Objective To observe the efficacy of proparacaine hydrochloride in preoperative venipuncture. Methods Two hundred and furty patients hospitalized for preoperative venipuncture, between June 2015 to December 2015 in Jiangmen Central Hospital, were equally randomized into the intervention group and control group: the former was treated with proparacaine hydrochloride and the control group used traditional method. Visual analogue scale (VAS) was adopted to assess the effects of the anesthesia effect. At the same time the one-time success rate of puncturing and the adverse reactions were observed and compared between the two groups. Results Patients of the intervention group felt significantly less painful than that the control one (P<0.05). The successful rate of the intervention group was significantly higher than that of the control group (P<0.05). Conclusion Proparacaine hydrochloride is safe and effective for preoperative which reduces pain.

OBJECTIVEPotention drug-targets on anti-neuropathy of stroke were summarized, and it will provide materials for developing innovation components traditional Chinese medicine on anti-cerebral infarction neuropathy.

METHODThis article had done a series of researching work about neurovascular unit which includes three kinds of cells: neuron, gliacyte,brain microvascular endothelial cell, then signal mechanism of cell death or apoptosis of each section of stroke neuropathy was analysised by the historical documents.

RESULTThere are five important pathways: inflammatory factor-MMPs pathway- Caspases, Ca2+ -mitochondrial pathway-Caspases, Ca2+ -Phospholipase-PI-3K/AK pathway, Ca2+ -radical-MAPK pathway, Ca2+ -NO-protease pathway, among all the nodes, Caspases, Ca2+, NO were the most important ones.

CONCLUSIONDeveloping the multi-mechanism and multilevel of traditional chinese medicine under the guidance of the theories of network pharmacology and neurovascular unit will play an important role in studying the key links of signal-network of stroke neuropathy.

Calcium ; metabolism ; Caspases ; metabolism ; Cerebral Infarction ; metabolism ; prevention & control ; Drug Delivery Systems ; methods ; Humans ; MAP Kinase Signaling System ; Matrix Metalloproteinases ; metabolism ; Medicine, Chinese Traditional ; methods ; Models, Biological ; Pharmacology ; methods ; Phosphatidylinositol 3-Kinases ; metabolism ; Polyneuropathies ; metabolism ; prevention & control ; Proto-Oncogene Proteins c-akt ; metabolism ; Signal Transduction

Objective To explore the influencing factors of different bowel preparation before colonoscopy on the intestinal cleanliness and polyp detection rate .Methods From March to August in 2018, at the Center of Endoscopy of Huashan Hospital Affiliated to Fudan University , the patients who underwent colonoscopy were selected and their general data of bowel preparation regimens were collected .Self-factors of the patients, different bowel preparation regimens , bowel preparation quality and polyp detection rate were observed.The quality of bowel preparation was evaluated by Boston bowel preparation scale (BBPS).T test, and analysis of variance and chi-square test were used for statistical analysis .Results Among 1008 patients who underwent colonoscopy , there were 506 males and 502 females, and average age was (57.3 ±13.7) years. There were statistically significant differences in BBPS score of patients with different body mass index (BMI), Parkinson disease and history of abdominal surgery (F=3.319, t=-2.060 and -2.544;all P<0.05).The BBPS score of patients with three-day low residue diet before examination was higher than that of those without preparation before examination (6.04 ±2.50 vs.5.54 ±2.73), and the difference was statistically significant (t=2.514, P=0.010).The BBPS scores of 2000 mL polyethylene glycol electrolyte lavage solution (PEG) taken once , 2000 mL PEG taken separately , 3000 mL PEG taken once and 3000 mL PEG taken separately were 5.06 ±2.88, 6.11 ±2.44, 5.94 ±2.32 and 6.10 ±2.47, respectively, and the difference was statistically significant (F=7.242,P<0.01).There were significant differences in polyp detection rates among the patients with different age , gender, BMI, and with history of constipation , hypertension and diabetes mellitus (χ2 =33.170, 8.489, 12.024, 4.034, 26.790, 10.381;all P<0.05).The polyp detection rate of patients with oral methyl silicone oil was higher than that of patients without oral methyl silicone oil (52.6％, 30/57 vs.29.7％, 221/744), and the difference was statistically significant (χ2 =12.934, P<0.01).Age (odds ratio (OR)=1.328, 95％confidence interval (CI) 1.162 to 1.517) and BMI (OR=1.412, 95％CI 1.115 to 1.787) were independent risk factors for polyp detection rate .Conclusions Parkinson disease, history of abdominal surgery and BMI are the related factors affecting the quality of bowel preparation before colonoscopy .Age and BMI are independent risk factors for polyp detection rate .

Objective This study compares a dual-freeze protocol with a triple freeze protocol for hepatic cryoablation in the Tibetan pig model.Method Cryoablation with a dual-(10-5-10-5 min)and triple-freeze (5-5-5-5-10-5 min) protocol for the normal livers of 9 Tibet pigs was performed under exposed operation.Temperature changes of cryoprobes and diameter changes of iceballs were measured during the ablation,and seven days later the pathological changes of cryozones were reviewed and the surface and depth cryolesions were measured.Results Compared with cryoablation with two freeze-thaw cycles,there was a greater iceball diameter for cryoablation by three freeze-thaw cycles.Also,seven days after cryosurgery,there were similar surface and deep cryolesions in dual-and triple-freeze protocols.Pathologically,the triple freezing protocol was associated with a longer zone of complete necrosis.Conclusions With the same freezing time (20 min),the triple-freeze protocol may become a more powerful liver-ablation method in cryosurgical application.

Objective To study the clinical and pathological characteristics of early gastric cancer ( EGC) and to evaluate the value of blue laser imaging combined with magnification endoscopy ( BLI-ME) in the diagnosis of EGC. Methods A retrospective study was conducted on data of 255 patients with EGC diagnosed in Huashan Hospital from January 2014 to January 2017, including 33 cases of preoperative BLI-ME intensive examination. According to the Japanese classification of gastric carcinoma of Japanese Gastric Cancer Association, the EGCs were histopathologically divided into differentiated and undifferentiated subtypes. Clinical characteristics, endoscopic features, pathological type, lymph node metastasis, and lesion characteristics of BLI-ME were analyzed. Results Among the 255 cases of EGC, 164 cases ( 63. 31％) were male, 242 cases ( 94. 90％) were over 40 years old, 182 cases ( 71. 37％) belonged to differentiated type, 93 cases ( 36. 47％) were located in gastric antrum, 92 cases ( 36. 08％) were type 0-Ⅱc under endoscopy, and 37 cases (14. 51％) had lymph node metastasis. Comparative analysis showed that the lymph node metastasis rate was significantly lower in mucosal carcinoma compared to submucosal carcinoma[ 5. 04％(7/139) VS 25. 86％ (30/116),χ2=22. 109, P=0. 000], lower in differentiated carcinoma compared to undifferentiated carcinoma[9. 89％ (18/182) VS 26. 03％ (19/73), χ2=10. 938, P=0. 002], and lower in tumors with maximum diameter of lesion≤2. 0 cm compared to maximum diameter of lesion>2. 0 cm [ 9. 88％ ( 16/162 ) VS 22. 58％ ( 21/93 ) , χ2 =7. 687, P=0. 009 ] . Among the 33 cases undergoing BLI-ME, differentiated EGC was mainly fine-network pattern (13. 64％, 3/22), intralobular loop pattern (ILL)-1 (59. 09％, 13/22) and ILL-2 (22. 73％, 5/22), whereas undifferentiated subtype patients were characterized as ILL-2 ( 45. 45％, 5/11 ) and corkscrew pattern ( 54. 55％, 6/11 ) . Conclusion The incidence of EGC is higher in male with age over 40 years. Gastric lesions occur most frequently in the antrum, and the most common microscopic morphology is 0-Ⅱc type. Tumor>2. 0 cm or invasion of submucous layer, and undifferentiated carcinoma are prone to lymph node metastasis. The assessment of mucosal microvascular pattern and micro surface structure under BLI-ME facilitate to determine the pathological type of EGC.

Objective To explore the application effect of throughout nursing management mode in the free treatment of acquired immune deficiency syndrome (AIDS) in outpatient.Methods Follow the principle of voluntary participation,seventy-two infected person or patients with AIDS were chosen and were divided into the intervention group (n =34) and the control group (n =38).The control group received the routine nursing management mode,and the intervention group received the throughout nursing management mode.The seven compliance indicators were observed and analyzed one year after the intervention.Results The average interval time from confirming HIV to detecting CD4 cell count firstly was 20 d,and the average interval time from finding CD4 less than 350/μl firstly to antivirus treatment was 30 d in the intervention group,and were lower than 30 d,60 d in the control group,and the differences were statistically significant (Z =3.42,3.13,respectively; P ＜ 0.01).The proportions of full compliance,partial compliance in the intervention group were respectively 82.4％,14.7％,and were better than those in the control group(52.6％,34.2％),and the difference was statistically significant (Z =-2.693,P ＜ 0.01).The proportions of the standard of follow-up in the intervention group were respectively 82.4％,and were better than 55.3％ in the control group,and the difference was statistically significant (x2 =6.057,P ＜ 0.05).The proportions of detecting CD4 cell count every three months,the increased CD4 more than 100/μl 6-12 months after the antivirus treatment,the viral suppression 6-12 months after the treatment in the intervention group were respectively 97.1％,79.4％,82.4％,and were better than 81.6％,44.7％,60.5％ in the control group,and the differences were statistically significant (x2 =4.354,5.678,4.138,respectively; P ＜ 0.05).Conclusions The throughout nursing management mode can urge the patients to detect CD4 cell count and standardize the follow-up,and can promote the patients to treat as soon as possible,and increase the medication compliance,and improve the treatment effect,and reduce the incidence and mortality of AIDS-related diseases.

Objective:To investigate the incidence and risk factors of active human cytomegalovirus (HCMV) infection in patients with severe community-acquired pneumonia.Methods:Patients who required respiratory support and were diagnosed with severe community-acquired pneumonia in the respiratory intensive care unit (RICU) of the First Affiliated Hospital of Guangzhou Medical University from March 1, 2019 to June 1, 2020 were consecutively screened and divided into active HCMV infection group (20 cases) and non-active HCMV infection group (95 cases) based on whether a patient has active HCMV infection or not. Differences in demographic data, laboratory findings, and clinical outcomes were compared between the two groups. Moreover, logistic regression was applied to analyze risk factors for active HCMV infection.Results:The 20 of 115 patients with severe community-acquired pneumonia requiring respiratory support were confirmed to have active infection with HCMV, with a prevalence of active HCMV infection of 17.4%. The pneumonia severity index (PSI) and suppressor T lymphocytes (Ts) in active HCMV infection group were higher than that of the control group, and all the differences were statistically significant ( Z=2.432, P=0.015; Z=2.036, P=0.042); whereas lymphocytes, monocytes, blood lactate, and platelet levels were lower than those of the control group, and all the differences were statistically significant ( P < 0.05). Patients with active HCMV infection had a higher transfusion rate than the control group, and the differences were statistically significant (χ 2=3.941; P=0.047). Increasing levels of PSI and Ts percentage were independent risk factors for active HCMV infection ( OR=1.03, 95% CI: 1.01~1.05; OR=1.06, 95% CI: 1.00~1.11; P < 0.05). RICU length of stay, complication rates, and 90-day all-cause mortality were higher in the active HCMV infection group than the control group, and all the differences were statistically significant ( P < 0.05). Conclusions:Active HCMV infection is highly prevalent in patients with severe community-acquired pneumonia and associated with several adverse clinical outcomes, with PSI and Ts cell levels being independent risk factors.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.