Impact of field triage on contact-to-device time in patients with ST-segment elevation acute ;myocardial infarction / 中国介入心脏病学杂志

Objective To determine whether field triage would reduce median contact-to-device ( C2D ) time in patients with ST-segment elevation acute myocardial infarction ( STEMI ) . Methods Consecutive patients with STEMI underwent primary percutaneous coronary intervention( PCI) from March 2010 to February 2014 in Shanghai Pudong Gongli Hospital were analyzed. Patients were divided into two groups. A total of 121 patients were admitted by field triage and 101 patients by non-field triage. The primary study point was C2D time and the study points secondary included ( door-to-balloor, D2B) time, peak Troponin I ( TnI) levels, hospital mortality and 30 days follow-up mortality. Results Baseline and procedural characteristics between the two groups were comparable. Comparing to non-field triage group, the C2D time was reduced [(92. 0 ± 56. 0)min vs. (131. 0 ± 61. 0)min,P﹤0. 01]. The D2B time was lower in the field triage group vs. the non-field triage group [(55. 0 ±26. 0)min vs. (96. 0 ±31. 0)min,P﹤0. 01]. The percentage of patients with C2D time less than 90 minutes increased significantly from 85. 1% to 98. 3%( P﹤0. 01 ) in the field triage group. Peak TnI level was significantly reduced in the field triage group [(23. 5 ±22. 0) μg/L vs. (43. 5 ± 39. 0) μg/L,P﹤0. 01]. In-hospital mortality and 30 days follow-up mortality did not significantly differ between the 2 groups (3. 3% and 3. 0%, P=0. 885;3. 3% and 5. 0%, P=0. 544, respectively). Conclusions In STEMI patients, field triage was associated with significantly reduced C2D and D2B times.

Efficacy and Safety Assessment for Treating Active Rheumatoid Arthritis Patients by Integrated Traditional Chinese and Western Medicine / 中国中医药信息杂志

Objective To evaluate the clinical efficacy and safety of integrated traditional Chinese and Western medicine in treating active rheumatoid arthritis (aRA).Methods A prospective randomized controlled study was carried out. Totally 148 aRA patients were divided into the control group and the treatment group, 74 cases in each group. Control group was treated with MTX (methotrexate) and LEF (leflunomide), while the treatment group took traditional Chinese medicine based on syndrome differentiation, on the basis of treatment with MTX and LEF. The therapeutic course for all was 3 months. Efficacy indexes, like clinical symptoms and signs, ESR, TCM syndrome integrals, DAS 28 score, and safety indexes were observed.Results This study finally completed 136 cases, including 69 cases in the treatment group and 67 cases in the control group. In the two groups, significant improvement of clinical signs and symptoms, ESR, DAS28, and TCM syndrome integrals after treatment were shown, with statistical significance (P0.05). The significant efficiency of the treatment group was 11.59% (8/69), and the control group was 5.97% (4/67), with statistical significance (P<0.05). Adverse reactions occurred fewer in the treatment group than in the control group (P<0.01).Conclusion Compared with single traditional Chinese medicine, integrated traditional Chinese and Western medicine for treating aRA can better improve DAS28 and TCM syndrome integrals, and reduce the incidence of adverse reactions.

The clinical observation of different sequences of intravenous administration on sufentanyl-induced cough / 中国基层医药

Objective To evaluate the effects of different sequences of intravenous administration on sufenta-nyl-induced cough during induction of general anesthesia.Methods One hundred patients,aged 20 ~60 years,weig-hing 45 ~82 kg,ASA Ⅰ or Ⅱ,scheduled for elective surgery under general anesthesia,were equally randomized to two groups by using a random number table:sufentanyl-propofol group(group SP)and propofol-sufentanyl group(group PS).In group SP,sufentanyl 0.4μg/kg was injected intravenously over 5s,and then propofol 2mg/kg was injected intravenously.In group PS,propofol 2mg/kg was injected intravenously,and then sufentanyl 0.4μg/kg was injected intravenously over 5s.The occurrence,intensity and the time of cough were recorded within 1 min after sufentanyl injection.Results The incidence of cough was 38%(19 /50)in group SP which was significantly higher than the 12%(6 /50)in group PS(χ2 =9.013,P 0.05).Conclusion Administration in the propofol-sufentanyl sequence can effectively reduce the occurrence of sufentanyl-induced cough as compared with that in the sufentanyl-propofol sequence during induction of general anesthesia.

Efficacy of laryngeal mask airway Supreme in elderly patients with hypertension / 中华麻醉学杂志

Objective To evaluate the efficacy of laryngeal mask airway (LMA) Supreme in the elderlypatients with hypertension.Methods Forty elderly patients with more than 1-year history of hypertension,aged65-75 yr,weighing 45-70 kg,with body mass index ＜ 35 kg/m2,were randomized into 2 groups (n=20 each):intratracheal intubation group (group T) and LMA Supreme group (group S).Anesthesia was induced with fenta-nyl,propofol and vecuronium.LMA Supreme was inserted in group S or intratracheal intubation was performed ingroup T for mechanical ventilation.Anesthesia was maintained with sevoflurane,propofol and vecuronium.Thesystolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR) and pulse oxygen saturation(SpO2) were recorded after entering the operating room (T0),at 0,1,2 and 5 min after LMA insertion or intuba-tion (T1-4),at skin incision (T5),and immediately after removal of LMA or extubation (T6).Venous blood samples were taken at T0-4,6 for determination of plasma epinephrine (AE),noradrenaline (NE) and dopamine (DA)concentrations.The insertion and removal responses,LMA insertion/intubation time and the number of inserting LMA/intubation were recorded.The lung compliance,airway peak pressure,airway sealing pressure and airway plateau pressure were detected after LMA insertion/intubation.The side effects occurred in the pharynx were recorded after removal of LMA or extubation.Results Compared with group T,the SBP,HR,insertion and removal responses,incidence of side effects and plasma AE,NE and DA concentrations were significantly decreased and LMA insertion/intubation time was significantly shortened in group S (P ＜ 0.05).Compared with the baseline value at T0,the concentration of plasma NE was significantly increased at T2 in group S,the concentration of plasma NE was significantly increased at T1-4.6 and the concentration of plasma AE and DA was significantly increased at T1.3 in group T (P ＜ 0.05).Conclusion LMA Supreme has better efficacy for airway management in the elderly patients with hypertension than intratracheal intubation,with lower insertion and removal responses and fewer side effects occurred in the pharynx.

Effect of total intravenous anesthesia on intrapulmonary shunt fraction and arterial oxygenation during one-lung ventilation for thoracoscope surgery / 中国医师杂志

Objective To observe the effect of total intravenous anesthesia (TIVA) on intrapulmonary shunt fraction and arterial oxygenation during one-lung ventilation (OLV) for thoracoscope surgery.Methods Forty patients scheduled for thoracoscope surgery were randomly assigned to two groups ( n =20),group of TIVA (A) and group of intravenous anesthesia combined with inhalational anesthesia(B).After inducing and intubating,patients were assigned to maintenance of anesthesia with propofol ( group A)or with sevoflurane ( group B) in order to maintain a BIS between 40 and 60.Mean arterial pressure (MAP),heart rate (HR),SpO2 and Paw were measured in four phases,always in the lateral position,10min after beginning two-lung ventilation (TLV),15 min after beginning OLV (OLV + 15 ),30 rain after beginning OLV ( OLV + 30) and 60 min after beginning OLV ( OLV + 60).Blood samples were drawn simultaneously and analyzed within 5 min.The Qs/Qt at each phase was calculated.Adverse events including hypotension,bradycardia,hypoxemia,delayed emergence and restlessness in recovery period were recorded.Results In all patients,a decrease in PaO2 and an increase in the Qs/Qt occurred during OLV were observed.But PaO2 values in group A were significantly higher than those in group B ( 177 ±88 vs 125 ±63;150 ±65 vs 110 ±67;188 ±69 vs 128 ±52) ( P ＜0.05).The Qs/Qt in group B was significantly higher than those in group A (34.2 ±5 vs 28.8 ±2;38.4 ±8 vs 32.1 ±6;37.1 ±2 vs 29.5 ±2,P ＜0.05).MAP values in group A were significantly lower than those in group B at the phase:OLV + 15 and OLV +30(72 ± 10 vs 88 ± 14;74 ± 12 vs 89 ± 10) ( P ＜ 0.05 ).The incidence of hypotension and delayed emergence in group A was higher than those in group B ( 10 case vs 4 case;9 case vs 2 case).The incidence of restlessness in recovery period in group B was more than those in group A (9 case vs 3 case).The differences between two groups were significant ( P ＜ 0.05).Conclusions Compared with sevoflurane-sufentanyl combined anesthesia,TIVA with propofol can efficiently decrease intrapulmonary shunt fraction and improve arterial oxygenation during OLV for thoracoscope surgery,which is good for the prevention of hypoxemia.

Effect of Inhibiting of HBx expression on epithelial-mesenchymal transition and apoptosis of liver cancer cells / 中华肝胆外科杂志

Objective To investigate the effects and possible mechanism of action of inhibiting hepatitis B virus X protein (HBx) expression on liver cancer metastasis. Methods The suppression of HBx expression in MHCC97H cells was performed by siRNA interference technique, and the effects of HBx suppression on the metastasis of MHCC97H cells were detected by Matrigel invasion assays and in a lung-metastasis mouse model. The expression levels of related epithelial-mesenchymal transition (EMT) and apoptosis proteins were examined by Western blotting. Results Introduction of HBx-siRNA into MHCC97H cells inhibited the expression of HBx and the ability to metastasize,downregulated the expression of Twist and N-cadherin, and upregulated E-cadherin expression. These changes resulted in inhibiting EMT of MHCC97H cells. Meanwhile, apoptosis involved in the Twist-P53 pathway was also found. Conclusions Inhibiting expression of HBx can decrease the metastatic a-bility of MHCC97H cells by changing EMT and inducing apoptosis.

Investigating the correlation between PTPN22 C1858T polymorphism and rheumatoid arthritis in Han nationality in Xiamen area / 中华风湿病学杂志

Objective To assess the correlation between FFPN22 C1858T polymorphism and rheumatoid arthritis(RA)in Han people in Xiamen area by TaqMan-MGB real-time PCR．Methods A casecontrol study was carried out in Xiamen Han population．Their blood samples(100 RAs and 100 controls respectively)were collected and the PTPN22 C1858T polymnrphism was tested by TaqMan-MGB real-time PCR．Results①A technique of TaqMan-MGB teal-time PCR was established to investigate PTPN22 C1858T polymorphism；② Onlv 1858 C allele was presented in all the RAs and controls，and no T allele was detected．Conclusion There is no PTPN22 1858T allele in Han people in Xiamen area．It is suggested that there's no association between PTPN22 C1858T polymorphism and RA．

The effect of tramadol on perioperative insulin resistance in patients undergoing pulmonary lobectomy / 中国基层医药

ObjectiveTo investigate the effect of tramadol on perioperative insulin resistance in patients un dergoing pulmonary lobectomy.MethodsThirty patients undergoing pulmonary lobectomy,were randomly divided in to two groups :group T(tramadol group)and group C (control group), five minutes before skin incison, group T re ceived tramadol 1.5 mg/kg intravenously (IV), followed immediately by a continuous infusin of 0.5mg/kg per hour until the end of surgery, and the control group received normal saline instead of tramadol.Blood samples were takenfrom vein for determination of plasma blood sugar,insulin, IL-6 and TNF-α concentrations before induction of anesthe sia(T0) ,at the end of the operation(T1) ,four hours after operation(T2)and seven oclock on the next morning(T3),and the value of ISI was calculated.ResultsThe concentrations of blood sugar, insulin,TNF-α and IL-6 at T1 andT2 ,T3 increased significantly compared to baseline(T0) in both groups(P ＜ 0.05).The concentrations of blood sugar,insulin,IL-6 and TNF-o at T1 ,T2 and T3 were significantly lower in group T than that in group C (P ＜0.05).Thevalue of ISI was significantly higher in group T than that in group C (P ＜ 0.05).ConclusionTramadol could allevi ate perioperative insulin resistance in patients undergoing pulmonary lobectomy by inhibiting plasma blood sugar,insu lin,IL-6 and TNF-α.