A retrospective analysis of intravenous deep sedation for uncooperative pediatric patients undergoing oral treatment in outpatient clinic / 中华麻醉学杂志

To retrospectively analyze the efficacy of intravenous deep sedation for uncooperative pediatric patients undergoing oral treatment in outpatient clinic.The uncooperative pediatric patients, aged 2-10 yr, with an expected treatment time<2 h, who underwent oral treatment in outpatient clinic from November 2015 to October 2018, were selected.Dexmedetomidine was delivered via nasal spray, midazolam was taken orally or delivered via nasal spray, and sevoflurane was inhaled for sedation before treatment.Propofol was administered by target-controlled infusion during treatment to make patients achieve deep sedation.A total of 251 patients were enrolled and successfully completed oral therapy.Sedation before treatment: 154 cases (61.4%) received dexmedetomidine via nasal spray delivery, 14 cases (5.6%) received oral midazolam, 3 cases (1.2%) received midazolam via nasal spray delivery, and 80 cases (31.9%) inhaled sevoflurane, and ideal sedation (Ramsay sedation score ≥4) was achieved in each pediatric patients.Temporary interruption of oral treatment due to physical activity occurred in 39 cases (15.5%), coughing occurred in 39 cases (15.5%), transient hypoxemia (time< 30 s) was found in 32 cases (12.9%), and these conditions returned to normal within 30 s through pausing the operation, deepening anesthesia, oral suction, lower jaw thrust or inhaling oxygen, etc.Only 1 case developed emergence agitation (Riker sedation-agitation scale score 5) during stay in the recovery room.No patients developed complications such as sore throat, vomiting, aspiration or obstruction of the upper respiratory tract.Intravenous deep sedation technique can be used for oral treatment in outpatient clinic in uncooperative pediatric outpatients and raise comfort of medical treatment for pediatric patients.

A retrospective analysis of intravenous deep sedation for uncooperative pediatric patients undergoing oral treatment in outpatient clinic / 中华麻醉学杂志

To retrospectively analyze the efficacy of intravenous deep sedation for uncooperative pe-diatric patients undergoing oral treatment in outpatient clinic.The uncooperative pediatric patients,aged 2-10 yr,with an expected treatment time＜2 h,who underwent oral treatment in outpatient clinic from No-vember 2015 to October 2018,were selected.Dexmedetomidine was delivered via nasal spray,midazolam was taken orally or delivered via nasal spray,and sevoflurane was inhaled for sedation before treatment.Propofol was administered by target-controlled infusion during treatment to make patients achieve deep seda-tion.A total of 251 patients were enrolled and successfully completed oral therapy.Sedation before treat-ment: 154 cases(61.4％)received dexmedetomidine via nasal spray delivery,14 cases(5.6％)received oral midazolam,3 cases(1.2％)received midazolam via nasal spray delivery,and 80 cases(31.9％)in-haled sevoflurane,and ideal sedation(Ramsay sedation score≥4)was achieved in each pediatric patients.Temporary interruption of oral treatment due to physical activity occurred in 39 cases(15.5％),coughing occurred in 39 cases(15.5％),transient hypoxemia(time＜ 30 s)was found in 32 cases(12.9％),and these conditions returned to normal within 30 s through pausing the operation,deepening anesthesia,oral suction,lower jaw thrust or inhaling oxygen,etc.Only 1 case developed emergence agitation(Riker seda-tion-agitation scale score 5)during stay in the recovery room.No patients developed complications such as sore throat,vomiting,aspiration or obstruction of the upper respiratory tract.Intravenous deep sedation technique can be used for oral treatment in outpatient clinic in uncooperative pediatric outpatients and raise comfort of medical treatment for pediatric patients.

Therapeutic effect of intravenous drip of MTG combined comprehensive rehabilitation on patients with stroke hemiplegia and its impact on neurologic impairment score／ / 心血管康复医学杂志

To discuss therapeutic effect of intravenous drip of monosialic tetrahexose ganglioside (MTG) combined comprehensive rehabilitation on patients with stroke hemiplegia and its impact on neurologic impairment score (NIS).Methods : A total of 100 patients with stroke hemiplegia treated in our hospital were randomly and e‐qually divided into routine treatment group (received routine comprehensive training treatment including work ther‐apy ,exercise therapy etc .) and combined treatment group (received intravenous drip of MTG based on routine treatment group) ,both groups were continuously treated for four weeks .Limb and neurologic function ,and im‐provement of quality of life (QOL) were compared between two groups .Results : Oneight weeks after treatment , total effective rate of limb function in combined treatment group was significantly higher than that of routine treat‐ment group (94. 0% vs.76. 0%, P＝0.030) ;after one ,four and eight‐week treatment ,along with time went on , there was significant rise in Glasgow coma scale (GCS) score in two groups ,and those of combined treatment group were significantly higher than those of routine treatment group [one week :(8. 56 ± 2. 47) scores vs .(7.24 ± 2.01) scores ,four weeks :(11.26 ± 2.81) scores vs .(9.23 ± 2. 01) scores ,eight weeks :(13.28 ± 3.43) scores vs .(11. 43 ± 2.65) scores] , P＜0. 01 all ;compared with before treatment ,there were significant rise in each dimension score of QOL in two groups after eight‐week treatment ,and each dimension score of combined treatment group was sig‐nificantly higher than that of routine treatment group , P＝0. 001 all.Conclusion : Intravenous drip of MTG com‐bined comprehensive rehabilitation possesses significant therapeutic effect on patients with stroke hemiplegia .It can significantly improve limb and neurologic function state ,improve quality of life in these patients .

The effects of nicardipine induced controlled hypotension in patients underwent orthognathic surgery: A systematic review and meta-analysis / 实用口腔医学杂志

Objective:To evaluate the clinical effects of nicardipine for induced controlled hypotension in patients underwent orthognathic surgery.Methods:The related trails were searched from English and Chinese literature databases.The quality of the RCTs was evaluated by 2 indepandent reviewers.The data were statistical analyzed using the Rev Man 5.3.3 software.Results:5 RCTs with 248 patients were included.Meta-analysis and descriptive analysis indicated that blood loss of nicardipine group was more than that of remifentanil group [WMD =43.85,95％ CI(20.52,67.18)].There was no significant difference in blood loss between nicardipine group and dexmedetomidine group and nitroglycerin group.There was no significant difference in transfusion between nicardipine group and the control group.Nicardipine increased the heart rate during controlled hypotension and caused QT prolongation (P ＜ 0.001).Nicardipine had no adverse effects on cerebral oxygen saturation and neurophysiological function.Urinary N-acetyl-1-b-D-glucosaminidase was lower in nicardipine group than that in remifentanil group (P ＜ 0.05).Conclusion:Nicaridpine is effective in the induced controlled hypotension during orthognathic surgery,with potential renal protective effect.However,it is not better than the remifentanil on reducing the blood loss.Nicardipine can increase the heart rate and prolong the QT interval during the controlled hypotension.

Application study on supervision system of hospital-university collaboration in class teaching of nursing undergraduates / 中国实用护理杂志

Objective To evaluate the application effect of supervision system of hospital-university collaboration on class teaching of nursing undergraduates,so as to provide reference to promote the link-up between nursing theory and clinical practices.Methods The supervision group of hospital-university collaboration were formed by selecting 30 excellent clinical instructors from university-affiliated hospitals and 12 nursing teachers,they listened to the teachers in classes randomly and recorded,simultaneously filled in rating forms about the class with students.Supervision meetings were held and targeted strategies were put down regularly,their effects were evaluated through interview and investigation methods.Results Professional teachers accepted their suggestions and took some actions to make a change.The results of rating forms showed that the quality of classroom teaching were improved gradually.Conclusions The supervision system of hospital-university collaboration can enhance the sense of responsibility of teaching,contribute to the integration between the hospital and university.It should be continued as a long-run system.

Clinical analysis of comprehensive interventional therapy in treatment of lower extremity deep venous thrombosis / 中国基层医药

Objective To study the treatment efficacy and safety of transjugular filter implantation combined with dorsal venous pressure thrombolysis in the treatment of lower extremity deep venous thrombosis.Methods According to the random digital methods,80 patients with lower extremity venous thrombosis were divided into 2 groups,40 cases in each group.The observation group was given jugular vein filter implantation combined with dorsal venous pressured thrombolysis guided by the radiologic intervention,and control group was individually given the dorsal vein of foot pressure thrombolytic therapy.After treatment,the clinical effect was compared between the two group.Results The application of urokinase aggregates and thrombolysis time in the observation group were significantly lower than those in control group,thigh and calf circumferences reduced length before and after thrombolytic therapy in the observation group increased significantly than those in the control group(t =1.35,5.42,1.83,0.89,all P ＜ 0.05).The total effective rate of the control group was 60％,which was significantly lower than that of the observation group 85％ (x2 =3.85,P ＜0.05).The incidence rate of complication in the control group was 32.50％,that in the observation group was 30％,there was no statistically significant difference between the two groups(x2 =0.67,P ＞ 0.05).Conclusion Transjugular filter implantation combined with dorsal venous pressure thrombolysis in the treatment of lower extremity venous thrombosis has better efficacy and safety.

A study of intratumor microvessel density and lymph node micrometastases of pN0 supraglottic laryngeal squamous cell carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the correlation between intratumor microvessel density(IMVD) and lymph node micrometastases.@*METHOD@#IMVD and lymph node micrometastases were stained with CD105 and CK19 antibody by immunohistochemical method of SABC respectively.@*RESULT@#IMVD marked with CD105 antibody correlated with T stage and lymph node micrometastases (P < 0.01).@*CONCLUSION@#The result show that IMVD marked with CD105 antibody highly correlated with lymph node micrometastases. It could be a index to evaluate the prognosis of patients with pN0 supraglottic laryngeal squamous cell carcinoma.

A study of intratumor microvessel density and lymph node micrometastasesof pN0 supraglottic laryngeal squamous cell carcinoma / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the correlation between intratumor microvessel density (IMVD) and lymph node micrometastases. Method: IMVD and lymph node micrometastases were stained with CD105 and CK19 antibody by immunohistochemical method of SABC respectively. Result:IMVD marked with CD105 antibody corre-lated with T stage and lymph node micrometastases(P<0.01). Conclusion: The result show that IMVD marked with CD105 antibody highly correlated with lymph node micrometastases. It could be a index to evaluate the prog-nosis of patients with pN_0 supraglottic laryngeal squamous cell carcinoma.

Feasibility of 99Tcm-HL91 single photon emission computed tomography and CT imaging in detecting hypoxic brain tissue following hypertensive cerebral hemorrhage / 中国组织工程研究

BACKGROUND: The presence of ischemic penumbra in hypertensive cerebral hemorrhage is the hot spot and still controversial. The value of 4,9-diaza-2, 3, 10, 10-tetramethydodecan-2, 11-dione dioxime (HL91) tagged with 99Tcm on detecting the hypoxic brain tissue surrounding the hypertensive cerebral hemorrhage nidus, which represents the penumbra is still waited for confirmation.OBJECTIVE: To investigate the value of 99Tcm-HL91 single photon emission computed tomography (SPECT)/CT imaging on detecting hypoxic tissue in the patients with hypertensive cerebral hemorrhage.DESIGN: Control study.SETTING: Department of Neurology, Jiangmen Municipal Central Hospital, Guangdong Province.PARTICIPANTS: This series included 22 patients with hypertensive cerebral hemorrhage examined between March 2004 and March 2005 in Jiangmen Municipal Central Hospital. All cases revealed sudden onset of the disease, presented with the history of hypertension. These patients were diagnosed with hypertension after admission. The hemorrhage occurred in the anterior circulation territory in all cases and the volume of hemorrhage ranged from 10 mL to 63 mL. Minimally invasive stereotaxic aspiration was performed in 3 cases, craniotomy debridement in 1 case, and expectant treatment in the remaining cases. The period of time from the symptom onset to the examination was form 12 hours to 1.5 years, including more than 1 month in 5 cases. Control group consisted of 6 cases were clinically diagnosed with melancholia and anxiety disorders. Cerebral hemorrhage and acute cerebral infarction were ruled out by integrated CT scan in these 6 cases.METHODS: All 22 patients with hypertensive cerebral hemorrhage and 6 normal controls underwent 99Tcm-HL91 SPECT imaging and combined with CT scan.MAIN OUTCOME MEASURES: ① Identification of radioactive concentrations at one side of the peripheral zone of the lesions by visual analysis on two consecutive slices at two different axial directions were considered aspositive hypoxic imaging. ② The other was ROI semi-quantification measuring radiocounting ratio (R) between the region of visible radioactive concentrations, the center of the nidus, and their contralateral mirror region. R ＜ 0.8 or R ＞ 1.2 was considered to be abnormal. ③ Hypoxic region was defined by integrated CT fused imaging, and its volume was calculated using Xelerix workstation. The volume of the hypoxic tissue and hemorrhage was computed by Duotian formula: length of the maximum cross-section of the hemorrhage × width × slice number × 1/2.RESULTS: All 28 patients were involved in the final analysis. ① Perihemorrhagic radioactive concentrations which represented positive hypoxic imaging was revealed on 99Tcm-HL91 SPECT imaging in 18 cases out of 22 patients with cerebral hemorrhage, and positive rate was 77.78%. Bilateral cerebral hemisphere showed symmetric negative imaging in 6 cases of the control group. ② The fused SPECT/CT images revealed hypoxic region was around the intracerebral hemorrhage, small portion was within the nidus of hemorrhage with irregular shape. R value was 1.75±0.10 in perihemorrhagic hypoxic region in 18 cases with positive imaging, and R value was 1.05±0.11 in the basal ganglia in the control group. There was statistically significant difference between the two groups (P ＜ 0.01). ③ There was a positive linear correlation between maximum volume of hematom and hypoxia volume (correlation coefficient: r=0.7517, P ＜ 0.01).CONCLUSION: Relying on the mechanism about demonstrating the hypoxic tissue on fused SPECT/CT imaging, the hypoxic tissue would represent the penumbra may exist in the territories located around the cerebral hemorrhage. The positive territories may be reversible, I.e. The important portion of the penumbra. 99Tcm-HL91 SPECT/CT imaging can detect the hypoxic tissue surrounding the cerebral hemorrhage. The volume of hypoxic tissue is correlated with the hemorrhagic volume. The procedure is promising and could be applied in clinic.

Polypeptide from Chlamys farreri prevents UVB-induced apoptosis in the HaCaT cells through death receptor pathway and mitochondrial pathway / 中国药理学通报

Aim To investigate whether the polypeptide from Chlamys farreri(PCF)protected HaCaT cells from UVB-induced apoptosis through Fas-caspase-3 and ROS-cytochrome C.Methods Experiment designs were divided into five groups:control group,UVB model group,UVB+5.69 mmol?L-1PCF group,UVB+2.84 mmol?L-1 PCF group,UVB+1.42 mmol?L-1 PCF group.SiRNA for Fas inhibited Fas expression of UVB-induced HaCaT cells.Using agarose gel electrophoresis,the effects of Fas siRNA and ROS scavenger NAC on UVB-induced apoptosis of HaCaT cells were investigated.Expression levels of cytochrome C andcaspase-3 after inhibitory Fas were determined by Western blot analysis.Intracellular ROS was detected by means of an oxidation-sensitive fluorescent probe(DCFH-DA).Results SiRNA for Fas had inhibitory effects on UVB-induced apoptosis of HaCaT cells and caspase-3 expression.NAC had inhibitory effects on UVB-induced apoptosis of HaCaT cells.PCF inhibited UVB-induced generation of ROS and cytochrome C release dose-dependently.Conclusions PCF protected HaCaT cells from UVB-induced apoptosis.Its inhibitory effect on apoptosis could be attributed to inhibition of Fas-caspase-3 and ROS-cytochrome C pathways.