2.Advances in MicroRNA and anaesthetic research
Journal of Medical Postgraduates 2015;(2):207-211
It has long been concerned about the mechanism , pathology and toxicology of anaesthetic involving drug addiction and its influence on human body .In recent years , as a short non-coding RNA negatively regulating the genes in cells , MicroRNAs (miRNAs) may turn out to be a focus issue which is related to apoptosis , metabolism, inflammation, and tumorigenesis.This article illuminates the influence on gene expression introduced by common anaesthetics and the interaction between gene and its target site . Analyzing the potential medical applications of miRNA , this article reviews the correlation between miRNAs and anaesthetic to provide new evidences in this emerging field .
3.Antimicrobial therapy in patients with acute pancreatitis complicated with infection
Journal of Medical Postgraduates 2017;30(7):684-692
Infection can complicate different stages of acute pancreatitis.The probability of infection is related to the existence and extent ofpancreatic necrosis: up to 30% of patients with pancreatic necrosis develop infection.The timing of infection is variable and usually peaks in the second to fourth week after the onset of pancreatitis.IPN(infected pancreatic necrosis)is the most common type of secondary pancreatic infection.Infectious complications in severe acute pancreatitis are associated with considerable morbidity and mortality.Antimicrobial therapy is one of the fundamental elements of therapy.Diagnosis of secondary pancreatic infection is challenging and radiologic characteristic (air bubble sign) and CT guided fine-needle aspiration (FNA) are reliable diagnostic strategies.Antibioticuse should be rational in terms of a rational indication, a rational spectrum, and a rationalduration.Prophylactic antibiotics are not beneficial in improving prognosis.The only rational indication for antibiotics is documented infection.The empirical antibiotics should cover common microbials of hospital-acquired intra-abdominal infection and with good pancreatic penetration.Also, fungal infections are often present in thesepatients, and early diagnosis and antifungal coverage should be considered.Duration is in fact largely determined by the presence and efficacy of source control.When there is no or minimal residual infection left after a source control procedure, a duration of 7 to 10 days is probably sufficient.On the other hand, if the source of infection has not been removed completely, prolonged courses until the residual necrosis has been sterilized are necessary.
4.Diagnosis and prognosis evaluation of 18F-FDG PET/CT in bone marrow infiltration of lymphoma
Journal of International Oncology 2016;43(5):395-397
18 F-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) and bone marrow biopsy (BMB) have high consistency in the detection of lymphoma bone marrow infiltration (BMI).18F-FDG PET/CT has a high sensitivity to Hodgkin lymphoma (HL) and aggressive non-Hodgkin lymphoma (NHL) BMI,while the sensitivity of indolent NHL is low.Since 18F-FDG PET/CT may appears false positive or false negative,so it can not replace the conventional BMB.We can carry out a BMB under the guidance of 18F-FDG PET/CT,which can greatly improve the detection rate of BMI.
5.Maternal and Perinatal Morbidity after 40 weeks and Postdate Pregnancy
Journal of Shanghai Jiaotong University(Medical Science) 2006;0(02):-
Objective To analyse the maternal and perinatal morbidity after 40 weeks and postdate pregnancy,and to research suitable time of labor induction. Methods Clinical data of 357 pregnant women after 40 weeks with normal menstrual period were analysed.They were divided into four groups according to the different weeks of gestation. Results There were no significant difference in the four groups for maternal and perinatal morbidity,the rate of spontaneons labor,the degree of cervical repine and the successful rate of labor induction.The successful rate of artificial rupture of membranes was higher in the groups with Bishop score ≥6(P
7.Controlled decompression for treatment of severe head injury: a meta-analysis
Liang SHEN ; Zhongzhou SU ; Yue ZHOU
Chinese Journal of Trauma 2016;32(5):406-409
Objective To evaluate the effect of controlled decompression on complications such as delayed intracranial hematoma,acute encephalocele and cerebral infarction in patients with severe traumatic brain injury.Methods Pubmed,Cochrane Library,Wanfang data,VIP and CNKI wcrc searched for related literaturc about controlled decompression (treatment group) and traditional surgical methods(control group) for severe traumatic brain injury.The data that met the inclusion criteria were extracted,and analyzed statistically using the Review Manager 5.3.Results A total of 12 studies were included in this meta-analysis,with respective 730 patients in control group and 908 patients in treatment group.Controlled decompression versus traditional treatment methods reduced incidence of delayed intracranial hematoma (RR =0.55,95% CI 0.44-0.70,P < 0.01),acute encephalocele(RR =0.42,95% CI 0.32-0.53,P < 0.01) and cerebral infarction (RR =0.42,95% CI 0.32-0.55,P <0.01).Conclusion Applied to treat severe traumatic brain injury,controlled decompression exhibit significantly lower rate of delayed intracranial hematoma,acute encephalocele and cerebral infarction than traditional methods.
8.Role of long non - coding RNA in the pathogenesis of diabetic retinopathy
Xiu-Juan, YUE ; Sheng, SU ; Ping, LIU
International Eye Science 2017;17(10):1852-1855
Long non-coding RNA ( LncRNA) is a class of transcript (>200 nucleotides) that do not encode proteins. It plays an important role in epigenetic regulation and gene expression at transcriptional or post transcriptional level. The abnormal expression of LncRNA may lead to various pathological processes. Diabetic retinopathy ( DR ) is a multifactorial disease. Recent studies have shown that many specific expressions of LncRNAs are closely related to the genesis of DR. In this review, we summarized the recent advances in the function of LncRNA, the regulatory mechanisms of LncRNA involved in the development of DR, and the related therapies.
9.Individualized lung protective ventilation regimen based on pressure-volume curve for one lung ventilation in patients undergoing thoracic surgery
Jianluo SI ; Yue SU ; Shaotuan SONG
Chinese Journal of Anesthesiology 2011;31(7):847-849
ObjectiveTo evaluate the effectiveness of setting PEEP and tidal volume (VT ) according to pressure-volume (P-V) curve during one lung ventilation (OLV) in patients undergoing thoracic surgery.Methods Twenty-five ASA Ⅰ or Ⅱ patients of both sexes aged 44-64 yr weighing 57-75 kg undergoing lobectomy under general anesthesia were enrolled in this study.Double-lumen tube was inserted.Correct positioning was verified by flberoptic bronchoscopy.The patients were mechanically ventilated.P-V curve was measured by SSS system during OLV.Lower inflection point (LIP)and upper inflection point (UIP) were determined.The pressure at LIP (PLIP) and volume at UIP (VUIP) were measured.Bilateral lungs were ventilated for 30 min (T0) at first before OLV was started.PEEP was set at PLIP + 0.196 kPa and VT was set at VUIP,and the patients were ventilated for 30 min (T1).VT was then reduced to 80% of VUIP.OLV was performed for another 30 min (T2).VT was then further reduced to 60% of VUIP and the patients were ventilated for 30 min (T3).PEr CO2 was maintained at 4.67-6.00 kPa.Arterial blood and central venous samples were taken at T0-3.Blood gas analysis was performed.Qs/Qt was calculated.MAP,HR,CVP,peak airway pressure (Peak),airway resistance (Rsw) and lung compliance (CL) were measured and recorded at T0-3.ResultsHR,Ppeakk,Rsw and Qs/Qt were significantly increased while CL and PaO2 decreased at T1-3,CVP was significantly increased at T1.2 and MAP and PaCO2 were increased at T3 as compared with the baseline values at T0.Ppeak and Rsw were significantly decreased at T2.3 and PaO2 was significantly increased while Qs/Qt decreased at T2,CVP was decreased,MAP and PaO2 were increased at T3 as compared with the values at T1.ConclusionsMechanical ventilation with VT set at 80% of VUIPandPEEPatPUIP+0.196kPa provides best ventilatory efficacy for OLV in terms of PaO2 and hemodynamics.
10.Effects of different positions of the patients mechanically ventilated under general anesthesia on respiratory mechanics during one or both lung ventilation before thoracotomy
Wei LIU ; Yue SU ; Wanming GENG
Chinese Journal of Anesthesiology 1994;0(03):-
Objective To investigate the effects of different positions of the patients mechanically ventilated under general anesthesia on respiratory mechanics during one or both lung ventilation before thoracotomy.Methods Twelve ASA Ⅰ or Ⅱ patients of both sexes (8 males, 4 females) aged 33-63 years weighing 62-85 kg scheduled for general thoracic surgery were studied. The preoperative lung function of the patients was normal. The patients were premedicated with intramuscular pethidine, promethazine and atropine. Anesthesia was induced with fentanyl, droperidol, midazolam, propofol and vecuronium. Left-sided double-lumen tube was inserted and correct placement was confirmed using a fiberoptic bronchoscope inserted through the bronchial lumen. Anesthesia was maintained with propofol and vecuronium infusion. The magnitude of neuro-muscular blockade was monitored by stimulation of radial nerve with TOF pulses. T4/T1 was maintained at 0 during study. The patients were placed in supine, left and right lateral position. In each position both lungs, left and right lung were ventilated for 10 min respectively. The non-ventilated bronchial lumen was open to the air during one-lung ventilation. The ventilatory parameters were kept unchanged during the study (VT = 8-10 ml?kg-1 , RR = 12 bpm, I:E = 1:2). Pressure-volume loop (P-V loop), peak airway pressure (Ppeak), airway resistance (Raw), total compliance (CT) (lung and thorax) and PETCO2 were measured and recorded at the end of each 10 min ventilation using S/5 monitor ( Datex-Ohmeda Finland) . Results During both lung ventilation Ppeak was significantly increased and CT was significantly decreased in left and right lateral position as compared with supine position ( P