OBJECTIVE To evaluate the efficacy and side effect during target controlled infusion of remifentanil and propofol in elderly patient undergoing nasal-endoscopy surgery.METHODS 60 patients of nasal-endoscopy surgery were devided into two groups based on age(non-elderly group age

Objective To analyze the characteristics of the genotype, phenotype, and follow-up of Gitelman's syndrome (GS) in the largest group of Chinese patients. Methods Sixty seven patients with GS underwent SLC12A3 gene analysis. Clinical characteristics and biochemical findings at the first presentation as well as follow-up were reviewed. Additionally, the associations of genotypes and phenotypes were explored. Results Forty-one different SLC12A3 mutations were identified in 67 patients with GS, including 11 novel ones, and 5 recurrent ones. 3 families (5. 7% ) had triple SLC12A3 mutations. Typical hypocalciuria and hypomagnesemia were not found in 6(9% ) and 8 (11. 9% )patients, respectively. In addition, male patients had an earlier age of onset and a higher urinary fraction excretion of electrolytes. 2 patients presented with chronic kidney disease, 13 (19. 4% ) with type 2 diabetes, 14 (20. 9% )with impaired glucose tolerance, and 5(7. 5% ) with impaired fasting glucose. Conclusion This study revealed 41 mutations in 67 Chinese patients with GS, including 11 novel variants and 5 high-frequency ones. Fraction excretion of electrolyte in urine may be more sensitive in the evaluation of phenotype compared with those of blood. It is difficult to correct hypokalemia and hypomagnesemia in GS. Patients with GS are at higher risk of the development of diabetes than ordinary people.

BACKGROUND:Conductive biomaterials are considered potential candidates for transmitting electrical signals for myocardial repair.Combining cell-based or cell-free strategies with conductive biomaterials to replenish cardiomyocytes and/or restore electrical signaling pathways is a promising approach for cardiac repair. OBJECTIVE:To evaluate the effect of polypyrrole-chitosan conductive composite hydrogel on cardiac function in rats with myocardial ischemia-reperfusion injury. METHODS:The polypyrrole-chitosan conductive composite hydrogel was prepared by chemical oxidative polymerization.The micromorphology,biocompatibility and conductivity of the hydrogels were characterized.Thirty adult SD rats were selected to establish a myocardial ischemia-reperfusion injury model by clamping the left anterior descending branch of the heart and then releasing it.After 21 days of modeling,the rats were divided into three groups by the random number table method:Normal saline was injected into the left ventricular infarction area and infarction margin area in the blank group.Chitosan hydrogel was injected into the left ventricular infarction area and infarction margin area in the ordinary hydrogel group.The polypyrrole-chitosan conductive composite hydrogel was injected into the left ventricular infarction area and infarction margin area,with 10 rats in each group.The corresponding time points after modeling were set,and cardiac mechanical function(echocardiogram,pressure-volume analysis),cardiac electrophysiology(electrocardiogram,programmed electrical stimulation,optical mapping technology,microelectrode array technology,eight-lead electrocardiogram,and electrical resistivity of the scar area)and cardiac histology were detected. RESULTS AND CONCLUSION:(1)There were a lot of pores on the surface of the conductive composite hydrogel,and the conductivity was(3.19±0.03)×10-3 mS/cm,which had good biocompatibility co-cultured with smooth muscle cells.(2)After 105 days of modeling,echocardiogram and pressure-volume analysis showed that compared with the blank group and the ordinary hydrogel group,the conductive composite hydrogel could significantly improve the contractile function of the heart of rats with myocardial ischemia-reperfusion injury.The results of electrocardiogram,programmed electrical stimulation,optical mapping technology,microelectrode array technology,eight-lead electrocardiogram,and electrical resistivity of the scar area examination at 105 days after modeling displayed that,compared with the blank group and the ordinary hydrogel group,the conductive composite hydrogel could significantly improve the electrical conduction function of the heart of rats with myocardial ischemia-reperfusion injury and reduce the occurrence of arrhythmia.Masson staining of heart tissue at 105 days after modeling exhibited that there were different degrees of fibrosis in the myocardial infarction area of the three groups.Compared with the normal saline group and the ordinary hydrogel group,the conductive hydrogel group had more normal myocardial tissue and less fibrosis in the myocardial infarction area.(3)The results verify that polypyrrole-chitosan conductive composite hydrogel may promote the repair of infarcted heart after ischemia-reperfusion injury by increasing the electrical conduction velocity of infarct scar area tissue,increasing scar thickness,enhancing synchronous cardiac contraction,and reducing damaged tissue.

Humans ; Botulinum Toxins, Type A/therapeutic use* ; Esotropia/drug therapy* ; Neuromuscular Agents ; Injections ; Treatment Outcome ; Oculomotor Muscles

AIM: To explore the variance in efficacy between botulinum toxin A(BTA)injection and extraocular muscle surgery in managing large-angle(≥+60 PD)acute acquired concomitant esotropia(AACE).METHODS: A retrospective analysis was conducted on clinical data of 60 patients with AACE treated at our hospital from June 2020 to December 2022. Patients were divided into three groups based on different treatments: 2.5 IU BTA injection group(14 cases), 5.0 IU BTA injection group(29 cases), and surgical group(17 cases). Follow-up was conducted for 6 mo after treatment to observe the degree of strabismus after the correction of refractive error, visual function, treatment effectiveness, and occurrence of complications after BTA injection.RESULTS: At 6 mo post-treatment, the degree of strabismus in the surgical group and the 5.0 IU BTA injection group was lower than that in the 2.5 IU BTA injection group(P<0.017). However, there was no significant difference in the degree of strabismus between the surgical group and the 5.0 IU BTA injection group(P>0.017). The effective rate of the 5.0 IU BTA injection group was higher than that of the 2.5 IU BTA injection group(86% vs 43%, P<0.017). There was no difference in visual function among the three groups(P>0.05). The incidence of complications after treatment was not significantly different between the 2.5 IU BTA injection group and the 5.0 IU BTA injection group(43% vs 52%, P>0.05).CONCLUSION: For AACE patients with esotropia degree ≥+60 PD, bilateral medial rectus injection of 5.0 IU BTA can yield outcomes comparable to traditional extraocular muscle surgery, with the advantages of minimal trauma and simple and convenient operation.