Objective To investigate the adverse reactions influence factors of deep sedation anesthesia.Methods 120 cases with elective gastrointestinal tumor resection were chosen and given deep sedation anesthesia.The occurrence of intranperative bemodynamic changes at each time point and adverse reaction were statistically analyzed.Results SBP,DBP,HR and SpO2 values at different anesthesia time point had significant differences (F =9.688,10.258,7.586,8.992,all P =0.000).26 cases had intraoperative and postoperative adverse reactions,the incidence was 21.7％,8 cases with hypotension,4 cases with bradycardia,6 cases with nausea and vomiting,2 cases with apnea,6 cases with other adverse reactions.No death and serious adverse reactions occurred.Senility,depth anesthesia application history,psychological stress and obesity were risk factors of intraoperative and postoperative adverse reactions of gastrointestinal tumor by deep sedation anesthesia(OR values =9.806,0.119,0.105,10.521,all P ＜0.05).Conclusion Adverse reaction incidence of gastrointestinal tumor by deep sedation anesthesia was high,and more performance for hemodynamic response,anesthesiology doctors could improve patients prognosis by regulating the perioperative risk factors.

Adrenal Hyperplasia, Congenital ; complications ; metabolism ; Body Height ; Growth Disorders ; etiology ; Humans ; Risk Factors ; Steroid 21-Hydroxylase ; metabolism

Objective To compare the prevalence of patent foramen ovale (PFO) in young and middle-aged patients with cryptogenic ischemic stroke (CS) and in normal population.Methods The casecontrol study included consecutive 318 young and middle-aged patients with CS and 336 normal control subjects with matched age and sex for group comparisons.Stroke risk factors including hypertension,diabetes mellitus,hyperlipidemia,ischemic heart disease,atrial fibrillation,carotid atherosclerosis plagues and smoking,etc.were studied.Transesophageal echocardiography (TEE) were performed to detect the presence of PFO.The prevalence of PFO and difference of risk factor levels between the groups was compared.Then the odds ratios (OR) of a PFO was estimated in CS patients versus control subjects.Results The prevalence of PFO was significant higher in patients with CS than in control subjects (145/318,45.6 ％ versus 46/336,13.7％,P ＜0.001).The odds ratio(OR) for PFO in CS for patients versus control subjects was 5.3 (confidence interval,3.6 to 7.8).The mean size of PFO was larger in stroke group than that in control group (P ＜ 0.001).There were no significant differences in levels of other stroke risk factors between two groups.Conclusions PFO may play an important role in etiology of CS in young and middleaged adults.Larger and longer PFOs may be more concomitant with ischemic attacks.More efforts should be employed in patients with CS to detect PFO for further treatment.

Objective To examine the relationships between the level of serum visfatin and obesity,nonalcoholic fatty liver disease (NAFLD)in children and adolescents. Methods Serum visfatin levels of 106 obese children/adolescents (including 49 non-NAFLD children and adolescents and 57 NAFLD children/adolescents in which consisting of 42 mild ones,15 moderate-to-severe ones)with another 69 lean children/adolescents as their controls,were examined by indirect sandwich ELISA.Results When comparing the serum visfatin levels,there was no significant difference noticed between the obese group ( 1.71 ± 0.37) ng/ml and the lean group ( 1.75 ± 0.37) ng/ml (P=0.455).With the severity of NAFLD,the serum visfatin level showed an elevation in obese children and adolescents [ obese without NAFLD ( 1.59 ± 0.36) ng/ml,obese with mild NAFLD ( 1.74 ± 0.36) ng/ml,obese with moderate-to-severe NAFLD (1.97 ± 0.36) ng/ml,P＜0.05].In the obese group,serum visfatin levels seemed to be related to age (^β=-0.326,P=0.000),alanine aminotransferase (ALT) (^β =0.286,P=0.004) and the degree of NAFLD (^β =0.246,P＝0.014).Conclusion The level of serum visfatin was related to non-alcoholic fatty liver in obese children and adolescent.

One new dicyclopeptide cyclo-(L-N-methyl Glu-L-N-methyl Glu) (1), together with one new natural dicyclopeptide cyclo-(L-methyl Glu ester-L-methyl Glu ester) (2), and two known dicyclopeptides cyclo-(L-methyl Glu ester-L-Glu) (3), and cyclo-(L-Glu-L-Glu) (4), were isolated from the aerial parts of Dianthus chinensis L. Their structures were determined by spectroscopic analyses and chemical methods.
Dianthus ; chemistry ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Plant Components, Aerial ; chemistry ; Plants, Medicinal ; chemistry

Objective To investigate the mechanism of quinolone resistance in Psendomonas aeruginosa.Methods The minimum inhibitory concentrations (MICs)of ciprofloxacin and levofloxacin with and without carbonylcyainde-m-chlorophenylhydrazone(CCCP)were determined by agar dilution method.Polymerase chain reaction(PCR)and DNA sequencing were used to study the mutations in quinolone resistance-determining region of gyrA and parC genes.The strains were genotyped by enterbacterial repetitive intergenie consensus-PCR(ERIC-PCR).Results Sixteen quinolones-resistant Pseudomonas aeruginosa strains were obtained.The MICs of ciprofloxacin and levofloxacin were not reduced significantly by adding CCCP.Thr-83→Ile of gyrA and Ser-87→Leu of parC were found simultaneously in 16 strains of resistant Pseudomonas aeruginosa.Analysis of ERIC-PCR products indicated that 16 quinolone-resistant strains had an identical band pattern which was different from that seen in the sensitive strains.Conclusion Mutations in gyrA and parC may be the main mechanism of quinolone resistance in clinical isolates of Pseudomonas aeruginosa.

Objective To analyze the diagnosis and prognosis value of abdominal CT scans in patients with acute pancreatitis complications.Methods 151 cases with acute pancreatitis were selected.The relationship between abdominal CT performances and the common complications and death in patients was analyzed.The prognosis of patients with different Balthazar CT severity index (CTSI) grade was compared.Results The complication rate of patients with CT signs of fatty liver, pleural effusion, liver gap effusion, adrenal gland involvement (AGI), penirenal space involvement (PSI) and gastric bare area involvement (GBAI) was significantly higher than that of patients with negative CT findings above (P<0.05).With CTSI grading increasing, the patient''s fasting time, heating time, hospital stay, recovery time of blood amylase were extended, and the incidence of pseudo cyst, transit surgery, organ failure and death was gradually increasing (P<0.05).Conclusion Severe fatty liver, AGI, GBAI, PSI and liver gap effusion are risk factors for acute complications and death in patients with pancreatitis.

Objective Meta-analysis the efficacy and safety of Exenatide and insulin therapy oral hypoglycemic drugs effect of obesity with type 2 diabetes .Methods According to the research purpose to set up the screening of related literature and exclusion criteria; formulatethe searching strategy, through PubMed、the Chinese Biological Medicine Datebase(CBM)、 CNKI、Wanfang Data Knowledge Service Platform, VIP to retrieve all theliterature selection of efficacy and safety by Exenatide oral hypoglycemic drugs and insulin therapy of obese type 2 diabetes mellitus.Choose met inclusion exclusion criteria, the complete data information randomized controlled trial (RCT) as the research object; Apply to the international commonly used Jadad score method to evaluate quality included in the test; To process the relevant data in the test ; Apply the ReviewManager 5.1 software to analysis the extracted research data.Analysis the results and put forward conclusions.Results Participants included 11 RCT , meta analysis results showed that compared with the Exenatide, in terms of reducing fasting glucose ,insulin effect more apparent [MD = 0.35, 95％CI: (0.11, 0.59), P = 0.004)]. In control effect of glycosylated hemoglobin, there was no statistically significant difference[MD=-0.04 ,95％CI:(-0.20,0.11), P=0.58],between Exenatide and insulin. Compared with the insulin, Exenatide reduce BMI more apparent[MD=-2.77,(95％CI: -3.34,-2.20),P<0.00001]; Compared with the insulin, Exenatide reduce insulin resistance index, the effect is more obvious[MD=-1.67,95％CI:(-1.93,-1.41), P<0.00001]; Adverse reaction in the process of treatment, the insulin is more likely to lead to hypoglycemia, [OR = 0.32, 95％ CI: 0.19, 0.54), P<0.0001]; While Exenatide are more likely to lead to gastrointestinal adverse reaction [OR = 4.04, 95％ CI: 2.35, 6.93), P<0.00001).Conclusion According to the Meta-analysis: Exenatide can be used in the treatment of oral hypoglycemic drugs of adult obesity with type 2 diabetes, and obvious effects of treatment of insulin resistance, long-term results still needs a large number of samples of high quality RCT to verify.