1.The Thought Of The Relationship Between Patients and Medical Houseman
Mingzhang XU ; Liang SHI ; Zhuo PENG ; Yue CHAO
Chinese Medical Ethics 1994;0(06):-
In this article, we clarify the most important four facets about developing the Relationship Between Patients and Medical Houseman , including experienced mastery of the basic medical theories, comprehending basic medical skills, cultivating favorable occupation morality , and bringing out the means to advance the Relationship Between Patients and Medical Houseman in order to acquire the better social effect .
2.Efficacy of Ambu AuraOnce laryngeal mask airway in Chinese patients undergoing general anesthesia
Zenghua XU ; Yang WANG ; Chunling YAN ; Mingzhang ZUO
Chinese Journal of Anesthesiology 2015;35(7):851-854
Objective To evaluate the efficacy of Ambu AuraOnce laryngeal mask airway (LMA) in Chinese patients undergoing general anesthesia.Methods Fifty-six female patients, aged 20-64 yr, weighing 45-75 kg, of American Society of Anesthesiology physical status Ⅰ or Ⅱ (Mallampati Ⅰ-Ⅲ), scheduled for elective breast surgery under general anesthesia, were equally and randomly divided into either Ambu AuraOnce LMA group (group A) or LMA Supreme group (group S) using a random number table.After induction of anesthesia, Ambu AuraOnce LMA was inserted in group A, and LMA Supreme was placed in group S.After successful placement of LMA, correct position was confirmed by fiberoptic laryngoscopy.Intermittent positive pressure ventilation was performed during surgery to maintain pulse oxygen saturation > 95% and partial pressure of end-tidal CO2 at 30-45 mmHg.The success rate, insertion time, extubation time, airway sealing pressure, peak airway pressure and occurrence of air leakage of LMA were recorded.After removal of the LMA, the blood stains on the LMA were checked, and the occurrence of hypoxemia, regurgitation, nausea, vomiting and bucking was recorded.The occurrence of sore throat, hoarseness and dysphagia was also recorded within 24 h after surgery.Results There were no significant differences in terms of insertion time, overall success rate, success rate at first attempt, removal of LMA time, airway sealing pressure, and incidence of air leakage of LMA, hypoxemia, blood stains on the LMA, sore throat, hoarseness and dysphagia between the two groups.The rate for correct position of LMA confirmed by fiberoptic laryngoscopy was significantly higher in group A than in group S.Conclusion Ambu AuraOnce LMA can safely and effectively be applied for airway management in Chinese patients undergoing general anesthesia.
3.Efficacy of different doses of dexmedetomidine combined with propofol for drug-induced sleep endoscopy in patients with snoring
Ruifang JIA ; Huijie XU ; Ming YANG ; Mingzhang ZUO
Chinese Journal of Anesthesiology 2016;36(3):314-317
Objective To evaluate the efficacy of different doses of dexmedetomidine combined with propofol for drug-induced sleep endoscopy (DISE) in the patients with snoring.Methods Sixty patients with snoring,aged 24-62 yr,with body mass index of 24-37 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective DISE,were randomly divided into either group Ⅰ or group Ⅱ,with 30 patients in each group.In Ⅰ and Ⅱ groups,dexmedetomidine was infused over 10 min in a loading dose of 0.4 and 0.8 μg/kg,respectively,followed by an infusion of 0.4 μg · kg-1 · h-1.At 15 min of dexmedetomidine infusion,propofol was given by target-controlled infusion with the initial target plasma concentration (Cp) of 1.0 μg/ml.At 2 min after the target effect-site and plasma concentrations were balanced,the Cp of propofol was increased/decreased by 0.2 μg/ml to maintain the Cp of propofol stable during DISE.Bispectral index (BIS) value was recorded before anesthesia (T1),at 10 and 15 min of dexmedetomidine infusion (T2,3),at 2 min after the target effect-site and plasma concentrations were balanced (T4),at the beginning of DISE (T5),when the fiberoptic laryngoscope was placed at the site of oropharynx (T6),at the end of DISE (T7),at emergence (T8),and while discharge from the examination room (T9).Richmond Agitation Sedation Scale (RASS) scores were recorded at T1-4.Sleep was recorded within 15 min of dexmedetomidine infusion.The emergence time,discharge time,and anesthetics-related adverse events were recorded.Results All the patients completed DISE successfully.BIS values were maintained at 75-90,and RASS scores ≤ 4 during dexmedetomidine infusion.BIS values were maintained at 65-75 during DISE.Compared with group Ⅰ,BIS values were significantly decreased at T4,and RASS scores were significantly increased at T2-4,the sleep rate was significantly increased within 15 min of dexmedetomidine infusion,the Cp of propofol was significantly decreased during DISE,the emergence time was significantly prolonged (P<0.05),and no significant change was found in the discharge time and anesthetics-related adverse events in group Ⅱ (P> 0.05).Conclusion Dexmedetomidine infused at 0.4 μg · kg-1 · h-1 after infusion of a loading dose of 0.8 μg/kg combined with propofol provides better efficacy for DISE in the patients with snoring.
4.Discussion on the Coping style of Undergraduates and the Correlative Factors during the Epidemic Period of SARS
Yan GAO ; Mingzhang XU ; Yufeng YANG ; Kaina YAO
Chinese Medical Ethics 1995;0(02):-
Objective:To explore the coping styles and the correlative factors in college students during the epidemic period of SARS. Methods:Questionnaires of ways of coping, psychological & behavioral and EPQ were used to investigate. Data were analysed with a multiple correlation and regression analysis by SPSS.Results:The style that “Don't take a question so serious ”was used mostly. How to cope with SARS was mainly influenced by dread, psychoticism,extrovision-introvision factor and age.Conclusions:Generally college students can positively react to SARS, but there are still many problems. Psychological education should be given on coping with emergent and sudden events of public health to college students.
5.Efficacy of dexmedetomidine combined with remifentanil for drug-induced sleep endoscopy in pa-tients with snoring
Hui YU ; Huijie XU ; Ying ZHANG ; Zhan GAO ; Yingbin SHI ; Hai LI ; Nannan ZHAO ; Mingzhang ZUO
Chinese Journal of Anesthesiology 2018;38(3):308-311
Objective To evaluate the efficacy of dexmedetomidine combined with remifentanil for drug-induced sleep endoscopy (DISE) in the patients with snoring. Methods Sixty patients of both sexes with snoring, aged 18-61 yr, with body mass index of 21. 0-33. 1 kg∕m2 , of American Society of Anesthe-siologists physical statusⅠ or Ⅱ, scheduled for elective DISE, were randomly divided into either dexme-detomidine combined with propofol group (group P) or dexmedetomidine combined with remifentanil group (group R), with 30 patients in each group. Dexmedetomidine was infused within 10 min in a loading dose of 0. 6 μg∕kg, followed by an infusion of 0. 6 μg·kg-1 ·h-1 for 10 min in both groups. Then propofol was given by target-controlled infusion with the initial target effect-site concentration (Ce) of 1. 0 μg∕ml in group P, and remifentanil was given by target-controlled infusion with the initial target Ce of 1. 5 ng∕ml in group R. At 2 min after the target effect-site and plasma concentrations were balanced, the Ces of propofol and remifentanil were adjusted by increments of 0. 2 μg∕ml and 0. 2 ng∕ml, respectively, until satisfactory snoring occurred and then the Ce was maintained at this level in P and R groups. Bispectral index value was re-corded at 5 min after admission to the operating room (T1 ), at 20 min of dexmedetomidine infusion (T2 ), at 2 min after the target effect-site and plasma concentrations were balanced (T3 ), at the beginning of DISE (T4 ), when the nasopharyngolarygnoscope reached the site of oropharynx (T5 ) and at the end of DISE (T6 ). Observer's Assessment of Alertness∕Sedation scale scores were recorded at T1-4 . The time for prepar-ing sedation, recovery time, the lowest value of SpO2 and development of adverse events were recorded. Re-sults Sixty patients completed DISE successfully. Compared with group P, the bispectral index value at T3-6 was significantly increased, the time for preparing sedation was prolonged, the recovery time was short-ened, the lowest value of SpO2 was increased, and the incidence of respiratory depression was decreased in group R (P< 0. 05). There was no significant difference in Observer's Assessment of Alertness∕Sedation scale scores at T1-4 between two groups ( P> 0. 05). Conclusion Combination of dexmedetomidine and remifentanil produces better efficacy for DISE than combination of dexmedetomidine and propofol in the pa-tients with snoring.
6.Efficacy of dexmedetomidine in preventing agitation during recovery from general anesthesia in patients undergoing uvulopalatopharyngoplasty
Xiaoyan MENG ; Ruifang JIA ; Mingzhang ZUO ; Huijie XU
Chinese Journal of Anesthesiology 2018;38(10):1166-1168
Objective To evaluate the efficacy of dexmedetomidine in preventing agitation during recovery from general anesthesia in patients undergoing uvulopalatopharyngoplasty (UPPP).Methods Sixty adults patients with obstructive sleep apnea syndrome,of American Society of Anesthesiology physical status Ⅰ or Ⅱ,aged 24-62 yr,with body mass index of 24-37 kg/m2,undergoing elective UPPP,were divided into dexmedetomidine group (group D) and conventional group (group C) using a random number table method,with 30 patients in each group.Dexmedetomidine was infused in a loading dose of 0.8 μg/kg over 10 min starting from 10 min before anesthesia induction,followed by a continuous infusion of 0.4 μg · kg-1 · h-1 for 30 min in group D,while the equal volume of normal saline was given instead of dexmedetomidine in group C.Anesthesia was induced and maintained by target-controlled infusion of propofol and remifentanil,and bispectral index value was maintained at 40-60 during surgery.Patients were extubated after they restored spontaneous breathing completely,opened eyes on verbal command and responded to verbal command,and then the patients were transferred to the recovery room,and oxygen was inhaled by mask.The emergence time,extubation time and development of agitation were recorded.Verbal rating scale was used to assess pain at 30 min after patients were transferred to the recovery room.Results Compared with group C,the incidence of agitation was significantly decreased,pain was reduced,and the emergence time was prolonged in group D (P<0.05).There was no significant difference in extubation time between two groups (P>0.05).Conclusion Dexmedetomidine can effectively prevent the occurrence of agitation during recovery from general anesthesia in patients undergoing UPPP.
7.The efficacy and safety of morinidazole combined with appendectomy in treating purulent or gangrenous appendicitis: a randomized, controlled, double-blind, multi-center clinical trial
Yun TANG ; Mingqing TONG ; Hao YU ; Yanping LUO ; Mingzhang LI ; Yongkuan CAO ; Mingfang QIN ; Lie WANG ; Xiaoqiang WANG ; Bo PENG ; Yong YANG ; Shuguang HAN ; Chungen XING ; Bing CAI ; Jianming HUANG ; Jiazeng XIA ; Bainan LYU ; Liang XU ; Jilin YI ; Dechun LI ; Guoqing LIAO ; Xiaofeng ZHEN ; Daogui YANG ; Zhongcheng HUANG ; Haibo WANG
Chinese Journal of General Surgery 2017;32(8):678-682
Objective To assess the efficacy and safety of morinidazole combined with appendectomy in treating purulent or gangrenous appendicitis.Methods Double-blind randomized controlled multicenter clinical trial was designed and conducted.Totally 437 patients were included,219 in the control group and 218 in the experimental group.Cases of purulent or gangrenous appendicitis were enrolled and assigned to each of the two groups.The control group received ornidazole injection for 5 to 7 days while the experimental group received morinidazole injection.Both groups underwent appendectomy.Clinical response,micrombiological outcomes,overall response were evaluated.Adverse events and side effects were recorded.Results No significant difference was observed between the two groups regarding the clinical healing rate at 5-10 days after medicine withdrawal,anaerobia clearance and overall healing rates.Adverse events occurred in 140 patients (32.1%).Incidence of adverse events in the control group and the experimental group was 34.7% and 29.4%,respectively (P > 0.05).The overall incidence of side effects was 15.1% (66 cases).Side effects were less seen in the experimental group compared with that in the control group (11.5% vs.18.7%,P < 0.05).The most frequent side effects were aminotransferase rising,thrombocytosis,nausea,vomiting and electrocardiographic abnormality.Conclusions The effect of morinidazole plus operation was comparable with ornidazole in treating purulent or gangrenous appendicitis.The safety of morinidazole is better than ornidazole.