Adult ; Benzene ; poisoning ; Cord Blood Stem Cell Transplantation ; Female ; Humans ; Infant, Newborn ; Leukemia ; etiology ; surgery ; Male ; Treatment Outcome ; Young Adult

Objective To compare the effects of remifentanil infused at different rates on median effective target plasma concentration (EC50) of propofol inhibiting responses to laryngeal mask airway (LMA) insertion and determine the optimum infusion rate of remifentanil when used for fiberoptic bronchoscopy in pediatric patients.Methods Eighty-four ASA Ⅰ or Ⅱ pediatric patients,aged 7 months-3 years,scheduled for elective fiberoptic bronchoscopy,were randomly assigned into 3 groups (n =28 each):normal saline group (group C),remifentanil infused at 3 ng· kg-1 ·min-1 group (group R1) and remifentanil infused at 5 ng· kg-1 · min-1 group (group R2).Responses to LMA insertion were defined as body movement and/or bucking during insertion.The initial target plasma concentrations of propofol were 5.2,4.8 and 4.4 μg/ml in groups C,R1 and R2,respectively.The target plasma concentration of propofol was determined by up-and-down sequential allocation.Each time the target plasma concentration increased/decreased by 0.2μg/ml.EC50 and 95 ％ confidence interval of propofol blunting responses to LMA insertion were determined by probit method.Results EC50 (95 ％ confidence interval) of propofol was 5.03 (4.92-5.12) μg/ml,4.71 (4.58-4.84) μg/rnl and 4.46 (4.20-4.94) μg/ml in groups C,R1 and R2,respectively.There was no significant difference in EC50 of propofol between groups R1 and C (P ＞ 0.05).EC50 of propofol was significantly lower in group R2 than in groups C and R1 (P ＜ 0.05).Conclusion The infusion rate of remifentanil should not be lower than 5 ng· kg-1· min-1 when combined with propofol in pediatric patients undergoing fiberoptic bronchoscopy.

ObjectiveTo evaluate the safety and efficacy of tirofiba in the treatment of patients with acute ST-elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI). MethodsA total of 158 patients with acute STEMI were randomly divided into tirofiban group 1 (59 cases, received tirofiban before PCI), tirofiban group 2 (56 cases, received tirofiban when PCI) and control group(43 cases, only received PCI). The coronary reperfusion flow(TIMI grade) of infarct related artery (IRA) after PCI, the resolution of the sum of ST segment elevation(sum STR) at 90 min after the procedure, the changes of myocardial enzyme at 6 h and 12 h afterwards, the left ventricular ejection fraction (LVEF) 1 week later, the major adverse cardiac events(MACE) within 30 d, bleeding and thrombocytopenia complications were analyzed and compared among the three groups. ResultsTIMI reperfusion grades in tirofiban group 1[98.3％(58/59 )]and tirofiban group 2[92.9％(52/56)]were higher than those in control group[60.5％(26/43)](P ＜0.05). The resolution of sum STR at 90 min after PCI in tirofiban group 1 [(89.3 ± 6.9)％]and tirofiban group 2[(82.4 + 7.3)％]was higher than that in control group[(65.6 +8.1 )％](P＜ 0.01 ),and there was significant difference between tirofiban group I and tirofiban group 2 (P＜0.05 ). The occurrence of MACE within 30 d was lower in tirofiban group 1 and tirofiban group 2 than that in control group (P＜ 0.05). The level of CK-MB at 6 h and 12 h afterwards was lower in tirofiban group 1 than that in tirofiban group 2,and tirofiban group 2 was lower than control group (P＜ 0.05). LVEF 1 week later in tirofiban group 1[(56.2 + 6.4)％]was higher than that in tirofiban group 2[(51.1 + 4.9)％]and control group[(49.8 + 5.7)％](P ＜ 0.05),but there was no significant difference between tirofiban group 2 and control group (P ＞ 0.05). Although bleeding incidence in tirofiban group 1 and tirofiban group 2 was higher than that in control group, no severe bleeding and thrombocytopenia was observed. Conclusion Tirofiban can safely and effectively reduce the incidence of the ischemic events in the patients with acute STEM1 during preoperative of emergency PCI.

Objective To investigate the in vitro susceptibility of Minocycline and polymycin B against clinical islates of pan-drug resistant Acinetobacter baumanii ,to provide laboratory support for clinical treatment for drug selection.Methods The susceptible test of Minocycline and polymycin against 39 isolates of pan-drug resistant Acinetobacter baumanii were determined by K-B meth-od.Results 38 strains of pan-resistant Acinetobacter baumanii were sensitive to polymyxin B,sensitive rate was 97.4%,20 strains sensitive to minocycline,the sensitivity rate was 51.3%.polymyxin B sensitivity was more sensitive than Minocycline (P < 0.05). Conclusion Polymycin B had strong activit ies against pan-drug resistant Acinetobacter baumanii .

Objective To evaluate the performance of an improved skin prick test in the screening for allergens.Methods A total of 475 patients with chronic urticaria who aged from 3 to 81 years were enrolled in this study,and classified into the control group (n =235) and research group (n =240).Traditional and improved skin prick test were conducted in the control and research group respectively.The allergen detection rate was compared between the two test methods.Results The allergen detection rate was 65.4％ and 67.2％ respectively for the improved and traditional skin prick test,respectively (P ＞ 0.05).House dust mites were the most common sensitizing agent.Conclusion The improved skin prick test can offer reliable evidence for chnical diagnosis with a relatively convenient and safe procedure.

Objective To evaluate the safety and effectiveness of vitrectomy combined with internal limiting membrane (ILM) tamping on macular hole and retinal detachment (MHRD) in highly myopic eyes.Methods 23 patients (23 eyes) were retrospectively reviewed,who were diagnosed as MHRD through examination of the ocular ftmdus,optic coherence tomography (OCT) and B-mode ultrasonography.There were 5 males (5 eyes) and 18 females (18 eyes).The mean age was (62.35 ± 8.28) years.The mean course of disease was 1.1 months.The logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) was 2.31 ± 0.72.The mean axial length was (28.66 ± 1.99) mm.All patients underwent 23G microincision vitrectomy.After vitreous gel and cortex were gently resected,the ILM around the edges of the macular hole was stained with indocyanine green,and was folded and pushed to fill the macular hole gently.Then silicone oil or C3F8 gas tamponade was applied in 18 eyes and 5 eyes,respectively.The silicone oil was removed after 3 months.The follow-up was 6 months.The BCVA,macular hole closure,retinal anatomical reattachment were retrospectively observed,and were used to evaluate the safety and effectiveness of the surgery.Results At the 6 months after surgery,the logMAR BCVA was improved to 1.13 ± 0.38,the difference was significant (t=l 5.33,P=0.00).The postoperative macular hole closure rate and retinal anatomical reattachment rate were 100％.There were no ocular or systemic adverse events observed in all patients.Conclusion Vitrectomy combined with ILM tamping is an effective and safe treatment for the high myopic eyes with MHRD.

Abnormalities, Multiple ; diagnosis ; genetics ; Child ; Chromosome Deletion ; Chromosomes, Human, Pair 22 ; genetics ; Female ; Genetic Testing ; Humans ; Karyotyping ; Mutation ; Ring Chromosomes

Objective To investigate the relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP) and tissue Doppler imaging (TDI) derived cardiac function index (Tei index) in patients with acute coronary syndrome under different plasma glucose levels and to evaluate the influence of hyperglycemia on the preciseness of cardiac function assessment with NT-proBNP.Methods Consecutive patients with acute coronary syndrome admitted to the department of cardiology in Guangdong General Hospital were prospectively enrolled.Based on their plasma fasting glucose level,patients were divided into hyperglycemia group (fasting plasma glucose ≥ 6.1 mmol/L) and euglycemia group (fasting plasma glucose ＜ 6.1 mmol/L).All the patients underwent transthoracic echocardiagraphy and tissue Doppler imaging (TDI) investigations.Blood samples were obtained within 24 hours of hospitalization for measurment of NT-proBNP level.Relationship between TDI-Tei index and the level of NT-proBNP in the two groups were analyzed respectively.Results The TDI-Tei index,the systolic index and the diastolic index were all significant higher in the hyperglycemia group (n =27) than those in the euglycemia group (n =35)(0.68±0.14) vs.(0.61 ±0.10),P =0.03; (0.29±0.07) vs.(0.26±0.05),P =0.045; (0.38±0.08) vs.(0.35 ±0.050,P =0.03,respectively.In both groups,TDI-Tei and In NT-proBNP showed significant linear regression.In the hyperglycemia group,TDI-Tei =0.175 + 0.068 In NT-proBNP,R2 =0.702,P ＜ 0.01.In the euglycemia group,TDI-Tei =0.185 + 0.060 In NT-proBNP,R2 =0.405,P ＜ 0.01.Conclusions (1) Compared with patients suffering from an acute coronary syndrome with euglycemia,the global cardiac function of patients with hyperglycemia is poorer; (2) NT-proBNP correlates significantly with TDI-Tei in both hyperglycemia and euglycemia patients with acute heart syndrome.It is appropriate to assess global cardiac function with NT-proBNP in patients suffering from ACS complicated with hyperglycemia.

Objective To explore the relationship between cough variant asthma (CVA) and mycoplasma pneumoniae (MP) infection.Methods Fifty children with CVA were chosen as the experimental group at random,and 50 children with acute upper respiratory infection,who went to the hospital in the same time and with similar age,were chosen as control group.The MP-IgM of children in both groups were tested by the granule agglutinating method.Results Significant difference (? 2=9.013 P

Objective:To investigate the characteristics and significance of insulin-like growth factor 1(IGF- 1) and insulin-like growth factor binding protein 2 (IGFBP2) expressions in ankle cartilage of patients with Kashin-Beck disease (KBD).Methods:In this case-control study, 10 KBD patients who were hospitalized in the Department of Orthopedics of Shaanxi Provincial People's Hospital from January 2010 to December 2016 were selected as KBD group, and 10 patients with ankle fracture caused by trauma but without talus injury during the same period were selected as control group, the cartilage tissues of the two groups were collected. IGF-1, IGFBP2 positive cells, the mRNA and protein expressions of IGF-1, IGFBP2 in the cartilage tissues were detected by immunohistochemistry, real-time fluorescent quantitative PCR and Western blotting, respectively. According to the expressions of IGF-1 and IGFBP2 in ankle cartilage of KBD patients, a patient with amputation caused by trauma was selected in Shaanxi Provincial People's Hospital, and ankle joint cartilage was taken to prepare chondrocytes for in vitro cell verification experiments. The chondrocyte were divided into control group (0 ng/ml T-2 toxin), T-2 treatment group (20 ng/ml T-2 toxin) and T-2+ IGFBP2 silenced group (20 ng/ml T-2 toxin+ 50 nmol/L IGFBP2 siRNA), the MTT method and dimethyl methylene blue staining were used to detect the activity of chondrocyte and the secretion of sulfated glycosaminoglycan (sGAG). Results:In the control group and the KBD group, the number of IGF-1[(47.26 ± 8.97), (68.15 ± 7.42) cells] and IGFBP2 positive cells [(27.56 ± 5.40), (71.85 ± 7.62) cells] in the cartilage tissues were significantly different ( t = 4.487, 9.402, P < 0.01). Compared with the control group, the IGF-1, IGFBP2 mRNA and protein expression levels in KBD group were significantly higher, the differences were significantly different ( t = 3.340, 20.700, 4.684, 8.699, P < 0.05 or < 0.01). In cell experiment, the chondrocyte activitives and sGAG contents of the control group, T-2 treatment group, and T-2+ IGFBP2 silenced group were significantly different ( F = 226.70, 80.66, P < 0.01); among them, the cell activitives and sGAG contents of the T-2 treatment group and T-2+ IGFBP2 silenced group were lower than those of control group ( P < 0.05), and the T-2+ IGFBP2 silenced group were higher than those of the T-2 treatment group ( P < 0.05). Conclusions:The expressions of IGF-1 and IGFBP2 in the ankle cartilage of KBD patients are significantly higher. Silencing IGFBP2 gene can reduce the inhibitory effect of T-2 toxin on chondrocyte activity and the secretion of sGAG.