Effect of intraoperative alveolar recruitment maneuver on intraoperative oxygenation and postoperative pulmonary function tests in patients undergoing robotic-assisted hysterectomy: a single-blind randomized study

Abstract Background Robotic-Assisted Hysterectomies (RAH) require Trendelenburg positioning and pneumoperitoneum, which further accentuate alteration in respiratory mechanics induced by general anesthesia. The role of Recruitment Maneuver (RM) as a lung-protective strategy during intraoperative surgical settings has not been much studied. We planned this study to evaluate the effect of RM on perioperative oxygenation and postoperative spirometry using PaO2/FiO2 and FEV1/FVC, respectively in patients undergoing RAH. Methods Sixty-six ASA I‒II female patients scheduled for elective RAH were randomized into group R (recruitment maneuver, n = 33) or group C (control, n = 33). Portable spirometry was done one day before surgery. Patients were induced with general anesthesia, and mechanical ventilation started with volume control mode, with Tidal Volume (TV) of 6-8 mL.kg−1, Respiratory Rate (RR) of 12 min, inspiratory-expiratory ratio (I: E ratio) of 1:2, FiO2 of 0.4, and Positive End-Expiratory Pressure (PEEP) of 5 cmH2O. Patients in group R received recruitment maneuvers of 30 cmH2O every 30 minutes following tracheal intubation. The primary objectives were comparison of oxygenation and ventilation between two groups intraoperatively and portable spirometry postoperatively. Postoperative pulmonary complications, like desaturation, pulmonary edema, pneumonia, were monitored. Results Patients who received RM had significantly higher PaO2 (mmHg) (203.2+-24.3 vs. 167.8+-27.3, p < 0.001) at T2 (30 min after the pneumoperitoneum). However, there was no significant difference in portable spirometry between the groups in the postoperative period (FVC, 1.40 ± 0.5 L vs. 1.32 ± 0.46 L, p= 0.55). Conclusion This study concluded that intraoperative recruitment did not prevent deterioration of postoperative spirometry values; however, it led to improved oxygenation intraoperatively.

Near-infrared spectroscopy-based study of the effects of gaming addiction disorders on brain cognitive control functions / 国际生物医学工程杂志

Objective:To explore the effects of game addiction disorders on brain cognitive control functions based on near-infrared spectroscopy.Methods:Thirteen subjects were screened according to the Online Game Addiction (OGA) Scale. The experimental paradigm was the stop-signal task. The relative concentration levels of oxyhemoglobin (HbO 2) and deoxyhemoglobin (Hb) in the prefrontal region of the brain during cognitive activity were collected using near-infrared spectroscopy to assess the cognitive control function of the subjects. Results:The game-addicted patients had lower keystroke accuracy in the stop-signal task than healthy subjects, and the difference was statistically significant ( P<0.05). Compared to healthy subjects, game-addicted patients had less activation in prefrontal areas and showed uncontrolled behavior and brain activity. Conclusions:Game addiction disorders impair brain cognitive control, which in turn triggers a weakening of cognitive control. The results of this study provide a reference for the prevention and treatment of game addiction.

Clinical characteristics of nucleic acid negative neonates delivered by pregnant women infected with SARS-CoV-2 in Sanya, Hainan / 中国热带医学

@#Abstract: Objective　To explore the clinical characteristics of nucleic acid negative newborns delivered by pregnant women infected with SARS-CoV-2 (Omicron variant BA. 5.1.3) in Sanya area, and to provide evidence for understanding its clinical characteristics. Methods　A retrospective analysis was performed on 14 neonates with negative nucleic acid delivered by pregnant women who tested positive for SARS-CoV-2 (Omicron variant BA.5.1.3) in Sanya Central Hospital (the Third People's Hospital of Hainan Province) from June 2022 to September 2022 (observation group, n=14). The corresponding nucleic acid-negative newborns delivered by pregnant women detected negative with SARS-CoV-2 (Omicronon variant strain BA.5.1.3) were set as the control group (n=56), and the general data and clinical characteristics of neonates in the two groups were compared. Results　There was no significant difference between the observation group and the control group in pregnancy diabetes, pregnancy induced hypertension, gestational pre-eclampsia, fetal intrauterine distress, premature rupture of membranes (P>0.05); there was no significant difference between the observation group and the control group in terms of sex, gestational age, birth weight, age, mode of delivery, birth Apgar score, heart screening, pulmonary disease, glucose 6-phosphate dehydrogenase (G6PD) deficiency, thalassemia, breast milk jaundice, hemolytic jaundice (P>0.05). The bilirubin level, blue light irradiation cases and the duration of blue light irradiation of the newborns in the observation group at 7 days after birth were higher than those in the control group (P<0.05); the ratio of blood oxygen saturation ≥ 90% in the observation group was lower than that in the control group (21.43% vs 89.29%, P<0.05), and the ratio of blood oxygen saturation occasionally<90% was higher than that in the control group (57.14% vs 10.71%, P<0.05). The ratio of blood oxygen saturation<90% had no significant difference compared with that in the control group (7.14% vs 0, P>0.05), and the ratio of blood oxygen saturation reduced to the required oxygen uptake was higher than that in the control group (14.29% vs 0, P<0.05). Conclusions　The jaundice manifestation of the nucleic acid-negative newborns delivered by pregnant women infected with SARS-CoV-2 (Omicronon variant strain BA.5.1.3) in Sanya area is relatively obvious, with blood oxygen saturation easily lower than 90% and even requiring oxygen inhalation in severe cases.

Meranzin Hydrate Improves Depression-Like Behaviors and Hypomotility via Ghrelin and Neurocircuitry / 中国结合医学杂志

OBJECTIVE@#To investigate whether meranzin hydrate (MH) can alleviate depression-like behavior and hypomotility similar to Chaihu Shugan Powder (CSP), and further explore the potential common mechanisms.@*METHODS@#Totally 120 Spraque-Dawley rats were randomly divided into 5-8 groups including sham, vehicle, fluoxetine (20 mg/kg), mosapride (10 mg/kg), CSP (30 g/kg), MH (9.18 mg/kg), [D-Lys3]-GHRP-6 (Dlys, 0.5 mg/kg), and MH+Dlys groups by a random number table, 8 rats in each group. And 32 mice were randomly divided into wild-type, MH (18 mg/kg), growth hormone secretagogue receptor-knockout (GHSR-KO), and GHSR+MH groups, 8 mice in each group. The forced swimming test (FST), open field test (OFT), tail suspension test (TST), gastric emptying (GE) test, and intestinal transit (IT) test were used to assess antidepressant and prokinetic (AP) effects after drug single administration for 30 min with absorbable identification in rats and mice, respectively. The protein expression levels of brain-derived neurotrophic factor (BDNF) and phosphorylated mammalian target of rapamycin (p-mTOR) in the hippocampus of rats were evaluated by Western blot. The differences in functional brain changes were determined via 7.0 T functional magnetic resonance imaging-blood oxygen level-dependent (fMRI-BOLD).@*RESULTS@#MH treatment improved depression-like behavior (FST, OFT) and hypomotility (GE, IT) in the acute forced swimming (FS) rats (all P<0.05), and the effects are similar to the parent formula CSP. The ghrelin antagonist [D-Lys3]-GHRP-6 inhibited the effect of MH on FST and GE (P<0.05). Similarly, MH treatment also alleviated depression-like behavior (FST, TST) in the wild-type mice, however, no effects were found in the GHSR KO mice. Additionally, administration of MH significantly stimulated BDNF and p-mTOR protein expressions in the hippocampus (both P<0.01), which were also prevented by [D-Lys3]-GHRP-6 (P<0.01). Besides, 3 main BOLD foci following acute FS rats implicated activity in hippocampus-thalamus-basal ganglia (HTB) circuits. The [D-Lys3]-GHRP-6 synchronously inhibited BOLD HTB foci. As expected, prokinetic mosapride only had effects on the thalamus and basal ganglia, but not on the hippocampus. Within the HTB, the hippocampus is implicated in depression and FD.@*CONCLUSIONS@#MH accounts for part of AP effects of parent formula CSP in acute FS rats, mainly via ghrelin-related shared regulation coupled to BOLD signals in brain areas. This novel functionally connection of HTB following acute stress, treatment, and regulation highlights anti-depression unified theory.

Evaluation of placental oxygenation by blood oxygen level dependent MRI in hyperoxia / 中华放射学杂志

Objectives:To explore the value of blood oxygen level-dependent (BOLD) MRI in evaluating the changes of placental oxygenation during maternal hyperoxia.Methods:From October 2017 to March 2020, 22 singleton pregnant women with normal placenta showed by ultrasound were prospectively included in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. Pregnant women wore oxygen mask before examination, and then underwent BOLD MRI examination for 10 min. The pregnant women inhaled air in the first 3 min and continuously inhaled oxygen with purity greater than 90% in the next 7 min (flow rate 12 L/min). The average value of BOLD signal of the whole placenta, fetal side of placenta, maternal side of placenta and maternal kidney were measured and calculated in the first 3 min as before oxygen and the last 3 min of the end of oxygen inhalation as after oxygen. The ΔBOLD was calculated which was the change value of BOLD signal before and after oxygen inhalation. The BOLD values of placenta and maternal kidney before and after oxygen inhalation were compared by using paired t-test. The ΔBOLD of the whole placenta, the fetal side of the placenta and the maternal side of the placenta were compared by using one-way ANOVA, and the LSD method was used for pairwise comparison between groups. Results:There were significant differences in BOLD values of the whole placenta, fetal side of placenta and maternal side of placenta before and after oxygen inhalation ( t=-4.62, P<0.001; t=-4.73, P<0.001; t=-3.57, P=0.002). There was no significant difference in BOLD value of maternal kidney before and after oxygen inhalation ( t=0.35, P=0.740). The ΔBOLD values of the whole placenta, fetal side of placenta and maternal side of placenta were (12.8±2.2)%, (15.1±2.7)% and (6.4±1.3)% respectively. The overall difference was statistically significant ( F=4.49, P=0.015). The results of pairwise comparison showed that there was no significant difference in ΔBOLD between the whole placenta and the fetal side of the placenta ( P=0.450). There were significant differences in ΔBOLD between whole placenta and maternal side of placenta ( P=0.037) and between fetal side and maternal side of placenta ( P=0.005). Conclusion:Under the condition of maternal hyperoxia, the BOLD signal of placenta increased significantly, and the change of fetal side of placenta was more obvious than that of maternal side. BOLD-MRI has the potential of semi-quantitative and real-time evaluation of placental oxygenation.

Research progress on the interaction between myopia and visual cortex / 中华眼底病杂志

Myopia is a major problem of public health in China, and even in the world, and slowing down the progress of myopia has become a hot issue of concern. However, the effects of the current therapeutic and interventional modalities to myopia, including optical lenses, chemical drugs, and laser surgery, the effect of treatment and intervention is not very satisfactory, and these modalities may incur some side effects. This situation suggests that the pathogenic and regulatory mechanisms of myopia remain elusive, and the myopia treatments lack the accurate and effective targets to the etiology. A complete visual experience depends on the entire visual pathway from the retina to the visual cortex, in which any structural and functional defect can lead to visual abnormalities. In recent years, with the advances in the infrared spectroscopy and the magnetic resonance imaging technology, more and more evidence has shown that the progression of myopia is related to the visual cortex. Improving the functional connectivity and blood prefusion between different regions of the visual cortex may impede myopia profession. In-depth understanding of the interaction between myopia and the visual cortex is helpful to search for accurate and effective myopia treatment targets and novel intervention strategies.

The application of blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI) to the protection of language functional area during postoperative IMRT of cerebral gliomas / 中华放射医学与防护杂志

Objective:To investigate the clinical application value of blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI) to the protection of language function in patients with unilateral frontal and temporal lobes glioma receiving postoperative intensity modulation radiation therapy (IMRT).Methods:A total of 27 patients with unilateral frontal and temporal lobe gliomas were treated with postoperative radiotherapy. The planning CT and BOLD-fMRI were performed before radiotherapy, and the language functional areas were delineated based on the fused images of 3D T1 and CT. IMRT technology was used to develop radiotherapy plans with and without language function area protection, naming conventional and protective radiotherapy plans respectively. The maximum radiation dose ( Dmax), average radiation dose ( Dmean), target conformal (CI) and dose uniformity (HI) of PTV of the two plans were compared and analyzed to ensure that the protective radiotherapy plan could meet the radiotherapy standard. Then, the Dmax and Dmean of the language function area were compared and analyzed to evaluate whether the Dmax and Dmean of the language function area were decreased in the protective radiotherapy plan. Results:There were no significant differences in CI, HI, Dmax and Dmean of PTV between the conventional radiotherapy plan and protective radiotherapy plan ( P>0.05). There were statistically significant differences in Dmax and Dmean of Wernicke′s and Broca′s (healthy side and affected side) between the conventional radiotherapy plan and protective radiotherapy plan ( t=3.073-12.707, P<0.05). Dmax and Dmean of Wernicke′s and Broca′s (healthy side and affected side) were decreased in the protective radiotherapy plan compared with the conventional radiotherapy plan, and the decrease was significant in the healthy side. Conclusions:BOLD-fMRI combined with IMRT can not only guarantee the target dose of patients with glioma receiving postoperative radiotherapy, but also reduces the radiation dose to the language function area. Chinese reading task and paragraph comprehension task are the stimulation mode of language function in patients after brain tumor surgery. These tasks are simple and the effect is accurate.

Protective effect of hemoglobin oxygen carrier with different oxygen affinity on isolated rat hearts / 中国输血杂志

【Objective】 To explore the protective effects of hemoglobin base on oxygen carries (HBOCs) with different oxygen affinity on isolated rat hearts. 【Methods】 Using Langendorff isolated heart perfusion model, 45 adult male SD rats (SPF grade), perfused with 30 min KH solution baseline, were randomly divided into sham operation group and control group: St. Thomas (STS) solution perfusion volume was 3mL/100g body weight; high P50 HBOCs group: [STS + high P50 HBOCs (P50=35.0 mmHg, 2.5 mg/100 g) product] perfusion volume was 3mL/100g body weight; medium P50 HBOCs group: [STS + medium P50HBOCs (P50=26.5.0 mmHg, 2.5 mg/100 g) product] perfusion volume was 3 mL/100 g body weight; low P50 HBOCs group: [STS + low P50 HBOCs (P50=11.0 mmHg, 2.5 mg/100 g) product] perfusion volume was 3mL/100g body weight, and the heart was arrested and placed in a 37℃ water bath to make the heart ischemic for 35 minutes, and then reperfused for 2 hours. The left ventricular development pressure (LVDevP), left ventricular end diastolic pressure (LVEDP), the rate of change of left ventricular pressure (LVPCR) and heart rate (HR) in the rat heart during reperfusion were observed and recorded. 1 min perfusion fluid from each rat in the basic and reperfusion phase was taken, and blood gas analyzer was used to measure the blood gas indexes of rats, and the myocardial injury marker enzymes [cardiac enzyme creatine kinase (CK-MB), lactate dehydrogenase (LDH) and the release of α-hydroxybutyrate dehydrogenase (α-HBDH)] were measured by ELISA kit. 【Results】 The cardiac function and the release of myocardial enzymes in the 5 groups of rats in the basal cardiac perfusion stage were similar (P>0.05). However, in the reperfusion stage, except for the insignificant changes in HR (P>0.05), the heart LVDevP (mmHg) of the three P50 HBOCs groups and the control group were 10.69±3.65 vs 8.50±2.88, 23.26 ±5.62 vs 8.50±2.88, 35.60±3.82 vs 8.50±2.88, LVEDP (mmHg) were 43.34±8.08 vs 54.64±7.42, 39.43±8.30 vs 54.64±7.42, 31.46±4.11 vs 54.64±7.42, dp/dt were 12.09±9.96 vs 6.09±0.98, 25.65±8.87 vs 6.08±0.98, 35.32±9.33 vs 6.09±0.98, -dp/dt were 17.53±11.28 vs 11.39±2.16, 28.80±13.70 vs 11.39±2.16, 43.36±3.83 vs 11.39±2.16, respectively (all P<0.05); the rebound situation and the release of CK-MB, LDH, and α-HBDH in the three P50 HBOCs groups were better than those in the control group (P<0.05). Among the three P50HBOCs products, the low P50HBOCs group had the best cardiac function indexes. The myocardial enzyme indexes of the high, medium and low HBOCs groups were CK-MB (ng/mL): 110.47±4.04, 90.2±2.46, 77.1±3.51; LDH (U/L): 162.23±7.71, 135.13±23.69, 92.20±4.21; a-HBDH (U/L): 228.00±8.03, 172.30±8.99, 131.00±2.02. 【Conclusion】 STS solution containing HBOCs products can improve the function of the reperfused heart at normal temperature ischemia for 35 min and 2 h reperfusion, and reduce heart damage. The STS solution containing low P50 HBOCs has the most obvious protective effect in rat isolated heart perfusion.

Relationship between sleep architecture and severity of obstructive sleep apnea / 浙江大学学报·医学版

OBJECTIVE@#To investigate the effect of obstructive sleep apnea (OSA) on different sleep stages, and the relationship between N3 stage of non-rapid eye movement sleep and respiratory abnormal events.@*METHODS@#A total of 188 adult patients who underwent overnight polysomnography(PSG)monitoring in Sir Run Run shaw Hospital of Zhejiang University from June 24th to December 26th 2019 were enrolled in the study. OSA patients were classified into 3 groups (mild, moderate and severe) according to the apnea-hypopnea index (AHI). PSG data, AHI and the lowest SPO in each stage of sleep were compared among three groups.@*RESULTS@#There was no significant difference in total sleep time and sleep efficiency among patients with different severity of OSA (all >0.05). The proportion of N3 stage in moderate and severe OSA groups were significantly smaller than that in mild OSA group (all <0.05). The proportion of N3 stage in severe OSA group was also smaller than that in moderate OSA group (<0.05). In addition, severe OSA group had a longer latency of N3 stage than mild and moderate OSA groups (all <0.05). The latency of N3 stage in moderate OSA group was longer than that in mild OSA group (<0.05). The AHI in N3 stage was markedly lower than that in other sleep stages (all <0.01), regardless of the severity of OSA. Supine AHI in N3 stage in mild and moderate groups was significantly lower than that in N1, N2 and rapid eye movement (REM) stages (all <0.01). Supine AHI in N3 stage in severe group was also lower than that in N2 and REM stages (<0.05 or <0.01). The lowest SPO in N3 stage was significantly higher than that in N1, N2 and REM stages (<0.05 or <0.01), regardless of the severity of OSA.@*CONCLUSIONS@#s The proportion of N3 stage is lower in OSA patients, and N3 stage has less sleep respiratory events than non-N3 stages. The results suggest that the increased N3 stage proportion may indicate less severity of OSA.

Improvement of cognitive function in older adults based on near-infrared spectroscopy / 中国组织工程研究

BACKGROUND: Cognitive aging is an age-related cognitive degeneration that can develop into a cognitive dysfunction in the end stage. There is no clear therapeutic principle in clinical practice, but it is generally recognized that exercises can delay cognitive aging. OBJECTIVE: To summarize the current progress and shortcomings of exercise-delayed cognitive aging based on near-infrared spectroscopy. METHODS: In line with the PRISMA guidelines, the first author searched PubMed, WOS, CNKI, and WanFang using the keywords of “exercise, near-infrared spectroscopy, cognition, elderly or older adults, cathepsin B, brain-derived neurotrophic factor” in Chinese and English, respectively. Literature addressing senile cognitive function based on the near-infrared spectroscopy technique was retrieved, and 37 eligible articles were retained for further analysis. RESULTS AND CONCLUSION: We performed a comprehensive analysis of exercise-delayed cognitive aging based on near-infrared spectroscopy and confirmed that exercise improves the activation of cortex in different brain regions and thus improves cognitive function. Long-term aerobic exercise has better effects in the improvement of cognitive function than short-term exercise, which is more conducive to delaying cognitive aging. The underlying physiological mechanism may be that exercise improves blood flow in the brain, stimulates the secretion of neurotrophic factors from the skeletal muscle, and promotes the growth, survival and proliferation of neurons. However, there is no uniform standard for the interventional strategies. There are many links to be further improved, such as integration of individual differences and indexes in different brain regions, procedures for testing physical conditions (cardiovascular and lung diseases), to enhance the reliability of relevant parameters.

Effect of sodium carboxymethyl starch on erythrocyte rheology and oxygen carrying function / 国际药学研究杂志

Objective: To investigate the physicochemical properties of sodium carboxymethyl starch(CMS) and its effect on erythrocyte rheology and oxygen carrying function. Methods According to the requirements of Chinese Pharmacopoeia,the physicochemical properties were determined for CMS120,CMS380 and hydroxyethyl starch 130 (HES130),including pH value,osmotic pressure molar concentration and viscosity. Normal saline,CMS120,CMS380 and HES130 were mixed with whole blood(7:3,V/V),respectively,and the experimental groups were set as whole blood group,whole blood+normal saline(NSB)group,whole blood+CMS120(CMS120B)group,whole blood+CMS380 (CMS380B)group,and whole blood+HES130(HES130B)group. The colloid osmotic pressure,blood viscosity,eryth- rocyte deformation and aggregation,and the partial pressure of oxygen when blood oxygen saturation was 50%(P50)val- ue were measured for each of these groups. Results: The osmotic pressure molar concentration and the viscosity of CMS120 and CMS380 were both significantly higher than those of HES130(all P<0.05)as indicated by the determina- tion of physicochemical properties. Compared with the whole blood group,the colloid osmotic pressure was significantly increased in the CMS380B and CMS120B groups(P<0.05),which was also significantly higher than that in the HES130B group(P<0.05). At low shear rate(10/s),compared with the whole blood group,the whole blood and the plasma vis- cosities were significantly increased in the NSB,CMS380B and CMS120B groups(all P<0.05),but the whole blood viscosity was significantly decreased in the HES130B group(P<0.05). Under the conditions of shear rate 10/s,50/s and 150/s,compared with the HBS130B group,the whole blood and the plasma viscosities were both significantly in- creased in the CMS120B and CMS380 groups(all P<0.05). At the effect of high shear rate,both the CMS380 and HES130 groups showed a tendency to promote erythrocyte deformation,and the CMS120B and CMS380B groups promot- ed erythrocyte aggregation,while the HES130B group inhibited erythrocyte aggregation amplitude(P<0.05). The P50 value was significantly higher in the CMS380B group than in the HES130B group(P<0.05). Conclusion: CMS130 and CMS380 could improve the rheological properties of erythrocytes and CMS380 could also promote the oxygen release of erythrocytes.

Correlation between blood oxygen level dependent fMRI signal and GABA content in anterior cingulate cortex after acupuncture of Hegu (LI4) / 针刺研究

OBJECTIVE: To explore the correlation between blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI) signal and neurotransmitter γ-aminobutyric acid (GABA) concentration in the prefrontal cortex area after acupuncture or Von Frey filament stimulation (epidermal stimulation) at the right Hegu (LI4). METHODS: A total of 76 healthy volunteers (23 men and 53 women, 24.5±1.4 years in age) were recruited in the pre-sent study. Each volunteer received two sessions of fMRI magnetic resonance scanning (MRS) examinations, with an interval of one week between two sessions. The MRI scan sequences included pre-task MRS, resting state BOLD and task MRS, BOLD. A region of Interest (ROI) of 35 mm×30 mm×25 mm was located at the bilateral medial prefrontal cortex areas. In the two sessions of examinations, the right LI4 point was stimulated by manual acupuncture or Von Frey filament-pressing. The tasks were designed as the block design. Each block contained 3 intermittent acupoint stimulations, lasting 30 s in each stimulation and with two minutes' pause between two stimulations. The MRS data were processed by using Linear Combination (LC) Model software (for assessing GABA content), and the BOLD data of fMRI was analyzed by using SPM12 software (comparison within each group), REST1.8 (comparison between two groups), separately. RESULTS: Extensive deactivations were induced by both stimulations, mainly involving the midline regions as the medial prefrontal lobe, and limbic lobe. The deactivation effect of manual acupuncture stimulation was more extensive and intensive than that of Von Frey filament stimulation, especially in the medial prefrontal lobe. Data from 66 volunteers (after exclusion of 10 participants due to bigger standard deviation of GABA/Glx) showed no marked correlation between the GABA concentration and BOLD activation in the anterior cingulate cortex area in both groups(manual acupuncture stimulation group: r=－0.07, －0.08, 0.04; P=0.57, 0.88, 0.74; Von Frey filament epidermal stimulation group: r=－0.10, －0.09, －0.01; P=0.43, 0.46, 0.96). CONCLUSION: Acupuncture of LI4 elicits a stronger and broader negative activation effect in the limbic-paralimbic-neocortical network including the medial prefrontal cortex in comparison with Von Frey filament stimulation, but no apparent correlation was found between the GABA concentration and BOLD activation in the anterior cingulate cortex after manual acupuncture and Von Frey stimulation.

Anesthetic effect of sufentanil combined with propofol in different target-controlled concentrations in patients with breast cancer / 中国基层医药

Objective@#To explore the anesthetic effect of sufentanil combined with propofol with different target control concentration for breast cancer patients.@*Methods@#From January 10, 2015 to December 20, 2017, according to the digital table, 80 patients with breast cancer in the Maternal and Child Health Hospital of Cixi were randomly divided into three groups: group A(28 cases, the intraoperative sufentanil plasma target control concentration was 0.2ng/mL), group B (27 cases, the intraoperative sufentanil plasma target control concentration was 0.4ng/mL), group C (24 cases, the intraoperative sufentanil plasma target control concentration was 0.8ng/mL). The plasma target control concentration of propofol in three groups was 3μg/mL.The hemodynamic level[mean arterial pressure(MAP), heart rate(HR)], blood oxygen saturation(SpO2), recovery time, respiratory recovery time and incidence of adverse reactions were compared among the three groups.@*Results@#The MAP of T2, T3 and T4 in group A, group B and group C[T2: (78.56±7.42)mmHg vs.(76.98±7.65)mmHg vs.(69.36±7.69)mmHg; T3: (88.24±7.61)mmHg vs.(86.95±7.59)mmHg vs.(69.41±7.70)mmHg; T4: (72.32±7.51)mmHg vs.(69.24±7.21)mmHg vs.(66.52±6.85)mmHg], HR[T2: (73.65±8.75)times/min vs.(73.49±8.69)times/min vs.(68.36±7.79)times/min; T3: (76.75±8.95)times/min vs.(75.58±7.96)times/min vs.(68.65±7.36)times/min; T4: (71.42±7.41)times/min vs.(70.24±6.49)times/min vs.(64.39±6.62)times/min] showed significant differences[F(MAP)= 8.524, 15.365, 5.325; F(HR)=8.104, 12.521, 5.015, all P<0.05]. However, there were no statistically significant differences in SpO2 among group A, group B and group C in T2, T3 and T4(all P>0.05). There were no statistically significant differences in resuscitation time and respiratory recovery time among group A, group B and group C (all P>0.05). There was no statistically significant difference in the incidence of adverse reactions among group A, group B and group C(P>0.05).@*Conclusion@#0.8ng/mL sufentanil combined with 3μg/mL propofol has better anesthetic effect on patients undergoing breast cancer surgery, which is helpful to maintain hemodynamic stability.

BOLD-MRI in evaluation on oxygenation status of renal tissue before and after hypoglycemic treatment of patients with type 2 diabetes mellitus / 中国医学影像技术

Objective: To evaluate renal tissue oxygenation level and its correlation with blood glucose level after hypoglycemic therapy in diabetic patients using BOLD-MRI. Methods Renal BOLD-MRI scans were performed on 23 patients with type 2 diabetes (diabetic group) before and after hypoglycemic therapy and 23 normal controls (control group). R2* values of renal cortex and medulla were measured and statistically analyzed. Results R2* value of renal cortex in diabetic group and control group were lower than that of renal medulla (all P<0.001). R2* value of renal medulla in diabetic group before hypoglycemia was higher than that after hypoglycemia and in control group (both P=0.001), and there was no significant difference of R2* value of renal medulla between diabetic group after hypoglycemia and control group (P=0.941). There was no significant difference in renal cortical R2* value among diabetic group before and after hypoglycemia and control group (P=0.572). R2* value of renal medulla was positively correlated with blood glucose level (r=0.365, P=0.002), while of renal cortex had no correlation with blood glucose level (r=-0.014, P=0.908). Conclusion: Hypoglycemic treatment can help to improve oxygenation of renal medulla in diabetic patients. BOLD-MRI can be used to evaluate changes of renal oxygen content before and after hypoglycemic treatment.

Development of a Portable Pulse Oxymetry Simulator System / 中国医疗器械杂志

This article describes the design of a portable blood oxygen simulation system that can be used to simulate various blood gas saturation states of the human body. The system can be used to simulate various states of blood gas saturation, and can also simulate large blood oxygen saturation dynamic range, pulse rate range and perfusion index range. It can be used for testing, but not for clinical examination instruments. Moreover, the system has the characteristics of small size and low cost compared with the commercial blood oxygen simulator. Although the simulation system is not directly used for the detection of blood gas saturation of patients, it is also an essential equipment in the production and testing process, so it has certain practical value.

Effects of tracheal indwelling pipette on blood oxygen saturation and complications in patients with severe pneumonia / 中国基层医药

Objective To investigate the effect of tracheal indwelling pipette on blood oxygen saturation and complications in patients with severe pneumonia. Methods From December 2014 to December 2016,68 patients with severe pneumonia in Ji'nan Central Hospital were selected and divided into the observation group and the control group according to the random number table method,with 34 cases in each group. The two groups were given conventional phlegm,anti - infection and other symptomatic treatment. The observation group received suction tube through nasal insertion on the need for suction based on the conventional treatment. The control group received mouth or nasal suction according to the patients ' condition at any time based on the conventional treatment. The blood oxygen saturation before and after sputum aspiration were compared in the two groups,the incidence of complications were recorded. Results Before sputum suction,the SpO2 ,RR in the observation group were (89. 5 ± 1. 4)％ ,(31. 1 ± 1. 5)times/ min,respectively,which in the control group were (89. 7 ± 1. 5)％ and (31. 2 ± 1. 4)times/ min,respec-tively,there were no statistically significant differences between the two groups (t = 0. 568,P = 0. 572,t = 0. 284,P =0. 777). After sputum suction,SpO2 was significantly increased in the observation group [(98. 4 ± 1. 3)％ ],RR was significantly lower than that before suction[(19. 8 ± 2. 7) times/ min],the differences were statistically significant between the two groups(t = 27. 163,P = 0. 000;t = 21. 333,P = 0. 000). The SpO2 in the observation group[(98. 4 ± 1. 3)％ ] was significantly higher than (90. 2 ± 2. 6)％ in the control group (t = 16. 448,P = 0. 000). The overall incidence rate of the complications and mortality in the observation group were 26. 5％ and 11. 8％ ,respectively, which were significantly lower than 67. 6％ and 52. 9％ in the control group (χ2 = 11. 57,P = 0. 000;χ2 = 13. 17, P = 0. 000). Conclusion Intravascular retention of suction tube can significantly improve the patients' blood oxygen saturation,reduce the risk of serious complications,and has a positive significance to improve the treatment effect.

Development of CT and MRI enhanced scanning tracking monitor / 医疗卫生装备

Objective To develop a tracking monitor for patient vital signs after CT and MRI enhanced scanning so as to execute auto alarm in case of patient discomfort and allergic reactions.Methods The monitor composed of a sub machine,a principal machine and a large-screen display used ultra-low power digital blood oxygen plate LPDSPO2V1.4 and fingertip sensor to acquire data on blood oxygen saturation and heart rate,the acquired data were transmitted to the principal machine with NRF24L01 wireless transmission module, and then the principal machine executed data auto analysis, storage, auto alarm for out-of-limit data and sent the data to the display.Results The monitor could be used for checking blood oxygen saturation and heart rate as well as implement early warning against allergic reactions.One-year trials proved that there were no death in case 87 cases of minor allergic reactions and 3 severe ones occurred.Conclusion The monitor proves its safety and efficiency by decreasing the incidence rate of severe reactions after CT and MRI enhanced scanning,and thus is worthy promoting clinically.

Non-invasive non-contact physiological parameters monitoring system based on Arduino / 医疗卫生装备

Objective To design a non-invasive non-contact physiological parameters monitoring system to realize physiological status real-time monitoring. Methods The system was developed with Arduino hardware and its integrated development environment,high-precision high-sensitivity GY-MCU90615 infrared thermometric module and Si1143 heart rate and blood oximeter module,which was composed of five parts of physiological parameters acquisition,development platform,COM port transmission, network transmission and data terminal. Results The desired requirements were met by continuous, non-invasive,non-contact and accurate monitoring of body temperature,oxygen saturation and heart rate.Conclusion The system gains advantages in design and convenience, and thus is worthy promoting for physiological parameters monitoring in the hospital,geracomium and home.

The value of blood oxygen level dependence and arterial spin labeling MRI in the early diagnosis of renal allograft dysfunction / 中华放射学杂志

Objective To investigate the value of blood oxygen level-dependent (BOLD) and arterial spin labeling (ASL) MRI in the early diagnosis of renal allograft dysfunction. Methods A total of 53 patients with allograft kidney transplantation from December 2014 to April 2017 in Tianjin First Center Hospital were prospectively collected. In all cases, the serum creatinine value was detected, and the estimated glomerular filtration rate (eGFR) was calculated. All patients were divided into three groups according to the eGFR. There were three groups;continuous renal transplant function group (group A, 19 cases), short term allograft dysfunction group (group B, 17 cases), and continuous renal function damage group (group C, 17 cases). Fifty-three patients were examined by BOLD and ASL MRI at 10 to 14 days after operation. Twenty one patients were reviewed by BOLD and ASL MRI at 10 to 13 weeks after operation (A, B and C group were 7, 6, 8 cases). The values of renal cortex R2* (R2*=1/T2*), renal medullary R2* and renal cortical renal blood flow (RBF) were measured in each group. One-way analysis of variance (ANOVA) was used to compare the differences of eGFR and BOLD, ASL index (renal cortex R2*, renal medulla R2*, renal cortex RBF value) after the first post renal transplant among the 3 groups. Correlations between BOLD and ASL index with eGFR index in the first post renal transplant were assessed by using Pearson correlation analysis. The efficacy of BOLD and ASL in the differential diagnosis of continuous renal transplant function group and short term allograft dysfunction group by the receiver operating characteristic (ROC). Paired samples t test was used to compare the differences of eGFR, BOLD and ASL indexes for the baseline and follow-up. Results The differences of eGFR, cortical R2*value, medullary R2*value and cortical RBF value were statistically significant between the 3 groups (P<0.05). The transplanted kidney medullary R2* value and cortical RBF value were positively correlated with eGFR (r values were 0.553, 0.687; P<0.01). There was no correlation between transplanted kidney renal cortex R2*value and eGFR value (P>0.05). The area under ROC was 0.776 for the renal medullary R2*in the diagnosis of continuous renal transplant function group and the short term allograft dysfunction group;with the threshold of 24.5, the sensitivity of diagnosis of renal allograft short term allograft dysfunction was 58.8%, specificity was 84.2%;the area under ROC for renal cortex RBF was 0.881, with the threshold of less than 277 ml·100 g-1·min-1, the sensitivity was 70.6%, specificity was 89.4%. During follow-up, eGFR, cortical R2*and medullary R2*in group A remained stable, while the renal cortex RBF value went slightly higher, and the differences were statistically significant ( P<0.05). The cortical R2* values in group B remained stable, eGFR, renal medulla R2* and renal cortex RBF decreased, and the differences were statistically significant (P<0.05). The values of eGFR and R2*in group C remained stable, while the renal medullary R2* value and cortex R2* value increased slightly, and the differences were statistically significant (P<0.05). Conclusions This study shows that BOLD and ASL MRI can longitudinally monitor the functional status of the transplanted kidney and detect the abnormality of renal allograft function early. CRBF value shows high diagnostic value.

Blood Oxygen Level-dependent MRI Longitudinal Monitor of Changes in Blood Oxygen Levels in Remaining and Donated Kidney After Receiving Parental Kidney Transplantation / 中国医学影像学杂志

Purpose To discuss the value of longitudinal assessment of the remaining kidney of the donor and kidney blood oxygen level changes after receiving kidney transplantation by applying blood oxygen level-dependent (BOLD) MRI. Materials and Methods Sixty patients underwent parental kidney transplantation from Jul. 2015 to Feb. 2017 in Tianjin First Center Hospital were prospectively collected, including 30 healthy kidney transplant donors and 30 recipients corresponding to them. The donors received renal BOLD examination 3 days before and 2 weeks after unilateral nephrectomy. Recipients received renal BOLD examination 2 weeks after kidney transplantation, of which, 15 pairs of patients underwent parental kidney transplantation received renal BOLD examination again six months after surgery. The apparent transverse relaxation rate (R2*) values of the cortex and medulla at different times before and after transplantation were measured and recorded. The differences of R2* values between 30 donors' cortex and medulla in both kidneys before surgery were compared; the differences of R2* values between 30 pairs of subjects' cortex and medulla in remaining and donated kidney within 2 weeks before and after surgery were compared; variance gained through single factor repeated measurement was applied to analyze and compared the difference of R2* values between 15 pairs of follow-up subjects' cortex and medulla in remaining and donated kidney at different time points before and after surgery. Results All 60 subjects received MRI scan, and there was no statistical difference in R2* values between 30 subjects' cortex and medulla in both kidney before surgery (P>0.05). The difference between the cortex and medulla was statistically significant, with R2* value of medulla higher than that of cortex (P<0.01). R2* values of cortex and medulla of the remaining kidney in 30 subjects two weeks after receiving unilateral nephrectomy were lower than those before surgery. R2* value of cortex and medulla of donated kidney were both lowered before surgery, the difference of which was statistically significant (P<0.01). R2*values of cortex and medulla in remaining and donated kidney of 15 pairs of subjects who have received half a year's follow up were both evidently reduced two weeks after surgery, and R2* values six months after surgery were raised compared with two weeks after surgery, but were still lower than that before surgery, the difference of which were both statistically significant (P<0.05). Conclusion BOLD MRI can be used for longitudinal monitor of changes in blood oxygen levels in remaining and donated kidney after receiving parental kidney transplantation.