Objective To observe the impact of different pacing sites in hemodynamic and cardiovascular events after restoration of spontaneous circulation.Methods A total of 76 patients with-in hospital cardiac arrest occurred from November 2010 to January 2014 were confirmed by electrionic device monitoring or electrocardiogram and they received cardiopulmonary resuscitation,and their ages were over 18 years.Patients with end-stage of various disease,malignancy and cardiac arrest due to incurable diseases or debility of physical conditions were excluded.The 76 patients were divided into two groups according to pacing site checked by X-ray fluoroscopy in emergency rescue unit:right ventriclular outflow trace pacing group [n =36,male 26 cases,female 10 cases,age (57.31 ± 16.65) years] and right ventricular apex pacing group [n =40,22 male cases and 18 female cases,age (60.43 ± 15.48) years].All patients' QRS duration were measured by ECG after pacemaker implantition and left ventricular ejection fraction (LVEF),left ventricular short axis reduced rate (FS),heart rate (HR),cardiac index (CI) were tested by bedside echocardiography and non-invasive hemodynamic monitoring was used during the early to middle stage.All the hemodynamic variables and the cardiac events were observed after spontaneous circulation recovery.All the data were analyzed by SPSS version 13.0 statistical software.Results There were no significant differences in age,gender,the primary disease,the time from cardiac arrest to spontaneous circulation restoration and dosage of epinephrine (P ＞ 0.05).In comparison with right ventricular apex pacing group,LVEF,FS,HR,CI were higher in right ventriclular outflow trace pacing group [(0.46 ± 0.04)％ vs.(0.44 ±0.05)％,(0.34±0.05) vs.(0.32±0.04),(0.04±0.46) L/minvs.(3.47±0.46) L/min,(0.46±0.29) L/ (min · m2) vs.(2.46 ±0.26) L/ (min · m2),P ＜ 0.05] and right ventriclular outflow trace pacing group had shorter QRS duration than right ventriclular apex pacing group [(128.25 ± 6.06) ms vs.(151.93 ± 8.99) ms,P ＜ 0.05]; fewer atrial fibrilation event was detected in right ventriclular outflow trace pacing group after restoration of spontaneous circulation than that in right ventricular apex pacing group.But incidences of cardiac failure and thrombus were not different between two groups (P ＞ 0.05).Conclusions The right ventriclular outflow trace pacing resulted in better hemodynamic and fewer atrial fibrilation after restoration of spontaneous circulation.

Adolescent ; Adult ; External Fixators ; Female ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery ; Time Factors

Adult ; Aged ; Female ; Fracture Fixation ; Humans ; Male ; Middle Aged ; Tibia ; injuries ; surgery ; Tibial Fractures ; surgery ; Treatment Outcome

Objective:To analyze and compare the incidence of catheter related complications between midline catheter (MC) and peripherally inserted central catheter(PICC) within 30 days. Provide guidance and basis for medical staff to choose appropriate intravenous infusion tools to prevent catheter related complications.Methods:The randomized controlled trials, clinical controlled trials and cohort studies about MC and PICC related complications were searched in PubMed, Web of Science, Cochrane Library, Embase, EBSCO, Ovid, CNKI, VIP, Wanfang database and CBM, which were published at home and abroad up to December 31, 2021. After screening the literatures, extracting data and quality evaluation according to the inclusion and exclusion criteria, RevMan5.4 software was used for statistical analysis.Results:A total of ten articles were included in this study, including two randomized controlled trials, a clinical controlled trials, a prospective cohort study and six retrospective cohort studies, with 12 765 cases in MC group and 33 783 cases in PICC group. The results of Meta-analysis showed that the incidences of catheter-related bloodstream infection and catheter displacement in MC group were significantly lower than those in PICC group ( RR=0.37, 95% CI 0.18-0.76, P<0.05; RR=0.49, 95% CI 0.25-0.97, P<0.05). Conclusions:Compared with PICC in the early stage of intravenous infusion, MC is safer and more effective. When continuous infusion of isotonic or near-isotonic medications is required, and there is no need for continuous vesicant medications, MC can be preferred. However, more large-sample and high-quality studies are still needed to provide a basis for the popularization of MC in China.

Objective To examine the association between caregiver burden and comorbidity in elderly patients with cognitive impairment.Methods The study was conducted in 212 patients at the Memory Clinic and the Departments of Geriatrics and Neurology of Fuxing Hospital from September 2014 to September 2016.Recruited patients were assigned into a dementia group and a non-dementia group according to their cognitive status and were examined using mini mental state examination (MMSE),auditory verbal learning test (AVLT),activity of daily living (ADL),neuropsychiatric inventory(NPI),and Charlson comorbidity index(CCI).Their caregivers were surveyed with Zarit burden inventory (ZBI).Results The ZBI score was significantly correlated with patients' age,gender,CCI,MMSE,NPI,and ADL.The ZBI score was higher in male patients(21.21 ± 11.24)than in female patients(18.33±10.38).Age(r=0.10,P＜0.001),NPI(r=0.32,P＜0.001),ADL(r=0.29,P ＜0.001),and CCI(r =0.38,P ＜0.001) were positively correlated with caregiver burden,while MMSE(r =-0.28,P ＜ 0.001) was negatively correlated with it.Multiple linear regression model analysis indicated that MMSE,NPI,ADL,and CCI were influencing factors for caregiver burden.When CCI was stratified into CCIno dementia and CCIdementi8,influencing factors for caregiver burden were identified as MMSE,NPI,ADL,and CCIdementia.Conclusions Cognitive deterioration,decrease in ADL,and neuropsychiatric symptoms in elderly patients are the major causes of increased caregiver burden.Besides,the number and severity of comorbidity are independent factors for caregiver burden.

Objective: To examine the effects of high intensity interval training (HIIT) on body composition and cardiorespiratory fitness of obese primary school students, so as to provide a theoretical basis and practical reference for HIIT exercise prescription in schools. Methods: From August to December 2022, 25 obese children [age:(11.0±0.4)years, BMI:(23.3±0.8)kg/m 2] from a primary school in Shenzhen were recruited and divided into an exercise group ( n =13) and a control group ( n =12). After 12 weeks of exercise intervention [The durations of load period and intermittent period were 15 s, load exercise intensity was 100% maximal aerobic speed (MAS), and intermittent exercise intensity was 50% MAS, each time there were 2 groups× 8 rounds, and the rest between groups was 2 minutes, totaling 10 minutes, and 20 meter shuttle run test (20 m-SRT) was performed once every 4 weeks to adjust and update MAS], the changes in body composition and cardio respiratory fitness indexes of obese subjects before and after the intervention were compared. Results: After the intervention, body weight, BMI, body fat, body fat percentage, and visceral adipose tissue area of obese subjects in the exercise group decreased from (55.6±6.2)kg, (22.7±0.6)kg/m 2, (41.8±6.9)kg, ( 23.4± 5.5)% and (102.4±39.0)cm 2 to (52.3±5.8)kg, (21.1±0.8)kg/m 2, (38.6±6.3)kg, (20.2±4.5)% and (84.2±26.9)cm 2, respectively( t =8.73, 10.96, 7.02, 4.92, 4.95, P <0.05). SBP decreased from (115.4±9.7)mmHg to (112.3±8.7)mmHg ( t = 2.96 , P <0.05). The content of skeletal muscle, 20 m-SRT and VO 2max increased from (21.3±5.3)kg, (21.6±4.9) times and (39.4±2.0)mL/(kg ·min) to (21.8±5.2)kg, (31.4±6.3)times and (43.6±2.6)mL/(kg ·min), respectively ( t =-3.33, -8.37, -10.56 , P <0.05). Conclusions HIIT is an effective way to improve the body composition and cardiorespiratory fitness of obese primary school students. It is recommended that schools with the necessary conditions use this method as an intervention measure to help reduce weight and improve cardiovascular health among obese students.

Objective To investigate the knowledge and recognition of middle aged and elderly cognitive normal people in clock drawing test (CDT) and determine the items of CDT.Methods Two hundred and sixty four middle aged and elderly cognitive normal people from community were involved in the cross-sectional study.The questionnaire was comprised of 26 items scoring in CDT in literature.Each item was rated by subjects as complete agreement, partial agreement or disagreement.Pearson correlation analysis was used to analyze the related items of age and education degree.Results There were 5 items significantly related with age and education.Twelve items enjoyed complete agreement of more than 50％ and disagreement lower than 20％.The new scoring system was composed of 12 items, including the 12 complete agreement items excepted one which was significantly related to age and education, and one item that was proved to be sensitive to cognitive impairment.Conclusion The new scoring system with 12 items for CDT may be suitable in screening cognitive impairment with high identity, and further investigation about the validity and reliability should be conducted.

【Objective】 To evaluate the screening efficacy and practical value of the portable microfluidic biochemical analyzer in the detection of blood donors before blood donation. 【Methods】 Blood donor samples, clinical blood samples and constant quality control products were collected. Referring to the documents of ISO15189 and National Health Industry Standard, the precision and accuracy of hemoglobin (Hb) and alanine aminotransferase (ALT) were verified and compared with other detection systems. 【Results】 The MS200 biochemistry instrument has an intra-batch precision of 1.40% to 1.46%, inter-batch precision of 1.91% to 1.94%, and correctness bias of -0.9% to -1.3% for Hb test, and an intra-batch precision of 3.77% to 4.86%, inter-batch precision of 4.92% to 6.02%, and correctness bias of -3.0% to -4.8% for ALT test, which were within the range of quality requirements of industry standard. Comparison of Hb test results between MS200 biochemistry and Hb201 analyser on 1 189 peripheral blood samples from donors showed no statistically significant difference (P>0.05). 65 samples showed positive correlation between MS200 biochemistry and XS-900i automated hematology analyzer on Hb test results (R²=0.986, P=0.000). Correlation analysis of all the results of ALT detection by MS200 biochemical analyzer and AU480 biochemical analyzer in 1 065 samples showed a positive correlation (R²=0.965, P=0.000). The elevated ALT samples did not affect the Hb test results, and the samples with abnormal Hb value did not affect the ALT test results, with no interference between the two items in the detection. 【Conclusion】 The MS200 biochemical analyzer based on microfluidic technology has reliable methodological performance and can meet the need of pre-donation testing.

OBJECTIVETo investigate the feasibility and application value of improved anvil placement in laparoscopic resection of low rectal cancer with resection of anal eversion.

METHODSA retrospective study was performed on 17 patients who were operated by improved extracorporeal anvil placement in laparoscopic resection of low rectal cancer with resection of anal eversion at Huaihe Hospital of Henan University during June 2015 and June 2017.

INCLUSION CRITERIA(1) distance from tumor low margin to anal edge was 4 to 6 cm; (2) protrusive type tumor with a circumferential diameter of less than 3 cm; (3) ulcer type tumor with circumferential bowel infiltration of less than 1/2; (4) no distant metastasis(M0) and preoperative MRI of pelvic floor indicating T1-3N0. Patients with BMI>35 kg/m, or insufficient length of sigmoid and mesentery, or thickening sigmoid and mesentery were excluded. According to total mesorectal excision(TME) principle, rectum and its mesentery was resected completely; the sigmoid colon was cut off at the superior margin of tumor; the oval forceps was placed through anus to clamp and evert the rectum out of the anus; the rectum was transected at 1-2 cm from the lower edge of the tumor; the distal sigmoid colon was pulled out through anus; purse string suture was made after insertion of anvil and was restored to the abdominal cavity; end-to-end anastomosis of the rectum and sigmoid colon was performed after closing rectal stump.

RESULTSOf 17 low rectal cancer patients, 10 were male and 7 were female with age of 42 to 71 (median 58) years old and BMI of 20.6 to 33.5(median 26) kg/m. Preoperative staging indicated 2 cases of stage I, 15 cases of stage II. Distance from tumor low margin to anal edge was 4 to 6(median 5.0) cm and diameter of tumor was 3.4 to 4.8 (median 4.2) cm. All the patients completed operations successfully without conversion to laparotomy. The operation time was 124 to 182 (median 136) minutes. Distal sigmoid colon was difficult to pull out in 1 patient due to the insufficient free of the mesosigmoid, which was then successful after the mesosigmoid was dissociated with laparoscopy thoroughly again. The intraoperative blood loss was 10 to 50 (median 20) ml. Postoperative pathology reveled 2 cases of stage I, 12 cases of stageII and 3 cases of stage III; 1 case of poorly differentiated adenocarcinoma, 15 cases of moderately differentiated adenocarcinoma and 1 case of highly differentiated adenocarcinoma. The postoperative exhaust time was 24 to 128 (median 36) hours and hospital stay was 5 to 15 (median 8) days. No anastomotic leakage and intra-abdominal infection was found. Fifteen patients were followed up for 5 to 24 months without local recurrence or distant metastasis.

CONCLUSIONThe improved anvil placement in laparoscopic resection of low rectal cancer with resection of anal eversion without abdominal incision is safe and feasible.

Adult ; Aged ; Anal Canal ; surgery ; Female ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Rectal Neoplasms ; surgery ; Rectum ; surgery ; Retrospective Studies ; Treatment Outcome

【Objective】 To investigate the clinical application of self-developed magnetic anchoring device for assisting thoracoscopic pulmonary resection. 【Methods】 Eleven patients underwent thoracoscopic pulmonary assisted with resection magnetic anchoring technique at the Department of Thoracic Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, from March to May 2019. Their clinical data were retrospectively analyzed. The operation time, blood loss, blood transfusion volume, postoperative hospital stay, and postoperative complications were recorded. 【Results】 There were seven male and four female patients, with the average age of (51.6±13.9) years (range from 22 to 69 years). Three single-port and eight single-utility-port thoracoscopic surgeries were performed. Magnetic instruments provided good surgical field exposure in all operations. Among 11 surgeries, one was converted to thoracotomy and one to three-hole surgery due to enlargement and adhesion of hilar lymph nodes. The operation time was (107.8±63.1) minutes (range of 27-182 minutes). The blood loss was 50 (10-50)mL (range of 5-1 000 mL). No blood transfusion was needed during the operation. The postoperative hospital stay was (5.0±1.8) days (range of 3-9 days). No postoperative complications occurred in all the patients. 【Conclusion】 Magnetic anchor technique can effectively alleviate the "chopstick effect" in thoracoscopic surgery. Magnetic anchor technique is safe and feasible in assisting thoracoscopic pulmonary resection.