Objective To investigate the role of opioid receptors and vagus and sympathetic nerves in the remifentanil-induced cardiovascular depression in rabbits. Methods Forty 2-6 months old New Zealand white rebbits of both sexes weighing 1.5-2.5 kg were randomly divided into 5 groups (n = 8 each): group Ⅰ remifentanil (group R); group Ⅱ naloxone + remifentanil (group N+ R); group Ⅲ vagus nerve cut-off +remifentanil (group V+ R); group Ⅳ epidural block + remifentanil (group S+ R) and group V vagus nerve cutoff + epidural block + remifentanil (group V + S + R). The animals were anesthetized, tracheostomized and mechanically ventilated. PaCO2 was maintained at 35-45 mm Hg. Vecuronium 0.3 mg/kg was given iv every 40 min to keep muscle relaxed. Right carotid artery was cannulated for continuous MAP monitoring. ECG was continuously monitored. A bolus of remifentanil 5.0 μg/kg was administered iv in all 5 groups. In group N + R naloxone 40μg was given iv about 2 min before remifentanil. In group V + R bilateral vagus nerves were cut off through neck incision. After HR and MAP had stabilized for 30 min, remifentanil was given iv. In group S + R epidural block was performed at L6.7 interspace with 2% lidocaine to block cardiac sympathetic nerves. When HR and MAP decreased by 20% of the baseline values and stabilized for 30 min remifentanil was given iv. In group V + S + R bilateral vagus nerves were cut off first. Then epidural block was performed before remifentanil administration. MAP and HR were recorded at 1 min before iv remifentanil administration (T0 ), at 30 s (T1), 1,2, 3, 4, 5, 10, 15 and 20 min (T2-9 ) after remifentanil administration. Results Intravenous remifentanil 5.0 μg/kg significantly decreased HR at T1 and MAP at T1-7 as compared with those at T0 in group R. Pretreatmentwith naloxone 40 μg prevented remifentanil-induced decrease in MAP but did not affect remifentanil-induced decrease in HR in group N + R. Vagus nerve cut-off and sympathetic block induced by epidural anesthesia performed before iv remifentanil did not affect remifentanil-induced cardiac depression in group V + R, S + R and V + S + R. Conclusion Opioid receptors and vagus and sympathetic nerves are not related to remifentanil-induced decrease in HR. Remifentanil induces decrease in MAP by activating opioid receptors.

Objective To investigate the diagnostic value of color Doppler ultrasonography in congenital muscular torticollis (CMT). Methods The sonographic characteristics of 62 children with CMT confirmed clinically were retrospectively analyzed. Results Abnormal ultrasound features could be visualized in all of 62 children with CMT. According to the sonogram features, 62 children were divided into 2 types: mass-forming (32/62, 51.61%) and diffuse type (30/62, 48.39%). Arterial flow signals were detected in 18 children (18/62, 29.03%); RI was 0.73-0.88. Conclusion Ultrasonography has specific value for the diagnosis of CMT.

This research was to investigate the relationship between functional independence and adap-tive behavior in children with cerebral palsy using FunctionaI Independence Measure for Children(WeeFIM)and the Chinese version of Children’s Adaptive Behavior Scale(CABS).18 children with cere-bral palsy were measured.12 were males and 6 were females.Age ranged from 3 to 12,and average agewas 5.9444(SD= 1.9242).Results showed that the dimensions of the motor subscale of WeeFLM werepositively correlated to the independence of CAI3s(r=0.5725～0.7146);the dimensions of cognitive sub-scale of WeeFIM were also positively correlated to three elements of CABS(r=0.531 0～0.7873).WeeFIM total scores were positively correlated to the developmental quotierit of CABS(r=0.7053).Thisresearch showed that functional independence and adaptive behavior in cerebral palsy children were related,because the ditnensions of WeeFIM were correlated to the elements of CABS.WeeFIM can,therefore,re-flect the functions of cerebral palsy children in quantitative scales.This research can provide a new measure-ment which can be applied to the functional evaluation in medical rehabilitation of cerebral palsy.

10.3969/j.issn.1007-3969.2013.04.010

In this study ,we established Cross Priming Amplification (CPA ) technology for detection of influenza A virus (H1N1) approach ,and evaluated the method through clinical specimens .A set of specific primers were designed for CPA ac‐cording to the conservative gene sequences ,designed and realized in the same temperature reverse transcription of RNA and DNA amplification . The amplification products can be totally enclosed nucleic acid detection device for testing . Fourteen healthy pharyngeal swab specimens ,seven other respiratory viruses ,and six arboviruses strains were used as the controls .We used a method that application of gradient dilution to the H 1N1 virus strain as the control to test the sensitivity of the CPA .We also used 102 clinical pharyngeal swab specimens of H1N1 patients for detection object to evaluate the feasibility of CPA clinical detection .Results showed that the CPA reaction did not appear cross reaction on health cases samples and other viruses .The sensitivity of the CPA was approximately 10 copies/uL in the established method that exactly titer H1N1 virus strain gradient dilution test .As to the positive results among the clinical pharyngeal swab samples collected from patients at different stages after onset ,the CPA had the highest positive detection rate during the first three days after onset (100% ) .While the detection rate from day 4 to day 6 after onset was 79 .31% .After 7 days ,the detection rate was 9 .09% .The established CPA assay was a highly sensitive ,specific and reproducible approach for rapid detection of H1N1 virus ,which is conducive to the early diagno‐sis of influenza A virus (H1N1) for basic medical units .

Objective To investigate the refraction status of low vision children aged 4~14 years old. Methods 228 children (376 eyes) with low vision aged 4~14 years old were recruited with retinoscopy optometry under ciliary muscles paralysis. Results 53% (72 eyes) of the preschool group had hyperopia, 41.2% (56 eyes) had myopia, and 6.0% (8 eyes) had mix astigmia. 40.0% (96 eyes) of the school-age group had hyperopia, 55.0% (132 eyes) had myopia, and 5.0% (12 eyes) had mix astigmia. The incidence of hyperopia was higher in the preschool group than in the school-age group (P<0.05). The majority of the refraction status in both groups were ranged in high level. After refraction correction and using visual aid device, 27.4% of the low vision children improved, and the number was higher in children who had better naked vision (P<0.01). Conclusion The refraction status of pre-school children with low vision is mainly hyperopia. For school-aged children, the refraction status shows a majority of myopia. The refraction errors of low vision children are mainly ranged in high level and partial low vision children improved after refraction correction

OBJECTIVE:To provide reference for rational application of Levofloxacin hydrochloride injection in the clinic. METHODS:With reference to the package insert of Levofloxacin hydrochloride injection,the guiding principles of clinical use of antibiotics,by reviewing related literatures,based on the weighted TOPSIS methods,detailed rules for drug utilization review (DUR) of Levofloxacin hydrochloride injection were made. And then 100 archived medical records of Levofloxacin hydrochloride injection in the first half of 2014 were evaluated in respect of medication rationality based on these rules. RESULTS:Among 100 cases,relative proximity of 51 cases was more than 70%(51.0%);that of 37 was between 50%-70%(37.0%);that of 12 cases was between 30%-50%(12.0%). CONCLUSIONS:Established DUR method of Levofloxacin hydrochloride injection on the basis of weighted TOPSIS methods can be used to evaluate the rationality of drug use and promote more rational evaluation behavior. And the results indicate that unreasonable use of Levofloxacin hydrochloride injection is still common in the hospital.

Objective To characterize contemporary electrographic neonatal seizures by video electroencephalogram (VEEG) and to assess the value and the limitations of two-channel (C3-C4/T3-T4) amplitude-integrated electroencephalogram (aEEG) plus original EEG signals used to diagnose neonatal seizure with video EEG as a golden standard.Methods Sixty-six neonates admitted to Children's Hospital of Fudan University from January 2011 to July 2011 with clinical or suspected clinical seizure were investigated and bedside VEEG were recorded for more than 3 hours.VEEG signals were transformed into three kinds of aEEG signals by Galileo NT PMS software:one-channel aEEG (C3-C4),one-channel aEEG (C3-C4) plus original EEG,two-channel aEEG (C3-C4/T3-T4) plus original EEG.Electrical seizure activity on VEEG was signed out with respect to its occurrence,duration and localization of seizure onset; while aEEG seizure was recorded only with its occurrence.The relationship between aEEG and VEEG was analyzed by Spearman analysis.The value and the limitations of aEEG to diagnose neonatal seizure were evaluated by sensitivity,specificity,positive predictive value and negative predictive value.Results A total of 62 traces were suitable for analysis.(1) VEEG showed 39 seizure activities,among which 8 status epilepticus; and the rest 31 neonates had 352 non-status epilepticus electrical seizures,79.3％ (279/352) of which occurred over the centrotemporal region.(2) Eight cases with status epilepticus on VEEG were all diagnosed as status epilepticus on aEEG.For non-status epilepticus electrical seizures,the sensitivity of aEEG for detection of electrical seizures was as followed:49.1％ (173/352) for one-channel aEEG,54.5 ％ (192/352) for one-channel aEEG plus original EEG,81.2％ (286/353) for two-channel aEEG plus original EEG.Results from one-channel aEEG,one-channel aEEG plus original EEG and two-channel aEEG plus original EEG were all related to VEEG (ρ =0.790,0.907 and 0.953,respectively,P＜ 0.01).(3) Sensitivity of seizure detection was 66.7％ (26/39,95％ CI:0.62-0.81) for one-channel aEEG,74.4％(29/39,95％ CI:0.78-0.96) for one-channel aEEG(C3-C4) plus original EEG and 89.7％ (35/39,95％ CI:0.89-1.00) for two-channel aEEG(C3-C4/T3-T4) plus original EEG.Conclusions VEEG might help aEEG in diagnosis of neonatal seizure.two-channel aEEG (C3-C4/T3-T4) plus original EEG could significantly increase the sensitivity of neonatal seizures indentification.

[Objective]This study was designed to investigate the genetic evolution of the neuraminidase(NA)gene of seasonal A/H1N1 and 2009 novel A/H1N1 inflilenza virus,and discuss the genetic variation of influenza A virus.[Methods]The virus strains were separately isolated from the clinical samples collected in 2006 and 2009,and then identified as seasonal A/H1N1 and novel A/H1N1.The full length of the NA gene of these strains was amplified by RT-PCR.Then the genetic evolution and mutations of important functional sites were analyzed.[Results]The homology of NA gene between the 2009 novel A/H1N1 isolates and 2006 seasonal A/H1N1 isolates was low(77.9%～78.8%),so was the homology of NA gene between the 2009 novel A/H1N1 isolates and representative strains of different periods and 1979-2001 WHO recommended vaccine strains(78.1%～79.3%).But compared with the WHO recommended vaccine strains of 2009 novel A/H1N1,the homology reached more than 99%.The genetic evolution analysis revealed that NA gene of 2009 novel A/H1N1 had the closest genetic relationship with the swine influenza A virus(A/swine/Belgium/1/1983)from Eurasian Iineage,and some of the antigenic sites and neuraminidase active sites of NA gene of seasonal A/H1N1 were mutated after 2005.[Conclusion]The NA gene of 2009 novel A/H1N1 may originate from Eurasian Iineage of swine influenza virus.The variation of NA gene of seasonal A/H1N1 has occurred in a certain degree.Hence,it is very necessary to continuously monitor the variant of influenza A virus.

Objective:To investigate the current status of primiparas′ postpartum fatigue and paternal involvement, and to explore the relationship between primiparas′ postpartum fatigue and paternal involvement, and to provide reference basis for developing targeted intervention measures to alleviate postpartum fatigue of primiparas.Methods:A cross-sectional survey was conducted on 347 primiparas from Affiliated Hospital of Yangzhou University, Yangzhou Maternal and Child Health Care Hospital from September to December 2020 by convenience sampling. The survey instruments included the general information questionnaire, the Parenting Alliance Inventory (PAI), and the Postpartum Fatigue Scale (PFS).Results:The total score of PAI was (86.51 ± 12.07) points, and the level of paternal involvement was high. The total score of PFS was (16.68 ± 4.12) points. 95.97% (333/347) of primiparas had varying degrees of postpartum fatigue. There was a significant negative correlation between paternal involvement and primiparas′ postpartum fatigue ( r=-0.327, P<0.01). The results of multiple stratified regression analysis showed that paternal involvement was included in the influencing factor model of primiparas′ postpartum fatigue, which could independently explain 9.7% variation of primiparas′ postpartum fatigue. Conclusions:The higher level of paternal involvement could predict the lower level of primiparas′ postpartum fatigue. Medical staff should pay attention to the participation level of the spouses of primiparas in childcare, and improve the participation level of the spouses of primiparas in scientific ways to alleviate the postpartum fatigue of primiparas.