Comparison of analgesic efficacy and postoperative recovery between multi-point and single-point fascia iliaca compartment block in patients with hip fracture: a randomized controlled trial / 中华全科医师杂志

Objective:To compare the analgesic effect and postoperative recovery between multi-point and single-point ultrasound-guided fascia iliaca compartment block (FCIB) in elderly patients with hip fracture.Methods:From June 2019 to April 2020, 96 patients aged (71.1±5.4) years undergoing elective surgery for hip fracture in Renji Hospital were randomly assigned in multi-point block group or single-point block group, and the multi-point or single-point ultrasound-guided FCIB was performed for the two groups, respectively. The primary outcomes were the success rate for block of femoral nerve, lateral femoral cutaneous nerve and obturator nerve, and the 24 hours postoperative pain visual analog scale (VAS) score at rest and passive movement. The secondary outcomes were the onset time of sensory blocks of the above three nerves, complications of FICB, the satisfaction score of pain control during 48 hours after surgery and postoperative recovery of patients.Results:The success rate for block of lateral femoral cutaneous nerve in multi-point block group was 97.9% (47/48), which was significantly higher than that in single-point block group (83.3%(40/48)) ( P=0.031). The success rate for block of obturator nerve in multi-point block group was 95.8% (46/48), which was significantly higher than that in single-point block group which was 81.3% (39/48) ( P=0.025). The success rate of femoral nerve block in both groups was 97.9% (47/48) ( P=1.000). The 24 hours postoperative VAS scores at rest and passive movement in the multi-point block group were significantly lower than those in the single-point block group ( P<0.05). The onset time for block of lateral femoral cutaneous nerve and obturator nerve in multi-point block group was shorter than that in single-point block group ( P=0.025 and P<0.01). There was no significant difference in the onset time for block of femoral nerve between the two groups ( P=0.343). The satisfaction score of patients at 48 hours after surgery in multipoint block group was higher than that in single point block group ( P=0.024). The length of hospital stay in the multi-point block group was shorter than that in the single-point block group ( P=0.042), the proportion of intravenous analgesic drugs used after surgery was lower than that in the single-point block group ( P=0.041), and the complication rate within 30 days after surgery was also lower than that in the single point block group ( P=0.026). Conclusion:Compared with single-point block, ultrasound-guided multi-point block in iliac fascia space has advantages of increasing analgesic efficacy and promoting postoperative recovery in elderly patients with hip fracture.

Effect of inhalation of sevoflurane during cardiopulmonary bypass on early postoperative brain injury in patients undergoing cardiac valve replacement / 中华麻醉学杂志

Objective:To evaluate the effect of inhalation of sevoflurane during cardiopulmonary bypass (CPB) on early postoperative brain injury in the patients undergoing cardiac valve replacement.Methods:Forty-two American Society of Anesthesiaologists physical status Ⅱ or Ⅲ patients of either sex, aged 40-70 yr, weighing 47-86 kg, scheduled for elective single valve replacement under CPB, were divided into 3 groups ( n=14 each) using a random number table method: control group (group C), combined intravenous-inhalational anesthesia group (group CA) and sevoflurane group (group S). During CPB, propofol 4-6 mg·kg -1·h -1 was intravenously infused in group C, propofol 2-3 mg·kg -1·h -1 was intravenously infused, and 0.5 MAC sevoflurane was inhaled via the membrane oxygenator in group CA, and 1.0-1.5 MAC sevoflurane was inhaled via the membrane oxygenator in group S. The anesthesia and sedation index values were maintained at 40-60 during operation in the three groups.Blood samples were taken from arteries before anesthesia induction (T 1), at 30 min and 6 and 24 h after termination of CPB (T 2-4) for determination of plasma concentrations of neuron-specific enolase (NSE) and Tau protein. Results:Compared with group C, the plasma concentration of NSE was significantly decreased at T 2, 3, and plasma concentration of Tau protein was decreased at T 2-4 in group S, and the plasma concentration of Tau protein was decreased at T 2 in group CA ( P<0.05). Compared with group CA, the plasma concentration of NSE was significantly decreased at T 2, 3, and the plasma concentration of Tau protein was decreased at T 2-4 in group S ( P<0.05). Conclusions:Inhalation of sevoflurane during CPB can reduce early postoperative brain injury to a certain extent in the patients undergoing cardiac valve replacement.

Effects of intrauterine exposure to ambient fine particles on immune function-related indicators in neonatal rats / 中华围产医学杂志

Objective@#To investigate the effects of maternal exposure to ambient fine particles (PM2.5) in Fuzhou during pregnancy on immune responses to ovalbumin (OVA) in neonatal rats and the possible mechanisms.@*Methods@#Pregnant Sprague-Dawley rats were randomly assigned into four groups (ten in each): filtered air (FA) plus normal saline (NS), airborne PM2.5 plus NS (PM2.5-NS), FA plus OVA (FA-OVA) and PM2.5 plus OVA (PM2.5-OVA) groups. Pregnant dams in the PM2.5 exposure groups were placed in a PM2.5 exposure chamber in which the PM2.5 concentration was equal to the ambient air from the beginning of gestation till delivery, whereas the other dams inhaling air without particulate matters were put into a clean chamber. OVA sensitization was conducted through intraperitoneal injection of OVA at 50 μg per dam at 4 and 9 days of gestation, followed by inhalation of atomized 1% OVA for 30 min at 18, 19 and 20 days of gestation. Dams without OVA sensitization were given NS in the same way. Levels of interleukin (IL)-4, IL-5 and interferon-γ (IFN-γ) in neonatal rats' plasma were measured by enzyme-linked immunosorbent assay just after birth. Protein levels of transcription factors GATA-3 and T-bet in lung were analyzed by Western-blotting. Changes in microRNA(miR)-146a and miR-146b in spleen were detected by real-time polymerase chain reaction. Histological changes in lung were observed under light microscope. One-way analysis of variance and LSD test were used as statistical methods.@*Results@#(1) IL-4 level in plasma was significantly increased in PM2.5-NS [(18.56±7.04) ng/L], FA-OVA [(34.04±7.06) ng/L] and PM2.5-OVA groups [(45.67±8.18) ng/L] as compared with that in FA-NS group [(10.51±2.88) ng/L], and the level of IL-4 in PM2.5-OVA group was higher than that in PM2.5-NS and FA-OVA groups (F=54.667, P<0.001). Significantly increased IL-5 level in plasma was found in FA-OVA and PM2.5-OVA groups as compared with that in FA-NS group (F=6.253, P=0.023). Among the four groups, FA-OVA group showed significantly increased IFN-γ level in plasma (F=28.604, P<0.001). (2) GATA-3 level in lung tissues was significantly increased in PM2.5-NS (31.09±3.54), FA-OVA (35.24±5.00) and PM2.5-OVA groups (47.81±3.63) as compared with that in FA-NS group (24.19±3.12), and higher in PM2.5-OVA group than in PM2.5-NS and FA-OVA groups (F=96.581, P<0.001). T-bet level was significantly lower in FA-OVA and PM2.5-OVA groups than in FA-NS group. Moreover, PM2.5-OVA group showed decreased T-bet level as compared with that in PM2.5-NS and FA-OVA groups (F=30.852, P<0.001). (3) Expression of miR-146a in spleen was significantly enhanced in PM2.5-NS (1.72±0.27), FA-OVA (1.56±0.37) and PM2.5-OVA groups (3.06±0.52) than in FA-NS group (1.05±0.25). Moreover, PM2.5-OVA group showed enhanced expression of miR-146a as compared with that in PM2.5-NS and FA-OVA groups (F=42.276, P<0.001). Changes in the expressions of miR-146b were similar to those in miR-146a (F=28.776, P<0.001). (4) Stenosis or disappearance of alveolar spaces, accompanied with infiltration of inflammatory cells in interstitial substance and congestion in alveolar septum, was seen in FA-OVA and PM2.5-OVA groups and conditions in the latter group were more severe.@*Conclusions@#Intrauterine exposure to ambient PM2.5 negatively affects fetal lung development and immunological function in rats, especially when the dams are sensitized with OVA during pregnancy.

Effects of intrauterine exposure to ambient fine particles on immune function-related indicators in neonatal rats / 中华围产医学杂志

Objective To investigate the effects of maternal exposure to ambient fine particles (PM2.5) in Fuzhou during pregnancy on immune responses to ovalbumin (OVA) in neonatal rats and the possible mechanisms.Methods Pregnant Sprague-Dawley rats were randomly assigned into four groups (ten in each):filtered air (FA) plus normal saline (NS),airborne PM2.5 plus NS (PM2.5-NS),FA plus OVA (FA-OVA) and PM2.5 plus OVA (PM2.5-OVA) groups.Pregnant dams in the PM2.5 exposure groups were placed in a PM2.5 exposure chamber in which the PM2.5 concentration was equal to the ambient air from the beginning of gestation till delivery,whereas the other dams inhaling air without particulate matters were put into a clean chamber.OVA sensitization was conducted through intraperitoneal injection of OVA at 50 μ g per dam at 4 and 9 days of gestation,followed by inhalation of atomized 1％ OVA for 30 min at 18,19 and 20 days of gestation.Dams without OVA sensitization were given NS in the same way.Levels of interleukin (IL)-4,IL-5 and interferon-γ (IFN-γ) in neonatal rats' plasma were measured by enzyme-linked immunosorbent assay just after birth.Protein levels of transcription factors GATA-3 and T-bet in lung were analyzed by Western-blotting.Changes in microRNA(miR)-146a and miR-146b in spleen were detected by real-time polymerase chain reaction.Histological changes in lung were observed under light microscope.One-way analysis of variance and LSD test were used as statistical methods.Results (1) IL-4 level in plasma was significantly increased in PM2.5-NS [(18.56±7.04) ng/L],FA-OVA [(34.04±7.06) ng/L] and PM2.5-OVA groups [(45.67±8.18) ng/L] as compared with that in FA-NS group [(10.51 ±2.88) ng/L],and the level of IL-4 in PM2.5-OVA group was higher than that in PM2.5-NS and FA-OVA groups (F=54.667,P＜0.001).Significantly increased IL-5 level in plasma was found in FA-OVA and PM2.5-OVA groups as compared with that in FA-NS group (F=6.253,P=0.023).Among the four groups,FA-OVA group showed significantly increased IFN-γ level in plasma (F=28.604,P＜0.001).(2) GATA-3 level in lung tissues was significantly increased in PM2.5-NS (31.09 + 3.54),FA-OVA (35.24± 5.00) and PM2.5-OVA groups (47.81 ±3.63) as compared with that in FA-NS group (24.19±3.12),and higher in PM2.5-OVA group than in PM2.5-NS and FA-OVA groups (F=96.581,P＜0.001).T-bet level was significantly lower in FA-OVA and PM2.5-OVA groups than in FA-NS group.Moreover,PM2.5-OVA group showed decreased T-bet level as compared with that in PM2.5-NS and FA-OVA groups (F=30.852,P＜0.001).(3) Expression of miR-146a in spleen was significantly enhanced in PM2.5-NS (1.72±0.27),FA-OVA (1.56±0.37) and PM2.5-OVA groups (3.06± 0.52) than in FA-NS group (1.05 ±0.25).Moreover,PM2.5-OVA group showed enhanced expression of miR-146a as compared with that in PM2.5-NS and FA-OVA groups (F=42.276,P＜0.001).Changes in the expressions of miR-146b were similar to those in miR-146a (F=28.776,P＜0.001).(4) Stenosis or disappearance of alveolar spaces,accompanied with infiltration of inflammatory cells in interstitial substance and congestion in alveolar septum,was seen in FA-OVA and PM2.5-OVA groups and conditions in the latter group were more severe.Conclusions Intrauterine exposure to ambient PM2.5 negatively affects fetal lung development and immunological function in rats,especially when the dams are sensitized with OVA during pregnancy.

Effect of sevoflurane-based anesthesia on interventricular synchronization in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass / 中华麻醉学杂志

Objective To evaluate the effect of sevoflurane-based anesthesia on the interventricular synchronization in the patients undergoing coronary artery bypass grafting (CABG) with cardiopuhnonary bypass (CPB).Methods Twenty-four Amnerican Society of Anesthesiologists physical status Ⅱ or Ⅲ patients,aged 52-75 yr,with body mass index of 17-31 kg/m2,with body surface area of 1.7-2.2 m2,of New York Heart Association Ⅱ or Ⅲll,with left ventricular ejection fraction (LVEF) ≥45％,scheduled for elective CABG with CPB,were divided into 2 groups (n=12 each) using a random number table:propofol combined with remifentanil anesthesia group (group C) and sevoflurane combined with propofol and remifentanil anesthesia group (group S).After induction of general anesthesia,the patients were en-dotracheally intubated and mechanically ventilated.Anesthesia was maintained by Ⅳ infusion of propofol,remifentanil and cisatracurium,and the cerebral state index value was maintained at 40-60.In group S,the patients inhaled sevoflurane (the end-tidal concentration was 1.80％ for 50-59 yr and 1.60％ for 60-75 yr) for 60 min starting from 15 min after termination of CPB.After induction of anesthesia and before splitting of sternum,immediately before inhaling sevoflurane and at 30 and 60 min of sevoflurane inhalation,heart rate,cardiac index,LVEF,right ventricular eject fraction,QRS width and interventricular mechanical delay were recorded,and the occurrence of interventricular dyssynchrony was recorded.Results There were no significant differences between group C and group S in the heart rate,cardiac index,LVEF,right ventricular eject fraction,QRS width,interventricular mechanical delay or incidence of interventricular dyssynchrony (P＞0.05).Conclusion Sevoflurane-based anesthesia exerts no marked effect on interventricular synchronization in the patients undergoing CABG with CPB.

Comparative study on two serological detection methods of mycoplasma pneumoniae in children with mycoplasmal pneumonia / 中国医师进修杂志

Objective To compare the sensitivity and specificity of dot immunogold method (DIM) and particle agglutination (PA) for the diagnosis of mycoplasma pneumoniae (MP) infection. Methods The 190 serum specimens of 113 children with mycoplasmal pneumonia (infection group) and 50 serum specimens of 50 health children (health group) were tested for MP by PA and DIM- A and B. Results In infection group, the positive rates of DIM- A and B were 82.63% (157/190) and 84.74%(161/190), and there was no statistical difference (χ2 = 0.31, P>0.05); the positive rate of PA (titer ≥1:160) was 70.00%(133/190), the positive rate of PA was significantly lower than that in DIM-A and B, and there were statistical differences (P0.05); the positive of PA was 8.00% (4/50), the positive rate of PA was significantly lower than that in DIM- A and B, and there were statistical differences (P<0.05 or<0.01). Conclusions Compared with the PA, DIM has low sensitivity and poor specificity for clinical diagnosis. DIM is not suitable for clinical diagnosis of MP infection.

Effects of sevoflurane on right ventricular function after cardiopulmonary bypass in patients undergoing coronary artery bypass grafting / 临床麻醉学杂志

Objective To evaluate the effects of sevoflurane on right ventricular systolic function after cardiopulmonary bypass in patients undergoing coronary artery bypass grafting(CABG). Methods Eighteen patients with coronary heart disease,13 males,5 females,ASA Ⅱ or Ⅲ,aged 50-80 years,measuring 1 50-182 cm in height,weighing 5 1-96 kg,scheduled for CABG under CPB were enrolled in this study.Anesthesia was maintained with intravenous anesthesia, and 1 MAC sevoflurane inhalation lasted for 60 min after CPB.Hemodynamic indicators such as HR,MAP, CVP,cardiac output (CO),Systemic vascular resistance (SVR)and right ventricular parameters in-cluding tricuspid annular plane systolic excursion (TAPSE)and velocity (TAPSV)were recorded be-fore sternotomy (T2 ),30 min after CPB (T3 ),60 min after CPB (T4 ).Results Compared with T1 , CO was increased at T2 (P <0.05);compared with T2 ,CO was decreased at T3 and T4 (P <0.05 or P <0.01),with a statistical significance;compared with T1 ,TAPSE and TAPSV were increased at T2 (P <0.05 or P <0.01);compared with T2 ,TAPSE and TAPSV were decreased at T3 and T4 (P<0.05);with a statistical significance in TAPSE and TAPSV.Conclusion For the patients undergo-ing CABG under CPB,1 MAC sevoflurane inhalation after CPB can reduce right ventricular systolic function,which,however,is within the normal ranges.

Effect of nicardipine on hepatic blood flow in patients undergoing cardiac valve replacement with cardiopulmonary bypass / 中华麻醉学杂志

Objective To investigate the effect of nicardipine on the hepatic blood flow in the patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Twenty-six patients of both sexes,aged 30-64 yr,weighing 50-90 kg,with New York Heart Association Ⅱ or Ⅲ,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective mitral or aortic valve replacement,were randomly divided into either nicardipine group (group P,n =13) or control group (group C,n =13) using a random number table.Transesophageal echocardiography was used to measure the indexes of blood flow in the hepatic vein.Nicardipine 0.2-0.5 μg · kg-1 · min-1 was infused intravenously starting from beginning of CPB,and the infusion was stopped at termination of CPB in group P.After induction of general anesthesia,at 30 min after beginning of CPB,at 10 min before termination of CPB,and at 30 min after termination of CPB,the diameter of the right and middle hepatic veins (DR and DM),blood flow index in the right hepatic vein (QIR),blood flow index in the middle hepatic vein (QIM),and total blood flow index in the hepatic vein (QIR+M) were recorded,and the percentage of QIR+M in cardiac index (CI) (QIR+M/CI) or in QICPB (QIR+M/QICPB) was calculated.Before operation,and at 1 and 2 days after operation,blood samples were obtained from the median cubital vein for determination of total bilirubin,alanine aminotransferase,and aspartate aminotransferase (AST) levels in serum.Results Compared with group C,the serum levels of AST at 1 day after operation and serum levels of AST at 1 day after operation were significantly decreased (P＜0.05),and no significant change was found in DR,DM,QIR,QIM,QIR+M,QIR+M/CI and QIR+M/QICPB at each time point in group P (P＞0.05).Conclusion Nicardipine (0.2-0.5 μg · kg-1 · min-1) infused intravenously during CPB exerts no effect on the hepatic blood flow,and it is not related to the improvement in hepatic function in the patients undergoing cardiac valve replacement.

The relationship between syndrome differentiation of TCM and clinical test results of 196 cases with chronic ;hepatitis B / 中国基层医药

Objective To establish the corresponding relationship between syndrome differentiation of TCM and clinical test results in chronic hepatitis B patients,and thus to provide objective evidence for TCM treatment. Methods 196 patients with chronic hepatitis B,according to the Chinese medicine dialectical typing results were divided into five groups(liver kidney yin deficiency syndrome type 35 cases,Shire Zhongzu syndrome type 24 cases, Yang deficiency of spleen and kidney syndrome type 26 cases,damp heat resistance type and blood stasis syndrome type 42 cases,liver stagnation and spleen deficiency syndrome type 69 cases).HBV -DNA,hepatitis B,TBIL,ALT, TTT were detected.Results In the HBV -DNA test,the majority of the five groups were positive,the overall compar-ison,the difference was not statistically significant (P =0.937).But in the second liver five,TBIL,ALT and TTT detection,the detection results were reflected in the corresponding relationship between TCMsyndrome differentiation. Such as in TTT detection,liver kidney yin deficiency syndrome type and liver stagnation and spleen deficiency syn-drome type group of patients,most patients with TTT detection results between 7 and 10,two groups sequentially com-pared with the other three groups,the differences were statistically significant (all P =0.000);damp heat resistance type and blood stasis type in the patients group,TTT detection results were generally less than 6,two groups in turn compared with the other three groups,the differences were statistically significant (all P =0.000);Yang deficiency of spleen and kidney in the patients group,TTT detection results were generally more than 10,and compared with the other four groups,the differences were statistically significant (all P =0.000).Conclusion TCMsyndrome differen-tiation of chronic hepatitis B patients has a certain correlation with the clinical test results.

Value of plasma D-dimer, high-density lipoprotein, carcino embryonic antigen and carbohydrate antigen 724 on diagnosis of gastric cancer / 肿瘤研究与临床

Objective To evaluate the diagnostic value of the level of plasma D-dimer,high-density lipoprotein (HDL),carcino embryonic antigen (CEA) and carbohydrate antigen 724 (CA724) in gastric cancer.Methods The plasma and clinicopathological data of 103 gastric cancer patients and 111 normal controls were collected.The levels of D-dimer,HDL,CEA and CA724 were detected.SPSS 13.0 statistical software was applied to analysis the sensitivity and specificity of each examination method and to find out the appropriate combination.Results The levels of D-dimer,CEA and CA724 in patients with gastric carcinoma were 0.87 (2.69) μg/ml,2.66 (4.38) ng/ml,5.10 (7.79) U/ml,respectively,they were distinctly higher than those in normal controls [0.22 (0.21) μg/ml,1.28 (1.60) ng/ml,1.81 (1.60) U/ml,all P =0.000].HDL level was significantly lower in patients than that in normal controls [0.86 (0.35) mmol/L vs 1.29 (0.44) mmol/L,P=0.000].The area ofROC curve of D-dimer,HDL,CEA,CA724 were 0.799,0.859,0.739,0.743,respectively.The cut-off of D-dimer was 0.46 μ.g/ml,the sensitivity was 68.0 ％,the specificity was 86.5 ％.The cut-off of HDL was 0.995 mmol/L,the sensitivity was 73.8 ％,the specificity was 84.7 ％.The cut-off of CEA was 3.585 ng/ml,the sensitivity was 44.7 ％,the specificity was 92.0 ％.The cut-off of CA724 was 3.765 U/ml,the sensitivity was 57.3 ％,the specificity was 89.2 ％.The sensitivity of D-dimer+HDL+CA724 was 83.5 ％,the specificity was 89.2 ％.The sensitivity and specificity of D-dimer+HDL+CEA+CA724 were 84.5 ％ and 89.2 ％,respectively.Conclusions The D-dimer+HDL+CEA+CA724 may provide the evidence for diagnosis of gastric cancer.Combined detection has higher sensitivity and specificity.

Changes in right ventricular function in the early stage after cardiopulmonary bypass in patients undergoing coronary artery bypass grafting / 中华麻醉学杂志

Objective To evaluate the changes in the right ventricular systolic and diastolic function during the early period after cardiopulmonary bypass (CPB) in patients undergoing coronary artery bypass grafting (CABG).Methods Eighteen ASA physical status Ⅱ or Ⅲ patients of both sexes,with coronary heart disease (NYHA Ⅱ or Ⅲ),aged 50-80 yr,weighing 51-96 kg,with left ventricular ejection fraction≥50％,scheduled for elective CABG under CPB,were enrolled in this study.Before splitting of sternum and at 5 min after termination of CPB,the parameters of hemodynamics,cardiac output (CO)and variables of right ventricular function (using transesophageal echocardiography) including tricuspid annular plane systolic excursion (TAPSE),right ventricular fractional area change (RVFAC),tricuspid annular peak velocity during isovolumic contraction (IVV),peak velocity during ejection phases (St),early diastolic peak velocity (Et),late diastolic peak velocity (At),E/Et ratio and Et/At ratio were recorded.Results Compared with the baseline value before splitting of sternum,TAPSE,IVV,St,RVFAC,CO,E,Et and At were significantly increased,and no significant change was found in the parameters of hemodynamics and E/Et and Et/At ratios at 5 min after termination of CPB.Conclusion For the patients undergoing CABG,the right ventricular systolic function is significantly enhanced,and there is no obvious improvement in the right ventricular diastolic function during the early period after CPB.

Social network analysis and high risk behavior characteristics of recreational drug users: a qualitative study / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand the characteristics of recreational drug users' behaviors and social network, as well as their potential impact to the transmission of sexual transmitted infections (STI).</p><p><b>METHODS</b>Qualitative interview was used to collect information on rough estimation of population size and behavior change before and after recreational drug use. A total of 120 participants were recruited by convenient sampling from April to October, 2013 in a community of Qingdao city. Blood specimens were taken for HIV/syphilis serological testing and social network analysis was performed to understand the characteristics of their behavior and social network.</p><p><b>RESULTS</b>All participants used methamphetamine and 103 of them showed social connection. The prevalence of syphilis and HIV were 24.2% (29/120) and 2.5% (3/120) respectively. The estimated size of recreational drug users was big with a wide diversity of occupations and age range, and males were more frequent than females. Drug use may affect condom use and frequent drug users showed symptom of psychosis and neuro-toxicities. The size of social network was 2.45 ± 1.63 in the past 6 months, which indicated an increasing trend of the sexual partner number and risky behaviors.</p><p><b>CONCLUSION</b>Recreational drug use could increase the size of social network among sex partners, the frequency of risky sexual behaviors and syphilis prevalence, which indicate a high risk of HIV/STI among this population as well as a huge burden of disease prevention and control in the future.</p>

The analysis of the sensitivity and specificity by pulmonary artery catheter and transesophageal echocar-diography regarding volume responsiveness in cardiac surgery / 临床麻醉学杂志

Objective To analyze the sensitivity and specificity of several volume parameters regarding volume responsiveness.The studied volume parameters include pulmonary artery obstruc-tion pressure (PAOP),central venous pressure (CVP),right ventricular end-diastolic volume (RV-EDV)measured by Swan-Ganz pulmonary artery catheter and left ventricular end-diastolic area (LVEDA),inferior vena cava diameter (IVC)measured by transesophageal echocardiography (TEE). Methods Twelve patients with ASA Ⅱ or Ⅲ,scheduled for coronary artery bypass grafting were studied.After anesthesia induction,the TEE probe was put into the esophagus and Swan-Ganz cathe-ter was placed in right internal jugular venous.Measurements were made at the time before cutting the skin (T0 ),20 min after divorcing from cardiopulmonary bypass or finishing vascular anastomosis in off-pump surgery(T1 ),10 min after rapid infusion (T2 )and 30 min after rapid infusion (T3 ),re-spectively.Results The values of PAOP,IVC,LVEDA,COLVOT at time T2 increased significantly compared to those at time T1 (P <0.01).No obvious correlation (r=-0.298 5、r=-0.091 8、r=-0.243 6)was observed between △CVP、△PAOP、△RVEDV and △COLVOT (the difference between T2 and T1 );Meanwhile,△IVC and △LVEDA were well correlated to △COLVOT (r= 0.445 0、r=0.612 0).Using more than 1 5% change of COLVOT after volume expansion as definition of positive re-sponse,the areas under the receiver operating characteristic curves of CVP,PAOP,RVEDV,IVC and LVEDA were 0.389 (95% CI 0.035-0.743 ),0.458 (95% CI 0.109-0.807 ),0.333 (95% CI 0-0.671 ), 0.903 (95% CI 0.701-1.000 ) and 0.889 (95% CI 0.661-1.000 ), respectively. Conclusion PAOP,IVC,LVEDA,CO are more sensitive to the change of volume;while CVP and RVEDV have weak responses to volume changes.This indicates that IVC and RVEDA have more ad-vantage to estimate cardiac output increase and guide volume therapy.

Effect of sevoflurane preconditioning on left ventricular function in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass / 中华麻醉学杂志

Objective To evaluate the effect of sevoflurane preconditioning on the left ventricular function in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB).Methods Thirty ASA physical status Ⅱ or Ⅲ patients,aged 42-70 yr,with body height 152-181 cm,weighing 43-78 kg,scheduled for elective CABG under CPB,were randomly divided into 2 groups (n =15 each) using a random number table:control group (group C) and sevoflurane preconditioning group (group SP).Group SP inhaled sevoflurane with the end-tidal concentration corresponding to 1 MAC for 30 min after endotracheal intubation.Before sevoflurane preconditioning (T0) and at 60 min after termination of CPB (T1),mean arterial pressure (MAP),stroke volume index (SVI),pulmonary artery obstruction pressure and the TEE variables including left ventricular ejection fraction (LVEF),peak E wave velocity (E),systolic wave velocity (S),and diastolic wave velocity (D),and low propagation velocity (Vp) were recorded.S/D ratio and E/Vp ratio were calculated.Extubation time and duration of ICU stay were also recorded.Results Compared with the baseline value at T0,HR was significantly increased at T1 (P ＜ 0.05 or 0.01),and no significant change was found in the other parameters of the left ventricle function in the two groups (P ＞ 0.05).There was no significant difference in the parameters of the left ventricle function,extubation time and duration of ICU stay between SP group and C group (P ＞ 0.05).Conclusion Preconditioning with inhalation of sevoflurane with the end-tidal concentration corresponding to 1 MAC before CPB does not produce myocardial protection in terms of the left ventricular function or exerts little effect on the short-term outcomes.

Development of acupuncture manipulator and its application in animal shock model / 生物医学工程学杂志

We have developed a mini acupuncture manipulator, which can simulate the traditional needling therapy and can inquired about the acu-related physical parameters which could not be quantitatively studied in the past. For example, we can control the depth, velocity, angle, angular velocity, frequency and interval time of acupuncture. The experimental study on Sprague-Dawley rat's acute hemorrhagic shock model was conducted to compare the curative effect of acupuncture manipulator versus that of electroacupuncture. This experiment demonstrated that the acupuncture manipulator can imitate hand acupuncture in security and can produce the effect similar to that of electroacupuncture. So this mini acupuncture manipulator can be of applications in research, teaching and clinical treatment.

The protective role of erythropoietin induced by hypoxic preconditioning on cerebral injury and cognition after global cerebral ischemia / 中国中西医结合急救杂志

Objective To observe the protective effects of hypoxic preconditioning(HPC) on the improvement of the cognitive dysfunction(learning and memory) and the damage in hippocampus induced by global cerebral ischemia/reperfusion(I/R) in CA1 and CA3 for 5 days in rats,and on the regulation of expression of erythropoietin(EPO) protein to approach the mechanism of the protection.Methods One hundred and twenty adult male Sprague-Dawley(SD) rats were divided into four groups randomly: sham group,I/R group,HPC24 group(hypoxia for 24 hours before I/R) and HPC48 group(hypoxia for 48 hours before I/R).Hang(motor function),passive avoidance and Morris water maze tests were carried out on the 5th day after I/R to measure the motor and cognition functions;hematoxylin-eosin(HE) staining was used to detected histopathological changes in hippocampus tissues;and the contents of EPO were tested by immunohistochemistry at 1 hour and 4 hours after I/R from hippocampus CA1 and CA3 regions.Results Hang,passive avoidance and Morris water maze tests showed that I/R can injure rat cognition;the improvement of cognition was marked in HPC groups, and it was shown that the effects were more significant in HPC48 group than those in the HPC24 group(P

Protection of electroacupuncture and compound salviae in coordination on ischemia-reperfusion myocardium / 中国组织工程研究

BACKGROUND: Both electroacupuncture and salviae act on prevention and treatment ofis chemia-reperfusion injury, but, whether such action is achieved or not by coordination of both? OBJECTIVE: To probe into the effects of electroacupuncture and salviae on expression of myocardial cellular heat-shock protein 70mRNA that acts on protecting myocardium and on dopamine level that is the mark for myocardial injury after ischemia-repeifusion as well as the interaction between electroacupuncture and salviae. DESIGN: Factorial design of two factors. SETTLNG: Department of Anesthesia of Renji Hospital Affiliated to Shanghai Second Medical Scientific University. PARTICIPANTS: The experiment was performed in Animal Experimental Room of Renji Hospital from September 2001 to December 2002, in which 24 healthy New Zealand white rabbits were employed and randomized into 4 groups, 6 rabbits in each, named ① ischemia-reperfusion group (IR group), ② electroacupuncture group (EA group), ③ salviae group (SA group), ④ electroacupuncture + salviae group (ES group). METHODS: ① IR group: ischemia-reperfusion model was prepared by clipped the anterior descend branch of cardiac coronal artery for 30 minutes and released for 2 hours. ② EA group: modeling was done as the previous method. Twenty minutes before ischemia, electroacupuncture was done on Neiguan (PC 6), Yunmen (LU 2) and Lieque (LU 7), 0.8 V in voltage, 3.0-4.0 Hz in frequency. ③ SA group: modeling was done as the previous method. Before ischemia, salviae was injected intravenously once at 1.5 mg/kg, and was injected before and after reperfusion once respectively at 1.0 mg/kg. ④ ES group: modeling was done as the previous method. Both electroacupuncture and medication were applied in the group. The content of dopamine was determined in blood before ischemia,30 minutes after ischemia and 2 hours after reperfusion successively in rabbits of every group. Reverse transcription-polymerase chain reaction (RT-PCR) was used to determine myocardial heat-shock protein 70mRNA expression in ischemic and non-ischemic areas. RESULTS: After supplemented, 24 rabbits entered result analysis. ① Expression of myocardial heat-shock protein 70mRNA: that after ischemia and reperfusion was increased significantly compared that before ischemia in every group (P ＜ 0.01). That in the rest 3 groups was all higher than IR group,and that in ES group was higher than EA and SA groups (F=4.48, P ＜0.05). CONCLUSION: ① Both electroacupuncture and salivae stimulate expression of heat-shock protein 70 mRNA after ischemia and reperfusion, enhance protein stability of heat-shock protein 70 and alleviate myocardial damage. ② Both electroacupuncture and salivae inhibit increased dopamine content in the body after ischemia and reperfusion, reduce dopamine mediated injury and protect myocardium. ③ Coordination is present between electroacupuncture and salivae.