OBJECTIVETo compare the sedative effects of different doses of dexmedetomidine (DEX) and midazolam (MDZ) in dental implant surgery:

METHODSSixty patients undergoing dental implantation were selected and divided randomly into six groups (10 in each group). In group 1 (G1), a highdose of MDZ alone was administered intravenously. In group 2 (G2), a relatively low dose of MDZ and DEX was administered intravenously. In group 3 (G3), a highdose of MDZ and DEX was administered intravenously. In group 4 (G4), a lowdose of MDZ and a highdose of DEX were administered. In group 5(G5), a highdose of MDZ and a low dose of DEX were administered. In group 6 (G6), a highdose of DEX alone was administered intravenously. Blood pressure (BP), heart rate (HR), and arterial oxygen saturation values were measured. Sedation was assessed by determining the Ramsay sedation scores(RSS) during infiltration anesthesia (T1), incision (T2), cutting (T3), and suturing (T4). Before discharging from the hospital, patients were asked if they remembered the T1 to T4 procedures. The visual analogue scale (VAS) and the degree of patient satisfaction were assessed at the same time.

RESULTSIn T1 to T4, the systolic blood pressure (SBP) in G3 was the lowest and was significantly different from that in G1 and G2 (P < 0.05). In G1, the SBP was higher than that in G6 at the T3 and T4 points (P < 0.05). HR was below the preoperative (P < 0.05) in the G3 only. RSS was the lowest in G1 during the whole procedure. In G2, most patients obtained scores of 2-3. In G3, sedation was deeper, had more cases ofup to 5. In G4, most patients obtained scores of 3-4. In G5, some patients had a score of up to 5. The RSS in G6 was lower than that in G3 and G4 or G5 in T1 to T2, closer to G4 in T2. An evaluation of the VAS and the degree of patient satisfaction did not show any differences among the groups.

CONCLUSIONThe combination of DEX and MDZ is superior to a single intravenous injection. Low-dose MDZ combined with high-dose DEX achieved the highest quality of sedation in this study.

Anesthesia ; Blood Pressure ; Dental Care ; Dental Implants ; Dexmedetomidine ; therapeutic use ; Heart Rate ; Humans ; Hypnotics and Sedatives ; therapeutic use ; Midazolam ; therapeutic use ; Pain Measurement ; Patient Satisfaction ; Prospective Studies

Adult ; Diverticulum ; complications ; Echocardiography ; methods ; Heart Diseases ; diagnosis ; Heart Ventricles ; pathology ; Humans ; Male ; Young Adult

Objective To further elaborate the clinical characteristics,diagnosis,treatment and prognosis of primary cutaneous invasive epidermo-tropic CD8 positive cytotoxicity T-cell lymphoma.Methods The clinical characteristics,diagnosis and treatment of a patient with primary cutaneous invasive epidermotropic CD8 positive cytotoxicity T-cell lymphoma were summarized,and diagnosis and treatment of the disease from published literature were reviewed.Results After one year long,recurrence of exudative maculopapule on his body and limbs,a middle-aged male patient visited our hospital.Then,the patient was diagnosed as T2N0M0 Ⅰ phase of primary cutaneous invasive epidermo-tropic CD8 positive cytotoxicity T-cell lymphoma based on results of skin biopsy,immunohistochemistry,T-cell gene rearrangement and PET-CT.Through integrative medicine treatment (combination of bruceolic oil emulsion and chemotherapy with GDP regimen),the patient achieved complete remission (CR).The treatment and follow-up continues till now and his condition was stable.Conclusions Clinical occurrence of primary cutaneous invasive epidermo-tropic CD8 positive cytotoxicity T-cell lymphoma is rare and early diagnosis is difficult.It could be diagnosed with histopathology combined with T-cell gene rearrangement.In order to avoid misdiagnosis,great caution should be taken during disease history inquiry and physical examination,should be early lesion for delayed healing of recurrent lesions,biopsy should be conducted as soon as possible and immunohistochemistry should be performed simultaneously,which will provide a good basis for further treatment.

ObjectiveTo investigate suicidal ideation and its risk factors in patients with borderline personality disorder (BPD),and raise awareness of suicidal risk in BPD.MethodsPatients with BPD were selected from in-patient and out-patient departments as case group(n=84),while 84 subjects were selected as control group,1∶1 matched by gender and age.Barratt impulsiveness scale,Buss-Perry aggression questionnaire,childhood trauma questionnaire,Beck depression inventory,Beck hopelessness scale and Beck scale for suicide ideation were used to measure the two groups.Results(1)In case group,the number of incidence of suicidal occurred was 84.The scores of suicidal ideation in the recent week(4.94±4.57 vs 0.50±0.51),suicidal ideation in the worst situation(20.43±6.58 vs 1.26±2.60) and the total score(25.37±9.78 vs 1.76±3.65) were statistically higher than those in control group (t=8.499,24.972,20.847,all P<0.01).(2) Multiple regression analysis showed that motor impulsivity,physical neglect in childhood,impulsivity,co-morbidity of axis I disorders,physical abuse in childhood,unemployment and unmarried status were risk factors of suicidal ideation in patients with BPD (β=0.876,0.640,0.428,0.350,0.236,0.165,-0.205,all P<0.05).ConclusionThe suicide ideation of patients with BPD are prevalent and intense.Awareness of risk factors for patients with BPD,thereby reducing the risk of suicide.

OBJECTIVE To investigate the distribution and antimicrobial resistance among clinical isolates of Acinetobacter baumannii(ABA) from July 1 to Dect 31 2007 in Haidian Hospital of Beijing.METHODS A retrospective study on clinical distribution and antimicrobial resistance of 22 antibiotics to ABA was undertaken.RESULTS ABA frequently detected out in phlegm specimen with the detection rate of 86.4%.The drug-resistance to SCF and AMK was the lowest.CONCLUSIONS ABA had severe drug-resistance,SCF and AMK keep better activity to ABA.Rational selection and use of antibacterials is important to prevent the appearance of drug-resistance of ABA.

A percutaneous visceral tumor puncture director is introduced in this paper, which can be used for needle biopsy and brush biopsy in kinds of visceral tumor. The clinical informations show that the application of the director can increase the positive ratio of puncture, and it has important clinical value. The director is safe, practical and easy to operate.
Biopsy, Needle ; instrumentation ; methods ; Equipment Design ; Humans ; Neoplasms ; pathology ; Sensitivity and Specificity

Background and purpose:The patients with aggressive lymphoma who have a poor prognosis and unlikely to be cured with conventional chemotherapy. This study was aimed to evaluate the effect of high-dose etoposide in mobilization followed auto-SCT in treating refractory lymphoma. Methods:40 patients [median age 33 (13-61) years] with refractory non-Hodgkin’s lymphoma (NHL, n=32) or Hodgkin’s lymphoma (HD, n=8) received high-dose etoposide [VP16 10-15 mg/(kg·d)×2 d] in mobilization in our center. Remission status prior to mobilization was PD (n=40). The use of such granulocyte colony-stimulating factor [G-CSF, 5-10μg/(kg·d)] mobilized peripheral blood stem cells (PBSC) after high-dose etoposide until the end of leukapheresis. Peripheral blood stem cell was collected and frozen in-80℃refrigerator. All these patients received auto peripheral blood stem cell transplantation (auto-PBSCT). Conditioning regimen was BEAM (n=19, 47.5%) or CBV (n=21, 52.5%). Results:Twenty-eight pa-tients (70%) were assessable for response after high-dose etoposide at a median pretreatment time of 39 days (range 17-172 days), 12 patients (30%) had no response. Median follow-up of 28 (4-66) months, 16 patients (40%) reached CR after auto-PBSCT. Fifteen of the 28 patients (53.6%) who had response to high-dose etoposide reached CR, 4 patients (14.3%) reached PR, 9 patients (32.1%) succumb to progression of disease. One of the 12 patients (8.3%) who had no response to high-dose etoposide reached CR, 1 patients (8.3%) reached PR, 10 patients (83.4%) succumb to progression of disease. The estimated 1-year OS and EFS were 69%and 56.7%respectively, 2-years OS and EFS were 63%and 52%respectively. The prognosis of the patients who had no response to etoposide was poor. The estimated 1-year OS and EFS were 25%and 16.7%respectively. Two group of comparison differences have statistics signiifcance (P<0.01). Conclusion: High-dose etoposide could be used in refractory lymphoma as rescue therapy in mobilization. It can increase the EFS and OS of patients who had response. The hematopoietic stem cells collection and hematopoietic reconstitution are not affected by etoposide.

Abstract: Objective　To investigate the distribution and drug resistance of pathogenic bacteria separated from ascites of patients in Children’s Hospital Affiliated to Zhengzhou University from 2015 to 2021, and to provide a basis for rational clinical antimicrobial agents. Methods　Bacterial culture, bacterial identification and drug sensitivity analysis were performed on 1 058 non-duplicate ascites culture specimens from January 2015 to December 2021. The clinica1 and microbiologica1 data were ana1yzed by WHONET 5.6 and SAS 9.4 Results　Of the 1 058 specimens, 586 (55.39%) were positive for pathogenic bacteria, with a total of 781 strains isolated. There was no significant trend of increase or decrease in the positivity rate over different years. Male children (63.99%) were more prevalent than female children. Appendicitis (59.22%) was the most common disease and Escherichia coli was the most common causative bacteria. Among neonates (≤28 d), the bacteria with the highest detection rate were Klebsiella pneumoniae (23.50%) and Enterococcus faecium (23.50%), while among children (>28 d), the highest detection rate was Escherichia coli (35.98%). Gram-negative bacteria accounted for 64.79% of the 781 strains, mainly Escherichia coli (38.28%), Klebsiella pneumoniae (8.58%), and Pseudomonas aeruginosa (5.89%); Gram-positive bacteria accounted for 29.45%, mainly Enterococcus faecium (8.58%), Streptococcus constellatus (2.69%), and Enterococcus avium (2.43%); fungi accounted for 1.66% and anaerobic bacteria accounted for 4.10%. The resistance rates of Escherichia coli to cefoperazone/sulbactam, piperacillin/tazobactam, imipenem and meropenem were 6.02%, 4.35%, 4.35%, and 3.68%, respectively. The resistance rates of Klebsiella pneumoniae to these drugs were 59.70%, 59.70%, 50.75% and 53.73% respectively. Linezolid-resistant strains of Enterococcus faecium were found. Conclusion　Appendicitis is the most common abdominal infection in children, and the distribution of ascites pathogens varies with ages and diseases. The pathogenic bacteria are mainly Gram-negative bacteria, and the drug resistance of Klebsiella pneumoniae was more serious. It is particularly important to use antibiotics correctly and rationally to reduce the emergence of drug resistant bacteria.

Objective To investigate the nutrition status of the focus groups of iodine deficiency in the 5 coastal counties(districts)in Guangxi in 2008 to propose corresponding prevention and control measures.Methods In the 5 coastal counties(districts)in Guangxi,including Haicheng,Tieshangang,Yinhai districts and Hepu county in Beihai city,Qinnan district in Qinzhou city,the rates of iodized salt coverage,qualified iodized salt and consumption of qualified iodized salt had always been below the average level of Guangxi.In the study,6 towns were randomly picked in Hepu district,and 3 towns were randomly picked in each of the other 4 coastal counties(districts).Two administrative viRages were randomly picked in each town.Forty children ages 8 to 10 and 10 women of child-beating age from 18 to 42 which included 5 pregnant and lactating women,were picked from each administrative village.Arsenic-cerium catalyzed spectrophotometry(WS/T 107-2006)Was used to determine the urinary iodine.Results In total,1437 urine samples of the children Were picked.The median of the children's urinary iodine Was 191.0μg/L,with 1.4%(20/1437)of the children's urinary iodine<20 μg/L,and 5.4%(77/1437)<50 μg/L, and 20.3%(292/1437) < 100 μg/L. The medians of the children's urinary iodine were 134.5 - 220.0 μg/L.In Haicheng and Hepu, the medians of the children's urinary iodine were higher than 200 μg/L(220.0,209.5 μg/L, respectively). The medians of the children's urinary iodine in the other 3 counties(districts) were within the suitable range between 100 and 200 μg/L(134.5,162.4,199.3 μg/L, respectively). The medians of the 8- and 9-year-old ehildren's urinary iodine (192.3,206.7 μg/L, respectively) were higher than that of the 10-year-old children's(157.2 μg/L, χ2 = 19.644,41.997, all P < 0.017). Totally, 365 urine samples of the women were picked.The medians of the women's urinary iodine in the 5 counties were 88.2 - 195.6 μg/L, with 195.6 μg/L in Haicheng and 156.5 μg/L in Hepu, and 88.2 μg/L in Tieshangang, which was the lowest and below 100 μg/L. The median of the childbearing-age women's urinary iodine was the highest(152.6 μg/L). The median of the lactating women's urinary iodine was the second (131.9 μg/L). The median of the pregnant women's urinary iodine was the lowest (89.4 μg/L) and below 100 μg/L. Only 6.7%(2/30) of the pregnant women's urinary iodine were within the suitable range between 150 and 250 μg,/L. Conclusions In the 5 coastal counties(districts) in Guangxi, 8 to 10-year-old children had good nutrition levels while childbearing-age and lactating women were within the suitable range. As a whole, the pregnant women had insufficient iodine nutrition. We propose that the iodine nutritional status of pregnant women is monitored routinely, with further prevention, control measures, health publicity and education necessary to improve iodized salt coverage.

Objective:To study the effect of N-acetyltransferase 10(Naa10p)expression on the sensitivity of tongue squamous cell carcinoma Tca8113 cells to pingyangmycin(PYM).Methods:The lentiviral vectors of LV-shNaa10p,LV-Naa10p and control LV-NC were transfected into Tca8113 cells,the infection efficiency were identified,then the sensitivity of the infected cells to PYM was determined by MTS assay.Results:The IC50 of Tca8113-LV-shNaa10p group,Tca8113-LV-Naa10p group and Tca8113-LV-NC group were (20.772 ±0.106)μg/ml,(2.157 ±0.123)μg/ml and (6.301 ±0.069)μg/ml respectively(between groups P <0.05).Con-clusion:Knock down of Naa10p may reduce and over expression of Naa10p can increase the sensitivity of Tca8113 cells to PYM.