Objective To investigate the impact of propofol and midazolam on the time course of extubation in patients with mechanical ventilation.Methods The patients were randomly divided into the propofol group(n=37)and the midazolam group(n=52),which were further divided into three sedation stratums.The administration of two drugs were stoped immediately while weaning from the ventilator.The awakening time and extubation time of the two groups were recorded and compared with each other.Results Both awakening time and extubation time of the propofol groups were shorter than those of the midazolam group(P

Adult ; Aged ; Blood Cell Count ; Caffeic Acids ; therapeutic use ; Female ; Humans ; Leukemia, Promyelocytic, Acute ; drug therapy ; Male ; Middle Aged ; Tablets ; Treatment Outcome ; Young Adult

AIM: The impaired function of vascular endothelial cells occurs popularly in hypertensive patients. Hepatocyte growth factor (HGF) plays a crucial role on impaired function, and is related to prevalence, severity and target organ damages of hypertension. This study explored the relationship between HGF gene C57488A polymorphism and essential hypertension (EH). METHODS: ①Between June and December in 2006, totally 107 EH patients with an average age of (61?9) years, in them 47 cases with family history of hypertension, were recruited in this study. Informed consents were obtained from the patients who were all the Han residents of Hefei area, and the experiment was approved by the hospital ethical committee. The hypertension criteria formulated by Chinese Medical Association included the systolic pressure ≥140 mm Hg or diastolic pressure ≥ 90 mm Hg (1 mm Hg=0.133 kPa), or having received drug therapy for hypertension over one year. The patients were administrated with hypotensive drugs with one month. Meanwhile 110 normotensives without family history of hypertension and drug therapy were served as controls, with an average age of (60?8) years. Inclusion criteria: systolic pressure 0.05).②The distributions of HGF gene C57488A polymorphism were in agreement with Hardy-Weinberg equilibrium, indicating population representativeness. The frequencies of three genotypes CC, CA, AA were 0.809, 0.170, 0.021 and C, A alleles were 0.894, 0.106 in the EH group with family history respectively. Correspondingly, the frequencies were 0.733, 0.233, 0.033 and 0.850, 0.150 respectively in the EH patients without family history. Meanwhile, the frequencies were 0.527, 0.355, 0.060 and 0.705, 0.295 respectively in the controls.③The frequencies of genotype CC and allele C were both significant higher in EH with or without family history compared with the controls (P 0.05). CONCLUSION: HGF gene C57488A polymorphism is possibly associated with EH, and genotype CC and allele C may be the factors of genetic predisposition of EH in Han population of Hefei area.

Enteral Nutrition ; Humans ; Pancreatitis ; therapy ; Parenteral Nutrition

Objective To investigate the changes of central corneal thickness (CCT) caused by mydriasis with Mydrin-P.MethodsA total of 151 patients (302 eyes) with refractive errors were studied. Each eye had instillation of Mydrin-P to obtain mydriasis. CCT was examined before and after mydriasis by ultrasonic pachymeter. Changes of CCT were observed.ResultsCCT was 549.40±25.47 μm before mydriasis and 562.14±25.84 μm after mydriasis with a significant different between two examinations( P<0.001). ConclusionMydriasis with Mydrin-P can affect the measurement of CCT.

Objective To evaluate the blood-saving effect of tranexamic acid in elderly patients undergoing total hip replacement.Methods One hundred and sixty ASA Ⅱ or Ⅲ patientss of both sexes,aged 65-70 yr,with a body mass index of 16-22kg/m2,undergoing total hip replacement,were randomly divided into 2 groups(n =80,each):control group(group C)and tranexamic acid group(group T).Anesthesia was induced with midazolam,fentanyl,etomidate and atracurium.The patients were tracheal intubated and mechanically ventilated.PEr CO2 was maintained at 35-45 mm Hg.Aneslhesia was maintained with propofol,remifentanil and atracurium.Before the skin incision,tranexamic acid 15 mg/kg was infused over 15 m in in group T,while the equal volume of normal saline was given instead in group C.Hemoglobin(Hb),platelet count(PLT),prothrombin time(PT),and activated partial thromboplastin time(APTT)were monitored during operation to guide blood transfusion.Intraoperative and postoperative blood loss and allogeneic blood transfusion were recorded.Postoperative complications were also recorded.Results There was no significant difference in the amount of intraoperative blood loss between the two groups(P ＞ 0.05).The amount of postoperative blood loss was significantly smaller and less allogeneic red blood cell was transfused in group T than in group C(P ＜ 0.05).No complications occurred after operation in either group.Conchusion Tranexamic acid has blood-saving effect in elderly patients undergoing total hip replacement,but the clinical value is limited.

Objective To investigate the post traumatic stress disorder scores of undergraduate and the correlation between emotional approach coping(EAC) in unaffected region after Wenchuan-earthquake.Methods PTSD Check list-Civilian Version (PCL-C) and emotional approach coping scale(EACS) were used to assessed 880 undergraduates in Nanjing. Results (1)The average score of PCL-C was 30.52±9.64, and the prevalence rates of PTSD was found 5.3%.(2)Gender difference were found in social function(male:1.66±0.80,female:1.52±0.63, t =2.664,P =0.005) and positive scores of PTSD(male:31.32±10.81,female:29.81±8.41,t =2.263,P =0.022).(3)No significant difference was found in different specialty between PTSD,but in emotional procession and emotional expression.(4)Emotional-approach coping and expose time in front of media came into the regression equation of PTSD symptoms.Conclusion The score of PCL-C of undergraduate in unaffected region are infected by how long he spend in front of media and how he use emotion-approach coping strategy to cope with this shock bringing by Wenchuan-Earthquake

Objective To evaluate the diagnostic value of computer-aided diagnosis with three-dimensional volumetric measurement in solid pulmonary nodules on follow-up CT. Methods Forty-six patients with 58 solid nodules were evaluated.Each patient underwent chest CT at least twice.The volume, doubling times(DTs) and volumetric growth rates(VGRs) of nodules were calculated with three-dimensional volumetric measurement software. If there were significant statistical differences in DTs between malignant and benign nodules, Nonparametric test was used to make the analysis.If there were significant statistical differences in upper DTs'values between malignant and benign nodules, X2 test was used to make the analysis.Final diagnosis of all nodule were confirmed by pathology or by response to diagnostic therapy or by clinical follow-up.Results The DTs of 13 malignant nodules were <400 days in 12 nodules, with a range from 45 to 465 days (median, 159 days) ; the VGRs ranged from 8% to 329% (median, 30.0%).The VGRs of 45 benign nodules ranged from -38% to 24% (median, 0%).The DTs of 24 benign nodules that increased or not changed in size were >400 days in 22 nodules, with a range from 302 days to 55 158 days (median, 2 704 days); the VGRs ranged from 0 to 24% (median, 6.5%. Twenty-one nodules that decreased in size had the VGRs ranging from -38% to -4% (median, - 16.0%), and the DTs of these nodules could not be calculated by software.There were significant statistical differences in DTs between malignant and benign nodules(P <0.05).Taking 500 days, 400 days and 300 days as the upper value for malignancies there were statistically significant differences in these values between malignant and benign nodules(P < 0.01).Their sensitivities were 100.0%, 92.3%, 76.9% respectively and specificities were 87.5%, 91.7%, 100.0% respectively.Accuracies were 91.9%, 94.6% ,91.9% respectively and positive predictive values were 8,11,0.Conclusions Taking 400 days as the upper DTs'value for malignancies has important diagnostic value. Computer-aided diagnosis with three-dimensional volumetric measurement is sensitive to the volume changes of solid pulmonary nodules on follow-up CT, and is useful in the differential diagnosis of pulmonary nodules.

ObjectiveTo prospectively investigate whether any of the perfusion parameters would predict early tumor response to chemotherapy and/or radiotherapy and prognosis in non-small cell lung cancer (NSCLC). MethodsIn a prospective series, Perfusion CT were performed in 152 patients suspected lung cancer with 16-slice or 8-slice multislice CT. Contrast medium (50 ml) was injected at a rate of 4 ml/s with a power injector.The scanning delay was 10 seconds and the scanning time was 50 seconds.Among 152 patients,123 patients were proved lung cancer by pathology.With the perfusion 3.0 software, the parameters including blood flow (BF), blood volume (BV), mean transit time (MTT) and capillary permeability surface area product (PS) were calculated. The perfusion image quality was evaluated on a 4-1eveal scale. The treatment response after chemotherapy and(or) radiotherapy was assessed with Response Evaluation Criteria in Solid Tumors (RECIST) ,and then the relationship between perfusion parameters with early tumor response to chemotherapy and(or) radiotherapy was evaluated. Student t test and Kaplan-Meier estimates were used for data analysis. ResultsIn 84 patients (68.3%), the perfusion image quality was staged level 2 (moderate) and level 3 (good). Among them, 35 patients with NSCLC were assessed with RECIST after chemotherapy and (or) radiotherapy.In these 35 patients, The BF of responders and nonresponders was (81.0±33.6)and (56.3±23.1) ml·min~(-1)·100 g~(-1),respectively, which was significantly different(t=2.393, P=0.023). The median PFS of low-BF group (BF≤80 ml·min~(-1)· 100 g~(-1)) and high-BF group (BF>80 ml·min~(-1)·100 g~(-1)) was 11.8 and 8.0 months respectively (P>0.05), and the median PFS of low-BV group (BF≤6 ml/100 g~(-1)) and high-BV group (BF>6 ml/100 g~(-1)) was 9.2 and 8.0 months respectively(P>0.05), both of them were not significantly different.ConclusionNSCLC in high perfusion are relatively sensitive to chemotherapy and/or radiotherapy, and the response rate is relatively higher, but the progress time is relatively shorter.

Objective To discuss the necessity and methods of combined reconstruction of the injured posterior cruciate ligament(PCL)and posterolateral complex(PLC)of the knee. Methods From January 2001 to December 2006,28 patients with injury of both PCL(≥Ⅱ°b)and PLC(＞Ⅱ°)of the knee were treated operatively in our department.Eight patients received arthroscopic PCL reconstruction with single bundle of 5-6 strands of hamstring and conservative treatment of PLC during January 2001 to December 2003.Twenty Datients received arthroscopic PCL reconstruction followed by open operative repair of PLC with median 1/3 femoral biceps tendon and gracilis during January 2002 to December 2006. Results All the patients were followed up for 6 to 24 months postoperatively (mean,15 months).By Lysholm scoring,3 cases obtained good results and 5 poor in the first group,while 19 excellent and 1 good in the second group.The mean Lysholm scores were 47.1±8.2 and 86.7±7.2 respectively(P＜0.05).According to IKDC scale,3 patients(37.5%)in the first group and 19 patients (95.0%)in the second group were graded normal or nearlv normal(t=19.277,P＜0.05). Conclusion Arthroseopic PCL reconstruction with single bundle of 5-6 strands of hamstring plus PLC reconstruction with 1/3 femoral biceps tendon and gracilis is more reliable to restore the stability of the knee than PCL reconstruction only.