Objective To observe the safety of midazolam and fentanyl in coronary intervention and its effect on haemodynamics. Methods 150 cases undergoing coronary intervention were randomly divided into three groups(n=50 for each):the control group were given injection of 5 ml saline,midazolam group were given 0.04 mg/kg midazolam and combined fentanyl group were given injection of 0.02 mg/kg midazolam with 1.2μg/kg fent-anyl intravenously. Heart rate(HR),mean blood pressure(MAP),SpO<,2>,OAA/S and BIS were observed during the intervention and the patients' satisfaction and the incidence of complications were investigated. Results There was no significant difference among the three groups in MAP and HR (F=3.34,2.98,P>0.05). MAP increased from (95.7±14.5) mm Hg to (85.4±15.3) mm Hg after treatment (t=4.34,P<0.01) and HR increased from (83.3±23.4) times/min to (78.4±22.7) times/min in control group (t=3.37,P<0.01). BIS score was (90.5±7.2),(75.5±12.8) and (72.3±14.1) during intervention and 24 hVAS score was (53.5±25.4),(58.8±18.2) and (71.9±16.8) in control group,midazolam group and combined fentanyl group,with significant difference between groups (F=10.89,8.56,P<0.01). Conclusion Low dose of midazolam and fentanyl can make the patients calm,which relieves the tensity and anxiety and enhance the tolerance and safety of intervention but has no remarkable effect on bemodynamics.

Objective To evaluate the value of prenatal ultrasound in the interrupted aortic arch (IAA), and analyze the reasons of misdiagnosis and improve diagnostic ratio of this kind of defects. Methods Ultrasonic characteristics were analyzed in 16 fetuses with aortic arch anomalies, which were compared with ultrasound image and autopsy results of the normal fetus. The relativity of fetal IAA and abnormal chromosome was also analyzed. Results Among the 16 cases, 15 cases were confirmed by anatomy and the accuracy of ultrasound diagnosis was 94% (15/16), of which one case was serious constriction of aortic arch, one case was error type, three cases were obtained explicit type due to unsatisfactory results of prenatal ultrasound. The coincidence rate of ultrasonic type was 73% (11/15). All of the corrected diagnosed cases were detected with ventricular septal, of which 5 cases were detected with complete endocardial cushion defect, 9 cases were found extra cardiac malformations. Among the 7 karyotype check cases, 3 cases were diagnosed with Trisomy 18, 1 case Trisomy 13, while the rest 3 cases normal. The incidence rate of Trisomy 18 was 43 % (3/7). Conclusions Prenatal ultrasound shows a high accuracy in diagnosing fetal interrupted aortic arch (IAA ), but there’s a need to be improved in explicit typing. It is difficult to identify fetal interrupted aortic arch (IAA) and serious constriction of aortic arch (COA). The incidence rate of Trisomy 18 in the abnormal chromosome of fetal IAA is high.

0.05 ). On the contrary, the COX-2 score in nabumetone group was obviously lower than that in the operation group (P 0.05 ). Conclusion Nabumetone has obvious therapeutic effects on bile-reflux gastritis caused by duodenogastric reflux. Nabumetone can significantly decrease the level of COX-2 in the gastric mucus membrane.

navirus disease 2019 (COVID-19) in the patients younger than 18 years old infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant, and to provide a basis for determining the chest CT changes and efficacy of COVID-19 caused by Omicron virus variant in patients younger than 18 years old. Methods　The clinical and imaging data of 30 cases of patients younger than 18 years old infected with COVID-19 Omicron variant, who admitted to the Third People's Hospital of Shenzhen from February 11 to March 26, 2022 were collected and retrospectively analyzed. The clinical manifestations, imaging features and dynamic changes of lesions were summarized. Results A total of 41 intrapulmonary lesions in 30 patients with COVID-19 caused by SARS-CoV-2 Omicron variant. The main manifestations were patchy or nodular ground-glass opacities and/or consolidation, with focal subpleural distribution, lesions mainly occur in the right lung (70.73%, 29/41). There were 42 lesion morphologies, with 22 (52.38%) striped shadows and 16 (38.10%) nodular shadows, with small lamellar and patchy shadows predominating. There were 36 lesion density variations, with ground glass shadows being the most common, with a total of 24 ground glass shadows (66.66%) in each lobe of the lung, and also 6 consolidation lesions (16.67%) and 6 mixed ground glass opacity and consolidation lesions (16.67%). With the progression of the disease, lesions gradually enlarged, appeared on the 2nd day (312.93 mm3), peaked on the 9th day (1 837.18 mm3). The average absorption time of the lesions was (16±3) days, and there was no significant difference between the absorption time of patchy and nodular lesions (ground glass and/or consolidation) (t=0.853, P>0.05). The lesions showed focal ground-glass opacity in the early stage, 77.78% lesions were absorbed after treatment in the late stage. Inflammatory nodules were absorbed slowly (9-19 days), without residual fibrotic changes. Conclusions　The imaging manifestations of COVID-19 in patients younger than 18 years old infected with SARS-CoV-2 Omicron variant have certain characteristics, showed patchy or nodular ground glass opacities and/or consolidation, mainly distributed in the subpleural area, with small and few lesions and slow change, didn't remain fibrosis. Being familiar with its clinical and imaging manifestations can assist in early diagnosis, but confirming the diagnosis requires a combination of epidemiological history, clinical symptoms, SARS-CoV-2 nucleic acid and radiological manifestations.

ObjectiveTo investigate the electrocardiogram (ECG) characteristics of patients with early repolarization variant (ERV).Methods One hundred and six patients diagnosed of ERV based on clinical and ECG and the healthy control group of 100 patients were analyzed and ECG features and ERV site were compared between these two groups.Results The mean heart rate( [ 68.6 ± 8.4 ] beats/min vs [ 74.8 ± 12.6 ]beats/min),QRS time( [95 ± 10] ms,[96 ± 11] ms vs[ 388 ± 12 ] ms,[379 ± 14]ms),QT dispersion and Tp-Te ( [ 80.4 ± 7.6 ] ms vs [ 78.5 ± 8.3 ] ms) were compared respectively between ERV group and control group and there was no significant difference (P ＞ 0.05).The occurrence of J wave in inferior leads was 67.9％,15.1％for the side wall leads,and 17.0％ for the chest leads,thus inferior wall leads had higher incidence than other hads relativelv in ERV ( P ＜ 0.01 ).Conclusion ERV exhibits more occurrence in inferior wall leads.

OBJECTIVETo investigate and clarify the key surgical techniques and evaluate clinical effectiveness of modular cementless femoral stems(LINK MP modular stem) in complex revision hip arthroplasty.

METHODSFrom January 2002 to December 2013, 470 patients in Chinese PLA General Hospital received revision hip arthroplasties using MP stems. Among them, 246 patients were followed for an average of 5.7 years (ranged, 0.5 to 11 years). There were 148 males and 98 females, with an average age of 62.5 years old (ranged from 26 to 83 years old). The most common reason for revision was aseptic loosening of femoral stems (107 cases, 43.5%), followed by prosthetic joint infection (104 cases, 42.3%). Other reasons included unexplained hip or thigh pain, periprosthetic femoral fracture, prosthesis wear and dislocation. According to Paprosky classification of femoral deficiency, there were 171 cases of type IIIA (69.5%), 14 cases of type I, 39 cases of type II, and 22 cases of type IIIB. The average preoperative Harris hip score (HHS) was 37.4 ± 7.5. In addition, radiographic presentation, degree of patients' subjective satisfaction, and clinical effectiveness were assessed as well.

RESULTSThe average Harris score was im- proved to 87.8 ± 4.2 after operation,with significant statistical difference when compared to preoperative score (t = 92.13,P = 0.00). Analysis of patients' subjective satisfaction for leg length discrepancy, stability and overall degree of satisfaction showed that the number of patients with great satisfaction were 27, 60, 61 respectively. The most common complication was the periprosthetic fracture (intraoperatively 21 cases and postoperatively 8 cases). Other complications included infection (7 cases), dislocation (5 cases), numbness possibly caused by incomplete sciatic nerve injury (6 cases) and thigh swelling (3 cases). The X-ray taken at the final follow-up revealed that prosthesis subsidence occurred in 4 cases, 2 of which needed a second revision.

CONCLUSIONThe application of modular cementless femoral stems (LINK MP modular stem) in complex revision hip arthroplasty (especially in cases with the serious defect of proximal femoral bone) shows good results at both the short-term and long-term follow-up, especially in the revision for prosthetic infection with the high success rate. In order to avoid complications and improve clinical outcomes,the surgeons should carefully select proper surgery candidates,perform the procedure with care, and master the key surgical techniques.

Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; adverse effects ; methods ; Female ; Hip Prosthesis ; Humans ; Male ; Middle Aged ; Patient Satisfaction ; Postoperative Complications ; therapy

OBJECTIVETo explore clinical efficacy of Yiguanjian Decoction (YD) combined Adefovir Dipivoxil Tablet (ADT) in treating HBeAg negative chronic viral hepatitis B (CVHB) active compensated liver cirrhosis (LC) patients.

METHODSTotally 68 HBeAg negative CVHB active compensated LC patients initially treated were assigned to the treatment group and the control group using random digit table, 34 in each group. Patients in the control group took ADT alone, 10 mg each time, once per day. Those in the treatment group additionally took YD, one dose per day. The therapeutic course for all was 48 weeks. Levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil) were detected once in every two weeks. Hepatitis B virus (HBV)-DNA and four items of serum liver fibrosis [procollagen type I (PCN), hyaluronidase (HA), procollagen III peptide (PCIII), laminin (LN)] were detected once per every 4 weeks. Abdominal ultrasound B was performed before and after treatment. The inner diameter of the portal vein and the size of spleen were recorded. The fibrosis degree of liver was evaluated using Fibroscan. Efficacy of Chinese medicine (CM) was evaluated between the two groups before and after treatment using CM syndrome integrals. Efficacy of Western medicine (WM) was also evaluated between the two groups using Child-Pugh grading. Results Compared with before treatment in the same group, ALT and AST levels restored to normal levels, HBV-DNA turned negative (HBV-DNA < or = 1 x 10(2)) in the two groups after 48-week treatment. Besides, levels of TBil, ALB, PCIV, HA, PCIII, and LN obviously decreased (P < 0.05, P < 0.01). Results of ultrasound B showed the inner diameter of the portal vein and the size of spleen decreased. Fibroscan results showed that the elasticity value of the liver obviously decreased (P < 0.05). Besides, post-treatment levels of PCIV, HA, PCEJ, and LN, and the elasticity value of the liver decreased more obviously in the treatment group than in the control group (P < 0.01). There was no statistical difference in post-treatment levels of ALT, AST, TBil, ALB, inner diameter of the portal vein, or the size of spleen between the two groups (P > 0.05). Compared with before treatment in the same group, scores of Chinese medical syndrome and Child-Pugh scores decreased in the two groups after treatment (P < 0.05, P < 0.01). Besides, scores of Chinese medical syndrome decreased more obviously in the treatment group than in the control group (P < 0.05). The effective rate was 8824% (30/34) in the treatment group, higher than that of the control group [67.65% (23/34)] with statistical difference (P <0.05). Conclusion Combined treatment of YD and ADT could significantly improve symptoms of CM and fibrosis degree of liver of HBeAg negative CVHB active compensated LC patients.

Adenine ; analogs & derivatives ; therapeutic use ; Alanine Transaminase ; blood ; Antiviral Agents ; therapeutic use ; Aspartate Aminotransferases ; blood ; Bilirubin ; blood ; DNA, Viral ; blood ; Drugs, Chinese Herbal ; therapeutic use ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; drug therapy ; Humans ; Liver Cirrhosis ; drug therapy ; virology ; Organophosphonates ; therapeutic use ; Tablets

OBJECTIVETo evaluate the effects of periodontal treatment on the clinical response, systemic inflammatory parameters, and metabolic control of type 2 diabetes patients with moderate to severe periodontitis.

METHODSA total of 56 patients with mean clinical attachment level (CAL)>3 mm were included in the subgroup analysis. A repeated-measures ANOVA (group factor: treatment group and control group; time factor: initial visit, 1.5, 3, and 6 months) was used to analyze the probing depth (PD), CAL, bleeding on probing (BOP), high-sensitivity C-reactive protein (hsCRP), glycated hemoglobin (HbA1c), and fasting plasma glucose.

RESULTSSignificantly lower PD (F=62.898, P-0.000), CAL (F=51.263, P-0.000), BOP (F=75.164, P=0.000), hsCRP (F=6.391, P=0.010), HbA1c(F=4.536, P=0.011), and fasting plasma glucose level (F= 3.073, P=0.031) were observed after therapeutic periodontal improvement. The inter-group differences for PD (t=-2.050, P=0.045), BOP (t=-4.538, P=0.000), and hsCRP (t=-2.261, P=0.028) were statistically significant after therapy.

CONCLUSIONNon-surgical periodontal treatment can effectively improve periodontal status, circulating inflammatory status, and metabolic control of diabetic patients with moderate to severe periodontitis.

C-Reactive Protein ; Chronic Periodontitis ; Diabetes Mellitus, Type 2 ; Glycated Hemoglobin A ; Humans ; Periodontitis

OBJECTIVE:To establish a method for the simultaneous determination of ornidazole and dexamethasone sodium phosphate in Compound ornidazole film. METHODS:HPLC was performed on the column of Inertsil ODS-3 with mobile phase of methanol-20 mmol/L phosphate buffer(pH was adjusted to 7.40 with glacial acetic acid)(55∶45,V/V)at a flow rate of 1.0 ml/min, column temperature was 30 ℃,detection wavelength was 242 nm and volume injection was 10 μl. RESULTS:The linear range were 1-100μg/ml for both ornidazole(r=0.999 7)and dexamethasone sodium phosphate(r=0.999 9);RSDs of precision,stabili-ty and reproducibility tests were lower than 2.0%;recoveries were 96.50%-99.80%(RSD=1.02%,n=9) and 96.50%-99.60%(RSD=0.99%,n=9). CONCLUSIONS:The method is specific with good precision and stability and high accuracy,and can be used for the simultaneous determination of ornidazole and dexamethasone sodium phosphate in Compound ornidazole film.

Objective To explore whether IL-27 inhibited the pulmonary fibrosis through regulating the expression of TGF-β/Smad signaling pathway in the bleomycin-induced pulmonary fibrosis model. Methods Forty male C57/BL6 mice were randomly divided into normal control group(group A),bleomycin-induced pulmonary fibrosis group(group B),bleomycin+IL-27 group(group C)and bleomycin+IL-27 antibody group(group D) with 10 in each. Five mice in each group were sacrificed on days 7 and 28 after with intratracheal bleomycin. TGF-βR1,Smad1 and Smad3 in right lung tissue were measured by Western Blot. Results 1. In the bleomycin-induced pulmonary fibrosis model,the expression of TGF-βR1 was higher on days 7 and 28,which was inhibited by IL-27. 2. The expressions of p-Smad1 and p-Smad3 were highest in group D on days 7 and 28, but were lower in group C on day 7 than those in group B. Conclusion Exogenous IL-27 might alleviate pulmonary fibrosis through inhibiting the related protein phosphorylation in TGF-β/Smad signaling pathway.