Objective To investigate the effects of dexmedetomidine on tonsillectomy in children with sevoflurane combined with anesthesia recovery period of restless.Methods A total of 62 patients with tonsillectomy under general anesthesia from 2011 to 2015 in our hospital werecollected and randomly divided into the control group and the experiment group with 31 cases in each.Two groups of children were treated by 7％sevoflurane inhalation anesthesia induction,supplemented by a small amount of intravenous anesthetics propofol 2 mg/kg,sufentanil 2 μg/kg,CIS atracurium 150 μg/kg intravenous injection.Patients in the experiment group were treated by dexmedetomidine 0.2 μg/(kg·h)continuous intravenous infusion until the end of the operation,patients in the control group were treated by normal saline intravenous infusion.Compared the systolic blood pressure and heart rate of the 2 groups of before anesthesia induction,after anesthesia induction,after operation 5min,the end of the operation ; occurred rate of restless at after anesthesia extubation 5minutes,10minutes,15minutes,20minutes,25minutes.Results Compared with the control group,the systolic blood pressure and heart rate of the experiment group without statistical significance before anesthesia induction; after anesthesia induction,after operation,5min,at the end of operation,the systolic blood pressure and heart rate were lower(P<0.05); children recovery time,extubation time,recovery time of delivery from the anesthesia room were shorter(P<0.05); occurred rate of restless were lower after anesthesia extubation 5minutes,10minutes,15minutes,20minutes,25minutes(P<0.05).Conclusion Dexmedetomidine can prevent tonsillectomy after sevoflurane anesthesia result in the recovery period of restless.

Objective To investigate the risk factors of albuminuria in type 2 diabetes nephropathy patients. Methods 870 hospitalized patients with type 2 diabetes mellitus were included in the study. The patients were divided into normal buminuria group (n = 634) and persistent albuminuria group (n = 236) according to the 24h urinary albumin excretion. Diabetic chronic complication and related biochemical indicators were analyzed. Independent risk factors associated with diabetic nephropathy were analyzed. Results The differences in duration of diabetes, age, SBP, DBP, Hb, HbA1C, UA, TG, CHOL-C, HDL-C, diabetic retinopathy (DR), cardiovascular and cerebrovascular disease were statistically significant between two groups (P < 0.01). Regression analysis showed that independent risk factors of albuminuria of DN included duration of diabetes, SBP, Hb, UA, TG and DR. Conclusions Such risk factors of duration of diabetes, SBP, UA, TG, Hb and DR may be associated with the occurrence and severity of albuminuria of DN.

Animals ; Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Hydrocarbons, Brominated ; toxicity ; Isomerism ; Liver ; drug effects ; metabolism ; pathology ; Male ; Rats ; Rats, Sprague-Dawley

Animals ; Humans ; Mucous Membrane ; immunology ; metabolism ; virology ; Viruses ; immunology

Objective To analyze the risk factors and prognosis of Clostridium difficile infection (CDI) among hospitalized patients with inflammatory bowel disease (IBD).Methods From March 2014 to February 2015,216 first-time hospitalized patients with IBD were enrolled.Once hospitalized,stool samples were obtained for Clostridium difficile culture immediately,and at the same time toxins of Clostridium difficile (tcd) A and tcdB were detected by polymerase chain reaction(PCR).The incidence and risk factors of CDI in enrolled patients were analyzed.Chi square test and nonparametric test were performed for statistical analysis.Results Among the 216 IBD patients,there were 73 patients with ulcerative colitis(UC) and 143 patients with Crohn's disease(CD).The positive rate of CDI was 13.9 ％ (30/216) in IBD patients.The positive rate of CDI was 24.7 ％ (18/73) in UC patients,which was higher than that of CD patients (8.4％,12/143),and the difference was statistically significant (x2 =10.690,P＜0.01).As the severity of the disease increased,the rate of CDI positive patients in UC patients increased.Among three patients at remission period,17 patients at mild active stage,23 patients at moderate active stage and 30 patients at severe active stage,the CDI positive patients were zero,two,five,11,respectively,and the difference was statistically significant (x2 =4.820,P=0.028).In UC patients,the incidences of patients with hospitalization history in other hospitals within three months before admission in CDI positive group and negative group were 6/18 and 7.3％ (4/55),respectively,and the difference was statistically significant (x2 =5.740,P=0.020).In 30 days before admission,the rates of patients with proton pump inhibitor (PPI) taking history of two groups were 7/18 and 7.3％ (4/55),and the difference was statistically significant (x2=8.270,P=0.004).The length of hospital stay in CDI negative UC patients was 7.0 d (5.0 d,12.0 d),which was shorter than that of CDI positive patients (10.5 d (8.8 d,18.2 d)),and the difference was statistically significant (U=277.000,P=0.005).The rate of patients underwent intestinal operation in CDI negative CD patients within three months after CDI examination was 10.7 ％ (14/131),which was significantly lower than that of CDI positive patients (5/12) (x2 =4.520,P=0.010).Conclusions The incidence of CDI in hospitalized IBD patients was high,especially in UC patients;the risk factors included disease severity,prior hospitalization history within three months before admission and PPI taking history within 30 days before admission.CDI was correlated with poor prognosis.

OBJECTIVE To investigate the drug-resistant genes associated ?-lactams in Pseudomonas aeruginosa(isolated) in Shaoxing,Zhejiang Province.METHODS Thirty nine strains of P.aeruginosa were isolated from(hospitalized) patients,and drug-resistant genes were detected by PCR.RESULTS The positive rates of genes of TEM, CARB,VIM and DHA were 2.6%,30.8%,23%,and 7.7%,respectively,oprD2 gene was all lack.Genes of SHV,OXA-1 groups,OXA-10 groups,PER,VEB,GES,IMP,SPM and GIM were not found in all 39 isolates tested.CONCLUSIONS There are very high positive percentages of CARB and VIM genes in P.aeruginosa(isolated) clinically.The oprD2 gene lack is the important mechanism of P.aeruginosa resistant to(imipenem.) The CARB genes in P.aeruginosa are firsted report domestically.

Objective To explore the diagnosis of abdominal aortic aneurysm(AAA), operative opportunity, the way of operation selecting and the application of blood vessel prosthesis. Method The clinical data of 7 patients with AAA were analysed retrospectively.Results The type of DeBakey I thoracoabdominal aortic aneurysm patient was died of aortic aneurysm broke suddenly before operation, the other 6 patients with AAA underwent aortic aneurysm blooking, opening and replacement of blood vessel prosthesis. Dumbbell thoracoabdominal aortic aneurysm was operated by stayes. No complications of operation occurred. Conclusions Operation is a efficient way in treatment of abdominal aortic aneurysm. Diagnosis timely and definitly, selecting the way of operation in reason and blood vessel prosthesis are the keys to operation, while the correct treatment of perioperation period is the important guaranty of successful therapy.

Objective To investigate the genotyping of aminoglycoside modifying enzymes on Pan-drug resistant A..baumannii(PDRA)isolated.Methods The antibiotic susceptibility of 16 different antibiotics of A.baumannii were tested by K-B method,aminoglycoside modifying enzymes coding genes of A.baumannii were detected by PCR.Results The detection rates of OXA-23group were 41.8%and aminoglycoside modifying enzymes coding genes of aac(3)-Ⅰ,aac(6')-Ⅰand ant(3″)-Ⅰ were 64.1%,64.1% and 74.4%.Conclusions The study showed that it is more serious for PDRA carrying aminoglycoside modifying enzymes coding genes.

Objective To assess the quality of randomized controlled trials(RCT)abstracts published in Journal of Clinical Anesthesiology by CONSORT for Abstracts.Methods Articles invol-ving human RCTs published from 2012 to 2013 were reviewed and searched through WanFang Med Online.Trials involving animal experiments,in vitro,RCTs without abstract,and meta-analyses were excluded.According to the CONSORT checklists for abstracts,the quality of abstracts for RCT were assessed.Results In total,392 RCT abstracts were analysed.The median word counts of ab-stracts was 364 (IQR 306-444),sample size was 60 (IQR 40-80).Almost all abstracts provided an appropriate description of conclusions (100%), numbers randomized (99.0%) and objective (99.0%).The majority of abstracts described interventions (94.6%)and participants (82.4%).Re-quirements present in less than 50% of the abstracts were details regarding trial design (46.2%)and harms (48.7%).The descriptions of randomization (13.3%),blinding (1.8%),methods-outcome (3.6%)and results-outcome (9.7%)were very low.Moreover,title,recruitment and numbers ana-lysed were not reported.Conclusion The quality of RCT abstracts and adherence to the CONSORT checklist for abstracts remains poor,and the CONSORT for Abstracts should be endorsed to improve the quality of RCT abstracts as early as possible.

Background Histopathological examination is an important approach to the basic and clinical study in ophthalmology.Different fix methods of retinal samples produce a large impact.The first fixed way often is used at home,and the last fixed way is preferred abroad.The comparative study between the two ways is lack.Objective This study was to compare rat retinal frozen sections following 4 different fix methods and confirm a simpler and better way.Methods Forty eyeballs were extracted from 40 SD rats and were randomly divided into four groups using random number table,ten for each group.The eyeballs were firstly fixed in 4％ paraformaldehyde overnight,4％ paraformaldehyde for 2-3 hours,formalin-acetic acid-alcohol (FAA) mixture solution,and then OCT embedding was performed in 3 groups.However,the samples were fixed in cold acetone following first liquid nitrogen frozen,OCT embeded in the forth group.Retinal serial sections of 4 groups were examined and compared after hematoxylin and eosin staining under the optical microscope.Results Retinal tissue was loosened interlayerly,and clustering of cells in the inner nuclear layer (INL) and outer nuclear layer (ONL) were seen in the 4％ paraformaldehyde overnight fix group.The arrangement of interlayer and cells was improved in the 4％ paraformaldehyde for 2-3 hours group compared with 4％ paraformaldehyde overnight fix group.The retinal structure was closer among the layers in the FAA fixed group.In the later cold acetone fixed group,retinal morphology was more clear with the intact structure and regularly arranged cells in the ONL,INL and ganglion cell layer(GCL),as an living histology structure.Conclusions The first fix of retina produces a large impact on retinal morphology and structure.However,cold acetone fixation following first liquid nitrogen frozen is simpler,less time-consuming and more efficient way for the histopathological examination of retina.