1.Clinical analysis on 6 cases of hematological patients with rhino-orbital-cerebral mucormycosis
Medical Journal of Chinese People's Liberation Army 2017;42(7):643-646
Objectives To explore the clinical characteristics of hematologic disease complicated by rhino-orbital-cerebral mucormycosis (HD-ROCM) and improve the understanding, diagnosis and treatment of M-ROC.Methods For mastering the clinical characteristics, treatment and prognosis of HD-ROCM, the medical records of 6 HD-ROCM patients admitted from 2009 to 2015 were analyzed retrospectively, and related literatures were also retrieved and reviewed.Results All the patients had bone marrow transplantation, 2 out of 6 patients had neutropenia, 5 had endoscopic debridement in a few days to several months after the onset of symptoms, and 1 had open debridement. 3 out of 6 achieved local debridement, and the other 3 had radical debridement. Out of them, one died 8 days postoperation, 1 died at 1 month, 2 at 2 months and 2 at 6 months.ConclusionEarly diagnosis and timely surgical treatment are the key points for improving the survival rate of HD-ROCM patients.
2.Effect of midazolam-fentanyl-propofol given intravenously in sequence on level of sedation and depth of anesthesia
Xuebing XU ; Shouzhang SHE ; Yan YAN
Chinese Journal of Anesthesiology 1994;0(03):-
0.05 as compared with T3 ) . (3) 3 min after propofol injection OAA/S score dropped to 0 in all patients; AEP index and BIS decreased to 28.97?11 and 50? 11 respectively.Conclusions Induction of anesthesia with intravenous midazolam-fentanyl-propofol is smooth and effective with little circulatory disturbance.
3.The evaluation of anesthesia depth monitoring with auditory evoked potentials index during induction and tracheal intubation for the elderly
Xuebing XU ; Shouzhang SHE ; Yan YAN
Chinese Journal of Geriatrics 1995;0(02):-
0 05)respeetively before induction, which shoued no statistic difference between two groups.AEP index and BIS of two groups after induction were decreased to below 30 a nd 55 respeetively(T 1 vs. T 0 ,P0 01) ) . The changing tendency of the elderly group and the young group were identical a t all time points. Conclusions AEP index can be used for the anesthesia depth monitoring for the elderly without obvious auditory dysfunction during tracheal intubation.
4.Comparison of auditory evoked potential index and heart rate variability for monitoring the level of sedation and analgesia during PCEA
Yan YAN ; Shouzhang SHE ; Xuebing XU
Chinese Journal of Anesthesiology 1996;0(09):-
Objective To compare auditory evoked potential index (AEPI) , BIS , heart rate variability (HRV) and spectral edge frequency (SEF) for monitoring the level of analgesia and sedation produced by different analgesic mixture of PCEA. Methods Thirty ASA Ⅰ-Ⅱ patients undergoing upper abdominal surgery under general anesthesia were enrolled in the study.Patients with mental or hearing disorders were excluded. The patients were randomly divided into three groups . The basic analgesic mixture for PCEA was 0.2% ropivacaine + 0.01% morphine in the 3 group and the PCEA regimen was : loading dose 5ml , background infusion 1ml?h-1, bolus dose 1ml and lock-out interval 10 min. The difference among the 3 groups was that the 5ml loading dose contained clonidine l00?g in group Ⅱ or midazolam 2mg in group Ⅲ. The patients were premedicated with phenobartital and scopolamine. Epidural catheter was placed at T9-10 , a test dose of 1 % lidocaine 3-5ml was given to confirm the correct placement of the epidural catheter. General anesthesia was induced with midazolam 0.06mg?kg-1, fentanyl 4?g?kg-1, propofol 0.5mg?kg-1 and vecuronium 0.1mg?kg-1. Anesthesia was maintained after tracheal intubation with isoflurane inhalation and propofol infusion. Patients were transported to PACU after operation.PCEA was started after extubation when the patients was awake and complained of pain. The AEPI, BIS , HRV and SEF values and VAS, OAA/S scores were recorded before induction of anesthesia (T0 ) at the end of surgery (T1), 5, 15, 30 , 60 , 90 min and 2h, 4h, 8h, 20h, 24h after loading dose (T2-12). Results (1) AEPI was significantly higher than the baseline value when the patient was awake and feel pain ( P
5.EC_(50) of propofol by target-controll infusion,BIS_(50) and AAI_(50) for different levels of sedation during combined spinal-epldural anesthesia
Yong CHEN ; Shouzhang SHE ; Yan YAN
Chinese Journal of Anesthesiology 1995;0(02):-
Objective To measure the EC50 of propofol administered by target-controll infusion(TCI) and BIS50 and AAI50 for different levels of sedation during combined spinal-epidural anesthesia (CSEA). EC50 , BIS50 and AAI50 were defined as the effective target effect-site concentration of propofol and BIS and AAI values at which different levels of sedation were achieved in 50% of patients.Methods Forty-five ASA Ⅰ patients (37 males, 8 females) aged 16-60 yr weighing 35-86 kg undergoing lower abdominal or lower limb surgery under CSEA were studied. CSEA was performed at L2-3 or L3-4 interspace. 0.75% bupivacaine 2 ml (15 mg) was injected into CSF. Intermittent boluses of 2% lidocaine were given through the epidural catheter during operation when needed. The average level of spinal block was T8 (T6-10 ) . The patients were sedated with propofol given by TCI. The level of sedation was assessed using observer assessment of the alertness/sedation scale (OAA/S) . BIS, AAI, MAP, ECG, HR, RR and SpO2 were monitored during anesthesia. Binary logistic regression was used to estimate the population values for EC50 BIS50 and AAI50 at different OAA/S scores. Results The EC50 of propofol from the score of 4-1 on the OAA/S scale were 0.6, 1.0, 1.3 and 1.6 ?g?mi-1 ; the BIS50 values 85, 75, 67 and 61 and AAI50 values 72, 59, 39 and 30 respectively. Conclusion EC50 of propofol given by TCI, BIS50 and AAI50 for different levels of sedation were measured during operation under CSEA and are useful for maintaining conscious sedation during CSEA.
6.PRACTICE AND THINKING OF COSTING ACCOUNTING ON THE BASIS OF MEDICAL SERVICES USING THE GENERAL LEDGER MODULE OF UFIDA IN NEW“HOSPITAL AC-COUNTING SYSTEM”
Jun YAN ; Jiayu SHE ; Mingsheng LIU
Modern Hospital 2014;(8):126-128
Objective Through the study of medical services cost accounting , we want to find the laws and provide a theoretical basis for government departments to develop standards of medical service prices and control health care costs . Methods On the basis of department cost accounting, we use financial accounting software, to provide medical service items for collection and sharing in accordance with the project income ratio , workload standards.Results Dialysis the three costs dominate factors, the proportion of disposable materials (60.03%)is the key factor affecting the cost.Conclusion Hygiene material spending accounted for a larger proportion of total expenditure , in order to effectively control the medical expense in dialysis patients, efforts should be made to reduce the cost of hemodialysis consumables.
7.Clinical significance of detection of serum anti-Helicobacter pylori and pepsinogen in 118 patients with reflux esophagitis
Yongguo WU ; Qiumin SHE ; Jieying YAN
International Journal of Laboratory Medicine 2015;(14):2063-2064,2067
Objective To investigate the significance of detection of Serum anti‐Helicobacter pylori(HP)and pepsinogen(PG) in patients with reflux esophagitis(RE) .Methods 118 RE patients (RE group) ,60 patients with other other gastropathy (other gas‐tropathy group) and 60 healthy subjects (healthy group) were detected serum HP antibodies ,PG levels ,compared serum PGⅠ ,PGⅡ level ,PGR and HP antibody positive rate between the RE group ,the other gastropathy group and the healthy group ,between the patients at different pathological degrees of the RE group .Results The levels of PG Ⅰ ,PGR and HP antibody positive rate of the RE group were lower than those of the other gastropathy group and the healthy group ,the healthy group was lower than the other gastropathy group ,the difference was statistically significant (P<0 .05) ,and compared with the control group ,there was no signifi‐cant difference in serum PG Ⅱ levels (P>0 .05);The serum PGⅠ level ,PGR and HP antibody positive rate of patients in grade A , B of the RE group were lower than those of the patients in grade C ,D (P<0 .05) ,the difference was statistically significant ,and there was no statistical significance in serum PG Ⅱ levels of the patients in grade C ,D (P>0 .05) .Conclusion The serum PGⅠlevel ,PGR and HP antibody positive rate of the patients with RE decrease ,HP infection is a protective mechanism of RE ,the dis‐ease exacerbates with the infection decreases ,detection of serum HP antibody and the level of PG has important clinical value in the diagnosis and prognosis of RE .
9.Influence of tea polyphenols on the free radical metabolism in the liver cells of nutritional obesity rats.
Yan-rui LUO ; Jian-she WANG ; Cui DI
Chinese Journal of Applied Physiology 2012;28(3):196-198
Animals
;
Free Radicals
;
metabolism
;
Hepatocytes
;
metabolism
;
Male
;
Obesity
;
metabolism
;
Polyphenols
;
pharmacology
;
Rats
;
Rats, Sprague-Dawley
;
Tea
;
chemistry
10.Application of Circulation Water to Induce Hypothermia in the Operation of Treating Upper end of Shinbone Tumor
Yan CHEN ; Hong LI ; Yanling SHE ; Xiuyan JING ; Runa WANG
Chinese Journal of Practical Nursing 2001;17(2):21-22
It had some advantages when microwave induced hyperthermia were used to treat inferior femora and superior shinbone tumor.The device of circulation water,which could induce hypothermia during the treatment procedure needed to be used.Large amount of normal saline at the room temperature was perfused through this device,so the temperature of surrounding normal tissues and organs was reducd and the functions of nerve,vessel and knee were protected.It is safe and convenient measure that keep the operation go on smoothly.Summarized 54 cases of superior shinbone tumor that were used this device in the operation and experienced that it provided an effectiveness support for the operation.