1.The comparison of hemodynamics and respiratory mechanics between flexible reinforced laryngeal mask airway and tracheal intubation in functional endoscopic sinus surgery
Caixia LI ; Xia SHEN ; Lianhua CHEN
Fudan University Journal of Medical Sciences 2010;37(2):224-228
Objective To compare the hemodynamics and respiratory mechanics between flexible reinforced laryngeal mask airway (FRLMA) and tracheal intubation (TI) in functional endoscopic sinus surgery. Methods Forty-six patients (ASA) scheduled for selective functional endoscopic sinus surgery under general anesthesia were allocated randomly to either flexible reinforced laryngeal mask airway group (FRLMA, n=23) or tracheal intubation group (TI, n=23) with mechanical ventilation. MAP and HR were recorded before anesthesia induction, before intubation, after intubation immediately, before extubation and after extubation immediately. Parameters for respiratory mechanics included peak inspiratory pressure (PIP), plateau airway pressure (P_(plateau)), mean airway pressure (P_(mean)), positive end expiratory pressure (PEEP), peak inspiratory flow (FI_(max)), peak expiratory flow (FE_(max)), and end tidal CO_2 (P_(Et)CO_2). All of the above indicators were recorded 5, 10 and 15 minutes after intubation. Meanwhile, arterial gas analysis was examined. Complications such as aspiration, coughing, pharyngeal pain, hoarseness, muscular soreness and unseal of FRLMA were followed up 24 hours after extubation. Results MAP and HR were significantly higher in group TI than those in group FRLMA after intubation and extubation (P<0.05). PIP, P_(plateau), P_(mean) and VD/VT were significantly higher in group TI than those in group FRLMA (P<0.05). Complications such as coughing, pharyngeal pain and muscular soreness were significantly lower in FRLMA group than that in TI group (P<0.05). Conclusions The application of FRLMA on functional endoscopic sinus surgery is a simply handling method, with minor laryngeal stimulation during intubation and extubation, more stable hemodynamics, reliable respiratory mechanics and low incidence of postoperative upper airway complications.
2.MECHANISM OF INSULIN RESISTANCE IN PATIENTS WITH IMPAIRED GLUCOSE TOLERANCE AND TYPE II DIABETES MELLITUS
Hong XIA ; Jiawei CHEN ; Jie SHEN
Chinese Journal of Endocrinology and Metabolism 1986;0(03):-
Insulin sensitivity index (SI).glucose effectiveness (SG) and insulin secretion function were assessed by modified minimal model method (MMM) with frequently sampled intravenous glucose tolerance (FSIGT) test in the controls, in patients with impaired glucose tolerance (IGT), and type II diabetes mellitus (NIDDM). There was significant correlation between modified MMM and standard MMM in evaluating SI and SG. The results indicated that SI and SG were significantly elevated in the control than in the IGT and NTDDM groups. SI diminished much more in IGT group than in NIDDM group (P
3.The correlation of serum proinflammatory cytokines levels with the severity of acute pancreatitis
Min XIA ; Meiqin SHEN ; Weichang CHEN
Chinese Journal of Digestion 2011;31(6):401-404
Objective To explore the value of serum level of interleukin 6 (IL-6),tumor necrosis factor alpha (TNF-α) and high mobility group box-1 protein( HMGB1) in early assessment the severity and prognosis of acute pancreatitis (AP). Methods Thirty-three severe acute pancreatitis (SAP) patients and 38 mild acute pancreatitis (MAP) patients were selected as study objects;and 51healthy individuals were set as control group. Serum IL-6,TNF-α and HMGB1 concentrations were determined by enzyme-linked immunosorbent assay (ELISA),the association of them and the scores of Ranson,APACHE Ⅱ . Balthazar CT,serum biochemical parameters and prognosis was analyzed.Results The serum IL-6 levels of SAP group,MAP group and healthy control group were (553. 72±175.76) pg/ml,(265. 73±179. 95) pg/ml and (16. 43±3. 32) pg/ml;and there were statistical significance of these three groups (all P<0. 01). There was no significant difference of TNF-α in the three groups (all P>0. 05). The serum HMGB1 levels of SAP group,MAP group and healthy control group were (11. 48±6. 94)μg/L,(6. 13±5. 80)μg/L and (1. 82±0. 64)μg/L respectively,and there were statistical significant of these three groups (all P<0. 05). The correlation coefficient of serum HMGB1 with IL-6 and TNF-α were 0. 896 and 0. 724 (P<0. 01) respectively. The IL-6 level was positively correlated with the scores of Ranson,APACHE Ⅱ and Balthazar CT. The TNF-αconcentration was positively correlated with APACHE Ⅱ score,and the HMGB1 concentration positively correlated with scores of Ranson and Balthazar CT. The levels of IL-6,TNF-α and HMGB1were all positively correlated with the serum creatinine concentration. The IL-6 levels of patients with local and/or systemic complications were significantly higher than those without complications.Conclusion The serum levels of IL-6,TNF-α and HMGB1 are significantly correlated with the severity of pancreatitis,all of them take part in the development of acute renal insufficiency. The high level of serum IL-6 significantly correlated with complications.
4.Electrophysiological changes in rat ventricular myocardium of experimental diabetes and action of CVB-D
Zhangqiang CHEN ; Shenjiang HU ; Naiyun CHEN ; Qiang XIA ; Yueliang SHEN
Chinese Journal of Pathophysiology 1999;0(09):-
AIM: To investigate the electrophysiological changes of diabetic myocardium and effects of cyclovirobuxine D (CVB-D) on its electrophysiology. METHODS: Diabetes was induced in male SD rats, using a single injection of alloxan into tail vein. Untreated age-matched animals were used as controls. Animal electrocardiogram (ECG) was recorded by 2 weeks. Effects of CVB-D on isolated right ventricular papillary muscle from experimental diabetic rats and control group were observed by recording the transmembrane potentials with conventional glass microelectrodes. RESULTS: QT intervals in ECG and action potential duration (APD) at all levels were significantly lengthened in myocardium from week 2 of diabetes. Within the concentration of 13.3-63.3 ?mol?L~(-1), CVB-D prologated APD of diabetes in dose-dependent manner and more than that of control. Within the concentration of 33.3-63.3 ?mol?L~(-1), CVB-D depressed RP, APA, V_(max) and OS of diabetes in dose-dependent way and more than that of control. In addition, CVB-D at concentration of 20 ?mol?L~(-1) prologated APD in a time-dependent manner. The most prologation of APD was attained about 40 min in control, while more than 40 min in diabetes. CONCLUSION: The results show that QT intervals in ECG and APD at all levels are significantly lengthened in myocardium from week 2 of diabetes. CVB-D prolongates APD and inhibits RP, APA, OS and V_(max) more in diabetes than in control.
5.Exploration Study of the osteosarcoma devitalization technique by vacuum dehydra-tion at room temperature
Fei CHEN ; Xia ZHU ; Chaoyang WU ; Rongkai SHEN ; Jianhua LIN
Chinese Journal of Clinical Oncology 2016;43(17):741-746
Objective:To demonstrate the feasibility of the osteosarcoma devitalization method by vacuum dehydration at room tem-perature. Methods:For the in vivo study, the VX2 tumor mass was treated by vacuum dehydration, rehydrated in ice water, and im-planted in the rabbit to determine the safety time to deactivate the tumor. For the in vitro study, the osteosarcoma mass was devital-ized by vacuum dehydration, and the dehydration rate and ATPase activity were determined. Histopathological changes in the tumor were also observed. The change in the biomechanical strength of rabbit bone and tendon after vacuum devitalization treatment was detected. Results:At room temperature, the safety time to deactivate the VX2 tumor was 60 min, and the dehydration rate was 93.8%at this time point. After vacuum dehydration, the tumor mass evidently shrunk, presenting a porous structure. The osteosarcoma cell became small, and cell structure damage was observed under light microscope. Disrupted cell membrane and organelles were seen un-der transmission electron microscope as well as broken down chromosomes. The activity of ATPase was evidently lower than in the control group. The strength of bone and tendon did not decrease significantly after vacuum dehydration. Conclusion:Treatment by vacuum dehydration at room temperature for 60 min does not result in differences of the bone and tendon strength. However, it can inactivate both soft tissue and bone tumor mass completely.
6.Pathogens Causing Chronic Prostatitis and Their Distribution and Resistance
Bangshi XIA ; Zhonghai SHEN ; Ping CHEN ; Boqing LIANG ; Hongsong MA
Chinese Journal of Nosocomiology 2006;0(03):-
0.05).(3) The ratio of meticillin-resistant staphylococci was 91.5%.The ratio of resistance of staphylococci to(gentamicin),(erythromycin),ciprofloxacin and tetracycline was all above 50%,but was low to(nitrofurantoin) and rifampin.In 12 strains of Enterococcus faecalis,3 strains were VRE;8 resisted to high-level gentamicin;6 resisted to high-level streptomycin;the resistance rate to tetracycline,ciprofloxacin,rifampin and(erythromycin) ranged from 58.3% to 100.0%.In E.coli,8 of 14 isolates were positive for ESBLs.The resistance was high to usual antibiotics except imipenem,amikacin and Tazocillin.CONCLUSIONS Bacteria are the main pathogens of chronic prostatitis and terribly resist to clinical usual antibiotics.Infection with Uu,Mh and Ct should not be(ignored).It is necessary to diagnose and treat chronic prostatitis according to the results of pathogen(isolation) and drug sensitivity test.
7.Clinical Species Distribution and Drug Resistance of 201 Isolates of Enterococcus
Qilong LIN ; Bangshi XIA ; Zhonghai SHEN ; Sujuan ZHU ; Fen CHEN
Chinese Journal of Nosocomiology 2006;0(07):-
OBJECTIVE To study the clinical species distribution and drug resistance of Enterococcus.METHODS We had collected 201 isolates of Enterococcus by cultured in normal methods in our hospital from July 2005 to June 2008,and analyzed the characteristics of species distribution,drugsensitive test,drug resistance of high concentration aminoglycoside antibiotics and measured the ?-lactamase.RESULTS There are 106 E.faecalis strains(52.7%),76 E.faecium strains(37.8%) and 19 the other Enterococcus strains(9.5%).There were 102 Enerococcus strains separated from urine and 46 separated from sputamentum.The drug resistance rate of Enterococcus faecalis to erythromycin,tetracycline,rifampin and ciprofloxacin were more than 75.0% and the resistance rate of E.faecium to penicillin,ampicillin,erythromycin,rifampin,ciprofloxacin and nitrofurantoin were more than 93.0%;the total resistance rate of Enterococcus to vancomycin and teicoplanin were 14.4% and 10.4%,respectively.The number of the isolates resistant to high concentration aminoglycoside antibiotics was 151(75.1%);Enterococcus with positive ?-lactamase were 74(36.8%).CONCLUSIONS The infection in urinary system and respiratory system were mainly caused by E.faecalis and E.faeciumwith multidrug resistance.
8.Analysis of projects of infectious disease epidemiology sponsored by Nation-al Natural Science Foundation of China
Jianming WANG ; Yankai XIA ; Huijuan ZHU ; Feng CHEN ; Hongbing SHEN
Chinese Journal of Schistosomiasis Control 2016;28(3):331-335
Objective To analyze the projects on the infectious disease epidemiology sponsored by the National Natural Sci?ence Foundation of China(NSFC),explore the hotspot and development trend,and offer a reference for researchers in this field. Methods Based on the NSFC database,the projects on the infectious disease epidemiology(H2609)sponsored from 1987 to 2014 were analyzed. The changes of fund numbers,amounts and research fields were described. Results During the study period,NSFC sponsored 373 projects,including 228 general projects(61.1%),78 youth projects(20.9%)and 67 other projects(18.0%). The average amount of the grant was 358.2 thousand Yuan(20 thousand?8 million). The main sponsored re?search fields were mechanisms of pathogen and immunity(36.2%)and population?based epidemiological studies(33.0%). The top three diseases were hepatitis,HIV/AIDS and tuberculosis. Conclusion The amount of funding on researches of infectious disease epidemiology has increased continuously,which has played an important role in training scientific talents in the field of prevention and control of infectious diseases.
9.Different anticoagulant drugs during knee joint replacement:changes of hemorheology
Yong HU ; Dan PENG ; Yi SHEN ; Xia CHEN
Chinese Journal of Tissue Engineering Research 2015;(13):2023-2027
BACKGROUND:After knee joint replacement, patients are often treated with Rivaroxaban and Enoxaparin Sodium for postoperative anticoagulation, avoiding the formation of deep vein thrombosis in lower limbs. OBJECTIVE:To explore the application effects of different anticoagulant drugs in patients with knee joint replacement. METHODS:Ninety patients underwent knee joint replacement in Xiangya Second Hospital of Central South University from July 2011 to July 2014, were randomly divided into two groups, with 45 patients in each group. The experimental group was treated with Rivaroxaban, while the control group was treated with Enoxaparin. RESULTS AND CONCLUSION:Postoperative drainage volume, total blood transfusion, bleeding index, quantity of blood platelet, activated partial thromboplastin time, thrombin reduction time, whole blood viscosity, plasma viscosity, D-dimer coagulation index, HSS score at postoperative 2 weeks, average ecchymosis area, average thigh circumference, and average leg circumference were significantly better in the experimental group, than in the control group (P<0.05). The incidence of deep vein thrombosis of lower limbs in the experimental group was lower than that in the control group (P<0.05). Experimental findings indicate that, both Rivaroxaban and Enoxaparin can exert anticoagulation effect during the knee joint replacement, and Rivaroxaban is better.
10.Investigation of TCM Dispensary Allocation in Community Health Centers of Pudong New District in Shanghai
Chunxia XIA ; Xiaoling CHEN ; Yan LIU ; Bin SHEN
Chinese Journal of Information on Traditional Chinese Medicine 2015;22(11):10-12
Objective To understand the current situation of dispensary setting and personnel of community health service centers in Pudong New District in Shanghai (hereinafter referred to as Pudong New District).Methods Questionnaire survey covering the 45 community health service centers in Pudong New District was used.Results 42 community health service centers were equipped with TCM dispensaries among the 45 total units (93.3%);12 of them adopted outsourcing mode (26.7%);the average area of community dispensary was (32.3 ± 17.3)m2;the average number of TCM practitioners was 3.5 ± 2.0 people.Conclusion Community health service centers need to increase the allocation area of TCM dispensary and improve qualification of TCM practitioners.