The Current Situation of Internet Addiction and Its Impact on Sleep Quality and Self-Injury Behavior in Chinese Medical Students

Objective@#The purpose of this cross-sectional survey is to explore the current state of Internet addiction (IA) in Chinese medical students and its connection with medical students’ sleep quality and self-injury behavior. @*Methods@#Respondents were came from Wannan Medical College, China. The Young’s Internet Addiction Test, Pittsburgh Sleep Quality Index (PSQI), Self-Harm Questionnaire were used in this cross-sectional survey. A total of 3,738 medical students were investigated, 1,552 (41.52%) males, 2,186 (58.48%) females. T-test, chi-square test and MANOVA were used for data analysis. @*Results@#Of the 3,738 medical students, 1,054 (28.2%) reported having IA, 1,126 (30.1%) reported having poor sleep quality, 563 (15.1%) having self-harm behaviors. IA tends to be more female, upper grade students. The sleep quality of IA was worse than that of non-IA (χ2=54.882, p<0.001), and the possibility of self-injury was higher than non-IA (χ2=107.990, p<0.001). @*Conclusion@#This survey shows that the IA detection rate of medical students was 28.2%. Females, higher grade students had a higher IA detection rate. The low sleep quality and self-injury behavior of medical students are associated with IA.

Effects of Modified Qianjin Weijing Decoction on TNF-α and NF-κB in Rats with Lung Injury Induced by Particulate Matter / 中国中医药信息杂志

Objective To investigate the protective effect of modified Qianjin Weijing Decoction(MQJWJD)on TNF-α and NF-κB in rats with lung injury induced by particulate matter; To discuss relevant mechanism of action. Methods A tracheal drip 15 mg/kg fine particles of saline solution was used to establish modeling, every other day, three times. Thirty-two Wistar rats were randomly divided into normal group, model group and MQJWJD high-dose and low-dose groups, with eight rats in each group. Medication groups were given relevant medicine for gavage. The level of TNF-α in bronchoalveolar lavage fluid (BALF) was measured by ELISA. The expression of NF-κB protein in lung tissues was measured by immunohistochemistry. The histopathology of the lung injury was observed by light microscope. Results Compared with normal group, the level of TNF-α and the expression of NF-κB protein in the model group were higher than those in the normal group (P<0.01). Compared with model group, the level of TNF-α and the expression of NF-κB protein in MQJWJD low-dose and high-dose groups were lower than those in the model group (P<0.05, P<0.01). Pathological observation showed that, compared with normal group, model group showed intratracheal, alveolar and interstitial bacteria within a large number of fine particles calm, alveolar and pulmonary interstitial visible large amounts of phagocytic fine particles of macrophages and accompanied by more neutrophils and lymphocyte infiltration; Lung tissue pathological changes were significantly lighter in MQJWJD high-dose and low-dose groups than the model group. MQJWJD high-dose group showed mild inflammation, alveolar and pulmonary interstitial visible phagocytic fine particles of macrophages, a small amount of neutrophils and lymphocyte infiltration. Conclusion MQJWJD can reduce the pulmonary injury in rats induced by particulate matter and has protective effects on the rat model through decreasing the levels of TNF-α and the expressions of NF-κB protein in injured lung tissues.

Relevant research of PD-1, PD-L1 protein expression and K-RAS gene mutations in lung adenocarcinoma / 临床与实验病理学杂志

Purpose To investigate the association of the PD-1 and PD-L1 protein expression with K-RAS gene mutations in lung adenocarcinoma.Methods The protein expression of PD-1 and PD-L1 was detected by immunohistochemical EnVision two-step staining,the K-RAS mutation was examined by realtime fluorescent quantitative PCR.Results The positive rate of PD-1 and PD-L1 was higher in lung adenocarcinoma than benign lung disease (P ＜ 0.01).There was no relationship between PD-1 and PD-L1 protein expression with the gender,age,smoking condition,differentiation,lymph node metastasis and TNM stages (P ＞ 0.05).The K-RAS gene mutations were detectable in 8 patients (22.2％) among 36 lung adenocarcinoma,there was no association between K-RAS gene mutation with the gender,age,smoking condition,differentiation,lymph node metastasis and TNM stages (P ＞ 0.05).The correction analysis showed that there was no relationship between PD-1 and PD-L1 protein expression with K-RAS mutation (P ＞ 0.05).Conclusion The positive rate of PD-1 and PD-L1 is higher in lung adenocarcinoma than benign lung disease,but there is no relationship among PD-1 and PD-L1 protein expression with its clinal pathological characteristics and K-RAS mutation in lung adenocarcinoma.

Effect of Trifolium pratense L. extracts on the bone resorption and osteogenic differentiation of osteoclasts and the underlying mechanisms / 中国组织工程研究

BACKGROUND: Isoflavone isolated from Trifolium pratense L. has been found to be able to effectively inhibit bone resorption, reduce bone turnover rate, improve osteocyte activity and bone mineral density by enhancing the effect of estrogen, which is helpful for the prevention and treatment of osteoporosis. OBJECTIVE: To investigate the effect of Trifolium pratense L. extracts on the bone resorption and differentiation of osteoclasts.METHODS: Rat bone marrow cells were extracted, isolated by lymphocyte separation and cultured for 5 hours; then, the non-adherent cells were selected followed by induced by 30 μg/L macrophage colony stimulating factor and 75 μg/L RANKL (control groups), or different concentrations of Trifolium pratense L. extracts (0.3, 0.6 and 1.2 g/L) to observe their effect on the osteoclast differentiation and bone resorption. The levels of osteoclast differentiation-associated proteins c-fos and NFATcl were determined by western blot assay. RESULTS AND CONCLUSION: Compared with the control group, different concentrations of Trifolium pratense L. extracts could suppress osteoclast differentiation and bone resorption to different degrees. Tartrate-resistant acid phosphatase staining showed that Trifolium pratense L. extracts could significantly reduce the number of osteoclasts. Western blot assay results suggest that Trifolium pratense L. extracts significantly inhibited the expression levels of c-fos and NFATcl. These results reveal that Trifolium pratense L. extracts can inhibit osteoclast differentiation and bone resorption.

Exploration of homogeneous quality management among trans-regional medical unions / 中华医院管理杂志

This paper presents some ideas and practices to realize the homogeneity quality management process within the Beijing Children Hospital Group,the largest specialized medical group in the country.This research aims at providing references and thoughts on homogeneity quality management for trans-regional medical unions in the country.

Lethal coronary air embolism caused by the removal of a double-lumen hemodialysis catheter: a case report / 대한마취과학회지

Coronary air embolism is a rare event. We report a case in which an acute myocardial infarction occurred in the region supplied by the right coronary artery after the removal of a double-lumen hemodialysis catheter. Emergent coronary angiography revealed air bubbles obstructing the mid-segment of the right coronary artery with slow flow phenomenon distally. The patient expired due to myocardial infarction.

Unilateral vocal cord paralysis following a short period of endotracheal intubation anesthesia / 대한마취과학회지

No abstract available.

Intrusive luxation of tooth due to bite block after oral endotracheal intubation / 대한마취과학회지

No abstract available.

Experimental study of portal hemodynamics after microcapsule transplantation by intraportal and transarterial approach / 中南大学学报(医学版)

OBJECTIVE@#To compare the changes of portal hemodynamics after microcapsule transplantation by intraportal and transarterial approach with color doppler sonography.@*METHODS@#Thirty male dogs were divided into 2 groups randomly: Group PV (microcapsules implanted into the portal vein) and Group HA (microcapsules implanted into the hepatic artery). Both groups were divided into 3 subgroups(PV1, PV2, and PV3; HA1, HA2, and HA3) according to the number of implanted microcapsules (8,000/kg, 16,000/kg, and 32,000/kg). The internal diameter and flow velocity of the portal vein were measured with color doppler sonography before the transplantation,within 24 hours and 1, 2, and 4 weeks after microcapsule transplantation.@*RESULTS@#The flow velocity of the portal vein in Group PV1 and PV2 within 24 hours increased significantly (P 0.05). The flow velocity of the portal vein in Group PV3 within 24 hours decreased significantly (P 0.05). The level of ALT in Group PV and Group HA all increased significantly (P<0.05). And when the numbers of microcapsule transplantation were same, the level of ALT in subgroup PV were significantly higher than that in subgroup HA (P<0.05).@*CONCLUSION@#Microcapsule transplantation by transarterial approach is safer than by intraportal way, and the hepatic artery can contain more microcapsule than the portal vein.

Molecular characterization of 71 cases of glucose-6-phosphate dehydrogenase deficiency in Hainan province / 中华血液学杂志

<p><b>OBJECTIVE</b>To molecularly analyze in Han and Li individuals of glucose-6-phosphate dehydrogenase deficiency in Hainan, China.</p><p><b>METHODS</b>The amplification refractory mutation system (ARMS) was employed to detect G1376T, G1388A and A95G mutations. The coding regions and flanking intronic regions from the second to the thirteenth exons of G6PD gene was analyzed by DNA sequencing to characterize the gene mutations in samples without G1376T, G1388A and A95G mutations.</p><p><b>RESULTS</b>Among 29 Han cases of G6PD deficiency, 11 had G1376T (37.9%), 2 G1388A (6.9%), 1 G1376T and G1388A (3.4%) and 1 G1376T and A95G (3.4%) were identified. Mutations of G1376T, G1388A, A95G and their complex accounted for 51.7% of G6PD deficiency in the Han individuals. Among 42 Li cases of G6PD deficiency, 25 had G1376T (59.5%), 6 G1388A (14.3%), 2 A95G (4.8%), 4 G1376T and G1388A (9.5%), 1 G1376T and A95G (2.4% )were identified. These mutations accounted for 90.5% of the Li individuals. Gene mutation of 18 cases (14 Han and 4 Li individuals) remained unknown. Sequencing results of the 18 samples indicated that one case had a single base of T deletion at nucleotide 636 or 637 in the 5th intron (IVS-5 636 or 637 T del) and two cases had C1311T with IVS-11 T93C mutation.</p><p><b>CONCLUSION</b>G6PD G1376T and G1388A are the most common mutations in the populations of the Han and Li nationalities in Hainan. The IVS-5 636 or 637 T del mutation is first reported in Chinese, and the complex mutation of G1376T/A95G is first found in the Li nationality.</p>

Influence of Height and Vertebral Length on Spinal Anesthesia with 0.5% Hyperbaric Bupivacaine / 대한마취과학회지

BACKGROUND: Many factors determine the distribution of local anesthestics in the subaracnoid space. Especially, patient's height is considered an important determinant of the dose of spinal anesthesia. However, the relationship between height and the level of analgesia has not been clearly documented. We studied the correlation between vertebral lengths measured from C7 to the level of the iliac crest (C7-IC), to the sacral hiatus (C7-SH) and to the coccyx (C7-CX) and the level of analgesia injected a fixed amount of local anesthetic in spinal anesthesia. METHODS: Fifty six healthy patients who consented to spinal anesthesia for elective operation were studied. All patient were administered 0.5% hyperbaric bupivacaine 11 mg in the lateral decubitus position on a horizontal operation table. Immediately after drug injection, the patients were turned to the supine horizontal position. For the first 30 minutes, we measured the level of analgesia to pinprick every two minutes. RESULTS: The average of maximum cephalad spread of analgesia was T7.0 1.6. There were weak correlations between patient's height or C7-IC and the level of analgesia. However a significant correlation existed between vertebral length measured from C7 to SH and the level of analgesia. CONCLUSIONS: It is concluded that vertebral length (C7-SH) provides a more meaningful approach to dose selection than height.

A Statistical Analysis of Postoperative Deaths in the Hospital / 대한구급학회지

Introduction: Anesthesia deaths are rare, while deaths due to surgical or other risk factors are more frequent. The goal of this analysis is to evaluate risk factors associated with postoperative mortality. METHODS: We have analyzed 34,200 surgical patients between 1990 and 1996 through records of anesthesia. The following informations were recorded; age of patients, physical status, site of operation, time of death, primary cause of death. RESULTS: The results are as follows; 1) Of 34,200 surgical patients, 119 died in the hospital. 2) The postoperative mortality rose progressively with age and was highest above 70 years. 3) Within 48 hours, the mortality was 36.1% of total deaths, declined progressively thereafter. The patients who had head operations exceeded 45% of deaths during this period. Eight days after the operation the mortality rate was 34.2% of total deaths and the patients who had an elective operation of the abdomen were 60.8%. 4) 34.2% patients of the total deaths had brain damages. Of these, 79.5% showed physical status V and had an emergency head operation and 47.5% were 50~60 years of age. 17.5% and 13.2% of deaths were due to sepsis and respiratory insufficiency and 48.6% of these two categories were physical status II, III and had an elective operation and 55.5% were above 60 years. CONCLUSION: The postoperative mortality was highest in the patients who had an emergency head operation and primary cause of death was brain damage. The patients of above 60 years, had a physical status II, III, had an elective abdominal operation were succeptable to sepsis and respiratory insufficieny.

Early Detection of Pulmonary Edema by Pulse Oximeter during Cesarean Section: Case report / 대한구급학회지

This case showed that pulse oximeter was helpful for early detection of pulmonary edema during Cesarean section in a parturient woman with preoperative ritodrine treatment. Though arterial oxygen saturation ( Sp02 ) by pulse oximeter was low before the induction of anesthesia, the woman was anesthetized due to emergency situation. SpO2 was continuously low during the operation, so pulmonary edema was suspected. After the operaton, pulmonary edema was diagnosed on the chest x-ray. On the ECG, anteroseptal wall ischemia was detected. Supplementary O2 and diuretics therapy were performed. On the 3rd postoperative day, arterial blood gas analysis was within normal range. Four days after the operation, ECG was normalized and chest x-ray finding was much improved. 10 days later, chest x-ray finding was normalized.

Effects of Augmented Minute Ventilation on Cardiovascular and Ventilatory Changes during the Laparoscopic Cholecystectomy under General Anesthesia / 대한마취과학회지

BACKGROUND: The pneumoperitoneum created by CO2 insufflation during laparoscopic cholecystectomy has several potential hemodynamic and respiratory consequences. The purpose of this study is to investigate the effects of augmented minute ventilation on cardiovascular and ventilatory changes and to prevent hypercarbia due to CO2 insufflation during laparoscopic cholecystectomy. METHODS: Thirty-six patients were divided into three groups according to the level of minute ventilation. The three groups were: control group C (minute ventilation 100 ml/kg, respiratory rate 12 per minute), group R (MV 150 ml/kg, RR is 18 per minute) and group V (MV 150 ml/kg, tidal volume is 1.5 times as much as group C). We repeatedly measured mean arterial pressure , pulse rate , arterial blood gas analysis and end tidal carbon dioxide and peak inspiratory airway pressure before CO2 insufflation, 15 and 30 minutes after CO2 insufflation and 15 minutes after CO2 deflation. RESULTS: During CO2 insufflation, MAP significantly increased but PR showed little changes in all three groups. PaCO2 and PetCO2 increased in group C, whereas in group R and V, they remained unchanged during CO2 insufflation. But the level of PaCO2 in group V decreased more than in the other two groups after CO2 deflation,. PIP in group V increased 3 times as much as the control value. CONCLUSIONS: These results suggest that augmented minute ventilation in group R and V, prevented hypercarbia during CO2 insufflation and increasing the tidal volume in controlled ventilation was more effective than increasing respiratory rate after CO2 deflation.

Determination of Geniposide in Yigan Liangcha by RP-HPLC / 中药新药与临床药理

Objective :To establish a RP-HPLC method for the determination geniposide in Yigan Liangcha.Methods Luna C18 (4.6 mm?250 mm,5 ?m)was applied,the mobile phases consisted of acetonitrile-water(15∶85),the flow rate was 1.0 mL?min-1 and the detection wavelength at 238 nm.Results The average recovery of geniposide was 98.1 %and RSD were 0.42 %(n=5).There is a good linear relationship within the range of 10.12～50.60 ?g of geniposide.Conclusion The method is convenient,sensitive,accurate and reproducible and can be used the quality control of the Yigan Liangcha.

A Case of Hypoxic Encephalopathy Following Anesthesia for a Patient with Ludwig`s Angina / 대한마취과학회지

Ludwig's Angina is the term given to the symptoms resulting from infection of the submandibular space and is characterized especially by extreme edema of the floor of the mouth. Airway obstruction and respiratory difficulty is common due to edema of the mouth, tongue, and the glottis, from mediastinitis due to spread, or from septicemia or pneumonia. Thus it is necessary for the anesthetist to attend to specific management of airway maintenance. A 49 year old male had an operation for incision and drainage under balanced anesthesia. After the operation, posthypoxic myoclonus due to anoxia for three minutes appeared while in the recovery room. The patient, controlled by oxygen supply and diazepam and antiepileptics, has recovered from the seizures, but has not recovered from intention myoclonus and speech disturbance, which are slowly improving. This report describes this case of posthypoxic myoclonus following anesthesia and reviews the literatures.

The Effect of Regional Sympathetic Block in the Treatment of Herpes Zoster / 대한마취과학회지

We must be assured that sympathetic ganglion block interrupts a vicious cycle of nerve impulses. Therefore, it prevents vasospasm and improves local circulation. The sympathetic ganglion block is effective in acute stage of herpes zoster and reduces the incidence of post-herpetic neuralgia. Herpes zoster is more often involved in an immunosuppressive imbalance. Three cases of herpes zoster were treated by repeated sympathetic ganglion block with 1% proved. Duration from onset of pain was 1 week, 1 month and 2 months, respectively. The block decreased the degree of pain markedly and dried up the vesicle in the early stage. Two of these three cases had suffering from diabetes melitus.

A Case of Status Asthmaticus during Spinal Anesthesia for Cerarian Section of Chronic Asthma Patient / 대한마취과학회지

Asthma involves intermittent episodes of bronchospasm associated with wheezing and dyspnes and asymptomatic period. Many drugs and anesthetic agents can affect bronchomotor tone and asthmatic patients requiring anesthesia are at higher risk than nonasthmatics. The anesthetic management of the asthmatic patient continues to present a challenge to the clinical anesthesiologis, despite increased knowledge and better understanding of the pathogenesis of bronchial asthma and the availability of safer and more effective anesthetic agents and methods. We have experienced status asthmaticus during spinal anesthesia for Cesarian section of a chronic asthma patient. We report the case and review the relevant literature.

Residual Epidual and Subural Hematoma in the Occipital Area / 대한마취과학회지

In a 8 year-old boy who had epidural hematoma in the occipital area, had an episode of dislodgement of the endotracheal tube due to improper position. After operation, there were drowsy consciousness, irregular respiration, apnea, absence of cough reflex and swallowing reflex. Then these was no improvement in spite of treatment, and because of this hypoxic encephalopathy was diagnosed. WE suspected there might be some pathologic lesion volving the respiratory center and lower cranial nerves. CT scanning was performed and the result was diagnosed with epidural hematoma and subdural hematoma in the posterior fossa. The patient was reoperated.

Anesthetic Management for the Palient with Insuliaoma / 대한마취과학회지

Hyperinsullinism and the resultant hypoglycemia are hallmarks of functioning beta islet cell tumors of the pancreas. The management of one case of insulinoma during surgery for the removal of the tumor is described and the available literature on the subject reviewed. The outline of the anesthetic management for the insulinoma is as follows: 1) Anesthetists should understand the signs and the symptoms of hypoglycemia and hyperglycemia. 2) Preoprative management: a) infusion of glucose for avoiding hypoglycemia due to NPO after midnight. b) glucocorticosteroid administration with premedications. 3) Operative management: a) continuous determination of blood glucose level may be helpful. b) Maintenance of the glucose level about 50mg% above symptomatic CNS level have the advantage that exicision of the infulinoma can be immediately judged. c) The use of an agent that decreases CMRO2 and does not affect the insulin-glucose ratio is rational choice when concern about hypoglycemia exists. Thiopental-enflurane anesthesia with controlled ventilation maintaining normocarbia is recommended. d) beta-adrenergic blocker. These drugs must be avoided in the hypoglycemic state.