1.Effects of recombinant hemoglobin on balance of oxygen supply and demand in coronary heart disease rats
Qingli DOU ; Xiangyou YU ; Ya'nan GU ; Yuanhan GU ; Hong ZHENG ;
Chinese Critical Care Medicine 2016;28(12):1118-1122
Objective To discuss the influence of two recombinant hemoglobin (rHb1.1 and rHb2.0) and human serum albumin (HSA) on oxygen supply and demand balance in rat with coronary heart disease (CHD). Methods Male Wistar rats were randomly divided into normal control group, CHD model group, HSA treatment group, rHb1.1 treatment group and rHb2.0 treatment group, 20 rats in each group. Rat model of CHD was established by high fat diet combined with pituitrin injection. The mean arterial pressure (MAP) decreased to 40 mmHg (1 mmHg = 0.133 kPa) after femoral arterial blood was drawn from the femoral arteries, and the rats were resuscitated with 13.4% HSA, rHb1.1 and rHb2.0, respectively, at the rate of 60 mL·kg-1·h-1 (20 mL/kg). The changes of electrocardiogram (ECG) ST-segment were calculated before model reproduction and at 12 hours after the last time injection of pituitrin. MAP, heart rate (HR), superior mesenteric artery blood flow (QSMA) and arterial blood gas analysis were recorded at 0, 30, 60, 90 and 120 minutes after the administration. The blood was collected after 12-hour fasting, and serum total cholesterol (TC) and triglyceride (TG) were determined by enzymatic method. The pathological changes in cardiac tissue were observed with light microscope. Results Compared with the normal control group, the changes of ECG ST-segment and TC, TG of model group were significantly increased. Compared with the model group, rHb can significantly reduce the value of ST segment changes, and HSA has no such effect; rHb short-term infusion has no significant effect on blood lipids, but can reduce myocardial pathological changes. Compared with the normal control group, the MAP of the model group decreased significantly, the HR was increased, the QSMA was slowed down, the pH value, the residual alkali (BE), the arterial carbon dioxide partial pressure (PaCO2) and HCO3- were decreased significantly. MAP in rHb1.1 group and rHb2.0 group were significantly higher than those in HSA group. Values of MAP were significantly higher in rHb2.0 group than those in rHb1.1 group at 90 minutes and 120 minutes (mmHg: 80.9±3.3 vs. 69.4±4.9, 79.2±4.0 vs. 69.1±3.7, both P < 0.05). The HR of HSA, rHb1.1 and rHb2.0 decreased to normal in 30 minutes after administration, significantly lower than those in the model group (bpm: 534±46, 518±28, 526±37 vs. 609±52, all P < 0.05). In the rHb2.0 group, the QSMA increased significantly at 60, 90 and 120 minutes compared with the model group (qv·mL-1·min-1: 5.6±0.4 vs. 3.9±0.6, 6.2±0.6 vs. 4.1±0.4, 6.9±0.7 vs. 4.0±0.3, all P < 0.05), but there was no significant difference between the HSA group and the rHb1.1 group. The pH, BE, PaCO2 did not return to the normal level after administration of HSA; pH, PaCO2 and HCO3- in the rHb1.1 group returned to normal level at 60 minutes after administration, and BE returned to normal level at 90 minutes after administration. Each index in rHb2.0 group can restore to normal levels 30 minutes ahead of. Conclusion Recombinant hemoglobin can significantly improve the oxygen supply and demand balance of rats with CHD model, can quickly and effectively correct the hypoxic state of blood metabolic acidosis, and rHb2.0 has better effect than rHb1.1.
2.Perioperative rehabilitation nursing in supercapsular percutaneously assisted total hip arthroplasty
Lizhi PAN ; Ya'nan LIU ; Weijing GU ; Ying JI
Chinese Journal of Trauma 2017;33(1):88-92
Objective To investigate the effect of rehabilitation nursing in perioperative period of elderly patients with femoral neck fractures undergone supercapsular percutaneously assisted total hip (SuperPATH) arthroplasty.Methods A retrospective cohort analysis was made on 30 patients treated by total hip arthroplasty through the SuperPATH approach from January 2016 to July 2016.There were seven males and 23 females,aged 75-91 years (mean,77 years).Nursing methods contained application of pluralistic education before operation,application of body position management,psychologic support joint pain and sleep multidimensional strengthening nursing intervention and dislocation nursing after operation,and recovery training.Self-rating anxiety scale (SAS),self-rating scale of sleep (SRSS),Barthel index and Harris hip score were used to compare clinical manifestations before and after treatment.Results SAS score was 42.5-66.3 points [(50.0 ± 6.2) points] one day before operation,compared to 33.8-53.8 points [(41.5 ± 5.2) points] five day after operation (P < 0.05).SRSS score was 24-37 points [(29.9 ±3.1) points] one day before operation,compared to 14-34 points [(23.2 ± 5.3) points] five day after operation (P < 0.05).Barthel index was 20-40 points [(38.5 ± 4.4) points] one day before operation,was 35-55 points [(49.7 ± 6.3)points] two day after operation and was 55-70 points [(63.5 ± 5.1)] points five day after operation,showing significant differences (P < 0.05).Harris hip score was 4-25 points [(14.8 ±4.2)points] one day after operation,was 59-75 points[(67.3 ± 5.1) points] two day after operation and was 66-85 points [(79.2 ± 4.3) points] two weeks after operation,showing significant differences (P < 0.05).All incision healed primarily.No complications occurred.Conclusion Perioperative rehabilitation nursing of minimally invasive SuperPATH arthroplasty is effective in alleviating patients' anxiety,improving sleep status and self-care ability,enhancing postoperative rehabilitation effect and reducing risk of in-hospital complications.
3.Discussion on automated external defibrillator configuration optimization strategy of rapidly developing city: a case study of Bao'an, Shenzhen
Ya'nan GU ; Wenwu ZHANG ; Jian WEI ; Qingli DOU
Chinese Critical Care Medicine 2022;34(1):48-53
Objective:To explore the automated external defibrillator (AED) configuration optimization strategy in line with the characteristics of the rapidly developing cities by analyzing the actual coverage of AED in Bao'an District based on the real world data of out-of-hospital cardiac arrest (OHCA) in Bao'an District, Shenzhen City.Methods:The data of cardiac arrest database registered in Bao'an District of Shenzhen City from March 1, 2019 to February 29, 2020 were included in a retrospective observational study. The AED coverage of public and non-public areas was analyzed by calculating the minimum distance between the occurrence place of each OHCA event and the nearest AED. The minimum distance ≤100 m was set as AED coverage, and the minimum distance > 100 m was set as non-AED coverage. It was assumed that one AED was configured for each OHCA hotspot area, then the AED coverage changes were analyzed. Based on the actual situation that the AED in schools, governments, sports venues, subways, tourist attractions and parks of public areas in Bao'an District could not be obtained at any time within 24 hours, it was assumed that all AED in the public areas could be obtained at any time within 24 hours, the impact of AED available at any time on AED coverage was analyzed.Results:A total of 525 cases of OHCA were enrolled. The highest incidence of OHCA was found in residential and industrial areas [54.5% (286/525) and 14.3% (75/525), respectively]. There were 252 AED in Bao'an District, Shenzhen, and 115 OHCA events occurred within the coverage area of AED. Even if all AED met the ideal state that could be obtained at any time within 24 hours, the coverage rate was only 21.9% (115/525). The AED coverage rate of the public areas and non-public areas was 31.6% (37/117) and 19.1% (78/408) respectively, with uneven distribution, and the AED coverage rate of non-public areas was low. Assuming that the residential community and industrial zone with more than 2 OHCA cases were respectively equipped with one AED, the coverage rate of AED in the non-public areas increased from 19.1% (78/408) to 28.2% (115/408), basically meeting the requirement that AED could be obtained at any time when OHCA events occurred. Some AED in the public areas of Bao'an District were not available at any time within 24 hours. If the ideal state that all AED in the public area could be obtained at any time within 24 hours could be achieved, the AED coverage rate of all regions increased from 16.8% (88/525) to 21.9% (115/525), the AED coverage rate of the public areas increased from 29.1% (34/117) to 31.6% (37/117), the AED coverage rate of the non-public areas increased from 13.2% (54/408) to 19.1% (78/408).Conclusions:AED configuration in Bao'an District was unevenly distributed, and the coverage rate of AED in non-public areas was low. The allocation strategy for AED in fast-growing cities like Shenzhen should be as follows: on the premise of ensuring AED availability for 24 hours, priority should be given to covering the number of AED in the non-public areas including residential communities and industrial zones; AED is available in the public areas for 24 hours.
4.Clinical analysis of 51 female children with condyloma acuminatum
Dan HUANG ; Mei JU ; Baozhu CHANG ; Xu CHEN ; Xiaohua ZHANG ; Yan ZHU ; Ya'nan ZHOU ; Nan XU ; Kun CHEN ; Heng GU
Chinese Journal of Dermatology 2018;51(5):363-365
Objective To analyze clinical features and treatment outcomes of female children with condyloma acuminatum.Methods Female outpatients with condyloma acuminatum aged less than 12 years were enrolled into this study.Through a questionnaire survey,medical histories were collected,and a physical examination was performed in these patients.Polymerase chain reaction (PCR) was conducted to determine the genotypes of human papillomavirus (HPV).Descriptive statistical methods were used to identify high risk factors for condyloma acuminatum,manifestations of skin lesions,and results of HPV test.The number of sessions of laser therapy and photodynamic therapy was also recorded.Results A total of 51 female children aged under 12 years with a diagnosis of condyloma acuminatum were enrolled into this study.Their median age and course of disease (M [P25-P75]) were 3 (2-5) years and 6 (4-8) months respectively.Of the 51 patients,29 (56.9%) lived in the small towns or suburb of a city,and 16 (31.4%) lived in the rural areas.Only 2 children's parents had a definite HPV infection history.Twelve children (23.6%) usually wore open-seat pants,24 (47%) often took a bath in public bath houses,and only 1 child had a definite history of sexual assault.Among these patients,39 (76.5%) mainly had perianal skin lesions,and all cauliflower-like lesions occurred on the perianal area.A total of 35 patients underwent the HPV test in the exfoliated cells.The positive rate of HPV was 71.4%,and all the HPV-positive patients were infected by low-risk HPV types (HPV6/11).During the treatment,5 patients were lost to follow-up.In the remaining 46 patients,the median number of sessions of laser therapy and photodynamic therapy was 2 (1-4) and 3 (3-4) respectively.The median course of treatment was 4 (2-6) months.After the treatment,all the remaining 46 patients were cured with a recovery rate of 90.2% (46/51).Conclusions In these female children with condyloma acuminatum,the source of infection may maninly come from the environment,and skin lesions mostly occur on the perianal area.The prognosis is good after laser and photodynamic therapy.