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1.
Article in Chinese | WPRIM | ID: wpr-911209

ABSTRACT

Objective:To identify the risk factors for massive blood loss in pediatric patients with congenital scoliosis undergoing posterior hemivertebra resection.Methods:The clinical data of pediatric patients with congenital scoliosis who underwent posterior hemivertebra resection in our hospital from May 2017 to July 2019 were collected.The children were divided into group A (massive blood loss, blood loss/blood volume ≥30%) and group B (non-massive blood loss, blood loss/blood volume <30%) according to intraoperative blood loss.Logistic regression analysis was used to stratify the risk factors.Results:A total of 108 pediatric patients were enrolled in the study including 29 cases in group A and 79 cases in group B, respectively.There were significant differences in the preoperative Cobb angle, body mass index, the number of fused levels, the number of screws and operative time between the two groups ( P<0.05). Logistic regression analysis showed that the preoperative Cobb angle, operative time, the number of fused levels and body mass index were the risk factors for intraoperative massive blood loss ( P<0.05). Conclusion:Lower BMI, larger Cobb angle, increased operative time and more fused levels are the risk factors for massive blood loss in pediatric patients with congenital scoliosis undergoing posterior hemivertebra resection.

2.
Article in Chinese | WPRIM | ID: wpr-911191

ABSTRACT

The medical records of 11 pediatric patients undergoing resection of adrenal cortical carcinoma from January 2012 to January 2019 in our hospital were collected.Anesthesia management for resection of adrenal cortical carcinoma in children was analyzed and investigated.Anesthesia was induced by intravenously injecting atropine 0.01 mg/kg, dexamethasone 2-5 mg, propofol 2-3 mg/kg, sufentanil 0.3-0.5 μg/kg or fentanyl 1-2 μg/kg, rocuronium 0.5 mg/kg or cis-atracurium 0.1-0.2 mg/kg.Radial artery catheterization and femoral vein catheterization were performed under ultrasound guidance.Arterial blood pressure was continuously monitored.The esophageal thermometers probe was placed to continuously monitor body temperature.The catheter was placed to monitor urine volume.Intermittent positive pressure ventilation was performed after endotracheal intubation with the inspiratory oxygen fraction set 60%-100%, oxygen flow rate 2-3 L/min, tidal volume 7-10 ml/kg, ventilation frequency 20-26 times/min, inhalation/respiration ratio 1∶(1.5-2.0) and airway pressure 16-20 cmH 2O, and the end-tidal pressure of carbon dioxide was maintained at 35-45 mmHg.Anesthesia was maintained by inhaling 2%-4% sevoflurane and/or intravenously infusing propofol 0.10-0.15 mg·kg -1·min -1, and continuously infusing remifentanil 0.2-0.5 μg·kg -1·min -1.Hemodynamics was maintained within the normal range, and the bispectral index was maintained at 40-60 during the surgery.Before the tumor was completely removed, 5-10 mg/kg sodium hydrocortisone succinate was intravenously infused.At the end of the operation, sufentanil 0.75-1.00 μg·kg -1·d -1 or fentanyl 7.5-10.0 μg·kg -1·d -1 was continuously infused for postoperative analgesia until 48 h after operation.Operation was smoothly completed with stable anesthesia in all the pediatric patients.The tracheal tube was removed successfully after the operation.All children in this group were discharged from hospital and no death occurred.Anesthesia management for resection of adrenal cortical carcinoma required an appreciation of the clinical characteristics and perioperative pathophysiological changes.Paying attention to the changes in hormone levels during perioperative period and timely adjusting the children′s internal environment to maintain the stability of anesthesia and reduce the stress response were the keys to anesthesia management.

3.
Article in Chinese | WPRIM | ID: wpr-882903

ABSTRACT

Objective:To assess the impact of caudal regional anesthesia on complications after hypospadias repair with tubularised incised plate urethroplasty (TIP).Methods:A total of 125 cases with hypospadias undergoing TIP surgery from June 2017 to June 2019 at Beijing Children′s Hospital, Capital Medical University, were reviewed, aged 12-75 months, American Society of Anesthesiologists Ⅰ orⅡ grade.Totally, 86 cases had distal and 39 cases suffered from proximal hypospadias.Caudal anesthetics were used in 42 cases (caudal anesthesia group) and general anesthetics were used in 83 cases (general anesthesia group). All cases were repaired by TIP procedure.The children with urethral fistula and urethral stricture were followed up for 6 months, and multivariate statistical analyses were performed.Results:There were 11 cases of urethral fistula after hypospadias surgery, with 8 cases (9.64%)in the general anesthesia group and 3 cases (7.14%) in the caudal anesthesia group.There were no significant differences between the 2 groups ( χ2=0.223, P=0.636), and 12 cases of urethral stricture, with 8 cases(9.64%) in the general anesthesia group and 4 cases(9.52%) in the caudal anesthesia group.There were no significant differences between the 2 groups ( χ2=0.001, P=0.984). Based on multivariable Logistic regression, urethral fistula was associated with proximal hypospadias ( OR=0.036, 95% CI: 0.003-0.511, P=0.014), and the width of glans( OR=0.469, 95% CI: 0.220-0.998, P=0.049). Urethral stricture was correlated with proximal hypospadias( OR=0.004, 95% CI: 0.000-0.146, P=0.002), the width of urethral plate( OR=0.004, 95% CI: 0.000-0.422, P=0.020), and the duration of catheter( OR=72.976, 95% CI: 1.802-2 594.790, P=0.023). Conclusion:Caudal regional anesthesia appears to have no impacts on urethral fistula and stricture after hypospadias repair.

4.
Article in Chinese | WPRIM | ID: wpr-869943

ABSTRACT

Objective:To evaluate the effect of nalbuphine combined with propofol for esophageal dilation with gastroscope in the pediatric patients.Methods:A total of 150 pediatric patients with esophageal stenosis, aged 6 months-2 yr, weighing 6-15 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective painless balloon dilation with gastroscope under general anesthesia, were randomized into 3 groups ( n=50 each) according to the random number table method: nalbuphine 0.1 mg/kg plus propofol group (N 1P group), nalbuphine 0.2 mg/kg plus propofol group (N 2P group), and fentanyl plus propofol group (FP group). Nalbuphine 0.1 and 0.2 mg/kg and fentanyl 1 μg/kg were intravenously injected in N 1P, N 2P and FP groups, respectively, and 2 min later propofol 1.5-2.0 mg/kg was intravenously injected for sedation until the eyelash reflex disappeared in the three groups.Propofol 1.0 mg/kg was added when body movement occurred during surgery.The amount of propofol consumed during surgery, occurrence of body movement and respiratory depression, occurrence of adverse reactions such as postoperative nausea and vomiting, and laryngospasm, emergence time, Face Legs Activity Cry Consolability (FLACC) pain scale score and surgeons′ satisfaction were recorded. Results:Compared with group N 1P, the consumption of propofol, body movement classification ratio and FLACC score were significantly decreased, and the emergence time was shortened in group N 2P ( P<0.05), and no significant change was found in the parameters mentioned above in group FP ( P>0.05). There was no significant difference in the incidence of perioperative adverse reactions and degree of surgeons′ satisfaction among the three groups ( P>0.05). Conclusion:Nalbuphine combined with propofol can provide satisfactory anesthetic efficacy with fewer adverse reactions when used for esophageal dilation with gastroscope in the pediatric patients.

5.
Article in Chinese | WPRIM | ID: wpr-869932

ABSTRACT

The data of pediatric patients who underwent scoliosis surgery from July 2016 to July 2019 were collected retrospectively.The pediatric patients were divided into traditional ventilation group (T group) and lung-protective ventilation group (P group) based on the ventilator settings.Standardized tidal volume(V T)was obtained by V T/ideal body weight (IBW). Patients with standardized V T ≥ 8 ml/kg and without positive end-expiratory pressure (PEEP) were included in group T, and patients with V T <8 ml/kg and PEEP 4-8 cmH 2O were included in group P. The propensity score was used to match the baseline information and intraoperative variables in the two groups.A total of 415 pediatric patients accepted screening, and 171 cases were successfully matched, including 92 cases in group T and 79 cases in group P. Compared with group T, the incidence and grade of pulmonary complications were significantly decreased at day 30 after operation, postanesthesia care unit stay time was shortened, body temperature was decreased at 24 h after operation, V T, standardized V T and oxygenation index were decreased, P ETCO 2, PEEP, ventilation frequency and I∶ E were increased ( P<0.05), and no significant change was found in IBW, PaCO 2, incidence of postoperative surgical complications and anesthesia-related complications, plasma C-reactive protein concentration and white blood cell count at 24 h after operation, hospitalization time and hospitalization cost in group P ( P>0.05). In conclusion, the lung-protective ventilation strategy low V T combined with PEEP can decrease the risk of postoperation lung complications and is helpful in improving prognosis in the pediatric patients undergoing scoliosis surgery as compared with traditional mechanical ventilation strategy.

6.
Article in Chinese | WPRIM | ID: wpr-869815

ABSTRACT

Objective:To evaluate the efficacy of ultrasound-guided bilateral erector spinae plane (ESP) block for pediatric patients undergoing Nuss procedure with general anesthesia.Methods:Thirty-two American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 4-15 yr, undergoing Nuss procedure with general anesthesia, were divided into ESP block plus general anesthesia group (group EG, n=16) and general anesthesia group (group G, n=16) using a random number table method.Bilateral ESP blocks were performed after anesthesia induction in group EG.Intravenous analgesia was performed postoperatively in both groups.Face Legs Activity Cry Consolability (FLACC) scores both at rest and during coughing were recorded on admission to postanesthesia care unit (PACU) and at 1, 6, 12, 24 and 48 h after operation.When FLACC score at rest >4, ibuprofen 5.0-7.5 mg/kg was taken orally according to the requirements of pediatric patients and their parents.The intraoperative amount of propofol and remifentanil used and postoperative requirement for fentanyl and ibuprofen were recorded.The development of postoperative hypoxia (SpO 2 <90%), nausea and vomiting, and urinary retention was recorded.The development of puncture site infection, hematoma and subcutaneous emphysema was recorded.The tracheal extubation time, duration in PACU and length of postoperative hospital stay were also recorded. Results:Compared with group G, FLACC scores at rest within 12 h after operation and during coughing within 6 h after operation were significantly decreased, the intraoperative consumption of remifentanil was reduced, the postoperative requirement for fentanyl and ibuprofen was decreased, the incidence of hypoxemia was decreased, the tracheal extubation time and duration in PACU were shortened ( P<0.05), and no significant change was found in the consumption of propofol, incidence of nausea and vomiting, or length of postoperative hospital stay in group EG ( P>0.05). Conclusion:Ultrasound-guided bilateral ESP block can reduce the consumption of opioids in the perioperative period and enhance the analgesic efficacy with a higher safety, which is helpful in promoting short-term outcomes for pediatric patients undergoing Nuss procedure with general anesthesia.

7.
Article in Chinese | WPRIM | ID: wpr-828485

ABSTRACT

OBJECTIVE@#To analyze the usage of mental health assistance hotline during COVID-19 in Zhejiang province from January 25th to February 29th 2020, and summarize the characteristics of the demand for mental health services and the dynamic changes of public mental health status during COVID-19 pandemic.@*METHODS@#Both quantitative and qualitative methods were used. The calls related to pandemic were divided into four categories: medical, psychological, information and the others. The secondary categories of psychological calls were determined by text analysis. The number of calls were calculated weekly and the number of various types of calls over time were analyzed. We used stratified random sampling method to extract 600 cases of all kinds of calls related to pandemic and conducted a semantic analysis, through marking new, similar combination to form a feature set, then summed up the call content characteristics of each stage. Two hundred callers were followed up to understand how they felt about the call process in four aspects: the waiting time, call duration, the degree of problem-solving and the way to end the call.@*RESULTS@#In a total of 13 746 calls, 8978 were related to pandemic, among which 12.59%(1130/8978) were about medical issues, 26.50%(2379/8978) were about mental health, 27.18%(2440/8978) were about information regarding the pandemic and 33.74%(3029/8978) were about other pandemic related issues. Pandemic situation, relevant policy release, frequency of advertising campaigns were predictors of the number of calls per day during the pandemic (<0.05 or <0.01). The number of calls differed by gender and identities of callers (both <0.05). Finally 181 callers accepted telephone follow-up. Among them, 51.38%(93/181) of the callers thought that the waiting time was too long, 33.15%(60/181) of the callers thought that the call time was insufficient, 80.66%(146/181) of callers believed that the hotline could partially or completely resolve their concerns, and 39.23%(71/181) of the callers said the operator proposed to end the call.@*CONCLUSIONS@#s The changes of the number and content of the mental health assistance hotline calls reflected that the public mental health status experienced four stages during the pandemic: confusion, panic, boredom, and adjustment. The specialized mental health assistance hotlines should be further strengthened, and the efficiency should be improved. Mental health interventions should be tailored and adopted according to the characteristics of the public mental health status at different stages of the pandemic.


Subject(s)
China , Epidemiology , Coronavirus Infections , Epidemiology , Hotlines , Humans , Mental Health , Pandemics , Pneumonia, Viral , Epidemiology , Public Health
8.
Article in Chinese | WPRIM | ID: wpr-743316

ABSTRACT

Objective To compare the effect of ultrasound measurements of the distance from skin to vocal folds (DSV), neck diameter (d) and the ratio among the two measurements (R) used to predict difficult laryngoscopy. Methods Seventy-two toddelers scheduled to undergo general anesthesia, aged ≤ 3 years, falling into ASA physical status Ⅰ or Ⅱ, were included and categorized as having easy (n = 48, grades Ⅰ and Ⅱ) or difficult (n = 24, grades Ⅲ and Ⅳ) laryngoscopy based on the criteria of Cormack and Lehane. When children were ventilated by mask, we measured DSV by ultrasound; obtained d and R. Receiver operating characteristic (ROC) curve analysis was used to determine the DSV, d and R in predicting difficult laryngoscopy. The value of cutoff was obtained by maximizing the Youden's index. Results DSV was significantly shorter in difficult laryngoscopy group (P < 0.05). The areas under the ROC curve of R was 0.807, and the cutoff value was 0.090. the sensitivity was 70.83%, the specificity was 83.33% Conclusion The ratio of distance from skin to vocal folds to neck diameter is a good predictor of difficult laryngoscopy in children under 3 years old.

9.
Neuroscience Bulletin ; (6): 133-144, 2019.
Article in English | WPRIM | ID: wpr-775466

ABSTRACT

Autonomic disturbances often occur in patients with acute cerebrovascular disease due to damage of the central autonomic network. We summarize the structures of the central autonomic network and the clinical tests used to evaluate the functions of the autonomic nervous system. We review the clinical and experimental findings as well as management strategies of post-stroke autonomic disturbances including electrocardiographic changes, cardiac arrhythmias, myocardial damage, thermoregulatory dysfunction, gastrointestinal dysfunction, urinary incontinence, sexual disorders, and hyperglycemia. The occurrence of autonomic disturbances has been associated with poor outcomes in stroke patients. Autonomic nervous system modulation appears to be an emerging therapeutic strategy for stroke management in addition to treatments for sensorimotor dysfunction.


Subject(s)
Acute Disease , Animals , Autonomic Nervous System , Cerebrovascular Disorders , Humans , Nerve Net , Wounds and Injuries , Sensorimotor Cortex , Stroke
10.
Article in Chinese | WPRIM | ID: wpr-775229

ABSTRACT

Restoration of cerebral blood flow is particularly important for the treatment of ischemic cerebrovascular disease. It is notable that surgical approaches play a unique role in treating this devastating disease. Among them, mechanical thrombectomy facilitates rapid and effective recanalization of occluded intracranial large vessels causing ischemic stroke, which contributes to improvement of cerebral perfusion in the ischemic penumbra; decompressive craniectomy is an important therapeutic option for acute massive cerebral infarction, and the timing of surgery determines the final clinical outcomes; for carotid endarterectomy in carotid-artery stenosis, individualized surgical plan is important for the safety and effectiveness of the operation; in the surgical revascularization of Moyamoya disease, precise evaluation of clinical and radiological characteristics, optimal surgical strategies and accuracy of intraoperative judgment will yield maximal therapeutic effects; and hybrid surgery is feasible for the therapy of complex ischemic cerebrovascular diseases, such as extracranial/intracranial arteries tandem stenosis and symptomatic chronic total occlusion of carotid artery. This paper reviews recent technical and clinical advances in the surgical treatment of ischemic cerebrovascular disease.


Subject(s)
Brain Ischemia , General Surgery , Carotid Artery, Internal , General Surgery , Carotid Stenosis , General Surgery , Endarterectomy, Carotid , Humans , Stroke , General Surgery , Treatment Outcome
11.
China Pharmacist ; (12): 253-256, 2018.
Article in Chinese | WPRIM | ID: wpr-705501

ABSTRACT

Objective:To establish an HPLC method fro the simultaneous determination of baicalin,wogonin,baicalein and wog-nin. Methods:A DiamonsilTMC18(150 mm×4.6 mm,5 μm) column was used. The mobile phase was acetonitrile-0.1% H3PO4 with gradient elution and the detection wavelength was 278 nm.The flow rate was 1.0 ml·min-1,the injection volume was 5μl and the column temperature was 30℃. Results:The 4 flavonoids in wine-processed Radix Scutellariae showed good separation under the chro-matographic conditions with a good linear relationship within the corresponding linear range. The average recovery of each chemical component was 97.71%-98.34%,and the content of baicalin was with RSD<2.0%. The samples from 13 habitats accorded with the requirement of processed Radix Scutellariae in Chinese Pharmacopoeia. Conclusion: Wine can maintain flavonoid glycosides and de-stroy the self-degradation of Scutellaria baicalensis enzyme to the greatest degree,which not only ensures the clinical effects of wine-pro-cessed Scutellaria baicalensis,but also is convenient to the storage of Scutellaria baicalensis Georgi,however,wine can reduce the con-tent of flavonoid glycosides in Radix Scutellariae to varying degrees,so the processing technology needs to be improved further.

12.
Basic & Clinical Medicine ; (12): 145-149, 2017.
Article in Chinese | WPRIM | ID: wpr-507378

ABSTRACT

Objective To examine the relationship between CCT 5 ,γδ T cell and autoimmune diseases .Methods Recombinant CCT5 protein was cloned , expressed and purified in E.coli.Three peptides of CCT5 protein were used to prepare for anti-CCT5 monoclonal antibodies .Purified CCT5 protein was used to expand γδT cells from pe-ripheral blood mononuclear cells (PBMC).Plasma level of CCT5 in healthy donors, patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) were detected by ELISA assays .The correlation analysis between plasma CCT5 concentration and the percentage of different subtypes of γδT cells measured by flow cytometry was made . Results The CCT5 gene was amplified by PCR and the length of the target fragment was 1 750 bp.The expressed 65 ku CCT5 protein was purified and validated by SDS-PAGE.Two paired monoclonal anti-CCT5 antibodies were screened to detect CCT5 protein in plasma.Immobilized recombinant CCT5 protein was able to induce specific sig-nificant amplification of peripheral γδT cells.Correlation analysis of 10 healthy donors indicated significant corre-lation between the plasma CCT 5 concentration and the proportion of Vγ9 and Vδ2 γδ T cells.The plasma CCT5 concentration significantly decreased in autoimmune diseases patients , including RA and SLE .Conclusions These data suggest that CCT 5 could be a novel Vγ9δ2 γδT cell-related factor in autoimmune diseases , which deepen the understanding of Vγ9δ2 γδT cell function in autoimmune diseases .

13.
Basic & Clinical Medicine ; (12): 752-757, 2017.
Article in Chinese | WPRIM | ID: wpr-612311

ABSTRACT

Objective To optimize in vitro amplification of human γδ T cells with cytokines for tumor adoptive immunotherapy.Methods On the basis of the immobilized anti-TCR γδ antibody plus IL-2 system, other γ chain receptor family cytokines, including IL-7, IL-15 and IL-21, were tested to amplify human peripheral blood γδ T cells either alone or in diversity combination.The percentage of γδ T cells was measured by flow cytometry, and the proliferation efficiency of γδ T cells was calculated.The expression of proliferation-or cytotoxicity-related molecules on γδ T cells was examined by flow cytometry in order to explore the relevant mechanisms.The cytotoxicity of γδ T cells to Daudi cells was detected by lactate dehydrogenase.Results IL-15 alone but not IL-7 or IL-21 increases the γδ T cell purity, amplification efficiency and cytotoxicity to reach comparable levels to those of IL-2.IL-2 plus IL-15 up-regulates the expression of CD69 on γδ T cells and significantly increases their amplificationefficiency (P<0.05).IL-2 plus IL-21 enhanced the cytotoxicity of γδ T cells against Daudi cells by increasing the expression of granzyme A (P<0.001).The combination of IL-2, IL-15 and IL-21 significantly improves cytotoxicity of γδ T cells but reduces their amplification efficiency.In addition, when IL-21 was applied for a short time, it also enhanced the cytotoxicity of γδ T cells (P<0.05).Conclusions The combination of IL-2 and IL-15 as well as a short time addition of IL-21 is the best cytokine recipe to amplify human peripheral blood γδ T cells in vitro with immobilized anti-TCR γδ antibody, which can increase both the proliferation efficiency and the cytotoxicity to tumor cells of γδ T cells.

14.
China Pharmacist ; (12): 25-28,29, 2017.
Article in Chinese | WPRIM | ID: wpr-606111

ABSTRACT

Objective:To observe the effect of coix seed extract on non-alcoholic fatty liver disease (NAFLD), and discuss the mechanism of coix seed extract in the treatment of NAFLD in the repect of free fatty acid. Methods:Totally 60 SD rats were randomly divided into 6 groups with 10 ones in each, the normal group, the model group, the positive group ( Xuezhikang capsules, 1 g · kg-1), three coix seed extract groups respectively at high (20 g·kg-1), medium (10 g·kg-1) and low (5 g·kg-1) dosage. The normal group was given basic diet, the other 5 groups were given high fat diet to establish NAFLD rat model, the modeling time was 8 weeks, and the drug treatment started from the 5th week till the 8th week. The liver weight and fat weight and index were observed after the drug intervention. The serum total cholesterol (TC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), free fatty acid (FFA), fatty acid synthase (FAS), acetyl coenzyme A carboxylase (ACCa-se), C two acyl coenzyme A (MALONYL-CoA) , adenosine content of protein kinase ( AMPK) and adiponectin ( ADP) activated by glycosides were detected. Results: Com-pared with those in the normal group, the lipid metabolism related indices in the model group were significantly abnormal (P<0. 05), which suggested that the model was established successfully. After the drug intervention, the lipid metabolism related indicators in the positive group and the three drug groups were adjusted in varying degrees. Compared with those in the model group, TC, FFA and AMPK expression levels increased notably in the high dosage group and the positive group (P<0. 05), and the levels of ALT, AST, FAS, ACCa-se, MALONYL-CoA decreased at the same time (P<0. 05). Coix seed extract could decrease the body weight and liver wet weight in NAFLD rats and improve the related index significantly. Conclusion: The findings indicated that coix seed extract is highly effective in improving the pharmacological effect on NAFLD induced by high-fat diet, and the mechanism is achieved through ADP-AMPK-ACCase-malony-CoA-FFA axis.

15.
Article in Chinese | WPRIM | ID: wpr-610974

ABSTRACT

Objective To evaluate the efficacy of routine extraluminal use of an Arndt endobronchial blocker (AEB) for one-lung ventilation (OLV) in infants.Methods Thirty American Society of Anesthesiologists physical status Ⅰ or Ⅱ infants,aged 6-36 months,weighing 5-18 kg,undergoing elective thoracoscopic surgery,were enrolled in the study.The loop of AEB was fastened to the front of the endotracheal tube (ETT),and the blocker was placed externally to the ETT.After induction of general anesthesia,the AEB's placement was facilitated through the use of a fibreoptic bronchoscope.Mean arterial pressure,heart rate,end-tidal pressure of carbon dioxide,oxygen saturation and airway pressure were recorded before AEB placement (T1),during AEB placement (T2),at the beginning of OLV (T3),at the beginning of two lung ventilation (T4) and at extubation (T5).The AEB placement time and successful placement and lung collapse time were recorded.The satisfaction with lung collapse,AEB shifting,hoarseness and development of intraoperative adverse cardiovascular events and hypoxemia and hypoventilation during OLV were recorded.Results Compared with the baseline at T1,no significant change was found in heart rate or mean arterial pressure at the other time points (P> 0.05),airway pressure was significantly increased at T2,3,and end-tidal pressure of carbon dioxide was increased at T4 (P<0.05).The AEB placement time was (5.6± 1.2) min,the success rate of AEB placement 93%,the rate of satisfaction with lung collapse 83%,and the incidence of AEB shifting (only found in the pediatric patients in whom AEBs were placed on the right side) 13%.No intraoperative adverse cardiovascular events,hypoxemia or hypoventilation was observed in the pediatric patients in whom AEBs were successfully placed.Conclusion Routine extraluminal use of an AEB can provide a fast,safe and effective method for OLV in infants.

16.
Article in Chinese | WPRIM | ID: wpr-610972

ABSTRACT

Objective To evaluate the efficacy of closed-loop infusion of propofol for surgery on the body Surface in preschool and school-age pediatric patients.Methods American Society of Anesthesiologists physical status Ⅰ pediatric patients of both sexes,undergoing elective surgery on the body surface,were included in the study.One hundred twenty-four preschool pediatric patients (aged 3-6 yr) were divided into 2 groups (n=62 each) using a random number table:closed-loop group (CPRE group) and openloop group (OPRE group).Thirty-eight school-age pediatric patients (aged 7-12 yr) were divided into 2 groups (n=19 each) using a random number table:closed-loop group (CSTU group) and open-loop group (OSTU group).The target bispectral index (BIS) value was set at 50 during maintenance of anesthesia.Propofol was delivered using closed-loop anesthesia delivery system,and the target plasma concentration of propofol was automatically regulated in CpRE and CSTU groups.Propofol was given using open-loop anesthesia delivery system,and the target plasma concentration of propofol was manually regulated in OpRE and OSTU groups.The adequate anesthesia time ratio (BIS40-60%) and global score (GS) of the delivery system were recorded during maintenance of anesthesia.The consumption of propofol,frequency of regulation and mean BIS value were recorded.The delivery system-related complications were recorded during the perioperative period.Results Compared with group OpRE,the consumption of propofol,GS and mean BIS value were significantly decreased,BIS40-60% was increased (P<0.05),and no significant change was found in the frequency of regulation in group CpRE (P>0.05).Compared with group OSTU,GS was significantly decreased,BIS40-60% was increased (P<0.05),and no significant change was found in the consumption of propofol,mean BIS value or frequency of regulation in group CSTU (P>0.05).Compared with group CpRE,the consumption of propofol and GS were significantly decreased,BIS40-60% was increased (P<0.05).and no significant change was found in the mean BIS value or frequency of regulation in group CSTU (P>0.05).One pediatric patient in group CSTU developed airway spasm,and no severe complications were found in the other pediatric patients.Conclusion For surgery on the body surface in preschool and school-age pediatric patients,closed-loop infusion of propofol is safe and effective,the stability and precision of anesthesia is superior to that of open-loop anesthesia delivery system,and it provides better efficacy in school-age pediatric patients than in preschool pediatric patients.

17.
Article in Chinese | WPRIM | ID: wpr-300768

ABSTRACT

Two cases of hypoglossal canal dural arteriovenous fistulas (HCDAVF) were reported. The clinical manifestation, radiological features, treatment and prognosis were reviewed. Both cases presented chemosis and pulsatile tinnitus. 3D-time-of-flight (TOF) magnetic resonance angiography (MRA) demonstrated abnormal high signal in hypoglossal canal. Cerebral digital subtraction angiography (DSA) showed that these HCDAVFs were supplied by multiple intracranial and extracranial arteries, and fistulas were located in hypoglossal canal. Fistulas were blocked by coils and Onyx-18 through transvenous approach, and the angiography after the embolism showed complete occlusion of fistula. No adverse events after treatment and no recurrence during the follow up were observed.

18.
China Journal of Endoscopy ; (12): 90-93, 2016.
Article in Chinese | WPRIM | ID: wpr-621315

ABSTRACT

Objective To evaluate the effect and pathological characters for patients with early esophageal carcinoma and intraepithelial neoplasia after endoscopic submucosal dissection (ESD). Methods 69 patients from January 2013 to January 2016 were treated with ESD at the early stage of esophageal carcinoma and intraepithelial neoplasia. The clinical features and the size of the lesions of all the patients were collected. Then analyzed postoperative complications and pathological characteristics. Results Among 69 cases, 16 were early esophageal cancer, 38 were high-grade esophageal neoplasia and 35 were low-grade esophageal neoplasia. The whole piece resection rate was 100.00 % (69/69), complete resection rate and curative resection rate was 95.65 % (66/69), respectively. The largest removal diameter is 7.0 cm. Biopsy accuracy was 69.57 % (48/69). Compared with biopsy, diagnostic accuracy with ESD specimens is higher. Conclusion The early esophageal carcinoma and intraepithelial neoplasia can be treated with ESD. ESD can resect lesions primarily, provide complete specimen for further pathological assessment and improve diagnostic accuracy.

19.
Chinese Journal of Orthopaedics ; (12): 995-1001, 2016.
Article in Chinese | WPRIM | ID: wpr-496916

ABSTRACT

Venous thromboembolism (VTE) is a kind of venous disorder that the abnormal condensation of blood within the vein,leading to complete or incomplete vein obstruction.VTE is mainly a combination of deep vein thrombosis (DVT)and pulmonary embolism (PE) and is an important complication after major orthopedic surgery (total hip arthroplasty,total knee arthroplasty,hip fracture surgery).Foreign literature reported that incidence rate of VTE after arthroplasty was as high as 42%-57%.Conventional notion was that DVT and PE were two different but interrelated types of VTE,while the latest research reported that the formation of DVT and PE after arthroplasty may be two events individually.Prevention of VTE after major orthopedic surgery includes general,pharmacological and mechanical methods.The efficacy of physical combined with pharmacological methods was better than drug prevention alone in preventing distal DVT.Dabigatran,apixaban,rivaroxaban and other new oral anticoagulants were better than low molecular weight heparin and other traditional medicines in effectiveness and safety.The effects of low molecular weight heparin are remarkable,while it cannot take orally.A recent study found that staged VTE prophylaxis,namely patients received low molecular weight heparin injection in hospital,and received aspirin,rivaroxaban or dabigatran orally after discharge is safe and effective in prevention of VTE.

20.
Chongqing Medicine ; (36): 2327-2329,2333, 2016.
Article in Chinese | WPRIM | ID: wpr-604118

ABSTRACT

Objective To analysis the effects of Ang-(1-7) on the blood brain barrier permeability after subarachnoid hemor-rhage .Methods SAH-rats were produced by two times injection of blood into cisterna magna .Evans blue was used to detect the the permeability of SAH-rats brains and brain water content .RT-PCR and Western blot were performed to measure the expression of adhesion protein ICAM-1 and VCAM-1 in brains of SAH-rats .The artificial hemorrhagic cerebrospinal fluid (BCSF) was used to stimulate vascular endothelial cells (HBMEC) ,and the proliferation and apoptosis of HBMEC cell were analyzed .Results Ang-(1-7) reduced the content of Evans blue and brain water in brains of SAH-rats in dose and time dependent manner with the most sig-nificant change under the treatment of 10 - 5 mol/L Ang-(1-7) for 24 h (P< 0 .05) .Under the above condition ,the mRNA and pro-tein levels of ICAM-1 and VCAM-1 in brains of SAH-rats were significantly up-regulated (P< 0 .05) ,while the content of Evans blue in HBMEC cells stimulated by BCSF was obviously reduced .Besides ,Ang-(1-7) was observed to increase the expression of ICAM-1 and VCAM-1 in BCSF-stimulated HBMEC cells ,enhance the proliferation of HBMEC cells but reduce their apoptosis . Conclusion Ang-(1-7) plays a protective role in the blood-brain barrier damage induced by subarachnoid hemorrhage .

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