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Objective:To evaluate the value of modified magnetic bead screening for enrichment of cell-free fetal DNA (cffDNA) in non-invasive prenatal testing (NIPT).Methods:This study retrospectively recruited 31 cases with low concentration of cffDNA (<6.00%), Z value in the gray zone (3.00-4.00) at the first detection, or false-positive (confirmed by invasive prenatal diagnosis) or false-negative (confirmed by postnatal chromosome test) results among 11 000 pregnant women who underwent routine NIPT in Beijing Haidian District Maternal and Child Health Care Hospital from October 2017 to December 2019. Plasma samples collected for the first-time routine NIPT were used to enrich cffDNA using modified magnetic beads for NIPT (modified NIPT). Wilcoxon rank sum test was used to compare the modified NIPT with the routine NIPT in detecting the cffDNA concentrations of male fetuses.Results:Among the 31 pregnant women, there were 13 cases with low cffDNA concentration in routine NIPT, 11 having false-positive results in the routine NIPT (three for trisomy 13, four for trisomy 18 and four for trisomy 21, all were confirmed by invasive prenatal diagnosis), six with gray-zone Z values in the first-time NIPT (retesting indicating low risk) and one having false negative result for trisomy 21 (confirmed by postnatal chromosome test). Cell-free DNA (cfDNA) fragments less than 150 bp were effectively enriched using the modified magnetic bead screening and the concentration of cffDNA was increased from 4.43% (2.45%-17.61%) in routine NIPT to 13.46% (7.75%-36.64%) in the modified NIPT ( Z=-14.22, P<0.01). Results of the modified NIPT indicated that 13 cases with low cffDNA concentration of routine NIPT were successfully detected as low risk, as well as the risks in the six cases with gray-zone Z value and six of the 11 false-positive cases in the routine NIPT were low, which were consistent with the retest results of the routine NIPT, while high risk was found in one false-negative case. Conclusions:The modified NIPT could reduce the false positive rate by lowering the failure rate caused by low concentration of cffDNA and is able to identify false-negative cases. Compared with the routine NIPT, it shows a higher success rate and a lower false positive rate.
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Objective To analyze the pathogenic characteristics and resistance of severe lung infection patients in Suining area, and to provide a reference for early clinical intervention. Methods A total of 359 patients with pulmonary infection were selected in Suining city from December 2019 to December 2020.The patients were divided into mild group (231 cases) and severe group (128 cases) according to the severity of nosocomial pneumonia.Sputum samples were collected for pathogen identification and drug sensitivity test. Multivariate logistic regression was used to analyze the influencing factors of severe pulmonary infection. Results There were 128 cases of severe pneumonia in 359 patients with traumatic brain injury. 147 strains of pathogenic bacteria were isolated, including 91 strains (61.90%) of gram-negative bacteria, mainly including 42 strains (28.57%) of Acinetobacter baumannii, 29 strains (19.73%) of Pseudomonas aeruginosa and 16 strains (10.88%) of Klebsiella pneumoniae. There were 37 gram-positive strains (25.17%), and 31 strains (21.09%) were staphylococcus aureus. A total of 19 strains of fungi (12.93%); Acinetobacter baumannii and Klebsiella pneumoniae were more sensitive to cefoperazone sodium sulbactam sodium and iaropenem, and more resistant to benzylbenzicillin, sulfamethoxazole/trimethoprazine and cefazolin. Pseudomonas aeruginosa had higher sensitivity to ceftazidine, piperacillin/tazobactam, and higher resistance to cefazolin sodium, ampicillin and other drugs. Staphylococcus aureus was highly sensitive to linezolid, vancomycin and teicoranin, and had high resistance to cefazolin and penicillin. There were statistically significant differences between the two groups in age, GCS score, combined basic diseases >2, coma time >24h, hypoproteinemia and invasive operation (P<0.05). Logistic regression analysis showed that GCS score, hypoproteinemia and invasive operation were independent risk factors for severe pulmonary infection in patients with traumatic brain injuries (P<0.05). Conclusion Suining patients with gram-negative bacteria, mainly Acinetobacter baumannii, Pseudomonas aeruginosa, aeruginosa, should be based on the pathogen susceptibility results of patients, for invasive operation, high GCS score should be positive treatment, and actively correct hypoproteinemia, can reduce the occurrence of severe lung infection.
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Objective:To investigate the characteristics of atelectasis and its relationship with the degree of diaphragm inhibition in elderly patients with artificial pneumoperitoneum under general anesthesia.Methods:Patients of both sexes, aged 20-80 yr, of American society of Anesthesiologists physical status Ⅰor Ⅱ, with body mass index of 20-29 kg/m 2, scheduled for elective laparoscopic cholecystectomy under general anesthesia, were divided into 2 groups ( n=20 each) according to age: young and middle-aged group and elderly group.Total intravenous anesthesia was applied and intraoperative pressure of artificial pneumoperitoneum was set at 10 mmHg.Before anesthesia, at 5 min of mechanical ventilation, at 5 min of artificial pneumoperitoneum, at 20 min of artificial pneumoperitoneum, at 5 min after the end of artificial pneumoperitoneum and at 15 min after extubation, diaphragmatic excursion (DE) was measured at the right diaphragm point using M-mode ultrasound.The minimal DE was recorded and the maximum degree of diaphragm inhibition was calculated.B-mode was used to assess the lung ultrasound images at the upper bedside lung ultrasound in emergency (BLUE) point, the lower BLUE point and the diaphragm point, and the cumulative scores before anesthesia and perioperative maximum cumulative scores of lung ultrasound score (LUS) were recorded. Results:Compared with the young and middle-aged group, the maximum cumulative scores of LUS were significantly increased, the degree of DE before anesthesia, the perioperative maximum degree of diaphragm inhibition were increased ( P<0.05), and no significant change was found in LUS cumulative scores in elderly group ( P>0.05). Conclusion:The degree of atelectasis is more serious in the elderly patients with artificial pneumoperitoneum under general anesthesia, and the mechamism may be related to the increased degree of diaphragm inhibition.
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Clinical practice teaching of anesthesiology and critical care medicine course belongs to the module of clinical anesthetic application in the anesthesia teaching system. The basic idea for establishing this course is the clinical anesthesiology practice teaching which combines with clinical critical cases in accordance with the classification of the disease systems, and bases on pathophysiological theories of various organs. Real clinical cases were collected during the practice teaching, and discussed via students-teaching method. Then we comprehensively utilized task-oriented teaching, case-based teaching and problem-based learning, guided students to complete comprehensive analysis of various organ diseases on the basis of team cooperation, and improved students' practical problem-solving ability for clinical critical diseases by asking questions after reading books and guidelines.
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Objective@#To screen for hotspot gene mutations associated with genetic deafness in Chinese pregnant women, and to perform risk assessment and prenatal diagnosis in high-risk families.@*Methods@#Between November 2012 and October 2017, 26 117 pregnant women were screened by molecular hybridization microarray for 9 hot-spot mutations in 4 hereditary deafness related genes (GJB2 c. 35 del G, c. 176_191 del 16 bp, c. 235 del G, c. 299_300 del AT, GJB3 c. 538 C>T, SLC26A4 c. 2168 A>G, IVS 7-2 A>G, mitochondrial DNA 12S rRNA m. 1494 C>T, m. 1555 A>G). Genotype analysis was carried out in husbands of women carrying mutations, and prenatal diagnosis was carried out in the fetuses with high risk of deafness.@*Results@#Among all women tested, 1 208(4.63%) were carriers of genetic deafness mutations, 7 with hearing impairment were affected by homozygous or compound heterozygous mutations, 51 were mitochondrial gene mutation carriers, 103 were carriers of GJB3 c. 538 C>T heterozygous mutation, 1 026 were carriers of GJB2 or SLC26A4 heterozygous mutations, and 21 carried heterozygous mutations in two genes simultaneously. In 394 families, the husbands accepted gene sequence testing, and 27 in which were determined as carriers of mutations in identical genes as their wives. Among which, 18 families received prenatal diagnosis, and 5 fetuses were diagnosed as hereditary deafness. In 9 families who did not receive prenatal diagnosis, 1 neonate was diagnosed as compound heterozygote after delivery.@*Conclusion@#In order to prevent birth defects with congenital hearing problems, it is effective to provide screening for hotspot mutations in pregnant women and to perform prenatal diagnosis on high risk pregnancies.
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Objective To study the relationship between the cognitive function and speech recognition ability in young patients with OSAHS.Methods We selected 60 young male patients,according to the apnea-hypopnea index(AHI)and the severity of hypoxemia.They were divided into three subgroups on the basis of their syndrome severities:mild group (n= 19;AHI 5~15/h,85%≤minimum SaO2≤90%),moderate group (n= 20;AHI>15~30/h,80%≤minimum SaO230/h,minimum SaO2<80%).First,we used the MoCA scale for cognitive function tests and recorded the scores.Then 15 lists of sentence Mandarin Speech Test Materials(MSTMs)were utilized to test each group.A data analysis was performed using SPSS 17.0 software. Results The total MoCA scores(mild group:27.32±1.16;moderate group:25.85±1.23;severe group:24.52± 1.69;control group:28.52 ±1.16)decreased progressively as the disease severity increased,showing significant differences between the control group and the mild,moderate and severe groups of OSAHS patients (allP<0.05). When sound stimuli were presented at 22,24,and 26 dB SPL,the speech recognition rates in the patients with se-vere(35.4±22.6,56.3±23.9,75.2±16.5)lower than the other groups (mild group:38.4±23.5,58.3±25.5,79.2 ±18.5;moderate group:38.8±21.6,58.7±22.7,78.5±16.7;control group:39.4±23.5,60.3±24.3,80.2±16.4, respectively,allP<0.05).The differences in intensity of 50% recognition rate between the severe group(4.15± 0.80)and the control(3.62±0.41),mild (3.66±0.50)and moderate groups(3.72±0.55)of OSAHS patients were statistically significant(allP<0.05).Conclusion With hypoxia and disease severity increased,speech recogni-tion abilities in OSAHS patients decreased.This may be an important factor associated with cognitive assessment scale score.
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Objective To compare clinical efficacy between the situ secondary spleen pedicle amputation in laparoscopic splenectomy and open splenectomy for traumatic spleen rupture.Methods From January 2013 to June 2015 a total of 70 patients with splenic rupture undergoing splenectomy were devided into laparoscopic surgery (35 cases) and open surgery (35 cases) group.Clinical data included total intraoperative blood loss,the time spent on splenic artery ligation,total operation time,postoperative drainage volume,postoperative hemoglobin,platelet and albumin levels,time of anal exsufflation,hospital stay and postoperative complications.Results The average operation time in the OS group was shorter than that in LS group (P ＜ 0.05).However,LS group was better than the OS group in splenic artery ligation time,postoperative drainage volume,anus aerofluxus time,postoperative platelet count,postoperative albumin recovery,hospital stay and postoperative complications (all P ＜ 0.05).Conclusions The laparoscopic splenectomy by the amputation of in situ secondary spleen pedicle for traumatic spleen rupture has the advantages of a rapid recovery and a low postoperative complication.
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Objective@#To evaluate the feasibility of modified test system for sound localization (SL) in children.@*Methods@#Modified system (6 male, 9 female) and traditional method ( 5 male, 5 female) were used for evaluation of minimum audible angle(MAA) and root-mean-square error(RMS) error of 4 to 6 years old children, and the results were compared to verify the accuracy and effectiveness of the modified test system for children sound localization.SPSS 17.0 software was used to analyze the data(t test).@*Results@#(1) Comparison of veracity of modified system and traditional test: when tested at the positive front position using modified system, MAA and RMS error were(3.23±1.00)° and (13.68±5.18)° respectively.When using traditional method, MAA and RMS error were(3.17±0.59)°and (13.96±4.56)° respectively. No statistical differences were found between two groups(t value was 0.16, -0.14, both P>0.05). (2) Comparison of time used were as followed: when using modified system, it was (14.67±1.95) min for MAA, and (6.67±1.35) min for RMS error. When using traditional method, it was (36.30±6.81) min for MAA, and (21.00±3.50) min for RMS error. Time used were significant shorter in modified system than in traditional method (t value was-9.78, -12.37, both P<0.05).@*Conclusion@#Modified test system for children sound localization is useful and reliable in children′s horizontal SL test.The time used of modified test system is shorter than that of traditional test system.
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Post-infectious bronchiolitis obliterans is a severe form of chronic obstructive lung disease in children that follows an insult to the lower respiratory tract infection. It′s associated with viruses,bacteria and mycoplasma pneumoniae infection. Persist wheezing,recurrent exacerbation and exercise intolerance are the main manifestations. Mosaic attenuation and air trapping can be seen in HRCT. Lung function test shows obstructive dysfunction. Its prognosis is bad. Early identification and management of severe post-infectious bronchiolitis obliterans can improve prognosis greatly.
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Objective To investigate the value of dual-exponential model intravoxel incoherent motion (IVIM) DWI and conventional single-exponential DWI model based on readout segmentation echo-planar (RS-EP) sequence in differential diagnosis of simple rhinitis and chronic hypertrophic rhinitis.Methods Totally,20 patients confirmed by pathology were enrolled in this study and all of them underwent IVIM DWI and conventional DWI.The pure diffusion (D),pseudo-diffusion (D*),perfusion fraction (f) and conventional ADC maps were obtained respectively.The quantitative parameters of anterior,middle,posterior regions of inferior nasal concha mucosa were measured.Comparative statistical analysis was performed for comparing two groups and three regions.ROC analysis was conducted to assess the diagnostic performance.Results The ADC and D values in the simple rhinitis group were (1 938.84 ± 170.46) × 10-6 mm2/s,and (1 698.91 ±145.17) × 10-6 mm2/s.In chronic hypertrophic rhinitis group,the ADC value was (1 681.76± 132.21) × 10-6 mm2/s,and the D value was (1 439.39 ± 101.26)× 10-6 mm2/s.There were significant differences between the two groups (both P＜0.05).No significant differences were found for D* and f values between two groups (both P＞0.05).ADC values increased significantly from anterior region,middle region to posterior region (all P＜0.05).No significant difference was found for D* value among three regions (P＞0.05).ROC analysis demonstrated a higher area under the curve (AUC) for D value than ADC value (0.932±0.044 vs 0.896±0.058) with sensitivity,specificity,accuracy,positive and negative predictive values of 92.31％,93.75％,90.00％,93.75％,85.71％.Conclusion Based on RS-EP sequence,both IVIM DWI model and conventional single-exponential DWI model demonstrated great value in differential diagnosis of simple rhinitis and chronic hypertrophic rhinitis,and the IVIM-derived D value exhibited a higher diagnostic performance than the conventional ADC value.
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Objective To investigate the value of copy number variation analysis based on next-generation sequencing (NGS-CNVA) in the genetic analysis of missed abortion chorionic villi. Methods From August 2012 to May 2014, chorionic villi from 74 cases of missed abortion at 6-13 gestational weeks in Haidian Maternal and Child Health Hospital were collected and analyzed by karyotype analysis and NGS-CNVA. The results of the two methods were compared. Results (1) Karyotype analysis was carried out for the villi from the 74 missed abortion patients. Thirty cases were euploid, 26 cases were aneuploid, while 18 cases had structural abnormalities. The resolution of the karyotyping was 320 bands and the average report time was 22 days. (2) All of the 74 samples obtained NGS-CNVA results and the report time was 7-10 days. (3) The NGS-CNVA results of 56 cases were consistent with karyotype. Among them, 28 cases (28/56, 50%) had no copy number variants (CNV), and 19 cases (19/56, 34%)had CNV between 1 Mb and 10 Mb. 9 cases (9/56,16%) had CNV≥10 Mb found by NGS-CNVA, but not found by karyotyping. (4) According to the results of NGS-CNVA, karyotype were reviewed. The reviewed results found 7 cases with CNV<10 Mb and 3 cases with CNV≥10 Mb in 30 cases which got normal karyotype results at the first analysis. (5) Among the 18 cases of structural abnormalities, 6 cases were Robertsonian translocation. Sequencing technology could confirm the specific area of chromosome deletion/duplication in 8 cases, but could not locate them. Conclusions NGS-CNVA has lower failure rate, higher resolution, lower specimen requirement and shorter report time than karyotype analysis when used for the genetic analysis of missed chorionic villi . NGS-CNVA could be a useful genetic analysis method for the missed abortion villi.
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Objective To carry out a molecular screening of Chinese common deafness gene mutations in Chinese pregnant women group,so as to expatiate on the content,provide molecular epidemiological data,reduce the birth rate and provide a theoretical basis to the deaf children. Methods The molecular detection was done to the pregnant women underwent normal antenatal care in our hospital,using gene chips to screen the four com?mon deaf genes(GJB2,GJB3,SLC26A4 and mitochondrial 12S rRNA)in China;then,the newborn infants carrying mutations were treated with the hearing screening,using the methods of Otoacoustic Emissions(OAE)and Brainstem Auditory Evoked Potentials(BAEP),and the husbands of mutation carrying pregnant women were adopted molecular testing of the deaf susceptibility genes in order to investigate the correlation of the rate of pregnant women carrying the mutant genes and newborn infants deafness. Results Totally 2 067 cases of pregnant women were accepted to do the molecular screening,there were 110 cases of deafness mutations detected(5.320%),in which GJB2 gene(67 cases),GJB3 gene(6 cases), SLC26A4gene(33 cases),mitochondrial 12SrRNAgene(4 cases)mutation detection rates were 3.240%,0.290%,1.600%and 0.190%,respec?tively;especially:GJB2gene 235 del C,GJB2gene 299 del AT double mutant 1 case;GJB2gene 299 del AT,GJB3gene 538 C>T double mutant 1 case;GJB2 gene 235 del C,SLC26A4 gene IVS7?2 A>G double mutant 1 case. About 108 cases children newborn accepted to do the hearing screening,in which 3 cases had problems with the left ear,3 cases with the right ear,and 4 cases with the double ears. Conclusion The use of ge?netic deafness gene chip to do the molecular diagnostics in pregnant women can be convenient,fast and efficient for prenatal diagnosis of deafness, which provides a theoretical basis and good method for reducing the birth rate of deaf children and should be popularized more widely.
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<p><b>OBJECTIVE</b>To apply single nucleotide polymorphism (SNP) microarray for delineation of small supernumerary marker chromosome (sSMC) in two newborns.</p><p><b>METHOD</b>Chromosome karyotyping was performed on newborns who were born in Jan. 2013 and Jan. 2014 in Haidian Maternal and Child Health Hospital because of the abnormalities found in pregnancy checkups. SNP microarray analysis was carried out on 2 newborns with de novo sSMCs (one was mos 47,XY, + mar[45]/46,XY[5] and the other was mos 47, XY, + mar [30]/46, XY [20]), which could not be determined by conventional banding techniques. Genomic DNA was extracted from cord blood samples, amplified, tagged and hybridized following the manufacturer' s protocol. Data were collected and analyzed.</p><p><b>RESULT</b>There was a 78. 6 Mb duplication in chromosome 8 for Newborn A, which was associated with 8p22 duplication syndrome; and a 32. 7 Mb duplication in chromosome 13 for Newborn B, which was not yet reported definitely as pathogenic. The newborn A was identified with agenesis of the corpus callosum, obvious right eyelid drooping, the onset of low muscle tone and mental developmental lag behind their peers, while the newborn B had normal findings on physical and mental evaluation.</p><p><b>CONCLUSION</b>SNP-array can identify sSMCs of newborns at the DNA level, and can be used as an important supplement to the conventional karyotype analysis, but the pathogenicity of positive outputs need further verification.</p>
Asunto(s)
Humanos , Recién Nacido , Duplicación Cromosómica , Cromosomas Humanos Par 8 , Marcadores Genéticos , Hibridación Fluorescente in Situ , Cariotipificación , Análisis de Secuencia por Matrices de Oligonucleótidos , Polimorfismo de Nucleótido SimpleRESUMEN
Objective The aim of this study was to compare the basic characters of the speech - evoked audi‐tory brainstem response (speech - ABR) in healthy young women with that in post - menopause women and to get the changes of the probable factors for the auditory brainstem pathway encoding of speech sounds in healthy post -menopause women .Methods Speech - ABR of forty - seven normal hearing subjects including twenty - seven young women and twenty post - menopause women were recorded .The speech syllable /da/ as stimulus sound was trans‐mited to right ear by the insert earphones in speech - ABR test .Results The response waves of speech - ABR in post - menopause women were similar to those in young women ,which containal the onset responses (peak V and A) ,the transition (peak C) ,the frequency following responses (peak D ,E and F) and the offset response (peak O) .Except wave C ,the latency of wave V (6 .99 ± 0 .34ms) ,wave A (8 .32 ± 0 .49 ms) and wave O (48 .86 ± 0 .50 ms) in post - menopause women were evidently longer than those of in young women (the waveV :6 .60 ± 0 .25 ms ,wave A :7 .56 ± 0 .31 ms and wave O :47 .88 ± 0 .31 ms) ,while the amplitude of wave A ( - 0 .16 ± 0 .06 μV ) and O ( - 0 .12 ± 0 .06 μV ) in post - menopause women were obviously lower (modulus) than those of in young women (the wave A : - 0 .27 ± 0 .08 μV and O : - 0 .18 ± 0 .07 μV)(P< 0 .05) .In the FFR of speech - ABR ,the latency of wave D (23 .27 ± 0 .67 ms) ,wave E (31 .88 ± 0 .58 ms) and F (40 .61 ± 1 .22 ms) in post - menopause women were also longer than those of in young women (the wave D :22 .40 ± 0 .44 ms ,wave E :31 .00 ± 0 .43 ms and F :39 .53 ± 0 .61 ms) .Besides ,the amplitudes of wave D ( - 0 .12 ± 0 .04 μV ) and F ( - 0 .08 ± 0 .06 μV ) in post -menopause women were visibly lower (modulus) than those of in young women (the wave D : - 0 .17 ± 0 .08 μV and F : - 0 .16 ± 0 .07 μV)(P< 0 .05) . ④ The V /A slope also showed very significant difference ,the V/A slope in young women was much bigger than that in post - menopause women (P< 0 .05) .Conclusion The synchronism and phase locking of auditory brainstem pathway to processing and encoding capability in healthy post - menopause women is poorer than those of in young women .It may suggest that the growth of the age and the decrease of hor‐mone will weaken the ability to processing of speech sounds in women .
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Objective To explore whether the changes of sound source in the horizontal azimuth can induce mismatch negativity (MMN) ,and quantify the minimal audible angle which could elicit the MMN and to find effec‐tive way to test human's ability of sound localization in the horizontal plane .Methods With the self developed sound localization device and Bio - logic auditory evoked potentiometer ,in the free field hearing tests were performed on 30 healthy young volunteers according to oddball stimulation sequence .We adopted 1 000 Hz pure tone as the stand‐ard stimuli , the change of sound source location as experimental models ,using minimum audible angle (MAA ) measure procedure ,sound localization test was conducted at 0° ,± 45° ,± 90°standard positions in the horizontal plane .MMN was obtained by subtracting the ERP of deviant stimuli from the ERP of standard stimuli .The latency and amplitude of each MMN were recorded .Results The MMAs of normal young people were recorded and normal values of latency and amplitude of MMN were obtained .The results of the sound localization test for the youth were :MAA(0°)= 2 .09 ± 1 .81° ,MAA( - 45°)= 3 .84 ± 1 .61° ,MAA (45°) = 3 .69 ± 2 .39° ,MAA ( - 90°) = 4 .41 ± 1 . 41° ,MAA(90°)= 4 .23 ± 3 .22° ,separately .There was a significant effect of the location of the deviant stimulus , with those presented at 90° eliciting larger peaks and longer latency period than those presented at 0° .Conclusion Our findings suggest that changes of sound position in the horizontal azimuth can induce mismatch negative waves , and MMN on the basis of MAA test procedure could be used to evaluate the ability of sound localization .
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Objective To investigate the correlation between the degree of pathogenetic condition and cogni-tive impairment in young OSAHS patients. Methods Sixty-three patients (18～44 years old) were divided into 3 groups according to the assessment criteria regarding the degrees of pathogenetic conditions of hypoxemia and its persistence time: mild group(the lowest SaO2 ≥ 85 %, n = 20 ), moderate group (the lowest SaO2 : 65 ～ 84 %, n =24), and severe group (the lowest SAO2<65%, n= 19). Twenty-five healthy young adults were selected as the control group. All the subjects were tested with event-related potential, namely P300, the polysomnogram and the mini-mental state examination scale(MMSE). Results P300 latency in patients of three OSAHS groups was sig-nificantly prolonged as 326.1±12.7, 346.9±19.1, and 34.9±18.3 ms, as compared with those of control group: 311.9±18.3 ms (P< 0.05, respectively). In severe group, P300 latency was markedly increased compared with mild and moderate groups(P<0.01, P<0.05, respectively). No obvious differences were observed between mild and moderate groups(P=0. 095). The difference of hypoxemia lasting time could influence the P300 latency, such as when the hypoxemia lasting time was 4～60 seconds, the latency was 338. 12±13.7 ms, and when the hypoxemia lasting time increased to 60 ～ 140 s, the latency was prolonged to 354.74±16.7 ms(P = 0. 031 ). There was no difference among all groups in the P300 amplitudes. The MMSE scores for all patients were within normal limits andthere were differences between serve and control group(RA -RB=9. 91, P= 0. 003). Conclusion Among patients with OS-AHS, the impairment of cognitive function is con'anon. The degrees of pathogenetic conditions of hypoxemia and its lasting time may be used to evaluate the impairment degree of cognitive function in patients with OSAHS.
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Objective To investigate the effects on anti-expression of Osteopontin (OPN) by an antisense oligodeoxynucleotide (ASODN) targeting to low free energy region of OPN mRNA and its effects on the proliferation and apoptosis of human breast carcinoma cell line MCF-7. Methods Designing and synthesizing an ASODN based on minimum free energy algorithm in vitro,which targets to the low free energy region of OPN mRNA. Transfecting it into breast carcinoma cell line MCF-7 which expresses OPN in high level. The cell proliferation-inhibitory rate was determined by MTT method;The morphologic change was observed through transmission electron microscope (TEM);The OPN mRNA expression level was checked by RT-PCR method;Cell cycle and apoptosis rate were detected by flow cytometry (FCM) after transfection respectively. Results OPN ASODN inhibited the proliferation of the cells by a time and concentration dependent manner (P
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Objective To improve the precision of the traditional segmentation of echocardiogram, by suppressing the influence from inherent speckle noises in medical ultrasonic images. Method An automatic segmentation method based on reconstructed morphology was proposed in this paper. First, the opening and closing operations by reconstruction were imposed to the ultrasonic image. Second, the top-hat operation was used to extract the bright and/or dark features and to find out the boundaries corresponding to these features, whereby implemented the automatic segmentation. Result The segmented echocardiogram had less artificial boundaries resulted from speckle noise, and could accurately be extracted the artery and ventricle. Conclusion The presented method can detect both dark and bright objects accurately, and the boundary has a fine continuity. In addition, the algorithm is also applicable to the extraction of sole bright/dark features, accordingly to reduce the complexity and time needed and to improve the accuracy.
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Objective To investigate the hemodynamic and rheological effects of acute hypovolemic hemodilution with 6% hydroxyethyl starch (HES) at different infusion rates. Methods 20 ASA Ⅰ adult patients undergoing elective surgery were randomized to one of two groups with 10 patients each. The patients were premedicated with intramuscular midazolam 0.06 mg/kg and atropine 0.01 mg/kg 30 min before anesthesia. Before anesthesia an intravenous line was established and lacted ringer solution was infused at a rate of 5 ml. kg-1. h-1 . Anesthesia was induced with midazolam 0.2mg/kg , fentanyl 5μg/kg and vecuronium 0. lmg/kg and maintained with inhalation of 50 % N2O and 1% isoflurane. After tracheal intubation the patients were mechanically ventilated and PET CO2 was maintainted between 4.6-6.0 kPa.Swan-Ganz catheter was inserted via right internal jugular vein. The dorsalis pedis artery was cannulated for direct measurement of arterial pressure. 6% HES infusion rates were 10 ml.kg-1.h-1 in group Ⅰ and 20ml.kg-1 .h-1 in group Ⅱ respectively. ECG, heart rate (HR), arterial blood pressure (SBP, DBP and MAP), CO, CL, CVP, PAP, PCWP, SpO2, PET CO2 and inhalation concentrations of N2O and isoflurane were monitored before and 30, and 60 min after infusion was started. Arterial and venous blood samples were taken for blood gas analysis and rheological studies. Results The two groups were comparable with respect to demographic data. During HES infusion HR decreased and CL increased in both groups and there was no significant difference between the two groups. BP increased slightly at 60 min in group Ⅰ , whereas in group Ⅱ it tended to decrease. CVP, PAP and PCWP increased significantly in both groups especially at 60 min. Hct decreased from 36.2% ±4.5% to 30.4% ±4.1% in group Ⅰ and from 39.6%±8.0 % to 30.8% ± 5.9 % in group Ⅱ at 60 min. Hb and K value of erythrocyte sedimentation rate (ESR) equation decreased significantly in both groups especially at 60 min. Conclusions Intravascular volume expansion ismore efficient with increased infusion rate of HES but the influences on hemodynamics would be more significant. HES infused at 20 ml. kg-1 . h -1 is safe in healthy patient during operation with blood loss.[Key Words] Hemodilution; Hydroxyethyl starch; Hemodynamics; Hemorheology
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This study was concerned about comparing the degree and process of cardiopulmonary effect of propofol and midazolam. Forty-five adult patients,ASA grade Ⅱ, scheduled for elective operation, were randomly allocated to intravenously receiving midazolam 0.28mg?kg~(-1)(group Ⅰ,n=16), 0.40mg?kg~(-1) (group Ⅱ,n=16) ,or propofol 2.5mg?kg~(-1) (group Ⅲ,n=13) ,respectively. MAP ,HR, SpO_2 ,TV ,MV ,RR and P_(ET)CO_2 were monitored continuously before and in 30 minutes following the administration ,and the arterial blood gas analysises were performed before and 1,2,3,4,5,10,15,20 and 30 minutes after the administration. The results showed that in group Ⅰ, Ⅱ and Ⅲ after the administration separately,the maximal decrease of MAP were 20.0% ,22.8% and 22.20%, and occured in 10.8, 9.3 and 3.5 minutes;HR decreased maximally by 6.3% ,8.7% and 15.5%,TV by 76.6% ,81.3% and 91.3%/00 ,MV by 87.2%,91.6% and 93.6%,RR by 60.3%,67.5% and 83.6%; the incidences and durations of apnea were 37.5%vs 57.5 seconds,31.3%vs 68. O seconds and 76.9%vs 73.0 seconds. The MV recovered to the baseline 5 minutes in group Ⅲ and more than 10 minutes in group Ⅰ and Ⅱ following the administration. The arterial blood pH reduced and PaCO_2 increased significantly in three groups (P