Objective To evaluate the efficacy of ultrasound-guided sacral block in the obese patients by comparing it with the traditional positioning method.Methods Sixty obese patients,aged 25-50 yr,weighing 56-80 kg,with body mass index ≥ 30 kg/m2,scheduled for elective anorectal surgery,were randomly divided into 2 groups (n =30 each) using a random number table:ultrasound-guided sacral block group (group U) and traditional positioning method group (group T).The sacral canal puncture point was located via either ultrasonic or traditional positioning method.After successful puncture,1％ lidocaine 20 ml was injected.The number of patients in whom puncture was successful at first attempt and the number of patients in whom the time for puncture ≤ 1 min were recorded.The adverse reactions were observed.The efficacy of sacral block was evaluated.Results Compared with group T,the success rate of puncture at first attempt was significantly increased (P ＜ 0.05),and no significant changes were found in the number of patients in whom the time for puncture ≤ 1 min or efffcacy of sacral block in group U (P ＞ 0.05).No adverse reactions were found in the two groups.Conclusion Ultrasound-guided sacral block can raise the success rate of puncture at first attempt and provide similar efficacy of block in the obese patients when compared with the traditional positioning method,and thus has significant clinical value.

Objeetive To evaluate the relationship between aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT ratio) and metabolic syndrome in college students.Methods Anthropometric and metabolic measurements including fasting plasma glucose (FPG),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C),true insulin (TI),(AST and ALT) were assessed in a crosssectional study of 425 college students aged 19 to 24 years old (male 216,female 209) in 2009.The participants were then assigned to the AST/ALT ratio ＜ 1 group or the AST/ALT ratio ≥ 1 group.Metabolic syndrome was defined as Adult Treatment Panel Ⅲ criteria.Results AST/ALT ratio ＜ 1 was found in 146 subjects (34.4％).After adjustment for age and sex,AST/ALT ratio showed a positive correlation with HDLC (r=0.125) and negative correlations with body mass index (BMI,r=-0.281),waist circumtance (WC,r =-0.264),TG (r =-0.134),TI (r =-0.118) and HOMA-insulin resistance (HOMA-IR,r =-0.121) (all P ＜0.05).The prevalence of metabolic syndrome was 2.1％ and was similar in males and females (2.3％ vs.1.9％,P =0.774).Those with AST/ALT ratio ＜ 1 had a significantly higher prevalence of metabolic syndrome (4.8％ vs.0.7％,P =0.016).After adjustment for age,gender and BMI,the prevalence of metabolic syndrome of subjects with AST/ALT ratio ＜ 1 was nearly 7 (95％ CI:1.430 to 34.019,P =0.016) times of those with AST/ALT ratio ≥ 1.Conclusion AST/ALT ratio may be related with metabolic syndrome in college students.

A rapid and sensitive method based on ultrafast liquid chromatography-tandem mass spectrometry was developed and validated for simultaneous determination of Sudan Ⅰ, Sudan Ⅱ, Sudan Ⅲ, and Sudan Ⅳ levels in rat whole blood. Cleanert C18 mixed-mode polymeric sorbent was used for effective solid-phase extraction cleanup. Separation was carried out on a reversed-phase C18 column (100 mm × 2.1 mm, 1.8 μm) using 0.1% (v/v) formic acid in water/0.1% (v/v) formic acid in acetonitrile as the mobile phase in gradient elution. Quantification was performed by an electrospray ionization source in the positive multiple reaction monitoring mode using D5-Sudan I as the internal standard. Calibration curves showed good linearity between 0.2 and 20.0 μg/L, with correlation coefficients higher than 0.9990. The average recovery rates were between 93.05% and 114.98%. The intra- and inter-day relative standard deviations were within 6.2%. The lower limit of quantification was 0.2 μg/L. All the analytes were found to be stable in aseries of stability studies. The proposed method was successfully applied to a pharmacokinetic study of four Sudan dyes after oral administration to rats.

Objective:To evaluate the relationship between early postoperative recovery and frailty after digestive endoscopy-assisted minimally invasive surgery under intravenous anesthesia in the elderly.Methods:This study retrospectively selected hospitalized patients, aged ≥65 yr, scheduled for elective gastrointestinal endoscopic treatment.Early postoperative recovery time was defined as the period from the end of propofol administration to the achievement of a modified Aldrete score of 9.All the patients were divided into 2 groups according to whether the early recovery time after operation was less than 75%: normal early postoperative recovery time group and delayed early postoperative recovery time group.Frailty was assessed using the frailty phenotype (FP score 0-5), and the patient was diagnosed as frail (FP ≥3) or non-frail (FP 0-2). The age, sex, height, weight, smoking history, American Society of Anesthesiologists (ASA) Physical Status classification, type of operation, and baseline mean arterial pressure and heart rate were recorded.Logistic regression analysis was used to identify the risk factors for delayed early postoperative recovery time after minimally invasive digestive endoscopy under intravenous anesthesia in elderly patients.Results:A total of 214 patients were enrolled and divided into normal early postoperative recovery time group ( n=169) and delayed early postoperative recovery time group ( n=45). There were significant differences in frailty, age, drinking history of more than 10 yr, preoperative ASA Physical Status classification and propofol administration time between delayed early postoperative recovery time group and normal early postoperative recovery time group ( P<0.05). The results of logistic regression analysis indicated that frailty, age, ASA Physical Status classification Ⅲ, and propofol administration time were independent risk factors for the occurrence of delayed early postoperative recovery ( P<0.05). Conclusions:Frailty, age, ASA Physical Status classification Ⅲ and propofol administration time are independent risk factors for delayed early postoperative recovery time following digestive endoscopy-assisted minimally invasive surgery under intravenous anesthesia in elderly patients.

Objective To explore the implementation of multi-disciplinary healthcare teamwork in Fast Track Surgery( FTS). Methods A total of 500 patients,who would have laparoscopic radical resection of gastric cancer during January 2011 to December 2013,were averagely divided into control group( traditional nursing model and routine perioperative nursing) and experimental group ( multi-disciplinary healthcare teamwork)by random number table. The patients of experimental group received fast recovery process by careful design,strict work procedure,effective quality control and were assessed the effect of recovery,satisfaction of medical staffs and observed the application effect of multi-disciplinary healthcare teamwork. Results The satisfaction of experimental group for intervention was 97. 05% ,and the first time of fart(2. 13 ± 0. 69)d,first time to get out of bed(1. 33 ± 1. 13)d,length of gastric tube indwelling time(2. 00 ± 1. 56)d,first time to feeding time(5. 00 ±1. 42)d,post-hospitalization time(13. 24 ± 3. 12),that all were better than those of the control group(t = -16. 889 6,-25. 068 0,-14. 705 9,-14. 190 1,-5. 693 4;P <0. 05). Conclusions The multi-disciplinary healthcare team is an effective approach to promote patients' recovery in Fast Track Surgery, and is a effective way in the clinical.

OBJECTIVE: To investigate the relationship between serum 25(OH) vitamin D and liver fat content in nonalcoholic fatty liver disease (NAFLD). METHODS: A total of 120 patients with NAFLD admitted in our hospital between June and August, 2017 were enrolled and divided into 4 groups with different serum 25 (OH) vitamin D levels: >75 nmol/L (group A, =25), 50-75 nmol/L (group B, =35), 25-50 nmol/L (group C, =32), and < 25 nmol/L (group D, =28). For all the patients, serum 25 (OH) vitamin D level was measured by ELISA, and liver fat content was determined using in-phase opposed-phase TWI sequences. The measurement data were compared among the 4 groups to assess the association between serum 25(OH) vitamin D level and liver fat content. RESULTS: The liver fat content appeared to be higher in group B (28.66±6.45%) and group C (38.74±11.47%) than in group A (22.79 ± 6.10%), but the difference was not statistically significant (>0.05); the liver fat content in group D (54.79 ± 5.28%) was significantly higher than that in the other 3 groups (>0.05). Liver fat content increased significantly as serum 25(OH) vitamin D level decreased, showing an inverse correlation between them in these patients ( < 0.05, =-0.125). CONCLUSIONS In patients with NAFLD, a decreased serum 25(OH) vitamin D level is associated with an increased liver fat content, suggesting the value of serum 25(OH) vitamin D as a predictor of NAFLD.
Humans ; Liver ; pathology ; Non-alcoholic Fatty Liver Disease ; blood ; pathology ; Vitamin D ; blood