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1.
Basic & Clinical Medicine ; (12): 276-280, 2024.
Article in Chinese | WPRIM | ID: wpr-1018609

ABSTRACT

Objective To explore the practice and significance of the new course of"Enhanced Recovery after Sur-gery(ERAS)and Perioperative Management"for graduate students under multidisciplinary cooperation.Methods The Department of Anesthesiology collaborated with the Department of Clinical Nutrition,Department of Geriatrics and six related surgical departments to develop a course of 30 credit hours on"ERAS and Perioperative Manage-ment"in Peking Union Medical College Hospital.Researchers analyzed the teaching effectiveness of the course by collecting survey questionnaires and evaluating scheme report of ERAS case.Results Researchers found that ten graduates joined this course and they believed that learning improved their understanding of ERAS related knowl-edge,such as preoperative nutrition and functional state optimization,intraoperative volume and temperature man-agement,prevention of postoperative nausea and vomiting,and perioperative pain management.Students had high satisfaction with the course and believed that it would help improve their clinical literacy.Conclusions The new course of"ERAS and Perioperative Management"for graduates may support capacity building in terms of clinical logic and thinking about ERAS and promotion of skills for perioperative management.Our experience of graduates′training with"Enhanced Recovery after Surgery and Perioperative Management"course can be shared by other trainers of health institution of China.

2.
Basic & Clinical Medicine ; (12): 572-576, 2024.
Article in Chinese | WPRIM | ID: wpr-1018658

ABSTRACT

Objective Using our team's recent research achievement"the cervical ultrasound scanning route map"as a teaching tool,to evaluate its impact on the learning effectiveness and confidence of beginners in the process of learning cervical spinal ultrasonography.Methods This study is a before and after self-control study.After recruit-ment of 40 cervical ultrasound beginners,they had completed questionnaire 1.The questionnaire was designed with three self-assessment questions on theoretical knowledge of cervical spinal ultrasound,three self-assessment ques-tions on practical skills of cervical spinal ultrasound and one question on willingness to use cervical spinal ultra-sound in the future.After traditional teaching without involving the route map,beginners completed questionnaire 2 with the same content.After a 20 min break,teacher introduced and explained the route map to the beginners,then the beginners completed questionnaire 3.Questions related to satisfaction with this learning experience had been added to questionnaire 3.The answers to all questions were scored on a scale of 1-10.In this study,the main out-come was the comprehensive learning score,calculated as(sum score of theoretical knowledge+sum score of prac-tical skills+score of willingness to use cervical ultrasound in the future)/7.Results Beginners'comprehensive learning score at the three time points were 2.9±1.3,4.8±1.8,5.7±1.8,F(2,22)= 52.11,P<0.001,partial Eta squared=0.83.After introducing the route map,their comprehensive learning score increased 1.0(95%CI:0.46-1.49)(P<0.001)compared to scores after traditional training.Conclusions The route map may significantly improve learning effectiveness and confidence of beginners in the field of cervical spinal ultrasonography and can be used as a routine training tool in the teaching of cervical spinal ultrasonography.

3.
Journal of Medical Research ; (12): 65-70, 2023.
Article in Chinese | WPRIM | ID: wpr-1023571

ABSTRACT

Objective To systematically evaluate the efficacy of magnesium sulfate combined with conventional treatment in the treatment of severe acute pancreatitis(SAP).Methods Randomized controlled trial(RCT)comparing the efficacy difference between conventional treatment and conventional treatment combined with magnesium sulfate in the treatment of SAP were included by searching PubMed,Web of Science,CNKI and WanFang data knowledge service platform from the establishment of the database to July 1,2022.Meta-analysis was performed by Review Manager 5.4software to evaluate the prognosis of patients.Results Compared with the conven-tional treatment(water fasting,gastrointestinal decompression,fluid replacement,antibiotic treatment,inhibition of pancreatic enzyme se-cretion,maintenance of water,electrolyte and acid-base balance),magnesium sulfate combined with conventional treatment can reduce the mortality and complications related to SAP,and shorten the length of hospital stay,relief time of abdominal pain,duration of fever.Conclusion Magnesium sulfate combined with conventional treatment is superior to conventional treatment in improving the mortality,complication rate,length of hospital stay,relief time of abdominal pain,duration of fever in patients with SAP.

4.
Acta Pharmaceutica Sinica ; (12): 1849-1854, 2022.
Article in Chinese | WPRIM | ID: wpr-929435

ABSTRACT

Sixteen compounds were isolated from the ethanol extract of Illigera rhodantha by silica gel, ODS, and Sephadex LH-20 column chromatographies. These compounds were identified as (2R,3R)-2,3-dihydroxy-2-methylbutane-1,4-diyldibenzoate (1), p-hydroxyphenethyl trans-ferulate (2), 4-O-benzoyl-2-C-methyl-D-erythritol (3), N-trans feruloyl-3-methyldopamine (4), tribulusamide A (5), cryptomeridiol (6), teuclatriol (7), oleanolic acid (8), icario A2 (9), vanillic acid (10), p-hydroxybenzoic acid (11), gallic acid (12), ethyl gallate (13), chrysophanol (14), D-1-O-methyl-inositol (15), and hexadecanoic acid (16) based on their spectral data and physico-chemical properties. Compound 1 is an undescribed compound, of which its absolute configurations were determined by Mosher and ROESY methods; all the compounds except 10, 11 and 14 were isolated from Illigera genus for the first time. Compared with the positive control indomethacin, compounds 4-6, 8 and 9 inhibited significantly against the NO production in LPS-induced RAW 264.7 cells.

5.
Article in Chinese | WPRIM | ID: wpr-911188

ABSTRACT

Objective:To compare the effects of different anesthetic methods on the prognosis in the patients with stage Ⅲ breast cancer.Methods:Based on a multicenter randomized controlled trial (NCT00418457), 274 patients with untreated stage Ⅲ breast cancer, aged 18-85 yr, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, were enrolled in the study and assigned to thoracic paravertebral block (TPVB) combined with total intravenous anesthesia group (TPVB+ TIVA group, n=141) and general anesthesia group (GA group, n=133) by computer-generated randomization stratified by study site.The primary outcome parameter of this study was postoperative recurrence rate.The secondary outcome parameters were the degree of postoperative acute pain (assessed using visual analogue scale score), the incidence of postoperative nausea and vomiting (PONV), postoperative hospital stay time, and the incidence of persistent pain after breast cancer surgery (PPBCS) at 6 and 12 months after surgery (assessed using the modified Brief Pain Inventory). Results:Compared with group GA, no significant change was found in the postoperative recurrence rate ( HR=0.711, 95% confidence interval (CI) 0.418-1.210, P=0.209), the degree of postoperative acute pain and the incidence of PONV were decreased (mean difference ( MD) of visual analogue scale score -0.890, 95% CI -1.344--0.436, P<0.001; OR=0.236, 95% CI 0.083-0.674, P=0.007), and no significant change was found in postoperative hospital stay time and the incidence of PPBCS ( HR=1.000, 95% CI 0.778-1.286, P=1.000; OR=2.100, 95% CI 0.599-7.362, P=0.246) in group TPVB+ TIVA. Conclusion:Compared with general anesthesia alone, TPVB combined with total intravenous anesthesia can provide lower degree of postoperative acute pain and lower incidence of PONV, and exert no effects on postoperative recurrence, postoperative hospital stay time and PPBCS in patients with stage Ⅲ breast cancer.

6.
China Pharmacy ; (12): 720-724, 2021.
Article in Chinese | WPRIM | ID: wpr-875654

ABSTRACT

OBJECTIVE:To study the efficacy and safety of sacubitril valsartan sodium tablets combined with Bailing capsules in the treatment of chronic left heart failure with renal insufficiency ,and to provide reference for clinical drug use. METHODS : Totally 96 patients with chronic left heart failure with renal insufficiency who sought medical care in our hospital from Nov. 2018 to Nov. 2019 were divided into group A ,B and C according to table of random numbers ,with 32 cases in each group. Group A received conventional heart failure treatment and and Bailing capsules (2 g each time ,3 times a day );group B received conventional heart failure treatment and Sacubitril valsartan sodium tablets (50 mg each time ,twice a day );group C was given with heart failure treatment and Sacubitril valsartan sodium tablets (50 mg each time ,twice a day )and Bailing capsules (2 g each time,3 times a day ). 3 groups received consecutive 6 months of treatment. Clinical response rates of 3 groups were compared. Left heart function indexes [left ventricular end systolic diameter (LVESD),left ventricular end-diastolic diameter (LVEDD),left ventricular ejection fraction (LVEF)] and serological indexes [interleukin 1(IL-1),IL-6,N terminal brain natriuretic peptide precursor,glomerular filtration rate (GFR)] were detected before and after treatment. The occurrence of ADR were observed and recorded. RESULTS :During this study ,a total of 6 patients fell off ,and eventually 90 patients completed the study ,including 29 cases in group A ,30 cases in group B and 31 cases in group C. Before treatment ,there was no statistical significance in left heart function indexes or serological indexes among 3 groups(P> 0.05). After 6 months of treatment ,clinical response rate of group C was significantly higher than those of group A and B 163.com (P<0.05). Compared with before treatment , LVEDD, LVESD and serological indexes of 3 groups were decreased significantly after treatment (P<0.05),while LVEF and GFR were increased significantly (P<0.05);the changes of above indexes (except for IL- 1 level in serum ) in group C were significantly better than group A and B ,the changes of above indexes in group B (except for GFR )were significantly better than group A (P<0.05). No significant ADR were observed in 3 groups. CONCLUSIONS :Sacubitril valsartan sodium tablets combined with Bailing capsules can significantly decrease the level of serum inflammation factors ,and improve cardiac and renal function in patients with chronic left heart failure with renal insufficiency ,with good safety.

7.
Article in Chinese | WPRIM | ID: wpr-885070

ABSTRACT

Objective:To compare the patient-centered doctor-patient communication skills in anesthesiologists with different working experience and genders.Methods:The second and third year residents who had been trained as residents in the Department of Anesthesiology in our hospital from September 2017 and September 2018 and senior physicians who had worked for 10-15 yr in our hospital, were recruited to perform a preoperative interview in a standardized patient counter.Consultation and Relational Empathy (CARE) measure was used to assess the communication skills among senior physicians, residents, and anesthesiologists of different genders.The residents also took the objective structured clinical examination (OSCE) and theory examination.Results:Thirty-six residents and 20 senior physicians were included.There was no significant difference in the CARE measure score between residents and senior physicians and in the total CARE measure score between residents who received doctor-patient communication training at the stage of medical students and those who did not ( P>0.05). Compared with the residents in the second year, the listening ability score and decision-making ability score were significantly decreased ( P<0.05), and no significant change was found in the scores for the other items in the residents in the third year ( P>0.05). Compared with residents, the listening ability scores were significantly increased, and the caring ability scores were decreased ( P<0.05), and no significant change was found in the scores for the other items in senior physicians ( P>0.05). There was no difference in CARE measure scores between the male and female anesthesiologists.The resident′s CARE measure score was positively correlated with the annual OSCE score ( r=0.486, P<0.05), and there was no correlation between the resident′s CARE measure score and annual theoretical examination grade ( r=0.308, P>0.05). Conclusion:Senior anesthesiologists with more clinical experience are not superior to the junior residents in patient-centered communication skills, and the doctor-patient communication skills of residents are not related to their medical theoretical grade.Moreover, there is no significant difference between male and female anesthesiologists in terms of doctor-patient communication skills before surgery.Therefore, training of patient-centered doctor-patient communication skills should be strengthened at all levels of anesthesiologists.

8.
Article in English | WPRIM | ID: wpr-888244

ABSTRACT

Objectives To validate the reliability of the Chinese version of the Consultation and Relational Empathy (CARE) in physician-standardized patient (SP) encounter. We also tried to examine the agreement between video-based ratings and in-room ratings, as well as the agreement between the faculty ratings and SP ratings. Methods The CARE was translated into Chinese. Forty-eight anesthesia residents were recruited to make preoperative interview in SP-counter. Performance of each resident was graded by in-room raters, video raters and SP raters. Consistency between different raters was examined. Results The Chinese-CARE measure demonstrated high scale reliability with a Cronbach's alpha value of 0.95 and high consistency in the in-room ratings in intraclass correlation (coefficient=0.888,

9.
Article in Chinese | WPRIM | ID: wpr-755594

ABSTRACT

Objective To investigate the anesthesia residents' proficiency in the epidural puncture and training needs using questionnaire survey in China.Methods A questionnaire designed by ourselves was sent to anesthesia residents via the WeChat platform within 1 month.The data were recorded by the system automatically.Results A total of 795 anesthesia residents involved in the investigation,and the number of valid questionnaires was 753 (94.7%).There were 233 (30.9%) junior residents (0-2 yr of training),279 (37.1%) semi-senior residents (3-5 yr of training),and 241 (32.0%) senior residents (>5yr of training).Compared with junior group,the difficulty score for epidural puncture was significantly decreased,and the confidence scores for performing normal middle lumbar,difficult lumbar,lateral lumbar and thoracic epidural puncture were increased in semi-senior and senior groups (P<0.05).Compared with semi-senior group,the difficulty score for epidural puncture was significantly decreased,and the confidence scores for performing normal middle lumbar,difficult lumbar,lateral lumbar and thoracic epidural puncture were increased in senior group (P<0.05).The self-evaluated difficulty of epidural puncture was lower as the number of prior epidural cases was more (r=-0.719,P<0.01).There were 46.6% of the residents who had received simulation-based training before performing epidural puncture on the patient,among which most residents considered the simulation-based training is effective in helping to familiarize with procedure (77.2%),familiarize with anatomy (70.4%),simulate the texture of different layers (47.9%),and enhance success rate of epidural puncture (56.7%).There were 75.0% residents who considered visualization technology is helpful in enhancing the success rate and confidence of epidural puncture.Conclusion Currently,the proficiency of junior anesthesia residents in epidural puncture needs to be strengthened.The simulation-based training has not been widely applied in the epidural training,while residents think high of simulation-based training and are looking forward to visualization technique training.

10.
Article in Chinese | WPRIM | ID: wpr-709752

ABSTRACT

Objective To evaluate the effect of thoracic paravertebral block ( TPVB) combined with general anesthesia on early postoperative recovery in patients undergoing breast cancer surgery. Meth-ods A total of 201 patients with untreated primary breast cancer, aged 18-69 yr, with body mass in-dex <35 kg∕m2 , of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective surgery for treatment, were enrolled and randomly assigned to general anesthesia group (group GA, n =102) and TPVB combined with general anesthesia group (group TGA, n= 99). In group TGA, TPVB was performed under ultrasound guidance at 30 min before surgery, and 0. 75% ropivacaine 5 ml was injected at each puncture site of T1-5 . In group GA, local infiltration anesthesia was performed with 1% lidocaine 0. 2 ml at each puncture site. Anesthesia was induced with IV fentanyl, propofol and rocuronium in both groups. Anesthesia was maintained by inhaling sevoflurane ( group GA), target-controlled infusion of propofol (group TGA) and intermittent IV boluses of fentanyl or rocuronium. Bispectral index value was maintained at 40-60 during surgery. Verbal Rating Scale score was used to assess the severity of pain after surgery. Parecoxib sodium 40 mg, pethidine 50 mg, tramadol 50 mg or fentanyl 50 μg was selected and intrave-nously injected as rescue analgesics when Verbal Rating Scale pain score>4. The requirement for rescue analgesia and development of nausea and retching∕vomiting were recorded within 2 days after surgery. Chinese quality of recovery score was used to assess the early postoperative quality of recovery on days 1 and 2 after surgery. Results Compared with group GA, the quality of recovery score was significantly increased on days 1 and 2 after surgery, the incidence of postoperative nausea was decreased (P<0. 05), and no signifi-cant change was found in the requirement for rescue analgesia or incidence of retching∕vomiting after surgery in group TGA (P>0. 05). Conclusion TPVB combined with general anesthesia is more helpful than gen-eral anesthesia alone for early postoperative recovery in the patients undergoing breast cancer surgery.

11.
Article in Chinese | WPRIM | ID: wpr-709753

ABSTRACT

Objective To evaluate the effect of thoracic paravertebral block ( TPVB) combined with general anesthesia on the long-term quality of life in the patients undergoing breast cancer surgery. Methods A total of 156 patients, aged 18-64 yr, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, undergoing breast cancer surgery, were randomly assigned to TPVB combined with general anes-thesia group (TPVB+GA group, n= 78) and general anesthesia group (GA group, n = 78), and the pa-tients in two groups were matched with a ratio of 1 : 1. In group TPVB+GA, propofol (target effect-site concentration 2. 5-4. 0 μg∕ml) was given by target-controlled infusion, and patients received either single or multiple injections (T1-T5 ) of TPVB under ultrasound guidance at 30 min before induction of general an-esthesia. Group GA inhaled 2. 0%-2. 5% sevoflurane. The patients were followed up at 6 and 12 months after operation, postoperative chronic pain and chronic pain affecting daily life were assessed using the mod-ified Brief Pain Inventory, the development of neuropathic pain using neuropathic pain questionnaire-short form, and the development of long-term health-related quality of life by using the 12-item short-form scale. Results There was no significant difference in the incidence of chronic pain and chronic pain affecting dai-ly life, incidence of neuropathic pain or quality of life scale score at 6 and 12 months postoperatively be-tween the two groups (P>0. 05). Conclusion TPVB combined with general anesthesia exerts no effect on the long-term quality of life in the patients undergoing breast cancer surgery.

12.
The Journal of Practical Medicine ; (24): 277-280,284, 2018.
Article in Chinese | WPRIM | ID: wpr-697602

ABSTRACT

Objective To investigate the anesthetic effect and adverse events on different doses of oxyco-done combined with propofol target controlled infusion(TCI)in patients with choledocholithiasis undergoing endo-scopic retrograde cholangio pancreatography(ERCP)with endoscopic sphincterotomy(EST).Methods One hun-dred and twenty patients with choledocholithiasis underwent ERCP with EST in Department of Gastroenterology, Fuzhou General Hospital,from January,2016 to March,2017 were enrolled in this study.Patients were randomly divided into 4 groups(n=30 in each group)including the sufentanil control group(Group A),low dose of oxyco-done group(Group B),moderate dose of oxycodone group(Group C),and high dose of oxycodone group(Group D).Patients in Group A received 0.10 μg/kg intravenous sufentanil,and patients in Group B,C,and D received 0.08 mg/kg,0.10 mg/kg,and 0.12 mg/kg intravenous oxycodone,respectively,at 5 min before induction of gener-al anesthesia followed by propofol TCI. Effect of compartment concentration(Ce)of propofol,mean arterial pres-sure(MAP),and heart rate(HR)at the given time point when patients transferring to operation room(T0),after induction(T1),endoscope through throat(T2),and endoscope through major duodenal papilla(T3)were record-ed.The accumulative dose of propofol,duration of operation,and recovery time were also recorded.Intraoperative sever hypotension,bradycardia,respiratory depression,coughing and moving,and postoperative nausea and vom-iting were recorded. Results Propofol Ce at T1~T3as well as MAP and HR at T2and T3in Group B were signifi-cantly higher than those in Group A,C,and D,respectively(P < 0.05). The accumulative dose of propofol in Group B was more than that in Group A and C,while the accumulative dose of propofol in Group D was less than that in Group A,B,and C,respectively(P<0.01).Recovery time in Group D was longer than that in Group A, B,and C,respectively(P<0.05).Similar incidences of intraoperative sever hypotension,bradycardia,respiratory depression,coughing and moving,and postoperative nausea and vomiting were also observed. Conclusions 0.10 mg/kg intravenous oxycodone at 5 min before induction of general anesthesia combined with propofol TCI presents a favorable anesthetic effect in patients with choledocholithiasis undergoing ERCP with EST without a prolonged recovery time and the increased incidence of adverse events.

13.
Article in Chinese | WPRIM | ID: wpr-699558

ABSTRACT

Optical coherence tomography (OCT),as a noncontact,innovative technology,can produce high-resolution images of ocular tissues.This technology is originally used for posterior segment in ophthalmology,which were widely utilized for the anterior segment at first.The development of anterior segment OCT (AS-OCT) technology enables the precise visualization of anterior segment structure.Moreover,ultrahigh-resolution OCT (UHR-OCT) has been helpful for diagnosis and management of corneal and anterior segment diseases,including quantification of tear film for dry eye,authentication of ocular surface squamous neoplasia (OSSN),pterygium,keratoconus,traumatic corneal injuries,etc.Besides,UHR-OCT can be also used for planning and performing surgery for anterior segment,such as corneal transplantation,and monitoring of epithelial wound healing and postoperative course as well.Moreover,this technology can help understand the physiology and pathophysiology of the anterior segment structure.Therefore,this review will give a review on the application of UHR-OCT for diagnosis and management of corneal and anterior segment disorders.

14.
Article in Chinese | WPRIM | ID: wpr-699562

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Objective To investigate the effects of bradykinin (BK) on the proliferation of rabbit corneal endothehal ceils (RCECs) and the expression of tight junction-related proteins zonula occludens-1 (ZO-1) and zonula occludens-1-associated nucleic-acid-binding protein (ZONAB),and to explore the underlying mechanisms of BK on cell proliferation in corneal endothelium.Methods RCECs at logarithmic growth phase were treated with different concentrations of BK (0.01,0.1,1,10 μmol · L-1) BK group,with the controls left untreated.Morphological changes of cells in each group were examined under phase-contrast microscope,and MTT assays were used to detect cell proliferation at 24 h,48 h,72 h,96 h after BK treatment.And,at 72 h,the expression levels of ZO-1 and ZONAB protein were determined by Western blot.Results After 72 h of treatment,the cells in each group were fused into pieces and closely linked into a monolayer;but after 96 h,the growth of the cells was restricted,with the intercellular space become larger and the cells exfoliated.Compared with the control group,BK induced a significant increase of absorbance value and cell viability,and the differences were statistically significant (all P < 0.001),and the promoting effects showed a concentration-dependent manner,and 1 μmol · L-1 BK demonstrated the strongest regulative effect (P < 0.001).Western blot results showed that BK upregulated the expression of ZO-1 and ZONAB protein in a concentration-dependent manner.Conclusion BK can stimulate the proliferation of RCECs in a time-and concentration-dependent manner,and the mechanisms are probably associated with ZO-1/ZONAB-mediated signaling pathway.

15.
Article in Chinese | WPRIM | ID: wpr-609802

ABSTRACT

Objective To explore prevention and cure effects of the freeze-dried human fibrin glue as the way of the lacrimal duct embolization on xerophthalmia in perimenopausal female rabbit.Methods A total of 72 female rabbits,after anti infection treatment and were cut off third eyelid,were made into perimenopausal xerophthalmia rabbit models.After surgery,all of these rabbits were randomly divided into 6 groups (12 rabbits per group):No treatment group after surgery (group A),PBS prevention group (group B),freeze-dried human fibrin prevention group (group C);no treatment group after modeling (modeling time:Two weeks after surgery,group D),PBS treatment group (group E),freeze-dried human fibrin treatmentgroup (group F).The Schirmer test (SIT),corneal fluorescein (FL) and corneal confocal microscope were performed before and 2 weeks,4 weeks,6 weeks after injection.Results There were statistical differences in FL score and SIT in group A,group B and group C among different time points (F =27.346,10.608;P =0.000,0.001);There were statistical differences between FL scores and SIT among three groups (F =7.579,6.786;P =0.002,0.007);There was significant difference in FL scores and SIT trends among three groups(F =44.897,3.424;P =0.000,0.045).The FL score and SIT of group D,group E and group F were significantly improved after treatment for 2 weeks,4 weeks and 6 weeks,the differences were statistically significant (t =2.906,3.654,4.504;P =0.022,0.017,0.013.t =4.573,5.759,7.231;P =0.032,0.019,0.008);The difference between FL score and SIT in group E and group F was statistically significant after treatment (t =2.776,4.124,5.324;P =0.032,0.026,0.017.t =1.969,3.122,4.324;P =0.038,0.023,0.009).After injection of 6 weeks,the epithelial basal cells (F =17.306,P =0.002) and inflammatory cells (F =34.024,P =0.000) of group A,B and C were significant changed,the differences were statistically significant.After injection of 6 weeks,the epithelial basal cells (F =3.749,P =0.042)and inflarnmatory cells(F=8.806,P =0.005) of group D,E and F were significant changed,the differences were also statistically significant.Conclusion Lacrimal duct embolization with freeze-dried human fibrin glue is effective for the xerophthalmia.

16.
Article in Chinese | WPRIM | ID: wpr-609872

ABSTRACT

Accurate qualitative and quantitative assessment of anterior or posterior segment structures is crucial,not only for proper diagnosis of different ocular diseases but also for optimal surgical planning and postoperative follow-up.As a noninvasive and noncontact method,optical coherence tomography (OCT) has become an essential tests for the diagnosis of retinal diseases.To a more recent technology,swept-source OCT (SS-OCT) improved the depth of imaging and the scan speed,which can perform anterior segment evaluation liking corneal graft examination.Meanwhile,this newly technology add multimodal approach such as EVV,OCTA and En face OCT,for angiography and choroid mapping.Thus,SS-OCT has become a valuable imaging strategy to understand the pathologies of retinal diseases such as PVD,diabetic maculopathy,neovascularization and macular telangiectasia.With the use of multimodal approach,SS-OCT is beneficial for optimal surgical planning and postoperative follow-up for the vitreoretinal diseases,such as epiretinal membrane,retinal detachment,and diabetic taction retinal detachment.Moreover,this technology can help us better understand the ophthalmic pathologies of glaucoma and tumors.This article reviews the technical principles of SS-OCT and the advances in clinical applications.

17.
Article in Chinese | WPRIM | ID: wpr-609882

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Objective To analyze the thickness of cornea and corneal epithelium in healthy subjects by optical coherence tomography angiography (OCTA).Methods Totally 100 healthy subjects aged between 20 and 30 years were analyzed by OCTA technique.Using AngioVue OCTA system of retinal imaging mode,and using SSADA algorithm for imaging,the cornea and the corneal epithelium in the central corneal diameter range of 9 mm were measured.The differences of corneal and corneal epithelial thickness in different gender regions were compared.Results In the male and female group,the corneal central total thickness were (559.92 ±33.26) μm and(540.06 ±31.63)μm,and the corneal epithelial thickness were(57.78 ±4.88) μm and(56.88 ±4.57) μm,The total central corneal thickness and central corneal epithelial thickness of the male were greater than those of the female,the difference was statistically significant (t =3.06,2.10;all P < 0.05).The cornea of male was the thickest at S5,S7 and SN9,there were significant differences at S5 and S7 compared with female (t =2.93,2.83;all P < 0.05);The female cornea was the thickest at S5,SN7 and SN9,and the difference was significant at S5 compared with male.The cornea of male subjects was the thinnest at IT,which was statistically significant only at IT5 compared with female subjects in the same area (t =2.02,P < 0.05);The cornea of female subjects was the thinnest at T5,IT7 and T9,which was statistically significant only at T5 and T9 compared with male subjects in the same region (t =2.63,2.20;all P < 0.05);There was significant difference in corneal thickness between male and female at ST (t =3.1 1,2.79,2.33;all P < 0.05).The corneal epithelium was the thickest at IT5,I7,and I9,and the lowest at S5,S7 and S9,and there was no significant difference compared with female in the same region (all P > 0.05).The corneal epithelium of female at the IT5,T7,N9 were the thickest,SN5,S7,S9 were the thinnest;Except for M2 and SN5,there was no significant differences in corneal epithelium between male and female groups (all P > 0.05).Corneal central epithelium accounted for the largest percentage of total corneal thickness,and gradually decreased from inside to outside.Conclusion OCTA can be used to measure the thickness of corneal and corneal epithelial regions.

18.
Article in Chinese | WPRIM | ID: wpr-615861

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Objective To explore the application of video laryngoscope in patients with pituitary adenoma during endotracheal intubation.Methods Fifty-one patients (19 males, 32 females, aged 18-71 years, ASA physical status I or II) scheduled for resection of pituitary adenoma under general anesthesia were enrolled.These patients were randomly divided into two groups: Macintosh laryngoscope Group (group M, n=25) and Video laryngoscope Group (group VL, n=26).When performing endotracheal intubation, Macintosh laryngoscope was used to expose the glottis in group M, and video laryngoscope was used in group VL.Head tilted backward angle, mouth opening, thyromental distance, neck circumference, mandibular ramus length, modified Mallampati classification and the difficulty classification of mask ventilation of the patients in two groups were recorded during peri-operation period.The Cormark-Lehane grade, needed pressing of the cricoids cartilage, the ratio of a second attempt during intubation and the intubation time consumed were recorded.Results Less patients in group VL needed cricoids cartilage press (7.7% vs 48.0%) during the intubation than that in group M (P<0.01).Compared with group M, the Cormack-Lehane grade was significantly lower (P<0.01) and the intubation time consumed was significantly shorter in group VL [(32.4±11.7)s vs (45.8±12.6)s] (P<0.01).Conclusion In patients with pituitary adenoma,video laryngoscope may improve the glottis exposure and the success rate of intubation, as well as shorten the intubation time.

19.
Article in English | WPRIM | ID: wpr-281441

ABSTRACT

Objective To determine whether the myotoxic side effects of statin simvastatin affect skeletal muscle's sensitivity to caffeine and halothane.Methods Primary cultured neonate rat skeletal myotubes were treated with 0.01-5.0 μmol/L simvastatin for 48 hours. MTT was used to evaluate cellular viability. The gross morphology and microstructure of the myotubes were observed with a light and electron microscope, respectively. The intracellular calcium concentrations ([Ca]i) at rest and in response to caffeine and halothane were investigated by fluorescence calcium imaging. Data were analyzed by analysis of variance (ANOVA) test.Results Simvastatin (0.01-5.0 μmol/L) decreased myotube viability, changed their morphological features and microstructure, and increased the resting [Ca]i in a dose-dependent manner. Simvastatin did not change myotube's sensitivity to low doses of caffeine (0.625-2.5 mmol/L) or halothane (1.0-5.0 mmol/L). In response to high-dose caffeine (10.0 mmol/L, 20.0 mmol/L) and halothane (20.0 mmol/L, 40.0 mmol/L), myotubes treated with 0.01 μmol/L simvastatin showed a significant increase in sensitivity, but those treated with 1.0 μmol/L and 5.0 μmol/L simvastatin showed a significant decrease. The sarcoplasmic reticulum Castorage peaked in the myotubes treated with 0.01 μmol/L simvastatin, but it decreased when cells were treated with higher doses of simvastatin (0.1-5.0 μmol/L).Conclusions The myotoxic side effect of simvastatin was found to change the sensitivity of myotubes in response to high-dose caffeine and halothane. When dose was low, sensitivity increased mainly because of increased Cacontent in the sarcoplasmic reticulum, which might explain why some individuals with statin-induced myotoxic symptoms may show positive caffeine-halothane contracture test results. However, when the dose was high and the damage to the myotubes was severer, sensitivity was lower. It is here supposed that the damage itself might put individuals with statin-induced myotoxic symptoms at greater risks of presenting with rhabdomyolysis during surgery or while under anesthesia.

20.
Article in Chinese | WPRIM | ID: wpr-854621

ABSTRACT

Objective: To investigate the chemical constituents from the barks of Melia azedarach and their antidiabetes activities. Methods: The constituents were isolated and purified by silica gel, reverse phase silica gel, and Sephadex LH-20 column chromatography, and their structures were identified by spectra and physiochemical characteristic analysis. The agonist activities of the isolated triterpenoids against glucokinase (GK) and SIRT1, and the inhibitory activity against dipeptidyl peptidasesIV (DPPIV), and 11β-hydroxysteroid dehydrogenase (11β-HSD) were tested in vitro. Results: Six triterpenoids and three sterols were obtained from MeOH extract in the barks of M. azedarach and were elucidated as meliastatin 3 (1), kulonic acid (2), kulactone (3), sendanolactone (4), dubione B (5), 20, 24-cyclotirucalla-7(8)-en-16β, 21α, 25-trihydroxy-3-one (6), 3β-hydroxy-5, 8-epidioxy-ergosta-6, 22-diene (7), 2β, 3β, 4β-trihydroxy-pregn-16-one (8), and 3β-hydroxy-pregn-5, 17 (20)-dien-16-one (9). Compound 2 showed the inhibitory activity against 11β-HSD1 with the IC50 value of 54.15 nmol/L. Conclusion: Compounds 6-9 are obtained from this species for the first time. The tested compounds 1-4 are inactive against GK, SIRT1, and DPPIV, but compound 2 shows high selectivity against human 11β-HSD.

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