Objective To evaluate the effect of low dose fentanyl on target plasma concentration (CP) of propofol (P) given by target controlled infusion (TCI) required to prevent response to proseal laryngeal mask insertion in 50% of patients (EC50). Methods Forty-six ASA Ⅰor Ⅱ patients aged 20-50 yr with body mass index ≤ 30 kg/m2 undergoing elective gynecological laparoscopy were randomly divided into 2 groups (n=23each):propofol group (P) and propofol-fentanyl group (PF). Anesthesia was induced with TCI of propofol. The initial Cp of propofol TCI was set at 2.5 μg/ml in group PF and 4 μg/ml in group P. Following equilibration between plasma and effect site concentration of propofol, fentanyl 1 μg/kg (in group PF) or normal saline (in group P) was injected iv. Laryngeal mask airway (LMA) was inserted at 3.5 min after fentanyl administration. EC50 was determined by up-and-down sequential trial. The ratio of Cp between the two consecutive patients was 1.2 in group P and 1.1 in group PF. LMA insertion response was defined as nausea, bucking and/or body movement during insertion. "Probit method was used to calculate the Echo and 95 % confidence interval required to prevent LMA insertion response. Results The EC50 and 95 % confidence interval of propofol given by TCI required to prevent LMA insertion response was 4.68 (4.20-5.21)μg/ml in group P and 2.63 (2.45-2.83) μg/ml in group PF. There was significant difference between the 2 groups. Conclusion Fentanyl 1 μg/kg iv can significantly reduce the Cp of propofol TCI required to prevent LMA insertion response.

Objective To explore the perioperative experiences of congenital heart disease in infants.Methods From Jan.2000 to Aug.2006,109 patients with congenital heart disease were operated in our department,their clinical data were retrospectively collected and analyzed.The patients′ age ranged from 31 days to 3 years old (13.6 months).The body weight ranged from 2.1 to 16 kg (8.6 kg).Ninety-three patients were operated under hypothermic anaesthesia with cardiopulmonary bypass(CPB).Sixteen patients underwent deep thermal and low flow CPB.Ultrafiltration was used in 62 patients.Results There were 8 deaths and the operative mortality was 7.3%,4 cases caused by low output syndromeclos(LOS),3 cases caused by pulmonary hypertension and 1 case caused by lung intection.The morbidity was in 25 cases(22.9%),the main complications were LOS in 6 patients and respiratory complications in 18 patients,hydropericardium in 1 case,respectively.Conclusion To improve the operative and CPB technique,and to improve the skills of the postoperative managements of LOS and respiratory complications are the main points in the success of the cardiac operation in infants.

Objective To improve the diagnosis and management of parapharyngeal space(PPS)neoplasms. Methods Records of 85 patients with PPS neoplasms operated in 11 years were reviewed with regard to presenting signs and symptoms,histological characteristics,imaging technique,surgical approach and postoperative complica- tions.Results Benign rumors were found in 77 cases and malignant tumors were founded in 8 cases.Forty-one tu- mors originated from salivary glands;neurogenic tumors were found in 36 patients and 8 patients with tumors in oth- er organs.All were treated by surgical operation:the trans-eervical approach was used in 76 cases,tans-oral in 6 cases and the combined transoral-cervical approach in 3 cases.The complications after operation were facial nerve palsy(4 cases),hypoglossal nerve paralysis(2 cases)Horner syndrome(2 cases),vocal cord paralysis(2 cases),thyroid gland fistula(1 case),infects(1 case)and difficulty in breathing(1 case).Conclusion Tumors originated from salivary glands were the most common neoplasms in the primary parapharyngeal space neoplasms,and neurogenic tumors fol- lowed.High-resolution computed tomography or magnetic resonance imaging was essential for diagnosis and presurgi- cal planning.The transcervical approach was the preferred procedure for PPS tumors.

Objective: To study the quality and transdermal properties of matrine microemulsion-based hydrogel (MBH) to provide basis for the development of the preparation.Methods: The stability of MBH was observed at 4 ℃ for 3 months and the changes of particle appearance, viscosity, pH and matrine content were observed.The transdermal permeation of MBH was investigated by a dual chamber permeation and diffusion device with excised mouse skin as the barrier.Taking rabbits as the experimental subjects, the irritation of MBH to the normal skin and damaged skin was investigated.Results: The appearance, viscosity, pH and matrine content of MBH at 4 ℃ in 3 months did not change significantly.In vitro transdermal test showed that MBH had a good penetration rate on mouse skin, and no skin irritation occurred after single or multiple administrations.Conclusion: MBH has good stability and high rate of transdermal penetration without skin irritation, which is a promising drug delivery system of matrine with good application prospects.

Objective To discuss the different contrast injection rate on the 64 -slice spiral CT scan liver arterial phase reinforced effect.Methods 60 patients who received abdominal CT scan were selected from January 2014 to April 2015.According to the different conditions,they were divided into control group (30 cases)and liver cirrhosis group (30 cases).Then each group based on packet injection rate into 2.5 mL/s (control group 1,cirrhosis group 1)and 3.5 mL/s (control group 2,cirrhosis group 2).Select Smartprep technology contrast agent tracking all patients,when the abdominal aorta CT value ≥150 HU start scanning.The departure time,CT value of each group were recorded,abdominal aortic artery,simultaneous analysis of each component of image quality comparison.Results When the contrast agent injection rate of 3.5 mL/s,excellent rate of the control group (95.5%)compared with the contrast injection rate of 2.5 mL/s (91.7%)had no significant difference (χ2 =0.021,P =0.638);The cirrhosis good rate (94.7%)compared with the contrast agent injection rate of 2.5ml/s (72.7%)had obvious advantages, the difference was statistically significant (χ2 =5.233,P =0.032).When the contrast agent injection rate of 2.5mL/s, cirrhosis abdominal aorta average peak enhancement [(187.25 ±21.00)HU]and the control group [(195.35 ± 19.00)HU]had no significant difference (t =0.826,P =0.436).The average trigger time of the control group (21.68 ±1.93)s was significantly less than the cirrhosis group (25.13 ±2.13)s,the difference was statistically significant (t =2.064,P =0.047).When the contrast agent injection rate of 3.5 mL/s,the control group,the mean abdominal aortic peak enhancement [(247.82 ±39.00)HU]was significantly greater than the cirrhosis group [(223.81 ±35.00)HU],the difference was statistically significant (t =2.652,P =0.037).The average trigger time of the control group (18.62 ±1.36)s was significantly less than the cirrhosis group (24.57 ±0.92)s,the difference was statistically significant (t =3.362,P =0.033).Conclusion The greater the contrast injection rate,arterial peak at the same time it increases the peak time come to shorten.When the contrast agent injection rate consistent with the control group,the average trigger time is short,high average peak enhancement.Cirrhosis needs higher contrast injec-tion rate.

UNLABELLEDObjective: In order to assess the integrative cardiopulmonary function after percutaneous coronary intervention (PCI) in patients with stable coronary artery disease (CAD), we used symptom limited maximum cardiopulmonary exercise testing (CPET).

METHODSAll 59 patients diagnosed stable CAD by coronary angiography and echocardiography from August to December of 2014 in our hospital, were divided two groups. PCI group, 31 patients received PCI and drugs. Control group, 28 patients received drugs therapy only. All patients performed CPET before and after the treatment.

RESULTSAll patients safely completed CPET without any complications. The control group, all functional parameters were unchanged (P > 0.05). PCI group, the anaerobic threshold, peak oxygen uptake and peak oxygen pulse increased significantly (P < 0.05) from baseline,but not for others (P > 0.05). For individual analysis, PCI group had higher rates of increase (≥ 10% of baseline) in both peak oxygen uptake and peak oxygen pulse than those of control group (P < 0.05).

CONCLUSIONCPET is an objective, quantitative, safe and effective method to evaluate the clinical therapeutic efficiency. PCI can improve the integrative cardiopulmonary function in CAD patients.

Anaerobic Threshold ; Coronary Angiography ; Coronary Artery Disease ; surgery ; Exercise Test ; Heart Rate ; Humans ; Oxygen ; Oxygen Consumption ; Percutaneous Coronary Intervention

Objective To study the in vitro effects of different doses and different kinds of LMWH on CR, and to determine whether the CR test could be used to monitor LMWH. Methods The CR value was measured with different reagents ( glass beads, celite and kaolin ) in blood samples from twenty volunteer donors, which were spiked with increasing concentration of LMWH ( dalteparin, 0-1.8 IU/ml ). Then the CR test was performed again on the same blood samples spiked with the same concentration ( 0. 8 IU/ml ) but different LMWH ( dalteparin, enoxaparin and nadroparin ). Regression analysis was performed to establish a regression equation from corresponding LMWH levels. Results With the increasing of dalteparin dose, CR values were reduced gradually for all three reagents. When the concentration of dalteparin was 0-1.8 IU/ml,the value of CR was 20. 0-4. 5 IU/min for glass beads, 26. 1-6.6 IU/min for celite and 27. 2-7. 5 IU/min for kaolin. An exponential relationship was observed between the CR value and dalteparin concentration for three reagents( R2 = -0.796, -0.884, -0.921 ,P ＜0.01 ). All three kinds of LMWH with the same concentration (0.8 IU/ml ) induced a different change in CR. The value of CR was 7.4 IU/min with dalteparin,8. 5 IU/min with enoxaparin and 8.5 IU/min with nadroparin. Compared with the control group ( CR was 17.6 IU/min ), three kinds of LMWH had statistical significance ( t = 18.45, 12. 33, 14. 93, P ＜ 0.01 ).Compared with the enoxaparin and nadroparin, dalteparin induced a higher CR value ( t = 2. 552,2. 924,P＜0. 05 ). Conclusions There is an exponential relationship between CR value and dalteparin concentration for three reagents. Three kinds of LMWH can significantly reduce the value of CR. CR test can be used to monitor the anticoagulant effect of LMWH.

Objective Small-for-size syndrome (SFSS) is a common and serious problem after living donor liver transplantation (LDLT) of small grafts.To prevent SFSS by selecting large enough graft,enlarging outflow tract,and controlling the portal vein pressure and flow during LDLT.Methods 113 adult LDLT recipients were reviewed from Dec.1,2007 to Nov.30,2009.Enlarging the portal outflow tract by the incision of the anterior rim of the orifice of the right hepatic vein (RHV),modificating graft inflow,and selecting large enough graft were done to prevent SFSS.The relationship between the patients' GRWR,portal vein flow,portal vein pressure and the occurrence of SFSS was analyzed.Results All patients received the outflow orifice modification.The portal vein pressure and the portal vein flow were decreased after spleen artery ligation.No SFSS ocurred.Conclusion Selecting large enough liver graft,and enlarging portal vein inflow and outflow were safe for the LDLT recipients,and can effectively prevent SFSS.

Objective To evaluate the effects of curcumin on the expression of phosphorylated extracellular signal-related kinase (p-ERK) and phosphorylated cAMP response element binding protein (p-CREB) in the spinal dorsal horn and dorsal root ganglion (DRG) in type 2 diabetic neuropathic pain (DNP) in rats.Methods Type 2 diabetes mellitus was induced by high-fat and high-sucrose diet and intraperitoneal streptozotocin (STZ) 35mg/kg,and confirmed by fasting blood glucose level≥ 16.7 mmol/L in male Sprague-Dawley rats.Type 2 DNP was confirmed by the mechanical withdrawal threshold (MWT) and thermal withdraw latency (TWL) measured on day 14 after STZ administration ＜ 80％ of the baseline value,and the rats with type 2 DNP were randomly divided into 3 groups (n =27 each):type 2 DNP group (group DNP),curcumin group (group Cur) and solvent control group (group SC).Curcumin and corn oil 100 mg/kg (25 mg/ml) were injected intraperitoneally once a day for 14consecutive days starting from 14 days after administration of streptozocin in Cur and SC groups,respectively.Another 27 normal rats were served as control group (group C) and were fed with common forage.MWT and TWL were measured at 3,7 and 14 days after curcumin injection (T1 3),and the lumbar segment 4-6 of the spinal cord and DRGs were removed at the same time for determination of the expression of p-ERK and p-CREB (by Western blot).Results Compared with group C,MWT was significantly decreased,TWL was shortened,and the expression of p-ERK and p-CREB in spinal dorsal horn and DRGs was up-regulated at T1-3 in DNP and SC groups,and at T1 in Cur group (P ＜ 0.05).Compared with group DNP,MWT was significantly increased,TWL was prolonged,and the expression of p-ERK and p-CREB in spinal dorsal horn and DRGs was down-regulated at T2,3 in Cur group (P ＜0.05).There was no significant difference in the MWT,TWL and expression of p-ERK and p-CREB between DNP and SC groups (P ＞ 0.05).Conclusion Curcumin can attenuate type 2 diabetic DNP by inhibiting up-regulation of the expression of p-ERK and p-CREB in the spinal dorsal horn and DRG in rats.

Electronic case report forms (eCRFs) instead of the traditional paper case report forms (pCRFs) are increasingly used by investigators and sponsors of clinical research. We include a total of 14 phase III studies (8 pCRF, 6 eCRF) to compare paper and electronic data documentation both quantitatively and qualitatively in clinical studies. The result suggests that adaptions of electronic data capture (EDC) in clinical trials have the advantages in optimization of data capture process, improvement of data quality and earlier clinical decision compared to paper-based methods. Furthermore, the successful implementation of EDC requires accouplements with corresponding data management processes and reallocation of resources.
Clinical Trials, Phase III as Topic ; Data Collection ; methods ; Information Storage and Retrieval ; methods ; Medical Informatics