Airway Remodeling ; Asthma ; pathology ; physiopathology ; Child ; Humans

Asthma ; diagnosis ; therapy ; China ; Humans ; Practice Guidelines as Topic ; standards

Objective To observe the efficacy and safety of the etomidate target controlled in-fusion (TCI)in the total thoracoscopic mitral valve replacement surgery.Methods One hundred and ten patients,aged 29-55 years,48 males and 62 females with ASA grade Ⅱ or Ⅲ rheumatic mitral valve disease planned to be corrected with total thoracoscopic mitral valve replacement surgery were randomly divided into group E and group P,55 cases in each group.In group E,etomidate-sufentanil target controlled infusion was used for induction (the initiate plasma concentration of etomidate was 0.2 ng/ml and increased 0.1 ng/ml per minute according to the bispectral index and the effect-site concentration of sufentanil was maintained at 1.0 ng/ml)and maintenance.In group P,using propo-fol-sufentanil target controlled infusion for induction (the initiate plasma concentration of propofol was 1.0 ng/ml and increased 0.3 ng/ml per minute according to the bispectral index and the effect-site concentration of sufentanil was maintained at 1.0 ng/ml)and maintenance.We documented the incidence of hypotension during the induction phase, recorded the basic clinical parameters of patients,the dosage of vasopressors during induction and sufentanil during anesthesia,time of eyelash reflex absence,operation time,CPB time,clamping time,APACHE Ⅱ score when enter CCU,pos-itive inotropic score 24 h postoperatively,wakening time,mechanical ventilation time,CCU stay,in-hospital stay,blood glucose and lactic acid preoperatively,2,6,24 h postoperatively,cortisol,aldo-sterone and adrenocorticotropin preoperatively and 24 h postoperatively and postoperative complications in both groups.Results The incidence of hypotension during induction in group E was much lower than that in group P (P<0.05).The dosage of norepinephrine during the induction in group E were much less than group P (P <0.05).The wakening time,mechanical ventilation time,CCU stay and in-hospital stay in group E were significantly shorter than group P (P <0.05).The blood glucose and lactic acid at postoperative 2,6,24 h were much higher than the preoperative value within each group (P <0.05).They reached the maxim at 6 h postoperatively and began to decline at 24 h postoperatively. Blood glucose and lactic acid at all the time points between two groups were similar.Cortisol at 24 h postoperatively was much higher than the preoperative value in group P (P <0.05).The dosage of cortisol and aldosterone 24 h postoperatively in group E were much less than that in group P (P <0.05).The incidence of postoperative lung infection in hospital in group E was remarkably lower than that in group P (P <0.05).Conclusion Etomidate target controlled infusion can maintain stable he-modynamics during the induction period, shorten postoperative recovery time and reduce postoperative lung infection obviously,which can be safely used in total thoracoscopic mitral valve re-placement surgery.

Aged ; Female ; Humans ; Infant ; Lung Diseases ; diagnostic imaging ; Male ; Pulmonary Artery ; diagnostic imaging ; Tomography, X-Ray Computed

Acetates ; administration & dosage ; therapeutic use ; Asthma ; drug therapy ; etiology ; metabolism ; Bronchiolitis, Viral ; drug therapy ; Cysteine ; metabolism ; Humans ; Infant ; Infant, Newborn ; Leukotriene Antagonists ; administration & dosage ; therapeutic use ; Leukotrienes ; biosynthesis ; Nasopharynx ; secretion ; Quinolines ; administration & dosage ; therapeutic use ; Respiratory Syncytial Virus Infections ; drug therapy ; metabolism ; virology ; Risk Factors

Objective To evaluate the clinical effects and adverse reaction of raltitrexed combined with radiation for esophageal carcinoma in elderly patients.Methods Sixty patients were randomly divided into two groups by the envelope method, 30 patients in experimental group received raltitrexed combined with radiotherapy and 30 patients in control group received radiotherapy only.Patients in both groups received conventional radiotherapy with a total dose of 56-60 Gy/28-30 F.In experimental group, raltitrexed 2.6 mg/m2 was administered concurrently with the radiotherapy on d1 and d22.Two cycles of concurrent chemotherapy were administered during radiotherapy.The short-term effects, survival times and adverse reactions of the two groups were compared.Results The total effective rates of experimental group and control group were 93.3% and 73.3%, respectively, and there was statistically significant difference between the two groups (χ2=4.320, P=0.038).The median survival times of experimental group and control group was 24.0 months and 12.0 months, respectively, and there was statistically significant difference by Log-rank test (χ2=6.048, P=0.014).The major adverse reactions of grade 3-4 in experimental group and control group were radiation-induced esophagitis (10.0% vs.3.3%;χ2=0.268, P=0.605), leukopenia (13.3% vs.10.0%;χ2=0.000, P=1.000), thrombocytopenia (3.3% vs.0;P=1.000), nausea and vomiting (6.7% vs.0;χ2=0.517, P=0.472), and the differences were not statistically significant.Conclusion Raltitrexed combined with radiotherapy can enhance the short-term effect and prolong the survival time for the elderly esophageal carcinoma patients, and the adverse reactions are mild.It is worthy of further clinical study.

Evidence has shown that the abnormal expression of specific microRNAs (miRNAs) is associated with the occurrence,development and prognosis of pancreatic cancer,which is the potential target of forecast about invasion and metastasis of pancreatic cancer.There is close relation between miRNAs and biological characteristics of pancreatic cancer invasion and metastasis.Therefore,miRNAs are expected to become the new research targets of the mechanism of invasion and metastasis of pancreatic cancer.

Objective The influence of antiplatelet medications on prognosis after non -aneurysmal subarachnoid hemorrhage(SAH)is unknown.This study aimed to evaluate the risk of antiplatelet mdications in devel-oping SAH.Methods 420 patients who underwent catheter cerebral angiography after presenting with nontraumatic SAH were included.Outcomes were assessed by using the modified Rankin scale.Results A total of 420 patients underwent catheter angiography for evaluation of SAH.Of these,63 cases (15%)were angiogram -negative.The fraction of patients presenting with angiogram -negative SAH as well as the frequency of antiplatelet use among these patients significantly increased during the study period.Antiplatelet use was more commonly associated with angiogram-negative SAH(18 /63,28.6%)than with angiogram -positive SAH(39 /357,11%;P =0.001).At 14 days after presentation,poor outcome was significantly more frequent among patients who took antiplatelet agents (20 /63, 31.7%)than among those who did not(12 /63,20%;P =0.017).Conclusion Antiplatelet medication use is asso-ciated with poor early,but not late,outcomes after angiogram -negative SAH.More studies are needed to confirm this association.