Objective To investigate the effects on pancreas islet function in patients ubdergoing laparoscopic myomectomy during sevoflurane or propofol anesthesia.Methods Forty pa-tients,40-55 years,ASA Ⅰ or Ⅱ scheduled for elective surgery of laparoscopic myomectomy were randomly divided into two groups (n=20 each group).Propofol 2 mg/kg,sufentanil 0.5 μg/kg and rocuronium 0.9 mg/kg were used for induction,BIS was controlled between 40 and 55 during surgery.The anesthesia was maintained with sevoflurane and MAC was maintained with 0.7-1.3 in group S.The anesthesia was maintained with propofol continuous infusion and the plasma concentra-tion of target was set between 2.0 to 5.0μg/ml in group P.Blood glucose,insulin,c-peptide,gluca-gon and cortisol were measured at 3 time points:before induction of anesthesia (T0 ),start of surgery (T1 ),end of surgery(T2 ).Results Compared with T0 ,blood glucose,insulin,c-peptide,glucagon and cortisol in two groups were increased significantly at T1 and T2 (P <0.05).Compared with T1 , blood glucose,insulin,c-peptide,glucagon and cortisol in two groups were increased significantly at T2 (P <0.05).Compared with group S,blood glucose,glucagon and cortisol were increased indis-tinctively and insulin,c-peptide were increased significantly in group P at T1 and T2 (P < 0.05). Conclusion Compared with sevoflurane,propofol could promote the secretion of insulin and c-pep-tide,and inhibit cortisol and glucagon secretion,thus inhibit the rise of intraoperative blood glucose.

Objective To explore the effect of 20°trendelenburg position on hemodynamics during induction of general anesthesia of patients under gastrectomy.Methods One hundred and eighteen patients (77 males and 41 females,aged 50-60 years,ASA physical status Ⅰ or Ⅱ),scheduled for elective radical gastrectomy,were randomly divided into group A (n=40),group B (n=38) and group C (n=40).In group A,patients were placed in the supine position during induction of anesthesia,and vasopressors was administered when hypotension occurred.In group B,patients were placed in the supine position during induction of anesthesia and was placed in the 20°trendelenburg position when hypotension occurred,and vasopressor would be administered if blood pressure was not restored.In group C,patients were placed in the 20°trendelenburg position during induction of anesthesia,and vasopressors was administered when hypotension occurred.In all groups Lactated Ringer′s was infused at 15 ml·kg-1·h-1in 30 min before induction.Anesthesia was induced with propofol 2 mg/kg,sufentanil 0.5 μg/kg,rocuronium 0.9 mg/kg.The occurrence of hypotension and the total amounts of drug administrations were doccumented.Results Nineteen patients (47.5%) in group A,fourteen patients (36.8%) in group B and six patients (15.0%) in group C developed hypotention.The incidence of hypotension in group A and B was significantly higher than that in group C (P<0.05).In all groups the total dosage of ephedrine was used.Phenylephine was only used in the group A at a dose of 26.5±0.14 μg.The amounts of drug administrations in group B and C were significantly lower than that in group A (P<0.05).Two patients in group A went into a refractory hypotensive state.However,no patients in all groups fell into a serious arrhythmia state,so atropine was not used.Conclusion The 20°trendelenburg position during induction of general anesthesia of patients during gastrectomy can prevent hypotension during induction.This position is effective in the management of hypotension after the induction of general anesthesia and can decrease the amounts of drug administrations during induction of general anesthesia.

OBJECTIVETo document the investigation and control of an outbreak of gastroenteritis in City G, South China, and provide a reference for preventing future outbreaks.

METHODSAn ambispective cohort study was designed. Attack rate (AR) and relative risks (RR) were calculated to identify the causes of gastroenteritis. Investigations using questionnaires included personal interviews with patients and doctors, reviews of medical records, laboratory examinations of fecal specimens and continuous hygiene monitoring of water samples from the waterworks.

RESULTSOverall, 427/71534 (AR=5.97%) cases were identified between October 31 and November 12 2010. Geographic distribution was highly localized, with 80% of cases occurring in the areas supplied by waterworks-A. Consumption of water provided solely by waterworks-A was found to be associated with illness (RR=8.20, 95 CI%:6.12-10.99) compared with that from waterworks-B. Microbiological analyses confirmed the presence of Norovirus in six of eight fecal samples from symptomatic patients, two water samples from waterworks-A and two sewage samples. After taking effective measures, the hygienic indices of waterworks-A met health criteria again on November 9 and no cases were reported 3 days later.

CONCLUSIONThe outbreak reported here was caused by drinking tap water contaminated with sewage at the source. Early identification of possible contamination sources and awareness of changes that might negatively impact water quality are important preventive measures to protect public health.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Disease Outbreaks ; Female ; Gastroenteritis ; epidemiology ; etiology ; Humans ; Infant ; Male ; Middle Aged ; Water Pollution ; adverse effects ; Young Adult

In November 2018, the U.S. food and drug administration (FDA) issued guidance for the development of drugs for chronic hepatitis B virus infection (draft for comments) (hereinafter referred to as draft for comments), and in April 2022, the FDA issued Chronic Hepatitis B Virus Infection: Developing Drugs for Treatment, which has been updated with some details based on the Draft for Comments. This guidance further emphasizes the importance of HBsAg clearance in clinical trials, and classifies chronic suppressive therapy into two categories, namely noninferiority (NI) (or superiority) test with nucleos(t)ide analogues as control and add-on superiority trial with nucleos(t)ide analogues as control, and as for the latter, HBV DNA is no longer recommended as a primary endpoint of the trial, which poses a huge challenge to the development of innovative drugs targeting HBV DNA. The new finite duration therapy should aim to eliminate HBsAg and reduce virologic relapse and the risk of liver disease progression during treatment cessation. Reduction in HBsAg from baseline is not recommended as a primary endpoint for phase Ⅲ clinical trials, since the correlation between such reduction and clinical response remains unclear. In addition, this guidance also specifies the duration of treatment cessation and treatment consolidation period and the criteria for withdrawal of nucleos(t)ide analogues.