Objective To explore the effect and safety of target controlled infusion mode based on precision anesthesia concept in cardiac surgery anesthesia.Methods A total of 100 patients underwent cardiac surgery in our hospital were selected as the research subjects,and they were randomly divided into the control group and the observation group,with 50 cases in each group.The surgical types,surgical related indicators,dosage of anesthetic drugs,and complications of the two groups were compared.Results There was no statistically significant difference in the proportions of patients who underwent coronary artery bypass surgery,valve surgery,macrovascular surgery,artial septal defect repair surgery,or other types of surgery between the two groups(P>0.05).There were statistically significant differences in the surgical time,bleeding volume,infusion volume,proportion of cardiopulmonary bypass,times of postoperative analgesic drug use and mechanical ventilation duration between the two groups(P<0.05).The usage of various anesthetic drugs in the observation group was lower than that in the control group,with statistically significant difference(P<0.05).The incidence of complication in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The target controlled infusion mode based on precision anesthesia concept can be used for cardiac surgery anesthesia to reduce the dosage of anesthetic drugs and postoperative complications,and improve the anesthesia effect and surgical safety.

Objective: To investigate the relationship between body mass index (BMI) and sexual development in Chinese children. Methods: A nationwide multicenter and population-based large cross-sectional study was conducted in 13 provinces, autonomous regions and municipalities of China from January 2017 to December 2018. Data on sex, age, height, weight were collected, BMI was calculated and sexual characteristics were analyzed. The subjects were divided into four groups based on age, including ages 3-<6 years, 6-<10 years, 10-<15 years and 15-<18 years. Multiple Logistic regression models were used for evaluating the associations of BMI with sexual development in children. Dichotomous Logistic regression was used to compare the differences in the distribution of early and non-early puberty among normal weight, overweight and obese groups. Curves were drawn to analyze the relationship between the percentage of early puberty and BMI distribution in girls and boys at different Tanner stages. Results: A total of 208 179 healthy children (96 471 girls and 111 708 boys) were enrolled in this study. The OR values of B2, B3 and B4+ in overweight girls were 1.72 (95%CI: 1.56-1.89), 3.19 (95%CI: 2.86-3.57), 7.14 (95%CI: 6.33-8.05) and in obese girls were 2.05 (95%CI: 1.88-2.24), 4.98 (95%CI: 4.49-5.53), 11.21 (95%CI: 9.98-12.59), respectively; while the OR values of G2, G3, G4+ in overweight boys were 1.27 (95%CI: 1.17-1.38), 1.52 (95%CI: 1.36-1.70), 1.88 (95%CI: 1.66-2.14) and in obese boys were 1.27 (95%CI: 1.17-1.37), 1.59 (95%CI: 1.43-1.78), and 1.93 (95%CI: 1.70-2.18) (compared with normal weight Tanner 1 group,all P<0.01). Analysis in different age groups found that OR values of obese girls at B2 stage and boys at G2 stage were 2.02 (95%CI: 1.06-3.86) and 2.32 (95%CI:1.05-5.12) in preschool children aged 3-<6 years, respectively (both P<0.05). And in the age group of 6-10 years, overweight girls had a 5.45-fold risk and obese girls had a 12.54-fold risk of B3 stage compared to girls with normal BMI. Compared with normal weight children, the risk of early puberty was 2.67 times higher in overweight girls, 3.63 times higher in obese girls, and 1.22 times higher in overweight boys, 1.35 times higher in obese boys (all P<0.01). Among the children at each Tanner stages, the percentage of early puberty increased with the increase of BMI, from 5.7% (80/1 397), 16.1% (48/299), 13.8% (27/195) to 25.7% (198/769), 65.1% (209/321), 65.4% (157/240) in girls aged 8-<9, 10-<11 and 11-<12 years, and 6.6% (34/513), 18.7% (51/273), 21.6% (57/264) to 13.3% (96/722), 46.4% (140/302), 47.5% (105/221) in boys aged 9-<10, 12-<13 and 13-<14 years, respectively. Conclusions: BMI is positively correlated with sexual development in both Chinese boys and girls, and the correlation is stronger in girls. Obesity is a risk factor for precocious puberty in preschool children aged 3-<6 years, and 6-<10 years of age is a high risk period for early development in obese girls.
Adolescent ; Body Mass Index ; Child ; Child, Preschool ; China/epidemiology* ; Cross-Sectional Studies ; Female ; Humans ; Male ; Obesity/epidemiology* ; Overweight/epidemiology* ; Puberty ; Puberty, Precocious ; Sexual Development

OBJECTIVE: To investigate the clinical characteristics, laboratorial and bone marrow pathological features of primary thrombocytopenia (ET) patients with different mutations of CALR, JAK2 and MPL genes. METHODS: The chinical data of 120 cases of ET in Jiangsu provincial people's hospital/ The First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2017 were collected and analyzed, including 76 cases with JAK2 gene mutation, 40 cases with CALR gene mutation, 2 cases with MPL gene mutations, 2 cases without gene mutation. RESULTS: Among the ET patients, compared with the JAK2 gene mutation, CALR gene mutation showed statistically significant deareament of white blood cells and hemoglobin (P=0.001, P=0.01) and the male platelets in CALR group showed significant increament (P=0.04). Fourthermore, the average number of megakaryocytes and its cluster numbers in each hight power field of vision showed statistically significant decreament in CALR group as compared with JAK2 group (P=0.001, P=0.001), and thrombotic events in CALR group were signicantly lower than those in JAK2 group (7.5% vs 18.4%) (P=0.03). CONCLUSION Mutations of CALR, JAK2 have different clinical characteristics and blood pathological changes of Chinese ET patients, and their clinical significance is worth to explore.
Bone Marrow ; Calreticulin ; genetics ; China ; Humans ; Janus Kinase 2 ; genetics ; Male ; Mutation ; Receptors, Thrombopoietin ; genetics ; Thrombocythemia, Essential

To evaluate the relationship of volumetric changes and endoleaks after endovascular aneurysm repair(EVAR)for abdominal aortic aneurysms(AAAs). We retrospectively evaluated the clinical and imaging data of 54 patients who had underwent EVAR within 1 month after their aneurysms were detected.All patients received abdominal and pelvic enhanced computed tomography(CTA)for two follow-up visits in Peking Union Medical College Hospital from July 2014 to February 2019.Three-dimensional volumes and maximum diameters on axial CT of the aortic aneurysms were calculated by dedicated semi-automated 3D segmentation software before surgery(V and D),in the 4 postoperative month(Vand D),and in the 12 postoperative month(Vand D),respectively.The presence or absence of endoleak for each patient with the V/V,V/V,and V/V were calculated to assess the significance of volume changes with respect to endoleaks and the correlation between volume changes and maximum diameter changes on axial CT images. Of the 54 patients,endoleaks were found in 11 patients at the first follow-up visit(4 months after surgery),among whom 8 patients were arranged a second follow-up visit(12 months after surgery),during which endoleaks were found in 5 patients.Fifteen of 43 non-leaked patients underwent a second CTA examination,which revealed endoleak in one case.Patients who did exhibit endoleaks[ =11,V/V=1.086(1.033,1.116)]showed significant increases in aneurysm volume when compared with those who did not exhbit endoleaks[ =43,V/V=1.019(0.970,1.065)]at the first follow-up visit(=-2.695,=0.007),although no significant difference was found with regard to volume changes between endoleaks(=6,V/V=1.1±0.2,V/V=1.0±0.1)and non-endoleaks(=17,V/V=1.0±0.1,V/V=1.0±0.1)at the second follow-up visit(=0.725,=0.476)as well as between these two follow-up visits(=-0.021,=0.984).V and D were moderately correlated with V and D,respectively(=0.5,<0.001)and strongly correlated with V and D,respectively(=0.8,<0.001).V and D were strongly correlated with V and D,respectively(=0.8,<0.001). The changes of aneurysm volume cannot reliably reflect the occurrence of endoleaks.The change of maximum axial diameter of aneurysm has certain correlation with the changes of aneurysm volume.

Objective To study the anatomical variations of the origin of uterine artery(UA)by three-dimensional(3D)reconstructed computed tomography angiography(CTA)and facilitate the preoperative evaluation for gynecological surgeries or interventional therapies. Method The CTA findings of 112 patients with an average age of(31.4±6.6)years old who had received a pelvic CTA and undergone 3D reconstruction of the uterine artery were retrospectively analyzed. Results The average uterine volume was(95.6±26.8)cm .Of the UA 224 sides,144 sides(64.3%)arose from the interior gluteal artery and 51(22.8%)from internal iliac artery;in 29 sides(12.9%),the uterine artery,the inferior gluteal and the superior gluteal arteries arising as a trifurcation.The origin of UA was consistent between left and right sides in 68 patients(60.7%)and not in 44 patients(39.3%). Conclusion As a rapid,noninvasive,and economic technique,CTA can effectively display the anatomical variations of the origin of UA and thus can be used to guide interventional therapies and gynaecological surgeries.
Adult ; Computed Tomography Angiography ; Female ; Humans ; Imaging, Three-Dimensional ; Pelvis ; Retrospective Studies ; Uterine Artery ; anatomy & histology ; diagnostic imaging ; Uterus

OBJECTIVETo investigate the protective effects of the natural medicinal monomer isopsoralen (ISR) with estrogenic activity against oxidative damage in human lens epithelial cells B3 (HLE-B3) caused by hydrogen peroxide (H(2)O(2)) and to pursue the possible mitochondrial proteomic regularity of the protective effects.

METHODSHLE-B3 cells were treated with H(2)O(2) (300 μ mol/L), β-estradiol (E(2): 10(-8) mol/L) and H(2)O(2), ISR (10(-5) mol/L) and H(2)O(2), or left untreated. Altered expressions of all mitochondrial proteins were analyzed by protein array and surfaceenhanced laser desorption ionization time of flight mass spectrometry (SELDI-TOF-MS). The mass/charge (m/z) ratios of each peak were tested by the Kruskal-Wallis rank sum test, and the protein peak value of the m/z ratio for each treatment by pair comparison was analyzed with the Nemenyi test.

RESULTSH(2)O(2) up-regulated the expressions of two protein spots (with m/z of 6532 and 6809). E(2) mitigated the oxidative damage, and the expression of one protein spot (m/z 6532) was down-regulated. In contrast, ISR down-regulated both of protein spots (m/z 6532 and 6809).

CONCLUSIONSISR could effectively inhibit H(2)O(2)-induced oxidative damage in HLE-B3 cells. The protein spot at m/z of 6532 might be the target spot of ISR against oxidative damage induced by H(2)O(2).

Cell Line ; Epithelial Cells ; drug effects ; metabolism ; pathology ; Estradiol ; pharmacology ; Furocoumarins ; pharmacology ; Humans ; Hydrogen Peroxide ; toxicity ; Lens, Crystalline ; pathology ; Mitochondria ; metabolism ; Oxidation-Reduction ; drug effects ; Oxidative Stress ; drug effects ; Protective Agents ; pharmacology ; Proteome ; metabolism ; Proteomics ; methods

Objective To discuss the psychological characters in H1N1 suspicious patients during the isolated period, in order to provide proper nursing cares. Methods From May to Sep. 2009, 114 patients, who were in charged in the infective department of our hospital, were investigated by observation, conversation, and registration and were given psychological interventions. The results were analyzed by retrospective methods.Results 114 cases have psychological problems in different degrees, and most common problems were fear and anxiety. The patents with psychological problems in the hospital were worse than those at home. The patents over 15 years old were suffered from fear and anxiety more severely. But with proper nursing cares, all of them survived the isolated period. Conclusions The H1N1 suspicious patients have special psychological problems during the isolated periods, and they need proper nursing cares to meet satisfied outcome.

OBJECTIVETo evaluate the efficacy and safety of long-term treatment with arotinolol in patients with idiopathic dilated cardiomyopathy (IDCM).

METHODSSixty-three patients with IDCM were evaluated at baseline and after 12-month therapy with arotinolol. The conventional therapy for congestive heart failure was continued throughout the study with arotinolol as the only beta-blocker. Left ventricular function was assessed with the New York Heart Association functional class and two-dimensional echocardiography.

RESULTSAfter 12-month arotinolol treatment, there was a significant improvement in left ventricular systolic function. Left ventricular end-systolic dimension significantly decreased from 59.52 +/- 8.83 mm to 50.89 +/- 8.17 mm (P < 0.001). Left ventricular ejection fraction significantly increased from 27.39% +/- 7.94% to 41.13% +/- 9.45% ( P < 0.001). Left ventricular mass index decreased from 150.47 +/- 42.42 g/m2 to 141.58 +/- 34.36 g/m2 (P < 0.01). No adverse events leading to premature discontinuation of study drug occurred.

CONCLUSIONIn this preliminary study, 12-month arotinolol treatment has a favorable effect on left ventricular function in patients with IDCM, and it is safe and well tolerated.

Adrenergic beta-Antagonists ; adverse effects ; pharmacology ; therapeutic use ; Adult ; Cardiomyopathy, Dilated ; drug therapy ; physiopathology ; Echocardiography ; Female ; Humans ; Male ; Middle Aged ; Propanolamines ; adverse effects ; pharmacology ; therapeutic use ; Ventricular Function, Left ; drug effects

OBJECTIVETo investigate the obstructive site and the dynamic change of the upper airway in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) during sleep and wakefulness.

METHODSAfter being deprived of sleeping for 20 hours, sequential midline sagittal images of the upper airway were obtained in 21 patients during sleep and wakefulness with dynamic MRI. The obstructive state was studied according to hypopnea (< 10 s) and apnea (> or = 10 s). The length of obstruction site was measured and the dynamic characteristics of obstruction was observed. Statistical analysis was performed with paired t-test.

RESULTSThe obstruction at the level of the palatopharynx in patients with hypopnea during wakefulness was similar to that in patients with apnea during sleep. The maximal length [(6.61 +/- 1.23) cm], the minimal length [(0.95 +/- 0.22) cm] and maximal length difference [(5.66 +/- 1.27) cm] related to apnea during sleep were longer than those correlated with hypopnea [(2.99 +/- 0.51) cm, (0.72 +/- 0.23) cm, (2.27 +/- 0.67) cm, respectively] in wakefulness. (P < 0.01).

CONCLUSIONSThe obstruction of upper airway during sleep is dynamic and multilevel in patients with OSAHS. To a certain degree, hypopnea during wakefulness can give a clue to the obstructive state during sleep.

Adult ; Airway Obstruction ; diagnosis ; physiopathology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Sleep Apnea, Obstructive ; diagnosis ; physiopathology

OBJECTIVETo investigate the prognostic factors for patients with gastrointestinal stromal tumors (GIST).

METHODSFrom 2000 to 2003, clinical data of 41 cases with GIST were reviewed retrospectively. The clinicopathologic diagnosis was determined by immunochemistry. The relationships of the prognosis with mitotic counts, tumor size and location,range of tumor resection were analyzed.

RESULTSThe patients with GIST had pathological section of high expression in CD117, CD34 and vimentin (92.7%, 82.9%, 78%, respectively). Patients with tumor location in intestine, tumor size > 5 cm,mitotic counts > 5/50HPF, incomplete resection had poorer outcome, compared with those with tumor location in stomach and colon,tumor size < or = 5 cm,mitotic counts < or = 5/50HPF and complete resection (all P< 0.05).

CONCLUSIONComplete gross resection can improve prognosis for patients with GIST. Tumors with mitotic counts > or = 5/50HPF, tumor size more than 5 cm and tumor location in intestine are poor prognostic factors.

Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; diagnosis ; pathology ; surgery ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Young Adult