Objective To evaluate the effects on mechanical ventilation in ICU patients with dexmedetomidine merely and combined with dezocine, fentanyl, respectively.Methods Fifty-seven patients with mechanical ventilation in ICU were collected during Jun till Dec in 2016, 35 males and 22 females, aged 18-75 years, and classified into three groups with random number table method, among whom there were 17 patients treated with dexmedetomidine, 20 patients treated with dexmedetomidine combined with dezocine and 20 with dexmedetomidine plus fentanyl, the general condition, pain score, MAP and HR were compared before and after the treatment, ideal treatment time and mechanical ventilation time were also compared among the different groups.Results There were no statistical differences in the general condition, CPOT score, MAP and HR at different points and mechanical ventilation time.Whereas, the time of ideal sedation and analgesia was significantly faster in group C than that of groups A and B (P<0.05).Conclusion Dexmedetomidine combined with dezocine can reach the ideal analgesic effect more rapidly than dexmedetomidine solely or combined with fentanyl.

Objective:To observe the effects of toadpoison and arsenic on the ultrastructure of dental pulp,Methods :Dental pulp of 36 teeth in 3 dogs was exposed by operation and then direct dressing with toadpoison paste or arsenic paste was performed. 1,2,6 and 24 hours after operation ,the pulps were processed and examinedunder a trasmission electron microscope (JEM-2000EX). Results:In toadpoison treated group ,the deformityof the basernembrane of pulp nerve ,swelling of metochondrion,degeneration of nerve axite were observed 1 h after dressing,and were more obvious in 2, 6 and 24 h. Damage of capillary and pulp cells were alsoobserved.In arsenic treated group ,swelling and break of capillaries ,deformity and degeneration of mitochondrion and endoplasmic reticulum in endoepithelial cells were observed,and were more obvious following time lasting. Damages of pulp nerve and pulp cells were also observed. Conclusion:Toadpoison and arsenic are toxic to pulp tissues. But the angiotoxicity of arsenic is stronger than that of toadpoison,the neurotoxicity and protoplasmic toxicity of toadpoison are stronger than those of arsenic.

Based on the integration of the advanced visualization toolkit (VTK) and the real-time rendering System (VolumePro), 4D View, a 3D real-time visualization system of medical image, which applies real-time 3D medical image (such as MR, CT image, etc.) visualization and interaction was developed. Firstly the VTK, VolumePro and their integration were introduced briefly; then the system design and function template of 4D View system was discussed in detail; finally some visualization results acquired through 4D View was illustrated. According to the results, 4D View system can effectively resolve the poor real-time characteristic of 3D medical image visualization and interaction, so it will have a wide application area of the clinical diagnosis, therapy and medical research, etc in future.
Image Processing, Computer-Assisted ; instrumentation ; Imaging, Three-Dimensional ; instrumentation ; Software ; Systems Integration

Objective To investigate genetic polymorphisms of HPRTB, DXS6803 and DXS6809 STR loci in Tianjin Han female population, and to provide experimental data in the prenatal diagnosis of aneuploidies accurately and rapidly. Methods A total of 150 blood samples were collected in Tianjin Han population. QF-PCR and capillary electrophoresis were used in this study. The relevant data were analyzed by ABI Prism GeneMapper v3.0 software. Two homozygotes were se?lected from each locus for sequencing. The frequencies of the genotypes were checked using Chi-square test to verify Hardy-Weinberg Equilibrium. Data of genetic polymorphisms were calculated by PowerStatsV12 software. Results A total of 150 samples were successfully amplified in 24 hours. The 10, 6 and 10 alleles and 22, 12 and 29 genotypes were found respec?tively in HPRTB, DXS6803 and DXS6809 loci. The most common alleles were 14, 13 and 14. The higher frequencies of gen?otypes were 14-14, 12-13 and 13-14. No significant deviations from the Hardy-Weinberg equilibrium were observed in these three STR loci (χ2=10.554, 5.783 and 15.355, respectively, P>0.05). Values of He were 0.748, 0.649 and 0.806 for these three STR loci respectively. Values of Ho were 0.607, 0.700 and 0.713 respectively. Values of PIC were 0.706, 0.599 and 0.775 respectively. Values of PD were 0.894, 0.814 and 0.931 respectively. And values of PE were 0.299, 0.428 and 0.449 respectively. Conclusion HPRTB, DXS6803 and DXS6809 STR loci were highly polymorphic, which are favorable genetic markers on chromosome X and can be used in rapid prenatal genetic diagnosis.

Hypertension with high serum Homocysteine (Hcy) significantly increases the incidence of cardiovascular and cerebrovascular events, which is defined as H-Type Hypertension by Chinese scholars. Plenty of researches have confirmed that high prevalence of H-Type Hypertension in Chinese population is now the big public problem in China. Traditional Chinese Medicine(TCM)treatment shows the advantages in integral regulation, less side effect, and anti-Hcy effect in hypertension. This paper discussed the prevalence, TCM syndrome and TCM treatment progress in H-Type Hypertension to provide some ideas and references for the intervention of H-Type Hypertension by TCM.

Objective:To investigate the clinical manifestation, diagnosis and prognosis of heavy- and light-amyloidosis (AHL).Methods:The clinical data of two patients with AHL in Peking University People's Hospital and 21 cases of reported literature were reviewed to clarify the clinical and prognostic characteristics of AHL.Results:Compared with light-amyloidosis, most AHL patients were male, with high positive rate of blood and urine immunofixation electrophoresis and complete immunoglobulin. The manifestations of the kidneys were proteinuria, mainly composed of albumin, nephrotic syndrome and microscopic haematuria. The pathology of renal biopsy showed that Congo red staining positive substances were deposited in many sites (mesangial area, capillary wall, arteriole and renal interstitium), and immunofluorescence showed that monoclonal heavy chain with light chain (the type was consistent with the hematuria M protein) were clumpy deposition, which was consistent with amyloid deposition site. Heart involvement was rare, and the proportion of plasma cells in bone marrow was high.Conclusion:AHL is rare and its clinical manifestations of AHL are different from those of light-amyloidosis. The prognosis needs to be further observed.

Objective:To investigate the efficacy and safety of lenalidomide combined with bortezomib and dexamethasone (RVD) in patients with newly diagnosed multiple myeloma (NDMM).Methods:A total of 100 consecutive NDMM patients treated with RVD from August 2016 to September 2020 at Peking University People′s Hospital were retrospectively analyzed, including response, drug toxicity, follow-up and survival, and subgroup analysis.Results:The median follow-up time was 19.5 (2.0-57.0) months. For patients undergoing autologous stem cell transplantation (ASCT) after RVD regimen, the objective response rate (ORR)/complete response+stringent complete response (CR+sCR)/≥very good partial response (VGPR) rates were 100%, 73.3% (33/45), 95.6% (43/45) respectively. For 54 patients not receiving transplantation, the ORR/CR+sCR/≥VGPR rates were 79.6% (43/54), 18.5% (10/54), 51.9% (28/54) respectively. As to the survival analysis, 2-year progression free survival (PFS) rates were 84.5% and 70.9% in transplant and non-transplant patients respectively ( P=0.102). Two-year overall survival (OS) rates were 100% and 80.8% in transplant and non-transplant patients respectively ( P=0.003). The common hematologic adverse events (AEs) were thrombocytopenia (33%) and neutropenia (25%). Abnormal liver function (43%) and peripheral neuropathy (24%) were recognized more as non-hematologic AEs. Conclusion:RVD as front-line regimen has high efficient response rate and acceptable safety in Chinese NDMM patients.

Objective To investigate the risk factors of in-hospital mortality and establish a risk prediction model for patients receiving venoarterial extracorporeal membrane oxygenation(VA-ECMO).Methods We retrospectively collected the data of 302 patients receiving VA-ECMO in ICU of 3 hospitals in Guangdong Province between January,2015 and January,2022 using a convenience sampling method.The patients were divided into a derivation cohort(201 cases)and a validation cohort(101 cases).Univariate and multivariate logistic regression analyses were used to analyze the risk factors for in-hospital death of these patients,based on which a risk prediction model was established in the form of a nomogram.The receiver operator characteristic(ROC)curve,calibration curve and clinical decision curve were used to evaluate the discrimination ability,calibration and clinical validity of this model.Results The in-hospital mortality risk prediction model was established based the risk factors including hypertension(OR=3.694,95%CI:1.582-8.621),continuous renal replacement therapy(OR=9.661,95%CI:4.103-22.745),elevated Na2+ level(OR=1.048,95%CI:1.003-1.095)and increased hemoglobin level(OR=0.987,95%CI:0.977-0.998).In the derivation cohort,the area under the ROC curve(AUC)of this model was 0.829(95%CI:0.770-0.889),greater than those of the 4 single factors(all AUC<0.800),APACHE Ⅱ Score(AUC=0.777,95%CI:0.714-0.840)and the SOFA Score(AUC=0.721,95%CI:0.647-0.796).The results of internal validation showed that the AUC of the model was 0.774(95%CI:0.679-0.869),and the goodness of fit test showed a good fitting of this model(χ2=4.629,P>0.05).Conclusion The risk prediction model for in-hospital mortality of patients on VA-ECMO has good differentiation,calibration and clinical effectiveness and outperforms the commonly used disease severity scoring system,and thus can be used for assessing disease severity and prognostic risk level in critically ill patients.

Objective To investigate the risk factors of in-hospital mortality and establish a risk prediction model for patients receiving venoarterial extracorporeal membrane oxygenation(VA-ECMO).Methods We retrospectively collected the data of 302 patients receiving VA-ECMO in ICU of 3 hospitals in Guangdong Province between January,2015 and January,2022 using a convenience sampling method.The patients were divided into a derivation cohort(201 cases)and a validation cohort(101 cases).Univariate and multivariate logistic regression analyses were used to analyze the risk factors for in-hospital death of these patients,based on which a risk prediction model was established in the form of a nomogram.The receiver operator characteristic(ROC)curve,calibration curve and clinical decision curve were used to evaluate the discrimination ability,calibration and clinical validity of this model.Results The in-hospital mortality risk prediction model was established based the risk factors including hypertension(OR=3.694,95%CI:1.582-8.621),continuous renal replacement therapy(OR=9.661,95%CI:4.103-22.745),elevated Na2+ level(OR=1.048,95%CI:1.003-1.095)and increased hemoglobin level(OR=0.987,95%CI:0.977-0.998).In the derivation cohort,the area under the ROC curve(AUC)of this model was 0.829(95%CI:0.770-0.889),greater than those of the 4 single factors(all AUC<0.800),APACHE Ⅱ Score(AUC=0.777,95%CI:0.714-0.840)and the SOFA Score(AUC=0.721,95%CI:0.647-0.796).The results of internal validation showed that the AUC of the model was 0.774(95%CI:0.679-0.869),and the goodness of fit test showed a good fitting of this model(χ2=4.629,P>0.05).Conclusion The risk prediction model for in-hospital mortality of patients on VA-ECMO has good differentiation,calibration and clinical effectiveness and outperforms the commonly used disease severity scoring system,and thus can be used for assessing disease severity and prognostic risk level in critically ill patients.

AIM: To observe the effect of acute normovolemic hemodilution (ANH) autologous blood transfusion on the EEG bispectral index and muscle relaxation in elderly patients undergoing orthopedic surgery to explore the influence of autologous blood transfusion containing anesthetic components on the quality and safety of postoperative anesthesia recovery. METHODS: Forty patients, aged 65-75, weighing 55-80 kg, ASA grade I-II, with an estimated intraoperative blood loss of more than 600 mL, were selected for elective orthopedic surgery. The patients were randomly divided into two groups (n=20): group A was given acute normovolemic hemodilution (ANH), and the target value of Hct was 28%-30% after induction of anesthesia; group B was the control group which was given routine fluid infusion during operation without ANH. Bispectral index (BIS), TOF values and plasma concentrations of propofol and cisatracurium were measured at the beginning of autotransfusion (T