Objective To investigate the protective effects of transection of the cervical sympathetic trunk (TCST) on the gastric mucosal lesions in rats fastened to a board and immersed vertically in water, up to the level of xiphoid with the animals' heads up water for 6 hours. Methods Thirty male SD rats weighing 200-250 g were randomly divided into 3 groups ( n = 10 each): group A sham operation; group B sham operation + water immersion and group C TCST + water immersion. The animals were anesthetized with intraperitoneal 2.5% pentobarbital 40 mg?kg-1. Cervical sympathetic trunk was exposed at right common carotid artery bifurcation and cut. The gastric mucosal blood flow (GMBF) was measured with Doppler blood flow monitor after 6 h water immersion. Blood samples were taken from abdominal aorta for determination of plasma concentration of ET-1 and serum concentration of NO. Gastric mucosal ulcer index was determined according to Guth criteria.Results There was gastric mucosa bleeding and erosion in group B and C and the degree of injury was severer in group B than in group C. Plasma concentration of ET-1 and serum concentration of NO were significantly higher in group B than in group C and A.Conclusion TCST has protective effect on gastric mucosal blood flow in rats under stress by reducing blood ET and NO concentrations.

Objective To observed the clinical efficacy of captopril combined with amlodipine in hypertension patients of the influence of high noise.Methods A total of 150 hypertension patients who worked in ＞ 110 dB noise were divided into treatment group 1 (75 cases) and treatment group 2 (75 cases) by random digits table.Patients simply took enalapril in treatment group 1,patients took enalapril combined with amlodipine in treatment group 2.Selected 75 cases common hypertension patients were control group,they took enalapril combined with amlodipine.A year later,compared with three groups of plasma renin activity (PRA) and clinical efficacy.Results The PRA and efficient rate had no significant difference among three groups in half ayear (P ＞0.05).A year later,the PRA and efficient rate in treatment group 2 and treatment group 1 had obvious difference [(1.89 ± 0.37) ng/ (ml· h) vs.(2.40 ± 0.38) ng/ (ml· h),90.67 ％ (68/75) vs.72.00 ％ (54/75)] (P ＜ 0.05 or ＜ 0.01).But compared with control group no significant difference (P ＞0.05).Conclusion The clinical efficacy of captopril combined with amlodipine in hypertension patients is more apparent.

OBJECTIVE:To investigate the characteristics and regularity of pediatric adverse drug reactions(ADR)in our hos-pital in order to promote rational drug use of children. METHODS:In retrospective study,378 pediatric ADR cases collected from our hospital during 2010-2014 were analyzed statistically. RESULTS:Among 378 pediatric ADR cases,255 cases were male (67.46%),and 123 cases were female (32.54%);the incidence of ADR in patients aged from one year to three years were the highest (27.51%);most of the cases were induced by intravenous injection,accounting for 87.57%(331 cases);sterile powder for injection was main dosage form (236 cases,62.43%) anti-infective agents were the major cause of ADR in respect of drug types (50.26%),among which cephalothin ranked the first place(43.68%);the lesion of skin and its appendants were the most common clinical manifestation of ADR(56.35%),such as erythra and pruritus. And most of the cases were cured(64.29%)or im-proved(34.66%)after treatment. CONCLUSIONS:The occurrence of ADR are related to multiple factors,such as administration route and drug varieties. Great importance should be attached to indication,route of adiminstration,method,speed and so on,in order to promote rational drug use and reduce the occurrence of ADR.

OBJECTIVE:To evaluate the clinical efficacy of liraglutide and insulin glargine in the treatment of type 2 diabetes mellitus (T2DM) and conduct pharmacoeconomic analysis, and to provide economical and reasonable T2DM treatment plan. METHODS:80 T2DM patients were randomized into liraglutide group and insulin glargine group,with 40 cases in each group. Both groups were given Metformin hydrochloride sustained-release tablet orally 0.5-2.0 g/d,and diabetes mellitus diet and sport training guide after oral antidiabetic drug withdrawal of previous treatment plan. Liraglutide group was given Liraglutide injection hypodermically,0.6-1.2 mg,qd;insulin glargine group was given insulin glargine hypodermically at 22 o’clock,initial dose of 0.2 IU/(kg·d),adjusted according to the levels of PG,FBG,nocturnal blood glucose level till FBG≤7 mmo1/L and 2 h PG ≤10 mmol/L in both group. Treatment course of 2 groups lasted for 12 weeks. The changes of FBG,2 h PG,HbA1c and BMI were ob-served in 2 groups before and after treatment. 2 therapy plans were evaluated and compared by cost-minimization analysis. RE-SULTS:After treatment,the levels of FBG,2 h PG and HbA1c decreased significantly in 2 groups,compared to before treatment, with statistical significance (P<0.05),but there was no statistical significant difference between 2 groups (P>0.05). After treat-ment,BMI of liraglutide group decreased significantly compared with before treatment and insulin glargine group,with statistical significance (P<0.05). There was no statistical significant difference in BMI of insulin glargine group before and after treatment (P>0.05). Cost-minimization analysis showed that the cost of insulin glargine group in reducing FBG,2 h PG and HbA1c were less than liraglutide group,but were more than liraglutide group in reducing BMI. Sensitivity analysis demonstrated the stability and reliability of cost-minimization analysis. CONCLUSIONS:Lira-glutide and insulin glargine have the same clinical efficacy,but insulin glargine need lower cost in blood glucose control,and liraglutide is better therapy plan for body weight control.

Objective:To systematically evaluate the risk factors for postoperative pulmonary complications (PPCs) in elderly patients undergoing hip fracture surgery.Methods:PubMed, Embase, Cochrance Library, CBM, CNKI and Wanfang Databases were searched.Search strategy was subject word combined with random word.The case control and cohort studies involving the influencing factors for PPCs in elderly patients undergoing hip fracture from January 2000 to November 2020 were retrieved.PPCs included pneumonia, aspiration pneumonitis, pulmonary infections, respiratory failure, atelectasis and pleural effusion, etc.The quality of literatures was assessed by using Newcastle-Ottawa Scale, data were extracted and analysis was performed using RevMan5.3 software.Results:A total of 18 studies were finally enrolled, including 15 case control studies and 3 cohort studies.The results of analysis showed that the advanced age, male, history of smoking, low body mass index, history of cerebrovascular accident, history of chronic obstructive pulmonary disease, history of diabetes, preoperative albumin concentration<35 g/L, preoperative hemoglobin concentration<120 g/L, American Society of Anesthesiologists Physical Status classification≥Ⅲ, operation delay≥48 h and general anesthesia were the risk factors for PPCs ( P<0.05). Conclusions:There are numerous risk factors for PPCs in elderly patients undergoing hip fracture surgery, and advanced age, male, history of smoking, low body mass index, history of cerebrovascular accident, history of chronic obstructive pulmonary disease, history of diabetes, preoperative albumin concentration<35 g/L, preoperative hemoglobin concentration<120 g/L, American Society of Anesthesiologists Physical Status classification≥Ⅲ, operation delay≥48 h and general anesthesia are the risk factors for PPCs in elderly patients undergoing hip fracture surgery.

OBJECTIVE: To determine the incidence of surgical site infection (SSI) after abdominal surgery and to further evaluate the related risk factors of SSI in China. METHODS: The multicenter cross-sectional study collected clinical data of all adult patients who underwent abdominal surgery from May 1, 2018 to May 31, 2018 in 30 domestic hospitals, including basic information, perioperative parameters, and incisional microbial culture results. The primary outcome was the incidence of SSI within postoperative 30 days. SSI was classified into superficial incision infection, deep incision infection, and organ/gap infection according to the US Centers for Disease Control and Prevention (CDC) criteria. The secondary outcome variables were ICU stay, postoperative hospital stay, total hospital stay, 30-day mortality and treatment costs. Multivariate logistic regression was used to analyze the risk factors of SSI. RESULTS: A total of 1666 patients were enrolled in the study, including 263 cases of East War Zone Hospital of PLA, 140 cases of Affiliated Hospital of Qingdao University, 108 cases of The First Affiliated Hospital of Nanchang University, 87 cases of Central War Zone Hospital of PLA, 77 cases of West China Hospital, 74 cases of Guangdong General Hospital, 71 cases of Chenzhou First People's Hospital, 71 cases of Zigong First People's Hospital, 64 cases of Zhangjiagang First People's Hospital, 56 cases of Nanyang City Central Hospital, 56 cases of Lanzhou General Hospital of Lanzhou Military Command, 56 cases of Shandong Provincial Hospital, 52 cases of Shangqiu First People's Hospital, 52 cases of People's Hospital of Xinjiang Uygur Autonomous Region, 48 cases of The Second Xiangya Hospital of Central South University, 48 cases of Chinese PLA General Hospital, 44 cases of Affiliated Hospital of Xuzhou Medical University, 38 cases of Hunan Province People's Hospital, 36 cases of Dongguan Kanghua Hospital, 30 cases of Shaoxing Central Hospital, 30 cases of Northern Jiangsu People's Hospital, 29 vases of The First Affiliated Hospital of Zhengzhou University, 27 cases of General Hospital of Tianjin Medical University, 22 cases of Zigong Fourth People's Hospital, 21 cases of The Second Hospital of University of South China, 18 cases of Tongji Hospital, 15 cases of Nanchong Central Hospital, 12 cases of The 901th Hospital of PLA, 11 cases of Hunan Cancer Hospital, 10 cases of Lanzhou University Second Hospital. There were 1019 males and 647 females with mean age of (56.5±15.3) years old. SSI occurred in 80 patients (4.8%) after operation, including 39 cases of superficial incision infection, 16 cases of deep incision infection, and 25 cases of organ/interstitial infection. Escherichia coli was the main pathogen of SSI, and the positive rate was 32.5% (26/80). Compared with patients without SSI, those with SSI had significantly higher ICU occupancy rate [38.8%(31/80) vs. 13.9%(220/1586), P<0.001], postoperative hospital stay (median 17 days vs. 7 days, P<0.001) and total hospital stay (median 22 days vs. 13 days, P<0.001), and significantly higher cost of treatment (median 75 000 yuan vs. 44 000 yuan, P<0.001). Multivariate analysis showed that male rise(OR=2.110, 95%CI:1.175-3.791, P=0.012), preoperative blood glucose level rise(OR=1.100, 95%CI: 1.012-1.197, P=0.026), operative time (OR=1.006, 95%CI:1.003-1.009, P<0.001) and surgical incision grade (clean-contaminated incision:OR=10.207, 95%CI:1.369-76.120, P=0.023; contaminated incision: OR=10.617, 95%CI:1.298-86.865, P=0.028; infection incision: OR=20.173, 95%CI:1.768-230.121, P=0.016) were risk factors for SSI; and laparoscopic surgery (OR=0.348, 95%CI:0.192-0.631, P=0.001) and mechanical bowel preparation(OR=0.441,95%CI:0.221-0.879, P=0.020) were protective factors for SSI. CONCLUSIONS The incidence of postoperative SSI in patients with abdominal surgery in China is 4.8%. SSI can significantly increase the medical burden of patients. Preoperative control of blood glucose and mechanical bowel preparation are important measures to prevent SSI.
Abdomen ; surgery ; Adult ; Aged ; China ; Cross-Sectional Studies ; Female ; General Surgery ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Operative Time ; Postoperative Complications ; prevention & control ; Preoperative Period ; Retrospective Studies ; Risk Factors ; Surgical Wound Infection ; prevention & control