1.Conscious analgesia/sedation with remifentanil and propofol on the elderly patients undergoing gastroenterological endoscopic procedure
Erhua WANG ; Dandan GUO ; Can YANG ; Xiaoping GU ; Zhengliang MA
Chinese Journal of Digestive Endoscopy 2016;33(6):384-387
Objective To evaluate the efficacy and safety of the conscious analgesia/sedation scheme with remifentanil and propofol on the elderly patients under gastroenterological endoscopic procedure. Methods Retrospective analysis was performed on 3 500 cases with remifentanil and small?dose propofol under gastroenterological endoscopic procedures, and the procedure achievement, effects of the narcotic, adverse reactions and satisfactory results were summarized. Results All procedures were completed successfully. The ratio of the patients whose intended sedation depth arrived at referential induction was up to 91?3%(3 196/3 500).Hemodynamic change was slight and almost all patients could open eyes in no time, with short hospital stay. No serious adverse effects were observed except several patients complaining about mild bucking, abdominal distension and stomachache. The degree of patients′ satisfaction was high. Conclusion The conscious analgesia/sedation scheme with remifentanil and propofol can be effectively and safely used on gastroenterological endoscopic procedure among the elderly, but precise monitor and timely treatment of complications are still needed.
2.Effect of protective lung ventilation strategy applied from anesthesia induction period on lung compliance and oxygenation in patients undergoing gynecological laparoscopic surgery
Dandan FENG ; Jing HAO ; Huaye XU ; Xiaoping GU
The Journal of Clinical Anesthesiology 2016;32(8):748-752
Objective To explore the effects of protective lung ventilation strategy applied from anesthesia induction period on lung compliance and oxygenation in patients undergoing gyneco-logical laparoscopic surgery.Methods A total of 60 female patients underwent gynecological laparo-scopic surgery were randomly divided into protective lung ventilation strategy beginning from induction group (group A),protective lung ventilation strategy beginning after intubation group (group B),conventional ventilation group (group C).All the three groups received intermittent posi-tive ventilation.The oxygen concentration was 100% and oxygen flow rate was 2 L/min,the inhalation and exhalation ratio was 1∶2.Group A was given low tidal volume+low PEEP+lung recruitment ma-neuver (from induction,i.e.after the disappearance of spontaneous breathing,take mask ventilation lasted for 5 minutes with a tidal volume of 6 ml/kg,respiratory rate was 1 6 times/min,PEEP was 5 cm H 2 O,which was applied every 30 min);group B was given low tidal volume+low PEEP+lung recruitment maneuver (before intubation:tidal volume was 10 ml/kg,respiratory rate was 10 times/min;after intubation:tidal volume was 6 ml/kg,respiratory rate was 1 6 times/min,PEEP was 5 cm H 2 O,which was applied every 30 min);group C:tidal volume was 10 ml/kg,respiratory rate was 10 times/min.Ppeak,Pmean,CL were recorded at induction (T0 ),after intubation (T1 ),30 min (T2 ),60 min (T3 )during operation,release of pneumoperitoneum (T4 ).The arterial blood gas analysis was performed at T0 ,T1 ,T3 and after extubation (T5 ).Then the oxygenation index (OI)and pulmonary shunt fraction (Qs/Qt)was calculated.Results The Ppeak and Pmean were significantly higher among the three groups after pneumoperitoneum (T1 ,T2 ,T3 ,T4 )compared with T0 (P <0.05),Ppeak of group C was significantly higher compared with that of group A and group B and Pmean at T2 increased significantly (P < 0.05 );The CL of three groups decreased obviously after pneumoperitoneu (P <0.05),CL of group C was lower significantly than that of group A and group B at T3 ,T4 (P <0.05)while the difference between group A and group B were not significant.The OI of the three groups decreased significantly after exthbation (P <0.05)and the difference among the three groups was not significant.Qs/Qt of three groups increased obviously at T3 and decreased at T5 (P <0.05),Qs/Qt of group C was higher significantly than that of group A and group B at T3 (P <0.05).Only one patient in group C got pulmonary infection.Conclusion Compared with conventional ventilation,the protective lung ventilation strategy can significantly improve the lung compliance and oxygenation function in the patients undergoing gynecological laparoscopic surgery.
3.Case report of Weaver syndrome caused by EZH2 gene mutation
Xuewen YUAN ; Shanshan CHU ; Dandan WANG ; Qianqi LIU ; Wei GU
Chinese Journal of Applied Clinical Pediatrics 2021;36(5):380-382
The clinical data of a case of Weave syndrome admitted in the Department of Endocrinology, Children′s Hospital of Nanjing Medical University in October 2018 were retrospectively analyzed.The patient was a 9 years and 2 months old girl, who was hospitalized because of " growing too fast for 9 years" . After birth, the child is found to grow fast and have mental retardation, slurred speech, a blurred vision, a long face, a protruding forehead, ocular hypertelorism, epicanthus, nasal bridge pit, finger pads on both hands and feet, uncoordinated gaits, and intoeingpigeon toes.A novel heterozygous c. 1720A>G (p.K574E) mutation was detected in the exon 15 of the EZH2 gene of the patient.This mutation has not been reported at home and overseas.Sanger sequencing revealed that the patient′s parents did not carry the mutation.The disease is an autosomal dominant genetic disorder, and the parents and sibling of the patient have no corresponding symptoms, so it is inferred that the mutation is spontaneous.Based on the peculiarity of the face, clinical manifestations and the results of molecular genetics, the child was diagnosed as Weaver syndrome.
4.Evaluation of excess mortality risk related to heat wave in Ningbofrom 2013 to 2018
GU Shaohua ; JIN Yonggao ; LU Beibei ; WANG Aihong ; ZHANG Dandan
Journal of Preventive Medicine 2021;33(9):897-901
Objective :
To evaluate the excess mortality risk related to heat wave in Ningbo, Zhejiang from 2013 to 2018, so as to provide a basis for formulating coping strategies for heat wave.
Methods :
The data of daily mortality, meteorological and air quality from May to October in Ningbo from 2013 to 2018 were obtained from Ningbo Center for Disease Control and Prevention, Ningbo Meteorological Bureau and Environmental Monitoring Center of Ningbo, respectively. The generalized linear model ( GLM ) and distributed lag non-linear model ( DLNM ) were used to estimate the associations between heat wave and cause-specific mortality.
Results :
Among 1 104 days of the study period, 18 heat waves occured and lasted for 132 days, accounting for 11.96%. A total of 102 954 deaths were reported in the same period. The risks of mortality in circulatory system diseases ( RR=1.09, 95%CI: 1.03-1.16 ), respiratory system diseases ( RR=1.14, 95%CI: 1.04-1.25 ), digestive system diseases ( RR=1.38, 95%CI: 1.15-1.65 ), nervous system diseases ( RR=1.32, 95%CI: 1.08-1.61 ), mental disorders ( RR=1.51, 95%CI: 1.12-2.03 ) and accidental injury ( RR=1.18, 95%CI: 1.06-1.32 ) and all causes ( RR=1.10, 95%CI: 1.06-1.14 ) increased at lag 0-1 day of heat wave. The total excess death related to heat wave was 1 218 ( 95%CI: 731-1 705 ) . The excess deaths of circulatory system diseases, respiratory system diseases, accidental injury, digestive system diseases, nervous system diseases, mental disorders, urinary system diseases and endocrine system diseases were 313 ( 95%CI: 104-556 ), 206 ( 95%CI: 59-368 ), 164 ( 95%CI: 55-292 ), 122 ( 95%CI: 48-208 ), 69 ( 95%CI: 17-131 ), 56 ( 95%CI: 13-113 ), 18 ( 95%CI: -15-64 ) and 3 ( 95%CI: -51-72 ). The excess deaths of urinary system and endocrine system diseases was not statistically significant ( P>0.05 ).
Conclusion
Heat wave can increase the mortality risk on the day and after a day in Ningbo from 2013 to 2018. Circulatory system diseases, respiratory system diseases and accidental injury rank top three in excess deaths.
5.Health risk assessment of drinking water in Ningbo City
ZHAO Xuefei ; WANG Aihong ; SHI Bijun ; GU Shaohua ; ZHANG Dandan
Journal of Preventive Medicine 2024;36(4):333-337
Objective:
To evaluate the health risk of drinking water in Ningbo City, Zhejiang Province from 2021 to 2022, so as to provide insights into ensuring the safety of drinking water.
Methods:
The monitoring data of drinking water from 2021 to 2022 in Ningbo City were collected from the Chinese Disease Prevention and Control Information System. The routine indicators and disinfectant indicators (radioactivity indicators were excluded) of drinking water were evaluated according to the reference limits issued by Standards for Drinking Water Quality (GB 5749-2006), and the qualification rates were calculated. The indicators with detection rate higher than 50% were selected, and assessed the carcinogenic and non-carcinogenic risks via drinking water using the risk assessment model recommended by the United States Environmental Protection Agency.
Results:
A total of 1 678 samples were monitored in Ningbo City from 2021 to 2022. Sodium hypochlorite was the main disinfectant among 1 558 samples from centralized water supply (1 079 samples, 64.30%), and none of the 120 samples from decentralized water supply underwent disinfection treatment. The qualification rate of 88.38%, and the pollutants with a detection rate higher than 50% were nitrate, fluoride, trichloromethane and aluminum. The median carcinogenic risk value of trichloromethane was 2.964×10-6 (interquartile range, 3.909×10-6), and the median hazard quotient values of nitrate, fluoride, trichloromethane and aluminum were 1.631×10-2 (interquartile range, 1.361×10-2), 3.955×10-2 (3.164×10-2), 2.231×10-2 (2.942×10-2) and 2.136×10-4 (6.573×10-4), respectively.
Conclusion
The carcinogenic and non-carcinogenic risks through drinking water for 17 pollutants in drinking water of Ningbo City from 2021 to 2022 were at low levels.
7.The effect of bone marrow-derived mesenchymal stem cell transplantation on B cell activating factor and B cell activation in MRL/Ipr mouse
Xiaolei MA ; Zhifeng GU ; Jing HUANG ; Dandan WANG ; Jing LIN ; Huiqing LIU ; Lingyun SUN
Chinese Journal of Rheumatology 2010;14(2):94-97
Objective To investigate the effect and mechanism of murine bone marrow mesenchymal stem cells(BM-MSCs)transplantation on B-cell activating factor(BAFF)expression and B cell activation of MRL/Ipr mice.Methods Eighteen female MRL/Ipr mice were divided into the treatment group and the control group.Five female BAL B/C mice were used as negative controls.At the age of 18 weeks,the treatment group was transplanted with 1×10~6 murine BM-MSCs through vena caudalis,the control group was treated with 0.5ml sodium chloride.Enzyme linked immunoserbent assay(ELISA)was used to measure the level of the BAFF,IFN-γ,IL-2 and IL-10 in the serum.The percentage and numbers of Marginal zone,T1 and T2 B cells in spleen were detected by flow cytometry.Results①Eight weeks after transplantation,the level of BAFF [(32±14)ng/ml]in serum of the treatment group decreased significantly than the control group[(47±13)ng/ml](P<0.05)as well as the level of serum IL- 10,IFN-γ and IL-2 levels[(19±7)vs(40±13)pg/ml](P<0.01)[(25±20)pg/ml vs(38±25)pg/ml][(73±10)pg/ml vs(80±15)pg/ml].② Eight weeks after trans-plantation,the mice in the treatment group had lower percentages of marginal zone B cells[(15±4)% vs (21±5)%],and the numbers of marginal zone B cells were significantly decreased in the treatment group as compared with the control group[(9±6)×10~6 vs(19±10)×10~6,P<0.05].③ Eight weeks after transplantation,the mice in the treatment group had lower percentages of T1 and T2 B cells[(3.4±2.1)% vs(7.3±4.0)%][(2.6+1.4)%vs(4.8±2.7)%],and the numbers of T1[(2.7±1.7)×10~6 vs(5.1±2.0)×10~6,P<0.05]and T2 B cells[(2.0±1.2)×10~6 vs(3.7±1.7)×10~6,P<0.05]were both significantly decreased in the treatment group as compared with the control group.Conclusion BM-MSCs transplantation decreases the expression of BAFF in association with the diminished production of the pathogenic cytokines IFN-γ and IL-10.Inhibition of BAFF also results in decreased numbers of T1 and T2 B cells and MZ B cells.
8.Effect of Bairui granule and deacetylated ligustrazin injection on plasma BNP and FABP levels in children with heart failure and pneumonia
Dandan LANG ; Junhui YUAN ; Junfen ZHOU ; Sujuan GUO ; Hongdan GU ; Feihong CHEN
Chinese Journal of Biochemical Pharmaceutics 2017;37(3):101-103
Objective To study the effect of Bairui granule and Deacetylated Ligustrazin injection on plasma BNP and FABP levels in children with heart failure and pneumonia.Methods 60 children of heart failure and pneumonia who received therapy from July 2014 to June 2016 in our hospital were randomly divided into two groups, the observation group and the control group, 30 cases in each group.children in the observation group were treated with sodium phosphate creatine, and the control group was treated with 2-linolenic acid,the clinical outcomes, clinical signs, BNF, FABP, LVEF and LVEDP were compared between the two groups.Results After treatment, the total effective rate of the observation group was significantly higher than that of the control group, the difference was statistically significant (P<0.05); The heart rate, respiratory rate and blood oxygen saturation of the two groups were significantly improved compared with those before treatment ( P<0.05 ) , the heart rate and respiratory rate of the observation group were lower than those of the control group, the oxygen saturation was higher than that of the control group (P<0.05).After treatment, the BNF and FABP indexes of the two groups were lower (P<0.05), and the BNF and FABP indexes in the observation group were lower than those in the control group (P<0.05); The LVEF of the observation group was higher than that of the control group, the LVEDP index was lower than that of the control group, the difference was statistically significant (P<0.05).Conclusion Bairui granule and Deacetylated Ligustrazin injection in the treatment of heart failure with pneumonia has a good effect in the process, which will help reduce the BNP index in children, recovery of children's body function.
9.Role of mitochondrial apoptotic pathway in intrathecal doxepin-induced apoptosis in rat neurons
Kechang HUANG ; Dandan MA ; Zheng SUN ; Li′na SUN ; Zhifei XU ; Xiuxia GU ;
Chinese Journal of Anesthesiology 2015;(12):1435-1438
Objective To investigate the role of mitochondrial apoptotic pathway in intrathecal doxepin?induced apoptosis in rat neurons. Methods Twenty?four adult male Wistar rats, weighing 250-300 g, in which intrathecal catheters were successfully implanted without complications, were randomly divided into 4 groups ( n=6 each) using a random number table: control group ( group C) and different concentrations of doxepin groups (D5, D10 and D20 groups). In D5, D10 and D20 groups, 5, 10, and 20 mmol∕L doxepin 0. 2 μl∕g were injected intrathecally, respectively. In group C, the equal volume of normal saline was given instead. At 6 h after intrathecal administration, the animals were sacrificed, and the lumbar segments of the spinal cords were obtained for detection of the cell apoptosis ( by TUNEL assay) , expression of Bax and Bcl?2 ( by immunohistochemistry) , release of cytochrome c ( Cyt c) , and expression of caspase?3, caspase?8 and caspase?9 mRNA ( using real?time reverse transcriptase polymerase chain reaction) . Apoptosis rate and Bcl?2∕Bax ratio were calculated. Results Compared with group C, the expression of Bax was significantly up?regulated, the expression of Bcl?2 was down?regulated, Bcl?2∕Bax ratio was decreased, the release of Cyt c and apoptosis rate were increased, and the expression of caspase?3 and caspase?9 mRNA was up?regulated in D10 and D20 groups, the expression of Bcl?2 was down?regulated in group D20 ( P<0.05 or 0.01) , and no significant change was found in the parameters mentioned above in group D5 (P>0.05). The expression of Bax was significantly up?regulated, Bcl?2∕Bax ratio was decreased, the release of Cyt c and apoptosis rate were increased, and the expression of caspase?3 and caspase?9 mRNA was up?regulated in D10 and D20 groups, and the expression of Bcl?2 was down?regulated in group D20 as compared with group D5 ( P<0.05 or 0.01) , and in group D20 as compared with group D10 ( P<0.05) . There was no significant difference in the expression of caspase?8 mRNA among the four groups ( P>0.05) . Conclusion Mitochondrial apoptotic pathways, but not death receptor pathway, is involved in intrathecal doxepin?induced apoptosis in rat neurons.
10.Influence of narrative therapy on the family environment and values in adolescents with emotional disorder
Zhao ZHAO ; Wendong DU ; Yixin CHEN ; Tunong CHEN ; Dandan WU ; Shasha LI ; Simeng GU
Chinese Journal of Behavioral Medicine and Brain Science 2012;(12):1082-1084
Objective To explore the effect of narrative therapy on family environment and values in adolescents with emotional disorder.Methods 35 adolescents with emotional disorder and their parents from Affiliated Brain Hospital,Nanjing Medical University were enrolled and treated by narrative therapy.Family environment was assessed using Family Environment Scale-Chinese Version (FES-CV)and was compared between pre-and posttherapy.Results 28 adolescents with emotional disorder and their parents completed therapy.The cohesion,independence,intellectual orientation,active-recreation orientation and organization in FES-CV showed higher scores at post-therapy than at pre-therapy ((6.89 ± 2.56) vs.(4.21 ± 3.21) ; (5.54 ± 1.35) vs.(4.68 ± 1.51) ;(4.75±2.07)vs.(3.50±2.12);(4.07±2.65)vs.(2.50±2.32);(3.68±1.77)vs.(2.50±1.62)respectively).The contradict in FES-CV showed lower scores at post-therapy than at pre-therapy ((2.75 ± 2.44) vs (5.25 ± 2.50)).The values of adolescents with emotional disorder and their parents had a positive change after narrative therapy.Conclusion Narrative therapy is effective on the positive change of FES-CV and values of adolescents with emotional disorder and their parents.