Objective To study the preemptive analgesia effects and side reactions of flurbiprofen axetil in gynecological laparoscopy.Methods Sixty patients(ASAⅠ～Ⅱ)were randomly assigned into two groups with 30 cases each.GroupⅠreceived intravenous injection of flurbiprofen axetil 1mg/kg in 15 minutes before surgery.GroupⅡreceived intravenous injection of saline 1mg/kg at the same time.Postoperative analgesia efficacy was assessed by visual analogue scales(VAS)at 1,2,4,8.12,24h and side reactions were recorded after surgery.The overall satisfac- tion with analgesic therapy was evaluated after analgesia.Results VAS in groupⅠat 1,4,12,24h was lower than that in groupⅡ(P

OBJECTIVETo observe the regulatory effects of electroacupuncture with different acupoints combinations on blood lipid and atherosclerosis index (AI) in rats with hyperlipemia, so as to make a preliminary screening for the optimal acupoints combination for hyperlipemia.

METHODSOne hundred and five clean-grade SD male rats were randomly divided into 9 groups, including a normal group, a model group, a Quchi group, a Zhongwan group, a Fenglong group, a Quchi+Zhongwan group, a Quchi+Fenglong group, a Zhongwan+Fenglong group and a Quchi+Zhongwan+Fenglong group (three acupoints group), 17 rats in the normal group and 11 rats in the rest groups. The normal group was fed with normal diet, while the rest groups were fed with high-fat diet for 3 weeks to prepare the hyperlipemia model. All the rats were given unlimited water. After the establishment of model, the normal group was fed freely without any treatment; the model group was bundled and immobilized everyday; the rest groups were bundled, immobilized and treated with electroacupuncture at corresponding acupoints with disperse-dense wave, 20 min per time, once a day. After 4 weeks, the blood examples were collected from abdominal aorta to measure the total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C), and analyzed the AI in each group.

RESULTSAfter the treatment, TC, TG, HDL-C, LDL-C and AI in each acupuncture group were all lower than those in the model group (P<0.05, P<0.01). Compared with single acupoint group and the Quchi+Zhongwan group, the content of TC in the three acupoints group was lower (P<0.01). The differences of content of TG among each acupuncture group were not significant (all P>0.05). Compared with the rest 6 acupuncture groups, the content of HDL-C and AI in the three acupoints group were significantly different (all P<0.05). The content of LDL-C in the three acupoints group was decreased as compared with the Quchi group and the Zhong-wan group.

CONCLUSIONThe electroacupuncture at "Quchi" (LI 11), "Zhongwan" (CV 12) and "Fenglong" (ST 40) has more advantages on regulating the content of HDL-C and LDL-C as well as improving AI in hyperlipemia rats, and it has superior effects on blood lipid metabolism.

Acupuncture Points ; Animals ; Electroacupuncture ; Humans ; Hyperlipidemias ; blood ; therapy ; Lipids ; blood ; Male ; Rats ; Rats, Sprague-Dawley

Objective To develop a teaching and examination system based on Delphi for the obstetric nurse. Methods The teaching materials were collected for the obstetric nurse, the teaching and examination mode was analyzed, and Delphi was used for programming and MySQL database was applied to teaching and examination data. Results The system had easy operation, high stability and rapid response to the database, and could meet the requirements for the teaching and examination of the trainee nurse. Conclusion The system realizes informatization and high expansibility of obstetric teaching and examination, and thus is worthy promoting practically.

Adolescent ; Adult ; Aged ; Bronchiolitis ; complications ; diagnosis ; therapy ; Female ; Humans ; Male ; Middle Aged

BACKGROUNDDifficult airway remains not only a challenge to the anesthesiologists, but also a life-threatening event to the patients. Awake intubation is the principal choice to deal with difficult airway, and a key point for awake intubation is airway topical anesthesia. Yet, so far there is no ideal topical anesthesia approach for awake intubation. This study aimed at evaluating the effect of pressure-driven (by 10 L/min oxygen flow) lidocaine spray on airway topical anesthesia in order to find a powerful and convenient method for airway topical anesthesia for conscious sedation intubation.

METHODSThirty adult patients referred for elective surgery under general anesthesia, aged 18 - C60 years and Mallampati class I or II, were recruited for the study. Before topical anesthesia, the observer's assessment of alert and sedation (OAA/S) scale was controlled between 3 and 4 by intravenous midazolam (0.03 mg/kg), propofol (2 mg×kg(-1)×h(-1)) and remifentanil (0.05 µg×kg(-1)×min(-1)). Ten minutes after sedation, topical anesthesia was performed with the pressure-driven lidocaine spray; the driving pressure was achieved by an oxygen flow of 10 L/min. After topical anesthesia, tracheal intubation was performed and the intubation condition was assessed with modified the Erhan's intubation condition score by an experienced anesthesiologist, and a score of less than 10 was considered to be satisfactory. Attempts to intubate the patient were recorded, and the complications such as local anesthetic toxicity, mucosa injury, and respiration depression were also recorded. The mean arterial blood pressure (MAP), heart rate (HR) and pulse oxygen saturation (SpO2) were recorded at different time points before and after intubation. Patients were asked 24 hours after the operation whether they could recall the events during intubation.

RESULTSAll patients were intubated at the first attempt, the average intubation condition score was 7.0 ± 1.1, from 6 to 10, satisfied intubation condition. MAP and HR increased significantly but mildly immediately after the tracheal intubation (P < 0.05), and decreased to the pre-intubation level soon after intubation. There were no related complications and patients had no recall of the intubation procedures.

CONCLUSIONSTopical anesthesia with pressure driven 2% lidocaine spray, where pressure is achieved by 10 L/min oxygen flow, can offer satisfactory intubation conditions for conscious sedation intubation.

Adolescent ; Adult ; Anesthesia, Local ; methods ; Conscious Sedation ; methods ; Female ; Humans ; Intubation, Intratracheal ; methods ; Lidocaine ; administration & dosage ; therapeutic use ; Male ; Middle Aged ; Young Adult

Objective To investigate the circulatory supporting effect of the third generation fully magnetically levitated China Heart ventricular assist device (CH-VAD) under heart failure (HF) condition.Methods An in vitro mock circulatory system (MCS) was developed.This system could simulate a healthy adult under resting state and a patient with heart failure,and incorporate the CH-VAD to evaluate the assisting performance under continuous flow mode.Furthermore,CH-VAD was equipped with a pulsatile flow controller and its initial performance was accessed.The pulsatile mode was obtained by using sinusoidal velocity waveform of the pump which synchronized the CH-VAD with the ventricle simulator of the MCS.Results CH-VAD under continuous flow mode could recover the hemodynamic parameters (arterial pressure and cardiac output) under HF condition to normal range.Preliminary pulsatile test results showed that amplitude of current pulse speed had a minor influence on the hemodynamic performance.CH-VAD under continuous flow and pulsatile flow mode could obtain comparable mean arterial pressure,systolic arterial pressure,diastolic arterial pressure and mean flow.Conclusions CH-VAD can generate a certain degree of speed pulse via appropriate pulsatility control,so as to provide sufficient support on ventricular function.Further optimization on pulsatile controller of CH-VAD is required to conform to natural physiology.The developed MCS can be utilized as an effective and controllable in vitro platform for design,optimization and verification of VADs or other mechanical circulatory support devices.

AIM To establish an HPLC method for the simultaneous content determination of four constituents in Liujing Toutong Tablets (Angelicae dahuricae Radix,Magnoliae Flos,Ligustici Rhizoma et Radix,etc.).METHODS The analysis of 30％ ethanol extract of this drug was performed on a 35 ℃ thermostatic Waters C18 column (4.6 mm × 250 mm,5 μm),with the mobile phase comprising of methanol-4％ acetic acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 320 nm.RESULTS Puerarin,ferulic acid,imperatorin and isoimperatorin showed good linear relationships within the ranges of 60.6-303 μg/mL (r=0.999 9),1.59-7.95 μg/mL (r =0.999 9),1.57-7.85 μg/mL (r =0.999 9) and 0.752 5-3.762 5 μg/mL (r =0.999 7),whose average recoveries (RSDs) were 97.75％ (1.7％),97.68％ (2.3％),97.94％ (1.0％) and 98.29％ (1.6％),respectively.CONCLUSION This stable and reliable method can be used for the quality control of Liujing Toutong Tablets.

Objective To investigate the early warning factors for the efficacy of Conbercept in treating diabetic macular edema(DME)and build a Nomograph prediction model based on the early warning factors.Methods A total of 269 DME patients(269 eyes)treated with Conbercept at Nanchang First Hospital from January 2021 to March 2023 were se-lected and divided into an effective group and an ineffective group according to the therapeutic effect at 3 months after treatment.Single factor analysis was made on the efficacy of Conbercept.The random forest method was used to screen and reduce the dimension of the characteristic variables on the efficacy of Conbercept,Logistic regression was used to ana-lyze the relevant factors affecting the efficacy of Conbercept,and R language was used to draw the Nomograph prediction model on the efficacy of Conbercept.The decision curve analysis(DCA)was made to evaluate the clinical effectiveness of the Nomograph prediction model.Results The duration of diabetes,drinking history,fasting blood glucose,2-hour postprandial blood glucose,and glycosylated hemoglobin of patients in the ineffective group were higher than those in the effective group,while the macular central retinal thickness and vessel density in the foveal retinal deep capillary plexus were lower than those in the effective group(all P＜0.05).According to the random forest algorithm,the top five predic-tive factors for the efficacy of Conbercept were glycosylated hemoglobin,macular central retinal thickness,fasting blood glucose,2-hour postprandial blood glucose,and vessel density in the foveal retinal deep capillary plexus.Logistic regres-sion analysis showed that glycosylated hemoglobin(OR=5.012),fasting blood glucose(OR=3.877),and 2-hour post-prandial blood glucose(OR=4.231)were risk factors for the efficacy of Conbercept,while the macular central retinal thickness(OR=0.409)and vessel density in the foveal retinal deep capillary plexus(OR=0.410)were protective factors for the efficacy of Conbercept(all P＜0.05).The Nomograph showed that the C-index of the prediction model was 0.900(95％CI:0.859-0.941),the sensitivity was 90.58％,and the specificity was 75.64％.The DCA curve showed that using the Nomogram prediction model to predict the efficacy of Conbercept could obtain positive net benefit,suggesting that it had certain clinical effectiveness.Conclusion The efficacy of Conbercept for DME patients is affected by a variety of factors,including glycosylated hemoglobin,fasting blood glucose,2-hour postprandial blood glucose,macular central reti-nal thickness,and vessel density in the foveal retinal deep capillary plexus.The Nomogram model constructed based on the above factors may be used to predict patients'treatment response in early stage,providing evidence for clinical decision-making.

Objective To investigate the molecular-epidemiologic characteristics and genotypes of human calicivirus (HuCVs) in acute diarrhea patients in Hangzhou from 2009 to 2010.Methods Epidemiologic data and fecal specimens were collected from patients with acute diarrhea.HuCVs of 920 specimens were detected by PCR.PCR products of several positive samples were randomly selected and sequenced.All the sequences were analyzed,phylogenetically.Results 201HuCVs positive cases were identified from 920 facal specimens (21.8％).25 isolates would include norovims G Ⅰ -type,G Ⅱ -type for 170 strains and sapovirus for 1 1 strains.Norovirus G Ⅰ -type and G Ⅱ -type were detected in four specimens at the same time.Other specimens were mixed infection with norovirus G Ⅱ -type and sapovirus.Genotypes of HuCVs showed that norovirus G Ⅰ subtypes were G Ⅰ -1 (3 strains) and G Ⅰ -2 (1 strain).Norovirus G Ⅱ subtypes were G Ⅱ -4/2006b variant strains (7 strains),GⅡ-2 (1 strain),G Ⅱ -7 (1 strain) and G Ⅱ -4/2008 variant strains (2 strains) ;Sapovirus subtypes were G Ⅰ -2 (5 strains),G Ⅰ -1 (4 strains) and G Ⅱ-1 ( 1 strain).The prevalence rates of HuCVs were different in seasons and age groups.Conclusion HuCVs were one of the major pathogens causing acute diarrhea.Both multiple viruses and genotypes of HuCVs were found in the specimens.G Ⅱ-4/2006b variant and similar strains were identified,probably as the prevalent strains from 2009 to 2010 in Hangzhou,Zhejiang province.

OBJECTIVETo explore the possible role of CD28/CTLA-4 co-stimulators in immune pathophysiology of acquired aplastic anemia(AA).

METHODSBy FACS, the percentages of CD28, CTLA-4 expressing CD3+ CD4+ T cells and the level of Th1, Th2 in bone marrow were detected in 23 AA patients at active phase, 10 at recovery phase and 15 normal controls. The relationship between the co-stimulators, Th1, Th2, and absolute neutrophil counts (ANC) was evaluated.

RESULTS(1) The percentage of CD28 and CTLA-4 expressing CD3+ CD4+ T cells in bone marrow, and CD28+/CTLA-4+ ratios were (31.40 +/- 10.83)%, (2.45 +/- 1.30)% , and 17.02 +/- 13.44 in normal controls respectively, (39.84 +/- 10.89)%, (1.43 +/- 0.67)%, and 43.04 +/- 37.61 in AA at active phase, respectively, (22 +/- 9.08)%, (3.46 +/- 2.26)%, and 10.49 +/- 7.8 in AA at recovery phase, respectively. The percentage of CD28 and CD28+/CTLA-4+ ratio were significantly higher, while CTLA-4 were lower in active phase AA patients than in normal controls (P < 0.05). These values in recovery phase AA were comparable to those in normal controls. (The Th1, Th2, and Th1/Th2 in bone marrow were (4.21 +/- 2.11)%, (1.99 +/- 1.27)%, and 2.46 +/- 1.28 in normal controls respectively, (11.13 +/- 4. 96)%, (2.46 +/- 1.65)%, and 5.20 +/- 1.98 in active phase AA and (5.39 +/- 4.2)9%, (2.53 +/- 2.41)%, and 2.87 +/- 1.43 in recovery phase AA, respectively. The percentage of Th1 and Th1/Th2 ratio were significantly higher in AA patients at active phase than in normal controls (P < 0.05). (3) The CD28+/CTLA-4+ ratio was positively related to the Th1+ /Th2+ ratio (P < 0.05). ANC was negatively related to CD3+ CD4+ CD28+ T cells (P < 0.01), and positively to CD3 + CD4 ' CTLA-4' T cells (P < 0.01) respectively.

CONCLUSION(1) The expression of CD28 was increased while CTLA-4 decreased on the membranes of CD3+ CD4+ T cells in bone marrow of AA patients. (2) The abnormal expression of CD28 costimulator promoted the shift of immune balance to Thl type. (3) The unbalance of CD28+ / CTLA-4+ is important for the immune pathophysiology of AA.

Adolescent ; Adult ; Aged ; Anemia, Aplastic ; immunology ; metabolism ; Antigens, CD ; immunology ; metabolism ; CD28 Antigens ; immunology ; metabolism ; CD4-Positive T-Lymphocytes ; metabolism ; CTLA-4 Antigen ; Child ; Female ; Humans ; Male ; Middle Aged ; Th1 Cells ; immunology ; Th2 Cells ; immunology