1.Prevention and treatment of complications of propoful sedation and anesthesia during gastroscopy
Wanwen ZHANG ; Xiaogang SHAO ; Min WANG
Chinese Journal of Digestive Endoscopy 1996;0(05):-
Objective To alleviate or prevent the complication of propoful sedation and anesthesia during gastroscopy. Methods One thousand three hundred and fifty eight patients were undergone gastrosco-py under propoful sedation and anesthesia. Results Although some patients with intravenous use of propofol their blood pressure, heart and respiratory rate decreased in different extents, but others remained in normal range. During the operation, two cases(0. 15% )had hypotension which could be corrected after intravenous use of ephetonin; three cases (0. 22% ) had bradycardia that was restored after intravenous use of atropine; three hundred and eighteen cases (23. 42% )had cough which could be prevented by increasing the first dose of propofol and avoiding the pharyngeal simulation derived from operation; sixteen cases( 1. 18% )had serious chock accompanied with decreasing of blood oxygen saturation which could be alleviated by aspirating the guttural secretion, driving up the patients mandible and increasing oxygen inhalation, keeping the gastroscope dry and avoiding pumping water or air as passing through epiglottis are the effective methods in preventing chock. Forty six cases (3. 39% ) complained of pain in the injection site which could be alleviated by choosing a major vein and injecting drug slowly; forty three cases(3. 17% ) had nausea and two cases(0. 15% ) had phreno muscular spasm which could be alleviated or prevented by skilled manipulation; thirty nine cases (2. 87% )had vertigo after regaining consciousness, keeping in bed or deferring to wake the patient up are very effective in preventing and alleviating this symptom. Conclusion Although gastroscopy under propoful' s sedation and anesthesia is safe and effective, logical precautions are the keys to attain success and lessen complications.
2.Colonoscopy under propofol sedation and anesthesia
Wanwen ZHANG ; Tongwei OUYANG ; Xiaogang SHAO
Chinese Journal of Digestive Endoscopy 1996;0(06):-
0. 05 ) , but the control group had(P
3.Analysis of the characteristics of endoscopic and histopathological features of colorectal serrated adenomas
Wanwen ZHANG ; Baojun REN ; Huasheng TONG ; Yali ZHANG ; Bo JIANG
Chinese Journal of Digestive Endoscopy 2001;0(02):-
Objective To explore the endoscopic and histopathological features of serrated adenomas (SAs).Methods The data of patients with colorectal polyps diagnosed in the Digestive Endoscopy Center at Nanfang Hospital from January 2002 to July 2005 were reviewed and the detection rate, endoscopic appearances, pit patterns and histopathological features of SAs were analyzed.Results In 1928(16.21%) out of 11 894 patients undergoing colonscopy 2811 polyps were found.Among them 61 patients with 71 polyps were found,with a detection rate of 0.51%.The SAs,larger than hyperplastic polyps obviously,were found in patients 39.44% with diameter (larger than 1 cm).The incidence of pedunculated polyps in SAs (26.76%) was higher than that in hyperplastic polyps(13.25%),but less than in adenomatous polyps (43.95%).The pit patterns of SAs, were typeⅢ pit pattern (41.67%) and type Ⅳ pit pattern (18.33%), this result was similar to adenomatous polyps.The incidences of moderate and severe dysplasia of SAs were higher than those of tubular adenomas but lower than villous adenomas.The canceration rate of SA was 2.82%.Conclusion The endoscopic appearances,these of pit patterns and histopathological features of SAs,were different from hyperplastic polyps essentially, but similar to neoplastic polyps with potential malignancy,which should be emphasized in clinical practice.
4.Risk factors and intervention measures of mental disorders in ICU
Ying ZHANG ; Jun SU ; Hongjing MAO ; Wanwen REN ; Qingyu LI
Chinese Journal of Primary Medicine and Pharmacy 2016;23(16):2429-2433,2434
Objective To investigate the risk factors of mental disorders of patients treated in intensive care unit(ICU).Methods Collected from January 2013 to December 2014 ICU stay eligible cases,and analyzed the past history (hypertension,intemperance),previous surgery,mechanical ventilation,date of ICU admission,quality of care, APACHE II score,electrolyte disorder,LVEF,sleep disturbance,PCT,oxygenation index,drug use situation (midazo-lam,opioids)and the clinical care unit the incidence of mental disorders in relationship.Results 568 patients (male 345 cases,female 223 cases),mental disorders group of 157 patients,the clinical incidence rate of 27.6% overall;568 patients were in the sex ratio of 1.55:1,mental disorders group of 157 patients(96 males,61 females),male to female ratio 1.57:1,mean age was (65.5 ±11.2)years;no mental disorders group (249 males,162 females),male to female ratio 1.30:1,mean age was (48.8 ±14.3)years.Logistic regression analysis revealed that coronary heart disease,hypotension,alcohol abuse,surgery,mechanical ventilation,ICU admission time,quality of care,APACHE II score,electrolyte imbalance,ejection fraction,sleep disorders,procalcitonin,oxygenation index,use of midazolam or opioids were among the risk factors of ICU mental disorders.Mechanical ventilation,quality of care,hypotension,alco-hol abuse,and use of midazolam were independent risk factors for ICU mental disorders (all P <0.05).Conclusion ICU inpatients with past history of hypertension and intemperance,use of mechanical ventilation and midazolam should be closely monitored and evaluated,early psycho -psychiatric screening,and take effective measures in time;high -quality care can reduce the incidence of mental disorders in ICU patients significantly.
5.Effect of acute myocardial ischemia on pharmacokinetics of protocatechuic aldehyde in rats
Wanwen CAO ; Yuan CAO ; Lin ZHANG ; Bobo CHANG ; Yiqun TANG ; Xiaoquan LIU
Journal of China Pharmaceutical University 2010;41(2):156-159
Acute myocardial ischemia (AMI) was induced by occlusion of the left anterior descending (LAD) coronary artery in rats.AMI rats and normal rats were administered with protocatechuic aldehyde(Pal) at a single dose of 20 mg/kg through peritoneal injection.Concentrations of Pal,protocatechuic acid (PAC) and vanillic acid (VAC) in plasma were determined by HPLC to evaluate the effect of AMI on pharmacokinetics of Pal in rats.Pal was quickly metabolized to PAC,which was then methylated into VAC.Compared to the normal group,AUC_(0-∞) of PAC significantly increased from 14.01 ±3.11 to 22.31 ±4.96 μg·h/mL in AMI group (P < 0.01),and AUC_(0-∞) of VAC markedly elevated from 19.64 ±4.36 to 38.76±5.75 μg·h/mL (P<0.01).Both MRT of PAC and VAC increased (0.43 ± 0.08 h vs 0.27 ± 0.04 h,0.61 ± 0.11 h vs 0.38 ± 0.05 h,P < 0.01).Metabolic ratio M/P of PAC increased from 1.43 ±0.31 to 1.77 ±0.22 (P <0.05).Results indicated that AMI status had great influence on pharmacokinetic behavior of Pal.Meanwhile,the level of methylation was greatly increased.
6.Analysis for body composition status and development pattern of children and adolescents aged 6-17 years in Guangzhou
Chao CHEN ; Lun YANG ; Weihao HUANG ; Shuang LU ; Guangchuan ZHANG ; Wanwen YAO ; Yijin ZHENG ; Yi YANG ; Li LIU
Chinese Journal of Applied Clinical Pediatrics 2021;36(24):1887-1890
Objective:To analyze the current status of body composition and development patterns of children and adolescents aged 6-17 years in Guangzhou.Methods:This was a cross-sectional study involving 8 169 school students from 3 elementary schools and 3 middle schools in Guangzhou from March to December 2019.The fat-free mass (FFM) and fat mass (FM) were measured by the bioelectrical impedance analysis.The fat-free mass index (FFMI) and fat mass index (FMI) were calculated via the height standardization. T test was used to compare quantitative variables between groups.The growth pattern of body composition was described using the Hattori chart. Results:A total of 4 431 boys (54.24%) and 3 738 girls (45.76%) were involved in this study.FFM and FM both increased with age between boys and girls.Except for boys aged 11 years, FFM in boys were significantly higher than that in girls with the same age (all P<0.05). In the age of 7-10 years, FM in boys were significantly higher than that in girls with the same age, while it was significantly higher in girls aged 12 years and older than that of boys at the same age (all P<0.05). The Hattori chart showed that the difference in body composition between genders occurred after 11 years old.In contrast to girls, increases in the weight and body mass index (BMI) in boys were mainly attributed to the FFM development. Conclusions:The development of FFM and FM in children and adolescents varies with age, accompanied with the gender-specific features.FFM in boys is higher than that of girls at the same age.The weight gain in boys is mainly attributed to the development of fat-free tissues, and thus the utility of BMI may lead to the overestimation of obesity.