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OBJECTIVE:To investigate the effects of different doses of tanshinone ⅡAon hemodynamics in patients underwent non-extracorporeal circulation coronary artery bypass grafting(NECCABG). METHODS:A total of 66 patients underwent selective NECCABG during Nov. 2016-Apr. 2017 were selected and divided into control group(33 cases)and observation group(33 cases) according to random number tablet. Both groups were given Tanshinone ⅡAsodium sulfonate injection with loading dose of 0.4 μg/kg for 10 min at the beginning of surgery. Control group was given Tanshinone ⅡAsodium sulfonate injection 0.2 μg/(kg·h) continuously till the end of surgery;observation group was given 0.4 μg/(kg·h)continuously till the end of surgery. HR,MAP, central venous pressure(CVP),mean pulmonary arterial pressure(MPAP),pulmonary capillary wedge pressure(PCWP),cardiac index(CI),systemic vascular resistance index(SVRI),pulmonary circulation resistance index(PVRI)and the occurrence of ADR were observed in 2 groups before anesthesia induction(T0),5 min after tracheal intubation(T1),at the moment of sternum cut(T2),at the end of anastomosis of anterior descending branch(T3),at the end of anastomosis of right coronary artery(T4),at the end of operation(T5). RESULTS:At T0,there was no statistical significance in HR,MAP,CVP,MPAP,PCWP, CI,SVRI or PVRI between 2 groups(P>0.05). At T1-T5, HR,MAP,CVP,MPAP,PCWP,SVRI and PVRI of control group were significantly higher than at T0,with statistical significance(P<0.05). There was no statistical significance in CI of control group among at T1-T5and with at T0;there was no statistical significance in HR,MAP,CVP,MPAP,PCWP,SVRI or PVRI of observation group between at T1-T5with at T0 (P>0.05). At T1-T5,CI of observation group was significantly higher than at T0and than control group;HR,MAP,CVP, MPAP,PCWP,SVRI and PVRI were significantly lower than control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups during medication. CONCLUSIONS:Tanshinone ⅡA0.4 μg/(kg·h)is helpful to keep hemodynamics stable and improve heart function in patients with NECCABG with good safety.
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Objective To study the application of dynamic contrast-enhanced MRI (DCE-MRI)in preoperative TN staging of rectal cancer. Methods Seventy-two patients with rectal cancer confirmed by surgery and pathology underwent preoperative conventional MRI and DCE-MRI.The consistencies between conventional MRI and pathology,conventional MRI combined with DCE-MRI and pathology in diagnosing the TN staging were analyzed retrospectively.The quantitative parameters of DCE-MRI including Ktrans,Veand Kepwere measured to analyze the correlation with T staging and lymph nodes metastasis.Results The accuracy of conventional MRI and conventional MRI combined with DCE-MRI in diagnosing the T staging were 72.2% and 84.7%,respectively,in diagnosing the N staging were 65.3% and 77.8%, respectively.The DCE-MRI quantitative parameters (Ktransvalue,Vevalue and Kepvalue)were positively related to the T staging and lymph nodes metastasis(P<0.05).Conclusion DCE-MRI can improve the accuracy of the preoperative TN staging of rectal cancer. DCE-MRI quantitative parameters of Ktrans,Ve,Kepvalues can help to determine T staging and lymph node properties of rectal cancer.
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Objective To investigate the application value of functional magnetic resonance imaging nethods diffusion weighted imagingand dynamic contrast-enhanced magnetic resonance imaging in theT stagingof rectal cancer.Methods Through the retrospectively analysis of DWI and DCE-MRI images of 78 rectal cancer patients confirmed by pathology,the different of routine sequence examination and functional magnetic resonance imaging combined with routine sequence examination in T thestaging diagnosis were contrasted analysis.The correlation of ADC value and quantitative parameters of Ktrans,Kep and Ve values with tumor T staging was analyzed.Results The functional magnetic resonance imaging combined with routine sequence examination in T staging screened 68 cases successfully,and the accuracy rate was 87.2％.preoperative T staging and postoperative pathology of rectal cancerwas better thanroutine sequence examinationin T staging (59 cases,with the accuracy rate 75.6％) (Kappavalue:0.81 vs 0.65,P ＜ 0.05).The ADCvalue andDCE-MRI quantitative parameters values of K and Ve increased with the increase of tumor T staging (P ＜ 0.05).There was no statistically significant difference of Kep values.Conclusions The ADC value and DCE-MRI quantitative parameters (K and Ve values) had certain relevance with Tstaging of rectal cancer.The functional magnetic resonance imaging had a high accuracy in the preoperative T staging of rectal cancer,which proves certain clinical value in judging invasion depth of tumor in the rectal wall.
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This paper studies the problem of outcome prediction in anesthesia procedures. Anesthesia depth and blood pressures are used as typical outcomes in this study. Traditional diagnosis and control in anesthesia focus on a one-drug-one-outcome scenario. It is well understood, however, that consideration of multiple outcomes is necessary and beneficial for anesthesia managements. This paper introduces a method of modeling that significantly reduces the complexity of the problem and yet retains model accuracy. Utility of the modeling method is demonstrated in the areas of anesthesia outcome prediction and decision assistance