Objective To observe the effects of desflurane, sevoflurane and isoflurane on hepatic oxygen balance and hepatic blood flow Methods Fifteen pigs were randomly divided into three groups: A desflurane group(n=5), B sevoflurane group(n=5), C isoflurane group(n=5) This study observed the effects of desflurane, sevoflurane and isoflurane on systemic and hepatic blood flow and oxygen balance with different concentrations using continuous thermodilution cardiac output monitor and ultrasonic Doppler blood flow monitorResults ①Hepatic blood flow: total hepatic blood flow(THBF) decreased dose-dependently in three groups without significant differences between groups The effects of desflurnae and sevoflurane on THBF were same as those on cardiac output(CO), while the effect of sevoflurane on THBF was larger than that on CO ②Oxygen balance: both systemic oxygen delivery(DO_2) and hepatic oxygen delivery(HDO_2) decreased significantly with the increasing of inhalation concentrations, systemic oxygen delivery(VO_2) and hepatic oxygen consumption(HVO_2) decreased significantly only at high concentration The effects of desflurnae and sevoflurane on HVO_2 and HDO_2 were same as those on VO_2 and DO_2, while the effect of sevoflurane on HDO_2 was larger than that on DO_2, but the effect of sevoflurane on HVO_2 was still same as that on VO_2Conclusions Because of the dose-dependently decreased hepatic blood flow, hepatic oxygen delivery decreases significantly, but hepatic oxygen consumption can be maintained well by self-regulation of hepatic oxygen extraction ratio,indicating that there is almost no influence on hepatic intracellular respiration and metabolism

Objective To evaluate the diagnostic accuracy of dual source CT angiography (DSCTA) for coronary artery stenosis.Methods During the period from November 2012 to November 2013, a total of 210 patients with coronary artery disease underwent DSCTA and selective coronary arteriography (CAG). Taking CAG as the gold standard, the diagnostic accuracy of DSCTA for coronary artery stenosis was evaluated. Thirty patients receiving DSCTA and 30 patients receiving CAG were selected, and all of them underwent stent implantation in the anterior descending branch after imaging examination. The angiography positions, the used time of PCI and the used dosage of contrast agent were compared between the two groups. Results DSCTA was performed in 210 patients and a total of 2 630 segments of coronary stenosis or occlusion were detected. Compared with CAG, the diagnostic sensitivity, specificity, positive predictive value and negative predictive value of DSCTA were 95.4%, 96.2%, 91.3%and 100%respectively, which were not significantly different from those obtained by CAG (P=0.066). In performing DSCTA, 2-3 angiography positions were used (2-4 positions less than that of CAG), the used time of PCI was about 15 min (about 10 min less than that of CAG), and the mean used dosage of contrast agent was 48 ml (30-150 ml) (about half less than that of CAG). Conclusion DSCTA has higher accuracy in diagnosing coronary artery stenosis, quite similar to that of CAG. DSCTA is a safe, reliable and noninvasive examination method. Preoperative DSCTA can reduce exposure positions during angiography, can reduce the dosage of contrast agent, and can shorten the time of PCI as well, thus, iatrogenic radioactive radiation dose can be reduced.

Abstract: Objective To clarify the long-term evolution of hepatitis B virus (HBV) quasi-species in HBsAg asymptomatic carriers in Long'an county, Guangxi. Methods ELISA was used to detect serological markers of HBV. Viral loads were measured by real time PCR. HBV DNA was extracted from serum by kits. The whole HBV genome was amplified using nested PCR and amplicons were sequenced by next-generation sequencing (NGS). These sequences from NGS were analyzed by the software like Mega. Results Serum samples were collected from 9 HBsAg asymptomatic carriers in Longan County，Guangxi at 4 different time points in 2004, 2007, 2013, 2019 or 2020. A total of 23 serum samples and 309 full-length gene quasi-species sequences were obtained, with an average amount of (0.18±0.07) G sequencing data for each sample. Genotype of 55.54%(5/9) the studied subjects underwent genotype conversion during the long-term evolution process of HBV quasi-species, and the genotyping results of the phylogenetic tree in the PreS/S region are in perfect agreement with the results of the whole genome analysis; recombinant B/C, I/C were found; the Sn ranged from 0 to 0.37 and the genetic diversity ranged from 0 to 0.11, respectively. A total of 21 special single nucleotide/amino acid mutations (7 in the S region, 2 in the X region, 3 in the PreC region and 9 in the BCP region) and 6 deletion mutations were detected, multiple mutations were found and no drug resistant mutations were found; 77.8%(7/9) of the HBV strains carried by the subjects in 2004 had double mutations at nt1 762(A→T) and 1 764(G→A) and a stop mutation at nt1 896(G→A); HBV mutations can be restored from the mutant type to the wild type and (or) vice versa without antiviral drug pressure, and The evolution rate of HBV genome was 2.03×10-5~3.50×10-3.Conclusion HBV genotype, recombinants, genetic complexity and diversity of HBV quasi-species can change over time during in natural infection. The transformation between HBV mutation type and wild type reduces the value of predicting clinical outcomes by genetic types and related mutations to some extent. The HBV genome evolution rate of asymptomatic carriers of HBsAg in Long'an County is very high.

Objective To trace human umbilical cord mesenchymal stem cells (MSCs)labelled by USPIO-PLL which were transplanted into mouse subcutaneous xenotransplanted lung cancer by using 3.0T MR,to investigate the relationship between MSCs and VEGF expression and tumor angiogenesis by using SABC immunohistochemical method and to comprehensively analyze the effect of MSCs transplantation on lung cancer.Methods Cultured MSCs and poly lysine (PLL)was as a transfection agent which was magnetically labeled by USPIO and implanted into mice with subcutaneous xenotransplanted lung cancer through the tail vein.MRI was performed at pre-transplantation, 1 d and 10 d after transplantation and the tissues were performed by immunohistochemistry respectively.Results (1)MSCs could reach the tumor area at the first day after the transplantation and be monitored by MRI.MSCs increased at the 10th day.MRI signal intensity was reducedand the difference was statistically significant (P <0.05).The inhibitory rate of the 1st day and 10th day was positive;(2)At the 10th day after the transplantation,the rate of the VEGF positive expression in MSCs group was 86.67％,the value of MVD was 44 .22 ± 12 .36 ,and the rate of the VEGF positive expression in NS group was 26 .67 ％ ,the value of MVD was 20 .29 ±8.47 (P <0.05).Conclusion Tracing stem cell transplantation in vivo can be proceeded effectively by using 3.0T MR.Stem cell has bidirectional effect on lung cancer which inhibites the tumor growth by directional chemotaxis and differentiation,and also enhances expression of VEGF and angiogenesis at a certain extent.

Objective:To explore the effect of emergency nursing based on de-escalation thinking in patients with acute pancreatitis.Methods:From January 2019 to December 2020, 156 patients with acute pancreatitis in the Emergency Department of Beijing Friendship Hospital, Capital Medical University were retrospectively selected as the research object by convenience sampling. According to different nursing methods, the patients were divided into the control group and the intervention group with 78 cases in each group. The control group received routine nursing, and the intervention group implemented emergency nursing based on de-escalation thinking on the basis of the control group. The incidence of complications, treatment effect and nursing satisfaction were compared between the two groups.Results:The incidence of complications in the intervention group was lower than that in the control group, the total treatment effective rate was higher than that in the control group, and the patients in the intervention group were more satisfied with nursing skills, health education, and emergency measures than the control group, with statistical differences ( P<0.05) . Conclusions:Emergency nursing based on de-escalation thinking in patients with acute pancreatitis can effectively reduce the incidence of complications, improve the first aid effectiveness, and nursing satisfaction, which is worthy of clinical application.

Hydatid disease imposing serious threat on human health and great loss in livenotstock pastoralism remains a major public health problem in western China. To assess and monitor the effect of control program on transmission dynamics, we used the prevalence of cystic echinococcosis in slaughtered sheep at slaughterhouse as an indicator during the period of 2007 to 2013 in Emin County, Xinjiang Uygur Autonomous Region, China. The results showed a significant decline trend of prevalence in all age groups during the 7 years when the control program was implemented; particularly, the rate was reduced by 72% after first 3 years. Among the sheep slaughtered, the age distribution evidenced that the prevalence increased significantly as the sheep grew older. The baseline data indicated that the rate was 4.5% at the age <1, 6.7% at age 2~, and reached to the highest 17.9% at age > or =4 years. Earlier response to the intervention pressure was seen in the sheep at the younger age. Significant decline started from 2008 at the age <1, from 2009 at age of 1~, 2010 at 2~ to 3~, and the latest, in 2012 at age > or =4. This study demonstrated that the prevalence of cystic echinococcosis in slaughtered sheep may be used as an indicator to assess and monitor the transmission status during and after control program providing information for betterment of performance to sustain control strength.
Abattoirs/statistics & numerical data ; Animals ; China/epidemiology ; Echinococcosis/epidemiology/parasitology/prevention & control/*veterinary ; Female ; Male ; Prevalence ; Sheep ; Sheep Diseases/epidemiology/parasitology/*prevention & control

Objective:To investigate the immune effects of Clostridium difficile toxoid B (CdtB) vaccine formulated with different mucosal adjuvants through microneedle immunization, and to provide ideas for the prevention and treatment of Clostridium difficile infection. Methods:CdtB vaccine was prepared with purified Clostridium difficile toxin B(TcdB) after formaldehyde detoxification. Female BALB/c mice were immunized with different doses of vaccine alone or in combination with mucosal adjuvants. The titers of specific serum IgG and fecal IgA were detected at 0 d, 7 d, 14 d, 28 d and 42 d after immunization. The protective effects of CdtB vaccine were evaluated by cell neutralization assay and Clostridium difficile challenge infection. Results:(1) With the increase of immune dose, the mice immunized with CdtB vaccine alone by microneedle not only produced better serum specific IgG, but also had higher level of IgA in feces. (2) When the mice were immunized with CdtB vaccine containing LT or CTB adjuvant by microneedle, the trend of serum specific IgG titer in each group increased with the increase of immune dose, especially in the group containing LT adjuvant. There were significant differences in the trend of specific IgA titer in feces between the adjuvant groups and the group without adjuvant, but the adjuvant effect was not obvious. (3) No significant difference in serum IgG titer was observed between the mice immunized with 10 μg CdtB by microneedle or intraperitoneal injection, but microneedle immunization significantly increased fecal IgA level. (4) The neutralization titers of specific antibodies in mouse serum after immunization and the test results of challenge protection in mice confirmed that the use of CdtB vaccine had certain protective effects.Conclusions:CdtB vaccine had better immune effects in mice through microneedle immunization, but the adjuvant effects of LT and CTB were not significant.

Objective:To explore the demand and mode of palliative care for emergency dying patients by analyzing the case data of emergency death and cardiopulmonary resuscitation.Methods:The data of 776 cases of emergency clinical death and cardiopulmonary resuscitation in the Second Affiliated Hospital of Soochow University from 2017 to 2020 were retrospectively analyzed.Results:A total of 687 patients were included with (70.38 ± 16.57) years old, and 49.8% (342/687) of them were 75 years old and above; among them, 36.0% (247/687) patients or their families chose not to give cardiopulmonary resuscitation (DNR) in the last stage of their lives,and 63.2%(156/247) of DNR patients were 75 years old and above. The top four etiology of DNR were cerebral hemorrhage, respiratory failure, multiple organ dysfunction syndrome and out of hospital cardiac and respiratory arrest.After successful cardiopulmonary resuscitation, 37.5% (45/120) of the patients' family members chose to give up treatment again. The median stay time of DNR patients in the emergency room was 738.7 minutes.Conclusions:The patients who choosed DNR were mainly 75 years old and above, with cerebral hemorrhage, respiratory failure, multiple organ failure and cardiac and respiratory arrest. The detention of these patients in the emergency room increases the congestion of the emergency room, and at the same time, they can not get a peaceful palliative care environment. It is suggested that emergency medical staff should strengthen the awareness and improve the ability of palliative care. A relative independent area and corresponding soothing palliative treatment and nursing should be given to the DNR patients.

Objective To explore the application value of early humanistic care hospitalization mode in nursing of patients with acute myocardial infarction (AMI) treated by elective interventional therapy.Methods A total of 140 patients with AMI treated by elective percutaneous coronary intervention (PCI) in our hospital from November 2015 to December 2016 were enrolled in the study, and were randomly divided into observation group and control group, with 70 cases in each group.The control group was given routine nursing during hospitalization, and the observation group was given early humanistic care.The success rate of PCI, incidence of complications and recurrence rate of myocardial infarction were compared between the two groups.The left ventricular ejection fraction (LVEF), heart rate (HR) and serum creatine kinase isoenzyme (CK-MB) were determined.The emotion and degree of angina pectoris in the two groups were evaluated by the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) and Seattle Angina Questionnaire (SAQ), and nursing satisfaction were compared between the two groups.Results The success rate of PCI was significantly higher in the observation group than the control group.The incidence of postoperative complications and the recurrence rate of myocardial infarction were significantly lower in the observation group than the control group (P<0.05).After nursing, LVEF in the observation group was higher while HR and CK-MB level were significantly lower than those in the control group (P<0.05).After nursing, the SAS score and SDS score of the observation group were lower than that of the control group, and the SAQ score was higher than that of the control group (P<0.05).The nursing satisfaction of the observation group was higher than that of the control group (P<0.05).Conclusion The application of early humanistic care hospitalization mode in nursing of patients with AMI treated by elective PCI can significantly improve the success rate of PCI and nursing satisfaction, enhance laboratory indicators and emotion, relieve the degree of angina pectoris, and reduce the recurrence rate and incidence of complications.

Objective To explore the application value of early humanistic care hospitalization mode in nursing of patients with acute myocardial infarction (AMI) treated by elective interventional therapy.Methods A total of 140 patients with AMI treated by elective percutaneous coronary intervention (PCI) in our hospital from November 2015 to December 2016 were enrolled in the study, and were randomly divided into observation group and control group, with 70 cases in each group.The control group was given routine nursing during hospitalization, and the observation group was given early humanistic care.The success rate of PCI, incidence of complications and recurrence rate of myocardial infarction were compared between the two groups.The left ventricular ejection fraction (LVEF), heart rate (HR) and serum creatine kinase isoenzyme (CK-MB) were determined.The emotion and degree of angina pectoris in the two groups were evaluated by the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) and Seattle Angina Questionnaire (SAQ), and nursing satisfaction were compared between the two groups.Results The success rate of PCI was significantly higher in the observation group than the control group.The incidence of postoperative complications and the recurrence rate of myocardial infarction were significantly lower in the observation group than the control group (P<0.05).After nursing, LVEF in the observation group was higher while HR and CK-MB level were significantly lower than those in the control group (P<0.05).After nursing, the SAS score and SDS score of the observation group were lower than that of the control group, and the SAQ score was higher than that of the control group (P<0.05).The nursing satisfaction of the observation group was higher than that of the control group (P<0.05).Conclusion The application of early humanistic care hospitalization mode in nursing of patients with AMI treated by elective PCI can significantly improve the success rate of PCI and nursing satisfaction, enhance laboratory indicators and emotion, relieve the degree of angina pectoris, and reduce the recurrence rate and incidence of complications.