN(91.72 ± 24.46)ms,PNN50(2.83 ±2.07)%, RMSSD( 15.66 ±7.45)ms,frequency domain LF(647.54 ± 129.24)ms2, HF(596. 16± 127.66) ms2 in comorbid CHD and PD. There were significant differences with others groups(P < 0.05 ). Conclusion The autonomic nervous functional of the patients with CHD and PD were in disorder. The autonomic nervous functional disorder of the patients with comorbid CHD and PD was more severe.

16.
International Journal of Traditional Chinese Medicine ; (6): 900-902, 2011.
Article in Chinese | WPRIM | ID: wpr-422076

ABSTRACT

Objective To establish the determination method of baicalin in the children's YifeiPingchuan mixture by RP-HPLC.Methods A Kromasil C18 column was used with methanol-(0.4%)phosphoric acid-triethylamine (45 ∶ 55 ∶ 2 drops) as mobile phase with a column temperature of 28 ℃.The flow rate was 1.0 ml/min.The detection wavelength was set at 277 nm.Results The linear range of baicalin was 0.040~1.000 μg (r=0.9999) with a average recovery of 99.82 and RSD of 1.01%.Conclusion The method for quantification of baicalin was sensitive,accurate,and convenient,which can also be used as one of basis of quality standard for Yifei-Pingchuan mixture.

17.
Chinese Journal of Anesthesiology ; (12)1995.
Article in Chinese | WPRIM | ID: wpr-526929

ABSTRACT

Objective To evaluate the effect of lobe bronchus blockade with a branchial blocker on intrapulmonary shunt during radical esophagus cancer resection. Methods Twenty four ASA Ⅰ-Ⅲ patients with normal lung function aged 18-69 yrs undergoing elective radical esophagus cancer resection were randomized into 2 groups ( n = 12 each): group A one-lung ventilation (OLV) and group B lobe bronchus blockode. Radial artery and right internal jugular vein were cannulated for BP and CVP monitoring and blood sampling. Anesthesia was induced with midazolam 50 ?g?kg-1, fentanyl 4 ?g?kg-1, propofol 2 mg?kg-1 and vecuronium 0.1 mg?kg-1. In group A double-lumen tube (DLT) was used while in group B a single lumen endotracheal tube was placed first, then a bronchial blocker was inserted fiberoptically into the bronchus of lower lobe of the operated side. The patients were mechanically ventilated (FiO2= 100%, VT = 8 ml?kg-1 , RR = 10-15 bpm, I: E = 1:2). PaCO2 was maintained at 30-35 mm Hg. Anesthesia was maintained with 1.5%-2.0% isoflurane and intermittent Ⅳ boluses of fentanyl and vecuronium. BP, HR, CVP, SpO2, PETCO2 and airway pressure were monitored during operation. Blood samples were taken simultaneously from radial artery and central vein for blood gas analysis before induction of anesthesia when the patients were lying supine and breathing spontaneously (T0), after the lungs on both sides were ventilated for 30 min in lateral position (T1) and 30 min after OLV (group A) or lower lobe bronchus was blocked off (group B) in lateral position (T2). Qs/Qt was calculated (blood from central vein was used instead of mixed venous blood from pulmonary artery) . Blood concentrations of TXB2 and 6-k-PGF1 were determined by radioimmunoassay at T0, T1 and T2. Results There was no significant difference in demographic data between the two groups. At T2 the airway pressure in group A was significantly higher than that in group B. At T2 PaO2 was significantly higher in group B than in group A. Qs/Qt was significantly increased at T1 and T2 as compared to the baselines in both groups. Qs/Qt was significantly increased at T2 compared to that at T1 in group A only, while there was no significant difference between Qs/Qt at T1 and T2 in group B. The TXB2 concentration at T2 was significantly increased as compared to that at T0 and T1 in group A and was significantly higher than that at T2 in group B. Conclusion Lower lobe bronchus blockade was superior to OLV in terms of Qs/Qt and PaO2 during esophagus cancer resection.

18.
Chinese Journal of Immunology ; (12)1986.
Article in Chinese | WPRIM | ID: wpr-546236

ABSTRACT

Objective:To analyze the gene polymorphisms at code 54 of exon 1 in mannose-binding lectin(MBL) gene and the palsma MBL concentrations in Mongols and Huis in China.Methods:MBL plasma concentrations were measured by ELISA method with human MBL ELISA kit,Single nucleotide polymorphisms of MBL gene were determined with sequence analysis method.Geneticanalysis was deployed with SHEsis software,and the statistics package for social science,SPSS11.0 was used in the study.Results:The median values of MBL plasma in 79 Mongols and 69 Huis were 1 686 ng/ml and 1 909 ng/ml respectively and no significant difference was found between them(Z=0.63,P=0.4).In 79 Mongols,the variant allele frequencies of the codon 54 of MBL gene was 0.203,62.0% of the 79 cases were A/A exon type,while 35.4% were A/B type and 2.50% were B/B type instead.In all 69 Huis,the variant allele frequencies was 0.268,58.0% of 40 cases were A/A exon type,while 30.4% were A/B type and 11.6% were B/B type instead.The frequency of point mutation at +230 site was 0.203.No significant difference of variant allele frequencies was found between the Mongols and Huis nationalities(?2=1.772,P=0.183).Neither C nor D exon type were found in the study.The A/A wild type was associated with the highest plasma concentration with median values,the A/B type was associated with lower MBL levels and the B/B type with the lowest levels(?2=86.526,P

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