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This study delves into the effectiveness of combining remimazolam with low-dose propofol in pediatric fiberoptic bronchoscopy. Ninety children scheduled for fiberoptic bronchoscopy in our hospital were enrolled as research participants. Based on the intraoperative anesthetic drug regimen, the children were divided into three groups: group R (remimazolam 0.2-0.4 mg/kg), group P (propofol 1-3 mg/kg), and group RP (remimazolam0.2 mg/kg, propofol 0.5 mg/kg). Immediately post-anesthesia, group P exhibited lower blood pressure and heart rate (HR) compared to both group R and group RP (P < 0.05). As bronchoscope approached the glottis and epiglottis, group P continued to display lower blood pressure and HR compared to group R and group RP (P < 0.05). During lavage, group P maintained lower blood pressure and HR compared to both the R and RP groups (P < 0.05). Immediately post-anesthesia, group P demonstrated lower SpO2 compared to the R and RP groups (P < 0.05).During lavage, group P maintained lower SpO2 than group R and group RP (P < 0.05). In comparison with group R and group PR, group P showed shortened induction and recovery times (P < 0.05). The one-time entry success rate into the microscope was higher in group R than in group P, with the RP group showing an intermediate decreased (P < 0.05). Moreover, the cough score in R group was higher than in the P and RP groups (P < 0.05). Furthermore, the satisfaction rates of the RP group exceeded those of the R and P groups (P < 0.05). Remimazolam combined with low-dose propofol effectively balances the strengths and weaknesses of remimazolam and propofol, ensuring more stable hemodynamics, a lower incidence of adverse reactions, and optimal surgical conditions in pediatric fiberoptic bronchoscopy.
Subject(s)
Bronchoscopy , Propofol , Humans , Bronchoscopy/methods , Propofol/administration & dosage , Female , Male , Child, Preschool , Child , Blood Pressure/drug effects , Heart Rate/drug effects , Fiber Optic Technology/methods , Infant , Hypnotics and Sedatives/administration & dosage , BenzodiazepinesABSTRACT
ObjectiveTo provide a reference for the establishment of an ideal corneal neovascularization （CNV） animal model by summarizing the modeling characteristics of CNV animal models. MethodWith "CVN" as the theme word， this paper searched the China National Knowledge Infrastructure （CNKI）， Wanfang， Chinese medical journals full-text database， and PubMed database and screened out relevant literature on CNV animal experiments from 2013 to 2023. The database was established by Excel 2021， and the experimental animal strain， gender， modeling method， detection index， and application category were sorted out. The characteristics of the CNV animal model were analyzed. ResultAfter comparative analysis， it was found that the animal strains were Sprague-Dawley rats （87 times， 29.49%） and New Zealand white rabbits （52 times， 17.63%）. Male animals were recommended. Most modeling methods for efficacy verification and mechanism studies were the alkali burn method. Index detection methods included apparent index observation， histopathological detection， immunohistochemistry （IHC）， Western blot， and various polymerase chain reaction （PCR） tests. Detection indexes included apparent indication， corneal histopathology， CNV regulation， etc. ConclusionThe CNV model of SD rats induced by the alkali burn method is recommended for model replication， and the indexes are mainly selected from the growth of CNV， corneal histopathological test， and vascular endothelial growth factor （VEGF）-related test. In addition， according to the demand， the corneal apparent indication and the basic indexes related to the regulation of CNV， such as vascular endothelial growth factor receptor 2 （VEGFR2）， basic fibroblast growth factor （bFGF）， and secretogranin Ⅲ （Scg3） are also selected. Clinical treatment of CNV relies on anti-inflammatory drugs and anti-VEGF drugs， and there is a lack of application of traditional Chinese medicine （TCM）， so the model needs to be improved by adding elements of TCM syndromes.
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BACKGROUND: Age prediction powered by artificial intelligence (AI) can be used as an objective technique to assess the cosmetic effect of rejuvenation surgery. Existing age-estimation models are trained on public datasets with the Caucasian race as the main reference, thus they are impractical for clinical application in Chinese patients. METHODS: To develop and select an age-estimation model appropriate for Chinese patients receiving rejuvenation treatment, we obtained a face database of 10 529 images from 1821 patients from the author's hospital and selected two representative age-estimation algorithms for the model training. The prediction accuracies and the interpretability of calculation logic of these two facial age predictors were compared and analyzed. RESULTS: The mean absolute error (MAE) of a traditional support vector machine-learning model was 10.185 years; the proportion of absolute error ≤6 years was 35.90% and 68.50% ≤12 years. The MAE of a deep-learning model based on the VGG-16 framework was 3.011 years; the proportion of absolute error ≤6 years was 90.20% and 100% ≤12 years. Compared with deep learning, traditional machine-learning models have clearer computational logic, which allows them to give clinicians more specific treatment recommendations. CONCLUSION: Experimental results show that deep-learning exceeds traditional machine learning in the prediction of Chinese cosmetic patients' age. Although traditional machine learning model has better interpretability than deep-learning model, deep-learning is more accurate for clinical quantitative evaluation. Knowing the decision-making logic behind the accurate prediction of deep-learning is crucial for deeper clinical application, and requires further exploration.
Subject(s)
Artificial Intelligence , East Asian People , Humans , Algorithms , Databases, Factual , Machine Learning , Face , Automated Facial Recognition , AgingABSTRACT
ObjectiveTo summarize the modeling methods, test indicators, and evaluation methods of the animal models of urticaria and provide a basis for the subsequent research on urticaria models. MethodWith the keywords of "urticaria" and "animal model" and the time interval from inception to July 13, 2022, relevant articles were retrieved from CNKI, Wanfang Data, VIP, CBM, Web of Science, Embase, and PubMed. Two evaluators independently screened the articles and extracted the publishing time, sources, animal conditions, modeling methods, modeling time, and test indicators from the articles meeting the inclusion criteria to establish a data library for quantitative statistics and analysis. ResultA total of 116 articles were included, involving 129 animal experiments (102 in Chinese and 27 in English) of urticaria. In the last three years, the studies about the animal models of urticaria presented an obvious upward trend, and the articles were dominated by dissertations. KM mice and SD rats of both females and males were mainly used for the modeling of urticaria, and the models were mainly established by passive sensitization of skin for 14-16 days. The models were mainly evaluated based on apparent indicators such as blue-stained lesion area and ear swelling, supplemented by the pathological indicators of the skin and serum. ConclusionAlthough the experimental studies of urticaria are increasing, the modeling methods lack unified modeling standards and have low coincidence with clinical symptoms. Therefore, this paper analyzed the modeling elements and evaluation criteria of urticaria animal models, and proposed that both male and female KM mice (6-8 weeks old) or SD rats (8-10 weeks old) of SPF grade should be preferentially selected for modeling. Active and passive sensitization can be combined for the modeling, and the specific modeling elements such as modeling time and sensitization times need to be further explored. The model evaluation should include four aspects of behavior, appearance, pathology, and immunity.
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PURPOSE: To investigate the feasibility of multidisciplinary model of damage control (MMDC) in patients with acute cervical spinal cord injury (ACSCI) in winter Olympic sports. METHODS: A total of 110 patients with ACSCI who participated in winter Olympic sports were selected as the study subjects, and were divided into the study group (SG, n=60, MMDC) and the control group (CG, n=50, conventional intervention) according to the intervention mode. The clinical effects of intervention, changes in neurological function and muscle tone before and after intervention, the changes in motor function and activity of daily living during intervention, and patient satisfaction towards intervention were compared between the two groups. RESULTS: The effective rate of intervention in the SG was 98.33%, higher than 88.00% in the CG (P < 0.05), and the percentage of patients with Grade E injuries in the SG after intervention was 30.00%, significantly higher than 12.00% in the CG (P < 0.05). The scores of all dimensions of Ashworth scale in the SG were lower than those in the CG (P < 0.05). The patients in the SG exhibited higher FMA scale and modified Barthel index (MBI) scores than the CG from 1 to 6 months of intervention (P < 0.05). CONCLUSION: MMDC showed better efficacy, the patients' neurological function, muscle tone and motor function could be better restored, and patients' abilities of daily activities were improved after intervention.
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Objective:To evaluate the utilization of antifungal drugs in Nanjing area, and provide clinical reference for the rational use of antifungal drugs. Methods:According to the sales data of antifungal drugs in 34 hospitals in Nanjing area from 2013 to 2015, the utilization of antifungal drugs was analyzed in respects of consumption sum, DDDs and DDC. Results:The consumption sum and use of antifungal drugs increased year by year. The maximum amount of consumption sum growth rate was 41. 13%. Triazole drugs oc-cupied the top of consumption sum during the past three years, and the sales amount accounted for more than 60% of all. In term of consumption sum, voriconazole, fluconazole, itraconazole and caspofungin ranked top 4 of antifungal drugs. Clotrimazole topical prepa-rations and oral itraconazole ranked top 2 of DDDs, and caspofungin, micafungin and voriconazole ranked top 3 of DDC. Conclusion:The clinical application of antifungal drugs continues to increase during 2013 and 2015. Invasive fungal infection is a lethal factor at high risk. Choosing reasonable, effective, safe and economic of antifungal drugs is the first principle in clinical treatment.
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Objective To investigate the minimum dose of contrast medium when using spectral CT in cranial CTA. Methods Three groups of patients were required to undergo head CTA examination because of their condition,but different doses of contrast agents were injected.Among them,group 30 mL, group B, group 40mL, group C and group 50 mL were A. Results In group A,the lowest rate of excellent image (23.33%), B group, C group had higher rate of excellent image (93.33%, 96.67%), comparison of the data P<0.05; C group the highest rate of adverse reaction of contrast agent (P<0.05),data comparison P<0.05, A group, B group significantly adverse reactions of contrast agent there is no difference between the situation (P>0.05). Conclusion The use of 40 mL iodide contrast medium in the procedure of cranial CTA examination is effective and safe.
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Objective To investigate the minimum dose of contrast medium when using spectral CT in cranial CTA. Methods Three groups of patients were required to undergo head CTA examination because of their condition,but different doses of contrast agents were injected.Among them,group 30 mL, group B, group 40mL, group C and group 50 mL were A. Results In group A,the lowest rate of excellent image (23.33%), B group, C group had higher rate of excellent image (93.33%, 96.67%), comparison of the data P<0.05; C group the highest rate of adverse reaction of contrast agent (P<0.05),data comparison P<0.05, A group, B group significantly adverse reactions of contrast agent there is no difference between the situation (P>0.05). Conclusion The use of 40 mL iodide contrast medium in the procedure of cranial CTA examination is effective and safe.
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Objective:To evaluate the utilization of oral hypoglycemic drugs in 34 hospitals of Nanjing to provide clinical reference for the drug rational use. Methods: According to the sales data of oral hypoglycemic drugs in 34 hospitals of Nanjing from 2011 to 2013,the utilization of oral hypoglycemic drugs was analyzed retrospectively in respect of consumption sum,DDDs and defined daily cost ( DDC) by daily dose limit analysis method. Results: The top 3 oral hypoglycemic drugs in the list of consumption sum were acarbose,glimepiride and metformin. In terms of DDDs,glimepiride, metformin and gliclazide ranked the top 3. The consumption sum and DDDs of oral hypoglycemic drugs were increased year by year in Nanjing. The ratio of serial number of consumption sum and DDDs was from 0. 3 to 2. 0. Conclusion: The demanded quantity of oral hypoglycemic drugs is increased year by year from 2011 to 2013. The application conforms to the safe, effective and economic principle. The drugs should be chosen according to the drug characteristics in order to improve the abnormal glucose metabolism and prevent and treat the complications.
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OBJECTIVE To explore the rational application of aminoglycosides antibiotics.METHODS We randomly selected 520 patients' records of applying aminoglycosides antibiotics from Jan to Dec in 2007.Types of antibiotics,dosages,usage,ways of delivery and periods and combination of medicines were analyzed.RESULTS Out of the 520 cases,the oldest patient was 89 year and the youngest one was 7 years.The application rate of amikacin was the highest(35.6%),which was delivered mainly by iv,the combination of medicines accounted for 92.7%.CONCLUSIONS The application of aminoglycosides antibiotics in our hospital is basically rational.In some cases the improper antibiotics are used and the duration is a little longer,which should be supervised.
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OBJECTIVE: To investigate the use of antibiotics in medical insured inpatients with lung infection for reference of management of expenditure of antibiotics in the inpatients.METHODS: The data base documents of a total of 685 insured inpatients with lung infection(Jan.2004～Jun.2006) were collected for a statistical analysis in respect of the utilization and expenditure of antibitoics using defined daily dose and the ratio of order of consumption sum to that of DDDs as indexes.RESULTS: Cephalosporins and quinolones took the lead in expenditure and DDDs,accounting for 70.70% of total antibiotics in terms of consumption sum.CONCLUSION: The main factors affecting hospitalization expense were the application of cephalosporins and quinolones,thus emphasis should be paid to the supervising of these factors.
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OBJECTIVE To learn the situation of cephalosporins used in our hospital,and offer the scientific guidline base for their clinical use.METHODS Statistics methods were used to analyze dosage,sales volume and DDDS of cephalosporins during 2003-2007.RESULTS The usage of the first generation cephalosporins was reduced year by year,but the third generation of compoands cephalosporins and their oxef cephalosporins occupied the main places.The DDDs of cefoperazone/tazobactam usage ranked second for three years(2005-2007),and at the same period their DDDs consumption got top.CONCLUSIONS The situation of the usage of cephalosporins in our hospital is reasonable basically,but more attention should be payed to the usage of the third cephalosporins and their compounds and oxefs.
