Objective Evaluate the effects of venous-arterial modified ultrafiltration on hemodynamics compared to arterial-venous in children undergoing cardiopulmonary bypass (CPB) for repair of congenital heart defects. Methods Forty patients underwent MUF randomly divided into two groups,group V-A MUF (n =20) and group A-V MUF (n =20) for 10 min after CPB. They were studied before CPB, after CPB, 10 min after CPB, and 30 min after CPB. Haemodynamic data including heart rate, blood pressure, central venous pressure and hematocrit were recorded. Transoesophaegeal echocardiography determined left ventricular posterior wall thickness in end-systole ( LVPWs) and end-diastole (LVPWd) , end diastolic volume (EDV) , end systolic volume (ESV) and ejection fraction (EF) were measured and compared in two groups. Results Patients in V-A MUF maintained better systolic arterial blood pressure at 10 min and 30 min compared with 0 min values after CPB. A significant decrease in EF were observed in both groups immediately after CPB ( P < 0.05 ). Significant increase in EF was observed at 10 min (60% ) and 30 min (46% ) after CPB compared with 0 min value after bypass in V-A MUF (P <0.001 ). In A-V MUF, no such increase in EF was observed. EF were significantly higher at 10 min and 30 min in V-A MUF as compared with A-V MUF (P < 0. 001). There was also significant improvement in posterior wall thickness in V-A MUF (P <0.05). Haematocrit values were not different in duration of postoperative between two groups. Conclusion Veno-arterial modified ultrafiltration is a safe and effective method of improving hemodynamics in children following cardiac surgery.

OBJECTIVETo investigate the effectiveness of surgical strategies for Shang Ring circumcision in the treatment of short frenulum praeputii in patients with redundant prepuce or phimosis.

METHODSTotally, 130 cases of short frenulum praeputii with redundant prepuce or phimosis were randomly assigned to an experimental group and a control group of equal number to receive Shang Ring circumcision, the former by transverse incision in the distal penis foreskin and pull-up of the interior board, and the latter by conventional transverse incision and longitudinal suture of the frenulum praeputii. Comparisons were made between the two groups in the surgical duration, intraoperative blood loss, 24 h postoperative pain visual analog score (VAS), postoperative complications, satisfaction with the penile appearance, and the quality of sexual life.

RESULTSThe surgical duration, intraoperative blood loss, 24 h postoperative VAS, postoperative sexual satisfaction, and satisfaction with penile appearance were (4.60 +/- 1.20) min, (2.61 +/- 1.81) ml, 1.73 +/- 0.76, 98.5%, and 98.5%, respectively, in the experimental group, as compared with (21.60 +/- 6.30) min, (11.10 +/- 3.40) ml, 5.37 +/- 1.84, 70.3% and 69.8% in the control, with statistically significant differences between the two groups (P < 0.05). The incidence rates of such major complications as wound dehiscence, infection, and moderate to severe edema were 1.5% (1/65), 3.1% (2/65), and 4.6% (3/65), respectively, in the experimental group in comparison with 12.3% (8/65), 15.3% (10/65), and 30.7% (20/65) in the control, with statistically significant differences between the two groups (P < 0.05). None of patients had any serious complications.

CONCLUSIONShang Ring circumcision by transverse incision in the distal penis foreskin and pull-up of the interior board, with its advantages of shorter operation time, less blood loss, mild pain, fewer complications, and higher satisfaction and acceptance of the patients, can be used as an safe and effective approach to the treatment of short frenulum praeputii.

Aged ; Blood Loss, Surgical ; statistics & numerical data ; Circumcision, Male ; adverse effects ; instrumentation ; methods ; Edema ; epidemiology ; Foreskin ; abnormalities ; surgery ; Humans ; Incidence ; Male ; Operative Time ; Pain Measurement ; Pain, Postoperative ; diagnosis ; Patient Satisfaction ; Phimosis ; surgery ; Postoperative Period ; Prostheses and Implants ; Surgical Wound Dehiscence ; epidemiology ; Surgical Wound Infection ; epidemiology

China ; epidemiology ; Dust ; prevention & control ; Humans ; Silicon Dioxide ; chemistry ; Silicosis ; epidemiology ; prevention & control

Objective:To investigate the distribution of uric acid in different occupation, age and gender groups, and changes of prevalence of hyperuricemia (HUA) and its influencing factors in healthy adults who receiving physical examination in Nanjing.Methods:The study was conducted in 107 478 subjects who received physical examination from 2012 to 2016. The prevalence of HUA in different genders and different years was compared. Subjects were divided into non-HUA and HUA groups according to serum uric acid. The differences in metabolic indicators and ages between two groups were analyzed. Uric acid levels among different occupations were evaluated. A multivariate logistic regression analysis was used to estimate the odds ratios ( OR) of HUA. Results:The total HUA prevalence was 14.9%, in which the prevalence of HUA in men was significantly higher than that in women [20.5%(15217/74339)vs .2.5%(818/33139), P<0.01]. The prevalence of HUA in men sustained at a high level, while that in women trended to decrease during the five years. The prevalence of HUA increased with age in women (1.0%, 0.7%, 0.9%, 2.7%, 3.8% and 9.6% in subjects within 20-29, 30-39, 40-49, 50-59, 60-69 and ≥70 age groups, respectively, Pfor trend<0.01). The percentages of hypertension, hyperlipidemia and diabetes, and body mass index (BMI) in both men and women were significantly higher in HUA group than those in non-HUA group ( P≤0.01). Among all occupations, subjects in health care had the lowest levels of uric acid (298±91 μmol/L) and prevalence of HUA (10.4%), while, those in public security had the highest levels of uric acid [(342±82) μmol/L] and prevalence (16.5%). Multiple logistic regression analyses revealed that males, high triacylglycerol, high cholesterol, obesity and certain occupation were significantly associated with HUA. Conclusions:The prevalence of HUA in men is significantly higher than that in women. It increased with ages in women. Subjects in health occupations had the lowest levels of uric acid and HUA prevalence, while, those in public security had the highest levels among the six occupations. Obesity, hyperlipidemia, hypertension, occupations and males are positively associated with HUA.

Objective To observe the effect of different thyroid hormone level on the expression of synaptotagmin Ⅰ(Syt Ⅰ) in adult rat hippocampus. Methods All 28 adult male SD rats were assigned randomly into hypothyroid, hyperthyroid and control group, hypothyroid group was established by daily intraperitoneal injections with propylthiou raci(PTU, 10.0 mg/kg body weight) for 6 weeks and hyperthyroid group with L-Thyroxine (L-T4, 0.5 mg/kg body weight) for 3 weeks. Radioimmunity method was used to assay the levels of serum T3 and T4, immunohistochemical S-P technology to assay the levels of Syt Ⅰ protein in hippoeampus CA1, CA3 and dentate gyrus (DG). The layers analyzed in the different subfields include the polymorphic cell layer(the stratum oriens, SO), pyramidal cell layer(PCL), stratum radiatum (SR), lacunosum-molecular layer (SLM) in CA1 and CA3, granular cell layer(GL) and molecular layer(ML) in DG. Results The levels of serum T3 and T4[(0.34±0.12), (41.03± 11.37)nmol/L]in the hypothyroid rats were significantly lower than those in the control group[(0.65±0.15), (55.20±10.68)nmol/L, P < 0.01 or < 0.05], and the positive granule of Syt Ⅰ was significantly lower in PCL and SR of CA1 and CA3, GL of DG. The average optical value responsible for Syt Ⅰ immunoreactivity was obviously reduced in SO(0.048±0.007), PCL(0.299±0.035), SR(0.042±0.007), SLM(0.038±0.006) of CA1, PCL(0.085± 0.019), SR(0.040±0.011), SLM (0.038±0.006) of CA3, GL (0.076±0.019) of DG than normal controls (0.068± 0.014, 0.376±0.053, 0.053±0.008,0.056±0.009,0.118±0.026,0.052±0.010,0.053±0.009,0.099±0.015; P< 0.01 or < 0.05). Serum T3 and T4 levels [(1.43±0.30), (157.18±19.95)nmol/L]of hyperthyroid rats were significantly higher than those of control group(P < 0.01). The value was reduced in PCL(0.322±0.050), SR(0.039±0.006), SLM (0.042±0.006) of CA1, PCL(0.098±0.034), SR(0.046±0.013), SLM(0.046±0.010) of CA3 and GL(0.085± 0.024), ML (0.042±0.009) of DG (P < 0.05 or < 0.01). Conclusion Adult-onset of hypothyroidism and hyperthyroidism can reversibly decrease the expression of Syt Ⅰ in CA1, CA3 and DG regions of hippocampus.

OBJECTIVETo investigate the hand hygiene (HH) compliance and its influencing factors in order to improve the HH of healthcare workers (HCWs).

METHODSHH compliance of HCWs in randomly sampled departments in our hospital was observed and recorded single-blindly by specially-trained staffs using a uniform method.

RESULTSThe total compliance rate of HH of HCWs was 30.2%, which varied among different departments and posts, and working areas. It was significantly higher in ward doctors than in outpatient physicians (P < 0.01). However, the compliance was not significantly different among nurses in different departments (P > 0.05). The compliance of HH of HCWs after surgical procedures (40.4%) was significantly higher than that before procedures (19.6%) (P < 0.01).

CONCLUSIONThe compliance of HH of HCWs remains low, which is somehow affected by factors such as departments, posts, and treatment modes.

Female ; Guideline Adherence ; statistics & numerical data ; Hand Disinfection ; Humans ; Hygiene ; Male ; Personnel, Hospital ; statistics & numerical data

BACKGROUNDHyperbaric oxygen preconditioning (HBO) is a new method of ischemia preconditioning. In this study, we examined its effects on skin flap survival and the mechanisms involved.

METHODSThirty-six rats were divided into three groups: HBO preconditioning, control, and sham groups. An extended epigastric adipocutaneous flap based on the right superficial epigastric artery and vein was raised. A 3-hour period of flap ischemia was induced by clamping the pedicle vessels with a microvascular clamp. At the end of ischemia induction, the clamp was removed and the flap was resutured. Rats in the HBO preconditioning group were treated with HBO four times before surgery. Microcirculation in the skin flap was measured on postoperative days 1, 3 and 5. The size of the flap was measured on postoperative day 5, before the animals were sacrificed. Samples of the skin flap were prepared and stained with hematoxylin and eosin. The levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6 in the flap samples were measured.

RESULTSSurviving flap size was significantly higher in the HBO preconditioning group compared with controls, with a reduced inflammatory response and increased perfusion. IL-1, TNF-α, and IL-6 levels in the HBO preconditioning group were lower than in controls.

CONCLUSIONSHBO preconditioning improved flap survival in this ischemia-reperfusion rat model. The mechanisms responsible for this effect may relate to attenuation of the inflammatory response and increased flap perfusion following HBO preconditioning.

Animals ; Graft Survival ; Hyperbaric Oxygenation ; methods ; Ischemia ; surgery ; Male ; Microcirculation ; physiology ; Rats ; Rats, Sprague-Dawley ; Skin ; Surgical Flaps

OBJECTIVETo observe the effect of Chuanhuang No.1 Recipe (CHR) on renal function and micro-inflammation in phase 3 chronic kidney disease (CKD) patients.

METHODSTotally 60 phase 3 CKD patients were randomly assigned to the treatment group (treated by CHR) and the control group (treated by Losartan Potassium), 30 in each group. All patients received basic treatment. Patients in the treatment group took CHR decoction, 400 mL each time, one dose per day, while those in the control group took Losartan Potassium, 50-100 mg per day. All medication lasted for 24 weeks. Changes of serum creatinine (SCr), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), serum uric acid (UA), 24 h urinary protein excretion (24 h U-pro), urinary microalbumin (U-Alb), high-sensitivity C-reactive protein (hs-CRP), serum tumor necrosis factor (TNF)-alpha, and serum IL-6 were detected and compared before and after treatment. Efficacy was also compared.

RESULTSCompared with before treatment, SCr and BUN significantly decreased in the treatment group (P<0.05, P<0.01); eGFR in- creased (P<0.05). Only UA obviously decreased in the control group (P<0.05), but with no obvious change in SCr, BUN, or eGFR. Compared with before treatment, 24 h U-pro decreased after treatment in the treatment group (P<0.05), but with less decreased level when compared with the control group. U- Alb was also significantly decreased in the control group (P<0.01). There was statistical difference in 24 h U-pro and U-Alb between the two groups after treatment (P<0.05). Compared with before treatment, hs-CRP obviously decreased after treatment in the two groups, but serum levels of TNF-alpha and IL-6 obviously decreased only in the treatment group (P<0.05). The total effective rate was obviously higher in the treatment group than in the control group (70.00% vs. 43.33%, P<0.01).

CONCLUSIONCHR could efficiently improve the renal function of phase 3 CKD patients and alleviate the micro-inflammation.

Adult ; Blood Urea Nitrogen ; C-Reactive Protein ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Inflammation ; Interleukin-6 ; metabolism ; Losartan ; therapeutic use ; Male ; Middle Aged ; Phytotherapy ; Renal Insufficiency, Chronic ; drug therapy ; Tumor Necrosis Factor-alpha ; metabolism ; Urea

OBJECTIVETo study the necessity, feasibility, security of carotid angioplasty and stenting (CAS) for symptomatic carotid stenosis combined with kinking.

METHODSTwelve patients with symptomatic carotid stenosis and kinking demonstrated by digital subtraction angiography (DSA) received CAS from December 2003 to December 2009. There were 9 male and 3 female patients, age ranged from 59 to 77 years (mean 69.3 years). All the patients' clinical, imaging, intervention and follow up data were collected and analyzed.

RESULTSAll CAS procedures were successfully performed with 14 self-expandable stents placed. The mean degree of stenosis was reduced from 85.6% before stenting to 11.2% after stenting, the angle of kinking, according to Metz' category, were improved from less than 90° to more than 120° in each case. No perioperative procedure related stroke and transient ischemic attack (TIA) occurred. The clinical symptoms and signs of cerebral ischemia were improved or disappeared for all patients. During follow-up of these 12 patients for 6 to 72 months, one patient experienced ipsilateral carotid territory TIA and another patient experienced contralateral carotid territory TIA. DSA follow up of 5 patients demonstrated 1 case with in-stent restenosis and arterial kinking remote to the stent of internal carotid artery. CAS were performed again and CT angiography follow up demonstrated no kinking and restenosis 2 years after the intervention. Duplex scan of the other 7 patients demonstrated neither kinking nor restenosis.

CONCLUSIONSCAS seems to be feasible and safe for the patients with symptomatic kinking and stenosis, and maybe helpful to lower the risk of cerebral ischemia, but further study is needed.

Aged ; Angioplasty, Balloon ; methods ; Carotid Stenosis ; surgery ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Stents ; Treatment Outcome

Objective To structure the music database of TCM emotion treatment based on the TCM emotion theory and subjective emotion experience, setting the music played by Chinese musical instruments as materials. Methods This study adopted qualitative analysis and recruited 71 subjects (including 274 valid descriptions for emotion elicited by music) to select the names of music and to divide emotional categories of music. Then, 37 subjects (3132 valid evaluation) were adopted to assess emotional categories, degrees of favorite and familiarity for each piece of music by using quantitative analysis. Finally, 3 domain experts were invited to select music, to analyze music emotion, and to construct initially the database for TCM emotion treatment. Results Totally 120 songs were selected and eight emotional categories were divided, which were feelings of calm, refreshing, pleasure, detached, releasing, encouraging, expressing and pouring out. There was a moderate correlation between degrees of favorite and familiarity (average value of correlation coefficients after Fisher Z transformation was 0.50). The scores of anxiety correlated negatively with the degrees of favorite in the type of pleasure (r=-0.41, P=0.017). Accordingly, the methods of selecting music and regulation for five kinds of abnormal emotions in TCM were proposed. Conclusion This study preliminary establishes the TCM emotion music treatment database, providing standardized music and operable methods of regulating abnormal emotion for clinical TCM treatment.